COA Flashcards -
How are systemic medications administered?
Orally, injection (subcutaneously or intramuscularly) or intravenously
How should drops be properly instilled into a patient’s eye?
Into the lower cul de sac (lower fornix)
What does the term idiosyncrasy refer to with ophthalmic drugs?
A bizarre, peculiar reaction to a drug that is not commonly seen, such as; tremors, excitability or even collapse
What is the name of the instrument used to neutralize lenses?
Lensometer (Lensmeter)
When recording a prism in a spectacle prescription, what does the abbreviation BI stand for?
Base In
What is determined by focusing the thin lines in a manual lensometer?
The sphere of the spectacle prescription
What is the first step in performing lensometry?
Focus the eyepiece
When PRK is bring performed, time remaining in the procedure should be announced in increments of ______.
10 Seconds
Name the organism that is most destructive to the eye
Pseudomonas Aeruginosa
What procedure using an Argon Laser is thought to destroy areas of ischemic retina?
Panretinal photocoagulation or panretinal laser
What type of intraocular injection is made at the Pars Plana site with a needle and syringe of medication?
Intravitreal Injection
What are the parallel movements of the eyes from one gaze position to another
Versions
What is the movement of one eye called?
Duction
Versions and ductions are tested by using ______ to test the six pairs of ______ muscles.
Six Cardinal positions, yoke
The movement of the eye outward toward the temple is called ______
Abduction
What is the technique used to measure the radius of curvature of the anterior corneal surface?
A-scan Keratometry Length Measurements
Keratometry is performed with a device called a ______
Keratometer or ophthalmometer
Give three examples in which a Keratometry measurement would be useful
Contact lens fitting, refractive surgery, intraocular lens calculations, keratoconus
Keratometry is measured in ______
Diopters
Measuring intraocular pressure is also called
Tonometry
The higher the intraocular pressure of the eye, the ______ the eye
Harder
Applanation tonometry displaces less than ______ of aqueous.
0.5 microliters
When recording intraocular pressure, the reading of the Goldmann applanation tonometer scale should be multiplied by ______.
10
Because there are no rods or cones in the optic nerve head a ______ blind spot is created in the normal visual field.
Physiologic
A defect in the patient’s superior temporal retina, will affect the patient’s ______ field of vision
Inferior nasal
The two basic methods employed to map the field of vision are ______ and ______ perimetry
Kinetic, static
A localized area of reduced sensitivity in a visual field that is surrounded by an area of greater sensitivity is termed a ______.
Scotoma
An unfocused eyepiece can lead to an error of ______
1 diopter in the K reading
How many meridians are measured in keratometry?
2 meridians (usually 90 degrees apart)
The average K reading is ______
43-44 diopters
Keratometry measures the ______ of the anterior curvature of the cornea
Central 3.3 mm
The diffusion of oxygen through a contact lens material is referred to as ______.
DK value
True or False: The application and evaluation of a diagnostic lens on the eye is the best way to fit a contact lens
True
Name the instrument used to determine the posterior surface radius of curvature of a rigid contact lens
Radiuscope and/or Contacto Guage
Increased thirst, excessive urine production, increased hunger and weight loss are characteristics of which endocrine disease?
Diabetes Insipidus
What finding can occur 6 to 8 hours after a metallic foreign body enters the cornea?
Rust ring
Why are alkali burns more serious than acid burns on the cornea?
Alkali burns penetrate deeper
Variability in the functions of levator and extraocular muscles is characteristic of which systemic disease?
Myasthenia gravis
What is the name of the muscle membrane covering the interior sclera?
(Bulbar) Conjunctiva
What type of glaucoma constitutes an ocular emergency?
Acute angle-closure glaucoma
Protocols for pressure patching or shields require that adhesive tape must be applied from the ______ to the ______.
Bridge of the nose, ear lobe
What is the minimum thickness of safety lenses?
3.0 mm
What is the name of the important screening process used in emergencies to determine the patient’s ocular needs?
Triage
What is a hemorrhage confined to the anterior chamber termed?
Hyphema
______ drugs induce contractions of the iris sphincter
Miotic
Name the three types of ophthalmic preparations placed directly in the eye
Solutions, suspensions and ointments
What is the main disadvantage of using an ophthalmic solution?
The duration of contact with the eye is short, therefore it requires frequent installation
What is the disadvantage of using an ophthalmic ointment?
The ointment reduces vision by creating a greasy film over the surface of the cornea, and it is best used at bedtime.
Gross evaluation of the patient’s peripheral vision can be accomplished with ______ visual field testing.
Confrontation
The ______ visual field test compares the boundaries of the patient’s visual field with that of the examiner.
Confrontation
The amsler grid test determines the presence and location of defects in the ______ portion of the visual field.
central
During amsler grid testing the patient should be instructed to view the grid through his or her ______ correction.
near
Checking the calibration of the Goldmann applanation tonometer is performed with a ______.
Balance or calibration rod
The Goldmann applanation tonometer prism is best cleaned between patients with ______.
Hydrogen peroxide soaks or 1:10 bleach solution
Which dye solution is used when performing Goldmann applanation?
Fluorescein dye
What is the diameter of the corneal area properly applanated by a Goldmann tonometer?
3.06 mm
______ photography documents the posterior segment of the eye.
Fundus
______ devices create three dimensional digital images of the optic nerve and retina
Tomography
Three of the most common tomographic image devices are ______, ______ and _______.
Optical Coherence Tomography (OCT), Heidelberg Retinal Tomography (HRT) and GDx scanner laser polorimeter
The data provided by tomographic devices are useful in evaluating progressive ______ and _______ damage.
Optic nerve and retinal nerve fiber layer
Ophthalmic photography serves to ______ and _______ ophthalmic conditions.
document and diagnose
Which area of the cornea is the thickest?
The stroma
What type of patches should not be used on a patient with a lacerated globe?
a pressure patch
When long waiting times occur in the office what is the ophthalmic medical assistant’s responsibility?
To communicate with patients and keep them informed in a sensitive manner
What can be used to immobilize an infant for an ophthalmic examination?
A papoose board
______ is any irritation or inflammation of the conjunctiva
Conjunctivitis
In fundus photography, when the camera is too far from the eye, a ______ ______ will form around the image.
Blue-Grey Halo
“Diagnostic” or “standardized” ______ are performed for quantitative evaluation of a tissue’s structure, reflectivity and sound absorption
A-scans
______ photography is used to photograph the anterior segment of the eye.
Slit-lamp
Specular photomicrography is a method of evaluating the ______ surface of the cornea
endothelial
The visual acuity notation 20/200 indicates the patient could see the 200 optotype at ______ feet
20
If the patient perceives light and can indicate the source direction, the vision is recorded as ______
Light perception with projection (LPw/P)
The distance of 20 feet is used in visual acuity assessment because it approximates ______
Optical infinity
The visual acuity value of 20/40 is expressed as the metric equivalent ______
6/12
The pinhole acuity test is used to confirm whether ______ _______ is the cause of a decrease in visual acuity.
Refractive error
What is the normal range of ocular pressure?
13-20 mm Hg
Which method of tonometry is described as the measurement of the amount of pressure needed to flatten the cornea by a standard amount?
Applanation tonometry
What measurement error is produced when the fluorescein rings are too narrow during applanation tonometry?
Falsely low reading
What measurement error is introduced when the patient holding his or hear breath and/or wearing a collar that is buttoned too tightly, is applanated?
Falsely high reading
Measuring intraocular pressure is also called ______
Tonometry
______ ______ is a red dye useful in evaluating the integrity of the corneal epithelium.
Rose bengal
The ______ ______ test uses rainbow colored cups that must be arranged in order of similar hues
Farnsworth-Munsell 100-hue
The ______ _______ ______ color vision test consists of a series of plates with gray background and colored circles, crosses and triangles.
Hardy-Rand-Ritter
Name the tear deficiency test which uses strips of filter paper inserted into the lower fornix
Schirmer’s test
While assessing visual acuity, the assistant notes the patient consistently misses the optotypes on the temporal side of the chart, indicating a possible ______
Visual field defect
In visual acuity assessment, the brightness acuity tester (BAT) is used to evaluate _______ when there are opacities in the ocular media.
Glare
In patients with nystagmus, visual acuity often improves dramatically when the vision is assessed ______
Binocularly
At what distance are adult near visual acuity charts designed to be read?
14-16 inches from the eye
Normal visual acuity in a two month old infant may be estimated by______
fixation (follow at 3 months)
What is the name of the instrument used to measure extension of the anterior surface of the cornea beyond the lateral orbital rim?
Exophthalmeter
Name at least one example of a glare testing device
RVA, BAT (brightness acuity test) or Eye Con
Name the two measurements required to determine the dioptic power of the intraocular lens
A-scan (axial length of the eye) and Keratometry (corneal curvature)
When performing A-scan biometry, a 1mm error in axial length may result in a ______ diopters calculated IOL power error
Three
What is the term for the amount of time it takes for dry spots to form on the cornea when the eye is in a staring position
BUT (break-up time)
How is anterior chamber angle depth estimated using a slit lamp?
A thin light beam is placed at the limbus at an angle of approximately 60 degrees and the distance between the posterior limit of the corneal beam and the anterior limit of the iris beam is compared with the thickness of the optical section of the cornea
Which two ocular structures can touch if the anterior chamber is flat?
iris and cornea
When determining anterior chamber depth using a flashlight test, a shadow on the nasal iris indicates ______.
Abnormally shallow anterior chamber (narrow angles)
Ophthalmologists often estimate anterior chamber depth by measuring the angle between the ______ and ______
Anterior surface of the iris, posterior surface of the cornea
Which color vision test consists of pseudo isochromatic plates that determine red-green color anomalies and deficiencies?
Ishihara
Which color defects may ne distinguished by the Ishihara test?
red and green
How long are the Schirmer strips left in place during a tear test?
5 minutes
A-scan biometry measures the distance between ______
Internal ocular surfaces
The chief use of A-scan biometric is to measure the ______ ______ of the eye
Axial length
Jaeger notation, the point system, and the Snellen M Unit are units of measure used in recording ______ visual acuity
Near
In the visual assessment the acronym PAM represents the principal testing device known as the _______
potential acuity meter
The ability of human vision to discern shapes by their relative lightness and darkness is termed ______
contrast sensitivity
During visual acuity assessment the patient is able to clearly read the 20/20 line but misses one letter, the acuity is recorded as _______
20/20-1
Why is it important to observe the patient during visual acuity testing?
To ensure proper occlusion
What drug classification is contraindicated in patient’s with obstructive pulmonary disease or cardiovascular disease?
beta blockers
What symptoms are involved with an allergic reaction to a topically administered drug?
Edema of lids, redness, scaliness, vesicle formation, and oozing can occur with a reaction to an ophthalmic preparation
What are some of the side effects of long-term steroid drop use?
Rise in intraocular pressure, cataracts, decreased wound healing, and decreased resistance to infection
The absence of a lens in an eye is called ______
aphakia
The presence of an intraocular lens (IOL) is called ______
pseudophakia
______ is a chronic inflammation of the eyelid margins
Blepharitis
Name the retinal receptors that function best in dim lighting, number about 125 million, and are found in the periphery of the retina
Rods
Name the retinal receptors that are responsible for color vision, number about 6 million, and are found in the macula
Cones
What is the term used when there is a difference in pupil size?
Anisocoria
What is pupillometry?
The measurement of pupillary diameters
What is the name for the reflexive reaction that occurs when light is directed into one pupil and the pupil of the opposite eye simultaneously reacts?
Consensual pupillary reaction
What is the term for the range of procedures used in medical environments to prevent the spread of infectious microbes?
Aseptic technique
Surgical instruments most resistant to corrosion are made of ______ _______
stainless steel
When creating a sterile field, the drapes are usually _______ to moisture to prevent contamination
Impermeable
What is the most popular injected anesthetic for minor procedures?
Lidocaine
When performing cover-uncover test, the eye under the cover moves when uncovered, it is a _______, which is a _______ deviation.
Phoria, latent
Drainage of topical drops from the eye and their systemic absorption can be prevented by _______ ______.
punctal occlusion
What medications are used as topical anesthestics?
proparacaine and tetracaine
What is the color of bottle caps of prostaglandins?
teal
What are the classifications of the three large groups of anti-infective agents?
Antibiotics, antivirals, and antifungals
True allergic reaction can involve what symptoms?
itching, rash, difficulty breathing and weak or rapid pulse
In terms of lens thickness, the greater the refractive index, the ______ the lens
thinner
The distance from the center of the pupil of one eye to the center of the pupil of the other eye is termed _______
interpupillary distance
What is measured to obtain a monocular measurement of the IPD (interpupillary distance)
the distance from the bridge of the nose to the center of the pupil
Explain how to transpose a spherocylinder lens from plus to minus cylinder form, or from minus to plus cylinder
Algebraically add the sphere and cylinder powers, retain the cylinder power but change the cylinder sign, and change the cylinder axis by 90 degrees.
Transpose: +2.00 -2.50 x90
-0.50 +2.50 x 180
Which instrument measures the radius of curvature, or base curve, of a spectacle lens surface in diopters?
Geneva lens clock or measure
What is the spherical equivalent of -2.00 +3.00 x 90
-0.50 sphere
The trifocal portion of a +2.00 reading add will be ______
+1.00
What is the name of the test to determine the correct myopic correction using red/green filter on the projector?
Duochrome test
What is another reference or starting point for refracting a patient who has a poor retinoscopy reflex?
keratometry
What normally determines the strength of an add power for near correction?
the age of the patient
What type of refractometry is indicated for children with accommodative esotropia or patients who have latent hyperopia?
Cycloplegic refractometry
What is the distance from the back surface of a lens to the front surface of the eye called?
vertex distance
Define refractometry
the measurement of the refractive error of an eye
What is the name of the instrument that houses various lenses to determine the refractive error of an eye?
phoropter
What is an important factor when preparing a patient for refraction?
the refractionist must explain to the patient to choose the lens that provides the clearest vision
What is a common mistake made by a refractionist?
moving or flipping the lenses too quickly for the patient
What are three appropriate starting points for refracting a patient?
retinoscopy, autorefractometry, or patient’s current spectacle prescription
In what order should refinement of a refraction be performed?
sphere, axis, then power of cylinder
What accessory phoropter lens is utilized to refine cylinder axis and power?
Jackson cross cylinder
Name the 2 methods of refractometry
objective and subjective
In refractometry, the ______ method requires the patient to give answers to the examiner
subjective
When is the spherical equivalent best used in a spectacle prescription?
If a patient is an adult who has never worn glasses and requires a large astigmatic correction
Computer assisted corneal topography is instrumental in early diagnosis of _______
keratoconus
Corneal topography uses ______ colors to denote steeper areas of the cornea and ______ colors to denote the flatter areas of the cornea.
Warm (red, orange)
Cool (blue)
Today’s computer assisted corneal topography systems are based on data obtained from a reflected ______ ______ image.
Placido disc
______ does not appear on magnetic resonance imaging (MRI)
bone
Conjunctivitis may be ______, ______ or ______.
allergic, viral or bacterial
Sudden painless vision loss, which may continue to deteriorate over a few days, and may not recover is known as ______ ______ _______.
Ischemic optic neuropathy
Forward displacement of the eye in its bony socket causing the eye to bulge forward is termed _____
proptosis/exophthalmus
The cornea provides approximately ______ of the refractive power of the eye.
2/3
If dust accumulates on the mirror of the slit lamp, the technician may clean it by using what cleaning methods?
a lint-free cloth, a lens brush, or a blast of air
Who should repair and maintain equipment such as a laser?
a qualified service technician
A pupil diameter of less than ______ can produce a contraction of the visual field
2-2.5 mm
Normal peripheral limits of the visual field are ______ degrees nasally, ______ degrees superiorly, ______ degrees inferiorly, and ______ degrees temporally.
60, 60, 70, 90
In the grayscale printout of an automated perimeter the lighter area corresponds to ______ levels of illumination being seen by the patient.
Dim
When performing a proper site identification, what two things must be identified?
Correct patient
Correct site
The YAG laser is a ______ type of laser and uses quick pulses of energy.
cold
What is the method of choice in sterilizing intraocular implants?
ethylene oxide
Name the two main classified sections of most ophthalmic surgical procedures
Intraocular
Extraocular
The most common method of sterilizing instruments is ______
steam sterilization/autoclave
Name the two types of anatomical scrubs
Time
counted
A safety precaution when lasers are being used is wearing appropriate ______ ______.
eye protection
Name the four shapes of needle points
Taper point
Cutting
Reverse cutting
Spatula
Blockage of the central retinal artery by an embolus, which stops blood flow and causes acute loss of vision and a cherry red spot in the retina, is called ______
Central Retinal Artery Occlusion (CRAO)
What is the visual symptom, and it’s cause, often experienced by diabetic patient’s during episodes of increased blood sugar?
Blurred vision caused by temporary myopia or hyperopia due changes in the refractive index (R.I.) of the crystalline lens
Myopic shift = when the RI increases
Hyperopic shift = when the RI decreases
What instructions would be given over the phone to a patient who had splashed a chemical into the eyes?
Immediately flush the eyes with water for 15-20 minutes and then report to the ER or ophthalmologists office
The most common type of glaucoma is ______
Primary Open Angle Glaucoma (POAG)
Aqueous drains out of the eye through this net-like structure
Trabecular meshwork
Calibration of the applanation tonometer should be checked approximately every ______ months
2
or sooner with regular use
When cleaning a goniolens, what is used to rinse off the methycellulose?
Warm running water
When replacing a light bulb ______ can diminish its effectiveness and life
Oil from fingers
Diagnostic lenses that contact the eye can be sterilized using ______
Ethylene oxide gas
How should the removable glass slides inside the American Optical acuity projector be cleaned?
Wipe with clean, soft lint-free towel or photographic lens paper
What does HIPAA protect?
the dissemination of specific patient information
What is coding?
the application of numerical designations for medical diagnosis, procedures and services
What is the assessment of the use of services by a practice institution, clinic or individual physician?
Utilization review
Complete the statement: “if it isn’t documented, ______”
It didn’t happen
Name three reasons to dispense a therapeutic bandage contact lens
To protect cornea from eyelids and eyelashes
to promote corneal healing
to provide comfort
to stop wound leaks
to improve vision
for drug delivery
Name two measurements required to fit a contact lens
refraction
k-reading (keratometry)
Over wear of contact lenses may result in insufficient oxygen to the cornea called ______
Hypoxia ophthalmia
What are ethics?
moral principles and values that govern individual behavior
What must ophthalmic medical assistants abide by?
The laws of the state in which their employer practices and under the services of a licensed ophthalmologist.
Attempting to work independently of an ophthalmologist is considered ______
Practicing medicine without a license
What should an ophthalmic practice have in place to meet legal compliance?
A compliance officer, policies and procedures
What is HIPAA?
Health Insurance portability and accountability act
Which ocular condition is commonly associated with Sjogren’s syndrome?
Dry eyes (Dry mouth is another finding)
Which systemic disease can cause temporary fluctuations in refractive errors?
Diabetes mellitus
Name the virus that causes dendritic pattern of keratosis
Herpes simplex
What is the ideal position for a patient who feels faint
Head lower than heart
Where do you check for life on an adult CPR patient?
neck (carotid pulse)
Which accessories are used to check the calibration of an ophthalmometer/keratometer?
Three test balls made of steel, also called “Lensco Meter”
Name the nine components of the ophthalmic history
Chief complaint
present illness
past ocular history
ocular medications
general medical and surgical history
systemic medications
allergies
social history
family history
Why is it important to specifically ask a patient about the medications they are taking?
because certain medications may affect the eyes
What is the proper response to a patient’s request for the ophthalmic technician for medical advice or a diagnosis?
Refer the patient to the ophthalmologist
What is the term used for the reason of the patient’s visit?
Chief complaint
What elements are important in social history taking?
Smoking
alcohol
drug use
Prior use of topical pharmaceutical agencies is part of a patient’s ______
past ocular history
Pertinent family history of a patient should include which relatives?
parents
grandparents
genetic siblings
A patient describing an experience of getting hives after taking sulfa drugs is providing information about ______
An allergic reaction
What is the term for the spasmodic, rhythmic dilating and contracting pupillary movements during pupil function testing?
Hippus
What is the name of the test used for detecting a relative afferent pupillary defect?
Swinging flashlight test
Which muscle of the iris constricts in bright light?
Sphincter
What is pupil dilation termed?
Mydriasis
