Conjunctiva and cornea: punctal occlusion: 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: punctal occlusion

Sample item

A 55-year-old woman with Sjogren syndrome has a Schirmer value of 3 mm at 5 minutes and remains symptomatic on frequent artificial tears. Which step conserves her own tears?

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

The answer and the reasoning

D. Punctal plugs

In aqueous-deficient dry eye, punctal occlusion with plugs or cautery keeps the limited tears on the surface for longer. Dacryocystorhinostomy would improve drainage and worsen the problem. Antihistamines reduce secretion further.

Option by option

  • A. Dacryocystorhinostomy

    Dacryocystorhinostomy treats an obstructed duct and increases drainage, the opposite of what is needed.

  • B. Oral antihistamine

    Oral antihistamines have drying effects and would worsen aqueous deficiency.

  • C. Topical antibiotic course

    Antibiotics treat infection and do not correct tear deficiency.

  • D. Punctal plugs (correct)

    Correct. Plugs block the drainage route, retaining tears and lubricants.

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, Punctal plugs. In aqueous-deficient dry eye, punctal occlusion with plugs or cautery keeps the limited tears on the surface for longer.

Why is "Dacryocystorhinostomy" not the answer?

Dacryocystorhinostomy treats an obstructed duct and increases drainage, the opposite of what is needed.

Why is "Oral antihistamine" not the answer?

Oral antihistamines have drying effects and would worsen aqueous deficiency.

Why is "Topical antibiotic course" not the answer?

Antibiotics treat infection and do not correct tear deficiency.

What concept does this question test?

It tests Conjunctiva and cornea: punctal occlusion in Ophthalmology. Dacryocystorhinostomy would improve drainage and worsen the problem. Antihistamines reduce secretion further.

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: punctal occlusion?

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.