Retina: Lincoff rules: 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 · Retina: Lincoff rules

Sample item

A patient has an inferior rhegmatogenous retinal detachment in which the subretinal fluid level is higher on the temporal side than on the nasal side. According to Lincoff rules, where is the primary break most likely?

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

The answer and the reasoning

D. Temporal retina, on the side of the higher fluid level

In an inferior detachment with unequal fluid levels, the break lies on the side with the higher level. Locating the primary break guides buckle placement or tamponade. Superior breaks usually give fluid that spreads downwards on both sides of the disc.

Option by option

  • A. At 12 o'clock

    A break at 12 o'clock gives a superior detachment that spreads symmetrically down both sides.

  • B. At the macula

    A macular hole produces a posterior detachment, typically in high myopia.

  • C. Superonasal retina

    A superonasal break would produce a different pattern, with fluid spreading inferiorly around the disc.

  • D. Temporal retina, on the side of the higher fluid level (correct)

    Correct. The break lies on the side with the higher fluid level.

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, Temporal retina, on the side of the higher fluid level. In an inferior detachment with unequal fluid levels, the break lies on the side with the higher level.

Why is "At 12 o'clock" not the answer?

A break at 12 o'clock gives a superior detachment that spreads symmetrically down both sides.

Why is "At the macula" not the answer?

A macular hole produces a posterior detachment, typically in high myopia.

Why is "Superonasal retina" not the answer?

A superonasal break would produce a different pattern, with fluid spreading inferiorly around the disc.

What concept does this question test?

It tests Retina: Lincoff rules in Ophthalmology. Locating the primary break guides buckle placement or tamponade. Superior breaks usually give fluid that spreads downwards on both sides of the disc.

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 Retina: Lincoff rules?

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.