Krukenberg spindle formation on the corneal endothelium is a characteristic finding of which type of glaucoma?

NORCET 10 Mains

Medical & Surgical Nursing

Easy

Appeared in: NORCET 10 Mains

Explanation

A Krukenberg spindle is a vertical, spindle-shaped deposition of pigment on the posterior surface (endothelium) of the cornea.
This sign is a classic feature of Pigment Dispersion Syndrome, a condition that often leads to Pigmentary Glaucoma.
Pigmentary glaucoma is a form of secondary open-angle glaucoma where pigment granules from the iris clog the eye's drainage system (trabecular meshwork), increasing intraocular pressure.
The pigment deposition on the cornea occurs due to the circulation of aqueous humor, which carries the shed pigment particles.

Option B: Malignant glaucoma (or aqueous misdirection syndrome) is a rare form of glaucoma caused by the abnormal flow of aqueous humor towards the back of the eye (vitreous cavity), not by pigment deposition.
Option C: Acute angle-closure glaucoma is a medical emergency caused by the sudden physical blockage of the drainage angle by the iris. Its signs are acute and severe (e.g., intense eye pain, blurred vision, halos, nausea), not the slow deposition of pigment.
Option D: Neovascular glaucoma is caused by the growth of new, abnormal blood vessels on the iris and in the drainage angle, which block aqueous outflow. This is typically a complication of other diseases like diabetic retinopathy or central retinal vein occlusion.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of different types of glaucoma as background academic context rather than a clinical decision trigger.
Identifying a Krukenberg spindle during a routine eye exam is a critical finding that should prompt a full glaucoma workup.
It is a key sign of pigment dispersion syndrome, which carries a high risk of developing into pigmentary glaucoma and subsequent optic nerve damage if not monitored and treated.
Nurses should be aware that patients with pigmentary glaucoma are often younger than those with primary open-angle glaucoma and may be asymptomatic until significant vision loss has occurred.

How to Approach the Question

First, identify the key term in the question stem: 'Krukenberg spindle'.
Recognize that this is a specific, named clinical sign. The question is asking to link this sign to its corresponding disease.
This is primarily a factual recall question. Access your knowledge about the pathophysiology of different glaucoma types.
Analyze the term 'Krukenberg spindle'. It involves pigment. Now look at the options.
The option 'Pigmentary glaucoma' directly relates to pigment. This creates a strong initial link.
Briefly consider the other options to confirm they are incorrect. Malignant glaucoma is about fluid misdirection, angle-closure is about physical blockage, and neovascular is about new blood vessels. None of these primarily involve pigment deposition as their cause.

Concept Tested & Keywords

QO5L-Sp_ZDA0D-iVXPrVtK

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1312-1314