Neuro-ophthalmology and pupils: amaurosis fugax: 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 · Neuro-ophthalmology and pupils: amaurosis fugax

Sample item

A 66-year-old smoker has had a curtain-like loss of vision in one eye lasting three minutes. Which is the most appropriate next investigation?

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

The answer and the reasoning

B. Carotid duplex ultrasound

Transient monocular vision loss is often from emboli from the ipsilateral carotid artery, so carotid imaging is the priority. Orbital CT, lumbar puncture and the edrophonium test examine orbital, intracranial pressure and neuromuscular problems.

Option by option

  • A. Orbital CT

    Orbital CT studies orbital disease, not a transient embolic event.

  • B. Carotid duplex ultrasound (correct)

    Correct. Carotid duplex looks for the embolic source.

  • C. Edrophonium test

    The edrophonium test is for myasthenia.

  • D. Lumbar puncture

    Lumbar puncture is for raised intracranial pressure or inflammation, not a transient field event.

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, Carotid duplex ultrasound. Transient monocular vision loss is often from emboli from the ipsilateral carotid artery, so carotid imaging is the priority.

Why is "Orbital CT" not the answer?

Orbital CT studies orbital disease, not a transient embolic event.

Why is "Edrophonium test" not the answer?

The edrophonium test is for myasthenia.

Why is "Lumbar puncture" not the answer?

Lumbar puncture is for raised intracranial pressure or inflammation, not a transient field event.

What concept does this question test?

It tests Neuro-ophthalmology and pupils: amaurosis fugax in Ophthalmology. Orbital CT, lumbar puncture and the edrophonium test examine orbital, intracranial pressure and neuromuscular problems.

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 Neuro-ophthalmology and pupils: amaurosis fugax?

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.