Glaucoma: plateau iris: 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 · Glaucoma: plateau iris

Sample item

A 45-year-old woman had a patent laser iridotomy for an angle-closure attack. The central anterior chamber is of normal depth, yet gonioscopy shows a closed angle and the pressure rises again on dilatation. Which mechanism applies?

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

The answer and the reasoning

A. Anteriorly rotated ciliary processes holding the peripheral iris against the angle

In plateau iris syndrome the ciliary processes are anteriorly placed and push the peripheral iris into the angle, so closure persists despite a patent iridotomy. Ultrasound biomicroscopy shows the configuration. Treatment is laser iridoplasty or long-term pilocarpine.

Option by option

  • A. Anteriorly rotated ciliary processes holding the peripheral iris against the angle (correct)

    Correct. Anterior ciliary processes crowd the angle even with a flat central iris.

  • B. Lens subluxation pushing the iris forward

    Lens subluxation gives a shallow chamber with phakodonesis, not a normal central depth.

  • C. Pupillary block by a bulging iris

    Pupillary block is relieved by the iridotomy and gives a forward-bowed iris profile.

  • D. Fibrovascular membrane pulling the iris across the angle

    A neovascular membrane is a secondary closure after retinal ischaemia, with rubeosis.

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, Anteriorly rotated ciliary processes holding the peripheral iris against the angle. In plateau iris syndrome the ciliary processes are anteriorly placed and push the peripheral iris into the angle, so closure persists despite a patent iridotomy.

Why is "Lens subluxation pushing the iris forward" not the answer?

Lens subluxation gives a shallow chamber with phakodonesis, not a normal central depth.

Why is "Pupillary block by a bulging iris" not the answer?

Pupillary block is relieved by the iridotomy and gives a forward-bowed iris profile.

Why is "Fibrovascular membrane pulling the iris across the angle" not the answer?

A neovascular membrane is a secondary closure after retinal ischaemia, with rubeosis.

What concept does this question test?

It tests Glaucoma: plateau iris in Ophthalmology. Ultrasound biomicroscopy shows the configuration. Treatment is laser iridoplasty or long-term pilocarpine.

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 Glaucoma: plateau iris?

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.