**Core Concept**
Painful loss of vision is a clinical presentation that can be caused by various ophthalmological conditions. The underlying principle being tested here involves the pathophysiology of eye diseases that lead to both pain and vision loss. Conditions affecting the anterior segment of the eye are more likely to cause pain due to the presence of pain-sensing nerves.

**Why the Correct Answer is Right**
The correct answer is related to a condition that causes an acute increase in intraocular pressure, leading to pain and vision loss. This is characteristic of **primary angle closure glaucoma**, where the iris blocks the drainage angle of the eye, causing a sudden rise in intraocular pressure. This condition triggers pain and can lead to rapid vision loss if not treated promptly.

**Why Each Wrong Option is Incorrect**
**Option A:** Senile cataract typically causes painless, gradual vision loss. **Option B:** Primary open angle glaucoma also leads to gradual, painless vision loss due to progressive optic nerve damage. **Option D:** Anterior uveitis can cause pain and vision loss, but the primary symptom being tested here aligns more closely with the acute presentation of primary angle closure glaucoma.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that **primary angle closure glaucoma** is an ophthalmological emergency, requiring immediate treatment to prevent permanent vision loss. The symptoms include severe eye pain, blurred vision, headache, and sometimes nausea and vomiting.

**Correct Answer:** C. Primary angle closure glaucoma