Conjunctiva and cornea: topography in keratoconus: 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: topography in keratoconus

Sample item

A 20-year-old with worsening astigmatism has a normal slit-lamp appearance on first look. Corneal topography is done. Which finding supports keratoconus?

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

The answer and the reasoning

C. Localised inferior steepening

Topography in keratoconus shows localised steepening, often inferior or inferotemporal, with an asymmetric bow-tie. It detects early disease before slit-lamp signs. Regular astigmatism gives a symmetrical bow tie.

Option by option

  • A. Symmetrical bow-tie pattern in the central cornea

    A symmetrical bow tie is regular astigmatism, not keratoconus.

  • B. Uniform flattening of the whole cornea

    Uniform flattening is not seen, as keratoconus steepens the cone.

  • C. Localised inferior steepening (correct)

    Correct. Local inferior steepening is the topographic hallmark.

  • D. Superior peripheral thinning with a lipid edge

    Superior peripheral thinning with a lipid edge is Terrien degeneration.

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.

More Ophthalmology questions

Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Localised inferior steepening. Topography in keratoconus shows localised steepening, often inferior or inferotemporal, with an asymmetric bow-tie.

Why is "Symmetrical bow-tie pattern in the central cornea" not the answer?

A symmetrical bow tie is regular astigmatism, not keratoconus.

Why is "Uniform flattening of the whole cornea" not the answer?

Uniform flattening is not seen, as keratoconus steepens the cone.

Why is "Superior peripheral thinning with a lipid edge" not the answer?

Superior peripheral thinning with a lipid edge is Terrien degeneration.

What concept does this question test?

It tests Conjunctiva and cornea: topography in keratoconus in Ophthalmology. It detects early disease before slit-lamp signs. Regular astigmatism gives a symmetrical bow tie.

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: topography in keratoconus?

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.