Follow-Up Visits Flashcards
- In-office polishing of the anterior surface of a gas permeable lens surface will provide many benefits to the patient. Which of the following is not a benefit of polishing the lens in the office?
A. Cleaner lens surface
B. Increase lens comfort
C. Thinner lens edge
D. Removal of scratches on the lens surface
Thinner lens edge
- Which of the following modifications to a gas permeable lens can not be done in the office?
A. Blending of the peripheral curves
B. Addition of minus power
C. Polishing lens surface
D. Changing the base curve
Changing the base curve
- Punctal occlusion may be most beneficial for which of the following conditions?
A. Allergic conjunctivitis
B. Evaporative eye
C. Tear deficient dry eye
D. GPC
Tear deficient dry eye
- If a patient with exophthalmic eyes due to thyroid disease requires a toric lens:
- It will be forcibly expelled from the eye due to the bulging eyeball
- It may dehydrate excessively due to the lid retraction and dry eye condition that often accompanies thyroid disease
- Stability will be difficult to maintain since there are no lid forces to keep he lens in position
- The “watermelon seed” principle will help keep the lens in position
A. 1 and 2
B. 2 and 3
C. 1, 2 , 3, and 4
D. None of the above
2 and 3
- Which of the following is not characteristic of corneal edema?
A. Smokey vision
B. Spectacle blur
C. Increase in K readings
D. Peripheral flare
Peripheral flare
- Which of the following is not used when blending peripheral curves in office?
A. Slot gauge
B. Radius tools
C. Polishing compound
D. Suction cups or a spinner tool
Slot gauge
- The slit lamp illumination that gives an overall view of the cornea but limits detail is:
A. Sclerotic scatter
B. Diffuse
C. Specular reflection
D. Oscilatory
Diffuse
- When keratometric mires are reflected off a soft contact lens are only clear when the wearer blinks, the lens fit is too:
A. Small
B. Large
C. Steep
D. Flast
Steep
- Gross corneal edema, which manifests itself clinically as central corneal haze, is verified by the slip lamp using sclerotic scatter illumination. What specific technique does the examiner use to see this condition?
A. The naked eye an an angle between the slit lamp beam and the eye of 90°
B. The blue cobalt filter of the slit lamp and an angle of about 45°
C. The green filter of the slip lamp and an angle of about 45°
D. High magnification and an angle between the beam and scope of 180°
The naked eye an an angle between the slit lamp beam and the eye of 90°
- When inspecting the blend on the bevel of a GP lens with a fluorescent tube:
A. The lens must be held so the reflection of light on the anterior surface of the lens falls centrally on the lens
B. The fluorescent tube should be behind and below the examiner
C. An ideal blend should show a J-shaped or ski pattern in a smooth curve
D. In order to get the reflection continuous to the edge of the lens is must never be tilted
An ideal blend should show a J-shaped or ski pattern in a smooth curve
- Diffuse central punctate staining is an indication of:
A. A foreign body under the lens
B. Lens flare
C. Tight lens
D. Excessively wide transitional zone
Tight lens
- Sandy returns to your office after being fit with soft contact lenes. She has complaints of the lenses becoming uncomfortable and burning as the day progresses. What might be the reason?
A. The lens is too small
B. The lens is too flat
C. The lens is too tight
D. The lens is the wrong color
The lens is too tight
- With a rigid contact lens in place, a fluorescent pattern shows a concentration of fluorescein inferiorly and superiorly beneath the lens. Which one of the following types of astigmatism is represented by this pattern?
A. Lenticular astigmatism
B. Residual astigmatism
C. Against-the-rule astigmatism
D. With-the-rule astigmatism
With-the-rule astigmatism
- Mary is wearing a gas permeable lens with a base curve of 43.50 D and a power of +2.75 D. She requires a -0.75 D sphere over this lens. If you wish to order her a new lens with a curve of 43.00 D, what will the new power be?
A. +1.50 D
B. +2.00 D
C. +2.50 D
D. +3.00 D
+2.50 D
(HINT: Rx + Over refraction, then apply SAM/FAP)
- FDA group 1 soft lenses:
A. Have a water content greater than 50% and an ionic lens surface
B. Have a water content less than 50% and a non-ionic surface
C. Have a water content greater than 50% and a non-ionic surface
D. Have a water content less than 50% and an ionic lens surface
Have a water content less than 50% and a non-ionic surface
- Which type of slit lamp illumination will allow you to determine corneal thickening, thinning, and distortion and depth of foreign bodies or opacities in the cornea?
A. Diffuse illumination
B. Optic section
C. Retro-illumination
D. Conical beam
Optic section
- Corneal edema is observed inferiorly under a prism ballast toric soft lens. What is the probable cause?
A. Lens is too tight
B. Corneal oxygen demand is too low for this lens
C. Lens is too loose
D. Prism thickness is too great
Prism thickness is too great
- A soft lens has edge lift when observed on a cornea. How can this be corrected?
A. Steepen the base curve
B. Decrease the diameter
C. Flatten the base curve
D. Change to high water content lens material
Steepen the base curve
- In evaluating a soft lens with the kerotometry mires or retinoscopic reflex, you detect distortion immediately after the blink followed by clear mires. This is caused by:
A. A steep fitting lens
B. A properly fitting lens
C. A flat fitting lens
D. A tight fittinglens
A flat fitting lens
- Corneal microcysts are most apparent via biomicroscopy with which method of illumination?
A. Direct
B. Specular
C. Retro
D. Sclerotic scatter
Retro
- Which type of slit lamp illumination is used for observing tear break up time?
A. Diffuse illumination
B. Optic section
C. Direct illumination
D. Retro illumination
Diffuse illumination
- A non-wetting gas permeable lens may cause:
A. Hazy, filmy vision
B. Lens awareness
C. Dryness or grittiness
D. All of the above
All of the above
- Causes of lens flexure may include:
- Pressure exerted by the upper lid
- High Dk lens material
- Apical clearance lens design
- Against-the-rule astigmatism
A. 1 and 3
B. 2 and 4
C. 2 only
D. All of the above
All of the above
- When evaluating fluorescein patterns, a special filter must be used with:
A. Silicone acrylates
B. Polymethylmethacrylates
C. Polymers with a UV blocker
D. Hydroxyethyl methacrylate
Polymers with a UV blocker
- The Wratten filter is used with the biomicroscope to:
A. Enhance fluorescein evaluation
B. Disclose devitalize tissue
C. Reduce unwanted reflections
D. Evaluate vessel formation
Enhance fluorescein evaluation
- Which of the following could cause a patient’s rigid contact lens to displace frequently and pop out without cause?
- Excessive posterior peripheral curve
- Insufficent peripheral curve
- Steep base curve relationship
- Flat base curve relationship
A. 1 and 4
B. 2 and 3
C. 1 only
D. 2 and 4
1 and 4
- A rigid lens shows two curves on the convex surface when measured with the radiuscope. On the lensometer, it shows one power. What type of lens is this?
A. Front surface toric
B. Back surface toric
C. Bitoric
D. Warper
Warped
- A soft contact lens that is too loose may show all of the following EXCEPT:
A. Edge stand-off
B. Limbal compression
C. Excessive lens movement
D. Distorted retinoscopy directly after blinking
Limbal compression
- A patient with a high degree of with-the-rule astigmatism fitted with a spherical gas permeable lens will show touch:
A. On the horizontal meridian
B. On the vertical meridian
C. On the oblique meridian
D. On the residual meridian
On the horizontal meridian
- A rigid lens showing apical touch is an indication of:
A. A steep fit
B. An intrapalpebral fit
C. A flat fit
D. An astigmatic fit
A flat fit
- A rigid lens showing excessive apical pooling is an indication of:
A. A steep fit
B. An alignment fit
C. A flat fit
D. An astigmatic fit
A steep fit
- Contact lenses that have a non-spherical back surface are called:
A. Aspheric lenses
B. Tricurve lenses
C. Truncated lenses
D. Sperical lenses
Aspheric lenses
- A rigid lens showing central vaulting is indicative of:
A. Apical clearance
B. An alignment fit
C. A flat fit
D. None of the above
Apical clearance
- A rigid lens showing a band-shaped area of touch on the flattest meridian is an indication of a lens fit on a(n):
A. Steep cornea
B. Spherical cornea
C. Flat cornea
D. Astigmatic cornea
Astigmatic cornea
- When there is slight pooling of fluorescein the peripheral curve portion of a rigid lens, it indicates:
A. A tight kens
B. Slight edge lift
C. A toric lens
D. Slight lens warpage
Slight edge lift
- On a compromise cornea, such as one that has undergone a corneal graft, what lens characteristic would be most beneficial?
A. High wetting angle
B. High Dk/t
C. Electric blue color for glare
D. Lenticular design
High Dk/t
- What two design changes might be helpful on centering a high riding myopic lens?
- Flattening the base curve relationship
- Myoflange lenticular
- Hyperflange lenticular
- Prism ballast
A. 1 and 2
B. 1 and 3
C. 2 and 3
D. 3 and 4
3 and 4
- Gas permeable lens flexure may be eliminated by:
A. Reducing sagittal vaulting
B. Increasing center thickness
C. Choosing a lower Dk material
D. All of the above
All of the above
- Fluorescein is used to observe all of the following except:
A. Contact lens fit
B. Corneal striae
C. Corneal dry spots
D. Punctate staining
Corneal striae
- Mike, a welder whose Rx is -6.00 +2.00 x 180, has been advised to trade his PMMA lenses of 20 years for a modality that allows more oxygen to the cornea. The first lens of choice would be:
A. Soft spherical lens
B. Low to mid Dk GP
C. High Dk GP
D. Aspheric lens
Low to mid Dk GP
- When corneal epithelial cells suffer trauma, the first step toward resolution is:
A. Sliding and migrating of the adjacent remaining epithelial cells
B. The formation of an infiltrate
C. An increase in basal cell formation
D. Acceleration of the endothelial cell function
Sliding and migrating of the adjacent remaining epithelial cells
- Which of the following should be suspected when there are large fluctuations in a patient’s refractive error?
A. Diabetes
B. Grave’s Disease
C. Rhinitis
D. Sjogren’s Syndrome
Diabetes
- To increase tear exchange with a gas permeable lens, all of the following should be attempted EXCEPT:
A. Reduce the overall lens diameter
B. Flatten the peripheral curves
C. Increase the sagittal depth
D. Decrease the optic zone
Increase the sagittal depth
- Dry eyes are a common side effect of:
A. Antihistamines, decongestants and antibiotics
B. Oral contraceptives, Accutane, and antihistamines
C. Synthroid, decongestants, and sulfa drugs
D. Diuretics, anitbiotics, and antihistamines
Oral contraceptives, Accutane, and antihistamines
- In order to create a smooth blend between the intermediate and peripheral curve of the following contact, which radius tool should be used?
CPC 7.50 mm (45.00D), IPC 8.5 mm, PPC 10.50 mm
A. 8.5 mm
B. 9.5 mm
C. 10.2 mm
D. 11.5 mm
9.5 mm
- To correct a flat fitting gas permeable lens, you could:
A. Enlarge the optical zone
B. Decrease the optical zone
C. Decrease the sagittal zone
D. Decrease the lens diameter
Enlarge the optical zone
- Inferior punctate staining may be a sign of:
A. Allergies
B. Sensitivity to solutions
C. Sensitivity to lens material
D. Lagophthalmos
Lagophthalmos
- Which of the following will not cause the movement of a tight fitting gas permeable lens?
A. Enlarge the posterior optic zone
B. Decrease the posterior optic zone
C. Decrease the sagittal vaulting
D. None of the abve
Enlarge the posterior optic zone
- Which of the following is not important to document in medical records for contact lens patients?
A. Care system the patient is using
B. Lens parameters and materials
C. Care system the patient had problems with
D. Location at which the patient was originally taught insertion and removal
Location at which the patient was originally taught insertion and removal
