Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What is the characteristic appearance of the pupil after an acute episode of narrow-angle glaucoma?

1. Constricted and fixed

2. Dilated and fixed

3. Oval and reactive

4. Round and constricted

The correct answer is: Dilated and fixed

In an acute episode of narrow-angle glaucoma, the characteristic appearance of the pupil is dilated and fixed. This occurs due to the increased intraocular pressure that affects the muscles controlling the pupil. The dilated state results from the paralysis of the iris sphincter muscle, while the pupil remains fixed and unreactive to light due to the stress and conditions imposed by the increase in pressure within the eye. In contrast, other pupil shapes and reactions are associated with different conditions. For example, a constricted and fixed pupil typically points toward issues such as opioid use or a central nervous system event. An oval pupil can occur in cases of trauma or specific neurological disorders. A round and constricted pupil might indicate a more normal physiological state or a response to bright light, which is not the case in acute narrow-angle glaucoma. Thus, the dilated and fixed pupil is a key clinical sign of this ocular emergency.