Neuro-ophthalmology and pupils: optic nerve sheath meningioma: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Ophthalmology · Neuro-ophthalmology and pupils: optic nerve sheath meningioma

Sample item

A 45-year-old woman has slowly progressive visual loss in one eye with a pale optic disc and small opticociliary shunt vessels. CT of the orbit shows linear calcified thickening along the optic nerve. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Optic nerve sheath meningioma

Optic nerve sheath meningioma is a tumour of middle-aged women that causes slowly progressive visual loss, optic atrophy and opticociliary shunt vessels. Imaging shows a tram-track enhancement of the nerve sheath, often with calcification. An optic glioma occurs in children, usually in neurofibromatosis.

Option by option

  • A. Optic nerve sheath meningioma (correct)

    Correct. Tram-track calcified sheath thickening with shunt vessels in a middle-aged woman fits a sheath meningioma.

  • B. Optic nerve glioma

    Optic nerve glioma is a tumour of childhood with fusiform nerve enlargement.

  • C. Optic neuritis

    Optic neuritis is painful and acute and recovers, not slowly progressive.

  • D. Thyroid optic neuropathy

    Thyroid optic neuropathy shows enlarged muscles crowding the apex and not sheath calcification.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is A, Optic nerve sheath meningioma. Optic nerve sheath meningioma is a tumour of middle-aged women that causes slowly progressive visual loss, optic atrophy and opticociliary shunt vessels.

Why is "Optic nerve glioma" not the answer?

Optic nerve glioma is a tumour of childhood with fusiform nerve enlargement.

Why is "Optic neuritis" not the answer?

Optic neuritis is painful and acute and recovers, not slowly progressive.

Why is "Thyroid optic neuropathy" not the answer?

Thyroid optic neuropathy shows enlarged muscles crowding the apex and not sheath calcification.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: optic nerve sheath meningioma in Ophthalmology. Imaging shows a tram-track enhancement of the nerve sheath, often with calcification. An optic glioma occurs in children, usually in neurofibromatosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuro-ophthalmology and pupils: optic nerve sheath meningioma?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.