technician Flashcards
1
Q
Does a prism bend light rays toward the base of the prism or toward the apex of the prism?
A
Toward the base
2
Q
Mydriasis, ptosis, and anhydrosis are characteristic of BLANK syndrome.
A
Horner’s
3
Q
What is the near point of accommodation?
A
NPA is the position closes to the eye where a small object (usually small print) can be kept in sharp focus by maximal accommodation.
4
Q
Where in the visual field is the physiologic blind spot located?
A
15 degree temporal to fixation
5
Q
Why is 20 feet considered a practical distance for assessing distance visual acuity?
A
At 20 feet very little accommodation is required.
6
Q
What will distort the sound beam in immersion a-scan?
A
Bubbles
7
Q
How many meridians are measured in keratometry?
A
2 (90 degrees apart in cases of regular corneal astigmatism)
8
Q
When eye drops are administered, what is the procedure that will eliminate contamination?
A
The tip of the eyedropper does not touch the lashes or the eye or any other surface
9
Q
A patient with trichiasis may have this procedure to permanently remove eyelashes.
A
Electrolysis
10
Q
When using a streak retinoscope, if you see “with” motion, this indicates the need to palce what kind of lens power in front of the eye?
A
More Plus Power
11
Q
The power of a prism to bend light depends on the size of the angle at the apex of the prism. In what units is the power of a prism measured?
A
Prism Diopters
12
Q
Pupils that are small, irregular-shaped, non-reactive to direct or consensual light, but react to near stimulation are signs of what?
A
Argyll-Robertson Pupils, found in late syphilis
13
Q
What is the difference between versions and ductions?
A
Version is the parallel movement of BOTH eyes in any direction. Duction is the range of movement of ONE eye (in any direction) considered independently from movement of the other eye.
14
Q
What is the term for an area of partial or complete blindness within the confines of a normal or relatively normal visual field?
A
Scotoma
15
Q
What does the denominator represent in the distance visual acuity fraction 20/50?
A
The 50 represents the distance that a normal eye can see the chart letters. In this case, the normal eye can see the letters at 50 feet
16
Q
Why is the non-contact A-scan method considered superior by many experts?
A
Compression factor is eliminated
17
Q
What is the first step in keratometry?
A
Focusing the eyepiece
18
Q
Who signs the informed consent form prior to surgery?
A
The physician, patient (or legal guardian), and a witness
19
Q
What condition may arise during or following a minor procedure that may need immediate first aid?
A
Fainting, respiratory emergency, allergic reactions, drug reactions, central nervous system stimulation (tremors, convulsions, excitability)
20
Q
When using a streak retinoscope, if you see “against” motion, this indicates the need to place what kind of lens power in front of the eye?
A
more minus power
21
Q
What does the formula P=C/D represent?
A
This formula explains the relationship between the power of a prism and the ability to bend light. P is prism diopters. C is the displacement of the object in centimeters, and D is the distance between the prism and the virtual image in meters.
22
Q
What does the pupil look/act like in an acute glaucoma attack?
A
Mid-dilated and poorly reactive
23
Q
What is fusional convergence amplitute?
A
Amount the eyes can turn inward (toward each other) before double vision occurs. Measured in prism diopters.
24
Q
Which method of permietry is the most widely used and is essentially a screening test?
A
Confrontational visual field test
25
What is indicated by improved vision through a pinhole?
Refractive error; vision can be improved with eyeglasses or contacts.
26
The cornea is responsible for what percentage of the aberrations of the entire eye?
80-85%
27
The range of the keratometer may be extended with auxiliary lenses. What loose lens should be attached over the aperture of the instrument to extend the limit from 36D to 30D?
-1.00 D with the plano lens surface mounted toward the aperture
28
What is a major cause of patient dissatisfaction?
Time spent waiting in the reception area, unmet expectations.
29
What laser is used to coagulate blood or seal off blood vessels?
Argon laser or blue-green light laser
30
Two prisms placed base-to-base form the basis of what type of lens?
Convex (plus)
31
The swinging flashlight test is used to evaluate what 2 types of reaction to light?
The direct and consensual pupillary reaction
32
When using prism to measure the magnitude of strabismus, is the apex of the prism placed in the same or opposite direction of the eye turn?
The apex is placed in the same direction as the eye turn.
33
When calibrating a goldmann perimeter, the light meter should read at which measurement?
1,000 Apostilbs or 1430 lumens
34
Which type of testing determines the retina's ability to detect subtle differences in brightness or shading between targets and their backgrounds.
Contrast sensitivity testing
35
The corneal sensitivity test can be administered with what?
With fine hair of the cochet-bonnet esthesiometer
36
Does the mire reflection of a steeper corneal surface reveal a smaller or larger reflex?
Smaller. The chord length of the steeper cornea is shorter, resulting in a smaller mire reflection.
37
Name an urgent symptom that needs to be seen the same day?
Painful red eye; swollen eyelid; flashes of light; sudden double vision; or lid droop
38
Name three mechanisms of medical lasers that produce tissue damage.
Thermal, photodisruptive (ionizing) and photochemical
39
What do convex lenses do to light rays?
converge them
40
What percentage of the population has anisocoria?
Approximately 10% of the population has a difference in pupil size.
41
Which type of perimetry device uses mostly kinetic (moving) targets to map out the visual field?
Manual, such as goldmann perimeter
42
What information is gained from a PAM test?
It gives the physician an estimate of a patient's potential visual acuity
43
The imperfections of the optical system, such as refractive errors, and those caused by laser refractive surgery are referred to as what?
Aberrations
44
A patient calls complaining of halos around lights. When should this patient be scheduled?
This is a priority case to be seen within days.
45
What protective equipment is worn to prevent accidental laser exposure to all onlookers (patient's, technicians).
Laser eye protection (laser goggles)
46
What questions would you ask the patient when performing the amsler grid?
Is the center spot visible? While viewing the center, can you see all 4 sides? Do you see the entire grid? Are the horizontal and vertical lines straight and parallel?
47
What is the prince rule used to measure?
Near Point of accommodation
48
Name four main methods of infiltration anesthesia.
Nerve Block, retrobulbar, peribulbar, direct infiltration subcutaniously
49
What principles are used to measure corneal thickness?
Optical, ultrasound, corneal wavefront
50
What is the difference between hypopyon and hyphema?
Hypopyon is a pool of pus in the anterior chamber. Hyphema is a pool of blood in the anterior chamber.
51
Mydriatic drops act on what musculature to dilate the pupil?
Iris dilator muscle
52
When a procedure or test is recommended to the patient by the physician, an informed consent is obtained giving the physician permission to perform. Who obtains the informed consent?
The physician
53
How do you eliminate a crescent shaped artifact in fundus photography?
Move the camera in the opposite direction of the artifact.
54
Which virus commonly causes "fever blisters" on the lips and mouth and is responsible for most lesions of the cornea and eyelids?
Herpes Simplex Virus Type 1
55
An alternative to cleaning the applanation tonometer tip with an alchol sponge is to soak the prism tip for 5 minutes in what 2 solutions?
Either 3% hydrogen peroxide or in 1:10 dilution of household bleach and water
56
What is the proper procedure for patching an eye post cataract surgery?
An eyepad in place with strips of tape on an angle from the cheek to the forehead. Pastic or metal shield is commonly placed over the eyepad.
57
Where is vertex distance usually measured?
Back surface curvature of the lens to front surface of the center of the eye
58
Name two muscle surgeries that strengthen an extraocular muscle.
Resection, advancement
59
What are the two types of ultrasound heads?
Solid and fluid filled
60
Describe the symptoms of a patient undergoing an acute angle closure episode.
Severe ocular pain, redness, blurred vision, rainbow colored halos around lights, headache, nausea, vomiting.
61
What mydriatic agent can be used in establishing the diagnosis of horner's syndrome?
Paredrine or cocaine eye drops
62
If a patient calls the office with an emergency problem and the physician is not available, what should the technician do?
That patient should be referred to another ophthalmologist or emergency room
63
In fundus photography, a centrally located spectral reflection and haze along the periphery of the image area is a result of what?
excessive camera to cornea distance
64
the protozoan, BLANK, can be found in homemade contact lens solutions and can cause painful infections of the cornea.
Acanthamoeba
65
What is used to check calibration of the goldmann-type applanation tonometer?
Check the applanation for calibration using the manufacturer-supplied controlled calibration bar that came with instrument
66
When instilling more than one eye drop, how long should a patient be instructed to wait between eye drops?
Wait 1 minute with eye closed
67
If a right lens is displaced to the right of the 2nd circle, how much prism is in the lens?
2 D base in
68
An A-scan is performed prior to intraocular surgery to assist in determining what?
Axial length, which is needed to calculate intraocular lens power
69
A diamond knife may be measured by the caliper on the handle but should also be checked against a coin gauge, a ruler, or what kind of scope?
Microscope
70
What important questions should you ask the patient who has a chief complaint of double vision?
1. Are there 2 separate objects instead of 1?
2. Is the double vision still noticeable when one eye is covered?
3. Is the 2nd image horizontal or vertical from the main image?
4. When did the double vision begin?
71
Timolol is used in glaucoma management by decreasing what?
The formation of aqueous humor
72
True of False: Physician and staff should never criticize the word of another physician.
True
73
Short, light-colored streaks arising from the top or bottom of the frame are due to what?
Patient's lashes or hair
74
Why must a specimen be collected for testing before empiric treatment can be started?
Treatment might interfere with the ability to obtain and identify the disease-causing organism
75
What is the best method for storing a tonopen?
Store the tonopen with a tip cover over the tip and handle with care
76
At what age does a child quickly respond to occlusion therapy for amblyopia?
Ages 1-3
77
What are 2 characteristics of minus lens image?
Erect (right side up); Virtual
78
What condition is a true ocular emergency following cataract surery when a patient presents with symptoms of a painful red eye and decreased vision within the first week?
Endophthalmitis
79
How often should the applanation tonometer be calibrated?
Manufacturer recommends re-calibration annually with a calibration check (instrument maintenance) daily.
80
The most common side effects of glycerol (glycerin) are what?
Nausea, Vomiting, and headaches
81
Name 2 principles of autonomy.
Principle of disclosure and principle of informed consent.
82
What dyes are primarily used to perform ocular angiography?
Fluorescein sodium and ICG
83
Name the four main components of aseptic technique.
1. Sterilization of equipment
2. Sterilization of skin adjacent to operative site
3. Sterilization of hands of surgeon and assistant
4. Use of sterile solutions and ointments during and after the operation.
84
What should you avoid doing when changing light bulbs for ophthalmic instruments?
Avoid using bare hands, as the oil from your finger tips can etch an instrument bulb and diminish the effectiveness and life of the bulb.
85
What does Snell's law Determine?
Index of Refraction: Speed of light in air divided by the speed of light in the substance
86
What is the name of the glaucoma surgery that permits aqueous to filter out of the anterior chamber and form a conjunctival bleb?
Trabeculectomy
87
What red dye has an affinity for degenerative epithelium?
Rose Bengal
88
What type or class of medication is used for the treatment of herpes simplex of the cornea?
Anti-Viral agents such as acyclovir tablets, Viroptic, vidarabine (vira-a) ointment
89
Fluorescein sodium is available in what two different concentrations?
10% and 25%
90
What is the formula for prism displacement?
P=C/D (prism diopters equals decentration of image in cm divided by distance in meters.) ie if an image is displaced 1cm at 1m it equals 1 prism diopter
91
The main reason why the patient is visiting the doctor in the patient's own words is called the BLANK
Chief Complaint
92
What is used to check the calibration of the manual keratometer?
Metal test spheres provided by the manufacturer with known radius of curvature
93
When photographing the patient's name tag, which filter and what flash setting should be used?
A green filter and low flash setting
94
When should the perimetrist add complete cylindrical power to the lens holder as opposed to spherical equivalent?
If a cylinder is greater than one diopter
95
What is the most notorious or potentially damaging organism to contaminate ophthalmic solutions?
Pseudomonas Aeruginosa
96
Name the four most common microorganisms associated with eye disease.
Bacteria, Virus, Fungi, Protozoa
97
Tonometry measures BLANK BLANK?
Intraocular Pressure
98
What eye measurement is one of the primary factors in calculating the optimal IOL power?
Axial Length measurement
99
What are the 10 general types of mechanisms of disease and injury?
1. Infectious, 2. Inflammatory, 3. Allergic, 4. Ischemic, 5. Metabolic, 6. Congenital, 7. Developmental, 8. Degenerative, 9. Neoplastic, 10. Traumatic
100
Why is it important to have optical center alignment when performing lensometry?
Incorrect placement induces prism
101
Name at least five areas of good history taking.
1. Chief complaint/HPI, 2. Past Ocular History, 3. General medical history/social history, 4. Family Ocular/Medical history, 5. Allergies/Medications/vitamins/supplements
102
The accessory lenses on the outside of the phoropter casing can be cleaned with BLANK and BLANK.
Photographic Lens Cleaner, Lens Tissue
103
A controlled photograph for pseudofluorescence and autofluorescence is taken with the flash setting for fluorescein and with what filters?
Both the exciter filter and the barrier filter
104
If the patient responds to a target presented in the physiologic blind spot, this is referred to as a BLANK
Fixation loss/false positive
105
Subconjunctival injections are used primarily to treat what condition?
Intraocular infections and inflammation
106
Bacteria can be classified by their reaction when exposed to dyes. Name these dye procedures.
Gram staining and geimsa staining
107
One of the first and oldest methods used to determine intraocular pressure is BLANK
Tactile (finger) tension
108
In order to perform the IOL calculations, what other piece of information is required besides A-Scan and keratometry Readings?
A-constant
109
Why is it important to gather a family history on the patient?
Various disease processes develope in children or adults due to genetic (inherited) disorders
110
What is prentice's rule?
Formula to evaluate prism induced by decentration of optical center.
111
Name at least four catagories of ocular history related questions you may ask the patient.
1. History of glasses/contacts, 2. Surgery to either eye, 3. Trauma/eye conditions, 4. topical/oral medications taken for the eyes.
112
List ways to clean the dust on the lenses of a manual lensmeter.
1. Blowing the dust of with a clean, rubber bulb syringe, 2. a dust brush, 3. compressed canned air
113
What are the phases of fluorescein angiography?
Choroidal, arterial, arteriovenous, and late phase
114
Which defect is a complete nerve fiber bundle defect emanating from the blind spot, arching over or under the macula and ending on the nasal horizontal line?
Bjerrum's scotoma or arcuate scotoma
115
What medication route is used to treat conditions such as cellulitis, uveitis, and acute allergic reactions?
Treatment of medication may be given by route of injection (subcutaniously, intramuscularly, or intravenously)
116
name a common gram-positive bacterium that is a frequent cause of blepharitis, conjunctivitis, and infectious keratitis.
staphylococcus aureus
117
What is the name of the tonometer that consists of a footplate with a central moveable plunger fitted into a barrel?
Schiotz tonometer
118
On a preliminary examination, with a slit lamp, how can one make an estimation of the depth of the anterior chamber?
By shining a small penlight from the side
119
Name at least 5 different sources of ocular trauma.
1. Contusion/abrasions, 2. Blow (blunt force), 3. foreign body, 4. thermal injury, 5. chemical injury, 6. toxins
120
True or false: The higher the refractive error, the more important the placement of optical centers.
True
121
True or false: the internal trial lenses of the phoropter can be cleaned with alcohol.
False
122
Oral Fluorescein discloses which phase of angiography?
Late Phase
123
Autonomic drugs that affect the eyes are divided in to what 3 agents?
Mydriatic, Cycloplegic, and myotic
124
Name a gram-negative organism associated with contact lens overwear.
Pseudomonas Aeruginosa
125
Name the three common weights used in schiotz tonometry.
5.5g, 7.5g, and 10g
126
The anterior chamber depth is considered to be shallow at what degree?
10 degrees
127
Which type of prism is better for short term use?
Fresnel press on prism
128
The arm-to-retina time is usually how many seconds?
8-16 seconds
129
Why are cycloplegic drops essential in the refraction of children's eyes?
They paralyze the ciliary muscle so that the eye is no longer able to accommodate.
130
Which tonometry technique measures the force required to flatten the cornea?
Applanation tonometry
131
What is the highest range for fresnel press on prism?
40 diopters
132
What is the highest range for ground-in prism?
10 diopters in each lens
133
Polarized lenses block all light rays except those that do what?
Vibrate in the same direction
134
What is astigmatism?
A refractive error caused by the non-spherical (cylindrical) surface of the cornea or lens or both.
135
True or false: The principle of keratometry involves the utilization of the properties of the anterior surface of the cornea as a highly polished convex spherical mirror.
True. To measure the radius of curvature, a target or mire of known size is placed at a known distance.
136
When performing a B Scan, som echoes, such as vitreous membranes, may not be visible if which setting is too low?
Brightness
137
During Manual perimetry, how is the test object introduced to the patient?
From non-seeing to seeing areas
138
What does the numerator represent in the distance visual acuity fraction 20/30?
The patient is 20 feet from the chart.
139
What type of glaucoma is typically associated with a sudden rise in the intraocular pressure caused by mechanical obstruction of the angle, with sudden decrease in vision, red eye, halos around lights, nausea and excruciating pain?
Acute Angle Closure Glaucoma
140
Name the primary and secondary actions of the superior oblique muscle.
Primary Action: Intorsion, Secondary action: Depression, abduction
141
Name three common errors in aseptic surgical technique with masks and caps.
Mask covering mouth only and not the nose; mask too loose; hair protruding from cap
142
Using reflected light from the fundus is an excellent technique with which to demonstrate a variety of findings in the lens and cornea. What is this technique called?
Retro-Illumination
143
What type of corneal astigmatism does the following demonstrate? 45.00 @ 180 / 46.50 @ 090
With the rule
144
Are fesnel prisms usually applied to the front or the back surface of a patient's eyeglasses?
The Back Surface
145
"With the Rule" astigmatism is corrected by plus cylinder at or near which axis?
90 Degrees
146
The difference between the two meridians is the amount of conreal BLANK
astigmatism
147
When performing a B Scan, what would cause reverberation in the eye being scanned?
Insufficient Coupling
148
What is the most common type of visual field defect indicated in a hysterical patient?
Tubular or spiral
149
True or False: If a person with nystagmus has a preferred abnormal head posture, vision is tested with the head in this abnormal position.
True
150
Which glaucoma type is typically termed the "silent thief of sight" and why?
Chronic open angle glaucoma/primary open angle glaucoma, due to the gradual, slow progression of vision loss
151
What is the term used for the movement of both eyes to the left?
Levoversion
152
What is the minimum brush stroke for every portion of the hand when surgically scrubbing?
20-30 strokes
153
What filter is used to enhance visibility of the external tissues of the eye when using fluorescein dye?
Exciter Filter
154
What amount of corneal astigmatism does the following demonstrate? 44.00 @ 018 / 46.50 @ 108
2.5 diopters
155
Name the variable focusing power of the eye provided by the flexibility of the crystalline lens.
Accommodation
156
"Against the rule" astigmatism is corrected by plus cylinders at or near which axis?
180 degrees
157
Which type of defects either extend from the blind spot or point toward it?
Paracentral
158
When testing visual acuity, what are the black symbols on a very white background called?
Optotypes
159
What classic sign is characteristic of congenital glaucoma?
Buphthalmos- an abnormally large eyeball ("ox-eye")
160
What is the definition of sterilization?
Complete destruction of all microorganisms within or about an object
161
For greater reflection intensity to view the lens and cornea, what internal structure can serve as a brighter reflecting surface?
Optic Nerve
162
The distance between the two points at the edge of the reflected mire of the surface being measured is referred to as BLANK BLANK
Chord Length
163
Clinically, infinity is determined to be at what distance?
20 feet (6 meters) and beyond
164
Name the clinicial procedure performed by ophthalmic personnel for determining a patient's refractive error.
Refractometry
165
The binocular visual field equals how many degrees?
120 degrees
166
What is the Jaeger System?
A system of readable print and arbitrarily assigned numbers for near vision testing.
167
What is the condition called when the iris balloons forward, blocking aqueous flow, causing sudden increase in IOP?
Iris Bombe
168
What are the most commonly used sterilization methods in ophthalmology?
Autoclave (moist heat), boiling, dry heat, chemical, gas, radiation, ultraviolet
169
Fluorescein angiography requires a fluorescein filter set consisting of what?
An exciter filter and a barrier filter
170
When evaluating the mire reflection of the corneal surface, a longer chord length demonstrates what two things?
Flatter corneal curvature, larger mire
171
How is astigmatism corrected?
With spherocyclindrical lenses
172
What is the cause of a bitemporal hemianopsia?
A defect in the optic chiasm, eg a pituitary tumor
173
What is the difference between enuclation and evisceration?
Enucleation is total removal of the eye globe. Evisceration is removal of the contents only, leaving the outershell with the muscles attached.
174
What will the patient sign prior to surgery that outlines the procedure, risks,benefits, and possible complications?
Informed consent form
175
Differentiate between disinfection and sterilization.
Disinfection is the process of inactivating or eliminating most disease-causing organisms. Sterilization is the killing of all living organisms.
176
True or False: Physicians have a legal obligation to report suspicion of child abuse.
True
177
Name the cranial nerves that innervates each of the 6 ocular muscles.
CN III: Superior Rectus, Inferior Rectus, Inferior Oblique, Medial Rectus; CN IV: Superior oblique; CN VI: Lateral rectus
178
What should be done for your patient that becomes unconscious in the office?
Begin basic life support
179
Two prisms placed apex to apex form the basis of what type of lens?
Concave (minus)
180
Standardized filter paper is used to measure the amount of tear production. What is the name of the test?
Schirmer's test
181
What mild adverse reactions can occur besides a vasovagal reponse?
Nausea, Vomiting
182
A patient calls with a chemical contact to the face and eyes. What would be your first instruction to this patient?
Irrigate: Ex fill basin or tub with tap water and immerse patient's head into the water with eyes open under water. Water does not have to be sterile for irrigation, shower sink or anywhere to rinse the eye thoroughly.
183
What color stimulus on an automated perimeter would be chose to test for macular defects?
Red
184
Which systemic disease is associated with the eye findings referred to as graves' disease?
Thyroid Disease
185
A BLANK is a chemical that kills germs.
Germicide
186
If staff makes an error, should it be reported?
Absolutely; staff should be encouraged to disclose medical errors.
187
After estimating misalignment by conducting hirschberg test, you could use prism to conduct the BLANK test to equalize the corneal reflexes.
Krimsky
188
How does the ophthalmic assist the blind patient to the examination room?
Introduce yourself and offer your arm to the blind person.
189
What is the prince rule used to measure?
Near point of accommodation, and bifocal and trifocal add power.
190
What is TBUT in regards to tear test?
Tear break up time
191
What other moderate adverse reaction can occur besides fainting and phlebitis?
Hives (urticaria)
192
What instructions should be given to a patient prior to visual field testing?
Focus on target, do not look around for light, explain to patient what to expect (one of greatest sources of error is patient not knowing what to expect)
193
What is the benefit of using a blue stimulus on a yellow background in automated perimetry?
Earlier detection of visual field loss.
194
Which disease is indicated by the presence of microaneurysms, dot and blot hemorrhages, and lipid exudates from a leakage of the retinal vessles?
Background Diabetic retinopathy (systemic disease = diabetes
195
According to OSHA universal precautions, what solution is used to clean spills of blood or blood containing body fluids on a smooth surface? On a porous surface?
Household bleach and water in a 1:100 ration for smooth surfaces, and 1:10 ration for porous surfaces
196
What is the difference between a tropia and a phoria?
A tropia is a misalignment that continually manifests, while a phoria is a misalignment found only when covering one eye.
197
What should the patient be instructed to do to reduce systemic absorption of eye drops?
Punctal occlusion - block tear duct at inner canthus with fingertip covered by tissue as a drop is being instilled.
198
What is prentice's rule?
It's a formula to calculate induced prism effect caused by spectacle lenses whose optical centers have been decentered so they are not in line with a patient's visual axis. The formula is induced prism (in diopters) = lens power x optical center displacment (in CM)
199
What instrument provides comparison of the forward protrusion of each eye in relation to the bony orbit?
Exophthalmometer (ie hertel)
200
If a patient experiences stinging or burning around the injection site, what would be the most likely cause?
Extravasation of the dye
201
Name three true emergencies that should be treated within minutes.
Chemical burn to the eye, CRAO, Penetrating injuries to the eye, sudden loss of vision
202
What amount of visual field is measured using an amsler grid held at the proper distance?
Central 20 degrees
203
Name 2 indications that a contact lens solution is causing a toxicity or hypersensitivity.
Conjunctival Redness, punctate keratopathy, or corneal infiltrates
204
What are two common treatments for stabismic amblyopia that may be effective for children up to age six?
Place a patch over the dominant eye or use eye drops that blur the dominant eye, forcing the amblyopic eye to work.
205
What should be done to assist a patient who faints in the office?
Place patient's head between knees; loosen a tight collar; give smelling salts or ammonia; have patient remain in office 20-30 extra minutes to regain composure
206
Find the total amount of prism induced in the following situations: Glasses RX OD +12.00 sph; OS +10.00 sph; both optical centers are displaced 5mm temporally (decentered out)
OD has 6 prism diopters base out. Os has 5 prism diopters base out. The total is 11 prism diopters base out.
207
What should be set as the basic figure for comparison at subsequent readings when measuring forward protrustion at each eye in relation to the bony orbit?
The distance along the horizontal bar
208
If the posterior pole cannot be visualized, which instrument would be requested.
B-Scan
209
During goldmann perimetry when would the examiner use the patient's near correction?
For testing the central 30 degrees in patients over the age 30
210
Name a medication that should be kept on hand in case of severe allergic reaction to a drug.
Epinephrine; intravenous cortisone; benedryl
211
At what mark on the chart is the recording arm positioned and locked for calibrating a goldmann perimeter?
70 degrees
212
If the light on the slit lamp does not come on, what is the first thing you should check?
First check all electrical connections
213
True or false: rigid lens fittings nomograms may help determine the initial base curve to be evaluated if a diagnostic lens is not available.
True
214
What four characteristics of the pupil should be noted?
Size, Shape, reaction to light, reaction to near
215
While conducting a worth 4 dot test, what does it indicate when a patient sees only 2 dots?
Suppression of the eye behind the green lens
216
Name at least 3 categories of general medical and social history-related questions you may ask the patient.
1. current/past medical conditions; 2. current/past medications; 3. surgery/treatment for medical conditions; 4. pregnancy/nursing; 5. smoking/alcohol/drug use; 6. Patient's occupation/hobbies
217
What is a small instrument that attaches to the slit lamp projecting a beam of light containing a brightly illuminated snellen chart through the less dense area of a lens bypassing the cataract?
Potential acuity meter (PAM)
218
What procedures is performed to relieve the pressure in the anterior chamber secondary to an angle-closure glaucoma?
Laser peripheral iridotomy (LPI)
219
What is the name of the code of rules and customs to which physicians are expected to adhere?
Hippocratic oath
220
Turning the observer's eyepiece focus dial back and forth will stimulate BLANK and result in a false setting that may affect BLANK
Accomodation, the accuracy of the readings
221
How should the technician respond when a returning glaucoma suspect with an IOP reading of 31 mmhg at today's visit, asks you if he has glaucoma?
The technician should defer to the ophthalmologist for a diagnosis and medical advice
222
What five things should you check if an electrical instrument fails to work?
1. Is the electrical connection to the outlet secure?; 2. Is the electrical connection to the instrument secure?; 3. Is the bulb burned out or darkened?; 4. Did the instrument blow a fuse?; 5. Is the outlet/electrical fuse working?
223
Name the instrument used to determine posterior surface radius of curvature of a rigid contact lens.
Radiuscope and/or contacto gauge
224
Which cranial nerve innervates the iris sphincter muscle and dilator muscles?
CN III, the oculomotor nerve
225
The condition in which eyes shift involuntarily in a rhythmic beating motion is called BLANK
Nystagmus
226
An APD is noted in the patient's previous chart notes. Before instilling dilation drops, what should the technician check?
Pupil exam including: Pupil size; speed of pupil constriction to light, pupillary response to near fixation, direct and consensual pupillary reaction
227
Name the test in which the patient looks into a machine that shines a light directly into the patient's eye while the patient reads the letters on the eye chart.
BAT (Brightness Acuity Test)
228
Aqueous humor is produced by the BLANK
Ciliary Body
229
Name one principal of medical ethics
Autonomy, beneficence, non-maleficence, justice, and truth
230
True or false: with traditional methods of patient fixation, the readings will always be the apex of the cornea
False, there are a number of corneal conditions that the apex of the cornea will not measure. Alternative methods of fixation will be necessary to find the corneal apex
231
Define HIPAA
Health Insurance Portability and accountability act; 1996 act sets rules for patient privacy, security of health information, health insurance shifts after leaving an employer. Severe penalties for non-compliance.
232
What two things should you check with battery operated equipment?
1. Is the battery fresh/recharged?; 2. Is the bulb burned out or darkened?
233
What slit lamp filter is used in conjunction with fluorescein to evaluate fluorescein patterns with rigid and silicon hydrogel contact lenses?
Cobalt/UV
234
Irregularities in the shape of the pupil may come from BLANK
Congenital abnormalities, inflammation of the iris, trauma, surgical
235
What is stereoposis?
Visual blending of two similar (not identical) images, one falling on each retina, into one, with visual perception of solidity and depth.
236
At what distance are near vision charts designed to be read?
14-16"
237
Tonometer tips should be wiped clean and disinfected with BLANK
Alcohol preps, 3% hydrogen peroxide for 10 minutes, or a 1:10 dilution of bleach for 3 minutes
238
During informed consent, the physician must discuss all BLANK no matter how minimal, uncommon, or severe.
Risks
239
The range of the keratometer may be extended with auxiliary lenses. What loose lens should be attached over the aperture of the instrument to extend the limit from 52 to 61D?
+1.25D with plano lens surface mounted toward the aperture
240
What is the difference between a sign and a symptom?
A sign is an objective observation of the patient's condition noted by the examiner. A symptom is subjective observation noted by the patient, such as how well they see or feel.
241
Name four examples of lenses that contact the eye and may require disinfection or sterilization.
1. Diagnostic contact lens; 2. fundus contact lens; 3. gonio lens; 4. koeppe lens
242
Name 3 reasons to dispense a therapeutic bandage contact lens.
1. protect cornea from eyelids/lashes; 2. promote corneal healing; 3. provide comfort; 4. stop wound leaks; 5. improve vision; 6. drug delivery
243
A difference in pupil response to direct stimulation from each eye is known as BLANK
A relative afferent pupillary defect (RAPD) or marcus-gunn pupil
244
How does the maddox rod dissociate the eye and prevent fusion?
It changes the size, shape, and color of a point of light to a line (a streak) of light so that fusion is impossible
245
What is determined by the smallest object that can be clearly seen and distinguished at a distance?
Visual Acuity
246
Tonopen tonometery utilizes what technique to measure the intraocular pressure?
Applanation - measures the force needed to flatten the central cornea
247
Name 2 primary roles and responsibilities of the OMP?
Collect data; perform clinical evaluation as authorized by the physician
248
In ordinary room light, what is the diameter of the normal adult pupil?
Between 3-5mm
249
What is the near point of convergence?
NPC is that point at which fusion can no longer be maintained and one eye deviates outward; causing double vision
250
Ophthalmic technicians are usually knowledgeable about the findings of a test, the BLANK makes the diagnosis and estimates the prognosis and discusses with the patient.
physician
251
When is topical fluorescein used?
An ocular stain used to show defects or abrasions in the corneal epithelium and to obtain intraocular pressure by goldmann applanation
252
Which machine uses laser lights in a pattern of stripes in which the patient indicates the orientation of the stripes?
laser interferometer
253
The calibration bar used to check calibration of the goldmann tonometer is checked at what settings?
0, 2, 6
254
Name some devices available for measuring glare disability
TVA, BAT, Eye Con, or Miller-Nadler glare tester
255
What is the refractive index of crown glass?
1.523
256
Name at least 3 common medical conditions that can affect the patient's vision.
1. Diabetes; 2. hypertension; 3. cancer/neoplasm; 4. cardiovascular disease; 5. hyperthyroidism
257
Name a solution that is used to disinfect eyelid skin.
Betadine, ioprep, alchol, tincture of iodine 2%, phisohex
258
What is the spherical equivalent of the following prescription: +2.00 +1.50 x 090
+2.75 sph
259
What do concave lenses do to light rays?
Diverge
260
What is the impact of increasing the diameter of a contact lens without adjusting the base curve?
the increased sagittal depth will effectively tighten the fit
261
What is the name of the test used for detecting a RAPD?
swinging flashlight test
262
What are the common routes of giving medication to obtain an effect on the eye?
Topical, subconjunctival, intracameral, retrobulbar, intravitreal, oral, and continuous-release
263
What would be the next step in evaluating the patient's visual acuity when the patient cannot see the 20/400 line at the standard 20 foot distance.
repeat at a shorter distance
264
How much tolerance is allowed when checking the calibration of the goldmann tonometer?
+/- 0.05g or .5mmHg
265
Deficient color vision suggests what?
Retinal or optic nerve disease
266
What kind of astigmatism is represented by a minus spherical lens and a minus cylindrical lens?
Compound myopic astigmatism
267
Why is it important to note all prescribed and non-prescribed medications for a patient who is scheduled for ocular surgery?
Some medications have ocular side effects and some reduce the blood's ability to clot, potentially causing complications during surgery.
268
What instrument is used to grasp small tissues for either removal or suture insertion?
Forceps
269
Transpose the following eyeglass rx into minus cyl form: +2.00+1.00x093
+3.00-1.00x003
270
What is the focal length (in meters) of a 3 diopter lens?
.33m or 33cm
271
The diffusion of oxygen through a contact lens material is referred to as BLANK
DK Value
272
Which muscle of the iris constricts in bright light?
iris sphincter
273
What is the generic name for the carbonic anhydrase inhibitor "Diamox"?
acetazolamide
274
What is the proper way to record the visual acuity if the patient reads all but one chart letter on the 20/40 line?
20/40-1
275
What dye and filter are used to perform goldmann applanation tonometry?
Fluorescein dye and cobalt blue filter
276
Normal color vision with decreased visual acuity suggests what?
non-organic disease
277
The prescriptions: +1.00-3.00x180; -2.00+3.00x090 represent what type of astigmatism?
mixed astigmatism
278
True of false: You can assume that the person accompanying the patient during the eye exam is someone to whom you may release medical information.
false: ask the patient and document to whom you may release the patient's information to
279
Name the instrument that has a slim-handle and bowl-shaped end, either round or serrated, used to remove chalazia and other small cystic material.
Curet
280
Transpose the following eyeglass rx into minus cyl form: -2.00+1.25x173
-0.75-1.25x083
281
The stronger the power of a plus lens, the (more/less) distance it needs to focus.
less
282
Name the three different toric designs available in rigid materials.
front toric, back toric, bitoric
283
What is the term for the spasmodic rhythmic dilating and constricting pupillary movements during pupil function testing?
Hippus
284
Why are topical non-steroidal anti-inflammatory drugs (NSAIDS) sometimes preferred over corticosteroids?
They often achieve the required anti-inflammatory effect without the undesirable side effects such as elevated IOP with long term use
285
How is visual acuity recorded in infants and preverbal children who cannot read the chart?
Central - steady - maintained (CSM)
286
Pulsation of the semi-circles is an indication of the BLANK
heartbeat
287
In contact a-scan, a 1 mm compression may result in how many diopters of calcuated IOL power error?
3 diopters
288
An eye patch applied correctly will prevent BLANK and BLANK
Further Bleeding and lid edema
289
```
Give the prescription represented in the following optical crosses:
+3.00
|
180 ---------+3.00
|
090
0.00
|
180 --------- -2.25
|
090
-1.25
|
045 ---------+2.00
|
135
```
+3.00 sph
- 2.25+2.25x180 or 0.00 -2.25 x090
- 1.25+3.25x135 or +2.00-3.25 x045
290
What does snell's law determine?
Whether the refracted ray will be bent toward the normal or away from it.
291
What rigid lens position is more acceptable, high or low riding?
high
292
What is the term for pupil dilation?
mydriasis
293
What is the ocular stain used to identify defects on the conjunctiva?
Lissamine Green Stain
294
To obtain an accurate reading when three diopters of astigmatism or more are present in applanation tonometry, the prism axis is set at the BLANK BLANK BLANK
Minus cylinder axis
295
In contact A-scan, what type of anterior chamber manifest the least evidence of compression?
The longest ACD (anterior chamber depth) measurement
296
Name 2 instruments used for lacrimal irrigation
punctal dilator, lacrimal needle, lacrimal probe
297
What does index of refraction compare?
ratio speed of light in a vacuum to the speed of light in a given substance
298
True or false: the application and evaluation of a diagnostic lens on the eye is the best way to fit a contact lens
true
299
What is the term used when there is a difference in pupil size?
anisocoria
