Conjunctiva and cornea: topical anaesthetic abuse: 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: topical anaesthetic abuse

Sample item

A 30-year-old who has repeatedly used numbing drops to relieve eye pain now has a ring-shaped stromal infiltrate and a persistent epithelial defect, with pain that eases only for minutes after each instillation. What is the likely diagnosis?

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

The answer and the reasoning

C. Toxic keratopathy from topical anaesthetic abuse

Prolonged use of topical anaesthetic impairs epithelial healing and produces a ring-shaped stromal infiltrate, an immune response to epithelial debris. Management is to stop the drug and treat the cause of the original pain. Acanthamoeba pain is severe and is not relieved by drops.

Option by option

  • A. Herpes simplex stromal keratitis

    Herpetic stromal disease follows prior epithelial herpes and is not linked to anaesthetic use.

  • B. Fungal keratitis

    Fungal ulcers show satellite lesions and feathery margins after vegetable matter injury.

  • C. Toxic keratopathy from topical anaesthetic abuse (correct)

    Correct. Brief relief with each drop and a ring infiltrate fit anaesthetic toxicity.

  • D. Acanthamoeba keratitis

    Acanthamoeba pain is severe and not relieved by anaesthetic, and follows water or lens exposure.

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, Toxic keratopathy from topical anaesthetic abuse. Prolonged use of topical anaesthetic impairs epithelial healing and produces a ring-shaped stromal infiltrate, an immune response to epithelial debris.

Why is "Herpes simplex stromal keratitis" not the answer?

Herpetic stromal disease follows prior epithelial herpes and is not linked to anaesthetic use.

Why is "Fungal keratitis" not the answer?

Fungal ulcers show satellite lesions and feathery margins after vegetable matter injury.

Why is "Acanthamoeba keratitis" not the answer?

Acanthamoeba pain is severe and not relieved by anaesthetic, and follows water or lens exposure.

What concept does this question test?

It tests Conjunctiva and cornea: topical anaesthetic abuse in Ophthalmology. Management is to stop the drug and treat the cause of the original pain. Acanthamoeba pain is severe and is not relieved by drops.

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 Conjunctiva and cornea: topical anaesthetic abuse?

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.