Download NACOR FINAL EVALUATION 2026 TESTED QUESTIONS GRADED A+ and more Exams Nursing in PDF only on Docsity!
NACOR FINAL EVALUATION 2026 TESTED
QUESTIONS GRADED A+
⩥ New wearer comes for an unscheduled follow-up visit. They wear hydrogel monthly lenses. She comes in without the lenses on and complains of discomfort immediately upon insertion. What is the solution Answer: Edge Tear/damage Inspect the lens with or without slit lamp ⩥ Care regimen: ReNu Fresh Wearing time 8-10 hrs. VA OU 20/ Patient complains of dry eyes and increased lens intolerance. She received her lenses in April and it is now November. She finds the symptoms to be worse at work. Possible solution? Answer: Preservative sensitivity Pregnancy Any new medications or systemic issues? What is her environment like? It's fall and the heat may have been turned on. She may need a vent deflector or a humidifier ⩥ Patient is a new CL wearer. She wears the lenses for awhile, but can't increase time above about 8 hrs.
Possible solution? Answer: If fitting in a lens material known to be good for dry eyes and using hydrogen peroxide disinfection or daily disposable wear doesn't help, consider dry eye therapy- Steroids, fish oil, lid scrubs and massage, lubricants and then refit ⩥ What are two common reasons that patients have decreased vision with cls? Answer: They switched the lenses or the lens is inverted ⩥ Rx OD - 2.25-0.75X OS - 2.50-0.50 X K's OD 42.00/42.75 @ OS 42.00/42.50 @ TBUT 9 seconds OU CL's OU - 2.50/8.7/AV Oasys VA OD 20/25-3 OS 20/20- 2 She comes for follow-up complaining of reduced vision with the contact lenses only. What should you do? Answer: Can try toric lens in the right eye with aspheric in the left ⩥ What could possible problems be if the patient is complaining of decreased VA with both cls and specs? Answer: 1. Ocular condition
- Edema
⩥ When should we be concerned about corneal vascularization? Answer: When the vessels look like they are headed straight into the cornea and they are more than 1.5mm in length ⩥ What is the treatment if corneal vascularization is seen? Answer: 1. Change to SiHi lens to increase the O
- Reduce wearing time to DW ⩥ How is injection grades? Answer: 0=not present 1= mild conjunctival or limbal injection 2= moderate conjunctival or limbal injection 3=severe conjunctival or limbal ⩥ What are striae and which type of lens are the likely seen with? Answer: They are folds at Descemet's level and are very rarely seen with SiHi's. Will see with hydrogel lenses ⩥ What are microcysts? Answer: They are trapped metabolic debris that occurs after 2-4 months of chronic hypoxia
⩥ What is the treatment for microcysts and what lenses are they seen in? Answer: They are seen in hydrogel lenses and the treatment is to increase the O2 or decrease the WT ⩥ What endothelial changes can occur with hydrogel lenses? Answer: Polymegathism (Size) Polymorphism (Shape) ⩥ Contact Lenses were dispensed a month ago. 1st time wearer Routine check VA OU 20/ SLE: Good fit, 1mm lag Without lenses on, you see an arcuate staining in the inferior periphery greater in the OD Answer: Lens removal from the cornea, removal of lens with fingernails or corneal exposure from a lens exposing the inferior cornea. Inferior arcuate staining is due to pulling the lens straight off the cornea because they are pulling cells from the cornea ⩥ Rx OU - 5. WT 7 days EW Contact Lenses: 8.3/-4.75/Acuvue2 (Replaced weekly) VA OD 20/40-2 OS 20/ OR OU - 0.
⩥ If you want to loosen a lens, what needs to be done? Answer: Smaller or flatter ⩥ What happens to the BC if you increase the mm? Answer: The lens gets flatter ⩥ How do you tighten a lens? Answer: Go larger or steeper ⩥ What is the number one complication to SiHi lenses? Answer: GPC ⩥ What is GPC? Answer: Giant Papillary Conjunctivitis which is an autoimmune reaction to deposits on the lens the patient is wearing. ⩥ What are symptoms of GPC? Answer: 1. Minimal increase in mucous secretion, mild itching on lens removal
- Lens awareness, minimal itching with lens wear, blurred vision
- Increased lens movements, mucous secretions, and decreased wearing time
- Lens intolerance, mucous discharge ⩥ What is the number one treatment of GPC? Answer: Provide the wearer with a clean lens ⩥ What is the Tx for GPC? Answer: Change to a DD lens and use an allergy drop like Patanol, pataday, Elestat, Optivar, Bepreve, Lastacaft ⩥ Contact Lenses: Air Optix Night and Day, 8.4 BCR
- 3.50 OU Patient's last exam was 2 years ago Patient's Care regimen: Generic solutions, whatever is on sale VA 20/20 OU SLE: Reveals Grade 1 & 2 papilla WT 14 hrs. Answer: Might not be GPC because you have to have itching and discharge for it to be considered GPC ⩥ Patient has worn monthly replacement lenses for > 5 years. She does not necessarily replace them monthly. She is experiencing decreased WT, discharge upon awakening and itching with CL wear. Answer: GPC, evert the lid and look for papillae and hyperemia
upper lid. After 48 hours, you have him resume wear. He returns in 2 weeks with a painful OS. At this visit you observe an arcuate staining pattern under the left upper lid. Answer: SEALs, Change to a different lens design or lower modulus ⩥ What is CLARE? Answer: CL induced Acute Red Eye. Gram negative organisms on the lens which release endotoxins. Pt wakes up with red, watery, painful eyes. Caused by overnight cls wear ⩥ What is the treatment for CLARE? Answer: D/C lens wear and use lubricants ⩥ What are infiltrates and where are they typically located? Answer: They are typically located near the limbus and are inflammatory cells lying within the stroma. ⩥ What is the treatment when a pt has infiltrates? Answer: D/C lens wear until the infiltrate disappears ⩥ What is CLPU? Answer: Contact lens peripheral ulcer. There are no raises edges, no ocular pain, no discharge, and no AC reaction. Will see hyperemia in the region
⩥ What are the risk factors for Microbial Keratitis also known as Bacterial corneal ulcer? Answer: 1. Overnight Lens Wear
- Poor compliance with len and case hygiene
- Epithelial Trauma
- Smoking
- Males
- Swimming in lenses
- Purchase of lenses from internet ⩥ What are the symptoms of microbial keratitis? Answer: Severe pain, lacrimation, hyperemia, photophobia with epithelial disruption. Single irregular lesion. ⩥ What is characteristic of microbial keratitis? Answer: Stromal infiltration in the area of epithelial defect surrounded by edema. Can have anterior chamber reaction, lid edema, and loss of VA ⩥ What is the treatment for microbial keratitis? Answer: 1. D/C the lens/Aggressive Antibiotic)
- Culture lens and case
⩥ Patient comes in to the office with pain, photophobia & tearing. He has D/C lens wear. Minor discomfort first noticed at 4pm the day before. Used an old bottle of lubricant and it improved. He did not remove the lens until the following morning when his eye became extremely uncomfortable. Staining reveals a small 1mm circular area of staining surrounded by haziness in the cornea. Answer: Ulcer? Especially concerning with disruption of cornea and old solution use (introducing bacteria to a break in the cornea) ⩥ Patient comes for 1 week check after wearing lenses extended wear Air Optix Night & Day. There are small bubbles which do not move on the blink. Answer: Most likely mucin balls, could be microcysts If disappear upon removal, mucin balls. Unusual to have microcysts with high Dk lens ⩥ Lenses are 1 1/2 yrs. old. The patient has been wearing them for 2- 3 mths. without removal. Compliance to care is questionable. They woke up Sat. with a red painful eye, photophobic, watering. Injection is grade 3, there's an infiltrate at 11o'clock, no staining. Answer: CLARE-Overwear ⩥
