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
What is the name of the important screening process used in emergencies to determine a patient’s ocular needs?
Ophthalmic Patient Services and Education 14%
Triage
A patient’s spouse calls and says that the patient has several pain in one of their eyes, can’t be in bright light, and vomitting.
What emergency are they likely experiencing?
Ophthalmic Patient Services and Education 14%
Acute angle-closure
They need to be seen emergently, come in right now!
What type of exam would be needed on a patient who does not allow anybody to touch them?
Ophthalmic Patient Services and Education 14%
Exam Under Anesthesia (EUA)
Finish this statement: If it’s not recorded…
Ophthalmic Patient Services and Education 14%
Then it didn’t happen (or exist)
The suffix -opia means this.
Ophthalmic Patient Services and Education 14%
Eye
When a patient returns for a glasses check was are 4 things you should check before re-refracting.
Ophthalmic Patient Services and Education 14%
- The optical center
- The glasses Rx
- Seg height for progressives
- The fit of the glasses on the patient’s face
While optical does this at VEI, you should know all of these!
A patient come in and says that they want to have their lids lifted. What is the medical term for that procedure?
Ophthalmic Patient Services and Education 14%
Blepharoplasty
What are the directions the doctor may have you explain to a patient who has a stye, but needs to try therapy before an I/D?
Ophthalmic Patient Services and Education 14%
To do warm compresses and lid scrubs 4x/day, as well as using artifical tears.
The most common type of anesthesia used for cataract surgery is this.
Ophthalmic Patient Services and Education 14%
Retrobulbar injection
Angle-closure glaucoma is most often prevented and treated with this laser.
Ophthalmic Patient Services and Education 14%
Laser peripheral iridotomy (LPI)
How should you respond to a patient who asks you how do the dilation drops work or why you need 2 drops?
Ophthalmic Patient Services and Education 14%
We use 2 different types of medicine because we have 2 muscles in our iris. One of the drops relaxes (paralyzes) one of the muscles, while the other drop stimulates the second muscle forcing it open. This allows for quick dilation so that the patient doesn’t have to wait all day to dilate well enough for the doctor.
Why do we typically advise patients to only use ointment tears or medication at night?
Ophthalmic Patient Services and Education 14%
Because the ointment can cause the vision to be blurry for a long length of time.
A patient is upset because the refraction you did, did not imporve their vision. How should you repond to the patient?
Ophthalmic Patient Services and Education 14%
Assure them that you showed them every option that could make their vision better, and that the doctor would let them know if there was anything going on in the back of the eye.
When performing any test on a patient it is important to do this prior to performing the test.
Ophthalmic Patient Services and Education 14%
Explain to the patient what they can expect and give them clear instructions as to what you will need them to do to get the test done.
Your doctor asks you to explain how to use the Amsler Grid to a patient. What would you tell them?
Ophthalmic Patient Services and Education 14%
This grid should be check at least once a day. Put it in a location that you can easily see it and test yourself (bathroom mirror or refrigerator). Block each eye individually and look at the center dot. Notice if any of the lines are wavy, broken, missing, or different in any way. If any notices are made, please call us right away.
What are some of the insturctions you may have to give a post-op cataract surgery patient?
Ophthalmic Patient Services and Education 14%
- Don’t drop your head below your waist
- How to use their eye drops properly
- Wear your patch at night while sleeping to prevent accidental injury
- No rubbing of the eyes
- No swimming in pools, hot tubs, lakes/ponds, rivers, or oceans
- Call us with any redness, vision changes, swelling, or pain
A patient calls in and c/o of loss of vision. What are 2 important questions you should ask besides which eye?
Ophthalmic Patient Services and Education 14%
Was it sudden or gradual? Was/Is there any pain?
What vision is the definition of “legal blindness”?
Ophthalmic Patient Services and Education 14%
20/200 or worse best corrected with both eyes.
Which ocular condition is commonly associated with Sjogren’s syndrome?
General Medical Knowledge 14%
Dry eyes
Dry mouth is another finding in Sjogren’s syndrome
Which systemic disease can cause temporary fluctuations in refractive errors?
General Medical Knowledge 14%
Diabetes mellitus (DM)
Name the virus that causes a dendritic pattern of keratitis
General Medical Knowledge 14%
Herpes simplex
Increased thirst, excessive urine production and increased hunger and weight loss are characteristics of which endocrine disease?
General Medical Knowledge 14%
Diabetes insipidus
What finding can occur 6-8 hours after a metallic foreign body enters the cornea?
General Medical Knowledge 14%
Rust ring
Why are alkalil burns more serious than acid burns on the cornea?
General Medical Knowledge 14%
Alkali burns penetrate deeper
Variability in the functions of levator and extraocular muscle is characteristic in which systemic disease?
General Medical Knowledge 14%
Myathenia gravis
What is the name of the mucous membrane covering the anterior sclera?
General Medical Knowledge 14%
Conjunctiva (bulbar)
Palpebral conjunctiva is on the inside of the eyelids.
Blockage of a central retinal blood vessle by an embolus, which stops blood flow to the eye, causing acute loss of vision and a cherry red spot in the retina, is called what?
General Medical Knowledge 14%
CRAO (Central Retina Artery Occlusion)
Arteries bring blood from the heart to the eye, veins take blood back.
What is the visual symptom, and its cause, often experienced by diabetic patients during episodes of increased blood sugar?
General Medical Knowledge 14%
Blurred vision caused by temporary changes in the refractive index (R.I.) of the crystalline lens.
(myopic shift is when the R.I. increases; and hyperopic shift is when the R.I. decreases)
This is the most common type of glaucoma.
General Medical Knowledge 14%
Primary Open Angle Glaucoma (POAG)
Can also be called COAG C=Chronic
Aqueous humor drains out of the eye through this net-like structure.
General Medical Knowledge 14%
Trabecular Meshwork
Which layer of the cornea is the thickest?
General Medical Knowledge 14%
The Stroma
Inflammation of the conjunctiva is called this.
General Medical Knowledge 14%
Conjunctivitis
Conjunctivitis can be one of three types, what are they?
General Medical Knowledge 14%
Allergic, viral, and bacterial
Allergic is most common
Forward displacement of the eye in its bony socket causing the eye to bulge forward is called what?
General Medical Knowledge 14%
Proptosis/exophthalmus
This is typically seen in thyroid patients
The cornea provides approximately how much of the refractive power of the eye?
General Medical Knowledge 14%
2/3
~40D, they eye has a total of ~60D
The absence of a lens in an eye is called this.
General Medical Knowledge 14%
Aphakia
The presence of an intraocular lens (IOL) is called this.
General Medical Knowledge 14%
Pseudophakia
Name the retinal receptors that function best in dim lighting, number about 125 million and are found primarily in the periphery of the retina.
General Medical Knowledge 14%
Rods
Name the retinal receptors that are responsible for color vision, number about 6 million and are found primarily in the macula.
General Medical Knowledge 14%
Cones
What is a hemorrhage confined to the anterior chamber called?
General Medical Knowledge 14%
Hyphema
What part of the eye is responsible for ~1/3 of the refractive power of the eye.
Crystalline lens
This can also change is power, adding plus so we can see at near.
This part of the retina is exclusively made up of cones.
General Medical Knowledge 14%
Fovea
The macula does have some rods, but the very center (fovea) is all cones
How do you abbreviate:
1. Right eye
2. Left eye
3. Both eyes
General Medical Knowledge 14%
- OD
- OS
- OU
Spell the branch of medicine concerned with the diagnosis and treatment of disorders of the eye.
General Medical Knowledge 14%
OPHTHALMOLOGY
Cranial nerve III is called the oculomotor nerve. What areas of the eye does it innervate?
General Medical Knowledge 14%
- Levator muscle (eyelid)
- Sphinctor muscle of the iris
- Ciliary muscles that control the lens
- 4 extraocular muscles (SR, IR, MR, IO)
If a cotton tip has a drop of blood on it, does it have to be disposed of in a bio-hazard receptacle?
General Medical Knowledge 14%
No, only materials that are soaked in blood need to be put in a bio-hazard receptacle?
All needles and glass must by put into a sharps container!
Specular microscopy is a method of evaluating this layer of the cornea.
Ophthalmic Imaging 5%
Endothelial
In OCT, the “T” stands for this, a device that creates 3-D cross-sectional digital images.
Ophthalmic Imaging 5%
Tomography or Tomographer
These three common tomographic image devices are used to image the retina and nerve.
Ophthalmic Imaging 5%
OCT-optical coherence tomography, HRT-Heidelberg retinal tomography, and GDx scanner laser polorimeter
The GDx is obsolite due to the OCT and HRT. It only scans the nerve.
The data provided by tomographic devices of the nerve are useful in evaluating progressive damage to this layer of the retina.
Ophthalmic Imaging 5%
Retinal nerve fiber layer (RNFL)
Computer assisted corneal topography is instrumental in early diagnosis of this corneal condition.
Ophthalmic Imaging 5%
Keratoconus
Corneal topography uses these colors to denote steeper areas of the cornea.
Ophthalmic Imaging 5%
Red, orange, and yellow
Corneal topography systems are based on data obtained from a reflected image off of this background with concentric rings.
Ophthalmic Imaging 5%
Placido disc
Corneal topography uses these colors to denote flat areas of the cornea.
Ophthalmic Imaging 5%
Blue and green
Computer assisted corneal topographer systems are based on data obtained using this imaging technology.
Ophthalmic Imaging 5%
Scheimpflug imaging
This type of scan is a true ultrasound of the eye.
Ophthalmic Imaging 5%
B-Scan
B, like Baby scan.
In fundus photography, when the camera is too far from the eye, you will see this around the image.
Photography and Videography 5%
Blue-grey halo
This type of photography is used to photograph the anterior segment of the eye.
Photography and Videography 5%
Slit lamp
This type of photography documents the posterior segment of the eye.
Photography and Videography 5%
Fundus
Ophthalmic photography can be used to do these two things for ophthalmic conditions.
Photography and Videography 5%
Document and diagnose
This is the type of photography that done when the doctor is looking for leakage of the retinal blood vessels.
Photography and Videography 5%
Flourescein Angiography
When the camera is not centered properly, you will see this appear in the photo.
Photography and Videography 5%
An orangish, yellowish, or whitish crescent on one side of the image,
When taking these types of photos it requires that you take a central photo and then a photo about 10 degrees off center to produce a 3D effect when viewed together.
Photography and Videography 5%
Stereo (this is typically done for the optic nerve to determine it’s depth into the eye)
When taking external photos prior to a patient having strabismus surgery, how many photos are required?
Photography and Videography 5%
10
A head shot showing postion, then up close photos of just the 2 eyes in 9 different postions. The six cardinals postions, plus straight up and straight down, and primary gaze.
In fundus photography, a red free filter is used to evaluate which structure(s) in the eye?
Photography and Videography 5%
Blood vessels
In slit lamp photography there are several different illuminations that can be used. When taking general slit lamp photos, this type of illumination is used, because it is a softer light that evenly illuminates the entire area without highlighting something specific.
Photography and Videography 5%
Diffuse
This is commonly used by the doctor to examine the front of the eye.
This diagnostic test is performed for quantitative evaluations of a tissue’s structure, reflectivity and sound absorption. This is typically used when optical biometry cannot obtain the measurements.
Biometry 3%
Ultrasound A-scan
Often done for axial length measurements when the cataract is too dense.
A-scan biometry measures the distance between these structures.
Biometry 3%
Internal ocular surfaces.
From the cornea to the lens, from the front of the lens to the back of the lens, from the back of the lens to the retina, from the retina to the sclera, and from the sclera to the orbital fat.
All spikes should be at a 90 degree angle to ensure accuracy.
When performing A-scan biometry, a 1mm error in axial length may result in an error of this many diopters post-op.
Biometry 3%
Three
Name the two measurements required to determine the dioptric power of the intraocular lens
Biometry 3%
A-scan (axial length of the eye) and keratometry (corneal curvature)
Optical biometers uses this instead of sound to determine the measurements.
Biometry 3%
Light
What are 2 examples of optical biometry.
Biometry 3%
IOL Master and Lenstar
What is the number that must be entered into the IOL calculations called? It is provided by the manufacturer, but can be refined based on the variations of a surgeon’s outcomes and surgical technique.
Biometry 3%
A-constant
Optical biometers must be calibrated how often using a test eye?
Biometry 3%
Daily
The average axial length of an adult eye is how many millimeters?
Biometry 3%
23-25 mm
Name of the instrument that houses various lenses to determine the refractive error of the eye?
Refraction, Retinoscopy, & Refinement 5%
Phoropter
Define the property of refraction
Refraction, Retinoscopy, & Refinement 5%
The Property of Refraction is the bending of the path of waves/rays of visible light as they pass from one transparent medium into another of a different density. The speed of the waves and it’s wavelength will also change.
Essentially it is the bending of light.
What are some important directions that should be explained when preparing a patient for refraction?
Refraction, Retinoscopy, & Refinement 5%
- Choose the lens that provides the clearest vision of the options shown.
- Remind them to keep their forehead forward.
- Blink normally during the duration of the test.
What are some common mistakes made during the refraction of a patient?
Refraction, Retinoscopy, & Refinement 5%
- Not making sure the patient is comfortable.
- Not leveling the phoropter.
- Not giving good directions and having to ask the same question a different way to get the desired answer.
- Flipping the lenses too quickly.
- Forgetting to occlude the eye not being tested.
What are three appropriate starting points for refracting a patient?
Refraction, Retinoscopy, & Refinement 5%
- Autorefraction
- Patient’s current Rx
- Patient’s last manifest
- Retinoscopy (this is a lost art, but it is still tested on!)
What is the order of operations for a refraction?
Refraction, Retinoscopy, & Refinement 5%
- Sphere
- Axis
- Cylinder Power
- Sphere again if the cylinder power was altered. This is done to be sure the spherical equivalent is kept.
Remember SACS
What is the name of the lens used to refine cylinder axis and/or power?
Refraction, Retinoscopy, & Refinement 5%
Jackson Cross Cylinder (JCC)
Retinoscopy is this method of refraction, where the examiner decides what the prescription is vs the patient giving answers.
Refraction, Retinoscopy, & Refinement 5%
Objective refraction
This method of refraction requires the patient to give answers to the examiner.
Refraction, Retinoscopy, & Refinement 5%
Subjective refraction
Why is pinholing the patient useful prior to performing refraction?
Refraction, Retinoscopy, & Refinement 5%
It lets the examiner know if the decreased visual acuity is due to a refractive error or not. If the vision isn’t improving, the examiner can expect that they may not get an improvemet in visual acuity with refraction.
This is of course if there isn’t user error by the patient.
What is the name of the test to determine if the refraction is correct using red/green filter on the projector?
Refraction, Retinoscopy, & Refinement 5%
Duochrome test
This is done to assess over minusing on each eye individually.
What other measurement can you reference to asses the amount of cylinder power and it’s axis in a patient?
Refraction, Retinoscopy, & Refinement 5%
Keratometry measurements.
These provide the amount of curvature at the flattest and sttepest parts of the cornea and are useful if there is a problem with the cylinder power and/or axis.
What normally determines the strength of an add power for near correction?
Refraction, Retinoscopy, & Refinement 5%
The age of the patient
What method of refraction is indicated for children with accomodative esotropia or patients who have latent hyperopia?
Refraction, Retinoscopy, & Refinement 5%
Cycloplegic (wet) refraction is best used in these situations.
What is the distance from the back surface of a lens to the front of the eye called?
Refraction, Retinoscopy, & Refinement 5%
Vertex distance
Transpose this Rx:
-2.75-1.25x105
Optics and Spectacles 2%
-4.00+1.25x015
- Combine the sphere and the cyl powers:
-2.75-1.25=-4.00 - Change the sign of the cyl power, but not the actual power:
+1.25 - Change the axis by 90 degrees:
015
Keep the signs with the numbers!
Which instrument measures the radius of curvature, or base curve, of a spectacle lens surface in diopters?
Optics and Spectacles 2%
Geneva lens clock
What is the spherical equivalent of
-2.00 +3.00 x 90?
Optics and Spectacles 2%
-0.50 sph
- Take half of the cylinder power:
+3.00/2=+1.50 - Combine that with the sphere:
-2.00+1.50=-0.50 - That’s it!
Spherical equivalent is taking a cylinder Rx and making is sphere only.
The add power of the trifocal portion of a lens with a +2.00 reading add will be what power?
Optics and Spectacles 2%
+1.00
The trifocal add power is always half of the reading add power.
In the terms of lens thickness, the center of a myopic lens is thinner or thicker then the outer part of the lens?
Optics and Spectacles 2%
Thinner
The reverse is true for a hyperopic lens, it is thicker in the center!
What is the distance from the center of one pupil to the center of the other pupil called?
Optics and Spectacles 2%
Interpupillary Distance
What are some symptoms a patient can experience if their PD was measured incorrectly?
Optics and Spectacles 2%
- Blurred vision (sometimes described as looking underwater)
- Eye strain
- Fatigue
- Headaches
- Possible double vision
Transpose this Rx:
-1.25+2.75x175
Optics and Spectacles 2%
+1.50-2.75x085
- Combine the sphere and the cyl powers:
-1.25+2.75=+1.50 - Change the sign of the cyl power, but not the actual power:
-2.75 - Change the axis by 90 degrees:
085
Keep the signs with the numbers!
Which color defects may be distinguished by the Ishihara test?
Supplemental Testing 3%
Red and green
Which color vision test consists of pseudo isochromatic plates that determine red-green color anomalies and deficiencies?
Supplemental Testing 3%
Ishihara color plates
How long are the Schirmer strips left in place during a tear test?
Supplemental Testing 3%
Five minutes
The most accurate way a technician can estimate the anterior chamber depth is to use this machine.
Supplemental Testing 3%
The slit lamp
Only a doctor can perform a gonioscopy.
Which two ocular structures can touch if the anterior chamber is flat/shallow?
Supplemental Testing 3%
Iris and cornea
When determining anterior chamber depth using a flashlight test, a shadow on the nasal iris indicates that the AC is this.
Supplemental Testing 3%
Abnormally shallow or narrow angle
What is the name of the instrument used to measure extension of the anterior surface of the cornea beyond the lateral orbital rim (eye protrusion)?
Supplemental Testing 3%
Exophthalmometer
What does BAT stand for and what does it measure?
Supplemental Testing 3%
Brightness Acuity Test measures glare.
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 starting (not blinking) position?
Supplemental Testing 3%
TBUT or BUT (tear break-up time)
This green dye is useful in evaluating the integrity of the corneal epithelium.
Supplemental Testing 3%
Lissamine Green
This has replaced Rose Bengal due to it burning the eyes.
The _____ _____ test uses rainbow colored cups that must be arranged in order of similar hues.
Supplemental Testing 3%
Farnsworth-Munsell 100-hue or Farnsworth D-15
This color vision test consists of a series of plates with a gray background and colored circles, crosses, and triangles.
Supplemental Testing 3%
Hardy-Rand-Ritter
Name the tear deficiency test which uses strips of filter paper inserted into the lower fornix
Supplemental Testing 3%
Schirmer’s Test
Should color vision be tested monocularly or binocularly?
Supplemental Testing 3%
Monocularly.
If tested binocularly, one eye could make up for color deficiencies in the other eye and will be missed when color deficiency is acquired (not congenital).
This is the test for measuring the thickness of the cornea.
Supplemental Testing 3%
Pachymetry
When using a penlight to determine anterior chamber depth, it is important to be sure the light is aligned this way with the cornea.
Supplemental Testing 3%
Perpendicular, if it is at any other angle a shadow could be produced or missed!
How many seconds is considered a normal TBUT?
Supplemental Testing 3%
10 seconds
What are 2 conditions where the thickness of the cornea can determine treatment?
Supplemental Testing 3%
Glaucoma and Fuch’s Endothelial Dystrophy
The Goldmann applanation tonometer prism is best cleaned between patients with what solution(s).
Tonometry 4%
Hydrogen peroxide soaks or 1:10 bleach solution
Alcohol is accepted, but the other 2 are better.
In order to check the calibration of this method of tonometry, a balance or calibration rod must be used.
Tonometry 4%
Goldmann Applanation
When performing Goldmann Applanation this dye is necessary to see the mires.
Tonometry 4%
Fluorescein dye
What is the diameter of the corneal area applanated by a Goldmann tonometer?
Tonometry 4%
3.06mm
Know this about the goldmann applanator!!!
The scientific word for measuring IOP is this.
Tonometry 4%
Tonometry
The suffix -metry means to measure
When the IOP increases, the eye will start to feel this way.
Tonometry 4%
Harder
Putting pressure on the eye can cause aqueous humor to displace, Goldmann applanation only diplaces about this much aqueous humor.
Tonometry 4%
0.5 microliters
When recording intraocular pressure, the reading on the Goldmann applanation tonometer scale should be multiplied by this much.
Tonometry 4%
Ten
What is the normal range of intraocular pressure?
Tonometry 4%
10-21 mmHg
To applanate means to do this.
Tonometry 4%
To flatten
What measurement error is produced when the fluorescein rings are too narrow during applanation tonometry?
Tonometry 4%
False low reading
When applanating, what measurement error is produced when a patient holds their breath or is straining?
Tonometry 4%
False high reading
What is the unit of measurement is used for IOP?
Tonometry 4%
millimeters of Mercury (mmHg)
Hg is the symbol for Mercury on the peroidic table.
The iCare is this type of tonometry where a probe is “fired” onto the cornea, creating a very small applanation, and the IOP is determined by how long it takes for the probe to return to its resting postion.
Tonometry 4%
Rebound
This method of tonometry has largely been replaced by applanation because it doesn’t account for the scleral rigidity.
Tonometry 4%
Schiøtz (Indentation) Tonometry
This hand held method of applanating can take accurate measurements on an irregular cornea and over a soft contact lens.
Tonometry 4%
Tono-Pen
How is it recorded when the patient perceives light and can indicate the source direction?
Visual Assessment 6%
Light perception with projection (LP w/P)
The visual acuity notation 20/200 indicates the patient could see the 200 optotype at how many feet?
Visual Assessment 6%
20
The numerator ALWAYS represent how far the away the patient is!!
The distance of 20 feet is used in visual acuity assessment because it is considered this.
Visual Assessment 6%
Optical infinity
How is the visual acuity value of 20/40 expressed as the metric equivalent?
Visual Assessment 6%
6/12
20/20=6/6, 20/30=6/9, 20/40=6/12, 20/50=6/15, 20/60=6/18, 20/70=6/21…
If a patient has decreased vision, performing this acuity test will usually demonstrate that the decreased vision is due to a refractive error.
(NOT REFRACTION)
Visual Assessment 6%
Pinhole acuity
Jaeger notation and the point system are units of measure used in recording this type of vision.
Visual Assessment 6%
Near
In visual assessment the acronym PAM represents this testing device.
Visual Assessment 6%
Potential acuity meter
No longer in use, we typically will use the “super pinhole” method prn.
The ability of human vision to discern shapes by their relative lightness and darkness is referred to as this.
Visual Assessment 6%
Contrast sensitivity
During visual acuity assessment the patient is able to clearly read the 20/30 line but misses one letter, how would you record the acuity?
Visual Assessment 6%
20/30-1
Why is it important to observe the patient during visual acuity testing?
Visual Assessment 6%
To ensure proper occlusion
Patients will always cheat subconsciously when an eye has poor vision.
While assessing visual acuity the assistant notes the patient consistently misses the optotypes on the same side of the chart. This may indicate that the patient may have this.
Visual Assessment 6%
Visual field defect
When there are opacities in the ocular media, a BAT may be use to asses them the their potenital to cause this problem.
Visual Assessment 6%
Glare
In patients with nystagmus, visual acuity often perfomed this way because when one of the eyes is occulded the nystagmus worsens.
Visual Assessment 6%
Binocularly
When refracting or other testing we fog their eye with a +5.00
At what distance are adult near visual acuity charts designed to be read?
Visual Assessment 6%
14-16 inches from the eye
Normal visual acuity in a two-month old infant may be estimated by?
Visual Assessment 6%
Fixation (follow at 3-months)
If a patient cannot see the largest optotype on the chart the next thing you should check is this.
Visual Assessment 6%
Their ability to Count Fingers (CF) at a certain distance.
The standard chart used to assess visual acuity is this chart.
Visual Assessment 6%
Snellen acuity chart
Each letter on most visual acuity charts are subtended this much.
Visual Assessment 6%
5 minutes of arc
This visual field test is done by comparing the boundaries of the patient’s visual field with that of the examiner to determine a patient’s gross visual field.
Visual Fields 4%
Confrontation (CVF)
The Amsler grid test determines the presence and location of defects in what part of the visual field?
Visual Fields 4%
Central
During Amsler grid visual field testing, the patient should be wearing this type of correction if applicable.
Visual Fields 4%
Near
Because there are no photoreceptor cells (rods or cones) in the optic nerve, this is produced in the visual field.
Visual Fields 4%
Physiologic blind spot
A physical defect in the patient’s superior temporal retina, will cause a visual field defect in this part of their vision.
Visual Fields 4%
Inferior nasal
Fresh Prince…everything is flipped and turned upside down.
What are the two basic methods of perimetry are used to map the field of vision?
Visual Fields 4%
Kinetic and static
Static=HVF Kinetic (moving)=GVF
A localized area of reduced sensitivity in a visual field that is called this.
Visual Fields 4%
Scotoma
An absolute scotoma means there is no vision at all, e.g. ON blind spot
This unit of measurement is used to indicate the brightness of the light used during a visual field.
Visual Fields 4%
Decibel
A visual field defect occupying the right or left half of the visual is referred to as this.
Visual Fields 4%
Hemiaopia/Hemianopsia
When performing a visual field, the patient’s near correction should only be used when testing the central how many degrees?
Visual Fields 4%
Thirty (30)
If used for >30, it will be distorted and a false depression of the VF
The presence of ptosis can result in this part of the visual field.
Visual Fields 4%
Superior
Only the retina is flipped, the lid is blocking the actual superior VF.
If a pupil is only about 2 mm or less, this can happen to the visual field.
Visual Fields 4%
Contraction, appear to be smaller and more narrow than it actually is.
Normal peripheral limits of the visual field are how many degrees in each direction? Nasal, Superior, Inferior, and Temporal.
Visual Fields 4%
60 degrees for both nasally and superiorly, 70 degrees inferiorly, and 90 temporally.
In the grayscale printout of an automated perimeter the lighter area corresponds to what levels of illumination being seen by the patient.
Visual Fields 4%
Dim levels
The dimmer the light seen, the better and more sensitive the vision.
A patient with a bitemporal visual field defect means that this area of the visual pathway is affected.
Visual Fields 4%
Optic chiasm
(usually a pituitary tumor that has grown and is now touching the chiam causing vision loss)
There can be a high number of these errors when the patient is clicking too much because they are afraid they will “miss” a light.
Visual Fields 4%
False-positive error
A false-negative happens when the patient isn’t paying attention.
Name the two types of surgical scrub methods
Surgical Assisting 7%
- Anatomincal timed (so much time spent scrubing a specific area)
- Counted brush stroke (certain number of strokes used to clean each area)
The most common method of sterilizing instruments is this.
Surgical Assisting 7%
Steam sterilization
Wearing this, is a safety precaution when lasers are being used.
Surgical Assisting 7%
Eye protection
Name the four shapes of suture needles.
Surgical Assisting 7%
- Taper point
- Cutting
- Reverse cutting
- Spatula
When performing a proper site identification, what two things must be identified?
Surgical Assisting 7%
Correct patient and correct side
The YAG laser is this type of laser, using quick pulses of energy without heating up tissue.
Surgical Assisting 7%
Cold
What method of sterilization is used in sterilizing intraocular lens implants?
Surgical Assisting 7%
Ethylene Oxide
This is a chemical germicide, we call this cold sterilization
Name the two main classification areas of most ophthalmic surgical procedures.
Surgical Assisting 7%
Intraocular and Extraocular
Name five types of sutures used in ophthalmic surgery.
Surgical Assisting 7%
- Plain catgut
- Vicryl
- Nylon
- Silk
- Prolene
What is a common blade used for ophthalmic surgeries?
Surgical Assisting 7%
Diamond blade
An operating room must be amoric. Define amoric.
Surgical Assisting 7%
No particles
This type of water should be used in an autoclave to help prevent stains from happening on the instruments.
Surgical Assisting 7%
Distilled (even better is deionized distilled water)
Prior to sterilization, this should be done to all instruments.
Surgical Assisting 7%
Cleaning with a neutral cleaning solution or an enzyme cleaner for instruments with blood and debris on them.
The process of complete elimination or destruction of all forms of microbial life is this.
Surgical Assisting 7%
Sterilization
