Optic neuropathy: non-arteritic AION: 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.

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Ophthalmology · Optic neuropathy: non-arteritic AION

Sample item

A 55-year-old diabetic hypertensive with a small crowded cup has painless sudden inferior altitudinal field loss on waking. What is the likely diagnosis?

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

The answer and the reasoning

D. Non-arteritic anterior ischaemic optic neuropathy

NAION results from hypoperfusion of the short posterior ciliary supply in a disc at risk, with a small cup-disc ratio. It causes sectoral disc swelling and altitudinal field loss, and phosphodiesterase inhibitors and nocturnal hypotension are linked.

Option by option

  • A. Papilloedema

    Papilloedema is bilateral from raised ICP.

  • B. Optic neuritis

    Optic neuritis is painful in younger patients.

  • C. Glaucoma

    Glaucoma progresses slowly with cupping.

  • D. Non-arteritic anterior ischaemic optic neuropathy (correct)

    Correct. A crowded disc with altitudinal loss is typical.

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.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Non-arteritic anterior ischaemic optic neuropathy. NAION results from hypoperfusion of the short posterior ciliary supply in a disc at risk, with a small cup-disc ratio.

Why is "Papilloedema" not the answer?

Papilloedema is bilateral from raised ICP.

Why is "Optic neuritis" not the answer?

Optic neuritis is painful in younger patients.

Why is "Glaucoma" not the answer?

Glaucoma progresses slowly with cupping.

What concept does this question test?

It tests Optic neuropathy: non-arteritic AION in Ophthalmology. It causes sectoral disc swelling and altitudinal field loss, and phosphodiesterase inhibitors and nocturnal hypotension are linked.

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 Optic neuropathy: non-arteritic AION?

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.