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COA STUDY GUIDE
Name the nine components of the ophthalmic history. - correct answer Chief complaint, present illness, past ocular history, ocular medications, general medical and surgical history, systemic medications, allergies, social history, and family history. Why is it important to specifically ask a patient about the medications they are taking? - correct answer Because certain medications may affect the eyes. What is the proper response to a patient's request from the ophthalmic technician for medical advice or a diagnosis? - correct answer Refer the patient to the ophthalmologist What is the term used for the reason for the patient's visit? - correct answer Chief complaint What elements are important in social history taking? - correct answer Smoking, alcohol, and drug use Prior use of topical ocular pharmaceutical agents is part of a patient's ________. - correct answer Past ocular history Pertinent family history of a patient should include which relatives? - correct answer Parents, grandparents, and genetic siblings A patient describing an experience of getting hives after taking sulfa drugs is providing information about __________. - correct answer An allergic reaction What is the term for the spasmodic, rhythmic dilating, and contracting pupillary movements during pupil function testing? - correct answer Hippus
What is the name of the test used for detecting a relative afferent pupillary defect? - correct answer Swinging flashlight test Which muscle of the iris constricts in bright light? - correct answer Sphincter What is pupil dilation termed? - correct answer Mydriasis What is the term used when there is a difference in pupil size? - correct answer Anisocoria What is pupillometry? - correct answer The measurement of pupillary diameters. 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 - correct answer Consensual pupillary reaction Calibration of the applanation tonometer should be checked approximately every _____ months. - correct answer Two (or sooner with regular use) When cleaning the goniolens, what is uses to rinse off the methycellulose? - correct answer Warm running water When replacing a light bulb _____ can diminish its effectiveness and life. - correct answer Oil from fingers Diagnostic lenses that contact the eye can be sterilized using? - correct answer Ethylene Oxide gas How should the removable glass slides inside the American Optical acuity projector be cleaned? - correct answer Wipe with clean, soft lint-free towel or photographic lens paper
Each black ring seen in the lensometer eyepiece reticle measures how much prism? - correct answer 1 diopter for each ring When performing lensometry, what is indicated if both thin and wide lines are in focus at the same time? - correct answer The lens is spherical. What is the technique used to measure the radius of curvature of the anterior corneal surface? - correct answer A-Scan Keratometry Length Measurements Keratometry is performed with a device called a ______. - correct answer Keratometer or ophthalmometer Give three examples in which a keratometry measurement would be useful. - correct answer Contact lens fitting, refractive surgery, intra ocular lens calculations, keratoconus Keratometry is measured in _______. - correct answer Diopters An unfocused eyepiece can lead to an error of _______. - correct answer 1 diopter in the K reading How many meridians are measured in keratometry? - correct answer 2 meridians (usually 90 degrees apart) The average K reading is _____. - correct answer 43 to 44 diopters Keratometry measures the _______ of the anterior curvature of the cornea. - correct answer Central 3.3 mm The diffusion of oxygen through a contact lens material is referred to as _______.
True or false: The application and evaluation of diagnostic lens on the eye is the best way to fit a contact lens. - correct answer True Name the instrument used to determine the posterior surface radius of curvature of the rigid contact lens? - correct answer Radiuscope and or Contacto Gauge Name three reasons to dispense a therapeutic bandage contact lens. - correct answer To protect cornea from eyelids and eyelashes, to promote corneal healing, to provide comfort, to stop wound leaks, to improve vision, or for drug delivery. Name two measurements required to fit a contact lens. - correct answer Refraction and K-reading (keratometry) Overwear of contact lenses may result in insufficient oxygen to the cornea called _______. - correct answer Hypoxia Ophthalmia What are Ethics? - correct answer Moral Principles and values that govern individual behavior What must ophthalmic medical assistants abide by? - correct answer The laws of the state in which their employer practices and under the service of a licensed ophthalmologist Attempting to work independently of an ophthalmologist is considered _______. - correct answer Practicing medicine without a license What should an ophthalmic practice have in place to meet legal compliance? - correct answer A compliance officer, policies and procedures What is HIPAA? - correct answer Health Insurance Portability and Accountability Act
_______ is a major contributing factor in contracting the parasitic organism Acanthamoeba - correct answer Contact lens wear Universal precautions are mandated by OSHA but were developed by the _______. - correct answer U.S. Centers for Disease Control Washing hands between patients is one example of _______. - correct answer Universal Precautions Drainage of topical drops from the eye and their systemic absorption can be prevented by _______? - correct answer Punctal occlusion What medications are used as topical anesthetics? - correct answer Proparacaine or tetracaine What is the color of bottle caps of prostaglandins? - correct answer Teal What are the classifications of the three large groups of anti-infective agents? - correct answer Antibiotics, antivirals, and antifungals A true allergic reaction can involve what symptoms? - correct answer Itching, rash, difficulty breathing, weak or rapid pulse _______ drugs induce contraction of the iris sphincter. - correct answer Miotic A cycloplegic drug will blur vision at near due to temporary loss of _______. - correct answer Accommodation Name the three types of ophthalmic preparations placed directly in the eye? - correct answer Solutions, suspensions, ointments
What is the main disadvantage of using an ophthalmic solution? - correct answer The duration of contact with the eye is short, therefore it requires frequent instillation. What is the disadvantage of using an ophthalmic ointment? - correct answer The ointment reduces vision by creating a greasy film over the surface of the cornea, and is best used at bedtime. Name the five basic requirements for ophthalmic preparations? - correct answer Tolerance, tonicity, sterility, stability, and penetration What is benzalkonium chloride - correct answer A preservative commonly used in ophthalmic preparations What is the name of the most notorious organism found in ophthalmic preparations? - correct answer Pseudomonas Aeruginosa Eye drops penetrate the eye directly through the _______ and into the anterior chamber. - correct answer Cornea How should drops be properly instilled into a patient's eyes? - correct answer Into the lower cul de sac (lower fornix) How are systemic medications administered? - correct answer Orally, injection (subcutaneously or intramuscularly), or intravenously. What does the term idiosyncrasy refer to with ophthalmic drugs? - correct answer An idiosyncrasy is a bizarre, peculiar reaction to a drug that is not commonly seen, such as tremors, excitability or even collapse. What drug classification is contraindicated in patients with obstructive pulmonary disease or cardiovascular disease? - correct answer Beta Blockers
When performing cover-uncover test, if the eye under the cover moves when uncovered, it is a _______ which is a _______ deviation. - correct answer Phoria, latent What is the term for an obvious misalignment of the eye? - correct answer Tropia An outward deviation of the eye(s) is a(n) _______ and an inward deviation of the eye(s) is called a(n) _______. - correct answer Exodeviation, esodeviation What is the term for the range of procedures used in medical environments to prevent the spread of infectious microbes? - correct answer Aseptic technique Surgical instruments most resistant to corrosion are made of _______. - correct answer Stainless Steel When creating a sterile field the drapes are usually _______ to moisture to prevent contamination. - correct answer Impermeable What is the most popular injected anesthetic for minor procedures? - correct answer Lidocaine When PRK is being performed, time remaining in the procedure should be announced in increments of _______. - correct answer 10 seconds Name the organism that is most destructive to the eye. - correct answer Pseudomonas Aeruginosa What procedure using an Argon Laser is thought to destroy areas of ischemic retina? - correct answer Panretinal photocoagulation or panretinal laser
What type of intraocular injection is made at the pars plana site with a needle and syringe of medication? - correct answer Intravitreal injection Name the procedure that uses the following instruments: probes, syringe, lacrimal needle (cannula), and punctum dilator. - correct answer Lacrimal probing and irrigation Name the two common facial nerve blocks. - correct answer Van Lint and O'Brien technique What intraocular injection infiltrates the soft tissue of the globe, rather than the muscle cone itself? - correct answer Peribulbar Anesthesia The most important step in successful LASIK is care and preparation of the _______. - correct answer Microkeratome Which ocular condition is commonly associated with Sjogren's syndrome? - correct answer Dry eyes (dry mouth is another finding of Sjogren's syndrome) Which systemic disease can cause temporary fluctuations in refractive errors? - correct answer Diabetes mellitus (DM) Name the virus that causes a dendritic pattern of keratitis. - correct answer Herpes simplex What is the ideal position for a patient who feels faint? - correct answer Head lower that the heart Where do you check pulse on an adult CPR patient? - correct answer Neck (carotid pulse)
Aqueous drains out of the eye through this net-like structure. - correct answer Trabecular Meshwork What type of glaucoma constitutes an ocular emergency? - correct answer Acute Angle-Closure Glaucoma Protocols for pressure patching or shields require that the adhesive tape must be applied from the a)_______ to the b)_______ - correct answer a) Bridge of nose; b) ear lobe What is the minimum thickness of safety lenses? - correct answer 3.0 mm What is the name of the important screening process used in emergencies to determine a patient's ocular needs? - correct answer Triage What is a hemorrhage confined to the anterior chamber termed? - correct answer Hyphema Which layer of the cornea is the thickest? - correct answer The Stroma What type of patch should not be used on a patient with a lacerated globe? - correct answer A pressure patch When long waiting times occur in the office what is the ophthalmic medical assistant's responsibility? - correct answer 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? - correct answer A papoose board _______ is any irritation or inflammation of the conjunctiva. - correct answer Conjunctivitis
Conjunctivitis may be _______, _______, or _______. - correct answer Allergic, viral, bacterial Sudden painless vision loss, which may continue to deteriorate over a few days, and may not recover is known as _______. - correct answer Ischemic Optic Neruopathy Forward displacement of the eye in its bony socket causing the eye to bulge forward is termed _______. - correct answer Proptosis.exophthalmus The cornea provides approximately _______ of the refractive power of the eye. - correct answer 2/ The absence of a lens in an eye is called _______. - correct answer Aphakia The presence of an intraocular lens (IOL) is called _______. - correct answer Pseudophakia _______ is a chronic inflammation of the eye lid margin. - correct answer Blepharitis Name the retinal receptors that function best in dim lighting, number about 125 million and are found in the periphery of the retina. - correct answer Rods Name the retinal receptors that are responsible for color vision, number about 6 million and are found in the macula. - correct answer Cones In fundus photography, when the camera is too far from the eye, a _______ will form around the image. - correct answer Blue-grey halo
What is an important factor when preparing a patient for refraction? - correct answer The refractionist must explain to the patient to choose the lens that provides the clearest vision. What is a common mistake made by the refractionist? - correct answer Moving or flipping the lenses too quickly for the patient. What are three appropriate starting points for refracting a patient? - correct answer Retinoscopy, autorefractometry, or patient's current spectacle Rx In what order should refinement of a refraction be performed? - correct answer Sphere, axis, then power of cylinder What accessory phoropter lens is utilized to refine cylinder axis power? - correct answer Jackson Cross Cylinder Name the two methods of refractometry. - correct answer Objective and subjective In refractometry, the _______ method requires the patient to give answers to the examiner. - correct answer Subjective When is the spherical equivalent best used in a spectacle Rx? - correct answer If a patient is an adult who has never worn glasses and requires a large astigmatic correction What is the name of the test to determine the correct myopic correction using red/green filter on the projector? - correct answer Duochrome test What is another reference or starting point for refracting a patient who has a poor retinoscopy reflex? - correct answer Keratometry
What normally determines the strength of an add power for near correction? - correct answer The age of the patient. What type of refractometry is indicated for children accommodative esotropia or patients who have latent hyperopia? - correct answer Cycloplegic refractometry is best used in these situations. What is the distance from the back surface of a lens to the front surface of the eye called? - correct answer Vertex distance Explain how to transpose a spherocylinder lens from plus to minus cylinder form, or from minus to plus cylinder. - correct answer Algebaically add the sphere and cylinder powers, retain the cylinder power but change the cylinder sign and change the cylinder axis by 90 degrees. Transpose: +2.00 -2.50 x 90 -0.50 + 2.50 x 180 Which instrument measures the radius of curvature, or base curve, of a spectacle lens surface in diopters? - correct answer Geneva lens clock or measure What is the spherical equivalent of -2.00 +3.00 x 90 - correct answer -0.50 sphere The trifocal portion of a +2.00 reading add will be _______. - correct answer +1. In terms of lens thickness, the greater the refractive index, the _______ the lens. - correct answer Thinner The distance from the center of the pupil of one eye to the center of the pupil of the other eye is termed _______. - correct answer Interpupillary Distance
Ophthalmologists often estimate anterior chamber depth by measuring the angle between the a)_______ and b)_______. - correct answer a) anterior surface of the iris b) posterior surface of the cornea What is the name of the instrument used to measure extension of the anterior surface of the cornea beyond the lateral orbital rim? - correct answer Exophthalmometer Name at least one example of a glare testing device. - correct answer TVA, BAT (Brightness Acuity Test), or Eye Con Name the two measurements required to determine the dioptric power of the intraocular lens. - correct answer A-scan (axial length of the eye) and keratometry (corneal curvature) When performing A'scan biometry, a 1mm error in axial length may result in a _______ diopter calculated IOL power error. - correct answer Three What is the term for the amount of time it takes for dry spots to form on the cornea when the eye is in staring position? - correct answer BUT (break-up time) Checking the calibration of a Goldmann applanation tonometer is performed with a _______. - correct answer Balance or calibration rod The Goldmann applanation tonometer prism is best cleaned between patients with _______. - correct answer Hydrogen peroxide soaks or 1:10 bleach solution Which dye solution is used when performing Goldmann applanation? - correct answer Fluorescein dye What is the diameter of the corneal area properly applanated by a Goldmann tonometer? - correct answer 3.06mm
Measuring intraocular pressure is also called _______. - correct answer Tonometry The higher the intraocular pressure of an eye, the _______ the eye. - correct answer Harder Applanation tonometry displaces less than _______ of aqueous. - correct answer 0.5 microliters When recording intraocular pressure, the reading on the Goldmann applanation tonometer scale should be multiplied by _______. - correct answer Ten What is the normal range of intraocular pressure? - correct answer 13-20 mm Hg Which method of tonometry is described as the measurement of the amount of pressure needed to flatten the cornea by a standard amount? - correct answer Applanation tonometry What measurement error is produced when the fluorescein rings are too narrow during applanation tonometry? - correct answer Falsely low reading What measurement error is introduced when a patient, holding his/her breath or wearing a collar that is buttoned too tightly, is applanated? - correct answer Falsely high reading The visual acuity notation 20/200 indicates the patient could see the 200 optotype at _______ feet - correct answer Twenty (20) If the patient perceives light and can indicate the source direction, the vision is recorded as _______. - correct answer Light perception with projection (LPw/P)
