COA (Non multiple choice) Flashcards
Why is it important to specifically ask a patient about the medications they are taking?
History Taking 5%
Because certain medications may affect the eyes and can they can also clue you into what medical conditions they have and did not mention.
Name the eight components of the ophthalmic history
History Taking 5%
1) Chief complaint
2) History of present illness
3) Past ocular history
4) Medications (ocular and systemic)
5) General medical & surgical history
6) Drug allergies
7) Social history
8) Family history
What is the proper response to a patient’s request from the ophthalmic technician for medical advice or a diagnosis?
History Taking 5%
Refer the patient to the ophthalmologist
What is the term used for the main reason for the patient’s visit?
History Taking 5%
Chief complaint
What elements are documented in social history taking?
History Taking 5%
Smoking, alcohol, drug use, occupation, and hobbies
Prior use of topical ocular pharmaceutical agents that have failed is documented in what part of the history?
History Taking 5%
Past ocular history
Pertinent family history of a patient should include which relatives?
History Taking 5%
Parents, grandparents, and genetic siblings
A patient describing an experience of getting hives after taking sulfa drugs is providing information that should be documented in what section of the history?
History Taking 5%
Drug allergies
How many components of the HPI must be present to be able to bill a level 4 E/M code?
This changed in 2021, but the test has not been updated since then!
History Taking 5%
4 (location, duration, quality, timing, severity, context, aggravating, or relieving factors)
This program determins Medicare payment adjustments based on performance of certain measures.
History Taking 5%
MIPS (Merit-based Incentive Payment System)
What is the name of the test used for detecting a relative afferent pupillary defect?
Pupil Assessment 3%
Swinging flashlight test
What is the term for the spasmodic, rhythmic dilating, and contracting pupillary movements during pupil function testing?
Pupil Assessment 3%
Hippus
Which muscle of the iris causes constriction in bright light?
Pupil Assessment 3%
Sphincter
What is the medical term for pupil dilation?
Pupil Assessment 3%
Mydriasis
What is the term used when there is a difference in pupil size?
Pupil Assessment 3%
Anisocoria
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?
Pupil Assessment 3%
Consensual pupillary reaction
When cleaning the goniolens, what is used to rinse off the gel?
Equipment Maintenance and Repair 2%
Warm running water
Be sure to never submerge a goinolens (or any lens) in water/liquid.
Calibration of the applanation tonometer should be checked at least how often?
Equipment Maintenance and Repair 2%
Two months (or sooner with regular use)
When replacing a light bulb why is it important to not touch it?
Equipment Maintenance and Repair 2%
Oil from fingers can diminish its effectiveness and life.
The process of eliminating or reducing harmful microorganisms from objects and surfaces is called what?
Equipment Maintenance and Repair 2%
Disinfection
Sterilization is the process of killing all microorganisms
How should the removable glass slides inside the American Optical acuity projector be cleaned?
Equipment Maintenance and Repair 2%
Wipe with clean, soft, lint-free towel/cloth or lens tissue
Never use tissue or other cloths as they can scratch the slides.
If dust accumulates on the mirror of the slit lamp, the technician may clean it by using what cleaning methods?
Equipment Maintenance and Repair 2%
A lint-free cloth, lens brush, or canned air.
Who should repair and maintain equipment such as a laser?
Equipment Maintenance and Repair 2%
A qualified service technician
Which accessories are used to check the calibration of an ophthalmometer/keratometer?
Equipment Maintenance and Repair 2%
Three test spheres made of steel, also called “Lensco Meter”
What should be used to clean the accessible lenses of a phoropter?
Equipment Maintenance and Repair 2%
Photographic lens cleaner and lens tissue or a lens cloth
What size letters (optotypes) are typically used to calibrate visual acuity projectors?
Equipment Maintenance and Repair 2%
20/200
When recording prism in a spectacle Rx, what does the abbreviation BO stand for?
Lensometry 3%
Base out
B=Base; O=Out; I=In; U=Up; D=Down
BO, BI, BU, BD
What is the instrument used to neutralize lenses?
Lensometry 3%
Lensometer (Lensmeter)
What is determined by focusing the thin lines in a manual lensometer?
Lensometry 3%
The sphere of the spectacle Rx is determined by the thin lines.
Sometimes this can also be referred to as a “single line”.
What is the first step in performing lensometry?
Lensometry 3%
Focus the eyepiece
THIS IS ALWAYS THE FIRST STEP WHEN ASKED ABOUT EQUIPMENT!!!
Look at the reticle (bullseye) when focusing!
Typically, if you cannot center the thick and thin lines in the lensometer, the lens has what?
Lensometry 3%
Ground-in prism
Most times there is induced prism in progressives, but it is equal OU.
Each black ring seen in the lensometer eyepiece reticle measures how much prism?
Lensometry 3%
1 diopter for each ring
When performing lensometry, what is indicated if both thin and wide lines are in focus at the same time?
Lensometry 3%
The lens is spherical
When reading glasses in a manual lensometer, you go from the skinny lines to the fat lines by turning the power dial towards you, are you reading the glasses in minus or plus cylinder?
Lensometry 3%
Plus
Turning the dial away from you to go from skinny to fat would be minus.
If you find that you are reading the glasses in the incorrect cylinder form, what would you do to get into the correct cylinder form?
Lensometry 3%
Change the axis by 90 degrees
Keratometry is performed with a device called what?
Keratometry 2%
Keratometer or ophthalmometer
What is the technique used to measure the radius of curvature of the anterior corneal surface?
Keratometry 2%
Keratometry
Topography can also be used.
Give three examples in which a keratometry measurement would be useful.
Keratometry 2%
- Contact lens fitting
- Refractive surgery
- Intraocular lens (IOL) calculations
- Keratoconus
- Irregular Astigmatism
The unit of measurement used in keratometry is what?
Keratometry 2%
Diopters
millimeters (mm) can also be used
An unfocused eyepiece can lead to an error reading of approximately how much?
Keratometry 2%
Up to 1 diopter
How many meridians are measured in keratometry?
Keratometry 2%
2 meridians
Always 90 degrees apart or perpendicular!
The average K reading is about how many diopters?
Keratometry 2%
43 to 44 diopters
The keratometer measures how much of the cornea?
Keratometry 2%
The central 3 mm optic zone
True or false: The application and evaluation of a diagnosis lens on the eye is the best way to find a contact lens.
Contact Lenses 2%
True
The diffusion of oxygen through a contact lens material is referred to as the what?
Contact Lenses 2%
DK Value
Name the instrument used to determine the posterior surface radius of curvature of a rigid gas permeable (RGP) contact lens.
Contact Lenses 2%
Radiuscope
Name three reasons to dispense a therapeutic bandage contact lens.
Contact Lenses 2%
- Protect cornea from eyelids and eyelashes
- Promote corneal healing
- Provide comfort
- Stop wound leaks
- Improve vision
- For drug delivery
What two measurements are required to fit a contact lens?
Contact Lenses 2%
Refraction and K-reading (keratometry)
Overwear of contact lenses may result in insufficient oxygen to the cornea, this is called what?
Contact Lenses 2%
Hypoxia
What are Ethics?
Medical Ethics, Legal, & Regulatory Issues 4%
Moral principles and values that govern individual behavior
What must ophthalmic medical assistants abide by?
Medical Ethics, Legal, & Regulatory Issues 4%
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 (providing a diagnosis or deciding on treatment) is considered this and is illegal.
Medical Ethics, Legal, & Regulatory Issues 4%
Practicing medicine without a license
What should an ophthalmic practice have in place to meet legal compliance?
Medical Ethics, Legal, & Regulatory Issues 4%
Policies and procedures, along with a compliance officer.
What is HIPAA?
Medical Ethics, Legal, & Regulatory Issues 4%
Health Insurance Portability and Accountability Act
From 1996
What does HIPAA protect?
Medical Ethics, Legal, & Regulatory Issues 4%
Patient privacy and the dissemination of specific patient information
What is CPT coding?
Medical Ethics, Legal, & Regulatory Issues 4%
The application of numerical designation for medical diagnosis, procedures, and services
Complete the statement: “If it isn’t documented…”
Medical Ethics, Legal, & Regulatory Issues 4%
It didn’t happen
What is ICD-10-CM?
Medical Ethics, Legal, & Regulatory Issues 4%
International Classification of Diseases-10th revision-Clinical Modification
What important process is documented when the physician or physican 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?
Medical Ethics, Legal, & Regulatory Issues 4%
Informed consent
True or False: A patient’s medical record is considered a legal document?
Medical Ethics, Legal, & Regulatory Issues 4%
True
You can be legally held accountable for anything documented under your login, so keep it secure!
All patient should be treated with this, regardless of ethnicity, race, or economic class.
Medical Ethics, Legal, & Regulatory Issues 4%
Dignity and respect
Four common causes of eye infections are what?
Microbiology 3%
Bacterial, viral, fungal, and protozoa
Technicians may assist with collecting these, which are are used to identify what infectious organism is growing and allow the doctor to treat effectively.
Microbiology 3%
Cultures
Contact lens wearers are more susceptible in contracting what parasitic organism, especially when swimming in fresh water (lakes/ponds) or using homemade contact lens solution?
Microbiology 3%
Acanthamoeba
Universal precautions are mandated by OSHA but were develeoped by the what governement department?
Microbiology 3%
U.S. Centers for Disease Control (CDC)
Washing hands between patients and wearing gloves are examples of this?
Microbiology 3%
Universal Precaution
A fungal infection is most commonly transmitted by what type of material?
Microbiology 3%
Organic material (plant material such as a stick, leaf, or thorn)
Systemic absorption and drainage of eye drops can be prevented by doing this?
Pharmacology 3%
Punctal occlusion
What medications are used as topical anesthetics?
Pharmacology 3%
Proparacaine or tetracaine
What is the color of the bottle cap of a prostaglandin?
Pharmacology 3%
Teal
What are the classifications of the three large groups of anti-infective agents?
Pharmacology 3%
Antibiotics, antivirals, & antifungals
What sysmptom sets an allergic reaction apart from a bacterial or viral infection?
Pharmacology 3%
Itching
This class of drugs induce contraction (contriction) of the iris sphincter.
Pharmacology 3%
Miotic
A cycloplegic drug will blur vision at near due to temporary loss of this.
Pharmacology 3%
Accomodation
What are the three types of ophthalmic preparations used to deliver medication to the eye?
Pharmacology 3%
Solutions, suspensions, ointments
What is the main disadvantage of using an ophthalmic solution vs and ointment?
Pharmacology 3%
The duration of contact with the eye is short, therefore it requires frequent instillation.
What is the main disadvantage of using an ophthalmic ointment?
Pharmacology 3%
The ointment reduces vision by creating a greasy film over the surface of the cornea, so it is best used at bedtime.
How do ophthalmic preparations absorb directly into the eye?
Pharmacology 3%
Penetration of the cornea
What is benzalkonium chloride?
Pharmacology 3%
A preservative commonly used in ophthalmic preparations.
Abbraviated as BAK and is highly susceptible to allergic reactions.
Name the organism most frequently found in ophthalmic preparations.
Pharmacology 3%
Pseudomonas Aeruginosa
Eye drops penetrate the eye directly through the _____ and into the anterior chamber
Pharmacology 3%
Cornea
How should drops be properly instilled into a patient’s eyes?
Pharmacology 3%
Into the lower cul de sac (lower fornix)
Never drop driectly onto the cornea, it can cause a minor abrasion.
Drugs taken orally, by injection, or intravenously are considered these types of medications.
Pharmacology 3%
Systemic Medications
What drug classification is contraindicated in patients with obstructive pulmonary disease or cardiovascular disease?
Pharmacology 3%
Beta blockers
What can be side effects of long-term steroid drop use?
Pharmacology 3%
Rise in intraocular pressure (IOP), cataracts, decreased wound healing, and decreased resistance to infection
What is the condition in which the eyes shift involuntary in a rhythmic beating motion?
Ocular Motility 4%
Nystagmus
Nystagmus indicates a problem with the this organ and not the extraocular muscles.
Ocular Motility 4%
Brain
What is stereopsis?
Ocular Motility 4%
Three-dimensional visual perception based on images being received by each eye.
Someone with one functional eye can have depth perception, not stereo VA
What is the easiest objective test used to detect misalignments?
Ocular Motility 4%
Hirschberg Light Reflex Test
What are the movements of both eyes from one gaze position to another?
Ocular Motility 4%
Versions
What is the movement of one eye called?
Ocular Motility 4%
Duction
When performing EOMs, the muscles are checked in how many different positions?
Ocular Motility 4%
Six cardinal positions
There are six muscles in each eye!
The movement of the eye outward toward the temple is called what?
Ocular Motility 4%
Abduction
When performing the cover-uncover test, we are checking for what type of deviation?
Ocular Motility 4%
Tropia
What is the term for a latent or hidden deviation?
Ocular Motility 4%
Phoria
An outward deviation of the eye(s) is called this?
Ocular Motility 4%
Exodeviation
An inward deviation of the eye(s) is called this?
Ocular Motility 4%
Esodeviation
What is the mnemonic device used to remember the innervation of the muscles?
Ocular Motility 4%
SO4LR6 everything else is three.
If the muscle isn’t the SO or the LR it’s innervated by the 3rd nerve!
Surgical instruments most resistant to corrosion are made of what?
Surgical Assisting 4%
Stainless Steel
What is the term for the range of procedures used in medical environments to prevent the spread of infectious microbes?
Surgical Assisting 4%
Aseptic technique
True or False: When creating a sterile field the drapes are usually impermeable to moisture?
Surgical Assisting 4%
True, this is to prevent contamination.
What is the most common local anesthetic injected for minor/in office procedures?
Surgical Assisting 4%
Lidocaine
When PRK is being performed, time remaining in the procedure should be announced in increments of how many seconds?
Surgical Assisting 4%
10 seconds
Name the organism that is most destructive to the eye because is it drug resistent and can lead to death.
Surgical Assisting 4%
Pseudomonas Aeruginosa
What procedure using an Argon Laser is used to destroy areas of ischemic retina?
Surgical Assisting 4%
Panretinal photocoagulation or panretinal laser
This area of the eye is approximately 4 mm in width and used to enter the posterior segment of the eye for intravitreal injections or retina surgery.
Surgical Assisting 4%
Pars Plana
Name the procedure that requires probes, a syringe, lacrimal needle (cannula), saline, and punctum dilators to be performed.
Surgical Assisting 4%
Lacrimal probing and irrigation
Typically a minor procedure has this many days of a post-op period.
Surgical Assisting 4%
10 days
What injection infiltrates the soft tissue of the globe to anesthetize, rather than the muscle cone itself?
Surgical Assisting 4%
Peribulbar injection
When injected into the cone it is a retrobulbar injection.
When evaluating a patient for LASIK, this measurment is vital to ensure there is enough stromal tissue to perform the surgery.
Surgical Assisting 4%
Pachymetry or corneal thickness (CCT)
What is the ideal position for a patient who feels faint?
Ophthalmic Patient Services and Education 14%
Head lower than the heart
It is best to lay these patients back in the exam chair.
Where do you check pulse on an adult patient to assess the need for CPR/BLS?
Ophthalmic Patient Services and Education 14%
Neck (carotid pulse)
What instructions would be given over the phone to a patient who had splashed a chemical into the eyes
Ophthalmic Patient Services and Education 14%
Flush the eyes with water for 15-20 minutes and then report to the ophthalmologist’s office or ED.
What type of patch should not be used on a patient with a lacerated globe?
Ophthalmic Patient Services and Education 14%
A pressure patch
When long wait times occur in the office what is the ophthalmic medical assistant’s responsibility?
Ophthalmic Patient Services and Education 14%
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?
Ophthalmic Patient Services and Education 14%
A papoose board
A patient calls and says they had an episode of sudden painless vision loss (completely black) in one eye.
What emergency are they likely experiencing?
Ophthalmic Patient Services and Education 14%
Ischemic Optic Neuropathy
They need to be seen today!
A patient calls in and says that they are experiencing redness and irritation around their lash line. What chronic inflammation of the eye lid margin are they likely experiencing?
Ophthalmic Patient Services and Education 14%
Blepharitis
They can be given instructions over the phone and seen within 24 hours.
Why do protocols for pressure patching or shields require that the adhesive tape be firmly applied starting from the cheek up to the forehead?
Ophthalmic Patient Services and Education 14%
So that the cheek can be raised helping keep the eye closed.
No patch is better than a poorly taped pressure patch!
What is the minimum thickness of safety lenses?
Ophthalmic Patient Services and Education 14%
3.0 mm