Clinical Optometry III Final exam - Everything else (Refractive error, etc.)

Direct

This is the equation for ____________ ophthalmoscopy.

17.5x

What is the magnification during direct ophthalmoscopy for a 10D myope?

Indirect

This is the equation for ____________ ophthalmoscopy magnification. (Essentially step 1 times step 2).

2.188x

What is the magnification during indirect ophthalmoscopy on a 10D myope using a 20D lens that creates an image 40cm from the observer?

0.83x

What is the magnification during indirect ophthalmoscopy on a 10D hyperope using a 30D lens that creates an image 50cm from the observer?

WDlens

The _____________ is the viewing distance from the lens to the observer.

WDimg

The _____________ is the viewing distance from the image to the observer.

WDimg

This equation is needed to calculate the ___________.

2.38x

Find the magnification during BIO when using a 20D lens held on a 10D myope at 40cm from the observer:

flens

This equation is used to find the __________.

2.14x

Find the magnification during BIO when using a 20D lens held on an emmetropic patient at 40cm from the observer:

Increase

As you decrease the power of the condensing lens (30D to 20D), the magnification will _________________.

Decrease

As you decrease the power of the condensing lens (30D to 20D), the FOV will _________________.

Increase

As you increase the working distance during BIO, the FOV will _________________.

Decrease

As you increase the working distance during BIO, the magnification will _________________.

180

Your head should be placed ________ degrees away from the meridian that you wish to examine during BIO.

8

The FOV of a 20D lens is about ______ disc diameters.

Decrease

As BIO lens power increases (20D to 30D), retinal irradiance will _____________.

10

Clinically, we should minimize continuous exposure of a single area of the fundus to a max of _____ seconds during SLE.

BIO

The _______ provides a real, inverted, and laterally reversed image of the fundus.

40

Clinically, we should minimize continuous exposure of a single area of the fundus to a max of _____ seconds during BIO.

10DD

Label 1

4DD

Label 2

3DD

Label 3

6DD

Label 4

8DD

Label 5

Topical anesthetic

Benoxinate would be considered a ____________________________.

Topical anesthetic

Proparacaine would be considered a ____________________________.

Topical anesthetic

The mechanism of action for a ________________________ is to prevent the generation and conduction of nerve impulses.

Ester

All topical anesthetics used in optometry have an _______________ functional group.

Amide

If the functional group of an anesthetic is an ____________, it will have a longer duration of action and be metabolized by the liver.

Increase

As the length of the structure of the topical anesthetic increases, the potency will _____________.

Desquamation

For topical anesthetics, a complication can be _____________________ of the corneal epithelium which is more severe in patients with dry eye.

Retardation

For topical anesthetics, a complication can be _____________________ of the epithelial healing which inhibits epithelial mitosis.

False

T/F: It is okay to prescribe a topical anesthetic like proparacaine for patient take home use.

Self-administration

Due to corneal toxicity, ______________________ of a topical anesthetic is a contraindication due to the possibility of corneal scarring which can lead to permanent vision loss.

Topical anesthetic

Intense pain, severe tearing, and photophobia were the most common symptoms of patients who are abusing a _________________________.

Ring-shaped

57.7% of patients with anesthetic abuse keratopathy have a ____________________ opacification.

Hypopyon

An accumulation of pus in the anterior chamber of the eye is called a _________________ which is common in topical anesthetic abuse cases.

Proparacaine

Which topical anesthetic is least toxic to microorganisms?

Benoxinate

Which topical anesthetic is only available combined with fluorescein?

Fluorescein

Which dye absorbs blue (493nm) light and emits green (520nm) light?

Tight junctions

Disruption of _______________ at the epithelial surface leads to ingress around cells which can cause hyperfluorescence when using fluorescein dye.

False

T/F: Fluorescein stains the damaged cells themselves.

False

T/F: Fluorescein binds to cells to stain them.

Fluorescein

Which dye can only enter the epithelium where there is interrupted continuity of the epithelial surface?

Against the rule

What type of astigmatism is shown here?

With the rule

What type of astigmatism is shown here?

Fluorescein

Which dye do we use for Jones test and TBUT?

Benoxinate

The presence of which topical anesthetic with fluorescein helps prevent bacterial contamination?

False

T/F: Rose bengal is a vital dye.

Rose bengal

Which dye is an iodine derivative of fluorescein that stains tissue pink or magenta?

Rose bengal

Which dye will instantly kill and then stain unprotected cells that are exposed to it?

Glycocalyx

The toxicity of rose bengal can be blocked by an intact ________________.

Rose bengal

Which dye is this:

Lissamine green

Which dye stains identically to rose bengal but is a vital dye?

Lissamine green

Which dye is this:

Ester

If the functional group of an anesthetic is an ____________, it will have a shorter duration of action and be metabolized locally.

Lissamine green

Which dye is the best one to use for staining the conjunctiva?

Pilocarpine

What drug with a green cap is a muscarinic agonist?

Antimuscarinic

Tropicamide, cyclopentolate, and atropine are all considered what type of drug?

Tropicamide

Which antimuscarinic only lasts about 4-6 hours?

Antimuscarinic

Tropicamide is what type of drug?

Antimuscarinic

Cyclopentolate is what type of drug?

Antimuscarinic

Scopolamine is what type of drug?

Category C

All mydriatic/cycloplegic drugs are what pregnancy category?

Antimuscarinic

Spastic paralysis and brain injury are risk factors for potential CNS side effects from _________________ agents.

Atropine

The most potent and longest acting anticholinergic:

Antimuscarinic

Hot as a hare, Blind as a bat, Dry as a bone, Red as a beet, and Mad as a hatter - all describe systemic overdose symptoms of _________________ drugs.

Cyclopentolate

What is the drug of choice for routine cycloplegic refraction and commonly comes in a 1% solution?

Cyclopentolate

Which antimuscarinic readily crosses the blood-brain barrier and can cause transient psychotic reactions?

Cycloplegic refraction

A ________________ is necessary to diagnose latent hyperopia and pseudomyopia.

Phenylephrine

What drug is a DIRECT alpha-adrenergic agonist?

Cocaine

Which drug inhibits the reuptake of norepinephrine?

False

T/F: Phenylephrine is a cycloplegic agent.

10%

The __________ solution of phenylephrine is used to break posterior synechiae.

Phenylephrine

Tricyclic antidepressants and MAO inhibitor use are contraindications for use of which mydriatic drop?

Phenylephrine

Orthostatic hypotension and Malignant hypertension are contraindications for use of which mydriatic drop?

Phenylephrine

Systemic side effects of ______________________ include acute systemic hypertension, ventricular arrhythmia, tachycardia, and subarachnoid hemorrhages.

Hydroxyamphetamine

What alpha-adrenergic agonist is used for localizing lesions in Horner’s syndrome?

Apraclonidine

The process of developing super-sensitivity takes weeks to occur, therefore _________________ would not be a good differential in EARLY diagnosis of horner’s.

Hydroxyamphetamine

Dilation with __________________________ indicates the cause for the honer’s syndrome lies with either the 1st or 2nd order neuron.

Apraclonidine

Which drug does NOT dilate the normal pupil in Horner’s and relies upon norepinephrine supersensitivity because it is a very weak direct agonist?

False

T/F: Tropicamide is a pregnancy category B drug.

Dynamic contour tonometer

What type of tonometry is designed to be less affected by corneal properties even though it is still transcorneal?

False

T/F: Diaton tonometry requires an anesthetic.

3 mmHg

You have decided to start glaucoma therapy on the left eye of a patient. The baseline IOP is 25 mmHg and 28 mmHg in the right and left eyes, respectively. At the follow-up visit you find the IOP to be 20 mmHg OU. What is the treatment effect?

6 mmHg

You have decided to start glaucoma therapy on the right eye of a patient. The baseline IOP is 22 mmHg and 22 mmHg in the right and left eyes, respectively. At the follow-up visit you find the IOP to be 24 mmHg OD and 30mmHg OS. What is the treatment effect?

7 mmHg

You have decided to start glaucoma therapy on the right eye of a patient. The baseline IOP is 25 mmHg and 21 mmHg in the right and left eyes, respectively. At the follow-up visit you find the IOP to be 28 mmHg OD and 31mmHg OS. What is the treatment effect?

Manometry

The only method that is capable of recording the true intraocular pressure (invasive):

Pressure phosphene

The Provue tonometer is provided for home use and measures the ___________________ ("eclipse" or dark circle) in order to determine IOP.

Impact-rebound tonometry

A device with a ballistic-like mechanism that measures the return bounce of an object after impacting the eye:

Impact-rebound tonometry

Both iCARE and the Diaton tonometer are examples of _____________________________.

iCare

Which form of Impact-rebound tonometry is transcorneal?

Diaton tonometer

Which form of Impact-rebound tonometry is transpalpebral?

iCare

For use of the ________________________ device, no anesthetic or fluorescein is required, it has a disposable tip, and it records the average of 6 reliable readings.

Central corneal thickness

The iCARE tonometer has a good correlation with GAT and both devices are equally affected by __________________________.

True

T/F: iCare is a great option for pediatric patients.

iCare

Which tonometer is a useful screening tool that does NOT require a smooth regular cornea and is more comfortable than an air puff?

Diaton tonometer

Which tonometer analyzes the deceleration of a free-falling metal rod after impacting the eyelid?