COA Flashcards - ATP
The most common method of sterilizing instruments is ______.
Steam Sterilization
Name the two types of anatomical scrubs
Timed and counted
A safety precaution when lasers are being used is wearing appropriate ______ ______.
Eye Protection
Name the four shapes of needle points
Taper, cutting, reverse cutting and spatula
When performing a proper site identification, what two things must be identified?
Correct patient and correct side
The YAG laser is a ______ type of laser and uses pulses of energy.
Cold
What is the method of choice in sterilizing intraocular lens implants?
Ethylene Oxide
Name the two main classified sections of most ophthalmic surgical procedures.
Intraocular and Extraocular
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
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 _______.
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
During visual field testing the decibel is the unit utilized to indicate the ______ of the test object.
Brightness
A visual field defect occupying the right or left half of the visual field is termed a ________.
Hemianopia
A presbyopic patient’s near add should be used in testing the central _______ degrees of the visual field
Thirty (30)
The presence of ptosis can result in a ______ visual field defect.
Superior
A pupil diameter of less than ______ can produce a contraction of the visual field.
2 to 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
The visual acuity notation 20/200 indicates the patient could see the 200 optotype at ______ feet.
Twenty (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 pinhole acuity test is used to confirm whether a ______ ______ is the cause of a decrease in visual acuity.
Refractive error
Jaeger notation, the point system and the Snellen M Unit are units of measure used in recording ______ visual acuity.
Near
In 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
While assessing visual acuity the assistant notes the patient consistently misses the optotype 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 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
Name the nine components of the ophthalmic history.
Chief complaint, present illness, past ocular history, ocular medications, general medical & surgical history, systemic medications, allergies, social history and 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 from the ophthalmic technician for medical advice or a diagnosis?
Refer the patient to the ophthalmologist
What is the term used for the reason for the patient’s visit?
Chief complaint
What elements are important in social history taking?
Smoking, alcohol and drug use
Prior use of topical ocular pharmaceutical agents is part of a patient’s ______.
Past ocular history
Pertinent family history of a patient should include which relatives?
Parents, grandparents, and 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 specific, 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
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
What is the distance from the back surface of a lens to the front surface of the eye called?
Vertex distance
In what order should refinement of a refraction be performed?
Sphere, axis, then power of the cylinder
What accessory phoropter lens is utilized to refine cylinder axis and power?
Jackson Cross
Name the two 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 Rx?
If a patient is an adult who has never worn glasses and requires a large astigmatic correction
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 the refractionist?
Moving or flipping the lenses too quickly for the patient
What are three appropriate starting points for refracting a patient?
Retinoscopy, autorefractometry, or a patient’s current spectacle Rx
______ 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 ______ damage.
OCT - optical coherence tomography, HRT - heidelberg retinal tomography, 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
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 evaluations of a tissue’s structure, reflectivity and sound absorption.
A-scan
______ 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 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 eye lid margin.
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
Conjunctivitis may be ______, ______, or ______.
Allergic, viral, 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
Which layer of the cornea is the thickest?
The Stroma
What type of patch should not be used on a patient with a lacerated globe?
A pressure patch
When long waiting time occur in the office what is the ophthalmic medical assistant’s responsibility?
To communicate with the patient and keep them informed in a sensitive manner
What can be used to immobilize an infant for an ophthalmic examination?
A papoose board
______ is an irritation or inflammation of the conjunctiva.
Conjunctivitis
What type of glaucoma constitutes an ocular emergency?
Acute Angle-Closure Glaucoma
Protocols for pressure patching or shields require that the adhesive tape must be applied from the a. ______ to the b. ______.
a. bridge of nose, b. 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 a patient’s ocular needs?
Triage
What is a hemorrhage confined to the anterior chamber termed?
Hyphema
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 termed?
CRAO (Central Retina Artery Occlusion)
What is the visual symptom, and its cause, often experienced by diabetic patients during episodes of increased blood sugar?
Blurred vision caused by temporary myopia or hyperopia due to changes in the refractive index (R.I.) of the crystalline lens (myopic shift = when the R.I. increases; and hyperopic shift = when the R.I. 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 eater for 15-20 minutes and then report to the ER or ophthalmologist’s office
The most common type of glaucoma is ______.
Primary Open Angle Glaucoma (POAG)
Aqueous drains out of the ye through this net-like structure.
Trabecular Meshwork
Increased thirst, excessive urine production, and increased hunger and weight loss are characteristics of which endocrine disease?
Diabetes insipidus
What finding can occur 6-8 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 the levator and extraocular muscle is characteristic in which systemic disease?
Myasthenia gravis
What is the name of the mucous membrane covering the anterior sclera?
Conjunctiva (bulbar)
Name the procedure that uses the following instruments: probes, syringe, lacrimal needle (cannula), and punctum dilator.
Lacrimal probing and irrigation
Name the two common facial nerve blocks?
Van Lint and O’Brien technique
What intraocular injection infiltrates the soft tissue of the globe, rather than the muscle cone itself?
Peribulbar Anesthesia
The most important step in successful LASIK is care and preparation of the ______.
Microkeratome
Which ocular condition is commonly associated with Sjogren’s syndrome?
Dry eyes (dry mouth is another finding in Sjogren’s syndrome)
Which systemic disease can cause temporary fluctuations in refractive errors?
Diabetes mellitus (DM)
Name the virus that causes a dendritic pattern of keratitis
herpes simplex
What is the ideal position for a patient who feels faint?
head lower than heart
Where do you check pulse on an adult CPR patient?
Neck (carotid pulse)
When PRK is being 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 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, if the eye under the cover moves when uncovered, it is a ______, which is a ______ deviation.
Phoria, latent
What is the term for an obvious misalignment of the eye(s)?
Tropia
An outward deviation of the eye(s) is a(n) ______ and an inward deviation of the eye(s) is called a(n) ______.
Exodeviation, esodeviation
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 ______.
Abduction
What is the condition in which the eyes shift involuntarily in a rhythmic beating motion?
Nystagmus
Nystagmus indicates a problem with the ______ and not the _______ _______.
Brain, extraocular muscles
What is stereopsis?
Three-dimensional visual perception
What is the foremost objective test used to detect misalignments?
cover test
To perform the cover test, the patient fixates on a ______ target.
distant
What drug classification is contraindicated in patients 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 use of steroid drops?
Rise in intraocular pressure, cataracts, decreased wound healing, and decreased resistance to infection
How should drops by properly instilled into a patient’s eyes?
Into the lower cul de sac (lower fornix)
How are systemic medications administered?
Orally, injection (subcutaneously or intramuscularly), or intravenously
What does the term idiosyncrasy refer to with ophthalmic drugs?
An idiosyncrasy is a bizarre, peculiar reaction to a drug that is not commonly seen, such as tremors, excitability or even collapse.
Name the five basic requirements for ophthalmic preparations?
Tolerance, tonicity, sterility, stability, and penetration
What is benzalkonium chloride?
A preservative commonly used in ophthalmic preparations
What is the name of the most notorious organism found in ophthalmic preparations?
Pseudomonas Aeruginosa
Eye drops penetrate the eye directly through the ______ and into the anterior chamber
Cornea
______ drugs induce contraction of the iris sphincter.
Miotic
A cycloplegic drug will blur vision at near due to temporary loss of ______.
Accommodation
Name the three types of ophthalmic preparations placed directly in the eye?
Solutions, suspensions, ointments
What is the main disadvantage of using an ophthalmic solution?
The duration of contact with the eye is short, therefore it requires frequent instillation
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 is best used at bedtime.
Drainage of topical drops from the eye and their systemic absorption can be prevented by ______ ______?
Punctal occlusion
What medications are used as topical anesthetics?
Proparacaine or tetracaine
What is the color of the bottle caps of prostaglandins?
Teal
What are the classifications of the three large groups of anti-infective agents?
Antibiotics, antivirals and antifungals
A true allergic reaction can involve what symptoms?
itching, rash, difficulty breathing, weak or rapid pulse
What is the normal range of intraocular 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 a patient, holding his/her breath or wearing a collar that is buttoned too tightly, is applanted?
Falsely high reading
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 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
Measuring intraocular pressure is also called ______.
Tonometry
The higher the intraocular pressure of an eye, the ______ the eye.
Harder
Applanation tonometry displaces less than ______ of aqueous.
0.5 microliters
When recording intraocular pressure, the reading on the Goldmann applanation tonometer scale should be multiplied by ______.
Ten
Checking the calibration of a 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
______ ______ 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 un order of similar hues.
Farnsworth-Munsell 100-hue
The ______ ______ ______ color vision test consists of a series of plates with a gray background and colored circles, crosses, and triangles.
Hardy-Rand-Ritter
What is the name of the instrument used to measure extension of the anterior surface of the cornea beyond the lateral orbital rim?
Exophthalmometer
Name the tear deficiency test which uses strips of filter paper inserted into the lower fornix.
Schirmer’s Test
Name at least one example of a glare testing device.
TVA, BAT (brightness acuity test), or Eye Con
Name the two measurements required to determine the dioptric 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 _______ diopter 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 depth estimated using a slit lamp?
a high thin 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 angle)
Ophthalmologists often estimate anterior chamber depth by measuring the angle between the a. ______ and b. ______.
a. anterior surface of the iris, b. 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 be distinguished by the Ishihara test?
red and green
How long are the Schirmer strips left in place during a tear test?
five minutes
A-scan biometry measures the distance between ______.
internal ocular surfaces
The chief use of A-scan biometry is to measure the ______ ______ of the eye.
axial length
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 a 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 x 90 ~~~ -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
Universal precautions are mandated by OSHA but were developed by the ______.
U.S. Centers for Disease Control
Washing hands between patients is one example of ______ ______.
Universal Precautions
The common causes of eye infections are ______, ______ and _______.
Bacterial, viral and fungal
______ are used to determine the sensitivity of organisms to certain drugs so that effective therapy can be carried out.
Cultures
______ ______ ______ is a major contributing factor in contracting the parasitic organism Acanthamoeba.
Contact lens wear
What is ICD - 9 - CM?
International classification of diseases, ninth revision, clinical modification
What important process is documented when the physician or physician delegate educates the patient on the risks, benefits, and alternatives of a surgical procedure and asks for the patient’s understanding and participation in the decision making process.
Informed consent
As an ophthalmic assistant, you will record your findings in what legal document?
The patient’s medical record
How should an ophthalmic assistant treat all patients?
With dignity and respect
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
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
Name three reasons to dispense a therapeutic bandage contact lens
Top protect cornea from eyelids and eyelashes, to promote corneal healing, to provide comfort, to stop wound leaks, to improve vision, or for drug delivery
Name two measurements required to fit a contact lens
Refraction and K-reading (keratometry)
Overwear of contact lenses may result in insufficient oxygen to the cornea called ______.
Hypoxia Ophthalmia
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 Gauge
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 to 44 diopters
Keratometry measures the ______ of the anterior curvature of the cornea
Central 3.3 mm
What is the technique used to measure the radius of curvature of the anterior corneal surface?
A-scan Keratometry Length Measurement
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, intra ocular lens calculations, keratoconus
Keratometry is measure in ______
Diopters
If you cannot center the thick and thin lines in the lensometer, the lens has ______
Ground-in prism
Each blank ring seen in the lensometer eyepiece reticle measures how much prism?
1 diopter for each ring
When performing lensometry, what is indicated if both thin and wide lines are in focus at the same time?
The lens is spherical
What is the name of the instrument used to neutralize lenses?
Lensometer (Lensmeter)
When recording prism in a spectacle Rx, what does the abbreviation BO stand for?
Base Out
What is determined by focusing the thin lines in a manual lensometer?
The sphere of the spectacle Rx is determined by the thin lines
What is first step in performing lensometry?
Focus the eyepiece
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
Which accessories are used to check the calibration of an ophthalmometer/keratometer?
Three test balls made of steel, also called “Lensco Meter”
What should be used to clean the accessible lenses of a phoropter?
Photographic lens cleaner and lens tissue
What size letters (optotypes) are typically used to calibrate visual acuity projectors?
20/200
Calibration of the applanation tonometer should be checked approximately every ______ months
Two (or sooner with regular use)
When cleaning the 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 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 of the reflexive reaction that occurs when a light is directed into one pupil and the pupil of the opposite eye simultaneously reacts?
Consensual pupillary reaction
