Glaucoma: acute angle closure management: 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: acute angle closure management

Sample item

In acute primary angle closure, which drug should be used only after IOP has been lowered, because the iris sphincter is ischaemic?

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

The answer and the reasoning

B. Pilocarpine

Pilocarpine does not work well at very high IOP due to sphincter paralysis and pushes the lens-iris diaphragm forward. After pressure is reduced with osmotics and aqueous suppressants, it opens the angle, and laser iridotomy follows.

Option by option

  • A. Oral acetazolamide

    Acetazolamide is used early to reduce aqueous formation.

  • B. Pilocarpine (correct)

    Correct. Miotic works only after pressure is first lowered.

  • C. Intravenous mannitol

    Mannitol is used early to reduce IOP.

  • D. Topical timolol

    Timolol is useful adjunctively early.

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, Pilocarpine. Pilocarpine does not work well at very high IOP due to sphincter paralysis and pushes the lens-iris diaphragm forward.

Why is "Oral acetazolamide" not the answer?

Acetazolamide is used early to reduce aqueous formation.

Why is "Intravenous mannitol" not the answer?

Mannitol is used early to reduce IOP.

Why is "Topical timolol" not the answer?

Timolol is useful adjunctively early.

What concept does this question test?

It tests Glaucoma: acute angle closure management in Ophthalmology. After pressure is reduced with osmotics and aqueous suppressants, it opens the angle, and laser iridotomy follows.

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: acute angle closure management?

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.