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How much accommodation does a 4D myope need to see clearly at distance?
None myopes dont accommodate at distance
A myopic patient is asked to move his head back and forth while observing the speckle pattern formed on a wall. How will the motion appear?
A hyperopic patient is asked to move his head back and forth while observing the speckle pattern formed on a wall. How will the motion appear?
Which muscle is responsible for spontaneous blinking?
Palpebral portion of orbicularis oculi
What pathogen is responsible for the disease known as Cat Scratch Disease?
What pathogen is responsible for the disease known as lyme disease?
Borrelia burgdorferi (lyme disease)
What pathogen is responsible for the disease known as Cat Scratch Disease?
Actinomyces israelii (caniculitis)
Which areas within the eye are autoregulated?
- Retinal vessels
- Optic Nerve
Majority of ocular pharmacological agents are:
Which type of antibodies are found in tears, saliva, and breast milk?
Which type of antibodies are first responders?
Which type of antibodies are most numerous in plasma?
Which of the glaucoma drugs have neuroprotective properties?
Hematuria is MOST likely the result of which condition?
In which of the following conditions can a Sampolesis line be found?
- Pseudoexfoliation glaucoma
- Pigment dispersion syndrome
The near point of accommodation (NPA) of a patient wearing a +2.25D ADD over his BEST distance correction is 19cm. If the ADD is removed, the NPA would then be at approximately:
33 cm (100/19 = +5.25; +5.25 - +2.25 = +3; 100/+3 = 33cm)
Both a husband and wife pass standard color vision tests. They have a son and a daughter. If the son tested positive for having a red-green color defect, what is the probability that the daughter will test positive for having a red-green color defect?
Where do the nerves that innervate the cornea enter?
What class of drugs used in the treatment of glaucoma can cause heterochromia?
While performing bruckners test, you notice a crescent on the superior portion of the pupil. What is most likely the refractive status of the patient?
While performing bruckners test, you notice a crescent on the inferior portion of the pupil. What is most likely the refractive status of the patient?
Which structures have the greatest oxygen consumption rate?
Why isn't aproclonidine used in chronic treatment of glaucoma?
Which of the following agents are considered bacterocidal? (pick 2)
- A) Amoxicllin
- B) Trimethoprim
- C) Doxycycline
- D) Vigamox
- E) Sulfacetamide
You have a patient who is suffering from renal disease. Which of the following drugs is not contraindicated in this patient?
- A) Minocycline
- B) Doxycycline
- C) Amphotericin B
- D) Tetracycline
What structure is responsible for draining the choroid?
A) Vortex veins
You examine your patients pupils and notice miosis. Direct testing did not cause any constriction, but the pupils constricted when a near stimulus was presented. Where do you suspect a lesion to be located?
Which section within medicare will cover for refraction?
Your patient is having a spasm where the eyes are pulled up and they are having trouble looking down. Which drug is the patient most likely using? (pick 2) (oculogyric crisis)
- A) Cyclopentolate
- B) Cetirizine
- C) Rifampin
- D) Methotrexate
- E) Chlorpromazine
What is the primary action of the superior oblique if the eye is abducted 39 degrees?
Your spectacles have a transmission of 60% and your windshield has a transmission of 75%. What is the total transmission of light while driving with your glasses?
45% (.6 x .75 = 45%)
Your patient brings their glasses to you and you measure the following prism from the lensometer; OD: 5 pd BU, 1 pd BO and OS: 2 pd BU, 6 pd BO What is the total amount of prism for these glasses?
3 pd BU OD, 7 pd BO (5-2 = 3; 1+6=7 BO)
Which of the following lens materials inherently blocks the most amount of UVA light?
- A) Hi index glass
- B) CR39
- C) Polycarbonate
- D) Glass
Which portion of the nephron is not permeable to water?
Ascending loop of henle (water does not leave here, as is the distal tubule)
Which portion of the nephron is permeable to water?
Descending loop of henle (only water leaves here)
Which of the following cells secrete histamine?
- A) Neutrophils
- B) Basophils
- C) Eosinophils
- D) T lymphocytes
Your patient underwent a penetrating keratoplasty. You are concerned with rejection. Which type of cell would most likely cause this?
Cytotoxic T cells
Which hormone is stored in the posterior pituitary?
- A) Oxytocin
- B) Prolactin
- C) TSH
- D) GH
Your 50 year old patient reports to your office complaining of color vision problems. She states that there is a yellow/green tint to her vision. Which medication would most likely cause this?
What are side effects associated with oral steroids?
- Decreased wound healing
Your 12 year old patient comes in with VA of 20/50 distance and near OU. Your manifest refraction gives +2.00D OU. After cycloplegic refraction, the patient has +4.75D OU. What is the latent hyperopia?
Your patient comes in complaining that they can't taste anything, particularly in the back of the tongue. Which cranial nerve do you suspect has a lesion?
The tear layer closest to the cornea is formed by what?
Goblet cells (mucin)
The tear layer farthest from to the cornea is formed by what?
Meibomian gland (lipid layer)
Which immunoglobin has the lowest concentration in the blood?
Which one of the following does not develop from the same origin as the others?
- A) Corneal epithelium
- B) Corneal endothelium
- C) Conjunctiva epithelium
- D) Lens epithelium
Quaternary in structure
Which of the following is not true about acetaminophen?
- A) Safe in pregnancy
- B) Fatal hepatatoxicity
- C) Anti-inflammatory effects
- D) Analgesic effects
Which of the following are considered risk factors for amblyopia? (pick 3)
- A) Prematurity
- B) Xeropthalmia
- C) Old age
- D) Exposure to smoking, drinking, or drugs in utero
- E) Mental retardation
- F) Heavy birth weight
Your 5D myope patient is about to undergo LASIK. The pachymetry reading gives 480um. What should the remaining stromal bed thickness measure after the procedure?
give an example of a class 2 LASER?
What test can help you differentiate the staphylococcus species from each other?
Upon examination of a 1 day post op cataract patient, you find that the IOP measurement is elevated. What could be the most likely reason for this?
You suspect Horners syndrome in your patient. After instilling apraclonidine in the miotic eye, it dilates. What order lesion can you suspect?
None if it dilates, then there is no horners
When two waves are in phase, this can also be called...?
Which of the following is true for base curves? (pick 3)
- A) In minus cylinder form, the base curve of a segmented multifocal is on the same side as the segment
- B) Base curve is found on the front surface
- C) Base curve is found on the back surface
- D) In plus cylinder form, the base curve is the flatter of the two curves
- E) In spherical lenses, the back sphere is the base curve
- F) The steeper curve in the back surface in minus cylinder is known as the toric base curve
Which of the following lens materials has the highest refractive index?
- A) CR39
- B) NXT
- C) Polycarbonate
- D) Trivex
Which of the following cannot be considered a short acting asthma agent?
- A) Levalbuterol
- B) Salmeterol
- C) Terbutaline
- D) Albuterol
What is the threshold for a 2 alternative forced choice test?
When performing an experiment, you find that if the intensity of a light bulb is doubled, then brightness is also doubled. If this is true, which psychophysical law is applicable?
Your drug addict patient has pinpoint pupils, seizures, papilledema, and respiratory depression. What can be used to reverse the overdose reactions? Antidote for narcotics and opoids
Your patient comes in complaining that their glasses sit too low on their face. As their brilliant optometrist, how can you adjust these frames?
Lower the vertical position of the pads
Methotrexate has multiple uses. Which of the following are considered adverse effects? (pick 3)
- A) Lymphomas
- B) Blue sclera
- C) Reyes syndrome
- D) Hepatotoxicity
- E) Orange tears
- F) Opportunistic infection
The photochromatic interval is zero at....?
Which of the following will not cause hypoglycemia?
- A) Sulfonylureas
- B) Glucophage
- C) Actos
- D) Glipizide
The visual disappearance of low temporal frequency stimuli is an example of the following phenomenon?
Your epileptic patient comes to your office with signs of a closed angle attack. Further investigation finds swelling of the choroid. Which this in mind, which drug is the patient most likely using?
Infrared A radiation arriving at the retina is mostly absorbed by:
Melanin in the retinal pigment epithelium
Which of the following are expected findings in the geriatric patient? (pick 3)
- A) Nerve fiber layer thinning
- B) Flatter cornea
- C) Increased anterior chamber depth
- D) Dermatochalasis
- E) Reduced corneal sensitivity
- F) Scleral thinning
A 25 yr old female patient reports taking birth control pills. Which of the following are adverse effects? (pick 4)
- A) Cataracts
- B) Papilledema
- C) Steven Johnson Syndrome
- D) Xerophthalmia (scientific word for dry eyes)
- E) CRVO
- F) Deep vein thrombosis
- G) Glaucoma
You are screening your 35 yr old African American patient for glaucoma. Pachymetry readings give OD: 445um OS: 485um. With Goldmann tonometry, you measure OD: 17mmHg OS: 18mmHg. What would the adjusted IOP measure?
OD: 24mmHg OS: 22mmHg
The magnification of the image in a plane mirror is?
B2 receptors are found in the following ocular structures
- Non pigmented ciliary epithelium
- Ciliary muscle
- Trabecular meshwork
Which of the following is true for pilocarpine?
- A) It will stimulate the radial muscle of the ciliary body to pull on the scleral spur and open the trabecular space to increases outflow
- B) It will stimulate the longitudinal muscle of the ciliary body to pull on the scleral spur and open the trabecular spaces to increase outflow
- C) The pupil will become miotic, thus opening the anterior chamber angle up to increase outflow
- D) It is used as a first line treatment in primary open angle glaucoma
What is true regarding infants visual acuity using the preferential looking technique?
- A) 20/20 at 3-5 years of age
- B) 20/600 at 6 months of age (20/100)
- C) 20/100 at 3 months of age (20/200)
- D) 20/200 at birth (20/600)
The visual cliff experiment shows that infants achieve depth perception by this age:
According to Fourier analysis, a square wave can be approximated by the sum of the sinusoidal waves. Given a sine wave having a spatial frequency of 3 cycles/degree, what is the spatial frequency of the fifth harmonic sinusoidal wave?
15 (3*5 = 15)
What is the minimum angle of resolution for a patient that has a 20/80 snellen visual acuity?
4 minutes of arc
A patient has a contrast sensitivity cut off of 20 cycles/degree. What is the associated Snellen visual acuity?
20/30 (600/20 = 30)
Which of the following can cause leukocoria in children? (pick 3)
- A) Congenital cataracts
- B) Diabetic retinopathy
- C) Toxocara canis
- D) Band keratopathy
- E) Retrolental fibroplasias
You are using your ophthalmoscope to examine a patient. You focus on the anterior portion of the lens. As you move yourself from left to right you notice an unknown structure that moves in the same direction. Where is the structure located?
Behind the lens
You are using your ophthalmoscope to examine a patient. You focus on the anterior portion of the lens. As you move yourself from left to right you notice an unknown structure that moves in the opposite direction. Where is the structure located?
In front of the lens
A temporal sinusoidal wave has a maximum luminance of 50-ft lamberts & minimum luminance of 20 ft-lamberts. What is the percent modulation of the wave?
The visual disappearance of low temporal frequency stimuli is an example of the following phenomenon:
- A) Purkinje
- B) Muller-Lyer Illusion
- C) Mach Bands
- D) Troxler
- E) Talbot-Plateau
Which of the following is not correct, regarding the middle temporal cortex (MT/V5) area of the brain?
- A) Involved in motion after effects
- B) It is part of the dorsal stream
- C) Responds best to global motion
- D) Encodes object recognition
- E) Responsible for the where
You are performing an EOG on your patient. The EOG is normal. Which condition would you least suspect:
What percent of the striate cortex is devoted to foveal vision?
The parvocellular stream is mainly responsible for information regarding:
- Red-green color information
Which is not true regarding cones in the human visual system?
- A) There are about 6-7 million of them
- B) Tend to decrease with age
- C) Associated with good vision
- D) Webers fraction for cones is lower than for rods
Wavelength difference discrimination is best at the following wavelengths:
495nm and 590nm
Which of the following can occur when the eyes are closed?
- A) pursuits
- B) VOR
- C) OKN
- D) Fusional vergence
Which of the following is true regarding OKN?
- A) Nasal to temporal OKN response dominate infants less than 4 months old.
- B) A negative response is indicative of poor visual acuity.
- C) OKN drum should elicit saccade followed by a pursuit.
- D) In infants, the cortical regions are not fully developed, causing subcortical regions to be involved.
What layer of the retina is the big arrow pointing to?
- A) Inner nuclear layer
- B) Outer nuclear layer
- C) Inner plexiform layer
- D) Outer plexiform layer
Given the following EOM movements, where do you suspect a lesion?
- A) Ciliary ganglion
- B) Edinger Westphal nucleus
- C) Occipital lobe
- D) Medial longitudinal fasciculus
During a 4 base out test, you place the prism over the right eye. Both eyes move to the left. When you place the prism over the left eye, there is no movement. Which of the following is correct?
- A)The right eye is suppressed.
- B) The left eye is suppressed.
- C) The patient has diplopia.
- D) Not enough information given.
You just received a pair of spectacles from the lab and you are going to verify them. Your prescription called for -6.00 -1.50 X 165. However upon verification you read -5.75 -1.50 X 163. According to 2010 ANSI standards, does this pair fall within tolerances?
B) No sphere out of range
What is the purpose of aspheric lens design?
Reduce the weight of the lens
A patient shows a hypertropia of the left eye in primary position. The hypertropia becomes more pronounced when he looks right and tilts his head to the left. What extraocular muscle is likely affected?
Left superior oblique
Your patient complains of diplopia and presents with a tip. You perform cover test in all positions of gaze and find 25pd esodeviation in down gaze. You find 15pd esodeviaton in primary gaze and 6pd of esodeviation in up gaze. Which of the following is false?
- A) The deviation is noncomitant.
- B) The patient has a V-shaped pattern of noncomitancy. (most eso at down)
- C) The patient may present with a tip up. . (Pt will want a tip down making eyes go up)
- D) The affected muscle is most likely a vertically acting rectus muscle.
- E) The patient will benefit from a base down prism. (BD makes eyes go up
to less eso)
You give a patient a rigid contact lens with a base curve of 7.50mm. The back vertex power of the contact lens is -4.50DS. After slit lamp examination, you decide to flatten the base curve by 0.1mm. What will be the new prescription for this patient? (remember that flatten means higher number ex from 7.5 to 7.6)
What can you determine from the following corneal topography print out?
Px has with the rule astigmatism
When performing Sheards minus method, your starting lens was a +5.00D. Complete blur was achieved at +2.00D. What is the amplitude of accommodation?
5.50D (5-2 = 3; 3+ WD of 1/40 cm (2.5) = +5.5)
Your patient is performing a test where they have to tell whether two lines are parallel or not. Where is the directional information processed?
Which of the following is false in regards to Mohindras retinoscopy?
- A) This is a monocular technique
- B) It is performed at 50cm
- C) It is not used to find a near prescription
- D) The working distance thats subtracted is -2.00D
When performing versions, you notice the patients right eye lags slightly. When you perform ductions the lag of the right eye is pronounced. Which of the following is least likely?
- A) The patient has a paresis of the right lateral rectus in the right eye.
- B) The patient has a paralysis of the right lateral rectus.
- C) A forced duction test on the right eye will be negative.
- D) The lag is caused by a palsy.
What is the near ADD for a patient whose near point is measured at 20cm with a +2.00D assisting lens in place? Assume the working distance is 40cm.
Which of the following purkinje images is the only real image?
Your patients right visual field is seen below. What is the eccentric viewing point for this patient?
- A) 3 o clock
- B) 6 o clock
- C) 9 o clock
- D) 12 o clock
Which of the following is false regarding a forced vergence curve? (pick 2)
- A) The y-intercept is the associated phoria.
- B) The x-intercept is the fixation disparity.
- C)The center of symmetry is useful for prescribing prism.
- D) The slope predicts the change in fixation disparity according to the change in demand.
- E) The associated phoria is the amount of prism that is required to neutralize fixation disparity.
You are evaluating a rigid contact lens under the slit lamp with fluorescein. You notice that there is apical pooling and peripheral touch. What is the next step in adjusting the fit?
Flatten the fit
Which of the following is false about amblyopia?
- A) There is no pathology present.
- B) The best corrected visual acuity is not as expected.
- C) Acuity is affected unilaterally.
- D) Visual acuity can range from 20/30 to LP.
- E) Occlusion causes the deepest amplyopia.
- F) Visual acuity improves with isolation of letters.
Which type of abnormal saccade does the image depict?
Your patient suffers a myocardial infaraction. Which type of necrosis is expected?
Your patient is amblyopic. Which of the following would you expect regarding their ocular motor skills? (pick 2)
- A) Normal amplitude of accommodation
- B) Accurate saccades
- C) Accurate pursuits
- D) Decreased latency of accommodation
- E) Decreased velocity pursuits
- F) Symmetrical OKN
- G) Unsteady monocular foveal fixation
Your patient is a healthy 65 year old male. He has no ocular pathology. Which of the following normal ocular changes would you expect to find? (pick 3)
- A) Decreased color vision
- B) Decreased corneal sensitivity
- C) Best corrected visual acuity will not reach 20/20
- D) Increased depth of the anterior chamber
- E) Hardening of the lens
- F) Vitreous syneresis
Your patient was punched extremely hard in the eye. Which orbital bone is most likely affected?
Where is the far point located for a 10D myope who is wearing a +6.00D lens?
Which of the following are considered antioxidants? (pick 3)
- A) UV light
- B) Vitamin C
- C) Vitamin A
- D) Vitamin K
- E) Vitamin D
- F) Glutathione
Transpose the following prescription to minus-cylinder form: -5.00-1.25x170.
How are presbyopes still able to see at near without the use of accommodation?
Increased depth of field
Which of the following is not equivalent?
- A) -4.75-1.50x180
- B) -6.25+1.50x090
- C) -4.75@180 and -6.25@090
- D) -6.25-1.50x180
- E) -4.75x090 and -6.25x180
Where is the pupil displaced?
Inferior and nasal
Which of the following is false about divergence excess?
- A) Patient will have an exophoria greater at distance than at near.
- B) Patient will have cosmesis complaints.
- C) The patient will have a receded NPC.
- D) Patient will have photophobia.
- E) The patient will have a normal amplitude of accommodation.
How far would you have to decenter a +2.50D lens to get 4 pd BO effect?
Which has the largest spatial summation?
- A) Rods
- B) Bipolar cells
- C) Retinal pigment epithelial cells
- D) Cones
The direction of optokinetic nystagmus is defined by:
You just diagnosed your patient with retinitis pigmentosa. Which of the following devices would benefit this patient?
- A) Keplerian telescope
- B) Hand held magnifier
- C) Stand magnifier
- D) Reverse telescope
When can a child walk by themselves?
Which of the following conditions can cause angioid streaks? (Pick 3)
- A) Pagets disease
- B) Sickle cell anemia
- C) Pigmentary glaucoma
- D) BRVO
- E) Ehlers Danlos
- F) Hypertension
- G) High hyperopia
Which cranial nerves are purely sensory? (pick 3)
- A) Facial nerve
- B) Trigeminal nerve
- C) Oculomotor nerve
- D) Olfactory nerve
- E) Vestibulocochlear nerve
- F) Optic nerve
At which stage does a child rely on object permanence?
Which tissue gives the most resistance to aqueous outflow?