Chapter 13 Ophthamalic Imaging

Question 1

When performing slit-lamp photography, a photograph of the eye using low magnification and diffuse lighting is recommended to:
a) judge the patient’s tolerance to the flash
b) judge the corneal reflection
c) provide identification
d) provide orientation

Answer 1

C- provide identification

Question 2

By convention as well as for ease of use, the illuminator in slit-lamp photography is usually positioned:
a) nasally
b) temporally
c) temporally for OD and nasally for OS
d) nasally for OD and temporally for OS

Answer 2

B- temporally

Question 3

You are taking a slit-lamp photo of an iris lesion that may be melanoma. The illumination technique of choice is:
a) diffuse
b) direct
c) indirect
d) retroillumination

Answer 3

B- direct

Question 4

You are taking a slit-lamp photo of a cortical cataract. The illumination technique of choice is:
a) diffuse
b) direct
c) indirect
d) retroillumination

Answer 4

D- retroillumination

Question 5

The method used to take photographs of the endothelial layer of the cornea is:
a) specular photomicrography
b) fluorescein angiography
c) corneal topography
d) retroluminar reflectography

Answer 5

A- specular photomicrography

Question 6

The most important thing to do before using any fundus camera each day should be:
a) confirm the diopter compensator is at the “+” setting
b) ensure all patients are dilated with homatropine
c) check to see that the eye piece is correctly set
d) clean the camera lens whether or not it is dirty

Answer 6

C- check to see that the eye piece is correctly set

Question 7

Setting the fundus camera eye piece should be done: a) with one eye shut, in dim light or darkness
b) with both eyes open, in dim light or darkness
c) with both eyes open in a normally lit room
d) with one eye shut in a normally lit room

Answer 7

B- with both eyes open, in dim light or darkness

Question 8

When setting the ocular of the fundus camera system, one must:
a) remove one’s own correction
b) turn the ocular to the maximum plus position, then rotate down
c) turn the ocular to the maximum plus position, then rotate up
d) turn the ocular to the maximum minus position, then rotate up
.

Answer 8

B- turn the ocular to the maximum plus position, then rotate down

Question 9

If you continue to turn the fundus camera ocular past the first point of clarity:
a) the reticle will become sharper yet
b) you can compensate for the patient’s refractive error
c) you may induce your own accommodation
d) the resulting photograph will be sharper

Answer 9

C- you may induce your own accommodation

Question 10

Inadequate dilation results in photographs with:
a) half of the frame unexposed
b) a general blur
c) a gray, fuzzy quadrant
d) a grainy appearance

Answer 10

B- a general blur

Question 11

In fundus photography, high corneal astigmatism can be compensated for by:
a) use of the correction device in the fundus camera b) placing the dioptric correction dial on “+” for plus cylinder
c) placing the dioptric correction dial on “–” for minus cylinder
d) having the patient wear a toric contact lens during photography

Answer 11

A- use of the correction device in the fundus camera

Question 12

To take a photo of the external eye with the fundus camera (eg, to document corneal edema that interferes with a clear view of the fundus):
a) change the diopter setting to “–”
b) change the diopter setting to “+”
c) have the patient sit back from the camera
d) a slit-lamp camera must be used

Answer 12

b) change the diopter setting to “+”

Question 13

Gross focusing with the fundus camera is generally accomplished by:
a) turning the eye piece until the subject is clear
b) moving the joystick
c) having the patient lean forward or back
d) changing the magnification setting

Answer 13

B- moving the joystick

Question 14

Focusing the fundus camera can be simplified by:
a) starting with the camera all the way back, then moving it forward
b) starting with the camera all the way forward, then moving it back
c) focusing the donut on the patient’s closed lid before composing the photograph
d) positioning the fixation light directly in front of the camera lens

Answer 14

C- focusing the donut on the patient’s closed lid before composing the photograph

Question 15

To allow scanning of the patient’s retina without moving the base of the camera mount:
a) move the fixation light and ask the patient to follow it
b) use the joystick
c) adjust the chin cup
d) swing the camera on its pivot

Answer 15

D- swing the camera on its pivot

Question 16

You are attempting to take fundus photographs and notice a whitish haze in the center of the subject. This may mean that:
a) the patient is highly myopic
b) the patient is highly hyperopic
c) the patient has his or her eye closed
d) the camera has drifted to one side

Answer 16

D- the camera has drifted to one side

Question 17

You are attempting to take fundus photographs and see a blue-gray halo around the subject. To correct this, you should:
a) move the camera closer
b) move the camera further back
c) reduce illumination
d) increase illumination

Answer 17

A- move the camera closer

Question 18

In the scenario above, you should:
a) reduce illumination
b) move the camera slightly down and to the right
c) move the camera slightly up and to the left
d) use the dioptric compensation device

Answer 18

B- move the camera slightly down and to the right

Question 19

Fundus photos of a patient with macular degeneration would focus on the:
a) optic disc
b) retinal periphery
c) fovea
d) superior field

Answer 19

C- fovea

Question 20

Poor detail on a fundus photograph can be caused by all of the following except:
a) improper focusing
b) hazy media
c) retinal pathology
d) failing to set the eye piece accurately

Answer 20

C- retinal pathology

Question 21

The camera most often used in external ophthalmic photography is a(n):
a) instant still camera
b) video camera
c) twin-lens reflex 35 mm camera
d) single-lens reflex 35 mm camera

Answer 21

D- single-lens reflex 35 mm camera

Question 22

All of the following are important information when illuminating isn’t the subject for external photography except:
A- avoid shadows falling on the area of interest
B) provide an even illumination across the area of interest
C) direct the illumination from the nasal aspect
D) avoid large flash reflection from the cornea

Answer 22

C - direct the illumination from the nasal aspect

Question 23

Ultrasound employs the use of:
A) light rays
B) sound waves
C) laser rays
D) electromagnetic waves

Answer 23

B- sound waves

Question 24

The A in A-scan stands for:
A) axial
B)amplitude
C) anti-orbital
D) audio

Answer 24

B- amplitude

Question 25

I’m standardized/diagnostic A-scans, the probe tip is placed:
A) perpendicular to the visual axis
B) relative to the area of interest
C) so sound waves will fall on the macula
D) so sound waves will fall on the optic nerve

Answer 25

B- relative to the area of interest

Question 26

In standardized or diagnostic A-scan, the purpose of the scan is generally to:
A) calculate intraocular lens power
B) calculate anterior chamber depth
C) evaluate abnormalities
D) evaluate the aqueous

Answer 26

C- evaluate abnormalities

Question 27

Extra echoes between the anterior and posterior lens spikes indicate:
A) a poor A-scan that should be repeated
B) a malfunctioning probe
C) a dense cataract
D) none of the above

Answer 27

C- a dense cataract

Question 28

Unwanted echoes that do not represent ocular structures are known as:
A) pseudo-echoes
B) artifacts
C) reservations
D) echoes of confusion

Answer 28

B- artifacts

Question 29

All of the following are true regarding computerized corneal topography except:
A) it evaluates four points of the corneal apex
B) it measures the curvature of the anterior cornea
C) it displays the results when a color-coded map
D)it analyzes light reflected from the cornea

Answer 29

A- it evaluated four points of the corneal apex

Question 30

Corneal topography is useful in each of the following except:
A) fitting rigid contact lenses
B) monitoring keratoconus
C) monitoring endothelial drop-out
D) preoperative refractive surgery evaluation

Answer 30

C- monitoring endothelial drop-out

Question 31

The corneal topography map most commonly used is the:
A) placido ring map
B) keratometry
C) refractive map
D) axial map

Answer 31

D- axial map

Question 32

A postoperative refractive surgery patient is complaining of glare and ghosting. Which of the following would provide the most helpful analysis?
A)slit-lamp evaluation
B) endothelial cell count
C) corneal anesthesiometry
D) corneal topography

Answer 32

D- corneal topography

Question 33

Scanning laser tests (HRT, GDx, OCT) generate results that are:
A) color-coded to indicate thickness of tissues
B) color-coded to show index of curvature
C) shown in grayscale
D) comparable to fluorescein angiography

Answer 33

A- color-coded to indicate thickness of tissues

Question 34

Which of the following would not generally be evaluated using scanner laser tests?
A) optic nerve cupping
B) macular swelling
C) vitreous detachment
D) a glaucoma suspect

Answer 34

C- vitreous detachment

Question 35

When using scanner laser as an aid in diagnosing glaucoma, the area of interest is the:
A) fovea
B) retinal nerve fiber layer
C) optic radiations
D) retinal pigment epithelium

Answer 35

B- retinal nerve fiber layer

Question 36

Scanning laser testing software evaluates the probability that:
A) the reading is accurate
B) further changes will occur
C) evaluated tissues are normal
D) changes are caused by operator error

Answer 36

C- evaluated tissues are normal