Conjunctiva and cornea: filamentary keratitis: 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 · Conjunctiva and cornea: filamentary keratitis

Sample item

A woman with severe dry eye has foreign body sensation and pain on blinking. Slit lamp shows short comma-shaped strands of mucus and epithelium attached at one end to the cornea, which stain with rose bengal. What is the best management?

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

The answer and the reasoning

C. Remove the filaments and use preservative-free lubricants

Corneal filaments appear in dry eye and recurrent erosion and cause pain by tugging on the epithelium. Treatment is to remove them, optimise lubrication and add a mucolytic such as acetylcysteine if needed. Steroids and antimicrobials do not address the cause.

Option by option

  • A. Begin topical antifungal therapy

    Filaments are not fungal hyphae and antifungals offer no benefit.

  • B. Start hourly topical corticosteroid drops

    Hourly steroids do not remove filaments and can thin an already compromised surface.

  • C. Remove the filaments and use preservative-free lubricants (correct)

    Correct. Removing filaments and improving the tear film treats the cause and the pain.

  • D. Plan lamellar keratoplasty

    Keratoplasty is unnecessary for a surface problem that responds to lubrication.

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 C, Remove the filaments and use preservative-free lubricants. Corneal filaments appear in dry eye and recurrent erosion and cause pain by tugging on the epithelium.

Why is "Begin topical antifungal therapy" not the answer?

Filaments are not fungal hyphae and antifungals offer no benefit.

Why is "Start hourly topical corticosteroid drops" not the answer?

Hourly steroids do not remove filaments and can thin an already compromised surface.

Why is "Plan lamellar keratoplasty" not the answer?

Keratoplasty is unnecessary for a surface problem that responds to lubrication.

What concept does this question test?

It tests Conjunctiva and cornea: filamentary keratitis in Ophthalmology. Treatment is to remove them, optimise lubrication and add a mucolytic such as acetylcysteine if needed. Steroids and antimicrobials do not address the cause.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Conjunctiva and cornea: filamentary keratitis?

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.