Term
| Where can you find a large portion of the general patient information you need when taking a case history and performing a visual screening? |
|
Definition
|
|
Term
| Once a patient has identified/described a problem to you, what four things do you need to determine about the problem? |
|
Definition
(1) Onset.
(2) Duration.
(3) Cause.
(4) Severity. |
|
|
Term
| When a patient reports he or she is on medication, what three things do you need to know about the medication? |
|
Definition
| What the medications are for, why they are taking it, and how long the patient has been on it. |
|
|
Term
| What is the SOAPP format? |
|
Definition
S = subjective – what the patient reports to you verbally.
O = objective – things you can see or measure.
A= assessment – doctor’s assessment of the patient’s condition.
P = plan – what will be done based on the assessment made of the patient.
P = Prevention – counseling. |
|
|
Term
| What three basic things should be included in a visual screening? |
|
Definition
| Case history, VA testing, and IOP testing. |
|
|
Term
| What is one of the basic functions of the eye clinic? |
|
Definition
| To measure visual acuity of patients. |
|
|
Term
| Why is it important to record visual acuity as accurately as possible? |
|
Definition
| For proper patient treatment and medico-legal reasons. |
|
|
Term
| In simple terms, what is visual acuity? |
|
Definition
It is a measure of how well the eye “gathers” light, how well the nerves in the visual pathway transmit
information to the brain, and what the brain does with that information. |
|
|
Term
| What are the most common test targets for a visual acuity chart? |
|
Definition
|
|
Term
| How many components is each letter composed of? |
|
Definition
| Each letter has five components. |
|
|
Term
| If a patient has 20/40 vision, what exactly does this mean? |
|
Definition
| That the smallest discernible letter the patient can read at 20 feet is the 40-foot letter. |
|
|
Term
What height should the 20/200 “E” be for a 20-foot test distance? An 18-foot test distance? A 15-
foot test distance? |
|
Definition
| 20-foot = 88 mm; 18-foot = 79.2 mm; 15-foot = 66 mm. |
|
|
Term
| What is an important safety item to remember when replacing a Project-O-Chart bulb that has burned out while in use? |
|
Definition
| The bulb and housing will be extremely hot; use a towel or lots of tissue to remove it. |
|
|
Term
| Why should you always use a cloth or tissue to install a new bulb in the Project-O-Chart? |
|
Definition
| The oil from your hands will cause hot spots and lead to short bulb life. |
|
|
Term
| What correction should the patient wear when performing visual acuity testing? |
|
Definition
| Their habitual correction (if applicable), unless your doctor requests otherwise. |
|
|
Term
| Which testing charts are used for testing young children and illiterate patients? |
|
Definition
| Tumbling E, Landolt C, and Object. |
|
|
Term
| If the patient is able to read over 50 percent of the letters on the 20/50 line and two letters on the 20/40 line, how is this recorded? |
|
Definition
|
|
Term
| If the patient cannot read the 20/400 “E” of the visual acuity chart from a distance of 3 feet, what would you do next? |
|
Definition
| The finger-counting test. |
|
|
Term
| How would you record the visual acuity results for an eye that had no perception of light? |
|
Definition
|
|
Term
| What is the clinical definition of amblyopia? |
|
Definition
Visual acuity that is 20/40 or worse in an eye even after the best correction possible has been applied to
improve the vision. |
|
|
Term
| Why would a patient reading 20/20 on a Snellen chart complain of poor vision? |
|
Definition
| Snellen acuity measures an individual’s ability to see high contrast images. |
|
|
Term
| Which contrast sensitivity chart is used for the Avaition CRS program? |
|
Definition
| The Precision Vision® chart. |
|
|
Term
| What is the test distance for contrast sensitivity testing? |
|
Definition
| Charts are designed for 4-meter test distance (patient to chart). 4 meters = 13 feet. |
|
|
Term
| What are the VA ranges for the PV chart if the PV chart is set at 4 meters, 2 meters, and 1 meter? |
|
Definition
If set at 4 meters, VA range = 20/10 to 20/125;
If set at 2 meters, VA range = 20/20 to 20/250;
If set at 1 meter, VA range = 20/40 to 20/500. |
|
|
Term
| What can cause vision to be degraded in bright light conditions? |
|
Definition
| Opacities in the ocular media will cause vision to be degraded under bright light. |
|
|
Term
| When using the OVT what does each of the standard tests check? |
|
Definition
Test 1 = Far vertical phoria, test 2 = far horizontal, test 3 and 4 = distant visual acuity, test 5 fusion and
depth perception. |
|
|
Term
| If a patient cannot see the white lines or numbered stairs in test one of the OVT, how is this recorded? |
|
Definition
Test 1 will be discontinued and an X will be recorded above the left and right hyperphoria in item 31 of the
SF 88. |
|
|
Term
| How would a patient report diplopia during test five of the OVT? |
|
Definition
| The patient reports seeing two arrows side by side or two circles, one above the other. |
|
|
Term
| What is the purpose of pupillary testing? |
|
Definition
| To detect and diagnose the presence of cranial lesions in, or near, the visual pathway. |
|
|
Term
| List the four pupillary tests. |
|
Definition
| Direct, consensual, accommodative, swinging flashlight. |
|
|
Term
| Under what type of lighting is pupillary testing performed? |
|
Definition
| It is done in a dimly illuminated exam room, with light distributed evenly throughout. |
|
|
Term
| What is the significance if there is a difference in the rate and symmetry of pupil constriction between the two eyes? |
|
Definition
| It is an indicator of a problem. |
|
|
Term
| What term is used to describe unequal pupil size? What percentage of adults normally has unequal pupil size, which is not caused by a pathological condition? |
|
Definition
| Anisocoria. Roughly 10 percent. |
|
|
Term
| What is another name for the swinging flashlight test? |
|
Definition
|
|
Term
| What is the distance the transilluminator is held for the direct pupillary reflex test? Why? |
|
Definition
| Three to four inches. So a good concentration of light will enter the patient’s eye and to avoid getting stray light in the opposite eye. |
|
|
Term
| Which test does not use a penlight to stimulate the pupillary response? What is used to stimulate the pupillary response in this test? |
|
Definition
| The accommodative pupillary reflex test. A fine-tipped object or small target for the patient to look at. |
|
|
Term
| While performing the swinging flashlight test, you move the penlight to the left eye and the pupil’s first movement is dilation. What does this indicate? |
|
Definition
| A positive (+) APD (afferent pupillary defect). |
|
|
Term
| How should you move the penlight from eye to eye when performing the swinging flashlight test? |
|
Definition
| Move the transilluminator straight across the nose, quickly, and smoothly. |
|
|
Term
|
Definition
| A normal pupil size fluctuation. |
|
|
Term
| Using the PERRLA method for recording, how would you record the test results of a patient whose pupils did not react to accommodation, but all else was normal? |
|
Definition
|
|
Term
| Other than PERRLA, what is another method for documenting pupil reflex tests? |
|
Definition
| Quantitative documentation. |
|
|
Term
| What path does the afferent pathway represent? |
|
Definition
| The path light and visual messages take to get to the brain. |
|
|
Term
| Where does the afferent pathway begin? |
|
Definition
| At the rods and cones of the retina. |
|
|
Term
| What path does the efferent pathway represent? |
|
Definition
| From the brain to the muscles of the iris. |
|
|
Term
| What task do the Edinger-Westphal nuclei perform? |
|
Definition
| Send an efferent message to the pupils. |
|
|
Term
| What findings would you expect in a patient with III CN palsy? |
|
Definition
Unequal pupil size (affected pupil larger); no constriction in dilated eye; no consensual response from the
dilated eye; and normal accommodative function in the good eye. |
|
|
Term
| A 5- to 10-percent solution of cocaine is used to absolutely confirm which pupil defect? |
|
Definition
|
|
Term
| What causes Adie’s pupil (tonic pupil)? Who does it primarily affect? |
|
Definition
| A viral infection damaging the ciliary ganglion or posterior ciliary nerves. Young women. |
|
|
Term
| What sexually transmitted disease can cause Argyll-Robertson pupils? |
|
Definition
|
|
Term
| What is a significant advantage the NCT has over conventional applanation tonometry? |
|
Definition
| There is no contact with eye. |
|
|
Term
| Why is it important to perform tonometry on every patient who can physically be tested? |
|
Definition
| To prevent any possible legal action against you, your doctor, or the medical facility. |
|
|
Term
| If the AO NCT II is calibrated properly, what should the “value” display read when you demonstrate the machine using a patient’s finger? |
|
Definition
|
|
Term
| When performing tonometry with the AO NCT II, can soft contact lenses be left in? |
|
Definition
| In some cases; check with your doctor first. |
|
|
Term
| Approximately, how far from the patient’s closed eyelid is the AO NCT II positioned when you set the safety lock? |
|
Definition
|
|
Term
| If the patient cannot see the red dot while looking at the white light inside the “puff” outlet of the AO NCT II, what should you do? |
|
Definition
| Turn the Rx knob until the patient can see the red dot. |
|
|
Term
| How would the AO NCT II indicate the air “puff” hit the patient’s eyelid? |
|
Definition
|
|
Term
| What are the two significant differences between the AO NCT II and the Reichert X-pert NCT? |
|
Definition
The X-pert NCT features a video monitor for the tester to look at rather than an eyepiece to look into (as on the NCT II). The X-pert NCT also has a control panel that can be used to operate most of the machine’s
features. |
|
|
Term
| How is the automatic mode selected on the Reichert X-pert NCT? |
|
Definition
| By pressing the AUTO/MAN key. |
|
|
Term
| On the Reichert X-pert NCT, what is the function of the erase key? |
|
Definition
| It erases erroneous results or “low confidence” readings. |
|
|
Term
| How do you know whether the Reichert X-pert NCT is properly positioned to “puff”? |
|
Definition
| When all three cursors intersect at the alignment dot. |
|
|
Term
| The III CN (oculomotor) innervates four of the six extraocular muscles. Which nerves innervate the other two muscles? |
|
Definition
The IV CN (trochlear) innervates the superior oblique, and the VI CN (abducens) innervates the lateral
rectus. |
|
|
Term
| What are the primary actions of the two oblique muscles? |
|
Definition
| Superior oblique = intorsion. Inferior oblique = extorsion. |
|
|
Term
| The alignment of the eyes can be classified into three general categories. What are they? |
|
Definition
| Orthophoria, heterophoria, and heterotropia. |
|
|
Term
| Of the three eye alignment categories, which is a latent (hidden) alignment problem? |
|
Definition
|
|
Term
| Which test is designed to evaluate the EOMs for possible muscle paresis? |
|
Definition
| The diagnostic (muscle) “H” test. |
|
|
Term
| During the diagnostic (muscle) “H” test, how many degrees above the midpoint, do you move the penlight to test the patient’s upward gaze? |
|
Definition
|
|
Term
| When performing the diagnostic (muscle) “H” test, what would be the proper-recorded response if it appeared the patient’s left superior oblique is paralyzed? |
|
Definition
|
|
Term
| When you have a patient look to his or her extreme left during the diagnostic (muscle) “H” test, you notice the patient’s right eye is not “tracking” the penlight to the midpoint. How would you record this? |
|
Definition
|
|
Term
| At what two distances is the cover test performed? |
|
Definition
| (Distance) 20 feet and (near) 16 inches. |
|
|
Term
| What two tests make up the cover test? |
|
Definition
| The unilateral cover test and the alternating cover test. |
|
|
Term
| What term indicates perfect eye alignment without the brain having to do any fine-tuning to maintain it? |
|
Definition
|
|
Term
| Which part of the cover test is performed first? |
|
Definition
| The unilateral cover test. |
|
|
Term
| List the testing sequence of the cover test: |
|
Definition
(1) unilateral at distance,
(2) alternating at distance (if no movement on unilateral),
(3) unilateral at near,
(4) alternating at near (if no movement on unilateral). |
|
|
Term
| What is the purpose of the unilateral cover test? |
|
Definition
| The purpose is to detect the presence of a tropia. |
|
|
Term
| You are doing the cover test on a patient. During the unilateral cover test, you cover the right eye, the left eye does not move. When you cover the left eye, the right eye does not move. You repeat the unilateral cover test three more times and get the same results each time. During the alternating test, the eyes move out. What condition is this? |
|
Definition
|
|
Term
| You are doing the cover test on a patient. During the unilateral cover test, you cover the right eye, the left eye moves in. You then uncover the right eye, the left eye moves out. You repeated the unilateral cover test three more times, getting the same results every time. What condition is this? |
|
Definition
| LXT Constant Left Exotropia. |
|
|
Term
| You are doing the cover test on a patient. During the unilateral cover test, you cover the right eye, the left eye moves up. When you uncover the right eye, the left eye does not move. You repeat the unilateral cover test three more times. One time, you get the same results. The other two times, you saw no movement of either eye during the unilateral cover test portion of testing. What condition is this? |
|
Definition
| LHypo(T) Intermittent Left Hypotropia. |
|
|
Term
| What type of problems is the Amsler grid designed to be used to detect? |
|
Definition
| Abnormalities in the central 20° of the field of vision. |
|
|
Term
| Describe the Amsler grid-recording chart. |
|
Definition
| A black grid pattern on a white background. |
|
|
Term
| Under what lighting conditions is the Amsler grid test performed? |
|
Definition
|
|
Term
| What could happen if the test distance is less than 12” when you perform the Amsler grid test? |
|
Definition
An area greater than 10° is subtended and may show the edge of the physiological blind spot. This could
cause the examiner to believe there is a defect when there is not. |
|
|
Term
| What could be wrong with the patient if he or she does not see the white dot in the middle of the test on chart #1? |
|
Definition
| He or she may have a central scotoma. |
|
|
Term
| For what are charts #5 and #6 used? |
|
Definition
| Pinpointing an area and the number of lines affected by distorted vision. |
|
|
Term
| For what is test #7 used? |
|
Definition
| A more thorough examination of the juxta-central area and in cases of high myopia. |
|
|
Term
| Is confrontation field-testing difficult to perform? Explain your answer. |
|
Definition
| No. It can be done relatively quickly, without fancy test equipment, and can be performed almost anywhere. |
|
|
Term
| When you are performing the confrontation field test, what do you compare the patient’s field of vision against to determine the presence or absence of an abnormality? |
|
Definition
| The examiner’s field of vision (yours). |
|
|
Term
| What is a laser eye exam? |
|
Definition
| The examination of the eyes of a patient who is, or has been, working around lasers. |
|
|
Term
| Where are the guidelines for laser eye exams? |
|
Definition
| AFOSH Standard 48–139, Laser Radiation Protection Program. |
|
|
Term
| What is the purpose of a laser eye exam? |
|
Definition
To detect abnormalities before an individual enters and/or leaves a work environment where lasers are, or
have been used, and whenever a suspected laser exposure has occurred. |
|
|
Term
| As an ophthalmic technician, what procedures will you accomplish on laser eye exam patients? |
|
Definition
Take the case history, test the corrected distance and near visual acuity, perform the Amsler grid test,
stereopsis test, and color vision test. |
|
|
Term
| What procedures will your doctor accomplish on laser eye exam patients? |
|
Definition
A dilated fundus exam and a slit lamp exam if the individual works with infrared or UV laser radiation. In
addition, if the distant visual acuity was not 20/25, the doctor will also need to perform a refraction. |
|
|
Term
| What form is used to report the results of a laser eye exam? |
|
Definition
|
|
Term
| What are two ways the brain deals with the problem of diplopia? |
|
Definition
| It either brings the two images together (fusion) or turns one of the images off (suppression). |
|
|
Term
| Which depth perception test can be used by flight medicine technicians for physical exam testing? |
|
Definition
|
|
Term
| What three items make up the Titmus stereo fly test? |
|
Definition
| Test booklet, polarized spectacles, and directions for use. |
|
|
Term
| What should patients who wear prescription spectacles do with them when taking the Titmus stereo fly test? |
|
Definition
| Keep them on and place the polarized spectacles over them. |
|
|
Term
| Is the suppression test performed when testing children? |
|
Definition
|
|
Term
| When you are using the Titmus stereo fly test on children and they successfully “grasp” the fly’s wings, what part of the test do you go to next? |
|
Definition
|
|
Term
| How is scoring for the Titmus stereo fly test recorded? |
|
Definition
In seconds of arc. In addition, you record the last correct diamond and the total number of diamonds. For
example, if the patient gets #1 through #7 correct, but misses #8 and #9, you would record it as “60 seconds
of arc, 7 of 9.” |
|
|
Term
| For what is the red lens test used? |
|
Definition
| To detect diplopia or suppression in all nine cardinal positions of gaze. |
|
|
Term
| The red lens test is used for what type of physical exam? |
|
Definition
|
|
Term
| If stereopsis is present, the patient will report seeing what color light? |
|
Definition
|
|
Term
| Any color a person perceives can be produced by a mixture of what three colors of light? |
|
Definition
|
|
Term
| Which color vision test is used for official Air Force physical exams? |
|
Definition
|
|
Term
| In the eye clinic, should all color vision testing be performed monocularly or binocularly? |
|
Definition
|
|
Term
| What is the “standard” color vision screening test used in the military? |
|
Definition
|
|
Term
| How many test plates does the VTS-CV (PIP) test have? |
|
Definition
|
|
Term
| List the two acceptable lighting sources for performing the VTS-CV (PIP) test. |
|
Definition
| Macbeth easel lamp or the Richmond Products True Daylight® lamp. |
|
|
Term
| How far should the patient be from the VTS-CV (PIP) test booklet during testing? |
|
Definition
|
|
Term
| When doing the VTS-CV (PIP) test on a person who has prescription spectacles, should the patient wear them or not? |
|
Definition
| Wear the spectacles only if he or she sees better with them on. |
|
|
Term
| Who is allowed to touch the colored portion of the VTS-CV (PIP) test plates? |
|
Definition
|
|
Term
| For how many seconds do you show a VTS-CV (PIP) test plate before moving on? |
|
Definition
|
|
Term
The VTS-CV (PIP) test plate has the number “29” on it. The patient reads the plate as saying “2.”
How would you score this plate? |
|
Definition
| As an incorrect response. |
|
|
Term
| To pass the VTS-CV (PIP) test, how many plates must the patient get correct? |
|
Definition
|
|
Term
| You perform the VTS-CV (PIP) test on a patient whom the doctor thinks is receiving too high a dosage of Plaquenil sulfate. The patient answers 9 test plates correctly with the right eye and 11 test plates correctly with the left eye. How would you record this information on the SF 600? |
|
Definition
| VTS-CV (or PIP) OD: 9/14 – Pt Fails; OS: 11/14 – Pt Passes. |
|
|
Term
| What form is used to record the results of the VTS-CV (PIP) test for an official Air Force physical exam? |
|
Definition
|
|
Term
| Although the D–15 color vision test is not a “pass” or “fail” test, what will the results from this test reveal? |
|
Definition
| The type and degree of color vision defect a person has. |
|
|
Term
| How many colored caps come with the D–15 test? How many are loose and moveable? |
|
Definition
|
|
Term
| What lighting can be used for D–15 testing? |
|
Definition
| Sunlight, Macbeth easel lamp, or Richmond Products True Daylight® lamp. |
|
|
Term
| What are the two considerations you should keep in mind when handling and storing the D–15 test? |
|
Definition
(1) Don’t leave the colored caps exposed to light needlessly; always close the case when not in use.
(2) Avoid touching the colored portion with the fingers, because the oils from the skin will discolor the
caps. |
|
|
Term
| How should the loose caps of the D–15 be arranged just prior to testing? |
|
Definition
| In random order in the case. |
|
|
Term
| When the patient is done arranging the caps of the D–15 test in the order he or she thinks is correct, how do you score the test? |
|
Definition
Close the lid, turn the case upside down and open it. Starting with the reference cap “P”, record the score
sheet with the order of the numbered caps. Then, connect the dots. The diagram is created when you connect the dots will reveal what type of color vision defect, if any, the patient has. |
|
|
Term
|
Definition
| The force of the blood pushing against the walls of the arteries. |
|
|
Term
| List some factors that could cause higher than normal blood pressure. |
|
Definition
Being an adult male, obesity, emotional distress, excitement, and physical exertion, disease conditions
affecting the circulatory and renal systems, pain, arteriosclerosis, and drugs. |
|
|
Term
| List some factors that could cause lower than normal blood pressure. |
|
Definition
| Being a female or a child, diseases weakening the heart, drugs, hemorrhaging (bleeding), and shock. |
|
|
Term
| What are the normal ranges for systolic and diastolic measurements? |
|
Definition
| Systolic: < 120 mm Hg. Diastolic: < 80 mm Hg. |
|
|
Term
|
Definition
| That part of space that one can see when the head and eyes are motionless. |
|
|
Term
| What are the normal monocular visual field degrees from fixation? |
|
Definition
| 95° temporal, 75° inferior, 60° nasal, and 60° superior from fixation. |
|
|
Term
| What two important functions does visual field testing satisfy? |
|
Definition
| Detecting abnormalities in the peripheral visual field, and monitoring changes in a normal or defective visual field. |
|
|
Term
| Most chorioretinal field defects are monocular; what disease process (in the chorioretinal area) produces a characteristic binocular field defect? |
|
Definition
|
|
Term
| In glaucoma, what is the most characteristic visual field loss called? |
|
Definition
|
|
Term
| What kinds of specific exams can the Humphrey® Visual Field Analyzer perform? |
|
Definition
| The glaucoma field, the macula study, and the neurological exam. |
|
|
Term
| What parameters can be changed? |
|
Definition
Fixation target, blind spot check size, test speed, foveal threshold test, central reference level, the
fluctuation test, and FASTPAC. |
|
|
Term
| What are the two possible fixation targets you can use on a patient with a central scotoma? |
|
Definition
| Either the small diamond or the large diamond fixation target. |
|
|
Term
| The FASTPAC option decreases test time by how much? |
|
Definition
|
|
Term
| What can the patient do to pause the test should he or she become fatigued? |
|
Definition
| Hold down the response button. |
|
|
Term
| What are the three indices of test conditions included on the printout that can assist the doctor in determining the reliability of the patient’s results? |
|
Definition
| Fixation losses, false positive errors, and false negative errors. |
|
|
Term
|
Definition
| The measurement of the central anterior curvature of the cornea. |
|
|
Term
| For what three things can keratometry measurements be used? |
|
Definition
To assess the curvature and power of the cornea, to judge the integrity of the corneal/tear surface, and to
follow the progress of patients with corneal distortion. |
|
|
Term
| In what order do you record keratometry readings? |
|
Definition
(1) The power in diopters.
(2) The axis of the horizontal meridian.
(3) The vertical power and axis.
(4) The condition of the mires. |
|
|
Term
| What is the basis of topography? |
|
Definition
| The basis of topography lies with the Placido disk technology. |
|
|
Term
| What are the four basic maps of the ATLAS system? |
|
Definition
| Curvature maps, refractive power maps, elevation maps, and irregularity maps. |
|
|
Term
| Summarize the uses of the corneal topographer? |
|
Definition
Early detection—identify early indication of pathological condition. This may help which course of action
is appropriate for each patient. Patient follow-up—examine the disease process over time to determine
whether a condition is worsening or stabilizing. Identify poor fitting contacts—identify distortion from
poorly fitted contact lenses. With this information, new lenses can be ordered and properly fitted. |
|
|
Term
|
Definition
| Refractometry is defined as the measurement of refractive error (objective measurement). |
|
|
Term
|
Definition
The sum of all steps performed to arrive at a decision as to what lenses if any, benefits the patient most. The
steps include refactometry, measurement of VA, measurement of accommodative ability, and clinical
judgment (subjective measurement). |
|
|
Term
| Describe the refraction process. |
|
Definition
The combination of this objective measurement, subjective input from the patient, and the clinical judgment
of the doctor (based on education and experience) lead to a prescription for the patient. |
|
|
Term
| Name the three types of autorefractors. |
|
Definition
| Subjective, objective, and combination objective/subjective. |
|
|
Term
| Which type of autorefractor is used in most clinics? |
|
Definition
|
|
Term
| How does an objective autorefractor automatically refract the eye? |
|
Definition
| It uses infrared light to automatically refract the eye much in the same way retinoscope does. |
|
|
Term
| In 80 percent of patients, the results given by the autorefractor are off by how many diopters? Is this discrepancy with the sphere or cylinder portion of the prescription? |
|
Definition
| +0.25D. It could be in either. |
|
|
Term
| What is the vertex distance? |
|
Definition
| The distance from the front surface of the eye (cornea) to the back surface of a spectacle lens. |
|
|
Term
| What is considered to be the average vertex distance? |
|
Definition
|
|
Term
| What happens if the vertex distance used during refractometry is different from the actual vertex distance of the patient’s spectacles? |
|
Definition
| The effective power of the lenses changes. |
|
|
Term
| What instrument is used to accurately measure vertex distance? |
|
Definition
|
|
Term
| When is it a good practice to take distometer readings? |
|
Definition
| When working with a patient whose prescription is ± 4.00 diopters, or greater. |
|
|
Term
| If a person wears minus (–) lens spectacles and decides to switch to contact lenses, will the contacts need to have more minus power or less? Explain. |
|
Definition
| Less. When dealing with a minus (–) power Rx, as the corrective lens moves closer to the eye, less D power is required. |
|
|
Term
| Who invented the slit lamp? |
|
Definition
|
|
Term
| What can the slit lamp be used to diagnose? |
|
Definition
Anterior segment eye diseases, corneal trauma, foreign body, keratitis, iritis, angle-closure glaucoma, and
cataracts. |
|
|
Term
| When using a slit lamp, what type of magnification should be used for a patient’s initial examination? |
|
Definition
|
|
Term
| In what order are the structures of the eye examined when using a slit lamp? |
|
Definition
(1) Lids and lashes.
(2) Conjunctiva.
(3) Cornea.
(4) Anterior chamber.
(5) Iris.
(6) Crystalline lens. |
|
|
Term
| When measuring the anterior chamber with a slit lamp, what does the “shadow” formed on the iris represent? |
|
Definition
| The depth of the anterior chamber. |
|
|
Term
| Why do tonometric methods that use indentation lead to less accurate readings when they are used for taking IOPs? |
|
Definition
| Because of the varying amounts of scleral rigidity. |
|
|
Term
| Which filter do you use on the slit lamp when taking pressure readings with the Goldmann applanation tonometer? |
|
Definition
|
|
Term
| When performing applanation tonometry, what setting do you use for the beam width? |
|
Definition
| The brightest and widest setting. |
|
|
Term
| In addition to taking photographs of the retina, what else can the fundus camera be used to photograph? |
|
Definition
|
|
Term
| What are two reasons for photographing both the internal and external ocular structures? |
|
Definition
| To document the appearance of the eye and to aid in the diagnosis of ocular conditions. |
|
|
Term
| What three media are used for storing ophthalmic photos? |
|
Definition
| Computer floppy disk or hard drive, 35-mm film, and Polaroid film. |
|
|
Term
| What advantage does Polaroid film have over 35-mm film? What advantage does 35-mm film have over Polaroid? |
|
Definition
Polaroid develops instantly and can be put in the patient’s chart immediately. 35-mm film provides a
sharper and more distinct photo. |
|
|
Term
| When taking fundus photos, why is adjustment of the viewing illumination sometimes challenging? |
|
Definition
| Some patients are more photophobic than others. |
|
|
Term
| What is the purpose of using different film speeds and types in a fundus camera? |
|
Definition
| It varies depending on the type of picture being taken (fundus vs. external). Even the type of internal photo makes a difference (fundus vs. red free). |
|
|
Term
| What is the purpose of the data imprint device on a fundus camera? |
|
Definition
| To put patient information on the photograph when it is taken. |
|
|
Term
| Which component of a fundus camera is used to modify the angle of the photograph being taken? |
|
Definition
| The angle changing lever. |
|
|
Term
| What are the four diopter compensation settings? What are they used for? |
|
Definition
“+” used for Rx of +5.00 to +23.00 and some external photographs;
“–” used for Rx of –9.00 to –23.00;
“O” used for emmetropic patients and Rx between +6.00 and –10.00; and “A” used for anterior (external
photography). |
|
|
Term
| What is a common misconception concerning the diopter compensation setting A? |
|
Definition
| That it is used for patients with high astigmatism. |
|
|
Term
| What are the five filter settings used in the fundus camera? What is each filter designed for? |
|
Definition
“N” is used for the normal fundus and external photos. “G” is the green filter and it heightens the contrast
between the blood vessels and the rest of the retina. It can also alter the appearance of the nerve fiber layer.
“E” is used for fluorescein angiography; allows only a blue wavelength of light to reach the retina. This light excites the fluorescein molecules.
“B” is used for the barrier filter; prevents the passage of the blue
light from the “exciter” filter to reflect back to the camera.
“E/B” places both the exciter and barrier filters in place at the same time; used for fluorescein angiography. |
|
|
Term
| What two ways can the fixation device be viewed? |
|
Definition
| Externally and internally. |
|
|
Term
| What three types of film primarily are used in ophthalmic photography? |
|
Definition
| Polaroid, 35-mm color, 35-mm B&W. |
|
|
Term
| Which film type is used when a high level of refinement, magnification, and clarity are needed? |
|
Definition
|
|
Term
| For what type of photography is 35-mm B&W film primarily used? |
|
Definition
|
|
Term
| Why is fluorescein angiography rarely performed in optometry clinics? |
|
Definition
| It requires an intravenous injection and must be done with the permission and presence of a medical doctor. |
|
|
Term
| Why should the patient’s eyes be dilated for good fundus photography? |
|
Definition
| The larger the pupil, the easier it is to photograph the fundus (retina). |
|
|
Term
| Why is it critical that you ensure the fundus eyepiece is properly focused? |
|
Definition
| The pictures will be blurry if it is not. |
|
|
Term
| When shooting 35-mm film, what do you do to identify a photo with a specific patient’s information? |
|
Definition
For cameras with a data plate—fill out the data plate with patient’s last name and last four; insert data tag
into insertion slot. For cameras without a data plate—write patient information on a white piece of paper,
set the camera for external photos, and photograph the piece of paper. |
|
|
Term
| What are the steps in setting up the fundus camera? |
|
Definition
Set the diopter compensation knob to whatever is needed for the patient. Set flash setting for type of film
being used. Set filter-switching knob (N, G, E, B, E/B). Set the angle-changing lever to angle specified by
the provider. Set the illumination control just past the middle position. |
|
|
Term
| If a patient has difficulty keeping an eye open for the photo, what can you do? |
|
Definition
| Have an assistant use a long Q-tip to hold the lids open. |
|
|
Term
| How is patient information recorded for a Polaroid photo? |
|
Definition
| It must be written on the photo after the picture is taken. |
|
|
Term
| Why is fluorescein angiography performed? |
|
Definition
| To study retinal circulation and diseases involving the retina and choroid. |
|
|
Term
| What are two color related properties of fluorescein? |
|
Definition
| It absorbs blue light and emits yellowish-green light. |
|
|
Term
| What happens to approximately 25 percent of patients having fluorescein angiography? |
|
Definition
| They become nauseated and may throw up. |
|
|
Term
| Why can’t you use the external photo capability of the fundus camera to replace an anterior segment camera? |
|
Definition
| Only the anterior segment camera can take highly magnified pictures for greater detail of the cornea, surrounding adnexa, and inside the anterior chamber of the eye. |
|
|
Term
| Where is the filter-switching knob set for taking external photographs? Where is the diopter compensation knob set? |
|
Definition
|
|
Term
| What type of film is usually used for external photos? |
|
Definition
|
|
Term
| What ethical problems could arise while you are performing ophthalmic photography? |
|
Definition
You may be asked to influence the outcome of a photo so that the need for surgery appears greater than the
actual need. |
|
|
Term
| When adjusting table height, what is a primary safety consideration? |
|
Definition
| When lowering the table, you must avoid crushing the patient’s legs. |
|
|
Term
| When measuring pupils with the Colvard pupilometer, how should you set the exam room lighting? |
|
Definition
You are trying to reproduce nighttime conditions. Turn off all room lights. Crack a door or use adjustable
lighting so there is enough light to examine the patient safely. |
|
|
Term
| With Colvard pupilometer, how do you enhance the image seen through the eyepiece? |
|
Definition
| Depress the ON/OFF button located on the instrument handle. Keeping the button depressed enhances the image seen through the eyepiece. |
|
|
Term
| With Colvard pupilometer, what should be done prior to turning the room lights on? |
|
Definition
| Release the light enhancement button before turning the room lights on. |
|
|
Term
| For what are corneal thickness measurements used ? |
|
Definition
| They are used in a number of different ways including but not limited too: PRK, LASIK and glaucoma screening. |
|
|
Term
| What should be done prior to using the pachymeter? |
|
Definition
| The instrument should be checked for calibration. |
|
|
Term
| Describe the correct positioning of the pachymeter’s probe when measuring corneal thickness. |
|
Definition
| It must be perpendicular to and touching the cornea. |
|
|
Term
| What two things can the Prince ruler be used to measure? |
|
Definition
1) Accommodative power of an eye.
2) Convergence capabilities of the eyes. |
|
|
Term
List the three refractive deficiencies that can be assessed when comparing your patient’s
accommodation to the expected “norms”. |
|
Definition
| Hyperopia, myopia, or accommodative disorders. |
|
|
Term
After administering the accommodation test to a 20 y/o patient, your readings on the Prince ruler
were as follows: OD - 12 cm; OS - 14 cm; and OU - 12 cm. What are the corresponding D power
readings for these FL measurements? What conclusions, based on the amplitudes of
accommodation, could you draw about your patient’s refractive status? |
|
Definition
| OD = 8.50D. OS = 7.00D. OU = 8.50D. The average amplitude of accommodation for a 20 y/o is 10.00D. Most likely the patient is hyperopic. |
|
|
Term
| Define near point of convergence. |
|
Definition
How close to the eyes an object may be brought before the patient:
1) sees double (diplopia),
or 2) stops converging (i.e. their eyes quit moving in with the target),
or 3) has one eye break fixation and deviate outward. |
|
|
Term
| Which flying class physical exams require the measurement of NPC? |
|
Definition
| Flying class physical exams I, IA, and II. |
|
|
Term
Why do you add 15 mm to the measurement taken from the Prince ruler when administering the
NPC test? |
|
Definition
| To account for the difference in distance between the zero mark of the ruler and the cornea. |
|
|
Term
Where, and on what form, are the results of the NPC test recorded for patients undergoing flying
class physical exams? |
|
Definition
| Under the heading “PC” in item 31 on the SF 88. |
|
|
Term
A person with what type of physiological eye condition could not accurately have his or her NPC
measured? |
|
Definition
| A patient with a heterotropia. |
|
|
Term
|
Definition
| It includes all USAF officers who hold a current USAF aeronautical rating. |
|
|
Term
| Define non-rated aircrew. |
|
Definition
It includes both USAF officers and enlisted members who are routinely required to be onboard the aircraft
to accomplish the primary mission. |
|
|
Term
|
Definition
| It includes military members who qualify for selection and entry into, and commencement of UFT. |
|
|
Term
|
Definition
| It includes all qualified rated aircrew. |
|
|
Term
| Operational support fliers fall into which flying class category? |
|
Definition
| Flying Class III (FC III). |
|
|
Term
| Which department is responsible for the healthcare of aircrew personnel? |
|
Definition
| FSO stands for “Flight Surgeons Office” also known as Flight Medicine. |
|
|
Term
| When would an aircrew member be placed in DNIF status? |
|
Definition
Anytime an aircrew member has a medical condition or is on medication that could compromise his or her
performance on duty. |
|
|
Term
| Which personnel are authorized flight goggles? |
|
Definition
| Only aircrew that wear helmets when flying are authorized flight goggles. |
|
|
Term
| What is meant by aircrew member wearing SCLs on a daily-basis only? |
|
Definition
| It means they are worn only during waking hours, not during sleep. |
|
|
Term
| At the end of each wearing period, what must aircrew members do with their contact lenses? |
|
Definition
| The aircrew members must remove, clean, and disinfect the contact lenses. |
|
|
Term
What can cause eye irritation to become more likely for an aircrew member wearing contact
lenses in flights lasting more than four hours? |
|
Definition
|
|
Term
| List the conditions that may lead to temporarily grounding of an aviator due to contact lens wear. |
|
Definition
Sensitivity to light, distorted vision, blurred vision, redness, watering of the eyes, discharge, minor
infections, abrasion of the cornea, discomfort. |
|
|
Term
| What must an aircrew member carry with him or her when flying and wearing contact lenses? |
|
Definition
| A backup pair of glasses. |
|
|
Term
| An aircrew member’s annual contact lens exam includes examinations by whom? |
|
Definition
| By the flight surgeon and by optometry. |
|
|
Term
| Who administers the aircrew SCL program? |
|
Definition
| The Flight Medicine Flight administers the SCL program. |
|
|
Term
| Who verifies the aircrew member’s visual acuity is 20/20 with contacts? |
|
Definition
Optometry clinic personnel verify the lenses fit properly and that 20/20 visual acuity is achieved at distance
and near with the lenses. |
|
|
Term
| Refractive surgery is an option for correcting which common eye problems? |
|
Definition
| Nearsightedness, farsightedness, and astigmatism. |
|
|
Term
| Which refractive surgery lacks stable visual correction required for many military jobs? |
|
Definition
|
|
Term
| Which refractive surgery is not an acceptable option for military personnel? |
|
Definition
| RK and intracorneal ring implantation. |
|
|
Term
Which refractive surgery consists of eight incisions extending to the limbus from just off center
of the cornea? |
|
Definition
|
|
Term
| List the five drawbacks of RK. |
|
Definition
1) glare,
2) unpredictable results,
3) daily changes in glasses prescription and visual acuity,
4) residual astigmatism,
and 5) greater susceptibility to perforation of the cornea by any ocular trauma. |
|
|
Term
Which refractive surgery consists of removing the epithelium and photoablating the stroma with
the excimer laser? |
|
Definition
| Photo-Refractive Keratotomy. |
|
|
Term
| Which instrument is used to cut a central corneal flap in refractive surgery? |
|
Definition
|
|
Term
What is the maximum refractive error and astigmatic correction allowable for the Air Force
aviation PRK program? |
|
Definition
| Refractive error: – 1.00 to – 5.50 diopters (in any meridian). Astigmatism: maximum of 3.00 diopters. |
|
|
Term
| What is the intent of the Warfighter program? |
|
Definition
| Better equip our fighting force not to provide cosmetic, elective surgery. |
|
|
Term
For patients having refractive surgery done, what three things must they understand prior to the
surgery in regards to expenses? |
|
Definition
| Medical center do not authorize Med Evacs. Medical center do not authorize funding for a non-medical attendant. Member’s expenses are not reimbursed if member is disqualified from treatment by the laser center. |
|
|
Term
| What symptoms may occur if NVGs are not maintained, adjusted, or fitted correctly? |
|
Definition
| Can cause frustration, headaches, and ultimately decreased flight safety. |
|
|
Term
| When using the NVDs, what must pilots do prior to each flight? |
|
Definition
| Pilots must perform a focusing routine with the goggles before each flight. |
|
|
Term
| How do NVDs allow pilots to perform operations at night? |
|
Definition
| They collect available ambient light from the night sky (stars, moon and man-made). The image is intensified and presented to the user through a series of optical lenses. |
|
|
Term
The image intensifier can produce a brighter image how many more times brighter than the
unaided eye? |
|
Definition
| 20,000 to 50,000 times brighter. |
|
|
Term
| What is the field of view for a member wearing the NVDs? |
|
Definition
|
|
Term
| What are the three classes of contact lenses? |
|
Definition
(1) Polymethmethacrylate Lenses or PMMAs,
(2) Rigid Gas Permeables or RGPs,
and (3) Soft Contact Lenses or SCLs. |
|
|
Term
| What is the abbreviation for polymethylmethacrylate? |
|
Definition
|
|
Term
| List the advantages and disadvantages of RGPs? |
|
Definition
Advantages: Oxygen transmissibility. Clear, crisp vision. Durability and deposit resistance. Easy maintenance. Relatively inexpensive.
Disadvantages: Require “custom” fitting. Initially uncomfortable.
Spectacle blur. Not compatible with many sports. |
|
|
Term
| With regards to RGP lenses, what does oxygen permeability refer to? |
|
Definition
| The ability of gases (air) to permeate (travel through) the lens material. RGP lenses allow oxygen (O2) to pass right through the lens. |
|
|
Term
| What do hydrophilic materials allow for? |
|
Definition
| Hydrophilic materials allow the patient’s tears to adhere to the lens surface and improve comfort and vision. |
|
|
Term
| List the advantages and disadvantages of SCLs? |
|
Definition
Advantages: Relatively easy to fit. Quick adjustment period. Not easily dislodged. May be used for cosmetic purposes.
Disadvantages: Must be cleaned and sterilized carefully. Less durable—must be replaced more frequently than RGPs. Risk of infection is higher with SCLs than RGPs. |
|
|
Term
| SCLs are made up of what percentage of water? |
|
Definition
|
|
Term
| Which SCLs are better at resisting protein buildup? |
|
Definition
| Hydrophilic materials typically resist proteins better. |
|
|
Term
| What are the four Rx parameters normally considered when prescribing SCLs? |
|
Definition
| Material, power, diameter, base curve. |
|
|
Term
| What is the purpose of visibility tints on an SCL? |
|
Definition
This tint does not affect the color of the patient’s eye, but makes the lens easier to see if it is dropped on a
white surface like a sink. |
|
|
Term
| What is the purpose of an X-chrom lens? |
|
Definition
| The lens helps some patients to better interpret colors or contrasts. |
|
|
Term
| Using the radioscope, your original index line is set at +2 and the final reading is 7.50. What is the resulting base curve of the RGP? |
|
Definition
|
|
Term
| What is the Schirmer tear test designed to measure? |
|
Definition
| The amount of tears produced by the lacrimal gland. |
|
|
Term
| For a normal Schirmer tear test, the tear test strips should be removed after how long? |
|
Definition
|
|
Term
| What is the normal moistened area on the Schirmer tear test for people over 40 years of age? |
|
Definition
| 10 to 15 mm in each eye at five minutes. |
|
|
Term
| What is the primary difference between Schirmer tear test #1 and Schirmer tear test #2? |
|
Definition
| The Schirmer tear test #2 is administered after an anesthetic is put in the eyes. |
|
|
Term
| What does the Schirmer tear test #2 eliminate? |
|
Definition
|
|
Term
| What two simple things can patients do to keep from confusing the right and left contact lenses? |
|
Definition
Always start with the right lens and remove the second lens from the contact case only after the first lens
has been inserted. |
|
|
Term
| Why is it not possible for an RGP contact lens to slip behind the eye? |
|
Definition
| The conjunctiva prevents this. |
|
|
Term
| What are the two methods for removal of an RGP or hard contact lens? |
|
Definition
| The one-finger and the two-handed. |
|
|
Term
| What are the two methods for ensuring that an SCL is not inside out? |
|
Definition
| The taco test and the bowl test. |
|
|
Term
| Before removing an SCL, where on the eye should you move it? |
|
Definition
|
|
Term
| List the types of solutions used in contact lens care and indicate whether they are used on RGP, SCL, or both. |
|
Definition
| Cleaning—both; rinsing—both; disinfecting—both; soaking/storing—both; neutralizing–SCL; conditioning/storing—RGP; enzyming—both; wetting—RGP; and lubricating—both. |
|
|
Term
| What is the main purpose of an enzyming solution? |
|
Definition
| To disintegrate the stubborn built-on protein that has not come off with daily cleaning. |
|
|
Term
| If fluorescein is installed while the patient is still wearing SCLs, what, if anything, will happen to the contact lenses? |
|
Definition
| The lenses permanently turn yellow. |
|
|
Term
| What are the two types of chemical disinfectants used with SCL? |
|
Definition
| Hydrogen peroxide and nonhydrogen peroxide. |
|
|
Term
| Why is the hydrogen peroxide system an excellent disinfectant? |
|
Definition
| Not only does it kill off most bacteria, it also disables the HIV/AIDS virus. |
|
|
Term
| List three dos and three don’ts associated with SCL handling or wear? |
|
Definition
Any three dos —Use only approved SCL solutions. Use the approved solutions only for what they are designed (i.e., don’t use a cleaning solution as a lubricant). Remove SCL before swimming. Remove SCL in the presence of noxious and irritating vapors. Remove SCL if you have to don a gas mask. Keep nonpreserved saline refrigerated. Disinfect the lenses after enzyming. Remove the lenses if there is any redness, discomfort, or blurred vision. Read the instructions if you are not sure! Any three don’ts —Use fluorescein with an SCL. (NOTE: If fluorescein is used, the patient should not put the lenses back into the
eyes for at least one hour.) Instill medications or other ophthalmic solutions in the eyes while wearing
contact lenses (both SCL and RGP). Wear lenses that have been contaminated. Some brands are not
compatible and can ruin the lenses. Always stay with the original brand you started with. |
|
|
Term
| What four things must you do to a lens after it has been used on one patient and before it is used on another patient? |
|
Definition
| Clean, disinfect, enzyme, and stored properly. |
|
|
Term
| What is the recommended disinfectant storage solution for lens fitting sets? |
|
Definition
|
|
Term
| When maintaining contact lens sets, how many days can you store the lenses between uses before replacing the disinfectant storage solution? |
|
Definition
|
|
Term
| After an RGP has been rinsed, and before inserting it on a new patient, what solution should you use on it? |
|
Definition
|
|
Term
| TRICARE does not cover which contact lens service? |
|
Definition
| Elective contact lens related services. |
|
|
Term
| Who is responsible for obtaining their lenses under the elective contact lens service program? |
|
Definition
| Patients are both physically and financially responsible for obtaining their lenses and solutions. |
|
|
Term
Which patients would qualify for contact lens fittings under the medically indicated contact lens
program? |
|
Definition
| Patients with corneal disorders, whose vision can only be corrected with a contact lens; patients who have had their crystalline lens removed but not replaced with an artificial lens; and patients with iris trauma requiring a colored lens to mask the defect. |
|
|
Term
| What do you need to do for medical logistics to order contact lenses for your clinic? |
|
Definition
| Fill out logistics’ form with the prescription information and a local supplier, and they order the lens. |
|
|
