CPOT Self Study Notes

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CPOT Self Study Notes
2011-07-26 23:06:21

CPOT Self Study Notes
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  1. List tasks paraoptometrics might perform.
    • -assist the optometrist
    • -supervise office staff
    • -test visual acuity of a patient
    • -order office supplies
    • -collect and record patient data
  2. What is the government agency that protects the privacy of patients?
  3. "To keep the visual welfare of the patient uppermost at all times" is a statement from the AOA...
    Code of Ethics
  4. List the four elements of telephone courtesy.
    • 1. Politeness
    • 2. Kindness
    • 3. Consideration
    • 4. Respect for others
  5. When taking a call from a patient for the optometrist, what should be attached to the message?
    Patient Record
  6. How do you treat a caller who is "shopping" for prices?
    think of the caller as a potential patient
  7. What should you do when scheduling a patient appointment?
    • offer two different appointment times
    • tell a new patient to arrive early to complete paperwork
  8. Loss of vision, severe pain in the eye, and flashing lights are complaints that should be handled as what category of triage?
  9. Define Triage.
    determining the priority of the patients complaints
  10. Define Recall
    the use of a letter, card, e-mail, or phone call to notify a patient of a need to schedule an appointment
  11. what is the simplest and most widely used method of filing?
  12. What is the reason for close monitoring when ordering solutions and drugs?
    if order too many, may expire before use
  13. Define Accounts Payable.
    Money which a company owes to vendors for products and services purchased on credit .
  14. Define Accounts Receivable.
    Money which is owed to a company by a customer for products and services provided on credit
  15. What is money used mostly for postage due and small amounts of office supplies.
    Petty Cash
  16. When is the best time to discuss payment policies with a patient?
    at the time of the first exam
  17. Explain the difference between vision care and medical insurance coverage.
    • -vision care should be billed for routine eye exams, refractions and glasses
    • -Medical insurance should be billed if a patinet has a medical diagnosis, such as glaucoma, cataracts, or eye injury
  18. Define Consultation Letter
    a letter sent to another health care provider concerning a patient who is being referred
  19. When medical records are requested, what must be signed by the patient or guardian if under 18 yrs old?
    Records Release
  20. Name the seven bones that form the orbit.
    • Sphenoid
    • Ethmoid
    • Lacrimal
    • Frontal
    • Maxilla
    • Palatine
    • Zygomatic
  21. List the three basic functions of the eyelids.
    • 1. Protect the eye
    • 2. Replenish and spread tear film evenly across the surface fo the eye
    • 3. Regulate the amount of tear fluid in the eyes.
  22. What is rapid forceful closre of the eyelids that protects the eye from foreign bodies and excessive light called?
    Reflex blinking
  23. What is the measurement for the palpebral fissures? (the space between the eyelids)
    10 mm
  24. Define Blepharospasm.
    A condition in which the lids are so tightly closed they cannot be opened.
  25. Define Ptosis.
    Drooping of the upper lid.
  26. Define Entropion.
    An inward turning of the lids, causing eyelashes to scratch the eye.
  27. Define Ectropion.
    The eyelid turns outward due to loss of elasticity of lid tissue.
  28. What is the muscle responsible for eyelid closure?
    Obicularis Oculi
  29. What muscle is responsible for eyelid retraction?
    levator palpebrae superioris
  30. What causes internal hordeolum?
    blockage of the Meibomian glands
  31. What is the conjunctiva?
    mucous membrane that covers the inside of the eyelids and the outside of the glode.
  32. Define Conjuntivitis.
    Inflammation of the conjunctiva
  33. Define Goblet Cells.
    Cells that produce mucus to aid in the stability of tear film.
  34. Define Glands of Krause and Wolfring.
    • glands that produce the watery layer of the tear film in the conjunction with the lacrimal gland.
    • located in palpebral conjunctiva
    • produces about 5% of aqueous layer of tears
  35. Define Glands of Zeiss.
    Glands that produce oil to protect the eyelashes from drying out and becoming brittle.
  36. Define Glands of Moll.
    • Sweat glands found in the lid margin
    • controls body temperature around the eyes.
  37. Name the three layers of tear film.
    • 1. Oily Layer-secreted by Meibomian glands
    • 2. Watery Layer- produced by lacrimal glands, moistens and coats anterior surface of eye, washes dust and debris to help prevent scratches on the cornea
    • 3. Mucin Layer- secreted by conjunctiva, coats outer layer of eyeball, acts as lubricant and vehicle to help watery layer adhere to or wet the eyeball.
  38. List four functions of the lacrimal system.
    • 1. Provide a smooth, optically clear corneal surface
    • 2. Wash away debris and cellular waste
    • 3. transport oxygen to the cornea
    • 4. inhibit growth of bacteria
  39. List in order the flow of tears through the lacrimal apparatus.
    • 1. Lacrimal Gland
    • 2. Lacrimal Ducts
    • 3. Conjunctival Sac
    • 4. Puncta
    • 5. Canaliculi
    • 6. Lacrimal Sac
    • 7. Nasolacrimal Duct
  40. Function of the Lacrimal Gland.
    • 95% of aqueous layer of tears
    • located under frontal bone at upper and outer angle
  41. Function of the Lacrimal Ducts.
    • Moves tears from eye into canaliculi by blinking
    • 6-12 per eye
  42. Function of the Conjunctival Sac.
    • collect and flow tears nasally toward medial canthus
    • located inferior fornix
  43. Function of the Puncta.
    • small openings in nasal aspect of upper/lower lid margins
    • tears drawn from surface of the eye through puncta to canaliculi
  44. Function of the Canaliculi.
    small tubes that carry tears from puncta to lacrimal sac
  45. Function of the Lacrimal Sac
    collection point for tears
  46. Function of the Nasolacrimal Duct.
    carries tears into nasal sinuses, drain into throat
  47. What are the fluids or "humors" that help maintain the shape of the eye?
    • aqueous
    • vitreous
  48. What is the function of the cornea?
    refract light
  49. Where does the cornea receive oxygen and nutrients from?
    • the fluid in front and behind it
    • conjunctival blood vessels
  50. List three conditions that could cause corneal neovascularization.
    • 1. edema
    • 2. inlfammation
    • 3. inadequate tear film oxygen content
  51. List the layers of the cornea.
    • Epithelium
    • Bowman's Membrane
    • Stroma
    • Descemet's Membrane
    • Endothelium
  52. Define Keratoconus.
    a condition in which the cornea thins and bulges forward
  53. what is the term used to describe the "white of the eye"?
  54. What is subconjunctival hemorrhage?
    pooling of blood between the conjunctiva and episclera
  55. What muscle causes the pupil to constrict in bright light?
    sphincter muscle
  56. What muscle is responsible for opening the pupil in dark conditions?
    dilator muscle
  57. Describe two major functions of the ciliary body.
    • 1. produce aqueous humor
    • 2. accommodation
  58. What is the diagnosis for when the optic nerve damage is present because the rate of aqueous drainage is not equal to the production of aqueous?
  59. What is the type of drug used to paralyze accommodation?
  60. Define presbyopia.
    loss of focusing ability that relates to the aging process
  61. What two structures does the choroid lie between?
    • sclera
    • retina
  62. What part of the retina is used when reading an eye chart?
  63. How many layers comprises the retina?
  64. Explain the reason viewing color is more difficult in dim illumination.
    Cones, which are responsible for color discrimination, are stimulated by light.
  65. Describe the function of the eye's crystalline lens.
    allows for accommodation (focusing on near objects)
  66. Define Cataract.
    cloudiness of the lens
  67. At what point do the fibers from the nasal retina of each eye cross in the visual pathway?
  68. What type of visual field defect will be present if damage occurs to the chiasm?
    bitemporal hemianopsia
  69. List the 6 EOM's
    • Medial Rectus
    • Lateral Rectus
    • Superior Rectus
    • Inferior Rectus
    • Superior Oblique
    • Inferior Oblique
  70. Define Convergence
    an eye movement in which both eyes move toward the nose
  71. What is optical infinity?
    at a distance of 20 feet, or 6 meters, light rays are virtually parallel
  72. What two factors influence the path of a light ray as it passes through a transparent medium?
    • Angle of incidence
    • index of refraction
  73. what is the speed of light in a vacuum?
    186,000 miles per second
  74. through what type of glass will light travel the slowest?
    flint glass because it has an index of refraction of 1.65
  75. List some common facts about convex lenses.
    • -can be referred to as plus lenses
    • -it is thinner on the edges and thicker in the middle
    • -it causes light rays to converge
  76. List some common facts about concave lenses.
    • -concave lenses minifies objects
    • -can be referred to as minus lenses
    • -it is thicker on the edges and thinner in the middle
    • -it causes light rays to diverge
  77. What is the focal length of a 5 diopter lense?
    20 cm
  78. what is the average total power, front and back, of the cornea?
    42.00 D
  79. How many diopters does the corneal curvature measure on the keratometer?
    44.00 D
  80. What is the average power of the crystalline lens?
    +18.00 D
  81. Describe the relationship of the crytalline lens' ability to accommodate to the natural process of aging.
    Amplitude of accommodation decrease with age
  82. Define Anisometropia.
    A condition of an unequal refractive state of the two eyes.
  83. Define Aniseikonia.
    A difference in image size caused by the refractive status of the two eyes.
  84. Define Emmetropia
    Parallel light rays are refracted by the unaided eye to focus on the retina
  85. Define Amblyopia
    Reduced visual acuity not correctable by refractive means
  86. Define Astigmatism
    Parallel light ras form two images in different meridians.
  87. Define Myopia
    Parallel light rays focus in front of the retina.
  88. Define Ametropia
    Refractive condition in which parallel rays of light do not focus on the retina.
  89. Define Hyperopia
    Parallel light rays focus behind the retina
  90. Define Aphakia
    Absence of the crystalline lens of the eye
  91. Define Presbyopia
    A reduced ability to accommodate that occurs normally with age.
  92. What is acceptable treatment for physiologic myopia?
    • Minus lenses or contact lenses
    • Concave spectacle or contact lenses
    • contacts that steepen the cornea
  93. Based on the average, non-accommodating eye with 60 D, a hyperopic eye with an optical power of 58.00 D would most likey be perscribed a spectacle lens with how much diopters of power?
    +2.00 D
  94. List four types of astigmatism.
    • 1. mixed
    • 2. simple
    • 3. compound
    • 4. irregular
  95. what role does accommodation play in hyperopia?
    a hyperopic person may not realize a visual problem exists because of the eye's ability to accommodate
  96. What type of surgery is NOT a treatment for refractive error?
  97. What is a disadvantage of reading glasses?
    distance objects will be blurry when viewed through reading glasses
  98. What lenses provide clear distance, near and intermediate vision?
  99. What is the common term for amblyopia?
    "lazy eye"
  100. describe what a light ray will do when it strikes a surface at 90 degrees.
    slow down
  101. A 1.00 D lens will refract light rays to a focus of _______ from the lens.
    1 meter
  102. Which of the following lens powers has the shortest focal length?
  103. What is the term for the pointed tip of a prism?
  104. Light rays passing through a prism will be bent toward the apex or the base?
  105. what unit of measurement is prism power measured by?
    prism diopters
  106. A 1 diopter prism will displace an image ____ cm for every ____ m of distance.
    • 1 cm
    • 1 m
  107. describe the difference between a spherical lens and a cylindrical lens.
    a spherical lens deviates rays of light in the same direction.

    a cylindrical lens deviates rays of light in more than one direction
  108. Define Biconcave.
    both surfaces are concave
  109. Define Biconvex
    both surfaces are convex
  110. Define plano convex
    one plano surface, the other surface convex
  111. Define Plano concave
    one plano surface, the other surface concave
  112. Define Meniscus
    one concave surface, the other surface convex
  113. which lens type is mostly used in phthalmic perscriptions?
  114. A spherocylindrical lens has two powers located how many degrees apart?
    90 degrees
  115. transpose the following RX into a minus cylinder perscription...

  116. What is the spherical equivalent for...

  117. what rule states...induced prism is equal to the lens power multiplied by the displacement in centimeters
    Prentice's Rule
  118. How does the optical lab avoid induced prism?
  119. What decentration is required if a frame PD is 60 mm and the patient's PD is 58mm?
    2 mm each lens
  120. What is the total near power for the following Rx?

    +2.00-1.00x100 Add +2.50
  121. What three characteristics must be considered in the design of an ophthalmic lens?
    • thickness
    • chromatic aberration
    • weight
  122. What is the manufacturing standard for glass lenses according to the American National Standards Institue (ANSI)?
    the lens must be heat or chemically tempered
  123. List three advantages of CR-39 lenses over glass lenses.
    • lighter
    • do not fog as easily
    • tinting is more uniform and can be manipulated
    • produce less glare and internal reflections
    • improve visual performance
  124. List three advantages of CR-39 lenses over glass lenses.
    • Glass lenses do not scratch as easily
    • thinner because the index of refraction is high
    • they do not warp as easily as CR-39
  125. why is polycarbonate a good choice of lens material for children and monocular patients?
    polycarbonate is more impact resistant than crown glass and CR-39
  126. What is the material used to make high-index plastic lenses?
  127. What factors must be considered in order to dispense the thinnest lens possible?
    • frame size
    • lens material
    • aspheric design
    • center thickness
  128. What is the ANSI Standard for drop-ball testing in dress eyewear?
    lenses must withstand the impact of a 5/8-inch steel ball dropped from a height of 50 inches.
  129. What is the ANSI Standard ofr drop-ball testing for industrial safety glasses?
    Lenses must withstand the impact of a 1-inch steel ball dropped from a height of 50 inches.
  130. Name two methods of treating glass lenses for impact resistance.
    • heat tempering
    • chemical tempring
  131. What type of PD is measured when fitting progressive addition lenses?
  132. What is an identifying factor of an executive or Franklin bifocal?
    A large ridge that runs across the entire width of the lens
  133. what is the most likely intermediate power if the near power is +3.00?
  134. What types of patients might require a balanced lens?
    • a patient with a prosthetic eye
    • a patient who is blind in one eye from advanced glaucoma
  135. What type of patient might require a Fresnel Press-On lens?
    an aphakic patient who has had surgery on one eye only
  136. If the distance PD is 64 and the near PD is 60, what is the seg inset?
    2 mm
  137. Describe a gradient tint.
    A gradient tint lightens toward the bottom of the lens.
  138. When focusing the eyepiece of a lensometer, why is it important to stop turning the eyepiece when a sharp focus is first obtained?
    turning the eyepiece past the point of focus could cause accommodation.
  139. If the lensometer is in proper calibration, and the eyepiece is properly focused, the target will come into a sharp focus without a lens present at what setting?
  140. When the lensometer was calibrated, the target focused sharply at +0.25 and was blurred at zero. You are neutralizing a lens and have a reading of +1.00 on the lensometer. How would you record this reading?
  141. If both sets of lines making up the target sharply focus at the same time, the lens being neutralized is what type of lens?
  142. If the two sets of lines in the target will not come into focus at the same time, the lens being neutralized is what type of lens?
  143. The cylinder lines will focus at a more _______ power reading than the sphere lines when neutralizing a lens in minus cylinder.
  144. If the spere lines are focused and unbroken at +3.00, axis 090, and the cylinder lines focus at +1.00, how would the prescription be recorded?
    +3.00 -2.00 x 090
  145. If the sphere lines are focused and unbroken at -1.00, axis 100, and the cylinder lines focus at -1.50, how would the prescription be recorded?
    -1.00 -0.50 x 100
  146. When measuring a lens in minus cylinder, if the cylinder lines focus at a more plus reading than the sphere lines, you should rotate the axis wheel by how many degrees?
    090 degrees
  147. If the vertical target lined in the distance prescription focus at -2.00 and the same lines focus at +0.50 in the near segment of the lens, the newar power should be recorded as what?
  148. An imprtant factor in measuring lenses with an automated lensometer is keeping the lens _____ against the lens stop.
  149. What must be accounted for when measuring prism?
    • -the patients PD
    • -the orientation of the prism
    • -the location of the lateral PRP or MRP
  150. Define frame eye size, or "A" dimension
    the largest horizontal measurment
  151. Define "B" dimension
    the largest vertical measurement
  152. Define Distance between lenses or "DBL"
    the seperation of the two lenses in a frame at the nasal bevel tips
  153. Define Bridge Size
    same as DBL, the seperation of the two lenses in a frame at the nasal bevel tips
  154. of the following which has the least amount of power in the vertical meridian?

  155. Of the following which should be measured first when verifying vertical lens positioning, or measuring the amount of vertical prism in the spectacle?

  156. When tapping a glass lens with your fingernail, the sound will be ____ than the _____ sound of a plastic lens.
    sharper, dull
  157. What is a lens clock used for?
    measure the surface powers and base curve of the lens
  158. True or False? A polycarbonate lens should be treated with a UV coating to avoid damage to the eye from UV radiation.
  159. The lens bevel used most commonly for low power lenses edged to fit into plastic and metal framesis called a what?
    standard or V bevel
  160. What does the fitting cross represent in the markings of a progressive lens?
    the position of the pupil on the lens
  161. Rule for Proper Fit
    the width of the frame from endpiece to endpiece should be approximately equal to the width of the facial bone structure just above the cheek bones.
    • Purpose
    • Keeps undue stress from being placed on the endpieces and hinges of the frame.
  162. Rule for Proper Fit
    the longer the face, the greater the vertical depth of the frame should be; the shorter the face, the smaller the vertical depth should be.
    • Purpose
    • Keeps the frame eyewire from touching the brow or cheek.
  163. Rule for Proper Fit
    the bridge of the frame should rest flat on the sides of the nose, evenly distributing the weight of the frame.
    • Purpose
    • Reduces red marks and broken skin caused by the misfit of the frame.
  164. Rule for Proper Fit
    the temple should extend 40mm behind the top of the ear and follow the contour of the face.
    • Purpose
    • Stabilizes the frame, allowing it to be held in place by touching, not pressure.
  165. The temples pressing into the sides of the head can cause what?
    the frame to be pushed down toward the end of the nose
  166. To check for X-ing of the bridge, you must view the frame from what position?
    the sides and the top
  167. A frame that follows the curve of the face is said to have what form?
    face form
  168. Use of interpupillary distance rule to verify that the frame is even is know as what?
    • vertical alignment
    • four-point touch
  169. Situation
    The glasses are being pushed off the nose because the temples are pressing too tightly.
    Frame Adjustment-widen the endpiece angles
  170. Situation
    One eyewire is closer to the face than the other.
    Frame Adjustment-Equalize the endpience bends
  171. Situation
    The frame slides down the nose.
    Frame Adjustment-Form the temple bend to a 45-degree angle at the top of the ear.
  172. Situation
    One eyewire is higher on the face than the other.
    Frame Adjustment-Equalize the temple hinge angles.
  173. What type of plier is used to Change the pantoscopic angle?
    Wide-jawed hinge angling
  174. What type of plier is used to Change the angle of the nosepads?
    Pad-angling pliers
  175. What type of plier is used for guard arm and endpiece bends?
    Round-flat jawed
  176. What type of plier is used to place tiny screws in hard to reach places?
  177. What type of pliers bends plastic and metal without marring the finish?
  178. List three nosepad angles that correspond to the slope of the nose
    • front angle
    • splay angle
    • vertical angle
  179. The angle that gthe frame front makes when the temple is viewed from the side is known as what?
    front angle
  180. Describe the procedure used for adding a mastoid bend to a temple.
    heat the temple behind the bend and make a depression in it with your thumb between the bend and temple end.
  181. What will aid in the best cosmetic appearance of a lens?
    • use of anti-reflective coating
    • choosing a round lens shape
    • centering the eye in the center of the frame
  182. What type of nosepad is the best choice for an elderly patient?
  183. List three physical attributes of a child that can make frame fitting a challenge.
    • longer eyelashes
    • underdeveloped nose bridge
    • head is more round
    • eyes are closer set
  184. The chief symptom should be recorded how?
    In the patient's own words
  185. What is the type of case history that is the easiest to delegate?
  186. Why should the paraoptometric question the patient family history?
    heredity may play a factor in may diseases, such as diabetes and high blood pressure
  187. True or False? When recording patient history, only the positive responses are pertinent.
  188. The first number or numerator of the Snellen notation represents what?
    testing distance
  189. In metric notation, 6/15 is the same as what?
  190. What is the properly calibration height of the 20/200 letter on the Snellen chart for a testing distance of 13 feet?
  191. Near vision acuities should be measured at a distance of what?
  192. In an examination room shorter than 20ft, what can be used to create an optical 20 foot distance?
    mirror system
  193. Why is the color vision testing more effective if performed monocularly?
    Acquired color vision defects are often monocular.
  194. What is the most common type of color vision testing?
    psuedoisochromatic plates
  195. Define Deuteranomalous.
    Green Weakness
  196. Define Tritanomalous
    Blue-yellow weakness
  197. Define Protanomalous
    Red Weakness
  198. What is the most common of all color defects?
    deuteranomalous trichromatism
  199. Name three "near-point" actions of the eye.
    accommodation, convergence, pupil constriction
  200. When is the break point or NPC found?
    the patient reports either diplopia or one eye loses fixation on the target
  201. What is the test used to determine the presence of a tropia?
    cover-uncover test (unilateral cover test)
  202. How much difference in mm is the near PD from the distance PD?
    3-5mm less
  203. The systolic pressure reflects the amount of force on the artery walls when the heart does what?
    heart beats
  204. The keratometer measures approximatley how many mm of the central cornea?
  205. The eyepiece of the keratometer should not be moved back and forth when focusing the cross, what will this cause if done?
    stimulates the accommodative system, resulting in an incorrect setting
  206. If the horizontal bars of the plus sign are not aligned, what must you do next?
    rotate the axis grip
  207. When recording the keratometry reading, the horizontal power reading is taken from the ________side of the instrument and the vertical power reading is taken from the _______side of the instrument.
    left, right
  208. True or False? A person with a low or normal pressure reading does not have glaucoma.
    False. A person with a low or normal pressure reading could have low-tension glaucoma.
  209. Describe the mire position when the cormea is properly centered and applanated?
    the inner edges of the semicircles touch
  210. Which tonometers have the advantage of being portable, fast and comfortable to hold?
  211. What instrument is used to test visual acuity under different lighting conditions?
    Brightness Acuity Tester
  212. The Potential Acuity Meter is used to determine the potential acuity of a patient who has what occular disease process?
  213. The fundus contains the ______, _______, and the _________.
    • retina
    • optic disk
    • retinal vessels
  214. What type of ultrasonography is used to determine the length of the eyeball.
  215. Corneal topography measurements should be performed when?
    prior to a refractive procedure such as LASIK.
  216. A pachymeter is used for what?
    measure corneal thickness
  217. True or False? In order for GDx or HRT to be performed, the patient must have dilating eyedrops instilled.
  218. The extent of monocular visual field measures....
    • 60 degrees superiorly
    • 75 degrees inferiorly
    • 105 degrees temporally
    • 60 degrees nasally
  219. The horizontal and vertical meridians intersect perpendicularly at the center point of fixation, seperating the visual field into what?
    four quadrants
  220. True or False? Every patient tested should have a nonseeing area in his/her field of vision.
  221. Evaluation of the visual field with a moving target is called what?
    kinetic testing
  222. Confrontation testing should be performed at what test distance?
    2 feet
  223. A tangeant sceen visual field performed at 1 meter measures how many degrees of the visual field?
    30 degrees
  224. Define Goldman Bowl Perimeter
    Fixation is monitored with a viewing telescope
  225. Amsler Grid
    • Tests the central visual field
    • patients can use this at home to monitor progressive changes
  226. Automated Perimeter
    Allows accurate testing of both the central and peripheral visual fields
  227. Describe an Arc Perimeter
    Rotatable, semicircular arc of 180 to 200 degrees
  228. Describe Autoplot Tangent Screen
    the use of a projected light target that is controlled by a handle on a pantograph
  229. Describe a Tangent Screen
    A black or gray matte-finished cloth, such as felt or velvet
  230. Describe Harrington Flocks Screener
    Flashes simple abstract patterns of dots and crosses.