Glaucoma: surgery for congenital glaucoma: 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 · Glaucoma: surgery for congenital glaucoma

Sample item

A 3-month-old with watering, photophobia and a corneal diameter of 12.5 mm has a hazy cornea that prevents a clear view of the angle. Which procedure is best?

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

The answer and the reasoning

D. Trabeculotomy ab externo

Primary congenital glaucoma needs early surgery. Goniotomy requires a clear cornea to see the angle, so when the cornea is hazy, trabeculotomy ab externo is chosen. Cyclodestruction is a salvage procedure, and drugs alone are inadequate.

Option by option

  • A. Goniotomy

    Goniotomy needs a clear cornea to visualise the angle, which is not possible here.

  • B. Medical therapy alone

    Medical therapy alone does not control congenital glaucoma and delays definitive surgery.

  • C. Cyclodiathermy

    Cyclodiathermy is a destructive procedure reserved for refractory cases.

  • D. Trabeculotomy ab externo (correct)

    Correct. Trabeculotomy does not need a clear corneal view of the angle.

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 D, Trabeculotomy ab externo. Primary congenital glaucoma needs early surgery.

Why is "Goniotomy" not the answer?

Goniotomy needs a clear cornea to visualise the angle, which is not possible here.

Why is "Medical therapy alone" not the answer?

Medical therapy alone does not control congenital glaucoma and delays definitive surgery.

Why is "Cyclodiathermy" not the answer?

Cyclodiathermy is a destructive procedure reserved for refractory cases.

What concept does this question test?

It tests Glaucoma: surgery for congenital glaucoma in Ophthalmology. Goniotomy requires a clear cornea to see the angle, so when the cornea is hazy, trabeculotomy ab externo is chosen. Cyclodestruction is a salvage procedure, and drugs alone are inadequate.

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: surgery for congenital glaucoma?

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.