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Optometry Board Practice Test for the NBEO^{®} Part 1 Test #1 – Optics This test is comprised of 20 items, which must be completed within 20 minutes. 
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Which patient will have the greatest accommodative and convergence demand when viewing a near object?
C. A hyperope wearing glasses will have the highest demand. A hyperope will have increased accommodative demand to overcome the prescription. When comparing, plus specs vs contact lenses, plus power spectacles require more convergence.
C. A hyperope wearing glasses will have the highest demand. A hyperope will have increased accommodative demand to overcome the prescription. When comparing, plus specs vs contact lenses, plus power spectacles require more convergence.
Assessment of a patient’s GP contact lens shows the lens moves inferiorly after each blink. Which of the following changes can improve lid attachment?
B. An increase in lens diameter will allow for better lid attachment. Flattening the base curve, decreasing center thickness to reduce weight, or changing to minus carrier design can help with lid attachment.
B. An increase in lens diameter will allow for better lid attachment. Flattening the base curve, decreasing center thickness to reduce weight, or changing to minus carrier design can help with lid attachment.
Fluorescein examination of a spherical GP lens demonstrates a bowtie pattern of lens touch and figure8 pattern of lens clearance. What type of corneal shape does this patient have?
A. This pattern is classic for WTR astigmatism. The opposite pattern of clearance and touch indicates ATR. General clearance or touch is more characteristic of a spherical cornea. You would expect an inferior spot of lens touch.
A. This pattern is classic for WTR astigmatism. The opposite pattern of clearance and touch indicates ATR. General clearance or touch is more characteristic of a spherical cornea. You would expect an inferior spot of lens touch.
Calculate the lacrimal lens for the following patient:
Keratometry: 43.00 @ 90 / 44.50 @ 180
Refraction: 2.00 1.00 X 180
Diagnostic lens: 7.67 / 3.00 / 9.2
B. First, calculate the BC of the DxCL → 337.5/7.67 = 44.00 D. The equation for lacrimal lake is LL = BC – K. In the 180 meridian, 44.00 – 44.50 = 0.50 D. In the 90 meridian, 44.00 – 43.00 = +1.00 D. Therefore, LL = +1.00 1.50 x 090.
B. First, calculate the BC of the DxCL → 337.5/7.67 = 44.00 D. The equation for lacrimal lake is LL = BC – K. In the 180 meridian, 44.00 – 44.50 = 0.50 D. In the 90 meridian, 44.00 – 43.00 = +1.00 D. Therefore, LL = +1.00 1.50 x 090.
Calculate the residual astigmatism of the following patient who is fit with a spherical GP contact lens without flexure nor warpage:
Keratometry: 42.50 / 44.00 @ 090
Refraction: 1.25 0.50 x 180
C. 1.00 x 090. The equation of note is RA = SRcyl – Kcyl. We know that SRcyl = 0.50 x 180. Using the K values, we determine the corneal cyl is 1.50 x 180. Solving for RA = (0.50 x 180( – (1.50 x 180) = +1.00 x 180 or 1.00 x 090
C. 1.00 x 090. The equation of note is RA = SRcyl – Kcyl. We know that SRcyl = 0.50 x 180. Using the K values, we determine the corneal cyl is 1.50 x 180. Solving for RA = (0.50 x 180( – (1.50 x 180) = +1.00 x 180 or 1.00 x 090
Which of the following GP lens design is best suited for a patient with the following data:
Keratometry: 43.00 / 46.00 @ 090
Refraction: 1.25 5.00 x 180
C. A back surface toric is appropriate as the information supports the “123” rule. The “1” is the residual astigmatism. The “2” is double the RA and represents corneal astigmatism. The “3” is double that of the corneal astigmatism and represents the vertex refraction (be sure to adjust the refraction before deciding which lens.
C. A back surface toric is appropriate as the information supports the “123” rule. The “1” is the residual astigmatism. The “2” is double the RA and represents corneal astigmatism. The “3” is double that of the corneal astigmatism and represents the vertex refraction (be sure to adjust the refraction before deciding which lens.
The fitting mark of a soft contact lens appears rotated clockwise 10 degrees on fit assessment. Using the following information, determine the next contact lens to fit on the patient?
Refraction: 1.00 1.00 x 075
Soft Toric Lens: 1.00 1.00 x 065
D. Using the LARS rule, the answer is 1.00 1.00 x 085. The mark has rotated clockwise, or Left, so will need to add the 10 degrees to an axis. Most forget that we adjust the axis of the original subjective refraction rather than the diagnostic lens. Therefore, 85 is the new axis.
D. Using the LARS rule, the answer is 1.00 1.00 x 085. The mark has rotated clockwise, or Left, so will need to add the 10 degrees to an axis. Most forget that we adjust the axis of the original subjective refraction rather than the diagnostic lens. Therefore, 85 is the new axis.
What is the minimum amount of clearance over the cornea for a fullysettled scleral lens?
C. The minimum amount of clearance is 50 microns. In practice, it is best to aim for 100150 but 50 microns will still allow for corneal clearance even with blinks.
C. The minimum amount of clearance is 50 microns. In practice, it is best to aim for 100150 but 50 microns will still allow for corneal clearance even with blinks.
Which of the following soft contact lenses would you use first for a patient with the following prescription?
Subjective refraction: 4.25 1.75 x 180
B. Using an optic cross, be sure to have 4.25 at the 180 and 6.00 at the 090. Vertexing results in 4.00 in the 180 and 5.50 at the 90. The final prescription is 4.00 1.50 x 180.
B. Using an optic cross, be sure to have 4.25 at the 180 and 6.00 at the 090. Vertexing results in 4.00 in the 180 and 5.50 at the 90. The final prescription is 4.00 1.50 x 180.
Silicone hydrogel contact lenses are designed for better oxygen transmission. What occurs to the transmission levels as one decreases the water content of the lens?
D. Increased oxygen transmission via silicone as the water content decreases. Increasing water content leads to lower ratio of Silicone to water. Therefore, more water in the lens means less oxygen from tears through the silicone.
D. Increased oxygen transmission via silicone as the water content decreases. Increasing water content leads to lower ratio of Silicone to water. Therefore, more water in the lens means less oxygen from tears through the silicone.
According to the FDA, how is a soft contact lens with low water content and the presence of ions classified?
C. This lens belongs to Group 3. Group 1 is defined as low water content and onionin. Group 2 is high water content and nonionic. Group 3 is defined by low water content and ionic. Group 4 is ionic with high water content. Group 5 describes all silicone hydrogel lenses.
C. This lens belongs to Group 3. Group 1 is defined as low water content and onionin. Group 2 is high water content and nonionic. Group 3 is defined by low water content and ionic. Group 4 is ionic with high water content. Group 5 describes all silicone hydrogel lenses.
Which of the following statements is FALSE regarding rigid, gaspermeable contact lenses?
A. Warpage occurs on AND off the eye. Flexure only occurs ON the eye. Higher Dk lenses have more chance of flexure.
A. Warpage occurs on AND off the eye. Flexure only occurs ON the eye. Higher Dk lenses have more chance of flexure.
A Pseudophakic, low vision patient uses a +11.00 DS hand held magnifier with a +3.00 ADD. What equivalent power would the patient achieve when he holds the magnifier directly to his bifocal (assume 0 cm of separation between lenses)?
C. Feq = +14.00 DS. To calculate, recall the equation Feq = F1 + F2 – cF1F2. As there is no separation in the equation, we simply calculate F1 + F2.
C. Feq = +14.00 DS. To calculate, recall the equation Feq = F1 + F2 – cF1F2. As there is no separation in the equation, we simply calculate F1 + F2.
A presbyopic patient has a 5x Galilean telescope designed for distance viewing with an objective lens of +12.00 DS. What is the expected power of the ocular lens?
D. The expected mag power is 60.00 DS. The equation of Mag Power = – Foc/Fobj. Solving this out, Mag = – (X)/+12.00 = 5 = 5×12 = – 60 DS. As this is a Galilean telescope, recall that the ocular lens will be minus.
D. The expected mag power is 60.00 DS. The equation of Mag Power = – Foc/Fobj. Solving this out, Mag = – (X)/+12.00 = 5 = 5×12 = – 60 DS. As this is a Galilean telescope, recall that the ocular lens will be minus.
What is the Snellen equivalent if a patient is able to read 1M print at 40 cm?
B. 20/50. The equation of note is test distance / M unit = 20 ft / size of Snellen letter. It is also an important number to recall as it represents average news print letter size and is a standard in low vision.
B. 20/50. The equation of note is test distance / M unit = 20 ft / size of Snellen letter. It is also an important number to recall as it represents average news print letter size and is a standard in low vision.
What is the effective magnification of a 20 D magnifier held at standard distance?
C. 5x. Recall the equation Effective magnification = F/4 = 20/4. Standard distance is 25 cm as the standard presbyopic and emmetropic patient needs a +4.00 add for magnification.
C. 5x. Recall the equation Effective magnification = F/4 = 20/4. Standard distance is 25 cm as the standard presbyopic and emmetropic patient needs a +4.00 add for magnification.
A patient presents with a distance BCVA of 20/120. What is the predicted starting ADD power?
A. +6.00. Recall Kestenbaum’s Rule when determining initial ADD power. In this case, BCVA is 20/120. Therefore starting ADD is 120/20 = +6.00 D.
A. +6.00. Recall Kestenbaum’s Rule when determining initial ADD power. In this case, BCVA is 20/120. Therefore starting ADD is 120/20 = +6.00 D.
You recently prescribed a +8.00D ADD to your low vision patient. The patient returns with complaints of double vision and eye strain. How much prism should you place in each eye to alleviate patient symptoms?
C. It would be appropriate to begin a prism trial with 10 BI in each eye. Recall the equation, ADD + 2 = prism in EACH eye.
C. It would be appropriate to begin a prism trial with 10 BI in each eye. Recall the equation, ADD + 2 = prism in EACH eye.
A low vision patient presents with an initial BCVA of 20/500 in both eyes. How would you classify their vision?
D. 20/500 is considered Profound low vision. Recall the following pairs: Normal = 20/12 20/25, NearNormal = 20/30 to 20/60, Moderate = 20/70 – 20/160, Severe = 20/200 – 20/400, Profound = 20/500 – 20/1000, Near Blindness > 20/2000. Blindness is no perception of light or motion.
D. 20/500 is considered Profound low vision. Recall the following pairs: Normal = 20/12 20/25, NearNormal = 20/30 to 20/60, Moderate = 20/70 – 20/160, Severe = 20/200 – 20/400, Profound = 20/500 – 20/1000, Near Blindness > 20/2000. Blindness is no perception of light or motion.
Which of the following criteria must be met to be diagnosed as legally blind according to the 2007 definition of legal blindness? (PICK 2)
B/D: THe legal definition for blindness is the inability to read any letters on the 20/100 line in the better seeing eye and/or a visual field less than or equal to 20 degrees. If there is a central scotoma, subtract scotoma from overall diameter.
B/D: THe legal definition for blindness is the inability to read any letters on the 20/100 line in the better seeing eye and/or a visual field less than or equal to 20 degrees. If there is a central scotoma, subtract scotoma from overall diameter.