Modern Medical Practice Midterm

Who should you refer a red eye patient you are not comfortable managing?

Ocular disease doctor/ OPTOMETRIST who is comfortable or specializes

What are SOME specialties of optometry?

Pediatrics/Binocular vision
Contact lens
Ocular disease
Low vision
Neurology
Sports vision
Traumatic brain injury

What are common Practice specialties

Dry eye clinics
Myopia control clinics
Ocular aesthetics clinic

How long is optometric residency training?

12-13 months

What was the first material that led to optical lenses?

Glass bead

Who was the "Father of Optics" and what was his significance to optometric history?

Euclid

What was discovered in Crete in 1927?

Two crystal magnifying lens

Who wrote about the Theory of Vision and Nature of Light? What is the Theory of Vision about?

Aristotle

What is Alhazen's contribution of optics?

Father of phycological and geometric optics (visual rays passing into the eye) Angle of refraction is related to angle of incidence

What led to the condemnation of reading glasses in the 11th century?

DEMONS and BLACK MAGIC

What role did Leonardo Di Vinci have in optometry?

emphasized and recognizing the importance of retina and its relationship with vision

What led to the need/demand/production of reading glasses?

The de-demonization of glasses and the rise of popularity of the printing press

Who filled the demand of production of reading glasses?

Guild of Master Spectacle makers

Who were credited for the telescopes?

Galileo Galilei

Who was credited for introducing bifocals?

Benjamin Franklin

List out the three types of opticians.

Refracting optician
Dispensing optician
Manufacturing optician

Describe the physiological branch of optics

(AKA Vision Science) Physiological studies of vision

Describe the Ophthalmic branch of optics

Optics of glasses and or contacts

Describe the Physical branch of optics

AKA wave optics: Study of phenomena such as interference, diffraction, and polarization

Describe the modern branch of optics

Technological Advances requiring optics such as topography and optical Tomography (OCT)

Who created the first ophthalmoscope?

Helmholtz

Who was the first refracting optician that tried to charge for an eye exam?

Charles prentice

Who measured his own astigmatism and created lenses to correct it?

Sir George Biddell Airy

Who created the numbering system to measure near visual acuities?

Hermann Snellen

What is the significance of the La Guardia Conference?

First meeting that changed the profession. Asked and advocated that optometrist should be able to diagnose and treatment ocular disease

The foundation of TRADITIONAL optometric education was built upon?

Optics and refraction

The foundation of a MODERN optometric education was built upon?

Medicine

In a TRADITIONAL optometric program, what are some ways that the curriculum may differ between programs?

Shadowing experience when students get 3rd year 4th year rotations

In a MODERN optometric program, what are the components that are introduced?

Optometric medicine, vision science, foundational medical sciences, applied medical sciences, medical specialties, clinical experiences

What is contributing to the rise of educational debt?

Rising cost of living and education

Does income increase or decrease with age?

Increase

As an independent doctor (being your own boss), which practice setting is most likely to generate the highest income? The lowest?

Highest- Partnership or group practice; lowest- independent contractor

As an associate doctor (working for someone else), which practice setting is most likely to generate the highest income? The lowest?

Highest- HMO/PPO setting; Lowest- associated at an OD or OMD practice

Which loan type requires a credit check?

Private

Which loan type is eligible for government-based student loan forgiveness?

Federal

Which loan type can be consolidated?

Federal

What is the curriculum in Years 1 & 2 for ophthalmology?

Basic sciences with preclinical work as well as preparation for clinic

What is the curriculum in Years 3 & 4 for ophthalmology?

3rd year: Short rotations of standard rotations like internal medicine, family medicine, general surgery, neuro, peds, ob/gyn, ER

4th year: Elective rotations

When does the ophthalmology rotation occur?

It does not always happen. If it does, it would be in 4th year

Describe the ophthalmology residency in Year 1

Internship of short rotations; repeat of 3rd year rotations from med school. Last 3 months are general ophthalmology.

Describe the ophthalmology residency in Year 2-4

•Usually 3 month rotations of subspecialty of ophthalmology: general, cornea, retina, glaucoma, oculoplastics.
•May do research but not always.
•Typically requires grand rounds

When does surgery get introduced? What type of surgeries? (OMD training)

Year 2; cataract surgery, pan retinal laser photocoagulation (retina lasers), and strabismus surgery (eye turn surgeries)

How does ophthalmology residency differ from ophthalmology fellowship?

•Ophthalmology residency occurs after med school and does not include specialized training in any of the sectors of the eye. It would be only general ophthalmology.
•Fellowship occurs AFTER an ophthalmology residency. This type of training would be considered specialty. Training is usually 1-2 years post-residency.

For training outside of school, how does it differ for optometry vs. ophthalmology?

•Ophthalmology (or medicine) generally are not required to obtain special training, certifications, or pay to perform any new procedures or equipment.

•Optometry must:
•Take classes or courses
•May have to gain a certification and take a test
•Will have to pay a fee
•May have to get observed by an outside physician

What training is required for DOs and what does DO stand for?

•Doctors of osteopathic medicine (DO)
•Focused on holistic healing and hands-on manipulation and they have Training similar to MDs

What training is required for PAs and what does PA stand for?

Physician assistants
Can be a masters or doctorate
•its a Post-graduate
P.A.s can operate independently but they have oversight by a MD or DO.

What training is required for NPs and what does NP stand for?

•Nurse practitioners
•Can be a masters or doctorate
•Post-graduate
N.P.s can operate independently

Patient recently had a concussion and has trouble with his vision. You have performed an eye exam and determined the ocular health is fine. You suspect that the concussion may be causing his symptoms. Who should you refer to?

TBI trained doctor/optometrist

13 yo boy wants to improve his agility and eye tracking while playing baseball. Who should you refer to?

Sports vision doctor/optometrist

You have determined a patient has visual field loss from a stroke. She is having trouble reading books and needs additional help. You have exhausted your treatment options. Who should you refer to?

Low vision doctor/optometrist

What are the advantages/disadvantages of doing a residency?

Advantages:

•Accelerated clinical experience

•Confidence builder

•Potential didactic/research experience

•Networking

•Post-residency opportunities

Disadvantages:

•Living wages

•Time commitment

•Limited to availability of positions to outside physician

Describe the Educational support for developing a specialty and provide examples.

experts in a field who come together to provide resources/education to others. Example = Gas Permeable Lens Institute

Describe the Clinical support for developing a specialty and provide examples.

Organizations with the goal to provide exceptional clinical care and educational support to its members. Example: American Academy of Optometry

Describe the Professional advancement support for developing a specialty and provide examples.

Organizations that have certification or advancement tracks that means distinction of excellence or expertise in that field. Example: Fellowship of the Scleral Lens Education Society

Describe the Social media groups support for developing a specialty and provide examples.

Loosely organized groups on social media like FB or IG. Examples: ODs on Facebook

Describe what the opinion articles are and how they support developing a specialty and provide examples.

Experts in the field who write articles in journals. Example: Contact Lens Spectrum

List out WHEN you should consider referring out to an ophthalmologist

•When something is outside of scope!
•Consideration of a patient's financial situation and whether or not he/she is insured

Pt has a suspicious lesion that you suspect is cancerous. Who should you refer to? OD or and OMD

OMD due to scope

Pt has a retinal detachment. The repair for this is outside of optometric scope. Who should you refer to?

OMD due to scope

Pt has a red eye but you are unsure what it is. Who should you refer to?

OD with experience in red eyes

Pt presents for an eye exam. You are suspicious for glaucoma but you don't have the equipment. Who should you refer to?

OD with equipment

You are practicing in Oklahoma. Pt needs a laser procedure for glaucoma (SLT) which is within optometric scope but you don't have a certificate for it. Who should you refer to?

OD with laser certification

Patient has a bump around the eyelids and wants it removed. Who should you refer to? (type of OMD)

Oculoplastics

Patient has keratoconus, a condition of the cornea. You think this patient needs a transplant. Who should you refer to? (type of OMD)

Cornea

Patient has a tear in the retina. Who should you refer to? (type of OMD)

Retina

Patient wants LASIK. Who should you refer to? (type of OMD)

General OMD

Patient has inflammation of the optic nerve. You suspect the patient may have multiple sclerosis, a neurological autoimmune condition. Who should you refer to? (type of OMD)

Neuropathology

Who invented the ophthalmoscope?

Hermann von Helmholtz

Which device is known for measuring corneal curvature and is used for contact lens fittings?

Keratometer

Which technology was introduced in 1991 for detailed imaging of the retina?

OCT (Optical Coherence)

What is the primary purpose of the trial lens set invented by Georg Fronmuller?

To perform refractions

Which device is used to capture images of the interior structures of the eye, such as the retina and optic nerve head?

Ophthalmoscope

True/False: The Snellen "Big E" chart, invented by Hermann Snellen, is still the most commonly used eye chart in optometry.

True

True/False: The Goldmann Perimetry is used for measuring intraocular pressure.

False (It is used for visual field testing.)

True/False: Fundus photography, first done by Jackman & Webster in 1886, required a long time to process due to being taken on film

True

T/F Retinoscopy is an objective way to determine a patient's refractive error.

True

T/F Dynamic retinoscopy, introduced by Andres Cross in the early 1900s, involves measuring the response of the retina to light.

True

What the purpose of Trial Lens Set

Performs refractions

What the purpose of Ophthalmoscope

Visualizes interior eye structures

What the purpose of Keratometer

Measures corneal curvature

What the purpose of Fundus Camera

Takes retinal photographs

What the purpose of Schiotz Tonometer

Measures intraocular pressure

What is the significance of the slit lamp introduced by Allvar Gullstrand in 1911?

anterior segment of the eye, including the cornea, lens, and anterior chamber.

Describe the role of autorefractors in modern optometric practice:

measurements of a patient's refractive error, improving examination efficiency and aiding in the diagnosis and prescription of corrective lenses.

Explain the importance of the dynamic retinoscope introduced by Andres Cross:

The dynamic retinoscope introduced by Andres Cross allows for objective determination of a patient's refractive error by observing the reflection of light from the retina, aiding in accurate prescription of corrective lenses.

The keratometer, invented by Hermann von Helmholtz in 1853, measures the ________ of the cornea.

curvature

The ________, introduced by Allvar Gullstrand in 1911, is essential for examining the anterior segment of the eye.

slit lamp

The phoropter, introduced by Henry DeZang in 1921, is also known as the ________.

refractor

The Snellen "Big E" chart, invented by Hermann Snellen in 1862, is used for measuring ________.

visual acuity

What is the gold standard for visual field testing?

Humphrey Visual Field (HVF)/Standard Goldmann Bowl Perimetry.

What are the benefits of Head Mounted Perimetry (HMP)?

Portability, simultaneous viewing without an eye patch, and AI support for monitoring

What does an A-scan measure and what are its uses?

Measures axial length and other eye components, used before refractive surgery and for myopia control.

How is a B-scan utilized in optometry?

Provides ultrasonic views of the eye, used to diagnose conditions like retinal detachment when the view is obscured by a dense cataract.

What initial exams are recommended within the first year of Plaquenil use?

Fundus examination, age-appropriate visual field, and spectral domain OCT.

What additional tests are frequently used to diagnose retinal conditions?

Electroretinography (ERG) and fundus autofluorescence (FAF).

What is the difference between topography and tomography?

Topography is a 2D scan of the cornea's curvature, while tomography is a 3D scan.

In what settings are these instruments commonly used?

Optometry practices, Refractive surgery practices and diagnosing corneal diseases like keratoconus.

What is Intense Pulse Light Therapy used for in dry eye treatment?

•Dry Eye Therapy
•Ocular Rosacea Therapy
•Chalazion Therapy

What is the difference between telehealth, telemedicine, and teleretinal imaging?

Telehealth is a broad term for remote healthcare services; telemedicine refers specifically to clinical care at a distance; teleretinal imaging captures and transmits retinal images for remote diagnosis.

How does AI enhance ophthalmic technology?

By creating databases to compare normal and abnormal findings, improving diagnostic tools like OCT and fundus photography.