COA test Flashcards
1
Q
What is the most common cause of blurred vision
A
A refractive error, which is a non-pathologic deficiency in the eyes optical system
2
Q
what is the term used for the reason for the patients visit
A
Chief complaint
3
Q
Define “presbyopia”
A
a gradual decrease in accommodation due to a physiologic change that becomes noticeable about the age of 40 years. (Difficulty reading)
4
Q
Recent onset of light flashes and floaters is an example of an ocular ***
A
urgency
5
Q
mild ocular irritation, itching and burning are patient complaints that would be handled as *** situation
A
Routine
6
Q
what systemic disease is important to note in the family medical history in African Americans
A
Sickle cell
7
Q
what ocular disease is important to note in the family ophthalmic history of African Americans
A
Glaucoma
8
Q
What elements are important in social history taking
A
Smoking, Alcohol and drug use
9
Q
the important screening process used in emergencies to determine a patients ocular needs is called
A
triage
10
Q
what information is obtained from a patient with a headache as the chief complaint
A
Family history, onset and duration, location(which area of head), severity. associated symptoms, what brings relief of headache
11
Q
what medications are used as topical anesthetics
A
proparacaine or tetracaine
12
Q
what is the color of bottle caps of mydriatic agents
A
Red
13
Q
what is the color of bottle caps of prostaglandin(Glaucoma) agents
A
Teal
14
Q
What are the names of three large groups of anti infective agents
A
antibiotic, antiviral, antifungal
15
Q
a true allergic reaction to a drug involves what symptoms
A
itching, rash, difficulty breathing, weak or rapid pulse
16
Q
what is a sign of sib-conjunctival hemorrhage
A
blood pooling under the conjunctive
17
Q
within how many hours should a patient with a retinal detachment be evaluated
A
24 hrs
18
Q
what is the most common symptom in age related macular degeneration
A
loss of central vision
19
Q
the mannerisms of blind children, such as walking in circles or rubbing their hands are termed
A
Blindisms
20
Q
what is the most common cause of blindness in the world
A
Cataracts
21
Q
what diagnostic term is used when a patients chief complaints are “tired eyes and fatigue” when describing symptoms
A
asthenopia
22
Q
what type of glaucoma presents with the following ocular signs and symptoms: fixed mid-dilated pupil, corneal edema, red eyes, blurry vision, pain
A
Acute angle closure glaucoma
23
Q
what are the five principle areas included in the history interview
A
Chief complaint, ocular history, medical history, family ocular and medical history, allergies
24
Q
onset and duration of symptoms is included in the patients ***
A
HPI - history of present illness
25
what is the common problem that presents with symptoms of floaters and flashing lights
PVD - posterior vitreous detachment
26
Sudden, painless loss of vision is an example of an ocular ***
emergency
27
prior use of topical ocular pharmaceutical agents is part of a patients
past ocular history
28
a history of strabismus surgery at age five should be included in what record
past ocular history
29
what is the term used to describe the absence of a natural lens
aphakia
30
pertinent family history of a patient should include which relatives
parents, grandparents and genetic siblings
31
What should you do if a patient is unable to provide you with the name(s) of the medication(s) he/she is taking
if unknown, have the patient call you office at a later time with the medication information or ask if you may call their physician or pharmacist for clarification
32
a patient describing an experience of getting hives after taking sulfa drugs is providing information about ***
an allergic reaction
33
a partially sighted patient can have a best - corrected visual acuity of *** in the better eye
20/60
34
Legal blindness is defined as
BCVA of 20/200 or worse in the better eye, OR visual field of 20 degrees or less in the better eye
35
define the abbreviation sc
without correction
36
while checking a patient's visual acuity, if the patient is unable to count fingers the examiner should proceed to ***
hand motion detection
37
What is the term for the spasmodic, rhythmic dilating, and contracting papillary movements during pupil function testing
hippus
38
Name the black felt perimeter, used for testing the central 30 degrees of peripheral vision
tangent screen
39
In the 20/20 notation, what does the numerator stand for
distance from patients eye to the chart
40
what is a distometer used for
caliper for measuring the distance between the back surface of an eyeglass lens and the front of the cornea (vertex distance)
41
what is anisometropia
unequal refractive errors in the two eyes, usually at least one or two diopters different
42
If you cannot center the intersection of the thick and thin lines in the lensmeter, the lens has ***
ground in prism
43
each black ring seen in the eyepiece reticle of the lensmeter measures how much prism
1 D each ring
44
what is the bausch & lomb trade name for the ophthalmometer
keratometer
45
What do you do 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 degree - less than 90 = add, greater than 90 = subtract
46
Transpose: +2.00 -2.50 x 90
-0.50 +2.50 x 180
47
which color vision test consists of pseudo isochromatic plates that determine red-green color anomalies and deficiencies
ishihara
48
what is the name of the instrument used to measure proptosis or exophthalmos in millimeters
Exophthalmometer
49
name two ocular disorders in which the exophthalmometer may be used for obtaining measurements
Graves' (or thyroid eye) disease, and ocular tumor
50
which refractive error is produced in an unaccommodating eye, when parallel rays focus behind retina
Hyperopia
51
which refractive error is produced when parallel rays focus in front of retina
Myopia
52
In which type of mirror does the tip of an object touching the glass, appear to touch its image?
front surface mirror
53
which test is performed in a patient describing metamorphopsia, straight lines appearing wavy, at near?
Amsler grid
54
how many degrees of central vision are measured by an amsler grid?
20 degrees - 10 degrees from fixation in every direction
55
which test measures the amount of tear production?
basic secretion, and Schirmer I and II
56
how long are the schirmer strips left in place during a tear test?
Five minutes
57
what is the name of the test used for detecting a relative afferent pupillary defect
swinging flashlight test
58
which muscle of the iris constricts in bright light
sphincter
59
how is anterior chamber depth estimated using a slit lamp
A high thin beam is placed at the limbus at an angle 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
60
which two ocular structures can touch if the anterior chamber is flat
Iris and cornea
61
which instrument measures the radius of curvature, or base curve, of a spectacle lens surface in diopters?
Geneva lens clock or measures
62
Which color defects may be distinguished by the Ishihara test
Rod and green
63
what is the spherical equivalent of -2.00 +3.00 x 90
-0.50 sphere
64
Transpose the following into minus cylinder: +3.00 +1.00 x 180
+4.00 -1.00 x 90
65
what is the first step in performing lensometry or keratometry
focusing the eyepiece
66
A-scan biometry measures the distance between
internal ocular surface
67
the chief use of A-Scan biometry is to calculate the desired power an an ***
intraocular lens implant
68
WHat is the name of the instrument used to measure extensions of the anterior surface of the cornea beyond the lateral orbital rim
exophthalmometer
69
when the amsler grid is held at the proper distance, and viewed with the distance and near corrections in place, each square subtends an angle of *** degree(s)
one
70
What is the pupil dilation termed
mydriasis
71
what is the term used when there is a difference in pupil size
anisocoria
72
when determining anterior chamber depth using a flashlight test, a shadow on the nasal iris indicates ***
Abnormally shallow anterior chamber (narrow angle)
73
Ophthalmologist often estimate anterior chamber depth by measuring the angle between a) *** and b) ***
a) anterior surface of the iris b) posterior surface of the cornea
74
the purpose of testing decreased visual acuity with the use of a pinhole serves to differentiate loss of vision between which two possible causes?
refraction error or eye disease
75
why is it important to observe the patient during visual acuity testing
to ensure proper occulsion
76
Name at least ONE example of a glare testing device
TVA,BAT(brightness acuity test) or Eye Con
77
At what distance are adult near visual acuity charts designed to be read at?
12-16 inches from eye
78
What is indicated if both the thin and wide lines are in focus at the same time while performing lensometry?
the lens is spherical
79
normal visual acuity in a two month old infant may be estimated by?
Fixate (follow at 3 months)
80
what is the name of the visual acuity test, for infants and non-verbal children, that uses gratings of vertical black and white stripes
Teller visual acuity
81
which ocular condition is commonly associated with sjogren syndrome?
Dry eyes (dry mouth is another finding in Sjogren syndrome)
82
which systemic disease can cause temporary fluctuations in refraction errors?
Diabetes Mellitus (DM)
83
what bacterium commonly causes contamination of fluorescein solution
pseudomonas acruginosa
84
name the virus that causes a dendritic pattern of keratitis
Herpes simplex
85
what is the ideal position for a patient who feels faint?
head lower than the heart
86
what is the ratio of chest compressions to artificial ventilations in one person adult CPR
30:2
87
where do you check pulse on an adult CPR patient
neck (carotid pulse)
88
the heart consists of how many chambers
Four
89
increased thirst, excessive urine production, and increased hunger and weight loss are characteristics of which endocrine disease?
Diabetic insipidus
90
which drug, that is included in a crash cart is used to increase the heart rate?
epinephrine
91
which parts of the eye can be affected by hypertension
vessels supplying retina, choroid and optic nerve
92
hemorrhage confined to the anterior chamber is termed
Hyphema
93
which corneal condition can result from proptosis?
Dry eye
94
name three infectious agents
bacteria, fungus, virus
95
what term is used when light rays focus on retina without requiring correction?
Emmetropia
96
How many pigments for vision are present in a normal human retina
Four (red, green, and blue in the cones and rhodopsin the the rods)
97
which hormone is insufficient in a patient with DM?
insulin
98
what is the term used to designate a range of procedures used to prevent spread of infectious microbes to and from patients and office personnel?
Aseptic technique
99
what finding can occur 6-8 hours after a metallic foreign body enters the cornea
Rust ring
100
what is the term for destruction of all microorganisms on instruments and materials?
sterilization
101
why are alkali burns more serious than acid burns on the cornea
Alkali burns penetrate deeper
102
a metal chamber equipped to use steam under high pressure to destroy microorganisms is termed?
Autoclave
103
variability in the functions of levator and extraocular muscle is characteristic in which systemic disease?
Myasthenia gravis
104
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 retinal artery occlusion)
105
what is the name of the mucous membrane covering the anterior sclera?
Conjunctiva (bulbar)
106
what are the three colors of receptors found in cones
Red. blue, and green
107
what is the term for the thickest layer of the cornea
Stroma
108
the eyes are considered to be part of which important anatomical system
central nervous system
109
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)
110
episodes of sudden temporary vision loss most likely indicates a disorder of which physiological system
cardiovascular
111
which systemic disease might cause a patient to need a snack during a complete eye exam
Type I (Insulin dependent DM or IDDM)
112
in metric notation, 100cm are equal to *** meters or *** millimeteres
one; 1,000
113
how many deciliters make one liter
Ten
114
universal precautions are mandated by OSHA but were developed by the ***
U.S. centers for disease control
115
washing hands between patients is one example of ***
Universal Precautions
116
what instructions would be given over the phone to a patient who had splashed a chemical into the eyes
Immediately flush the eyes with water for 15-20 minutes and then report to the ER or ophthalmologist office
117
the most common type of glaucoma is ***
POAG primary open angle glaucoma
118
instrument lenses that contact the eye can be sterilized by ***
Using ethylene oxide gas, and non-heat acration that does not exceed 125 degrees F
119
Aqueous drains out the eye through this net-like structure
Trabecular meshwork
120
what type of glaucoma constitutes an ocular emergency
Acute angle closure glaucoma
121
the condition of low blood sugar is termed
Hypoglucemia
122
what is the single most important thing an ophthalmic assistant can do to help prevent corneal infections during A-Scan biometry
Clean the probe after each use with an alcohol wipe
123
what is the most likely reason for a projected image to become dim, particularly on one-half of the acuity projector screen?
the projector bulb is failing, carbon deposit build-up is darkening the bulb
124
how should removable glass slides inside the American Optical acuity projector be cleaned
wipe with clean,soft lint free towel or photographic lens paper
125
what instrument, used to examine the retina, is easier to use with small or undilated pupils, permits a greater magnification and is mechanically easier to use?
direct ophthalmoscope
126
what instrument, used to examine the retina, is: used to examine the complete fundus in stereopsis, uses a hand-held condensing lens, and the image appears as inverted image of the retina?
indirect ophthalmoscope
127
Lack of calibration of the perimeter, small size of patients pupils and noise distractions can lead too *** errors in perimetry
artifactual
128
What is the correct way to clean the surface of the lense of a lesmeter when dist has fallen on them?
blow it off with a clean, dry rubber bulb syringe or compressed air
129
if the lensmeter controls feel tight to the operator, who should fix it?
a qualified service technician
130
in order to maintain the retinoscope, generally you need to keep an adequate supply of *** in the examining room
spare bulbs and batteries
131
the best way to maintain tangent screen test objects is to ***
wash them with mild soap and water
132
what is the best way to maintain a tangent screen
occasionally whisk it (dust it)
133
wipe the cross cylinder with a lens tissue occasionally, protect the instrument with a dust cover when not in use, and clean the retinoscopy lens with a glass cleaner and cotton-tipped swabs are good practice with regard to care of which instrument?
Phoropter
134
scheduled maintenance of a phoropter should be performed how often?
Every two years
135
if dust accumulates on the mirror of the slit lamp, the technician may clean it by using what cleaning methods?
a lent free cloth - lens brush or a blast of air
136
a standard habit for all personnel who use the slut lamp should be ***
check electrical connections, lock the base
137
what must be checked when troubleshooting why a non-portable ultrasound biometer fails to power up?
instrument fuses, electrical connections or the circuit breaker
138
if the mires projected through an ophthalmometer appear dim when looking through the eyepiece at the corneal surface, what is most likely the cause?
lamp bulb needs changing
139
if there is no light source when you turn on an ophthalmometer, the first step you should take is to ***
check that it is plugged into the outlet
140
what is the best way to clean the back lenses (retinoscopy lens, red lens, and Maddox rod) of the phoropter
clean with glass cleaner and cotton - tipped swabs
141
checking the calibration of a goldmann applanation tonometer is performed with a ***
balance or calibration rod
142
when calibrating the non-contact tonometer it is critical that ***
triggering is repeated several times
143
the muscle light that is suddenly too dim most likely needs ***
overnight charging
144
maintenance for a muscle light may include
bulb replacement
145
front surface mirrors in a projection system, should be cleaned by ***
a glass cleaner and cotton ball
146
who should repair and maintain equipment such as a laser?
a qualified service technician
147
what items would hinder the characteristic high reflectance of the screen used with a visual acuity projector?
abrasive scratches and fingerprints
148
what substance should be used to clean the screen for an acuity projector?
a solution of mild detergent and water
149
what is the best procedure for cleaning the mirror of a retinoscope?
blow off the dust with an empty bulb syringe that is clean and dry or with canned air
150
what accessories are used to check the calibration of an ophthalomometer?
three test balls made of steel, also called leusometer
151
if, after cleaning the joy stick pad with a cleaning solution, the slit lamp is still difficult to move, what additional product may be used on the pad?
3-in-1 oil or sewing machine oil
152
after changing the bulb on a slit lamp that does not illuminate, what other things should be checked if the problem persists?
contracts on the bulb cap, remove any dirt with a small file or knife (and always check that it is plugged in)
153
When reading should the light meter display when Goldmann perimeter is accurately calibrated for the stimulus?
1,000 apostles
154
which substance is used to disinfect the ultrasound transducer?
Hydrogen peroxide or alcohol
155
Name the best way to prolong the life of transilluminator bulbs and batteries
turn the instrument off when not in use
156
what should be used to clean the accessible lenses of of a phoropter
Photographic lens cleaner and lens tissue
157
Which solution should NEVER, be used on any working part of a phoropter (except the patient forehead and cheek rests)
Alcohol
158
The goldmann applanation tonometer prism is best cleaned between patients with ***
Hydrogen peroxide soaks or alcohol wipes
159
what is the reason to not immerse a laminated projector slide in water, in order to clean it?
water can enter between the two glass slides and wash off the letters or leave permanent water marks
160
what size letters (optotypes) are typically used to calibrate visual acuity projectors
20/200
161
what type of solutions should not be used on plastic prisms
Alcohol
162
what is the next step after disinfecting a goldmann applanation tonometer top with alcohol
Let it air dry for 1-2months
163
which type of tonometer may be cleaned with a dry pipe cleaner
Schiotz (indentation) tonometer
164
what may causes a rim artifact in perimetry
Corrective lens too far from eye
165
commercial cleaners may be used to clean which type of mirror
back surface mirror
166
which dye solution is used when performing goldmann applanation tonometry?
fluorescein dye
167
Which device uses compressed gas to applanate the cornea and measure the intraocular pressure
pneumotonometer and pneumatic or "air puff" tonometer
168
what is the diameter of the corneal area properly applanated by a goldmann tonometer
3.06mm
169
how man measurements does the tonopen record to give an average IOP results
average four (4) measurements
170
which tonometer device uses conversion tables to convert units into millimeters of mercury
Schiotz tonometer
171
which technique assumes that the rigidity of the sclera is normal
indentation
172
if scleral rigidity is high, the IOP will be ***
overestimated
173
most inaccuracies in Schiotz tonometry result in *** rather than *** readings
falsely low;high
174
measuring intraocular pressure is also called ***
Tonometry
175
when performing *** tonometry, the aqueous fluid in the anterior chamber between the cornea and iris is displaced.
Indentation
176
Patients with high myopia nay have *** ocular rigidity because the sclera is thinner and stretched.
Low
177
during Schiotz, tonometry, the greater the distance the plunger indents the cornea, the *** the eye or the *** the IOP
Softer;lower
178
What are the commonly used weights when performing Schiotz tonometry
5.5g, 7.5g, and 10g
179
When performing schiotz tonometry, if the tonometer should slide over the surface of the cornea, this may produce a ***
corneal abrasion
180
The higher the IOP of an eye the *** the eye
harder
181
Applanation tonometry displaces less than *** of aqueous
0.5 microliters
182
The goldmann applanation tonometer gives a reliable measurement of intraocular pressure to within *** mmHg
+0.5 mm Hg
183
Disadvantage of the goldmann tonometer include:
lack of portability; unreliable results with corneal distortion, scarring or high astigmatism; corneal abrasion; infection
184
What color filter is used when performing goldmann applanation tonometry
cobalt blue
185
for every increment of 1 on the goldmann applanation scale, this should be multiplied by ***
10
186
what is the normal range of IOP
13-20 mm Hg
187
which method of tonometry is described here: measurement of the amount of IOP needed to flatten the cornea by a standard amount?
Applanation tonometry
188
Name two possible complications of applanation tonometry
a) corneal abrasion b) spread of infection
189
what measurement error is produced when the fluorescein rings are too narrow during applanation tonometry
falsely low reading
190
what measurement error is introduced when a patient, holding his/her breath or wearing collar that is button to tightly, is applanted?
falsely high reading
191
which portable tonometer measures IOP by corneal indentation?
Schiotz tonometer
192
how long do airborne bacteria remain active in the operating room, for example if a person enters without a mask?
one hour
193
name three examples of antiseptic solutions used to wash hands in an operating room
tincture of iodine, povidone iodine, phisohex
194
when instilling ophthalmic drops or ointment, it is important that the tip of the container ***
never touches the eye, skin or eyelashes
195
Name the common types of ophthalmic suture
chronic gut, vicryl, nylon, silk polypropylene, mersilene
196
what is the first step before disinfecting or sterilizing surgical instruments
cleaning by mechanical abrasion
197
what is the term for "the complete destruction of all microorganisms"?
sterilization
198
Name six accepted methods of sterilization
dry heat, moist heat, chemical, gas, radiation, and ultraviolet light
199
"the process of inactivating or eliminating pathogenic microorganisms" describes
Aseptic technique
200
what does the acronym LASER stand for?
Light amplification by stimulated emission of Radiation
201
protocols for pressure patching or shields require that the adhesive tape must be applied from the a) *** to the b) ***
A) forehead b)cheek
202
which method of drug delivery might be recommended for a crying child
ointment
203
a bard parker blade, clamp and curette are instruments used for what surgical procedure?
Chalazion excision
204
patients question pertaining to surgical procedures should be answered by ***
the ophthalmologist
205
a patient with a lacerated globe must have a *** applied for protection
Fox shield or the bottom one-third of a styrofoam cup (do not use pressure patch)
206
a *** applied over the eye can minimize postoperative bleeding
Pressure patch
207
the *** ocular shield is fenestrated aluminum shield
Fox
208
a *** patch must not be used on a patient with a lacerated globe
Pressure
209
*** drugs are applied directly to ocular surfaces and/or surrounding tissues
Topical
210
what is the term for a drug that dissolves completely in a solvent?
Solution
211
a *** is a combination of liquid and drug particles, such as Pred Forte (prednisolone acetate)
Suspension
212
eso
Inward
213
Exo
Outward
214
Hyper
Up
215
Hypo
Down
216
What is the term for an eye that is constantly turned toward the nose?
Esotropia
217
What is the medical term that describes “unequal pupil size”
Anisocoria
218
The iris consists of different muscles. How many muscles does this part of the eye contain?
2
Iris sphincter
Iris dilator
219
What does OSHA stand for?
Occupational safety and health administration
220
During the duochrome test, the patient states that the letters in the green are more clear. What should be done in the phoropter?
Add more plus
221
A topical drug that dilates the pupil without affecting accommodation is termed ***
Mydriatic
222
a drug that produces a temporary paralysis of the ciliary muscle is termed ***
Cycloplegic drug
223
a cycloplegic drug may blur vision at near due to a temporary loss of ***
Accommodation
224
in what part of the eye should ophthalmic drugs be placed
Cul-de-sac or lower fornix
225
Drainage of topical drops from the eye and their systemic absorption can be somewhat prevented by
punctal occlusion by digital pressure
226
ophthalmic *** temporarily stain cells and tissues in the eye to highlight defects or necrosis
Dyes
227
*** drugs induce contraction of the iris sphincter
miotic
228
what drug reduces inflammation without using corticosteroids
Non-steroidal anti-inflammatory drug or NSAID
229
drugs that constrict blood vessels in the conjunctiva are termed
Decongestants or vasoconstrictors
230
what abbreviation is used for the recipe or directions of a drugs or lens prescription
Rx
231
if a patient is instructed to take a medication "q.o.d" the patient will take the medication how often?
every other day or on alternate days
232
which drug delivery method commonly produces temporary blurred vision?
ointment
233
what is the term for an injection delivering drugs under the skin
Hypodermic or sub-sutaneous
234
Interpupillary distance (IPD) is the distance between
center of the two pupils
235
The distance from the bridge of the nose to the center of a pupil is a ***
Monocular measurement of the IPD (Interpupillary distance)
236
what effect is produced when the distance between the optical centers of lenses mounted in a spectacle does not correspond to the IPD of a patient?
Prismatic or induced prism
237
what happens to light at the optical center of a lens
Nothing; light passes without being refracted
238
light rays are *** when they pass at an angle from one transparent medium to another of a different refractive index
Refracted
239
a prism bends light rays toward its ***
base
240
light rays centering two prisms placed base-to-base will be refracted so that the rays ***
converge
241
The distance from the posterior surface of a spectacle lens to the anterior surface of the cornea is termed ***
vertex distance
242
Bifocal spectacles will enable a patient to see clearly at *** distance
two; any combination of near, intermediate and far
243
The trifocal portion of a +2.00 reading add will be ***
+1.00 D
244
What is the minimum thickness of safety lenses?
3.0 mm
245
in terms of lens thickness, the greater the refractive index, the *** the lens
Thinner
246
a *** board may be used to immobilize an infant for an ophthalmic examination
papoose
247
how does acetazolamide (Diamox) affect the eye?
It reduces the volume of aqueous production
