Conjunctiva and cornea: primary acquired melanosis: 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 · Conjunctiva and cornea: primary acquired melanosis

Sample item

A fair-skinned 58-year-old man has a flat, patchy, brown, unilateral pigmentation of the bulbar conjunctiva that has spread over a year. Biopsy shows atypical melanocytes along the basal layer. What is the main risk of this lesion?

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

The answer and the reasoning

A. Progression to conjunctival melanoma

Primary acquired melanosis with atypia is a precursor of conjunctival melanoma and is excised with cryotherapy of the margins. It differs from benign racial melanosis, which is bilateral and stable. Squamous neoplasia arises from epithelial dysplasia and is not pigmented.

Option by option

  • A. Progression to conjunctival melanoma (correct)

    Correct. Atypical melanocytic proliferation can progress to melanoma.

  • B. Evolution into conjunctival lymphoma

    Conjunctival lymphoma gives a pink salmon patch, not brown pigmentation.

  • C. Conversion to squamous cell carcinoma

    Squamous carcinoma arises from dysplastic epithelium, not melanocytes.

  • D. Transformation into pterygium

    Pterygium is a degenerative fibrovascular growth and not a pigmented lesion.

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, Progression to conjunctival melanoma. Primary acquired melanosis with atypia is a precursor of conjunctival melanoma and is excised with cryotherapy of the margins.

Why is "Evolution into conjunctival lymphoma" not the answer?

Conjunctival lymphoma gives a pink salmon patch, not brown pigmentation.

Why is "Conversion to squamous cell carcinoma" not the answer?

Squamous carcinoma arises from dysplastic epithelium, not melanocytes.

Why is "Transformation into pterygium" not the answer?

Pterygium is a degenerative fibrovascular growth and not a pigmented lesion.

What concept does this question test?

It tests Conjunctiva and cornea: primary acquired melanosis in Ophthalmology. It differs from benign racial melanosis, which is bilateral and stable. Squamous neoplasia arises from epithelial dysplasia and is not pigmented.

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: primary acquired melanosis?

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.