Midterm I

Question 1

What is the widely accepted format for documentation of medical and allied health patient records?

Answer 1

1. Subjective
2. Objective
3. Assessment
4. Plan

Question 2

What are the three categories of a chief complaint?

Answer 2

1. blur/vision loss
2. discomfort/pain/irritation
3. routine vision check

Question 3

What are the uncorrected spherical errors associated with the following snellen VA’s: 1. 20/20; 2. 20/30; 3. 20/40; 4. 20/60; 5. 20/80; 6. 20/120; 7. 20/200

Answer 3

1. 0.25
2. 0.50
3. 0.75
4. 1.00
5. 1.50
6. 2.00
7. 2.00-3.00

Question 4

What are the uncorrected cylindrical errors associated with the following snellen VA’s: 1. 20/20; 2. 20/30; 3. 20/40; 4. 20/60; 5. 20/80; 6. 20/120; 7. 20/200

Answer 4

1. 0.25
2. 1.00
3. 1.50
4. 2.00
5. 3.00
6. 4.00
7. 5.00 or greater

Question 5

What is a complete and thorough listing of all the patient’s health care problems called?

Answer 5

diagnosis

Question 6

What should the first line of the body of a letter contain?

Answer 6

purpose of the letter

Question 7

What is a measurement of the fusion free position of the eye?

Answer 7

distance phoria

Question 8

If someone is not orthophoric at distance what is this abnormality related to?

Answer 8

1. fusional adaptation abnormality
2. position of eyes in orbit
3. relative lengths of EOMs
4. position of muscle insertions
5. genetic abnormality of EOM

Question 9

If a person has excessive convergence per 1.00D of accommodation do they have a high or low AC/A? 1. Eso or exo? 2

Answer 9

1. high AC/A

2. eso

Question 10

If a person has deficient convergence per 1.00D of accommodation do they have a high or low AC/A? 1. Eso or exo? 2

Answer 10

1. low AC/A

2. exo

Question 11

What type of fusional convergence (and what type of prism) accommodates for a deficit in tonic or accommodative convergence?

Answer 11

positive (BO) fusional vergence

Question 12

What type of fusional convergence (and what type of prism) accommodates for a excess in tonic or accommodative convergence?

Answer 12

negative (BI) fusional vergence

Question 13

What are Morgan’s expected for BI at distance?

Answer 13

x/7/4

Question 14

What are Morgan’s expected for BO at distance?

Answer 14

9/19/10

Question 15

What are Morgan’s expected for BI at near?

Answer 15

13/21/13

Question 16

What are Morgan’s expected for BO at near?

Answer 16

17/21/11

Question 17

What is an abnormal value for NPC?

Answer 17

> 6cm

Question 18

Do myopes accommodate more in contacts or glasses?

Answer 18

contacts

Question 19

Do hyperopes accommodate more in contacts or glasses?

Answer 19

glasses

Question 20

What does stereo acuity test for?

Answer 20

quality of fusion

Question 21

What are the conditions that can lead to reduced stereo acuity?

Answer 21

1. central suppression
2. peripheral suppression
3. high phoria with poor vergences
4. uncorrected refractive error
5. reduced VA from disease, amblyopia, etc

Question 22

What are the treatment options for convergence insufficiency?

Answer 22

1. VT to inc BO

2. near BI prism

Question 23

What are the treatment options for convergence excess?

Answer 23

1. VT to inc BI

2. near add

Question 24

What are the symptoms of binocular vision dysfunctions?

Answer 24

1. inc symptoms at end of day
2. blurred vision
3. intermittent diplopia
4. pulling sensation
5. asthenopia
6. headaches
7. burning or tearing
8. inability to sustain concentration

Question 25

What is the rule that positive relative convergence (BO to blur from demand) should be at least two times the phoria?

Answer 25

Sheard's Criterion

Question 26

What is the rule that neither vergence value should be more than twice the other?

Answer 26

Percival's Criterion

Question 27

What is the procedure to use an add to meet Percival's or Sheard's criterion?

Answer 27

1. determine amount of prism using Sheard's or Percivals 2. determine AC/A 3. divide prism by AC/A to determine add and round up to nearest 0.25

Question 28

When do you prescribe for binocular vision problems?

Answer 28

1. has symptoms (current or anticipated) | 2. performance problems (current or anticipated)

Question 29

What are vertical phorias more likely to be related to then horizontal?

Answer 29

physical/mechanical factors

Question 30

What is the epidemiology of a vertical phoria?

Answer 30

1. 20% of population (9% significant) 2. congenital 3. congenital or acquired 4th nerve paulsy

Question 31

What is the progression of a vertical phoria like for each epidemiology: 1. congenital 2. vascular/ischemic events 3. trauma 4. neoplastic

Answer 31

1. stable 2. improvement over time 3. stable 4. worsen over time

Question 32

What are key feature of a vertical phoria that can be observed by the doctor?

Answer 32

1. head tilt 2. facial muscle tension 3. reduced lateral vergences 4. reduced stereo acuity

Question 33

What are methods to analyze vertical phorias?

Answer 33

1. cover test 2. Von Graefe 3. Maddox rod 4. Borish card 5. vertical vergences 6. fixation disparity 7, occlusion (takes long time)

Question 34

How much prism should be prescribed to a vertical phoria patient?

Answer 34

1/2 to full amount

Question 35

What are the symptoms of accommodative dysfunction?

Answer 35

1. near blur 2. irritability 3. poor concentration 4. headaches

Question 36

What is the equation to find the normal amplitude values?

Answer 36

18.5 - 0.3x(age)

Question 37

What is the equation to find the minimum amplitude values?

Answer 37

15 - 0.25x(age)

Question 38

What is an abnormal PRA value?

Answer 38

1.50 or less

Question 39

What minimum monocular accommodative facility (flipper)? 1. Minimum binocular? 2

Answer 39

1. 12 cycles/min | 2. 10 cycles/min

Question 40

What are the theories to explain presbyopia?

Answer 40

1. lenticular 2. ciliary muscle 3. geometric (not accepted)

Question 41

At what ages do accommodative amplitudes begin to fall? 1. When do they reach zero? 2

Answer 41

1. 6 years | 2. 50 years old

Question 42

Do myopes or hyperopes need an add earlier? 1. At what age do these become similar? 2

Answer 42

1. hyperopes | 2. 45 yo

Question 43

What conditions make presbyopia symptoms worse for a patient?

Answer 43

1. reduced illumination 2. fatigued 3. illness

Question 44

What are the amplitudes of accommodation like for a presbyope?

Answer 44

below 3.00 D

Question 45

Is the AC/A for presbyopes increasing, decreasing, or staying the same?

Answer 45

increasing

Question 46

What are the tests used for the assessment and plan for a presbyope?

Answer 46

1. demo of age expected add 2. dynamic retinoscopy 3. amplitude of accommodation 4. bionocular cross cyl 5. near duochrome 6. NRA/PRA

Question 47

What were found to be the worst tests to use to determine an add power of a presbyope?

Answer 47

1. dynamic retinoscopy | 2. amps of accom

Question 48

What were found to be the best tests to use to determine an add power of a presbyope?

Answer 48

1. age expected | 2. most other acceptable

Question 49

What are common first add powers for presbyopes?

Answer 49

+0.75 to +1.25

Question 50

What is the equation for calculating the actual near add a patient is receiving with uncorrected or under-corrected distance refractive error?

Answer 50

EA = Rx(near) - (U(fp) - Rx(spec))

Question 51

Why is a phoropter not a good demonstration for an add power?

Answer 51

1. too dark | 2. patient cannot choose where to hold the material

Question 52

What is one of the most common causes of unhappiness with a new Rx and why?

Answer 52

error in add because loss of intermediate or adaptation

Question 53

What issues could lead to problems with the acceptance of a bifocal?

Answer 53

1. 4th nerve palsy | 2. exophoria (low AC/A) so may have to do VT before bifocal

Question 54

If the patient leans forward during seg height measurement will the segs be too high or too low?

Answer 54

too high

Question 55

Are seg heights higher or lower with longer vertex distance?

Answer 55

higher