This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Ophthalmology
[{'content': 'A patient has a miotic pupil, IOP = 25, normal anterior chamber, hazy cornea and a shallow anterior chamber in the fellow eye. Diagnosis is – \nSelect and explain. \nA. Acute anterior uveitis, B. Acute angle closure glaucoma, C. Acute open angle glaucoma, D. Senile cataract', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Here the two differential diagnosis are:-\n\ni) Acute anterior uveitis,\nii) Acute angle closure glaucoma.\n\nThe information in this question are :-\n\n\nMeiotic pupil\nNormal anterior chamber (with the shallow anterior chamber in the fellow eye)\nMildly elevated IOT : 25 mmHg (normal 10 - 21 mm Hg)\nHazy cornea\n\n\nNow we will discuss each of these :-\nAmongst the given options meiotic pupil is seen only in acute anterior uveitis.\nNormal anterior chamber with shallow anterior chamber in fellow eye may have any of the following :\n\n\nThe patient is predisposed to angle-closure glaucoma due to congenital bilateral shallow anterior chamber and this shallow anterior chamber is the normal depth of anterior chamber so, a normal appearing anterior chamber in the diseased eye is in fact deep due to any disease process.\n\nor\n\nDiseased eye has normal depth of anterior chamber. While the fellow eye has shallow anterior chamber and is predisposed to angle closure glaucoma.\n\n\nSo, the diseased eye has either normal depth or is deep (any of these can be seen in acute anterior uveitis).\nMildly elevated intraocular tension may be seen in acute anterior uveitis due to obstruction of the flow of aqueous from clogging of trabecular meshwork of anterior chamber. In an attack of acute angle closure glaucoma, IOP is usually markedly raised.\nThe hazy cornea may be seen both in angle closure glaucoma and acute anterior uveitis.\nSo, the most probable diagnosis is acute anterior uveitis.', 'role': 'assistant'}]