Conjunctiva and cornea: epithelial basement membrane dystrophy: 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 · Conjunctiva and cornea: epithelial basement membrane dystrophy

Sample item

A 55-year-old woman has sharp pain on waking that settles by midday. Slit lamp shows bilateral map-like grey lines, dots and fingerprint patterns within the corneal epithelium. What is the diagnosis?

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

The answer and the reasoning

D. Epithelial basement membrane dystrophy

Map-dot-fingerprint (Cogan) dystrophy is the most common anterior dystrophy in adults and a leading cause of recurrent erosion. Abnormal basement membrane impairs epithelial adhesion, so lids stick on waking and tear the epithelium.

Option by option

  • A. Reis-Bucklers dystrophy

    Reis-Bucklers is a childhood-onset Bowman layer disorder with geographic opacities.

  • B. Lattice dystrophy

    Lattice dystrophy shows refractile branching amyloid lines in the stroma.

  • C. Granular dystrophy

    Granular dystrophy shows discrete white crumb-like stromal deposits.

  • D. Epithelial basement membrane dystrophy (correct)

    Correct. Map, dot and fingerprint changes in the epithelium characterise this dystrophy.

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, Epithelial basement membrane dystrophy. Map-dot-fingerprint (Cogan) dystrophy is the most common anterior dystrophy in adults and a leading cause of recurrent erosion.

Why is "Reis-Bucklers dystrophy" not the answer?

Reis-Bucklers is a childhood-onset Bowman layer disorder with geographic opacities.

Why is "Lattice dystrophy" not the answer?

Lattice dystrophy shows refractile branching amyloid lines in the stroma.

Why is "Granular dystrophy" not the answer?

Granular dystrophy shows discrete white crumb-like stromal deposits.

What concept does this question test?

It tests Conjunctiva and cornea: epithelial basement membrane dystrophy in Ophthalmology. Abnormal basement membrane impairs epithelial adhesion, so lids stick on waking and tear the epithelium.

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 Conjunctiva and cornea: epithelial basement membrane dystrophy?

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.