Glaucoma: hypotony maculopathy: 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: hypotony maculopathy

Sample item

Two weeks after trabeculectomy with mitomycin, a patient has IOP of 3 mmHg, vision of 6/60, choroidal folds and macular oedema. The bleb is large and thin. What explains the vision loss?

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

The answer and the reasoning

A. Hypotony maculopathy from over-filtration

Excess filtration produces hypotony with macular folds, oedema and reduced vision. Management includes reducing outflow, with bleb compression sutures or autologous blood injection. Malignant glaucoma raises IOP, and blebitis is infective.

Option by option

  • A. Hypotony maculopathy from over-filtration (correct)

    Correct. Over-filtration lowers IOP and distorts the macula.

  • B. Malignant glaucoma

    Malignant glaucoma gives a flat chamber with raised IOP, not hypotony.

  • C. Blebitis

    Blebitis presents with a purulent, inflamed bleb and discomfort.

  • D. Pupillary block

    Pupillary block gives a high IOP with a shallow chamber.

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 A, Hypotony maculopathy from over-filtration. Excess filtration produces hypotony with macular folds, oedema and reduced vision.

Why is "Malignant glaucoma" not the answer?

Malignant glaucoma gives a flat chamber with raised IOP, not hypotony.

Why is "Blebitis" not the answer?

Blebitis presents with a purulent, inflamed bleb and discomfort.

Why is "Pupillary block" not the answer?

Pupillary block gives a high IOP with a shallow chamber.

What concept does this question test?

It tests Glaucoma: hypotony maculopathy in Ophthalmology. Management includes reducing outflow, with bleb compression sutures or autologous blood injection. Malignant glaucoma raises IOP, and blebitis is infective.

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: hypotony maculopathy?

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.