BLOCK REVIEW

Question 1

Define FOG

CAP:

REFINE:

BALANCE:

Answer 1

Blur their vision until they’re blurred enough to not see anything, walk them down on 20/40 line until they can first make out the letters add 3 clicks minus sphere, move on to CAP

Cylinder Axis Power: axis first, flip down JCC, stratle JCC, follow RED dots for MINUS phoropter, move 15 axis until pt stops, move on to REFINE

REFINE: fog again, 3 click blur out, walk them down again (3 clicks to refine)

DO LEFT EYE SAME WAY

Then BALANCE: can’t balance with amblyopia.

Question 2

If they’re bouncing around, go with the least ______ power

Answer 2

Minus

Question 3

If you want to double check your objective or subjective refractive findings (especially if they’re not seeing 20/20), what would you do FIRST?

Answer 3

PINHOLE to make sure nothing else is wrong with pt.

Question 4

If patient sees 20/25 how many click blur outs??

20/30?
20/40?
20/50?

Answer 4

4 clicks
5
6
7

Question 5

Which of the following is included ?

Binocular refraction

Replacing accommodation

Cylinder axis and power refinement

Binocular balance

Answer 5

Binocular balance

Question 6

If you dont have cyl or axis when you do manifest what do you do than FOG CAP REFINE BALANCE??

Answer 6

CPAP!

Fish for 15 degrees

Question 7

Interval of Sturm is what?

Answer 7

Difference between the vertical and the horizontal meridian.

Refining cylinder power..bringing them closer and closer together

-3.00-2.00x090

Whole lens -5.00, -3.00 at the 90

2D distance is the interval of sturm

Question 8

When doing the R/G test what patients should you avoid??

Answer 8

Colorblind people

Amblyopic

Cataracts (affects colors)

Macular degeneration?

Question 9

Give some reasons for doing a binocular refraction over monocular refraction

Answer 9

Reasons for doing binocular:

FUSION LOCK: helps with nystagmus
Anisometropia: BIG RX difference
Non-suppressing tropia’s (usually intermittent)

Question 10

Electronic health records:
________ reimbursement levels from insurance providers
Makes transfer of knowledge ________
Makes the provider more accurate with his or her __________ skills.

Answer 10

Increases
Easier
Diagnostic

Question 11

Define :
Amp Acc

Amp Response

Amp Facility

Answer 11

Amp Acc – maximum focusing
ability

Amp Response – over or under acc

Question 12

How do you measure the following

Answer 12

Amp Acc – NRA and PRA

Question 13

The comfortable range of accomodatioin is determined by what formula using Amp ACC?

Answer 13

Comfortable Acc Range = ½(Amp Acc)

Question 14

Amp of Accommodation based on age is calculated by

Minimum= 15.00D-0.25(pts age) 
Mean = 18.50D-0.30(pts age) 
Maximum= 25.00D-0.40(pts age)

Patients UNDER 40yrs

Answer 14

40yrs their minimum would be 18.5

Question 15

Give some reasons for a unilateral decrease in a patients Amp of ACC.

What would NOT show unilateral decrease in amp of ACC?

Answer 15

Anisocoric (unequal pupils) Addie’s
Inflammation or trauma to ciliary body
Improperly balanced manifest

Oral anticholinergic.. taken by mouth so BOTH pupils will be dilated

Question 16

When you do a manifest and your patients acuity is 20/40 OD OS but pin hole is 20/20 OD OS
What should you do?

Answer 16

Don’t record it, redo it, get it right ya dummy

Question 17

Using the minus lens technique for Amp ACC the patient reaches sustained blur at -1.50D You are working at 40cm What is the Amp ACC?

Find dioptic power, measure to be -1.50, WD is 2.5 (1/.4=2.5)

Their Amp ACC is…?

Answer 17

4!

2.5+1.5=4D

Question 18

It be unwise to measure Amp ACC on a patient with?

Answer 18

Presbyopia

Question 19

Based upon age appropriate prescribing for Presbyopia, what would you prescribe a 30 yr old 50 yr old 70 yr old
40 yr old 60 yr old???

Answer 19

30 NONE
40  +1.00
50  +2.00
60 +2.50
70 +2.50

Question 20

What is the appropriate endpoint for a bino balance?

Answer 20

Perceived equality between the eyes

OR

Dominant eye better when equality can not be achieved

Question 21

When you have no cyl axis or power in the manifest model you do 
FOG 
C-PAP 
Refine 
Balance

Answer 21

CPAP!!!

Question 22

During a manifest refraction, your patient starts to show fatigue and is running you all over the place. What are some options to find the most accurate manifest refraction?

Give up and reschedule the patient?

Answer 22

Dilate the patient with cycloplegic meds and do the manifest

without the patient being able to accommodate

Question 23

NRA is measured by using (+) or (-) lenses?

PRA is measured by using (+) or (-) lenses?

Answer 23

+

-

Question 24

What’s the most common method used for prescribing presbyopia? Why?

Answer 24

Age (time is money)

Question 25

What is your responsibility in educating the patient when it comes to the lenses they may choose to purchase?

Answer 25

Explain to them what it means (medical prescription by law). You need to tell them about lens options and warnings for ones that wont suffice