Ophthalmic Terminology and Procedures, Exams of Nursing

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COA JCAHPO TEST ACTUAL EXAM

QUESTIONS AND ANSWER

Disorders associated with headaches? - Hypertension or Brain Tumor Headaches caused by refractive error will not appear during? - 1. Not appear at night

2. Will not appear during sleep
3. Will not appear when you wake up Where is the aqueous humor located? - Between the lens and the cornea. How many rods are there? - 125 million Where are the rods located? - In the retina How many cones are there? - 6 million Where are the cones located? - In the retina. Rods are best in what lighting condition? - dim light Without rods what condition will occur? - night-blindness Rods are good in what color light? - Red What type of drops are used to dilate the eyes? - Mydriatic drops What type of drops are used to dilate the eyes and paralyze the fine focusing muscle for near vision? - Cycloplegic drops Measuring PD starts from where and ends where? - Nasal side of right pupil to the temporal side of the pupil on the patients left eye. What is Rhodopsin? - Rod pigment. (allows for visual purple) Rhodopsin forms in ______ and is destroyed by _____? - forms in dark, and is destroyed by light Rhodopsin is composed of what Vitamin? - Vitamin A (deficiency causes night blindness) What is Adie's Syndrome? - Tonic Pupil. (pupil responds to light stimulation very slowly)

How do you measure a patient's PD when they can only see from one eye? - measure from center of the pupil of the good eye to the center of the bridge of the nose How do you measure a patient's PD when they have unequal pupils? - measure from nasal side of the limbus of patients right eye to the temporal side of the limbus of the left eye. How do you measure a patient's PD when they have a squint? - Measure from the inner canthus of one eye to the outer canthus of the opposite eye. What are the most important disorders to ask patients about? - Diabetes High Blood Pressure (HTN) Heart Health/ Cardiovascular Issues Arthritis What are the main symptoms of diplopia? - Loss of alignment of eyes (covering one eye will always eliminate the second image) What is the cause of light flashes? - Retinal detachment What is the cause of Ptosis? - 3rd Nerve palsy or Diabetes What is the cause of Diplopia? - Thyroid Disorder Diabetes 3rd Nerve Palsy Myathenia Gravis What is the cause of sudden loss of vision? - Macular degeneration Retinal Detachment Retinal Vein or Artery Occlusion Retrobulbar Neuritis What is the cause of Foreign Body Sensation (FBS)? - Corneal Abrasion Herpes Simplex What is the cause of blurred distance vision in adults? - Diabetes Cataracts Macular Edema What is the cause of Halos around lights? - Angle Closure Glaucoma Cataracts What is the cause of spots before the eye? - Retinal Tear Vitreous Detachment

What are the most important items to ask patients during work up? - 1. Present and Past Health History

2. Medication (current and exact name/ purpose)
3. Allergies (drug, inhalants, contactants, food, injections, ingestants) What symptoms are associated with Acute conjunctivitis? - Discharge Pain Blurred Vision What organism is the cause of Acute Conjunctivitis? - Staph Aureus What are some important familial history of common ocular defects? - Myopia Strabismus Glaucoma What are the 6 steps to taking history? - 1. Chief Complaint
4. Secondary Problems of the eye
5. Systemic or general illness (current)
6. Past ocular disorders
7. Wear contacts or glasses?
8. Therapies, response to therapies What are the three main layers of tears? - Oily Layer (outer) Aqueous Layer (middle) Mucin Layer ( inner) What is the flow path of the aqueous humor? (PPATSA) - (PPATSA) Posterior Chamber---Pupil---Anterior Chamber---Trabecular Meshwork---Schlemm's Canal---Aqueous Vein Lens of the eye? - A biconvex structure that light passes through. Vitreous Body? - Fluid filled space located behind the lens, occupies 2/3rds of the volume of the eye. Name the drops used that do not have cycloplegic effects. (CHEEP) - cocaine (anesthetic) hydroxaphetamine eucatropine hydrochloride epinepherine (adrenalin) phenylephrine (not used anymore, bad for heart) Example of Cycloplegic Agents.

(TCASH) - Atropine (most powerful) homatropine Scopolamine Cyclopentolate Tropicamide When an object is viewed close at hand, what three actions occur? - 1. Convergence of eyes towards the object.

2. Accommodation.
3. Pupillary Constriction Swinging Flash Light Test is used to? - Compare the direct and consensual reflexes in the same eye. What are the causes associated with a patient with the symptom of dilated pupils? - 3rd Nerve Palsy Trauma Adie's Pupil Acute Glaucoma Drug usage What are the causes associated with a patient with the symptom of constricted pupils? - Horner's Syndrome Iritis Drug usage Blepharospasm - continuous squeezing of the eyelids together (occurs as a result of inflammatory disease of the anterior segments) The visual axis through the human eye is located? - on the nasal side of the pupil. The light reflex method - a type of PD measurement that gives the distance between the visual axis of the two eyes What are the two basic types of soft lenses used? - The hydrogel Lens The silicone Lens What are the 3 methods used today to disinfect hydrophilic lenses? - 1. Heat
4. Chemical
5. Ultraviolet exposure What are the steps to take for cleaning before removal of soft lenses? - Wash hands carefully No soaps with lanolin Dry Hands with a clean, lint-free towel

What is the use of enzyme cleaner? - For removal of protein deposits What is the most stringent cleaning system for soft contact lenses? - Hydrogen Peroxide systems for 20 min. Insertion of soft contact lenses start at the? - lower part of the sclera and is gently pushed onto the cornea with the lower eyelid. Removal of soft contact lenses start by? - Sliding the lens down with the index finger to the lower sclera and pinching the lens to remove. Macular Photo stress Test - A sensitive test for detecting macular dysfunction. Potential Acuity Meter (PAM) - Instrument attaches to a slit lamp and shows acuity after cataract surgery. Allows the physician to know that retina and media are intact. Interferometer - Using a red or white light that shines directly through the opaque portion of the cataract, it test out the proficiency of the retina for show of good postoperative acuity. Near vision charts are designed to be read at? - 14 - 16 inches Near Vision is recorded as the? - Smallest type that can be comfortably read at the distance at which the card is held. What are the different names for a lensometer? - Lensmeter, Vertometer, Vortexometer, Focimeter What are the 6 measurements required to fit a contact lens? - 1. The refractive error of the eye

2. The dioptric power of the cornea
3. The lens diameter
4. The lens thickness
5. The optic zone
6. The peripheral curve blending The dioptric power of the cornea is determined by? - Keratometer Readings With applanation tonometry, the contact of tear film should yield a displacement of _____mm? - 3.06 mm How do you protect the phoropter? - - A dust cover when not in use

• No alcohol
• face shield washed with soap and water, soak in alcohol, or boiled

• dry cleaning, ear swab/ tissue Projector Maintenece - - Glass slides and lenses wiped with a soft clean dry cloth
• Keep spare bulbs
• Do not remove lenses from barrel Projector screen maintenence - - Mild detergent solution
• Wipe screen surface gently with dampened absorbent cotton Replacing the lamp - Projector should be off for a few minutes before proceeding with lamp replacement A tan top on eye drops is for? - disinfectant A pink top on eye drops is for? - Anti-inflammatory/ steroids A red top on eye drops is for? - Mydriatics and cycloplegics A gray top on eye drops is for? - non steroidal anti-inflammatory A dark green top on eye drops is for? - Miotics A yellow top on eye drops is for? - Beta-blockers A dark blue top on eye drops is for? - beta blocker combinations An orange top on eye drops is for? - carbonic anhydrase inhibitors A turquoise top on eye drops is for? - prostaglandins When measuring lenses in the lensmeter, place the lens on the table _________ side towards you. - convex side After placing the lens in the lensmeter holder, center the lens then set the power to_____? - zero After the spherical power is obtained continue rotating the power wheel to bring the _______ - the second meridian into focus. (The difference is the cylinder power) The sign of the cylinder will be _______ that of the sphere? - opposite (at this point take the axis down) To find the addition of the lens, the difference between the _____ & the _____ must be found. - distance and the reading power must be found

Who invented the ophthalmoscope? - Herman Von Helmholtz What are the seven basic shapes of the face? - 1. Oval

2. Diamond
3. Round
4. Square
5. Inverted
6. Base-down triangle
7. Oblong Definition of Spectacles - An optical appliance composed of lenses and a frame with sides. PD is measured - From the nasal edge of the pupil on the right eye to the temporal side of the patient's left eye Light reflex method - used to measure PD gives distance between the visual axis of the two eyes Optical Center - The thinnest part in the center of any minus lens or the thickest part of the center of a plus lens Patients with long faces need these types of frames - wide frames or horizontally long Patients with long noses need these types of frames - low-fitting bridge bar and dark color Patients with small noses need these types of frames - keyhole bridge or bridge bar set high Patients with eyes set too closely together need these types of frames - frames that are greater in depth at outer ends Eyes positioned up and in or down and in are in what position? - Tertiary Position Duction - movement of one eye from one position to another in one direction Version - The movement of both eyes in the same direction Both eyes move right, this is? - dextroversion both eyes move left, this is? - levoversion both eyes move up, this is? - sursumerversion

both eyes move down, this is? - deorsumversion Lateral & Medial rectus muscles move the eye? - horizontally Superior and Inferior rectus moves they eye? - vertically Inferior and Superior oblique muscles move the eye? - intorts and extorts Intorsion - inward movement of the eye extorsion - outward movement of the eye How many muscles of the eye are there? - 6 Name the muscles of the eye. - medial rectus lateral rectus superior rectus inferior rectus superior oblique inferior oblique Maddox rod is? - a group of red or colorless parallel glass rods that act as a cylinder to dissociate the eyes and prevent from fusing. Maddox rod is used to detect what disorders? - heterotropia and heterophoria A prism? - is a triangular or wedge-shaped piece of plastic or glass that has the property of displacing a bundles of light toward the base of the prism. Prisms measure? - The presence and the amount of any Tropias or Phorias 3 Test used to measure muscle imbalance? - Krimsky Test Maddox Rod prism Test Cover Test At what age do children start to participate more voluntarily in the assessment of their visual acuity? - 3 - 5 years of age Pharmacology - deals with the basic properties of drugs, their actions, their fate in the human body, and their known side effects. Solutions are usually instilled in the? - The conjunctival sac Solutions that have a pH greater than 7 are said to be? - Alkaline or basic Solutions with a pH less than 7 are said to be? - Acidic

Most ophthalmic solutions have a pH that varies from _____ to ____? - 3.5 to 10. Tonicity - the concentration of the chemical in that solution What are alternative routes of medication - subconjunctival injections continuous-release delivery retrobulbar injections intracameral injections systemic medication Induction period - A delay in the time that occurs between the reaction to the use of particular drugs and the development of a state of hypersensitivity One of the most common ophthalmic preparations to cause allergic reactions of the skin of the eyelid is? - Atropine This drug used in glaucoma treatment can cause cataracts, iris cyst, and retinal detachment - Echothiophate Iodide Topically applied steroids can cause? - raised IOP, delay in wound healing, and increase potential viruses and bacteria Rx - take thou ung (unguentum) - ointment ac (ante cibum) - before meals pc (post cibum) - after meals ss - half The autonomic Nervous system is subdivided into? - The sympathetic and parasympathetic nervous system What drugs mimic the action of sympathetic and parasympathetic involuntary nervous system? - sympathomimetic and parasympathomimetic Mydriatic Drops - Act on the iris musculature and serve to dilate the pupils Cycloplegic drops - act not only on the iris by dilating the pupil but also on the ciliary body by paralyzing the fine focus muscles so the eye can no longer accommodate for near vision Mydriatic Agents - cocaine

hydroxyamphetamine eucatropine epinephrine phenylephrine Timolol - acts to decrease the formation of aqueous humor Drugs used to lower intraocular pressure include - Apraclonidine hcl topical dorzolamide (Trusopt) Lumigan Glycerin - is a thick, viscous liquid used to lower the intraocular pressure in acute narrow-angle glaucoma and before intraocular surgery. Urea - is a solution administered intravenously to quickly reduce the IOP in acute narrow-angle glaucoma Mannitol - administered intravenously, used interchangeably with urea Mast Cell Stabilizers - responsible for reducing the signs and symptoms of allergies Antihistamines - Relieves the clinical features of acute allergies Antibiotics - are chemical substances that can inhibit growth of bacteria and other microorganisims 2 families of antibiotics - Aminoglycoside antibiotics fluroquinolone antibiotics Myopia - Nearsightedness condition in which parallel rays of light come to focus in front of the retina Golmann Applanation Tonometer - gives a reliable measurement of intraocular pressure within +/- mmHg Two basic types of bridges? - the saddle and the keyhole The Datum Line? - An imaginary line that runs through the center of the lenses where all measurements are taken Polycoria - multiple pupils Posterior Chamber - space between the back of the iris and the front of the lens filled with aqueous.

Posterior Chamber Lens - an intraocular lens that is placed in the posterior chamber where a natural crystalline lens previously was created Posterior Pole of eye - the center of the posterior curvature of the eyeball Prentice's Rule - formula for calculating prismatic effect induced at any point in the lens (decentration x lens power = prism) Presbyopia - a gradual lessening of the power of accommodation due to a physiologic change that becomes noticeable about the age of 40. Prince's Rule - a measuring scale used for determining a patient's near point of accommodation Prism - an optical system that deviates the path of light Proptosis - protrusion of the eye (forward displacement) Prosthesis - replacement of a human eye by an artificial one Pseudoisochromatic Charts - charts with colored dots of various hues and shades indicating numbers, letters, or patterns; used for testing color discrimination. Pseudophakia - a condition in which an intraocular lens implant has replaced the crystalline lens Pterygium - a triangular fold of growing membrane that may extend over the cornea from the white of the eye. Ptosis - a drooping of the upper eyelid Quadrantopia - blindness or loss of vision in a quarter sector of the visual field of one or both eyes Recession - operation to sever the eye muscle from its original insertion and reattach it more posteriorly on the sclera. Refraction - deviation in the course of rays of light in passing from one transparent medium into another of different density Refractive Error - a defect in the eye that prevents light rays from being brought to a single focus exactly on the retina Refractive index - the refractive power of a substance in comparison with that of air refractive Media - transparent parts of the eye having refractive power; cornea and lens

Refractometry - the measurement of refractive error Resectin - Operation to remove a portion of a muscles and tendon and shorten it Residual Astigmatisim - the astigmatism present after the corneal astigmatism has been nullified by a contact lens Retina - innermost coat of the eye, formed of sensitive nerve elements and connected with optic nerve Retinal Detachment - a separation of the inner layer of the retina from the outer layer of the choroid Retinitis - Inflammation of the retina Retinitis Pigmentosa - a hereditary degeneration and atropy of the retina usually migration of pigment occurs Retinoblastoma - a malignant tumor of the retina Retinopexy - surgical reattachment of a detached retina Retinoscope - an instrument for determining the refractive state of the eye Retinoscopy - objective method of determining the refractive error of the eye by observing the movements of light refracted from the back of the eye Retrobulbar - behind the eyeball Retrolental Fibroplasia - a disease of the eye of the retina in the premature infant in which the retina is partially or completely detached and pulled forward against the posterior surface of the lens Rods and Cones - two kinds of cells that form a layer of the retina and act as light receiving media Rose Bengal - a dye used to detect cells that are damaged or unprotected by native muccoproteins s, sc (sine correction) - without correction Sac - a bag-like structure safety glasses - impact-resistant spectacles; available with or without visual correction for workshop or street-wear protection

Schirmer's Test - filter paper test for tear flow Schlemm's Canal - circular channel located deep in the limbus. The channel collects aqueous fluid from the anterior chamber to the episcleral veins Sceritis - inflammation of the sclera Scotoma - an area of reduced or lost vision in the visual field Scotopic Vision - vision in low light levels that involves rod photoreceptors Siderosis bulbi - deposits of iron pigment in the eyeball signs of congenital glaucoma - sensitivity to light tearing eyes tightly closed most of the day corneal thickness corneal edema over 12 mm corneal measurement size of infant cornea - less than 10.5 mm in horizontal diameter Tonometry - measuring IOP The circular tip of the Goldmann tonometer is about how many mm in diameter? - 3. mm The blue light should be approximately ____ degrees to the side of the tonometer. - 45 - 60 degrees When checking vision, the numerator portion signifies? - distance the patient is from the chart When checking vision, the denominator portion signifies? - distance from the chart at which a person with normal vision can see the chart letters By convention most visual acuity charts are constructed so that the sections of a letter subtend to________? - 1 min of arc An infant should be able to reach for toys by the age of? - 4 - 6 months An infant should be able to follow a light by the age of? - 3 months What letter is considered the easiest letter in the alphabet to identify? - L

What letter is considered the most difficult letter in the alphabet to identify? - B What is CSM? - The visual acuity in infants and preverbal children that is usually recorded as central-steady-maintained. What does CSM indicate? - - indicates that the eyeball fixates with the fovea along the visual axis

• Nystagmus does not occur in straight ahead position
• There is no preference for either eye Sheridan Gardiner and HOTV Test maybe helpful for? - Children in the intermediate stage in which they recognize some of their letters. What should be noted before taking a visual field? - Visual acuity with and without glasses. What is the test distance for the Golmann Visual Field? - 330 mm in perimeter Visual field screening is for rapidly determining? - The presence or absence of a field defect. Amsler Grid is devised to detect? - - Abnormalities in the central 20 degrees in the field of vision.
• Detects Macular Edema Central Scotoma - involves the fixation area and is always associated with a loss of visual acuity Pericentral Scotoma - the fixation area is relatively clear and the field immediately surrounding it is deficient Paracentral Scotoma - the area of depressed visual field is to one side of fixation Cecal Scotoma - involves the are of the normal blind spot Nerve Fiber bundle Scotoma can also be called - - Acruate Scotoma
• Bjerram Scotoma
• Comet Scotoma Nerve Fiber bundle Scotoma - extends around the fixation point from the blind spot in an arc and ends typically on the nasal field with a sharply demarcated border. Glaucoma - is a localized ocular disease characterized by optic nerve cupping and visual field loss and associated with elevated IOP. What are some factors associated with Glaucoma? - - Elevated IOP

• Familial History of Glaucoma
• African American or Hispanic Ancestry
• Diabetes
• Myopia
• Trauma to the eye What are the four classifications of Glaucoma? - - Open-Angle/ Chronic Glaucoma
• Primary Angle Closure Glaucoma
• Secondary Glaucoma
• Congenital or Infantile Glaucoma Auxillary lenses include cylinders of _____ and ____ diopters for each eye? - 0.12 and

Risley's Prisms Measure? - Muscle imbalance If lenses on phoropter are dirty, they should be cleaned with? - a lint-free swab slightly moistened with ether alcohol The forehead and cheek rests are removable and should be cleaned with? - cotton moistened in 70% alcohol solution Slit lamp microscopes are used for? - used to illuminate and examine under magnification the anterior segment of the eye. What four tests are done to determine the presence of AMD? - - Amsler Grid

• FA
• Indocyanine Green (ICG)
• OCT What is ICG? - Indocyanine Green dye used in digital imaging. The late phase for ICG pictures is taken at ____ minutes post injection? - 30 minutes ICG identifies what disorder? - Occult Neovascularization of the choroid What color has the longest wave length? - Red What is the wavelength for red? - 650 - 750mm the speed of violet, yellow, red, and green in air is? - 186,000 m/s Refraction? - bending of light The rate at which light travels through water is? - 140,000 miles per second

Index of Refraction - The ratio of the speed of light in a vacuum to that in a given medium. What is the equation for the Index of Refraction? - speed of light in air/ speed of light in a substance What is the index of refraction for the Aqueous Humor? - 1. What is the index of refraction for the Cornea? - 1. What is the index of refraction for Crown Glass? - 1. What is the index of refraction for water? - 1. What is the index of refraction for air? - 1. Meridian - Curvature of a lens in one direction Sturm's Conoid - Represents the astigmatic interval between the focal points What is the area between the two focal points of a spherocylinder called? - Sturm's Conoid What is the circle of least confusion? - represents the dioptric average of the spherocylinder. Under the duochrome principle, green is normally focused where? - In front of the retina Under the duochrome principle, red is normally focused? - behind the retina What are the two types of retinoscopes? - Spot and streak Reflex? - when using a retinoscope an area of the patient's retina illuminates and shows the refractionist a red-reflected glow Cross Cylinder - a refining instrument that determines the exact axis of the astigmatic error and the exact power of the cylinder Pinhole Disc - permits the examiner to differentiate poor vision caused by refractive errors or from poor vision resulting from disease of the eye Distometer - is a caliper used to measure the vertex distance. The vertex distance - is the distance from the cornea of the patients eye to the back surface of the lens inserted in the trial frame, refractor, or glasses.

Emmetropia - a normal eye in which all rays of light are imaged sharply on the retina. Ametropia - none if the rays focus on the retina Refraction - the sum of steps performed in arriving at a decision as to what lens or lenses will most benefit the patient What two functions do cycloplegic drops have? - - Arrest accommodation or focusing

• Dilate Pupil Lensmeter - records the optical center of the lens, its power, and the axis of the correcting cylinder. retinoscope movement: 'with movement' means patient is? - hyperopic retinoscope movement: 'against movement' means patient is? - myopic How many ocular muscles does each eye have? - 6 name the ocular muscles - - superior rectus
• inferior rectus
• medial rectus
• lateral rectus
• superior oblique
• inferior oblique medial rectus muscles moves the eye? - towards the nose or adducts the eye The lateral rectus muscle moves the eye? - horizontally to the outer side or abducts the eye The superior rectus muscle moves the eye? - up The inferior rectus muscle does what to the eye? - depresses the eye Orbicularis Oculi muscle does what to the eye? - closes the eye during winking, blinking, or forced lid closure. Levator palpebrae Superioris Muscle does what? - elevates lid The pigments of the cones are sensitive to? - Red, Green, & Blue Trichromat - posses all three cone pigments and has normal color vision Anomalous Trichromat - has a partial deficiency of one of the three cone pigments

Tritanomaly - deficiency in the third color blue Protanomaly - is deficiency in sensitivity to the first color (red) Deuteranomaly - deficiency of one pigment mediating green Isochromatic Plates - used to test for color blindness Ischihara's Test - Test for color blindness Hardy- Rand- Ritter Plates - Test for yellow-blue color blindness as well as red-green color deficiency What four test, test for depth perception? - Worth four dot Fly test Wirth Stereo Test Biopter Test What are the three layers of the tear film? - oily aqueous mucin the radius of curvature of the average cornea is - 7.8 mm the refractive Index of the cornea is - 1. Power of the cornea is? - 43.0 diopters Rose bengal - Red dye that is helpful in diagnosing keratoconjunctivitis Sicca Coloboma - A defect in the iris (indicates absence of some portion of the iris) Normal direct light response causes constriction of the pupil on? - the same side intact consensual response to light causes constriction of the pupil of the? - unilluminated eye or opposite eye When an object is viewed close at hand, three associated reactions occur? - 1. Convergence

2. Accommodation
3. Pupillary Constriction Gonio Lens - used to examine the ciliary body, the periphery of the retina, and the angle structures Neural Rim Fibers? - Fibers going through the optic nerve

Optic Cup - The depression on the center of the optic disc Specular Microscopic Examination - is the standard method of evaluating the morphology and cell count of the endothelial the more common powers of the Intraocular lenses are? - 18.00 to 22.00 diopters A-Scan - used to determine the axial length of the globe Cornea - the front or anterior sphere which is the smaller and more curved portion Sclera - posterior sphere of the eye that is white opaque the eye measures approximately - 24 mm eyelids - moveable folds protecting the eye from injury and excessive light Meibomian Glands - the largest oil-secreting glands which are embedded in the posterior connective tissue substance of the eyelids Most of the refraction of the lens takes place through the? - the cornea Five portions of the cornea? - 1. the epithelium

2. Bowman's Layer

3. The stroma (thickest)

4. Descemet's Membrane

5. Endothelium most of the refraction of the eye takes place through - the cornea 3 layers of Tear Film - 1. Outer Lipid Layer or Oily

6. Aqueous Layer

7. Mucous Layer Gonio Lens is used to examine? - 1. Ciliary Body

8. The periphery of the retina

9. the angle structures The gonio lens detects what disorders? - 1. Angle-Closure Glaucoma

10. Determines whether angle is open or close Gonio lens can locate? - preferential surgical sites of drainage in glaucoma surgery 6 Types of contact gonio lenses - 1. children's gonio lens

11. single-sided gonio lens

3. goldmann three-mirror contact lens
4. koeppe contact gonio lens
5. Four-Sided gonio lens
6. Operating gonio lens Posner diagnostic and surgical gonio prism - lens is used for viewing the anterior chamber The lighted surgical gonio prism was designed by? - Jerald L. Tennant Surgical gonio prism views? - - The alignment of feet of the anterior chamber that support an intraocular lens

• implants of anterior chamber lenses Gonioscope - handheld microscope keratometer (ophthalmometer) - helps to obtain the exact radius of curvature of the cornea Keratometry - measurement of the central anterior curvature of the cornea Astigmatism - the condition in which rays of light are not refracted equally in all directions 2 types of Astigmatism - - Regular Astigmatism
• Irregular Astigmatism Regular Astigmatism - Refractive condition that is corrected by cylinders Types of regular astigmatism - - Simple Astigmatism
• Compound Astigmatism
• Mixed Astigmatism At birth the cornea's shape? - Perfect Shape By age 4 the cornea's shape? - loses its spherical qualities With the rule astigmatism? - The horizontal axis of the cornea becomes more steeply inclined so that rays of light are refracted more acutely than those rays being refracted along the vertical axis of the cornea Cornea can be divided into five distinct portions? - 1. Epithelium

2. Bowman's Layer
3. The Stroma
4. Descemet's Membrane
5. Endothelium

The vitreous occupies ________ of the globes volume - 2/3rds The rods function best in? - Dim Light The cones function best in______? - day light Cones allow what type of vision? - Color Vision Damage of the rods result in? - night-blindness The optic nerve consists of how many axons? - 1 million Heterophoria? - the position the eyes assume when fusion is disrupted Esophoria - drifting in of the eye when under cover Exophoria - drifting out of eye when under cover Hyperphoria - drifting up or down of the eye under cover Lenticular Astigmatism - Astigmatism resulting from unequal bending of light by the crystalline lens. Astigmatism with the rule - The vertical corneal meridian has the steepest curvature Astigmatism against the rule - The horizontal meridian has the steepest curvature Average K's reading is? - 42 - 48 Diopters Rigid lenses use what material? - silicone and Flurocarbon What material is used in contact lens polymerization? - Polysulfone How many different rigid gas-permeable contact lens materials are there? - 48 Corneal Curvature is measured by? - An ophthalmometer or keratometer The contact lens rest on? - liquid cushion (tear film) and never on the eyes itself The difference between the front surface curvature and the back surface curvature of a contact produces? - The power of the lens Measurements required to fit a contact lens? - - the refractive error of the eye (minus cyl ony)

• the dioptric power of the cornea

• the lens diameter
• the lens thickness
• the optic zone
• the peripheral curvature blending Iridocyclitis - Inflammation of the iris and ciliary body Iris - Colored circular membrane suspended behind the cornea and immediately in front of the lens. What is the function of the iris? - functions to regulate the amount of light entering the eye by changing size of pupil Iris bombe' - bulging forward of the mid part of the iris Iritis - Inflammation of the iris Ischemia - localized blockage of blood (or anemia) of the retina Ishihara's Test - Test for detecting defects in recognizing colors Isopter - a line connecting points that are of equal sensitivity to light Jack-in-the-box phenomena - objects that appear to jump to view from the peripheral visual field when one wears strong plus lenses (occurs after cataracts) Jackson Corss Cylinder - a single lens composed of a plus cylinder & a minus cylinder of equal power perpendicular to each other (used in refraction) Jaeger's Test Types - Test for near vision K - The Keratometer reading of the corneal meridians Kayser-Fleischer Ring - Pigmented Ring encircling the cornea Keratectomy - Removal of a portion of the cornea Keratitis - inflammation of the cornea Keratitis Sicca - Dryness of the cornea Keratoconus - cone-shaped deformity of the cornea Keratometer - Instrument that measures anterior curvature of the cornea

Keratomileusis - Refractive surgery on which a portion of the cornea is removed, reshaped, or replaced. Keratopathy - A non inflammatory disease of the cornea Keratoplasty - Corneal transplant operation Kestenbaum Rule - A formula used to estimate the power of the low-vision aid that is needed. Krimsky Method - An assessment of the eye deviation with the use of prisms to equalize the position of the corneal light reflex in each eye Lacrimal - The tear producing and tear disposal system of the eye Lacrimal Gland - a gland that secretes tears Lacrimal Sac - the dilated upper end of the lacrimal duct Lacrimation - the act of producing tears (crying) Lagophthalmos - A condition in which the Eye lids do not completely close Lamellar Keratoplasty - operation in which only the diseased outer layers of the cornea are removed and the healthy donor cornea is sutured as a replacement Laser - An instrument that transforms an intense beam of light into energy that affects tissue Laser Trabeculoplasty - used to treat open-angle glaucoma by shrinking the trabecular meshwork to allow fluid to drain properly Lens - a piece of clear material that bends, or refracts light rays passing through it Lensectomy - A procedure to remove the clear crystalline lens to reduce high myopic errors Leukokoria - any pathologic condition , such as retrolental fibroplasia , that produces a white reflex in the pupillary area Leukoma - A very dense opacity of the cornea Light Adaptaition - power of the eye to adjust itself to variations in the amount of light Light Perception - Ability to distinguish light from dark

Industrial Impact-Resistant lenses will withstand a blow from 1-inch steel ball drop from?

• A height of 50 inches According to the American National Standards Institute, advise a minimum of _____mm at optical center & _____mm at edge? - 2 & 1 Polariscope - An instrument used to identify an impact-resistant lens Dacryocystitis - An inflammation of the lacrimal sac About ____-____% of the population is affected by dryness of the eye. - 15 - 25% Functions of tear film - - hydrates & protects the ocular surface
• reduces friction on blinking
• enhances oxygen to the cornea
• removes waste & cell-debris
• protects against infection Dry Eye Work Up - 1. History

2. Schirmer's Test
3. BUT (break up Time)
4. Tear meniscus height
5. Rose Bengal Test
6. Evidence of lag ophthalmic Rose Bengal Test - identifies not only dryness of the cornea but also that of the conjunctiva Dry eyes is due to? - An inflammatory process on the conjunctiva Keratoconjunctivitis Sicca - Dry eye Sjogren's Syndrome - Systemic disorder that includes: K-Sicca Joint Disease Skin Disease Help for Dry Eye - Vitamin A Flaxeed Capsules (1,000mg) On first meeting a blind person, what actions should be taken for care? - - Introduce yourself

• Offer your arm to the blind person
• Always walk slightly in front of the patient
• Ask if they need help

Autonomy - The right of persons to make their own decisions about what they will and will not allow. Informed Consent Represents - A partnership between medical professionals and their patients. Doctors have a fiduciary duty to ensure that each patient understand? - their treatment recommendations Microbiology - Branch of Science that deals with microscopic, unicellular & cell-cluster organisms. The major microbial categories that may be associated with the eye infections are? - - Bacteria

• Viruses
• Fungus
• Parasites Inoculum - a significant concentration of microbes Viruses can be viewed with what microscope? - Electron Only What are the routine stains of smears that may be performed by the ophthalmic Assistant - Gram Stain Gram Positive organisms stain what color? - Dark Blue or Purple Gram Negative Organisms stain what color? - Red or Pink The most common types of nutrient- rich culture media are? - - Blood Agar
• Chocolate Agar
• Thioglycolate Broth
• Sabouraud- dextrose agar The Aseptic technique demands? - - Proper sterilization of all instruments
• Sterilization of the skin adjacent to the operative site
• Sterilization of the hands of both the operator and the assistant
• Use of sterile solutions and ointments during and afer the operation Fusion - The power exerted by both eyes to keep the position of the eyes aligned so that both fovae project to the same point in space. Heterophoria - position of the eyes assume when fusion is disrupted hyperphoria - drifting up of eye