B. nerve impulses are regulated by myelination of the axons. The more myelination a nerve has the slower the impulse. Continuous condition is slower due to the fact that the nerve undergoes a repolarization phase that lasts longer than a non continuous conduction.

C. Petechiae.
Purpura are greater than 3 mm hemorrhages associated with trauma, local vascular inflammation, and low platelet counts. Ecchymoses is a hematoma that exceeds 1-2 cm and are considered subcutaneous hematomas or bruises. Hemoperitoneum is a large accumulation of blood in body cavities.

A,B. Risk factors for PVD include age, myopia, diabetes, intraocular surgery and inflammation, as well as trauma

C. Scleromalacia perforans is a rare, severe eye disorder developing an autoimmune damage of episcleral and scleral performing vessels.

D. simple cells are located in layer 4 of the LGN. Simple cells have elongated center surround receptive fields that respond to specific orientation, edge, color and depth.

A. Dry eye disease is directly linked to the lack of aqueous produced by the tear glands.

D. 2-5 days

C. posterior knees loop into the ipsilateral optic tract before crossing

D. Descemet membrane. The naked nerve endings are located in the epithelium and the nerves lose their myelin sheath as they enter the corneal stroma from the limbus

C. Decreasing edge lift will cause a decrease in oxygen not increase oxygen.

A. Type 1.

D. Symporter means the same. Ions are moved in the same direction together against a gradient. Usually a secondary passive process but can be a primary process as well.

C. High IOP and thicker cornea. A thicker cornea will cause a falsely low IOP reading. A thinner cornea will cause a falsely high IOP. The higher the IOP is past 21mmHg the higher the likelihood the patient will have glaucoma.

D. Scleral injury cause a decrease in IOP not an increase in IOP

D.

B. creates a positive tear lens.

B. Ceftriaxone 1g is a treatment for syphilis.

C. immediately posterior to the vortex veins

B. cGMP keeps Na+ channels open to promote depolarization when glutamate is released to bipolar cells. An increase in light decreases levels of cGMP resulting in closure of the sodium channels, hence the negative charge of the cell membrane increases to -65mV.

B. the mid periphery the lens must be closer to the eye then other parts of the lens in order to provide an ideal seal and lacrimal lens power for the patient.

B. K is actively outside on the tear film and moves into the stroma to the aqueous humor. As this happens Na passively enters epithelial cells from the tear film

C. Acyclovir is converted to its triphosphate form, acyclovir triphosphate (ACV-TP), which competitively inhibits viral DNA polymerase, incorporates into and terminates the growing viral DNA chain, and inactivates the viral DNA polymerase

D. Adrenergic antagonists are considered beta blockers. The MOA of beta blockers are to decrease the production of Aqueous Humor in the ciliary body

C. Need low wavelength and fast pulse = strong power and fast pulse

D. Raleigh scattering occurs because of this not Mie scattering

C.

E. produces a virtual image. A DO produces a real image

A. -10X ; Fobj=440mm Feye=44mm ; M=-440/44=-10X

E. Posterior communicating artery is the most commonly artery in the Circle of Willis that is subjected to aneurysm.

C. Anomaloscope test. Anomaloscope is the only color vision test that can determine anomalous trichromats from dichromates. It is considered one of 2 accurate color vision tests we have in our toolbox, followed by the ishihara test.

A. Eso deviation. Eso deviation has a nasal eccentric fixation point thus creating a crossing of the lines closer than normal

A,C,E

D. 499-420 falls on the blue light spectrum lower half. This is shown to cause slight corneal damage with long term exposure. Hence why blue light adaptive lenses are currently used to help alleviate side effects caused by blue light.

A. CR-39. The higher the abbe value the less amount of CA there is. CR 39 abbe 58, Polycarbonate abbe 30, Trivex abbe 43

A. 6.4cm : 80/20(8.73)(11/6)= 64 mm which is equivalent to 6.4 cm

A. Helper T cells

B. CD4 is expressed by T cells

C.

B. 7.67/+2.50. Index of refraction of most contact lens is 1.3375. To find the power of the cornea we use the equation (n-1/r)1000. (1.3375-1/7.58)1000=44.52. The answer choices that have a BCR of 7.50 we would need a compensation power of 1.50 in order to provide an adequate fit with no over refraction. For a BCR of 7.67 we would need a compensation power of 2.50 in order to provide an adequate fit with no over refraction.

A.B. Orbicularis oris presses the lips, mentalis depresses the lower lip as well as wrinkles the chin

A. Trachoma is a disease of the eye caused by infection with the bacterium Chlamydia trachomatis.

A. Hyaline degeneration occurs when smooth muscle is replaced by fibrous connective tissue and is the most common form of degeneration in leiomyomas. Patients do not present with uveitis, glaucoma, and keratitis when hyaline degeneration occurs.

B. Plasma. The blood that runs through the veins, arteries, and capillaries is known as whole blood, a mixture of about 55 percent plasma and 45 percent blood cells

D. verteporfin is used for injection with diode laser to treat CNVM caused by ARMD

A. Middle temporal cortex. The inferotemporal cortex, also known as the ventral pathway, allows for identification of the object and recondition, visual attention, and constancy. The frontal eye field is partially responsible for saccades as well as the superior colliculus.

B. second order

A. Sternocleidomastoid muscle

D. -3.00-2.00×090

D. The vitreous makes up 80% of the total volume of the eye. The total amount is 4mL

B. Light always bends towards the higher index

D. Gullstrand 2 is also known as the exact eye model. This means there are 6 refractive areas 2 of which are lens surfaces

A. Saccadic dysfunction. DEM test results indicated 4 different types of responses. Type 1 Essentially normal performance in Horizontal Time, Vertical Time, and Ratio. Type 2 Characterized as abnormally increased time to complete the Horizontal Test in the presence of normal performance on the Vertical Test. The Ratio would be abnormally high in this case. Type II behavior is characteristic of oculomotor dysfunction. Type 3 Typified as an abnormal increase in both the Horizontal Test and Vertical Test times, but with a normal Ratio. In the presence of a normal Ratio, the Horizontal Test time is influenced and increased because of an abnormal baseline. This represents a case of difficulty in automaticity in number calling skills, not an ocular motility deficit. Type 4 Increased Horizontal and Vertical Test times, and an abnormally high Ratio. This case is a combination of Type II and Type III behavior patterns. There are deficiencies in automaticity/oculomotor skills.

A. Systemic absorption of a drug is decreased when the drug is applied to the specific location of need. In this case systemic absorption is low when the drug is presented in inhalation form.

C. Pilocarpine 0.1% is better than 1%. Typically we use 0.125%. Cocaine is used in diagnosis of Horner’s syndrome

C. Behcet’s disease has no connection with the HLA b27 gene. Remember the UCRAP acronym to describe the HLA B27

D. Rapid neovascularization is present. Staphyloma of sclera present with no neovascularization. The sclera is avascular.

B. CD4 counts below 50 indicates a diagnosis of AIDS and those with a weakened immune system have a higher likelihood to contract cytomegalovirus.

D. Autosomal dominant skin condition. Corneal verticillata can be caused by chloroquine, hydroxychloroquine, amiodarone ( RA drug), Indomethacin, Tamoxifen, Rho kinase inhibitors, and fabry’s disease.

F. oral only one that undergoes first pass metabolism and passes through acidic stomach environment

C. Long pass filter. Long pass filters transmit only long wavelengths that result in only allowing transmission of “glare” causing wavelengths. AR coating mimics long pass filters

B. A neural circuit is a group of neurons in which impulse is affected at the same time usually in the same direction. Convergent means many neurons send a signal to one nerve. Divergent means one nerve sends a signal to several nerves.

C. superior wedge. The temporal third contains the papillomacular bundle

C. Formal operations. During this stage the individual becomes able to handle problems involving abstract ideas and to reason logically.

D. Iris collarette. The anterior vascular is formed before the membrane. The membrane contributes to the minor circle not the major circle. The pupillary rugg is epithelial tissue

B. Antigens are substances that cause the body to make an immune response against that substance. Antibody is a blood protein produced in response to and counteracting a specific antigen.

C. length of vitreous. Megalocornea is a rare developmental defect characterized by nonprogressive, usually symmetric, bilateral enlargement of the diameter of the cornea ≥13 mm. Buphthalmos is used to describe the visible enlargement of the eyeball detected at birth or soon after, due to any uncontrolled glaucoma in early childhood.

E. the I band is the only part of the muscle sarcomere that shortens when neural innervation occurs on the muscle. A is the Z line; B is the M line ; C: is the Z-line ; D is the actin filament; F is the A band

C. the Embryonic nucleus has the highest index of refraction. The lowest index of refraction is the outer cortex layer. The further deep you get into the lens the higher the index of refraction

B. bronchodilator. Bronchodilators are medications that usually come in inhalers — they relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier

C. Excimer laser is used to reshape the cornea thus resulting in correction of refractive error. Femtosecond laser is used to create the flap in LASIK

B. Glutamate cytotoxicity. Glaucoma is a disease of pressure irregulation leading to retinal necrosis. Glutamate is the eye’s excitatory neurotransmitter. As pressure on these nerves increases it will tend to over compensate for the lack of the signal transduction that occurs. Thus excess release of glutamate is a secondary issue that can cause damage to the nerves causing a glaucoma like damage.

C. Choroid. Choroidal blood flow is 10 times higher than the retina. However oxygen flow is low in this area

D. Mesenchyme. This layer only does bones and muscles of the orbital region

A. Toposcope

C. stroma is highly hydrophilic. Epithelium is hydrophobic but lipophilic

B. Conductivity and excitability. Like neurons, muscle is an excitable tissue, in that it can conduct or transmit electrical impulses (respond to stimuli)

B. glutathione is the primary protector against oxidative damage in the lens. Ascorbic acid also helps to protect the lens from oxidative damages but is not the main preventor of oxidative damage.

B. Phenylephrine.
There are no absolute contraindications to phenylephrine aside from hypersensitivity to the drug or any of its components. Phenylephrine contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms or less severe asthmatic episodes in susceptible people.

B. epinephrine

A. Pericytes. NVI is directly caused by diabetes which attacks pericytes on the short posterior ciliary arteries located in the inner nuclear layer which stops the autoregulation of the arteries and leads to retinal ischemia. Due to the newfound retinal ischemia, the RPE releases VEGF to create new blood vessel formation, otherwise known as neovascularization.

A. Cromolyn sodium. Montelukast is an antileukotriene drug. Albuterol is a short acting beta blocker. Zileuton is a Antileukotriene

C. 0.02mm per year

A. Internal jugular vein

B. 1.2 M ; 3’=M/0.4

D. Each cremaster muscle surrounds one of the testicles and its spermatic cord. The muscle helps to move the testicle toward and away from the body to maintain the ideal temperature for sperm production. This is why the scrotum hangs lower in warm conditions and closer to the body in cold weather.

D. lacrimal. Proteins are present in the lacrimal gland in addition to immunoglobulins, electrolytes, and water. Goblet cells secrete mucus. Zeis and meibomian secrete sebum or cholesterol

E. All of the above.

A. Identity achievement. Foreclosure is a psychological term that describes one of the key steps young people experience in the process of finding a sense of self. Diffusion lack of stability or focus in the view of the self or in any of the elements of an individual’s identity.

D. 40. The eye total has 60 Diopters of power. Cornea contributes 40D, and the lens contributes 20D.

A and D.

B. External carotid artery

A. Abdominal aorta is one of the most common sites of aneurysms next to the iliac and large arteries that flow into the heart

A. The cotton swab test is used to evaluate corneal sensitivity, specifically cranial nerve V1, the nasociliary branch off of the ophthalmic nerve.

B. Sherrington’s law of innervation is concerned with the contraction and relaxation of the muscles in the same eye. Hering’s law is the muscle innervation between 2 eyes. Remember sherring the same eye.

D. The question is asking what is an infectious cause of episcleritis. Anything granulomatosis automatically means infectious with the exception of sarcoidosis.

B. They become miotic due to supranuclear input reduction causing an increase in Edinger Westphal activity. Remember that the Edinger-Westphal nucleus is involved in pupillary constriction with the light response, a parasympathetic effect.

C. T4. T4 also known as triiodothyronine is found to be in decreased numbers when testing in patients with hypothyroidism. Elevated TSH are found also in hypothyroidism patients

A. Metabolic acidosis. This gas (carbon dioxide} must be eliminated from the body through exhalation. Inadequate exhalation of this gas will cause its accumulation. When carbon dioxide concentration in the blood increases, it causes the blood to be acidic, lowering its pH.

A.B.C.D 1.5/4=3.75 =x/20->20/75 ; 20/75=6/x

A.E. Scopolamine crosses the blood brain barrier which causes sedation. Scopolamine is also a Cholinergic antagonist and will stop AcH, and decrease a patient Blood pressure.

A. Redness of the conjunctiva is the most commonly reported side effect of netarsudil AKA Rhopressa. This is due to the fact that there are rho kinase receptors found on blood vessels. Rhopressa is an inhibitor of rho kinase which causes vasodilation of the blood vessels.

B. Purkinje image 1 is a direct result of reflection from the anterior corneal surface. When we do keratometry we are measuring the shape of the anterior cornea to see how to fit a RGP properly on that surface.

B. Mesenchyme.

C. Potassium is the main intracellular cation found. Sodium is the main cation found extracellularly

A. 3.28X ; 3in(0.0254/1in)=0.0762 m; (1/0.0762m)= (13.12/4) = 3.28X

C. 16 deg. We can solve this without any sin inverse or calculator. When light hits an object with a higher index of refraction the light is going to bend more creating less of a degree. 16 is the only number that is smaller than 25. Keeping this theory in mind will help you solve any problem like this.

A. A lesion above the medulla will lead to problems with motor control on the contralateral side of the upper body not the upper face. The facial muscles are controlled by the facial nerve found in the upper brain

A. Pyramidal motor cell axons come together and form the internal capsule. These fibers then move through the cerebral peduncles, pons and medulla to from the medulla pyramids

B. anterolateral system AKA spinothalamic pathway carries pain and temperature information from the body. Trigeminothalamic pathway carries pain and temperature information from the face.

C. Adrenal glands are the only directly innervated gland by the preganglionic sympathetic

D. Treponema pallidum is the organism responsible for causing syphilis and is detected using a venereal disease research laboratory testing. Toxoplasma gondii is tested using IgG immunological testing. Neisseria gonorrhoeae is found by a simple urine test and may be detected with a Thayer-Martin chocolate agar stain.

C. Koniocellular layers are located between each of the 6 layers throughout the LGN. The magnocellular layers are layers 1 and 2 on the ventral side of the LGN. Parvocellular layers are 3,4,5,6 on the dorsal side of the LGN.

D. Second generation antihistamine do not have drowsiness effects. First generation cross the Blood brain barrier and cause drowsiness because of this.

C. corrugator. Corrugators think concentration. Frontalis is the primary elevator of the eyebrows. Orbicularis is the primary depressor of the eyelids. Procerus elevates the nose

C. SPCN’s

A and C

B. B waves measure the activity of bipolar and muller cells. A wave measures photoreceptor activity. C wave measures RPE activity. Remember that an EOG can also be used to measure function of the RPE.

B. Uncrossed diplopia. Atypical UHARC paradoxical type 1: Pt will have opposite objective and subjective results

D. Decrease the OAD and increase the BC. Imagine the contact lens like a suction cup. The taller the cup the more it will not move and vice versa. In order to decrease the “height” of the suction cup and make it flatter we must cut or decrease the diameter. Increasing the BC can also cause the contact lens to be flatten.

D. The ciliary body is the main producer and minor drainer of the human eye in addition to helping with the accommodation.

A,E,F

A. Left superior rectus. Superior rectus primary action is elevation secondary action of INcyclo and tertiary action of ADDuction. When the patient is looking towards their left (abduction) you are solely isolating the elevator muscle to cause elevation with no help from secondary action muscles. Thus Left superior rectus is the correct answer. For a visualization draw a Parks 3 step diagram and look at what muscle is isolated for elevation

C. 16/0.5 = 32

B. H influenzae is the only gram negative coccobacilli on our outline. Staphylococcus is a gram positive cocci. Listeria is a gram positive bacilli.

B. Pressure inside is set to a infinite thin and covered by thin membrane is equal to the force necessary to flatten the sphere of the corneal shape

A, Dental abnormalities. Rieger’s syndrome is an autosomal-dominant disorder associated with malformation of the iris, pupillary anomalies, and hypoplasia of the teeth, with or without maxillary hypoplasia. A large family in which multiple individuals had both Rieger’s syndrome and IGHD. Rieger’s anomaly does not have dental abnormalities. Once dental is involved then it upgrades to syndrome.

B. Parinaud oculoglandular syndrome has no particular environment in which it thrives. Parinaud Oculoglandular Syndrome is a conjunctival disease characterized by a unilateral granulomatous follicular conjunctivitis associated with ipsilateral regional lymphadenopathy. There are many vectors that transmit organisms that cause oculoglandular syndrome, of which, Cat Scratch Disease is the most common cause.

E. direct agonist act on the muscle. Cholinergic fibers release acetylcholine

B. Fungal infection. Viral, bacteral, and mycoplasma infection are considered non necrosis. Fungal infections are harder to get rid of and thus cause more damage to localized areas of infection, AKA liquefactive necrosis.

D. Near visual acuity. Standard of care for glaucoma testing is goldmann tonometry for IOP, Humphrey visual field for any nerve damage analysis, Pachymetry in order to accurately adjust the IOP readings, Gonioscopy for determining if its closed angle or open angle glaucoma.

a. 17mm. Seg height= 0.5(A)- seg drop

D. Anterior capsular stars have no association with krukenberg spindles. Lens cataracts can push on the iris and can be a secondary cause of krukenberg spindles. The most common cause is lens zonules rubbing against the back of the iris releasing pigment causing those spindles to form.

A. Atropine is contraindicated in Down Syndrome patients. The MOA effect on down syndrome patients is unknown. Phenylephrine is contraindicated in anyone with blood pressure issues, betaxolol is contraindicated in patients with asthma. Pilocarpine is contraindicated in anyone with a retinal detachment or high hyperopes.

A. Iodine. Iodine was put into salt in 1924 to help prevent thyroid deficiency.

C. poor wetting provides uncomfortable fit for the patient but has minimal effect on vision compared to the other choices

C. Broad spectrum.

A. Chromatic aberration.

C. kayser fleischer ring is indicative of keratoconus

B. Parkinson’s disease key symptom is resting tremors

B. parasympathetic nerve endings surround goblet cells and cause increase in mucous secretions

B. hypothalamus. Puberty’s trigger lies in a small part of the brain called the hypothalamus, a gland that secretes gonadotropin-releasing hormone.

B. Alcoholism. Wernicke- Korsakoff syndrome is a direct cause of a lack of thiamine deficiency caused by alcoholism. Please note thiamine may also be referred to as Vitamin B1 and results in a cecocentral visual field defect as damage of the papillomacular bundle results in bilateral temporal optic disc pallor.

E. Together, the zygomatic bone makes up the lateral wall of the orbit with the greater wing of the sphenoid bone. Remember SMEL my medial wall → sphenoid, maxillary, ethmoid, lacrimal.

A. Cornea absorbs 80% of drugs in the eye. 20% or more is usually lost to the lacrimal system.

A. Everything to do with the iris muscles & epithelium and the retina is derived from the neural ectoderm → the neuroretina, RPE, neuroglia and anything involved with the optic nerve. Neural crest cells are involved with any structures that do not belong to the mesoderm, surface ectoderm or neural ectoderm → trabecular meshwork, iris and ciliary body, corneal stroma, corneal endothelium, Sclera, Choroid, Vitreous. Mesoderm involves muscles and mesenchyme (i.e. the endothelium of the blood vessels). Surface ectoderm includes the corneal epithelium, and all structures related to the lens and tears.

B. Stage 2. The roof develops a break and commences to develop a thickness macular hole. Watzke Allen test is positive when the slit beam is broken indicating where and how big the whole is.

B. Hydrogen bonds are the most common chemical bond in the body. Covalent bonds are typically found in DNA. Van der Waals are found in organic liquids. Ionic bonds occur between metals.

E. Only one that is a class one laser and is USED in surgical procedures. He-ne is also class one but is not USED in surgical procedures.

D. LGN. They originate from the LGN. The Parietal lobe contains the optic radiations that control the inferior section of the optic nerve or the superior portion of vision. The temporal lobe contains the optic radiations that control the superior ection of the optic nerve or the inferior portion of vision. PITS

A. Toxoplasmosis is more commonly found systematically than sarcoidosis. All options do cause posterior uveitis. Syphilis rarely causes posterior uveitis.

A. VA is the ability to identify the highest spatial frequency grating orientation. Meaning only one person can resolve dark and light bars.

B. FTAB-ABS and VDRL are test specifically for syphilis

B. Ovaries are where female gametes are stored (eggs).

B. Midbrain. local circuit neurons located in the midbrain near the oculomotor nucleus. These neurons generate a burst of action potentials. The onset of the burst is the command to generate a vergence movement, and the frequency of the burst determines its velocity

A,B. nanophthalmos is caused by fetal alcohol syndrome, mucopolysaccharidosis, myotonic dystrophy, achondroplasia

D. All of the above.

B. Answer doesn’t change due to the equation. 16/0.5 = 32

B. pilocarpine causes contraction of the iris sphincter which opens up the aqueous outflow.

A. Streptococcus Pyogenes. Remember this gram positive organism is beta-hemolytic meaning it has full hemolysis potential.It is classified as very opportunistic, breaking through the skin and secreing both endotoxins and exotoxins.

Staph aureus is the most common cause of blepharitis. Remember this organism is gram positive with features of being both catalase positive and coagulase positive. All other options are not microorganisms
Staphylococcus Epidermidis is the most common cause of postoperative endophthalmitis. Remember this organism is gram positive with features of being catalase positive but coagulase negative.

D. R=(10^2)/2(1.2) + (1.2/2) =42.27mm

B. Carteolol is a weak non-selective beta blocker. Carteolol does not cross the Blood brain barrier and thus has the lowest chance of causing anything to go on with the chemical balance of the brain.

C. In addition to these arteriolar actions, angiotensin II constricts the mesangial cells, an effect that tends to lower the GFR by decreasing the surface area available for filtration.

B. Blinking occurs from lateral to medial canthus and helps to move tears towards the puncta. The puncta under open conditions collect the tears through capillary attraction method

C. Epinephrine. Alpha adrenergic receptors are involved in neurotransmission and regulate the sympathetic nervous system through binding and activating the neurotransmitter, norepinephrine, and the neurohormone, epinephrine.

C. Exudates are a sign of Wet ARMD aka exudative ARMD. Submacular hemes are not located in the NFL because the macula does not possess the NFL layer. Drusens are indicative of dry ARMD AKA non exudative ARMD

B. moratorium. foreclosure is a psychological term that describes one of the key steps young people experience in the process of finding a sense of self. Diffusion lack of stability or focus in the view of the self or in any of the elements of an individual’s identity.

B. mesenchyme

B. Although liquefactive necrosis can be caused by focal bacterial infection, it is very rare. More often than not fungal infections lead to liquefactive necrosis due to the rapid spreading of the spores within the body.

E. Anterior cerebral and middle cerebral supplies the frontal lobe of the brain. Middle cerebral supplies blood to every part of the brain. The posterior cerebral supplies blood to the temporal and occipital lobes of the brain .

D. Hypertension. Hypertension is a side effect of adrenergic agonists because of vasoconstriction issues.

D. Frontal. Brodmann area 8 is the area involved in the management of uncertainty. Clinically if a patient comes in uncertain about everything and a saccadic defect. Then we can localize what area of the brain is affected.

C. Formal operations. During this stage the individual becomes able to handle problems involving abstract ideas and to reason logically.

C. 30% According to the Amblyopia treatment studies 30% of anisometropic amblyopes can be corrected by just Best rx only.
Chen AM, Cotter SA. The Amblyopia Treatment Studies: Implications for Clinical Practice. Adv Ophthalmol Optom. 2016 Aug;1(1):287-305. doi: 10.1016/j.yaoo.2016.03.007. PMID: 28435934; PMCID: PMC5396957.