Orbit: 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 · Orbit

Sample item

A child with a recent sinus infection develops fever, eyelid swelling, proptosis, painful and restricted eye movements. What is the commonest source of this infection?

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

The answer and the reasoning

D. Paranasal sinusitis, especially ethmoid

Orbital cellulitis most often spreads from the ethmoid sinuses through the thin lamina papyracea or via valveless veins. Pain on eye movement, proptosis and ophthalmoplegia distinguish it from preseptal cellulitis. Urgent imaging and intravenous antibiotics are needed because of the risk of intracranial spread.

Option by option

  • A. Dental abscess

    Dental infection can reach the orbit but is far less common than sinusitis.

  • B. External hordeolum

    A hordeolum is a localised lid infection that rarely extends into the orbit.

  • C. Dacryocystitis

    Dacryocystitis more often causes localised preseptal swelling near the medial canthus.

  • D. Paranasal sinusitis, especially ethmoid (correct)

    Correct. The ethmoid sinus abuts the medial orbital wall and is the commonest source.

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 D, Paranasal sinusitis, especially ethmoid. Orbital cellulitis most often spreads from the ethmoid sinuses through the thin lamina papyracea or via valveless veins.

Why is "Dental abscess" not the answer?

Dental infection can reach the orbit but is far less common than sinusitis.

Why is "External hordeolum" not the answer?

A hordeolum is a localised lid infection that rarely extends into the orbit.

Why is "Dacryocystitis" not the answer?

Dacryocystitis more often causes localised preseptal swelling near the medial canthus.

What concept does this question test?

It tests Orbit in Ophthalmology. Pain on eye movement, proptosis and ophthalmoplegia distinguish it from preseptal cellulitis. Urgent imaging and intravenous antibiotics are needed because of the risk of intracranial spread.

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 Orbit?

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.