Retina: Eales disease: 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 · Retina: Eales disease

Sample item

A 24-year-old Indian man has sudden floaters from a vitreous haemorrhage. Both eyes show peripheral retinal periphlebitis, sheathed veins and areas of capillary non-perfusion, with no diabetes, sickle disease or other systemic illness. What is the best treatment for the new vessels?

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

The answer and the reasoning

C. Scatter laser photocoagulation to ischaemic retina

Eales disease is an idiopathic obliterative periphlebitis of young adults with peripheral ischaemia and neovascularisation. Laser photocoagulation of ischaemic retina reduces VEGF drive and recurrent haemorrhage. Vitrectomy is used for non-clearing haemorrhage or traction.

Option by option

  • A. Long-term oral antibiotics alone

    Antibiotics do not address ischaemia and a causal infection is not established.

  • B. Observation until the haemorrhage resolves with no treatment

    Waiting leaves the new vessels free to bleed again.

  • C. Scatter laser photocoagulation to ischaemic retina (correct)

    Correct. Laser to ischaemic retina causes neovascular regression and prevents bleeding.

  • D. Intravitreal methotrexate

    Methotrexate is not standard treatment for neovascularisation.

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 C, Scatter laser photocoagulation to ischaemic retina. Eales disease is an idiopathic obliterative periphlebitis of young adults with peripheral ischaemia and neovascularisation.

Why is "Long-term oral antibiotics alone" not the answer?

Antibiotics do not address ischaemia and a causal infection is not established.

Why is "Observation until the haemorrhage resolves with no treatment" not the answer?

Waiting leaves the new vessels free to bleed again.

Why is "Intravitreal methotrexate" not the answer?

Methotrexate is not standard treatment for neovascularisation.

What concept does this question test?

It tests Retina: Eales disease in Ophthalmology. Laser photocoagulation of ischaemic retina reduces VEGF drive and recurrent haemorrhage. Vitrectomy is used for non-clearing haemorrhage or traction.

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 Retina: Eales disease?

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.