chapter 16 supplemental skills

Question 1

You are inputting data for IOL calculations and notice that the K readings are 44.5/42.75. This type of reading:
a) should prompt you to repeat the measurement
b) alerts you that lenticular astigmatism may exist
c) alerts you that axillary astigmatism may exist
d) is acceptable

Answer 1

d- is acceptable

Question 2

The manufacturer of a given IOL often supplies a specific number that must be entered into the IOL calculations when the lens is to be used. This number is referred to as a(n):
a) A-constant
b) fudge factor
c) personal identification number
d) optical constant

Answer 2

a- A-constant

Question 3

Which of the following poses problems in obtaining accurate measurements for IOL calculations?
a) patients with aphakia
b) patients who have had corneal refractive surgery
c) patients with posterior subcapsular cataracts
d) patients with dense brown cataracts

Answer 3

b- patients who have had corneal refractive surgery

Question 4

When calculating IOL power, each of the following are necessary except:
a) white-to-white corneal diameter
b) axial length
c) a calculation formula
d) K readings

Answer 4

a- white-to-white corneal diameter

Question 5

It is important to estimate the anterior chamber depth prior to dilation because:
a) open angles may precipitate an angle-closure glaucoma attack
b) narrow angles may precipitate an angle-closure glaucoma attack
c) narrow angles do not dilate as well and therefore require stronger dilating drugs
d) open angles dilate quickly and therefore require weaker dilating drugs

Answer 5

d- open angles dilate quickly and therefore require weaker dilating drugs

Question 6

In slit-lamp assessment of the corneal periphery, the dark interval should be a minimum of approximately how much of the total corneal width for the angle to be considered open and safe for dilation?
a) one-half
b) three-fourths
c) one-fourth
d) one-third

Answer 6

c - one-fourth

Question 7

When evaluating anterior chamber depth with the slit lamp, the illumination technique used is:
a) cobalt blue filter
b) narrow beam
c) wide beam
d) pinpoint beam

Answer 7

b- narrow beam

Question 8

Measuring corneal thickness via nonoptical pachymetry involves the use of:
a) specular microscopy
b) ultrasound
c) the slit-lamp microscope
d) a contact mirrored lens

Answer 8

b- ultrasound

Question 9

The type of pachymetry used to evaluate a glaucoma suspect is:
a) optical coherence tomography
b) central corneal curvature
c) peripheral corneal thickness
d) central corneal thickness

Answer 9

d- central corneal thickness

Question 10

The IOLMaster must be calibrated daily using a:
a) calibration weight
b) set of metal spheres of known curvature
c) “test eye”
d) calibration bar

Answer 10

c - “test eye”

Question 11

The Schirmer’s test might be indicated in all of the following except:
a) dry eye
b) contact lens pre-evaluation
c) epiphora
d) dacryocystitis

Answer 11

d- dacrocystitis

Question 12

The difference between Schirmer’s test I and II is:
a) the length of the test
b) the type of strips used
c) the use of an anesthetic
d) there is no difference

Answer 12

c- the use of an anesthetic

Question 13

Schirmer’s test II is used to measure:
a) reflux tears
b) reflex tears
c) normal tearing
d) drainage rate

Answer 13

c- normal tearing

Question 14

Measuring time for the Schirmer’s test is:
a) 1 minute
b) 2 minutes
c) 5 minutes
d) 10 minutes

Answer 14

c- five minutes

Question 15

A normally functioning lacrimal gland will produce how much wetting on a Schirmer’s test strip after 5 minutes?
a) 1 mm
b) 2.5 mm
c) 6 mm
d) 10 mm

Answer 15

d- 10 mm

Question 16

All of the following are used in evaluating tear break-up time (TBUT) except:
a) slit-lamp microscope
b) tear filter papers
c) fluorescein dye
d) cobalt blue light

Answer 16

b- tear filter papers

Question 17

When performing the TBUT test, the observer is looking for:
a) the appearance of dry spots
b) pooling of the fluorescein dye
c) reflex tearing
d) drainage of tears off the eye

Answer 17

a- the appearance of dry spots

Question 18

A TBUT of which of the following would indicate tear film dysfunction?
a) 10 seconds
b) 20 seconds
c) 30 seconds
d) 40 seconds

Answer 18

a- 10 seconds

Question 19

A patient with which of the following potential diagnoses would be tested with rose bengal?
a) glaucoma
b) corneal foreign body
c) severe dry eye
d) contact lens fitting

Answer 19

c- severe dry eye

Question 20

Each of the following might be evaluated using rose bengal except:
a) corneal endothelial drop-out
b) corneal abrasion
c) corneal herpes simplex
d) keratitis

Answer 20

a- corneal endothelial drop-out

Question 21

Each of the following is true regarding rose bengal except:
a) stinging may be severe
b) it requires the use of the cobalt blue filter
c) it stains tissue a reddish-pink color
d) it is available in drop and strip form

Answer 21

b- it required the use of the cobalt blue filter

Question 22

When performing a brightness acuity glare test, it is best to do which of the following?
a) Allow the patient to adjust to the light level before reading the letters.
b) Do glare testing through the phoroptor.
c) Time how long it takes for the patient to read the letters.
d) Calibrate the instrument.

Answer 22

a- allow the patient to adjust to the light level before reading the letters

Question 23

The photosensitive pigments of the eye are sensitive to:
a) red, green, and blue
b) red, blue, and yellow
c) red, green, and yellow
d) green, blue, and yellow

Answer 23

a- red, green and blue

Question 24

Color vision testing is used to detect all of the following except:
a) presence of normal color vision
b) type and severity of color defect
c) those who may not qualify for certain jobs
d) differentiate between congenital or acquired color blindness

Answer 24

D- differentiate between congenital or acquired color blindness

Question 25

The Ishihara color plates are useful: a) for screening purposes, such as job applications b) for detailed information on a patient’s color defect c) as a basis for referral to a neuro-ophthalmologist d) only for those who already know they have a defect

Answer 25

A- for screening purposes, such as job applications

Question 26

Illumination for the color plates test: a) varies according to the type of test administered b) should come from an easel lamp in a dark room c) should be natural daylight d) should be one-fifth of the room light

Answer 26

A- varies according to the type of test administered

Question 27

Before proceeding with the actual color plate test: a) the patient is shown a sample that is discernable to normal and abnormal alike b) the patient is shown a sample that is discernable only to those with a color deficit c) the lights should be dimmed d) the patient should be dilated

Answer 27

A- the patient is shown a sample that is discernible to normal and abnormal alike

Question 28

How long should the patient be given to recognize the figure in a color plate? a) 2 to 3 seconds b) 10 to 15 seconds c) 30 to 40 seconds d) as long as he or she needs

Answer 28

A- 2 to 3 seconds

Question 29

When using color plates, a score indicates abnormal color vision: a) when the patient misses 5% of the plates b) when the patient misses 10% of the plates c) when the patient misses 20% of the plates d) varies according to the type of test

Answer 29

D- varies according to the type of test

Question 30

Hereditary color vision defects usually affect: a) both eyes equally b) one eye more than the other c) one eye only d) the dominant eye

Answer 30

A- both eyes equally

Question 31

Which of the following should be color-vision tested one eye at a time? a) suspected blue-yellow defect b) suspected red-green defect c) suspected congenital color defect d) suspected acquired color defect

Answer 31

D- suspected acquired color defect

Question 32

Acquired color vision defects: a) can often be cured by wearing a green contact lens on one eye b) can often be cured if the causative factor is eliminated c) can often be cured by retinal surgery d) can often be cured by injections of photosensitive pigment

Answer 32

B- can often be cured if the causative factor is eliminated

Question 33

If the patient is suspected of having an acquired color vision defect, all of the following apply except: a) each eye can have a different degree of deficit b) the defect tends to remain stable over time c) he or she will tend to make color errors scattered all across the color wheel d) they can resolve

Answer 33

B- the defect tends to remain stable over time

Question 34

When should a child have his or her color vision checked? a) Only if there is a family history of color blindness. b) Prior to age 4. c) Before starting school. d) By age 10.

Answer 34

C- before starting school

Question 35

Color vision defects in children are frequently detected among those with: a) reading disabilities b) retinoblastoma c) sickle cell disease d) attention deficit disorder

Answer 35

A - reading disabilities

Question 36

In evaluating an axial length scan, the retinal echo must be: a) to the right of the scleral and orbital echoes b) the shortest of the scan c) in the center of the scan d) to the left of the scleral and orbital echoes

Answer 36

D- to the left of the scleral and orbital echoes

Question 37

In an axial length A-scan, if there is only one tall echo from the back of the eye with no other echoes behind it, this indicates: a) the presence of a tumor and that an x-ray should be done b) that the sound beam is directed to the macula and the measurement is correct c) that the sound beam is directed to the optic disc and the measurement is incorrect d) that the sound beam is directed at the macula and the measurement is incorrect

Answer 37

C- that the sound beam is directed to the macula and the measurement is correct

Question 38

A measurement error of 1 mm in an axial eye length could result in an unwanted postoperative refractive error of as much as: a) 0.1 D b) 1.0 D c) 0.3 D d) 3.0 D

Answer 38

D- 3.0 D

Question 39

When comparing the axial lengths of a patient’s left and right eye, how much of a difference between the eyes should signal you to repeat the measurement of both eyes? a) 1.0 mm b) 0.5 mm c) 0.3 mm d) 0.1 mm

Answer 39

C- 0.3 mm

Question 40

Laser interferometry uses which type of laser light? a) microwave b) ultrasonic c) infrared d) polarized

Answer 40

C- infrared

Question 41

The IOLMaster eliminates which of the following sources of error? a) shortened axial length due to compression b) distorted corneal curvature due to improper alignment c) inaccurate corneal diameter measurements due to parallax error d) mathematical formula selection errors

Answer 41

A- shortened axial length due to compression

Question 42

The IOLMaster evaluates each of the following except: a) horizontal corneal diameter b) corneal curvature c) refractive error d) anterior chamber depth

Answer 42

C- refractive error

Question 43

For safety reasons, the limit for the number of readings that may be taken per eye per day with the IOLMaster is: a) 5 b) 10 c) 15 d) 20

Answer 43

D- 20

Question 44

The ideal IOLMaster axial length graph is: a) a tall, central spike with only one peak and smaller spikes on either side b) a tall, central spike with two peaks and smaller spikes on the left c) a tall spike with only one peak and smaller spikes to the left d) a small, central spike and taller spikes on either side

Answer 44

A- a tall, central spike with only one peak and smaller spikes on either side

Question 45

With the IOLMaster, the ideal signal-to-noise ratio is: a) 0 or less b) 0.5 c) 1.5 d) 2.0 or more

Answer 45

D- 2.0 or more