Rosh Internal Medicine Boost Practice Exam

Severe symptoms along with a red eye and corneal changes in an older adult patient suggest what diagnosis?

1. Acute uveitis

2. Angle-closure glaucoma

3. Corneal ulcer

4. Conjunctivitis

The correct answer is: Angle-closure glaucoma

The presence of severe symptoms, a red eye, and corneal changes in an older adult patient strongly suggests a diagnosis of angle-closure glaucoma. This condition often presents with significant ocular pain, blurred vision, headache, and nausea, which align with the severe symptoms mentioned. The red eye is due to conjunctival injection, and corneal changes, such as edema or a hazy appearance, can occur as intraocular pressure rises rapidly, causing the cornea to lose its clarity. Angle-closure glaucoma typically occurs in older adults who may have predisposing factors such as hyperopia (farsightedness) or a narrow anterior chamber, making them more susceptible to the acute episodes that characterize this condition. The urgency of the situation is heightened in these cases, necessitating prompt recognition and treatment to prevent permanent vision loss. While other options, such as acute uveitis, corneal ulcer, and conjunctivitis, also cause redness and discomfort in the eye, the combination of the severe symptoms, corneal changes, and the age of the patient points specifically toward angle-closure glaucoma as the most likely diagnosis. Each of these other conditions may have some overlapping features, but the acute nature and specific clinical signs much more closely align with angle-closure