A 58-year-old man on prolonged high-potency topical corticosteroid drops after corneal transplant develops raised intraocular pressure with an open anterior chamber angle. The type of glaucoma he has developed is:

• A Angle closure glaucoma due to forward displacement of the lens-iris diaphragm
• B Open angle glaucoma due to increased aqueous humour production by the ciliary body
• C Open angle glaucoma due to decreased aqueous outflow through the trabecular meshwork ✓
• D Secondary angle closure due to neovascularisation of the drainage angle

Explanation

Corticosteroids increase deposition of glycosaminoglycans in the trabecular meshwork and reduce outflow facility, producing an open-angle secondary glaucoma. Aqueous production is unaffected, which rules out option B, and the angle is explicitly open, ruling out both angle-closure options. Roughly one third of the population are steroid responders, and risk rises with potency and duration of therapy.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.