NORCET 10 Mains: 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

Pigmentary glaucoma is the correct answer as Krukenberg spindle is a pathognomonic sign of this condition.
A Krukenberg spindle is a vertical, spindle-shaped deposit of pigment on the posterior surface of the cornea (endothelium).
This occurs when pigment granules from the posterior iris surface are shed into the aqueous humor.
These pigment particles are carried by convection currents within the anterior chamber and adhere to the cornea.
The same pigment particles also obstruct the trabecular meshwork, leading to elevated intraocular pressure and glaucomatous optic nerve damage.

Option B: Malignant glaucoma (or aqueous misdirection syndrome) involves the posterior diversion of aqueous humor, not pigment deposition on the cornea. It leads to a forward shift of the lens-iris diaphragm and secondary angle closure.
Option C: Acute angle-closure glaucoma is a medical emergency caused by the physical obstruction of the drainage angle by the iris. Its signs are a sudden, painful red eye, blurred vision, halos, and a fixed mid-dilated pupil, not a Krukenberg spindle.
Option D: Neovascular glaucoma is caused by the growth of abnormal new blood vessels (rubeosis iridis) over the iris and drainage angle, which block aqueous outflow. It is not characterized by pigment deposition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs and classification of glaucoma as background academic context rather than a clinical decision trigger.
Recognizing a Krukenberg spindle on slit-lamp examination is a key diagnostic clue for pigment dispersion syndrome and pigmentary glaucoma, prompting the nurse or clinician to check intraocular pressure and assess the optic nerve.
Pigmentary glaucoma often affects younger, myopic (nearsighted) individuals, so identifying this sign is crucial for preventing irreversible vision loss in this demographic.
Nursing care involves educating the patient about the chronic nature of glaucoma, the importance of adherence to prescribed eye drops to lower pressure, and the need for lifelong monitoring.

How to Approach the Question

First, identify the key clinical sign mentioned in the question: 'Krukenberg spindle formation on the corneal endothelium'.
This is a specific, knowledge-based term. Your goal is to recall or deduce the disease process associated with this sign.
Consider the term 'spindle'. This implies a specific shape of deposition.
Analyze the options provided, which are all types of glaucoma.
Mentally review the pathophysiology of each type of glaucoma. Pigmentary glaucoma is defined by the dispersion of pigment. Malignant glaucoma is about aqueous misdirection. Angle-closure is a mechanical blockage. Neovascular is about new blood vessel growth.
Connect the clinical sign (pigment deposition) to the most logical pathology. The deposition of pigment (Krukenberg spindle) directly links to pigmentary glaucoma.

Concept Tested & Keywords

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