Ocular trauma: cyclodialysis cleft: 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 · Ocular trauma: cyclodialysis cleft

Sample item

After blunt trauma, an eye has hypotony, a shallow anterior chamber and choroidal folds. Gonioscopy shows a gap between the ciliary body and scleral spur. What is the first step in treatment?

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

The answer and the reasoning

B. Topical atropine to relax the ciliary muscle

A cyclodialysis cleft lets aqueous escape to the suprachoroidal space. Atropine relaxes the ciliary muscle and can close small clefts, and persistent cases need laser, cryotherapy or surgery. Pilocarpine contracts the muscle and widens the gap.

Option by option

  • A. Oral acetazolamide

    Acetazolamide lowers aqueous formation and worsens hypotony.

  • B. Topical atropine to relax the ciliary muscle (correct)

    Correct. Cycloplegia can close a cleft before laser or surgery is needed.

  • C. Topical pilocarpine

    Pilocarpine contracts the ciliary muscle and worsens the cleft.

  • D. Trabeculectomy

    Trabeculectomy increases outflow and worsens hypotony.

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 B, Topical atropine to relax the ciliary muscle. A cyclodialysis cleft lets aqueous escape to the suprachoroidal space.

Why is "Oral acetazolamide" not the answer?

Acetazolamide lowers aqueous formation and worsens hypotony.

Why is "Topical pilocarpine" not the answer?

Pilocarpine contracts the ciliary muscle and worsens the cleft.

Why is "Trabeculectomy" not the answer?

Trabeculectomy increases outflow and worsens hypotony.

What concept does this question test?

It tests Ocular trauma: cyclodialysis cleft in Ophthalmology. Atropine relaxes the ciliary muscle and can close small clefts, and persistent cases need laser, cryotherapy or surgery. Pilocarpine contracts the muscle and widens the gap.

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 Ocular trauma: cyclodialysis cleft?

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.