Ophthalmic Patient services and education
Slit-lamp examination of your patient reveals a yellowish nodule on the conjunctiva just nasal of the cornea. Most likely this is a(n): A) pterygium B) Xanthelasma C) episcleritis D) pinguecula
D: A pinguecula appears as a yellow nodule, usually on the nasal side of the eyeball, A pterygium crosses onto the cornea, and the nodule associated with episcleritis generally is seen in a red eye. Xanthelasma appears on the lids.
Removal of the entire eye ball is an: A) evisceration B) exenteration C) ectropion D) enucleation
D: An enucleation is the procedure for removal of the eyeball. Evisceration is removal is the contents of the globe but not the globe itself. Exenteration is removal of the globe and all associated muscles, fat, and tissue (including the eyelids). Extropion is an out-turned eyelid.
All of the following are usually noncancerous skin and lid growths except: A) xanthelasma B) molluscum contagiosum C) milia (skin tags) D) basal cell tumors
D: Basal cell tumors are also known as basal cell carcinomas. This is a malignant tumor that should be removed and biopsied promptly.
Infection of the lacrimal sac is termed: A) canaliculitis B) lacrimitis C) lacrimal cystitis D) dacryocystitis
D: Dacryocystitis is the term for an infected tear sac. Canaliculitis is an infection of the canaliculus. Answers B and C are bogus.
Diabetic retinopathy is currently treated with: A) topical medication B) oral medication C) insulin injections D) laser
D: Diabetes itself is treated with answers B and C. Retinopathy is treated with laser.
Which laser is most commonly used in refractive surgery? A) yttrium-aluminum-garnet (YAG) B) argon C) krypton D) excimer
D: The excimer laser is used in refractive surgery. The YAG is a cutting laser, used for capsulotomy, adhesions, and iridotomy. The argon and krypton lasers are used in retinal vascular disease and in glaucoma procedures.
Entropion is defined as: A) lids that turn inward B) lids that have inward-turned hairs C) upper lids that droop D) lids that turn outward
A: An inverted lid is termed entropion
Blepharitis is a common: A) lid infection B) corneal infection C) lid droop D) retinal disorder
A: Blepharitis is a common lid infection (blephar-referring to eyelids and -it is meaning an inflammation).
One of the more common viruses seen in acquired immune deficiency syndrome (AIDS) patients is: A) herpes simplex B) herpes zoster C) Adenovirus D) Streptococcus
A: The AIDS patient, with a lowered immunity, is subject to infection. One of the more common is herpes simplex.
Symptoms of a posterior subcapsular opacity: A) mimic those of a cataract B) mimic those of angle-closure glaucoma C) include flashes and floaters D) can be alleviated with artificial tears
A: When a cataract is removed, the back part of the capsule that encloses the eye's natural lens is left in place to support the IOL. The capsule membrane is polished, but sometimes gets cloudy after surgery (a few months to a few years). The symptoms of a posterior subcapsular opacity are pretty much the same as those of a cataract: blurry/foggy vision, ghosting images, and problems with glare.
The most common cause of cataract is: A) smoking B) aging C) hypertension D) eye strain
B: It is current theory, that every person will get cataracts if he or she lives long enough. It is just that one person may be ready to be removed when they are 57 and another may be 91 and not need them removed yet.
A cataract is a: A) growth on the lens B) clouding of the cornea C) lens opacity D) growth on the retina
C: By definition, a cataract is an opacity of the crystalline lens; it is not a growth.
When repairing a lower lid laceration in the area of the punctum, tissue alignment is especially critical because: A. the lacrimal drainage system is involved B. the tear-producing ducts are involved C. infection may set in D. eyelash alignment may be affected
A: If a laceration involves the lower lid, next to the nose, the tear drainage system is involved. Permanent tearing may result if the drainage ducts are not properly aligned.
The main purpose of a biopsy is to: A) determine the type of lesion B) determine the effectiveness of surgery C) determine the expected outcome of surgery D) identify malingerers
A: In a biopsy, tissue is sent to a lab for identification. Usually, the concern is whether or not the tissue is malignant (cancerous).
A surgically created, conjunctiva-covered, external opening through which aqueous can drain is a: A) bleb B) seton C) drainage implant D) sebaceous cyst
A: In glaucoma surgery using a valve, a "bubble" or bleb is created between the conjunctiva and sclera as a site for venting aqueous from the eye.
Recurrent corneal erosion might be treated by: A) corneal scraping B) punctal occlusion C) enucleation D) corneal transplant
A: In the case of recurrent corneal erosion, the eroded area is carefully scraped. The idea is to create a smooth surface so the cornea will be able to heal normally.
Preoperative cataract surgery measurements of a patients corneal curvature is known as: A) keratometry (K Readings) B) exophthalmometry C) interferometry D) tonometry
A: Keratometry is used to measure the curvature of the cornea prior to cataract surgery. It is one of several variables used in determining the power of IOL implant to be used once the cataract has been removed.
Symptoms of cataract include: A) Halos B) floaters C) flashes D) foreign body semsation
A: Light entering an eye with a cataract is scattered and may result in halos around lights because the light is broken into its component colors.
Which of the following refers to a drooped upper lid? A) ptosis B) exophthalmos C) trachoma D) blepharospasm
A: Ptosis refers to the drooping of an organ or structure. When speaking of the eye, the term refers to the drooping of the upper lid. Blepharoptosis would be even more descriptive and accurate.
A popular technique for correcting refractive errors using laser technology is: A) laser assisted in situ keratomileusis (LASIK) B) radial keratitimy (RK) C) astigmatic keratotomy (AK) D) corneal implants
A: RK and AK are performed with blades, not laser. Corneal implants are done by conventional surgery.
Each of the following might be associated with a corneal transplant EXCEPT: A) follow-up radiation treatment B) tissue rejection C) irregular astigmatism D) 12 months recovery time
A: Radiation is not used with a corneal transplant.
A blockage of the nasolacrimal duct might result in any of the following except: A) recurrent erosion syndrome B) epiphora C) chronic infections D) tearing in an infant
A: Recurrent erosion syndrome is not related to a blocked nasolacrimal duct. Epiphora (tears streaming down the cheeks) and tearing in infants as well as chronic infections (occurring because microorganisms are not being flushed out of the system) are frequently hallmarks of this condition.
Prior to cataract surgery, an A-scan is used to: A) measure the length of the eye B) establish postoperative vision C) evaluated the corneal endothelium D) evaluate retinal health
A: The A-scan ultrasound is used to measure the axial length of the eye prior to cataract surgery. It is one of several variables in determining the power of an IOL implant to be used once the cataract has been removed.
Atherosclerosis is characterized by fatty deposits along the walls of the: A) arteries B) veins C) capillaries D) atrium
A: The condition of fatty deposits on the walls of the arteries is known as atherosclerosis. (Atherosclerosis is actually a form of arteriosclerosis, or hardening of the arteries.)
The intent behind intravitreal injections for macular degeneration is to: A) inhibit the growth of new, abnormal retinal blood vessels B) seal off leaking blood vessels C) reattach the macula D) create a drainage bleb
A: The medication given via intravitreal injection for macular degeneration is intended to interfere with neovascularization, or the growth of new, abnormal, fragile blood vessels.
Currently, the most commonly used type of anesthesia for cataract surgery is: A) topical B) retrobulbar injection C) intravitreal injection D) general
A: The most commonly used type of anesthesia for cataract surgery is topical.
Symptoms of cataracts include: A) ghost image B) vertical diplopia C) stabbing pains D) lid twitch
A: The scattered light can cause objects to appear doubled, although "ghost image" is usually a better description.
Insertion of a phakic IOL would be done for the purpose of: A) cataract removal B) correction of refractive error C) preventing cataracts D) intraocular medication
B: A "phakic IOL" is inserted into the eye without removing the natural crystalline lens. It is done for the purpose of correcting refractive errors.
Symptoms of cataracts include: A) granulated eyelids B) looking through a fog C) dull ache D) pressure sensation
B: A cataract may cause a general haze to the vision, as if looking through waxed paper.
Sagging and eversion of the lower eyelid is termed: A) entropion B) ectropion C) epiphora D) trichiasis
B: A sagging, everted (out-turned) lid is known as ectropion.
In the event that the eyeball is removed, an implant is placed into the orbit. The purpose of this implant is to: A) provide an attachment for electronic vision devices B) maintain the shape of the orbit C) cosmetically look like a natural eye D) keep the eye shut
B: After an eyeball is enucleated, an implant is placed into the eye socket to maintain the shape of the orbit. Without the implant, the orbit would tend to shrink, making it difficult to fit a prosthetic eye.
Infection of the lash follicle is a: A) chalazion B) hordeolum C) xanthelasma D) blepharitis
B: An infected lash follicle produces a sty or hordeolum. (A chalazion is an infected meibomian gland.)
The grafting of corneal tissue from one human eye to another is a(n)? A) enucleation B) keratoplasty C) dacryocystorhinostomy D) corneal topography
B: Another name for a corneal graft or transplant is a keratoplasty.
The term "secondary cataract is a misnomer because : A) most cataract are congenital B) once removed a cataract cannot grow back C) it actually occurs in the IOL implant D) it is actually an opacity of the cornea
B: Another name for a posterior capsule opacity is "secondary cataract," but this is a misnomer. Once removed, a cataract cannot grow back.
Your patient says his neighbor had her cataracts removed with laser and wants to know if his will be taken off in the same way. You tell him: A) "Yes, we use only the latest technology" B) "No, she's probably referring to the way we ultrasound to break the cataract into tiny pieces. It's not actually a laser." C) "Yes, it's called the YAG laser" D) "No, she doesn't know what she's talking about"
B: Because laser is used to treat postoperative capsule opacity, people often think that a cataract is removed that way as well. Answer D is not recommended; you can educate the patient without implying that someone is ignorant.
Diabetes is a condition resulting from: A) increased thirst and urination B) an imbalance in the insulin-glucose levels of the body C) an imbalance in the calcium content of the blood D) fluctuations in vision
B: Diabetes results when the insulin-glucose (sugar) levels of the body are imbalanced. Answers A and D are symptoms of diabetes, but do not cause it.
A person with esotropia might have what kind of surgery? A) trabeculectomy B) Recession and resection C) Blepharoplasty D) Ptosis repair
B: In strabismus (esotropia, exotropia), the condition is often corrected by moving the location where the extraocular muscles attach to the eye and/or shortening a muscle. One muscle is recessed (its insertion moved farther back on the eyeball) and the other resected (part of it removed, making it shorter).
Laser photocoagulation might commonly be used to treat all of the following except: A) hypertensive retinopathy B) hyphema C) diabetic retinopathy D) macular degeneration
B: Laser photocoagulation is frequently used to seal, especially blood vessels. Answers A, C, and D are all retinal conditions that may respond well to photocoagulation. A hyphema is blood is the anterior chamber, which is not treated with laser.
Surgery that is performed in order to correct hyperopia, myopia, and/or astigmatism as classified as: A) amniotic membrane transplant B) refractive surgery C) corneal transplant D) corneal endothelial correction
B: Logically, refractive errors are corrected using refractive surgery. Technically, any surgery that purposely alters the eye's refractive status could be considered refractive surgery, making cataract extraction with intraocular lens implant the most-performed refractive surgery.
The most likely route of human immunodeficiency virus (HIV) infection from patient to ophthalmic medical personnel would be: A) contaminated tears during applanation tonometry B) needle stick during minor surgery C) being in the same room with an HIV-positive patient D) shaking hands with an HIV-positive patient
B: Needle sticks remain the main source of transmission to medical personnel. The AIDS virus has been isolated from human tears, but there have been no known cases of transmission due to contact with contaminated tears.
Which of the following refractive surgeries DOES NOT involve creating a corneal flap? A) epi-LASIK B) photorefractive keratectomy (PRK) C) laser assisted subepithelial keratomileusis (LASEK) D. LASIK
B: PRK involves removing the corneal epithelium (compared to creating a flap that is later replaced) and shaping the underlying corneal layer.
Which of the following area general restrictions immediately following cataract surgery? A) no bathing B) do not bend over or lift anything heavy C) keep the eye patched at all times D) keep the head elevated when reclining
B: Patients are generally told not to bend over (ie, bending at the waist so that the head is dangling down). Inclining the head to read is okay, and it is fine to kneel to pick something up. Patients are also told not to lift anything heavy. Bathing is allowed, although the patient is cautioned not to get any water in the eye.
Ptosis surgery is done to repair which of the following? A) strabismus B) dropping upper lids C) lax lower lids D) redundant skin and fat
B: Ptosis is a drooping upper lid.
The removal of the jelly-like substance in the back of the eye is a(n): A) centesis B) vitrectomy C) evisceration D) enucleation
B: Removal of the vitreous is a vitrectomy (the suffix -ectomy refers to removal).
Which of the following systemic disorders is most commonly associated with dry eye: A) hypertension B) rheumatoid arthritis C) osteoporosis D) diabetes
B: Rheumatoid arthritis is commonly associated with dry eye, sometimes severe (keratitis sicca).
The standard test for diagnosis of dry eye is: A) rose bengal test B) Schirmer's test C) fluorescein D) nasolacrimal irrigation
B: Schirmer's tear test measures the amount of tears produced in a 5-minute test period.
Smoking can cause all of the following except: A) dry eye and tobacco amblyopia B) ptosis, trichiasis, and retinoblastoma C) increased risk of diabetic and hypertensive retinopathy D) increased risk of macular degeneration
B: Smoking pretty much affects the entire body. Externally, the smoke can contribute to dry eye. Smoking also increases the risk of retinal diseases, including diabetic and hypertensive retinopathy and macular degeneration. Tobacco amblyopia is visual decrease in an otherwise healthy eye, related to smoking.
A patient wants to have an upper blepharoplasty to improve his look. This type of surgery is termed: A) functional B) cosmetic C) mandatory D) sight- threatening
B: Surgery to improve appearance is cosmetic. Insurance is not likely to pay for it.
All of the following are infections that can be present at birth except: A) toxoplasmosis B) herpes simplex C) siderosis D) gonorrhea
C) If the mother is infected with toxoplasmosis, herpes simplex, or gonorrhea (Neisseria gonorrhoeae), the infant is at risk. Toxoplasmosis would occur in utero, herpes simplex and N. gonorrhoeae during birth. Siderosis refers to iron deposits in the tissues, which is not something that would be transmitted from mother to child.
A condition is which eyelashes grow inward, toward the eye is: A) lash ptosis B) blepharitis C) trichiasis D) keratitis
C) The condition of having inward-growing lashes ~ patients sometimes calls these "wild hairs" ~ is known as trichiasis.
The most common surgical treatment for a chalazion is: A) cautery B) electrolysis C) incise and drain D) probe and irrigate
C: A chalazion is often incised (cut into) and drained. Although not mentioned here, curettage may also be performed, where the exposed tissue is scraped.
A preoperative B-Scan might be required in which cataract patient: A) diabetic retinopathy B) macular degeneration C) extremely dense cataract D) pterygium
C: A dense cataract makes it difficult for the physician to see inside the eye to judge the health of the retina. A B-scan ultrasound might be done to make sure that the retina is not detached nor has any gross abnormality that might prevent vision improvement if the cataract was removed.
Postoperative cataract surgery vision might not be substantially improved in the patient with: A) ptosis B) small pupils C) macular degeneration D) strabismus
C: A patient who has macular degeneration may not notice much improvement after cataract surgery; the PAM may be able to help predict this. Explain it to the patient like this: If you have a great camera but the film is not good, you will not get a good picture regardless of the quality of the lens. The eye is like this. (Sometimes, cataract surgery is performed for a patient with macular degeneration to improve his or her "getting around" vision, rather than the central vision.)
The condition where the lacrimal gland slips down under the conjunctiva is know as a(n): A) obstructed tear gland B) conjunctival bleb C) prolapse D) pinguecula
C: A prolapse occurs when a structure slides out of place. The lacrimal gland can "fall" into the space between the globe and the conjunctiva, appearing as a yellowish, moveable mass under the conjunctiva on the superior area of the globe.
Which of the following might need to surgically removed because it is growing across the cornea? A. pingueculum B. punctual plug C. pterygium D. xanthelasma
C: A pterygium is a piece of fleshy tissue that grows from the conjunctiva onto the cornea. An "active" pterygium continues to grow and may need to be removed before it gets to the center and obscures vision.
Laser, scleral buckle, and intravitreal gas or air bubble are all treatments for: A) diabetic retinopathy B) retinal hemorrhage C) retinal detachment D) macular degeneration
C: A retinal detachment might be treated with laser (photocoagulation, to "fuse" tissue), a scleral buckle (a device that pushes the tissues together), or a "bubble" of gas or air (while it puts internal pressure on the area of concern).
Your physician has told the patient that she has a subconjunctival hemorrhage (SCH) and has left you to educate the patient. You should: A) warn her that she may later have a retinal detachment B) tell her to leave the pressure patch on for 24 hours C) reassure her that it will dissipate in 1 to 3 weeks D) impress her with the serious nature of the condition
C: An SCH in and of itself is not serious. The patient can be reassured. The exception would be if the SCH was the result of trauma, in which case answer a would be appropriate.
An infected meibomian gland causes a(n): A) blepharochalasis B) obstructed nasolacrimal duct C) chalazion D) hordeolum
C: An infected meibomian gland produces a chalazion.
The surgery to fix an out-turned eyelids is: A. ptosis repair B. trichiasis repair C. ectropion repair D. iridotomy
C: An outward-turned eyelid is call an ectropion, so this surgery is an ectropion repair.
A patient who has an upper blepharoplasty has been treated for: A) chalazion B) epicanthal folds C) dermatochalasis D) brow ptosis
C: An upper blepharoplasty ("lid lift") is the procedure used to treat dermatochalasis or redundant skin of the eyelids.
The purpose of extraocular muscles (EOM) surgery as a child might include all of the following EXPECT: A) prevention/resolution of amblyopia B) Cosmesis C) Correction of anisometropia D) Establish stereo vision
C: Anisometropia is a refractive problem where the refractive difference between the two eyes is 2.00 D or more. Strabismus surgery cannot change this; it must be resolved with optical correction. It is generally recommended that EOM surgery be done prior to a child's entering kindergarten so that the "crossed eyes" are no longer noticed (ie, for cosmetic reasons).
Your patient wants to know if she will have stiches in her eye after cataract surgery. You tell her: A) ''No, cataract surgery is always stitchless now" B) "No, cataract surgery is done with laser" C) "No, unless something changes during surgery" D) All the above
C: Answer A might be tempting, but it sounds too much like a guarantee. Although unlikely, there could be some type of intraoperative complication where the surgeon will suture the wound.
Your patient asks if he will still need glasses after cataract surgery. You tell him: A) "No, the intraocular implant will allow you to see normally" B) "No, everyone gets specialty implants now so you font need glasses" C) "Probably just to fine tune either distance or near vision." D) "No, all patient having cataract surgery see 20/20 after the procedure."
C: Answers A and D are patently incorrect and sound like a (dangerous) guarantee that the patient will see perfectly without correction once the cataract has been removed. Answer B is incorrect as well, because not everyone gets a "specialty" IOL (ie, multifocal or toric). Answer C is the only "safe" answer.
The main ocular concern in a patient with cancer is: A) accelerated presbyopia B) decreased blood supply to the eye C) spread of cancer to the eye's tissues D) decreased nerve response
C: Cancer can spread to any organ or tissue, including the eye.
Cataract can be caused by all of the following EXCEPT: A) exposure to ultraviolet light B) injury C) open-angled glaucoma D) diabetes
C: Having open-angle glaucoma does not predispose one to cataracts.
Hypertension mainly affects which eye structure? A) cornea B) lens C) retina D) optic nerve
C: High blood pressure (hypertension) affects mainly the retina.
Which of the following can occur in the eye as a result of atherosclerosis? A) posterior vitreous detachment B) macular edema C) central retinal artery occlusion D) corneal dystrophy
C: If a fatty plaque dislodges, travels through the bloodstream, and gets stuck in the central retinal artery, an occlusion can occur.
Angle-closure glaucoma is most often treated by performing a: A) surgical trabeculectomy B) valve implant C) laser iridotomy D) surgical iridectomy
C: In angle-closure glaucoma, the iris butts up against the anterior lens surface and is then pushed into the angle of the eye, blocking the drainage of aqueous from the eye. A laser iridotomy is done to create an opening in the iris to allow the aqueous to drain even when the angle is blocked.
All of the following are often seen in the patient with AIDS except: A) dry eye B) recurrent blepharitis C) xanthelasma D) optic neuritis
C: Of course and AIDS patient can develop xanthelasma (yellowish lid lesions related to cholesterol), but in general this is not directly associated with AIDS. In addition to A, B, and D, recurrent conjunctivitis is also common.
Reducing a cataract into small pieces by using a ultrasonic energy is termed: A) can opener method B) open sky technique C) phacoemulsification D) intracapsular extraction
C: Phacoemulsification uses sound waves to break the cataract into small pieces, which are then removed by suction through a small tube.
A patient with dry eyes might have which of the following procedure? A) lacrimectomy B) cyclocryo C) punctal occlusion D) punctal dilation
C: Punctal occlusion is sometimes used to prevent tears from draining off the eye's surface. Occlusion keeps the tears that are produced (not much, in a patient with dry eye) on the eye.
The surgical procedure where skin or other tissue is transplanted from one part of the body to another is a (n): A) flap B) incision C) graft D) Implant
C: Removing tissue (such as skin) from one part of the body and transplanting it onto another area is a graft. (Note: When a flap is performed, the tissue to be transplanted is not totally removed, but left partially attached and rotated to cover the adjacent area needing repair.)
Anesthesia for laser refractive surgery is usually: A) local B) general C) topical D) not needed
C: Topical anesthesia is used for refractive surgery.
Medications of concern for the preoperative cataract patient include all of the following EXCEPT: A) those containing aspirin B) those for erectile dysfunction C) estrogen based hormones D) blood thinners
C:Estrogen-based medications do not have any known effects on cataract surgery. Aspirin and blood thinners can cause operative and postoperative bleeding. Some treatments for erectile dysfunction have been known to cause the intraoperative complication of floppy iris syndrome.
The surgery to fix an in-turned eyelid is: A) epilation B) frontalis sling C) blepharoplasty D) entropion repair
D: An inward-turned eyelid is called an entropion; thus, the surgery is an entropion repair.
Which of the following is most commonly used in the treatment of retinal disease caused by hypertension? A) topical medication B) periodic injections C) conventional surgery D) laser surgery
D: As in diabetes, retinopathy caused by hypertension is treated with laser.
Symptoms of cataracts include: A) tearing B) ptosis C) increased contrast sensitivity D) change in color vision
D: Cataracts tend to cause a yellowing to a person's color vision. Often, after cataract surgery, a patient will notice that colors are more vivid.
Which of the following is not a symptom of dry eye? A) burning B) epiphora (streaming tears) C) gritty, foreign-body sensation D) extreme itching
D: Extreme itching is more often associated with allergies and infections, not dry eye.
Shingles is a systemic infection that can also affect the eye and is caused by: A) toxocara canis B) pseudomonas aeruginosa C) herpes simplex D) herpes zoster
D: Herpes zoster is the virus that causes shingles.
Herpes zoster occurs in patients: A) who have had malaria B) who have had a tetanus booster C) who have had tuberculosis D) who have had chicken pox
D: Herpes zoster, or shingles, occurs in those who have been previously infected with the chicken pox (varicella).
Which gives the most accurate idea of a cataract patients visual disability? A) pinhole B) standard Snellen vision chart C) PAM D) BAT
D: Of the tests listed, the BAT gives the best evaluation of what a patient with cataracts actually sees now. The results can indicate a level of disability that is not evident on testing with the regular Snellen eye chart. The BAT gives an actual measurement of how much worse the vision is in such bright conditions.
A posterior capsule opacity is treated by performing a: A) cryo-capsulotomy B) laser iridotomy C) surgical capsulotomy D) laser capsulotomy
D: Posterior capsule opacity is treated with a YAG laser, which is used to make an opening in the center of the capsule. This clears the visual axis, improving acuity.
Current, accepted treatment of a cataract is: A) "eye vitamins" B) laser ablation C) homeopathic eye drops D) surgical extraction
D: Surgical extraction is the only current method of treating cataracts.
In which of the following surgical procedures might a drainage implant be place in the eye? A) cataract surgery B) nasolacrimal surgery C) strabismus surgery D) glaucoma surgery
D: The aim of all glaucoma treatment is to decrease intraocular pressure. This is generally done in one of two ways: increasing drainage/outflow or decreasing production/inflow of aqueous humor. Thus, glaucoma surgery might involve placing an implant devised to drain aqueous fluid out of the eye.
Laser treatment for primary/chronic open-angle glaucoma is a(n): A) valve implant B) iridotomy C) iridectomy D) trabeculoplasty
D: The laser surgery for open-angle glaucoma is trabeculoplasty. The laser beam is aimed into the angle of the eye (between the cornea and iris root). The theory is that when the tissue heals, the scarring pulls the trabecular meshwork open, increasing aqueous outflow.
Each of the following is used in intraocular lens implant (IOL) calculation EXCEPT: A) K Reading B) desired postoperative refraction C) A-scan D) intraocular pressure
D: The patient's intraocular pressure does not figure into the formula used to determine the power of an IOL implant.
Redundant skin of the lids is referred to as: A) blepharoprosis B) subluxation C) ectropion D) dermatoxhalasis
D: The prefix dermato- indicates a condition involving the skin; the suffix -chalasis means relaxation. Thus, the combines term is dermatochalasis. (Note: Some references make a the distinction between blepharochalasis, which is a rarer problem involving intermittent swelling of the upper lids, and dermatochalasis, which is the common relaxing of the lid's skin.)
The hallmark of proliferative diabetic retinopathy is: A) fluctuating vision B) resistance to dilation C) increased intraocular pressure D) growth of new retinal blood vessels
D: The proliferative indicates that something is growing or spreading. Proliferative diabetic retinopathy occurs when new, abnormal blood vessels begin to spread into the retina of the diabetic. This is called neovascularization.
A cataract is often removed when: A) vision is reduced below 20/200 B) the cataract is ''ripe'' C) the patient fails a color vision text D) the patient notes impairment of daily living
D: Years ago, a cataract was not removed until it was "ripe". But with modern technology, a cataract can be removed whenever the notices that his or her vision decrease is interfering with his or her activities of daily living.
An infant with a blocked nasolacrimal duct might initially need which of the following procedures? A) dacryocystorhinostomy B) removal of the tear gland C) punctal dilation D) probe and irrigation
D:During fetal development, there is a membrane covering the nasolacrimal duct in the tear drainage system. This membrane usually disappears before birth, but sometimes remains. In this case, tears do not drain properly, and an infection can easily develop. The treatment is to open the membrane with a probe (thin wire) and then flush the drainage system with saline.
The aim of most types of glaucoma a surgery is to: A) increase aqueous production B) improve optic nerve health C) increase aqueous outflow D) avoid medication use
The aim of all glaucoma treatment is to decrease intraocular pressure. This generally done in one of two ways: increasing drainage/outflow or decreasing production/inflow of aqueous humor. Thus, glaucoma surgery might involve placing an implant devised to drain aqueous fluid out of the eye.
Hypertension is when, most of the time, the blood pressure is equal to or greater than: A) 140 systolic and/or 90 diastolic B) 120 systolic and/or 80 diastolic C) 180 diastolic and/or 95 systolic D) 200 systolic and/or 100 diastolic
A: Currently, the designation of hypertension starts when a person's blood pressure is consistently 140 to 159 systolic (or higher) and/or 90 to 99 diastolic (or higher). There is also a category known as "prehypertension," which ranges from 120 to 139 systolic and 80 to 89 diastolic. If the systolic is 180 or higher and/or the diastolic is higher than 110, emergency care is called for.
The procedure for removing a growth from the eyelid is: A) excision B) incision C) decompression D) biopsy
A. A procedure to remove a growth or other tissue is an excision. An incision is cutting into, but not necessarily removing, anything. A biopsy is when tissue is removed and sent to a lab for identification. A biopsy might be done once tissue is excised.
The vision a patient may have after cataract surgery can be estimated with: A) potential acuity meter (PAM) B) brightness acuity test (BAT) C) pinhole D) accurate refractometry
A: A PAM is used to estimate what vision will be once the cataract is removed.
A cataract that occurs due to some other condition or medication is known as: A) secondary B) subscapular C) congenital D) lenticular
A: A secondary cataract is caused by something else, such as trauma (including ultraviolet light), disease (eg, diabetes), or medication (eg, steroids).
When seeing a diabetic patient for a routine exam, it is important to know how stable her sugar level has been recently because fluctuations: A) can change the refractometric measurement B) can cause extraocular muscle palsies C) can cause diplopia D) can cause eye pain
A: A stable sugar level for about 6 weeks prior to refractometry is desirable for a good measurement. The refractometric measurement often varies as the sugar level fluctuates.
Leukemia and sickle cell disease both produce abnormal blood cells. These cells can: A) clump together and clog retinal blood vessels B) cause retinal detachment C) cause spasms of extraocular muscles D) interfere with nerve transmission
A: Any foreign material in the bloodstream has the potential for blocking blood vessels.
Symptoms of cataracts include: A. becoming more nearsighted B. becoming more farsighted C. early presbyopia C. discharge
A: As the lens opacity gets denser, the eye generally becomes more nearsighted or myoptic. This can happen even in a farsighted/hyperopic eye and is known as a myopic shift. A person who needed glasses to read may now find he or she no longer needs them. This phenomenon is known as "second sight" or the "honeymoon" stage of cataracts.
Speculate microscopy (cell count) might be needed prior to cataract surgery if the patient has: A) corneal dystrophy B) Graves disease C) astigmatism D) Dry eye
A: Cataract surgery invariably "bumps" the single-cell-layered corneal endothelium, which is already diseased in corneal dystrophy. Specular microscopy (also known as a cell count) may be done to evaluate the corneal endothelium prior to attempting cataract surgery to make sure it is healthy enough to withstand the operation.
Which of the following might be done on a patient with thyroid eye disease? A) exophthalmometry B) B-scan ultrasound C) glare test D) duochrome test
A: Exophthalmos, where the eye(s) bulge abnormally, is associated with thyroid eye disease. The instrument used to measure ocular protrusion is the exophthalmometer.
