A pt. presents with meiotic pupil of size 2 mm in diameter IOP is 25 mm of Hg. Cornea is hazy. AC is shallow in fellow eye, most probable diagnosis is:
**Core Concept**
The patient's presentation of a meiotic pupil with a small diameter, increased intraocular pressure (IOP), corneal haziness, and a shallow anterior chamber (AC) in the fellow eye is suggestive of angle-closure glaucoma. This condition occurs when the iris is apposed to the trabecular meshwork, blocking the outflow of aqueous humor and leading to a rapid increase in IOP.
**Why the Correct Answer is Right**
Angle-closure glaucoma is characterized by the obstruction of the trabecular meshwork by the iris, leading to a sudden increase in IOP. The meiotic pupil is a result of the iris being pulled anteriorly by the increased pressure in the posterior chamber. The corneal haziness is likely due to corneal edema secondary to the increased IOP. The shallow anterior chamber in the fellow eye suggests that the patient may be predisposed to angle-closure glaucoma due to a shallow AC, which can be a risk factor for this condition.
**Why Each Wrong Option is Incorrect**
* **Option A:** Uveitis is a condition characterized by inflammation of the uvea, which can cause a range of symptoms including pain, redness, and decreased vision. However, it is not typically associated with a meiotic pupil or increased IOP.
* **Option B:** Cataract is a condition where the lens of the eye becomes cloudy, leading to decreased vision. While cataracts can cause a range of symptoms, they are not typically associated with a meiotic pupil or increased IOP.
* **Option C:** Iridocyclitis is an inflammation of the iris and ciliary body, which can cause a range of symptoms including pain, redness, and decreased vision. However, it is not typically associated with a meiotic pupil or increased IOP.
**Clinical Pearl / High-Yield Fact**
A key feature of angle-closure glaucoma is the presence of a meiotic pupil, which is a result of the iris being pulled anteriorly by the increased pressure in the posterior chamber. This is a classic exam-relevant point that students should never forget.
**Correct Answer:** C.