Cornea: 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 · Cornea

Sample item

A man has a red, watering, photophobic eye. Slit-lamp examination after fluorescein staining shows a branching linear ulcer with terminal bulbs, and corneal sensation is reduced. Which treatment is appropriate?

ATopical natamycinBTopical atropine aloneCTopical acyclovir ointment with debridement if needed, and no topical steroid at this stageDTopical corticosteroid drops alone

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

The answer and the reasoning

C. Topical acyclovir ointment with debridement if needed, and no topical steroid at this stage

A dendritic ulcer with terminal bulbs and reduced corneal sensation is herpes simplex keratitis, and epithelial disease is treated with topical antivirals such as acyclovir or ganciclovir. Topical steroids alone worsen epithelial disease and can lead to a geographic ulcer, and are reserved for stromal disease under antiviral cover.

Option by option

A. Topical natamycin
Natamycin is an antifungal and has no effect on a virus.
B. Topical atropine alone
Atropine only eases ciliary spasm and does not treat the cause.
C. Topical acyclovir ointment with debridement if needed, and no topical steroid at this stage (correct)
Correct. Antiviral therapy treats the active epithelial infection.
D. Topical corticosteroid drops alone
Steroid alone would allow unchecked viral replication and enlarge the ulcer.

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.

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Topical acyclovir ointment with debridement if needed, and no topical steroid at this stage. A dendritic ulcer with terminal bulbs and reduced corneal sensation is herpes simplex keratitis, and epithelial disease is treated with topical antivirals such as acyclovir or ganciclovir.

Why is "Topical natamycin" not the answer?

Natamycin is an antifungal and has no effect on a virus.

Why is "Topical atropine alone" not the answer?

Atropine only eases ciliary spasm and does not treat the cause.

Why is "Topical corticosteroid drops alone" not the answer?

Steroid alone would allow unchecked viral replication and enlarge the ulcer.

What concept does this question test?

It tests Cornea in Ophthalmology. Topical steroids alone worsen epithelial disease and can lead to a geographic ulcer, and are reserved for stromal disease under antiviral cover.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Cornea?

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.