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Optometry Board Practice Test for the NBEO® Part 1 Full Length Test #1 – Afternoon Session This test is comprised of 175 items. This is PRACTICE mode. There is no countdown timer and answers are shown after each question. |
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In the United States, what is the leading cause of ophthalmia neonatorum?
D. Chlamydia is the leading cause of ophthalmia neonatorum in the US. HSV and gonorrhea may also lead to development of this condition.
D. Chlamydia is the leading cause of ophthalmia neonatorum in the US. HSV and gonorrhea may also lead to development of this condition.
A 35yo male presents with complaints of severe headaches that cause him to wake at night. They occur once or twice a day and seem to be temporal in location. These symptoms are most indicative of which of the following?
D. Cluster headaches are characterized by periods of attacks that occur for several weeks before going into remission. These headaches most commonly affect males between the ages of 30 and 50 years. These headaches can be accompanied with red eyes, nasal congestion, and transient or permanent Horner’s syndrome.
D. Cluster headaches are characterized by periods of attacks that occur for several weeks before going into remission. These headaches most commonly affect males between the ages of 30 and 50 years. These headaches can be accompanied with red eyes, nasal congestion, and transient or permanent Horner’s syndrome.
What is the most common mite found on the human eyelash?
D. Demodex folliculorum and D. brevis are the most common mites found on the human eye lash. Phthirus and pediculus are parasites that are contagious and easily spread. If seen in children it is a red flag! Molluscum, a DNA pox virus, is a viral infection of the skin common in children and immunocompromised patients.
D. Demodex folliculorum and D. brevis are the most common mites found on the human eye lash. Phthirus and pediculus are parasites that are contagious and easily spread. If seen in children it is a red flag! Molluscum, a DNA pox virus, is a viral infection of the skin common in children and immunocompromised patients.
An image is projected on a screen 3 m away. A 3 D prism is placed in front of the projector with the base facing to the right. How far and in which direction is the image displaced?
D. The image is displaced 9 cm to the left. The equation for this example is PrismPower = image displacement (in cm)/distance to screen (in m). This is why the answer is in centimeters. Next, we note that a prism moves images towards its apex. When the base is positioned to the right, the image moves to the left.
D. The image is displaced 9 cm to the left. The equation for this example is PrismPower = image displacement (in cm)/distance to screen (in m). This is why the answer is in centimeters. Next, we note that a prism moves images towards its apex. When the base is positioned to the right, the image moves to the left.
What is the mechanism of action of Macugen?
B. Macugen is an anti-neoplastic agent that prevents angiogenesis through inhibition of VEGF. PEDF has the opposite effect and is required to be in the proper balance of concentration as VEGF.
B. Macugen is an anti-neoplastic agent that prevents angiogenesis through inhibition of VEGF. PEDF has the opposite effect and is required to be in the proper balance of concentration as VEGF.
What organic molecule composes the stromal deposits in the cornea of a patient diagnosed with Schnyder’s dystrophy?
D. The fine yellow-white rings of crystals in Schnyder’s are composed of cholesterol. Macular Dystrophy presents with multiple gray-white opacities composed of mucopolysaccharides. Granular Dystrophy presents with snowflake granules composed of hyaline. Lattice Dystrophy presents with lattice-like branches of amyloid. Calcium is associated with Band K, which affects Bowman’s layer.
D. The fine yellow-white rings of crystals in Schnyder’s are composed of cholesterol. Macular Dystrophy presents with multiple gray-white opacities composed of mucopolysaccharides. Granular Dystrophy presents with snowflake granules composed of hyaline. Lattice Dystrophy presents with lattice-like branches of amyloid. Calcium is associated with Band K, which affects Bowman’s layer.
What is the most common benign orbital growth in adults?
B. Cavernous hemangioma is the most common benign orbital tumor in adults. Cavernous hemangiomas develop slowly and lead to unilateral proptosis. Capillary hemangiomas are the most common benign orbital tumor in CHILDREN.
B. Cavernous hemangioma is the most common benign orbital tumor in adults. Cavernous hemangiomas develop slowly and lead to unilateral proptosis. Capillary hemangiomas are the most common benign orbital tumor in CHILDREN.
Which of the following patients have the highest probability of developing acute, unilateral anterior nongranulomatous uveitis?
D. This patient has Ankylosing Spondylitis – an inflammatory condition that causes sacroiliitis in young males that improves with exercise. AS is the most common cause of acute, unilateral anterior nongranulomatous uveitis. You can recall the UCRAP conditions as the most common causes of acute, unilateral anterior nongranulomatous uveitis and for their association with HLA-B27. The last option refers to sarcoidosis – causes chronic, bilateral granulomatous anterior uveitis.
D. This patient has Ankylosing Spondylitis – an inflammatory condition that causes sacroiliitis in young males that improves with exercise. AS is the most common cause of acute, unilateral anterior nongranulomatous uveitis. You can recall the UCRAP conditions as the most common causes of acute, unilateral anterior nongranulomatous uveitis and for their association with HLA-B27. The last option refers to sarcoidosis – causes chronic, bilateral granulomatous anterior uveitis.
Which of the following are common systemic side effects with use of Carbonic Anhydrase Inhibitors? (PICK 2)
C/D: CAIs are known for several side effects. The most important to note include: metabolic acidosis, aplastic anemia, myopia shifts, bone marrow suppression, and depression. Other SE include metallic taste, tingling of limbs, thrombocytopenia, ED, and anorexia.
C/D: CAIs are known for several side effects. The most important to note include: metabolic acidosis, aplastic anemia, myopia shifts, bone marrow suppression, and depression. Other SE include metallic taste, tingling of limbs, thrombocytopenia, ED, and anorexia.
Lab testing in a patient with Hyperthyroidism will reveal:
D. Hyperthyroidism is characterized by elevated levels of T3/T4 hormones and low levels of TSH. This condition is caused by constant thyroid stimulation leading to increased production of T3/T4. Elevated levels of T3/T4 inhibits the production of TSH by the thyroid gland leading to decreased levels of TSH.
D. Hyperthyroidism is characterized by elevated levels of T3/T4 hormones and low levels of TSH. This condition is caused by constant thyroid stimulation leading to increased production of T3/T4. Elevated levels of T3/T4 inhibits the production of TSH by the thyroid gland leading to decreased levels of TSH.
What is the most common cause of entropion?
A: Involutional, or aging, is the most common cause of entropion (an inward turning of the eyelid). Other causes include mechanical (tumor), cicatricial (trachoma, Stevens-Johnson, chemical burns), or congenital.
A: Involutional, or aging, is the most common cause of entropion (an inward turning of the eyelid). Other causes include mechanical (tumor), cicatricial (trachoma, Stevens-Johnson, chemical burns), or congenital.
All of the following are expected results for Primary Sjogren’s syndrome EXCEPT:
D. Rheumatoid arthritis is not expected in Primary Sjogren’s syndrome. Primary Sjogren’s syndrome is defined as dry eye, dry mouth, and presence of autoantibodies. To diagnosis Secondary Sjogren’s, a patient must present with all the previous findings AND an autoimmune disease such as RA, SLE, and other connective tissues diseases.
D. Rheumatoid arthritis is not expected in Primary Sjogren’s syndrome. Primary Sjogren’s syndrome is defined as dry eye, dry mouth, and presence of autoantibodies. To diagnosis Secondary Sjogren’s, a patient must present with all the previous findings AND an autoimmune disease such as RA, SLE, and other connective tissues diseases.
Which of the following drug classes increase aqueous outflow in treatment of glaucoma? (PICK 3)
A/B/D. PG analogs, alpha agonists, and pilocarpine (a direct cholinergic agonist) all lower IOP by increasing aqueous outflow.
A/B/D. PG analogs, alpha agonists, and pilocarpine (a direct cholinergic agonist) all lower IOP by increasing aqueous outflow.
All of the following are clinical uses of Phenylephrine, EXCEPT:
A. Dilation withOUT cycloplegia. Phenylephrine is an adrenergic agonist that causes dilation with no effect on ciliary muscles. When used to differentiate, vessels will become blanched with episcleritis. With diagnosis of Horner’s Syndrome, it helps determine if lesion is pre- or post ganglionic. 10% Phenyl is used to break old or severe PAS.
A. Dilation withOUT cycloplegia. Phenylephrine is an adrenergic agonist that causes dilation with no effect on ciliary muscles. When used to differentiate, vessels will become blanched with episcleritis. With diagnosis of Horner’s Syndrome, it helps determine if lesion is pre- or post ganglionic. 10% Phenyl is used to break old or severe PAS.
Which of the following systemic conditions is associated with verticillata?
C. Fabry’s disease is associated with development of verticillata, also known as whorl or vortex keratopathy. Several medications (recall CHAI-T) as well as the condition sphingolipidoses can cause verticillata as well.
C. Fabry’s disease is associated with development of verticillata, also known as whorl or vortex keratopathy. Several medications (recall CHAI-T) as well as the condition sphingolipidoses can cause verticillata as well.
Which of the following is NOT associated with angioid streaks?
D. Osteogenesis imperfecta is not correlated with angioid streaks. Recall PEPSI as the most common causes of angioid streaks. Pseudoxanthoma elasticum, Ehlers-Danlos syndrome, Paget’s Disease, Sickle-cell disease, and idiopathic.
D. Osteogenesis imperfecta is not correlated with angioid streaks. Recall PEPSI as the most common causes of angioid streaks. Pseudoxanthoma elasticum, Ehlers-Danlos syndrome, Paget’s Disease, Sickle-cell disease, and idiopathic.
How long is the process of dark adaptation of the rod photoreceptors?
D. Rods take about 30-40 minutes for complete dark adaptation. Cones take about 5-10 minutes for light adaptation.
D. Rods take about 30-40 minutes for complete dark adaptation. Cones take about 5-10 minutes for light adaptation.
An elderly patient reports that over the past few years, their distance vision has improved gradually. They state that reading has become more difficult. Which of the following is the most likely cause of this complaint?
E. Cortical cataracts have been associated with hyperopic shifts in vision. Cerulean cataracts are congenital and present as small, blue-green opacities that rarely affect vision. Nuclear sclerosis is the most common aging cataract and most often leads to a myopic shift as the lens swells. Rosette cataracts are caused by trauma. PSC cataracts lead to reduced vision at distance and near, worse while reading with constricted pupils.
E. Cortical cataracts have been associated with hyperopic shifts in vision. Cerulean cataracts are congenital and present as small, blue-green opacities that rarely affect vision. Nuclear sclerosis is the most common aging cataract and most often leads to a myopic shift as the lens swells. Rosette cataracts are caused by trauma. PSC cataracts lead to reduced vision at distance and near, worse while reading with constricted pupils.
A patient presents with an 18Δ exophoria at near and is symptomatic for double vision. Vergence testing reveals near base out of 6/8/10 and near base in of 10/12/12. Calculate the expected total prism necessary to alleviate patient symptoms?
A. 10 pd BI. As we are calculating the prism necessary for exophoria, it is recommended to use Sheard’s Criterion. The equation is Prism = ⅔ Phoria – ⅓ Compensating Fusional Vergence. In this case, the phoria is 18Δ and the compensating fusional vergence (positive fusional vergence for exophoric patients) is the blur point of the BO measurement. To alleviate phoria we expect to move images to the fovea. Therefore the 10Δ will be BI. Remember this is total and NOT per eye.
A. 10 pd BI. As we are calculating the prism necessary for exophoria, it is recommended to use Sheard’s Criterion. The equation is Prism = ⅔ Phoria – ⅓ Compensating Fusional Vergence. In this case, the phoria is 18Δ and the compensating fusional vergence (positive fusional vergence for exophoric patients) is the blur point of the BO measurement. To alleviate phoria we expect to move images to the fovea. Therefore the 10Δ will be BI. Remember this is total and NOT per eye.
What is the most common cause of posterior uveitis?
A: Toxoplasmosis is the most common cause of posterior uveitis. Toxoplasmosis presents with unilateral vitritis in presence of a yellow-white retinal lesion near an old inactive scar. When looking within the eye, findings appear as “headlights in the fog”. Other conditions listed also lead to development of posterior uveitis.
A: Toxoplasmosis is the most common cause of posterior uveitis. Toxoplasmosis presents with unilateral vitritis in presence of a yellow-white retinal lesion near an old inactive scar. When looking within the eye, findings appear as “headlights in the fog”. Other conditions listed also lead to development of posterior uveitis.
A patient presents with a complaint of pink colored tears and urine. Which of the following medications would you most likely find on their medication list?
C. Rifampin, a drug used in the treatment of Tuberculosis, is known to cause orange-pink discoloration of tears and urine.
C. Rifampin, a drug used in the treatment of Tuberculosis, is known to cause orange-pink discoloration of tears and urine.
What is the most predictive risk factor for development of Hypertension?
A. Age is the most highly associated risk factor for hypertension. The remaining options are also risk factors.
A. Age is the most highly associated risk factor for hypertension. The remaining options are also risk factors.
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.
Where is the origin of the longitudinal muscle fibers of the ciliary muscle?
D: The Scleral Spur is the origin of the longitudinal muscle fibers. The muscle inserts into the anterior choroid.
D: The Scleral Spur is the origin of the longitudinal muscle fibers. The muscle inserts into the anterior choroid.
Which of the following statements regarding Optic Disc Drusen is INCORRECT?
D. Optic disc drusen are HYPERreflective on B scan ultrasound.
D. Optic disc drusen are HYPERreflective on B scan ultrasound.
What are the two functions of the medication, Sumatriptan? (PICK 2)
B/C. Sumatriptan, a drug commonly used as a therapy for Migraines, functions as an anti-inflammatory and vasoconstrictor. Sumatriptan is an agonist of 5-HT1B and 1D receptors.
B/C. Sumatriptan, a drug commonly used as a therapy for Migraines, functions as an anti-inflammatory and vasoconstrictor. Sumatriptan is an agonist of 5-HT1B and 1D receptors.
Which of the following is most likely to cause a macula only homonymous hemianopsia?
B. A tumor that causes compression of both the posterior and middle cerebral arteries is most likely to cause a macula-only homonymous hemianopsia. The macular center of the occipital lobe is superficial and fed by both arteries. Vascular events often only damage one of the sources, thus leading to macular sparing homonymous hemianopsia.
B. A tumor that causes compression of both the posterior and middle cerebral arteries is most likely to cause a macula-only homonymous hemianopsia. The macular center of the occipital lobe is superficial and fed by both arteries. Vascular events often only damage one of the sources, thus leading to macular sparing homonymous hemianopsia.
A mother presents with her 8 month old baby with concerns about an intermittent eye turn. The mother reports the right eye appears to turn inward while the infant watches videos on the iPad. Testing reveals orthophoria when conducted with +3.00 D lenses and a 20Δ right esotropia without lenses. Which of the following is MOST LIKELY diagnosis?
B. Accommodative esotropia is the most likely diagnosis at this time. There are a few pieces of information that are key. First, the infant is demonstrating an eye turn some of the time. This means there is either a stimulus to the eye turn or it may be a decompensated phoria. The second piece of evidence is the orthophoric position with +3.00D lenses. This indicates that when accommodation demand is low, the eye turn is not present (or reduced).
B. Accommodative esotropia is the most likely diagnosis at this time. There are a few pieces of information that are key. First, the infant is demonstrating an eye turn some of the time. This means there is either a stimulus to the eye turn or it may be a decompensated phoria. The second piece of evidence is the orthophoric position with +3.00D lenses. This indicates that when accommodation demand is low, the eye turn is not present (or reduced).
Which of the following might indicate malignancy of a lesion in the retina?
C. Presence of a halo is a positive sign and will steer diagnosis towards benign. To recall, remember the phrase “To Find Small Ocular Melanomas, Use Helpful Hints Daily”: Thickness (elevation >2mm), Fluid (subretinal), Symptoms, Orange pigment (lipofuscin), Margins are irregular, Ultrasound Hollowness, Halo absence, Drusen present.
C. Presence of a halo is a positive sign and will steer diagnosis towards benign. To recall, remember the phrase “To Find Small Ocular Melanomas, Use Helpful Hints Daily”: Thickness (elevation >2mm), Fluid (subretinal), Symptoms, Orange pigment (lipofuscin), Margins are irregular, Ultrasound Hollowness, Halo absence, Drusen present.
Which of the following are the correct combination of corneal layer and thickness? (PICK 3)
A,C,E: Note the sizes above. Bowman’s is about 10um and Descemet’s begins at 5um and increases to about 15um with age.
A,C,E: Note the sizes above. Bowman’s is about 10um and Descemet’s begins at 5um and increases to about 15um with age.
Which of the following drugs can cause a myopic shift? (PICK 3)
A/B/C. Topamax, Carbonic Anhydrase Inhibitors, and Pilocarpine are all known to carry the risk of myopic shift.
A/B/C. Topamax, Carbonic Anhydrase Inhibitors, and Pilocarpine are all known to carry the risk of myopic shift.
Which of the following is an autoimmune disorder in which antibodies target acetylcholine receptors?
C. Myasthenia gravis is caused by antibodies that target acetylcholine receptors. This condition leads to reduced muscle innervation over the course of a day leading to symptoms worse at night. Ocular findings include ptosis and diplopia. Recall the ice pack test and tensilon (Edrophonium) test.
C. Myasthenia gravis is caused by antibodies that target acetylcholine receptors. This condition leads to reduced muscle innervation over the course of a day leading to symptoms worse at night. Ocular findings include ptosis and diplopia. Recall the ice pack test and tensilon (Edrophonium) test.
Which of the following drugs used in the treatment against the Herpes Virus contains Thimerosal – a preservative known to cause SPK and delay of corneal wound healing?
A. Trifluridine, also known as Viroptic, contains Thimerosal – a mercury-based preservative found in drops. The remaining options are oral medications used in treatment of herpes virus.
A. Trifluridine, also known as Viroptic, contains Thimerosal – a mercury-based preservative found in drops. The remaining options are oral medications used in treatment of herpes virus.
Which of the following dystrophies is inherited in an autosomal recessive pattern?
A. Macular dystrophy is the only corneal dystrophy that is autosomal recessive. The rest of the options are autosomal dominant.
A. Macular dystrophy is the only corneal dystrophy that is autosomal recessive. The rest of the options are autosomal dominant.
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.
A patient presents with a lesion of the sympathetic pathway. Testing reveals a Pancoast tumor of the lung. Where is the lesion located in this Horner’s patient?
B. Between the CCB and the SCG. A lesion of the sympathetic pathway leads to development of Horner’s syndrome. These lesions can be defined by one of three regions: preganglionic central, preganglionic, and postganglionic. See answer choices for description.
B. Between the CCB and the SCG. A lesion of the sympathetic pathway leads to development of Horner’s syndrome. These lesions can be defined by one of three regions: preganglionic central, preganglionic, and postganglionic. See answer choices for description.
Which of the following tests measures a patient’s visual-motor integration skills?
D. Wold Sentence Copy is an example of a VMI test. The Beery VMI is another example. Piaget and Gardner, as well as Standing Angels in the Snow, are examples of tests of visual spatial skills. Visual analysis encompasses 6 sub-categories focused on analyzing images of different complexities.
D. Wold Sentence Copy is an example of a VMI test. The Beery VMI is another example. Piaget and Gardner, as well as Standing Angels in the Snow, are examples of tests of visual spatial skills. Visual analysis encompasses 6 sub-categories focused on analyzing images of different complexities.
Which of the following drug classes is safe to use during pregnancy?
C. Cephalosporins are safe to use during pregnancy. To recall, “She is not FATS, she is PACking a baby”. FATS are not safe to use during pregnancy and includes: Fluoroquinolones, Aminoglycosides, Tetracyclines, and Sulfonamides. PAC is safe to use and includes: Penicillins, Azithromycin (Macrolides), and Cephalosporins.
C. Cephalosporins are safe to use during pregnancy. To recall, “She is not FATS, she is PACking a baby”. FATS are not safe to use during pregnancy and includes: Fluoroquinolones, Aminoglycosides, Tetracyclines, and Sulfonamides. PAC is safe to use and includes: Penicillins, Azithromycin (Macrolides), and Cephalosporins.
Which of the following ocular complications is NOT associated with Herpes Simplex Virus?
B. Pseudodendritic keratitis is a complication of Herpes Zoster Virus. One would expect to find dendritic keratitis in HSV. Dendrites appear as branching areas of staining on the cornea with terminal end bulbs. Use of Rose Bengal or Lissamine Green staining is important in this diagnosis. Recall that HSV can lead to development of follicles.
B. Pseudodendritic keratitis is a complication of Herpes Zoster Virus. One would expect to find dendritic keratitis in HSV. Dendrites appear as branching areas of staining on the cornea with terminal end bulbs. Use of Rose Bengal or Lissamine Green staining is important in this diagnosis. Recall that HSV can lead to development of follicles.
All of the following ocular conditions are contraindications for Muro 128, EXCEPT:
D. Muro 128 is used to reduce corneal edema in conditions such as Fuch’s. The remaining conditions can lead to ulceration of cornea with use of Muro 128.
D. Muro 128 is used to reduce corneal edema in conditions such as Fuch’s. The remaining conditions can lead to ulceration of cornea with use of Muro 128.
Which of the following immune system components is associated with development of Contact Dermatitis?
B. Contact dermatitis is an example of a Type IV hypersensitivity reaction, also referred to as delayed or cell-mediated hypersensitivity. T-lymphocytes are the primary immune response in this type of reaction. Type I hypersensitivity uses IgE. Type II hypersensitivity is the more common IgM/IgG response. Type III hypersensitivity utilizes antigen/antibody complexes.
B. Contact dermatitis is an example of a Type IV hypersensitivity reaction, also referred to as delayed or cell-mediated hypersensitivity. T-lymphocytes are the primary immune response in this type of reaction. Type I hypersensitivity uses IgE. Type II hypersensitivity is the more common IgM/IgG response. Type III hypersensitivity utilizes antigen/antibody complexes.
A patient presents with a 1Δ exophoria at distance and 8Δ exophoria at exactly 40 cm. If the patient’s pupillary distance(PD) is 64mm, what is the calculated AC/A?
C. The calculated AC/A is 3.6. The equation of note is AC/A = PD(cm) + WD(m)[Phoria @ N – Phoria @ D]. When plugging in values, Exo is considered “-” and Eso is considered “+”. Therefore, AC/A = 6.4 + .4(-8-(-1)) = 3.6. CAREFUL that PD is in centimeters.
C. The calculated AC/A is 3.6. The equation of note is AC/A = PD(cm) + WD(m)[Phoria @ N – Phoria @ D]. When plugging in values, Exo is considered “-” and Eso is considered “+”. Therefore, AC/A = 6.4 + .4(-8-(-1)) = 3.6. CAREFUL that PD is in centimeters.
When should a patient diagnosed with Type 1 Diabetes Mellitus have a dilated fundus exam?
C. A patient diagnosed with T1DM should have a dilated fundus exam within 5 years of diagnosis. Patients diagnosed with T2DM are recommended to have a DFE upon diagnosis.
C. A patient diagnosed with T1DM should have a dilated fundus exam within 5 years of diagnosis. Patients diagnosed with T2DM are recommended to have a DFE upon diagnosis.
Which of the following is defined as the optical image of a physical aperture stop formed by all the lenses in front of it?
A. The entrance pupil is defined as the image of the aperture stop formed by all lenses in front of it. The exit pupil is the image of the aperture stop formed by all lenses behind it. An entrance port is the image of the field stop formed by all lenses in front of it. The image of the field stop formed by lenses behind it is known as the exit port.
A. The entrance pupil is defined as the image of the aperture stop formed by all lenses in front of it. The exit pupil is the image of the aperture stop formed by all lenses behind it. An entrance port is the image of the field stop formed by all lenses in front of it. The image of the field stop formed by lenses behind it is known as the exit port.
Which uveal layer is composed of myoepithelium?
E. Anterior iris epithelium – the rest of the options are composed of connective tissue
E. Anterior iris epithelium – the rest of the options are composed of connective tissue
All of the following are symptoms of Hypothyroidism, EXCEPT:
A. Heat intolerance is not associated with Hypothyroidism (low amounts of sympathetic innervation). Rather, the classic symptoms include COLD intolerance, weight gain, decreased appetite, weakness and lethargy.
A. Heat intolerance is not associated with Hypothyroidism (low amounts of sympathetic innervation). Rather, the classic symptoms include COLD intolerance, weight gain, decreased appetite, weakness and lethargy.
Which of the following is the most common cause of inflammation of the canaliculi?
E. Canaliculitis is most often caused by Actinomyces israelii. First signs include a pouting puncta, epiphora, and sulfur granular discharge.
E. Canaliculitis is most often caused by Actinomyces israelii. First signs include a pouting puncta, epiphora, and sulfur granular discharge.
Which of the following is a feedback regulator of synthesis and secretion of glucocorticoids?
A. ACTH (adrenocorticotropic hormone). ACTH secretion is diurnal and regulated by corticotropin releasing hormone. This secretion is increased during stress and highest in the morning.
A. ACTH (adrenocorticotropic hormone). ACTH secretion is diurnal and regulated by corticotropin releasing hormone. This secretion is increased during stress and highest in the morning.
Which of the following statements is FALSE regarding Plaquenil?
D. The greatest threat to vision with chronic use of Plaquenil is Bull’s Eye Maculopathy.The mechanism of action is similar to that of steroids. Standard of care (DFE within 1 year of initiation of drug therapy) is as above, exception being a 24-2 for patients of Asian descent.
D. The greatest threat to vision with chronic use of Plaquenil is Bull’s Eye Maculopathy.The mechanism of action is similar to that of steroids. Standard of care (DFE within 1 year of initiation of drug therapy) is as above, exception being a 24-2 for patients of Asian descent.
A 1mm error in axial length measurement prior to cataract surgery corresponds to how many diopters of refractive error?
C. 1 mm of axial length corresponds to about 3 diopters. This emphasizes the importance of accurate A scan measurements prior to surgery.
C. 1 mm of axial length corresponds to about 3 diopters. This emphasizes the importance of accurate A scan measurements prior to surgery.
Wernicke-Korsakoff Syndrome is caused by a deficiency of which vitamin?
B. Wernicke-Korsakoff Syndrome is caused by a deficiency of Vitamin B1 (thiamine). This condition is seen most commonly in alcoholics.
B. Wernicke-Korsakoff Syndrome is caused by a deficiency of Vitamin B1 (thiamine). This condition is seen most commonly in alcoholics.
A patient presents to your clinic with chemical burns to the eyes. As an astute doctor, you know to irrigate the eyes before performing any other tests. You determine that the pH has been neutralized and begin slit lamp examination. What finding is most concerning?
A. Limbal blanching indicates that the chemical burn has resulted in ischemia. Although the remaining options are of major importance, limbal blanching has the most long term consequences on the health of the eye.
A. Limbal blanching indicates that the chemical burn has resulted in ischemia. Although the remaining options are of major importance, limbal blanching has the most long term consequences on the health of the eye.
Serotonin, a neurotransmitter, is synthesized using which amino acid?
C. Tryptophan is the sole precursor for the synthesis of serotonin. We acquire this amino acid through our diet only.
C. Tryptophan is the sole precursor for the synthesis of serotonin. We acquire this amino acid through our diet only.
A child presents to the office with complaints of blurred vision. Subjective refraction reveals a refractive error of +4.00 -0.75 x 180. Cycloplegic refraction results in +7.00 -1.00 x 180. What are the latent and manifest hyperopia, respectively?
D. Latent hyperopia (refractive error that is correctable with accommodation) is +3.00 D. Manifest hyperopia (refractive error that is present in subjective refraction) is +4.00 D.
D. Latent hyperopia (refractive error that is correctable with accommodation) is +3.00 D. Manifest hyperopia (refractive error that is present in subjective refraction) is +4.00 D.
Which of the following statements regarding Timolol is INCORRECT?
C. Timolol may mask the signs of HYPOglycemia in Diabetic patients. Timolol is also known to mask signs and symptoms of hypothyroidism as well as increasing symptoms of muscle weakness in patients with myasthenia gravis. Long term drift describes an increase of IOP after chronic use of Timolol. Short term escape is an initial lowering of IOP before no longer having an effect. D describes the “crossover” effect.
C. Timolol may mask the signs of HYPOglycemia in Diabetic patients. Timolol is also known to mask signs and symptoms of hypothyroidism as well as increasing symptoms of muscle weakness in patients with myasthenia gravis. Long term drift describes an increase of IOP after chronic use of Timolol. Short term escape is an initial lowering of IOP before no longer having an effect. D describes the “crossover” effect.
Which of the following vitamins is NOT soluble in fat?
E. Vitamin C is soluble in water. To recall, “DEAK” are the four fat soluble vitamins.
E. Vitamin C is soluble in water. To recall, “DEAK” are the four fat soluble vitamins.
Which of the following muscles is responsible for spontaneous and reflex blinking?
A: The palpebral portion of the orbicularis oculi is responsible for spontaneous and reflex blinking. Voluntary blinking also includes the orbital portion of the orbicularis oculi
A: The palpebral portion of the orbicularis oculi is responsible for spontaneous and reflex blinking. Voluntary blinking also includes the orbital portion of the orbicularis oculi
Which of the following is an associated finding of Trachoma?
C. Along with Arlt’s lines other common findings in Trachoma include both follicular and papillary reactions of the palpebral conjunctiva, PAN, and potential SEIs. Dennie’s line are extra creases in adnexal skin in Atopic Dermatitis. Scheie’s line describes pigment in pigment dispersion syndrome. Stocker’s line represents the leading of a pterygium.The Hudson-Stahli line is iron deposition within the cornea that normally occurs with age.
C. Along with Arlt’s lines other common findings in Trachoma include both follicular and papillary reactions of the palpebral conjunctiva, PAN, and potential SEIs. Dennie’s line are extra creases in adnexal skin in Atopic Dermatitis. Scheie’s line describes pigment in pigment dispersion syndrome. Stocker’s line represents the leading of a pterygium.The Hudson-Stahli line is iron deposition within the cornea that normally occurs with age.
A patient is experiencing an asthma attack in your office. Which of the following medications needs to be administered?
B. Albuterol is a short acting Beta-2 agonist used as a rescue inhaler for Asthma and COPD. Other short acting agonists include Levalbuterol, Terbutaline, Metaproterenol (no longer used due to excessive cardiovascular effects) and Isoproterenol (nonspecific Beta agonist used in treatment of arrhythmias). Salmeterol is a long acting Beta-2 agonist used in maintenance therapy of the above conditions.
B. Albuterol is a short acting Beta-2 agonist used as a rescue inhaler for Asthma and COPD. Other short acting agonists include Levalbuterol, Terbutaline, Metaproterenol (no longer used due to excessive cardiovascular effects) and Isoproterenol (nonspecific Beta agonist used in treatment of arrhythmias). Salmeterol is a long acting Beta-2 agonist used in maintenance therapy of the above conditions.
Internuclear ophthalmoplegia is characterized by:
A. An INO is caused by a lesion of the medial longitudinal fasciculus (MLF). The MLF is responsible for coordinating the conjugate movement of eyes with associated head/neck movements. A lesion to the MLF causes an INO – loss of ipsilateral adduction and a contralateral nystagmus.
A. An INO is caused by a lesion of the medial longitudinal fasciculus (MLF). The MLF is responsible for coordinating the conjugate movement of eyes with associated head/neck movements. A lesion to the MLF causes an INO – loss of ipsilateral adduction and a contralateral nystagmus.
You conduct caloric testing on a patient in office. You slowly pour warm water into the patient’s left ear. In which direction will the eye move during the fast phase of the induced nystagmus in a patient with a functional vestibular system?
C. To the LEFT. Recall COWS – cold = opposite, warm = same. As we know nystagmus is named by the fast phase (not the slow fixation period). Thus, since the nystagmus is in the same direction with warm water, we know it is to the left.
C. To the LEFT. Recall COWS – cold = opposite, warm = same. As we know nystagmus is named by the fast phase (not the slow fixation period). Thus, since the nystagmus is in the same direction with warm water, we know it is to the left.
Which of the following regarding Vernal Keratoconjunctivitis is FALSE?
A. Cobblestone papillae are found on the UPPER palpebral conjunctiva. VKC is a form of seasonal allergies that most often affects young males. These young males present with complaints of intense itching and photophobia. Slit lamp examination reveals cobblestone papillae of the upper lid, trantas dots with gelatinous masses at the limbus, and redness of the eye. In extreme cases, epithelial keratitis leads to thinning and eventual ulceration of cornea – a shield ulcer.
A. Cobblestone papillae are found on the UPPER palpebral conjunctiva. VKC is a form of seasonal allergies that most often affects young males. These young males present with complaints of intense itching and photophobia. Slit lamp examination reveals cobblestone papillae of the upper lid, trantas dots with gelatinous masses at the limbus, and redness of the eye. In extreme cases, epithelial keratitis leads to thinning and eventual ulceration of cornea – a shield ulcer.
Which of the following findings are associated with NF1? (PICK 3)
A,B,D: The classic triad of Neurofibromatosis 1 includes cafe au lait spots, neurofibromas, and iris Lisch nodules. It is important to examine a patient for these signs in the presence of at least one of these findings. Other findings may include optic nerve gliomas and congenital glaucoma.
A,B,D: The classic triad of Neurofibromatosis 1 includes cafe au lait spots, neurofibromas, and iris Lisch nodules. It is important to examine a patient for these signs in the presence of at least one of these findings. Other findings may include optic nerve gliomas and congenital glaucoma.
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.
Which of the following conditions is caused by incomplete closure of the fetal fissure?
B. An optic nerve coloboma is caused by the incomplete closure of the fetal fissure during development. The degree of visual impairment varies depending on severity and location. The defect is most commonly located in the inferior nasal region of the disc.
B. An optic nerve coloboma is caused by the incomplete closure of the fetal fissure during development. The degree of visual impairment varies depending on severity and location. The defect is most commonly located in the inferior nasal region of the disc.
Which of the following signs would you NOT expect to find in Histoplasmosis?
B. Histoplasmosis does NOT cause vitritis. This is one major distinguishing factor when comparing to toxoplasmosis. Histoplasmosis is a fungal infection that is common to the Ohio-Mississippi River Valley.
B. Histoplasmosis does NOT cause vitritis. This is one major distinguishing factor when comparing to toxoplasmosis. Histoplasmosis is a fungal infection that is common to the Ohio-Mississippi River Valley.
Which of the following topical drugs has the longest mydriatic effect?
B. Of the options, Scopolamine has the longest mydriatic effect. Recall, ASH CiTy for length of cycloplegia and mydriasis with the cholinergic antagonists.
B. Of the options, Scopolamine has the longest mydriatic effect. Recall, ASH CiTy for length of cycloplegia and mydriasis with the cholinergic antagonists.
A patient presents with a congruous, homonymous hemianopia of the superior temporal visual field of both eyes. Where is the lesion most likely located?
C. The lesion is most likely located in the temporal lobe. To recall, think “pie in the sky”. If these findings were in the inferior field, it is suggestive of a lesion in the parietal lobe.
C. The lesion is most likely located in the temporal lobe. To recall, think “pie in the sky”. If these findings were in the inferior field, it is suggestive of a lesion in the parietal lobe.
Which of the following medications can lead to development of Reye’s Syndrome when given to young children?
C. Aspirin use in children leads to the development of Reye’s syndrome – a rapid degenerative brain disease that is marked with confusion, seizures, and multi-organ failure.
C. Aspirin use in children leads to the development of Reye’s syndrome – a rapid degenerative brain disease that is marked with confusion, seizures, and multi-organ failure.
All of the following medications are used in treatment of Tuberculosis, EXCEPT:
C. Pyrimethamine is NOT used in treatment of Tuberculosis. It is important to note that Isoniazid and Rifampin can be used in isolation for treatment of Latent TB. Active TB is treated with a combination of the RIPE medications.
C. Pyrimethamine is NOT used in treatment of Tuberculosis. It is important to note that Isoniazid and Rifampin can be used in isolation for treatment of Latent TB. Active TB is treated with a combination of the RIPE medications.
A concave glass surface of index 1.50 has a power of -12.00D in air. What is the dioptric power of the glass surface if it is placed under water (n = 1.33)?
B. -4.08 D. You must first determine r by using the equation [Fair = -12.00 D = (1.50 – 1) / r]. You determine that r = -0.0417m. Using the new equation [Fwater = (1.50 – 1.33) / -0.0417m].
B. -4.08 D. You must first determine r by using the equation [Fair = -12.00 D = (1.50 – 1) / r]. You determine that r = -0.0417m. Using the new equation [Fwater = (1.50 – 1.33) / -0.0417m].
Which of the following medications used in treatment of Diabetes Mellitus does NOT cause hypoglycemia?
A. Metformin is the only known DM drug that does not cause hypoglycemia. For this reason, Metformin is considered first line therapy for T2DM.
A. Metformin is the only known DM drug that does not cause hypoglycemia. For this reason, Metformin is considered first line therapy for T2DM.
Where is the sclera thinnest?
C: The sclera is thinnest at recti muscle insertions with a thickness of about 0.3mm. The thickest is the posterior pole at about 1mm.
C: The sclera is thinnest at recti muscle insertions with a thickness of about 0.3mm. The thickest is the posterior pole at about 1mm.
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.
A patient presents with an eye that is “down and out” with a fixed dilated pupil. What is the most likely cause of this presentation?
C. An aneurysm is the most likely cause of this CN3 palsy. The fixed, dilated pupil is indicative of a compressive CN 3 palsy. As the pupillary fibers course along the outside of cranial nerve 3, any growth, lesion, or pressure on the outside of the nerve will prevent the pupil from constricting. Vascular diseases affect the nerve from the inside and spare the pupillary fibers. HSV is more often correlated with Bell’s Palsy.
C. An aneurysm is the most likely cause of this CN3 palsy. The fixed, dilated pupil is indicative of a compressive CN 3 palsy. As the pupillary fibers course along the outside of cranial nerve 3, any growth, lesion, or pressure on the outside of the nerve will prevent the pupil from constricting. Vascular diseases affect the nerve from the inside and spare the pupillary fibers. HSV is more often correlated with Bell’s Palsy.
A patient is experiencing an opioid overdose in the waiting room. Which of the following medications must be given stat to reverse these effects?
A. Naloxone, also known as Narcan, is administered to those experiencing an opioid overdose. Narcan acts as an opioid antagonist to reverse effects.
A. Naloxone, also known as Narcan, is administered to those experiencing an opioid overdose. Narcan acts as an opioid antagonist to reverse effects.
What is the most common cause of ectropion?
B. Involutional. The most common cause of ectropion is a laxity of the muscles needed to adhere the lid to the globe that develops with age. Congenital and Cicatricial are quite rare in occurrence. Paralytic ectropion is caused by Bell’s Palsy.
B. Involutional. The most common cause of ectropion is a laxity of the muscles needed to adhere the lid to the globe that develops with age. Congenital and Cicatricial are quite rare in occurrence. Paralytic ectropion is caused by Bell’s Palsy.
Which of the four Purkinje images is real and inverted?
D. Purkinje image IV is the only image that is real and inverted. The remaining three are virtual and upright.
D. Purkinje image IV is the only image that is real and inverted. The remaining three are virtual and upright.
Which of the following are considered second generation Fluoroquinolones? (PICK 2)
A/D. Both Ciprofloxacin and Ofloxacin are second generation Fluoroquinolones. Recall “CO2” for second generation and “Three LEVO clover” for third generation. There are no first generation Fluoroquinolones. This information is important as second generation target Gram Negative bacteria while later generations could be used to target both Negative and Positive.
A/D. Both Ciprofloxacin and Ofloxacin are second generation Fluoroquinolones. Recall “CO2” for second generation and “Three LEVO clover” for third generation. There are no first generation Fluoroquinolones. This information is important as second generation target Gram Negative bacteria while later generations could be used to target both Negative and Positive.
Which eye movement has the shortest latency?
A. The vestibulo-ocular reflex has the shortest latency of all eye movements with a latency of 15msec. The purpose of the VOR is to stabilize the retinal image as the head moves so it must occur quickly.
A. The vestibulo-ocular reflex has the shortest latency of all eye movements with a latency of 15msec. The purpose of the VOR is to stabilize the retinal image as the head moves so it must occur quickly.
A patient presents with the following glasses prescription: +2.00 -3.00 x 090. What is the power in the 180 meridian?
D. The power in the 180 meridian is -1.00. On an optical cross, +2.00DS falls on the 90 meridian. Subtract the astigmatic difference of -3.00 to find the resulting -1.00DS.
D. The power in the 180 meridian is -1.00. On an optical cross, +2.00DS falls on the 90 meridian. Subtract the astigmatic difference of -3.00 to find the resulting -1.00DS.
All the following test the accuracy of accommodative response, EXCEPT:
B. The minus lens test is the only option that does not measure accuracy but instead measures amplitude.
B. The minus lens test is the only option that does not measure accuracy but instead measures amplitude.
Which of the following medications is commonly used in treatment of Parkinsons?
C. Bromocriptine, a dopamine agonist, is commonly used in treatment of Parkinsons. Amantadine is also considered a dopamine agonist used to treat Parkinsons.
C. Bromocriptine, a dopamine agonist, is commonly used in treatment of Parkinsons. Amantadine is also considered a dopamine agonist used to treat Parkinsons.
You are conducting Worth 4 Dot testing in a bright room. The young patient reports seeing two red dots to the left of three green lights. If the red lens is over the right eye, what is your conclusion?
D. Crossed diplopia. Recall that the right eye sees the red dots and the left eye sees the green dots. If the red dots were located to the right of the green, that is considered uncrossed (or ESO) diplopia. Red dots above or below the green are indicative of a hypertropia. A patient reporting only one set of lights indicates suppression of either eye. A report of 4 dots is what we hope for.
D. Crossed diplopia. Recall that the right eye sees the red dots and the left eye sees the green dots. If the red dots were located to the right of the green, that is considered uncrossed (or ESO) diplopia. Red dots above or below the green are indicative of a hypertropia. A patient reporting only one set of lights indicates suppression of either eye. A report of 4 dots is what we hope for.
What is the power of a thin lens made of Crown glass in air with a front radius of curvature of 4 cm (with a convex surface) and back radius of curvature of 2 cm (with a concave surface)?
C. The power of the thin, Crown glass lens (n = 1.523) is -13.08 D. First draw a picture of this image (should look like two “C”s). First find F1 = (n2 – n1)/r, then F2 with the same equation. Done correctly will result in F1 = +13.075 D; F2 = -26.15 D; F = F1 + F2 → F = 13.075 + (-26.15) = -13.075 D.
C. The power of the thin, Crown glass lens (n = 1.523) is -13.08 D. First draw a picture of this image (should look like two “C”s). First find F1 = (n2 – n1)/r, then F2 with the same equation. Done correctly will result in F1 = +13.075 D; F2 = -26.15 D; F = F1 + F2 → F = 13.075 + (-26.15) = -13.075 D.
_________ is the process by which complement proteins bind to an antigen to trigger phagocytosis of the cell.
B. Opsonization is the process by which complement proteins cover an antigen to initiate the immune system. Opsons alert the immune system to phagocytose the target cell.
B. Opsonization is the process by which complement proteins cover an antigen to initiate the immune system. Opsons alert the immune system to phagocytose the target cell.
Which of the following statements regarding the glycocalyx is INCORRECT?
C. The glycocalyx is found on the APICAL portion of the microvilli of the cornea. The glycocalyx is responsible for keeping the mucin layer adhered to the corneal surface.
C. The glycocalyx is found on the APICAL portion of the microvilli of the cornea. The glycocalyx is responsible for keeping the mucin layer adhered to the corneal surface.
A child demonstrating an understanding of object permanence indicates that the child has entered which developmental stage according to Piaget?
B. According to Piaget, object permanence indicates the beginning of the pre-operational stage (2-7 years). There are four stages: sensorimotor (0-2 years), pre-operational (2-7 years), concrete operations (7-12), and formal operations (12 years and older). Object permanence is the knowledge that an object still exists even if it is not in the same room.
B. According to Piaget, object permanence indicates the beginning of the pre-operational stage (2-7 years). There are four stages: sensorimotor (0-2 years), pre-operational (2-7 years), concrete operations (7-12), and formal operations (12 years and older). Object permanence is the knowledge that an object still exists even if it is not in the same room.
You measure a pair of spectacles using a manual lensometer. Your first reading is +1.00 D at the 90 meridian. Your second reading is -2.00 D. What is the final prescription?
D. The correct answer is +1.00 -3.00 x 090. Although cylinder lines are cleared at -2.00 D, the difference between both meridians is the DC of the prescription.
D. The correct answer is +1.00 -3.00 x 090. Although cylinder lines are cleared at -2.00 D, the difference between both meridians is the DC of the prescription.
Which of the following medications is a potent reverse transcriptase inhibitor used in the treatment of HIV?
B. Zidovudine, also known as Retrovir, inhibits the viral RNA-dependent, DNA polymerase responsible for reverse transcription. RIbavirin is used in treatment of Hepatitis C. Foscarnet is used in treatment of CMV that is not responding to other antivirals. Natamycin is an antifungal.
B. Zidovudine, also known as Retrovir, inhibits the viral RNA-dependent, DNA polymerase responsible for reverse transcription. RIbavirin is used in treatment of Hepatitis C. Foscarnet is used in treatment of CMV that is not responding to other antivirals. Natamycin is an antifungal.
What is the mechanism of action of Sildenafil?
C. Sildenafil, also known as Viagra, functions by inhibiting phosphodiesterase-5 (PDE-5). PDE-5 breaks down cGMP which will lead to weakening of smooth muscle.
C. Sildenafil, also known as Viagra, functions by inhibiting phosphodiesterase-5 (PDE-5). PDE-5 breaks down cGMP which will lead to weakening of smooth muscle.
The ANSI Z87.1 Safety Standard for high mass impact is measured using which of the following? (PICK 3)
A,C,D: There are two definitions within the ANSI Z87.1 Safety Standard for Impact: high mass impact and high velocity impact. High mass impact is the drop ball test. This test requires a pointed projectile that weighs 500g dropped from 50 inches. The high velocity impact is assessed using a 0.25 inch diameter steel ball fired at 150 feet per second.
A,C,D: There are two definitions within the ANSI Z87.1 Safety Standard for Impact: high mass impact and high velocity impact. High mass impact is the drop ball test. This test requires a pointed projectile that weighs 500g dropped from 50 inches. The high velocity impact is assessed using a 0.25 inch diameter steel ball fired at 150 feet per second.
Which law states that agonist and antagonist extraocular muscles of the SAME EYE are innervated at the same time?
D. Sherrington’s Law states that reciprocal muscles in the SAME eye will both be innervated to provide stability of eye position and gaez. Hering’s law states that yoked muscles in both eyes will receive equal innervation. Donder’s and Listing’s refer to unique orientations of the eye in space and how the eye achieves these positions.
D. Sherrington’s Law states that reciprocal muscles in the SAME eye will both be innervated to provide stability of eye position and gaez. Hering’s law states that yoked muscles in both eyes will receive equal innervation. Donder’s and Listing’s refer to unique orientations of the eye in space and how the eye achieves these positions.
A patient presents with complaints of blurred vision while reading. You see he is wearing a pair of bifocals and that the seg height appears too low. What adjustment can you make to adjust the spectacles?
B. You can increase the seg height by any of the following: narrow the pads, move pads down, increase vertex distance, reduce pantoscopic tilt, or shrink the bridge. Consider the opposite in cases where the seg height appears too high.
B. You can increase the seg height by any of the following: narrow the pads, move pads down, increase vertex distance, reduce pantoscopic tilt, or shrink the bridge. Consider the opposite in cases where the seg height appears too high.
During extraocular muscle testing, you note a small oscillation of the eyes in far left gaze. This is an example of which type of nystagmus?
B. End-point nystagmus is noted in extreme position of gaze. It is not noted at other times. Caloric nystagmus refers to the use of warm or cold water to induce eye movement. Optokinetic is related to viewing fast moving or rotating objects as the eye attempts to fixate a target. Rotational refers to rotation of the individual’s body. Latent refers to nystagmus that appears when one eye is occluded.
B. End-point nystagmus is noted in extreme position of gaze. It is not noted at other times. Caloric nystagmus refers to the use of warm or cold water to induce eye movement. Optokinetic is related to viewing fast moving or rotating objects as the eye attempts to fixate a target. Rotational refers to rotation of the individual’s body. Latent refers to nystagmus that appears when one eye is occluded.
Which of the following lens materials causes the most dispersion of light leading to increased chromatic aberrations?
B. Polycarbonate has the lowest Abbe value of all these options. Abbe value is inversely proportional to the level of chromatic aberrations. In other words, the higher the Abbe value, a lower amount of chromatic aberrations will be induced.
B. Polycarbonate has the lowest Abbe value of all these options. Abbe value is inversely proportional to the level of chromatic aberrations. In other words, the higher the Abbe value, a lower amount of chromatic aberrations will be induced.
A 15yo male presents with severely reduced vision with central visual field loss in both eyes. Dilated fundus exam reveals bilateral optic atrophy and presence of telangiectasia. What is the most likely etiology of this condition?
C. The above most accurately describes Leber’s hereditary optic neuropathy – transmitted through maternal inheritance. A single AA base substitution can describe many conditions including, but not limited to, Sickle Cell anemia. Abnormal collagen synthesis may lead to changes in vision due to corneal malformation and weakness of lamina cribrosa. Neither Trisomy 21 (Down Syndrome) nor Turner Syndrome (absent X) are known to cause these findings.
C. The above most accurately describes Leber’s hereditary optic neuropathy – transmitted through maternal inheritance. A single AA base substitution can describe many conditions including, but not limited to, Sickle Cell anemia. Abnormal collagen synthesis may lead to changes in vision due to corneal malformation and weakness of lamina cribrosa. Neither Trisomy 21 (Down Syndrome) nor Turner Syndrome (absent X) are known to cause these findings.
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 lens clock in air is calibrated for glass of index 1.53. The clock reads +6.00 D when it is placed on a spherical convex surface with an index of 1.66. What is the true dioptric power of the surface in air?
C. The true power is +7.47 D. To solve, first determine r using the clock reading: [Flc = +6.00 D = (1.53 – 1) / r; r = +0.08833m. Now solve for true with Flens = (1.66 – 1) / r = 0.66/0.08833 = +7.47 D)
C. The true power is +7.47 D. To solve, first determine r using the clock reading: [Flc = +6.00 D = (1.53 – 1) / r; r = +0.08833m. Now solve for true with Flens = (1.66 – 1) / r = 0.66/0.08833 = +7.47 D)
Acetylcysteine, a drug commonly used in treatment of Filamentary Keratitis, functions by breaking ______ bonds in proteins of mucus
A. Acetylcysteine, also known as Mucomyst, functions by breaking disulfide bonds. This medication is also used in treatment of severe dry eye disease and corneal burns.
A. Acetylcysteine, also known as Mucomyst, functions by breaking disulfide bonds. This medication is also used in treatment of severe dry eye disease and corneal burns.
A patient presents with complaints of sharp pain in her eye. Her IOP readings are 50mmHg OD and 15mmHg OS. What is the greatest risk to this patient’s vision?
B. The greatest threat to the patient’s vision is a CRAO. Elevated IOP leads to reversal of blood flow due to the change in perfusion pressure. Ischemic damage from CRAO is irreversible.
B. The greatest threat to the patient’s vision is a CRAO. Elevated IOP leads to reversal of blood flow due to the change in perfusion pressure. Ischemic damage from CRAO is irreversible.
Which of the following medications is known to cause the sclera to appear blue?
B. Minocycline may cause a blue sclera. Other causes of a blue sclera include Scleromalacia Perforans, chronic topical steroid use, and thin scleras in newborn infants.
B. Minocycline may cause a blue sclera. Other causes of a blue sclera include Scleromalacia Perforans, chronic topical steroid use, and thin scleras in newborn infants.
An astigmatic patient states the 2 o’clock and 8 o’clock lines are the most clear on a clock dial. What axis does this indicate?
D. The correct answer should be 60 since the clock dial equation is (lower number on the clock x30) which will give you in this case (2×30=60 degrees)
What is the Procedure of using a Lens Clock?
1) Multiply the smaller number (the lower number is always the number used in the clock dial equation) by 30 degree to find the orientation of the minus cylinder axis
D. The correct answer should be 60 since the clock dial equation is (lower number on the clock x30) which will give you in this case (2×30=60 degrees)
What is the Procedure of using a Lens Clock?
1) Multiply the smaller number (the lower number is always the number used in the clock dial equation) by 30 degree to find the orientation of the minus cylinder axis
Which of the following statements is FALSE regarding hyphemas?
B. It is imperative you DO NOT perform gonio or scleral depression until at least 1 month post-injury to avoid rebleeds. The most common cause of a hyphema is trauma so be sure to assess for iris sphincter tears, iridodialysis, rosette cataracts, lens subluxation, and other common traumatic findings.
B. It is imperative you DO NOT perform gonio or scleral depression until at least 1 month post-injury to avoid rebleeds. The most common cause of a hyphema is trauma so be sure to assess for iris sphincter tears, iridodialysis, rosette cataracts, lens subluxation, and other common traumatic findings.
All of the following medications may cause pseudotumor cerebri, EXCEPT
E. Naloxone is not known to cause PTC (otherwise known as Idiopathic Intracranial Hypertension). To recall, “SCANT” or “CATS-N”: Synthroid, Contraceptives, Accutane, Nalidixic Acid (in kids), Tetracyclines”
E. Naloxone is not known to cause PTC (otherwise known as Idiopathic Intracranial Hypertension). To recall, “SCANT” or “CATS-N”: Synthroid, Contraceptives, Accutane, Nalidixic Acid (in kids), Tetracyclines”
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.
The low frequency cut off of the contrast sensitivity function is due to which of the following?
C. The low frequency cut off is due to lateral inhibition in the retina. Lateral inhibition is produced by the interneurons: horizontal and amacrine cells. The high frequency cut off is due to optical aberrations and photoreceptor spacing.
C. The low frequency cut off is due to lateral inhibition in the retina. Lateral inhibition is produced by the interneurons: horizontal and amacrine cells. The high frequency cut off is due to optical aberrations and photoreceptor spacing.
Which of the following drug classes is CORRECTLY paired with its mechanism of action in treatment of Glaucoma?
C. Beta blockers reduce IOP by decreasing aqueous production. Cholinergic agonist (i.e.Pilocarpine) affects IOP by increasing corneoscleral outflow. Alpha agonists both decrease aqueous production and increase uveoscleral outflow. CAIs decrease aqueous production. PGs increase uveoscleral outflow.
C. Beta blockers reduce IOP by decreasing aqueous production. Cholinergic agonist (i.e.Pilocarpine) affects IOP by increasing corneoscleral outflow. Alpha agonists both decrease aqueous production and increase uveoscleral outflow. CAIs decrease aqueous production. PGs increase uveoscleral outflow.
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 drugs may cause aplastic anemia? (PICK 3)
A/C/D. The three medications that may cause aplastic anemia include: Acetazolamide, Methazolamide, and Chloramphenicol. Additionally, Trimethoprim, Pyrimethamine and Methotrexate may also cause aplastic anemia.
A/C/D. The three medications that may cause aplastic anemia include: Acetazolamide, Methazolamide, and Chloramphenicol. Additionally, Trimethoprim, Pyrimethamine and Methotrexate may also cause aplastic anemia.
All of the following are classic symptoms of Parkinson’s Disease EXCEPT:
B. Dementia is not a classic sign of Parkinson’s. To recall the signs, think of the mnemonic TRAP – Tremor at rest, Rigidity, Akinesia, and Postural instability.
B. Dementia is not a classic sign of Parkinson’s. To recall the signs, think of the mnemonic TRAP – Tremor at rest, Rigidity, Akinesia, and Postural instability.
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.
A patient presents with distance refraction of +5.00 D. Accommodative testing reveals amplitude of accommodation of +2.00 D. What are the absolute and facultative hyperopia, respectively?
C. Absolute hyperopia (hyperopia that cannot be neutralized with accommodation alone) is +3.00 D; the difference between the two values. Facultative hyperopia (amount of hyperopia neutralized by accommodation) is +2.00D; the total accommodative ability.
C. Absolute hyperopia (hyperopia that cannot be neutralized with accommodation alone) is +3.00 D; the difference between the two values. Facultative hyperopia (amount of hyperopia neutralized by accommodation) is +2.00D; the total accommodative ability.
Which of the following conditions are associated with nyctalopia? (PICK 3)
B,C,E: RP, Gyrate atrophy, and choroideremia lead to complaints of poor night vision (nyctalopia). Night blindness is a consequence of damage to the rod photoreceptors in the retina. It is important to note that nyctalopia is not limited to these three conditions.
B,C,E: RP, Gyrate atrophy, and choroideremia lead to complaints of poor night vision (nyctalopia). Night blindness is a consequence of damage to the rod photoreceptors in the retina. It is important to note that nyctalopia is not limited to these three conditions.
Topiramate is commonly used in the treatment of what condition?
C. Topiramate is clinically indicated for treatment of epilepsy to prevent seizures. It is important to know this medication as it may lead to blurred vision, diplopia, and nystagmus. More severe adverse effects include choroidal swelling leading to a myopic shift and acute angle closure glaucoma.
C. Topiramate is clinically indicated for treatment of epilepsy to prevent seizures. It is important to know this medication as it may lead to blurred vision, diplopia, and nystagmus. More severe adverse effects include choroidal swelling leading to a myopic shift and acute angle closure glaucoma.
Which of the following tests can be used to measure eccentric fixation?
B. Maxwell’s spot, as well as visuoscopy and Hidinger’s brush, are used to measure eccentric fixation. 4 BO test is used for ocular alignment, such as in microstrabismus syndrome. Bagolini lenses are used for ARC. W4D is used for sensory status.
B. Maxwell’s spot, as well as visuoscopy and Hidinger’s brush, are used to measure eccentric fixation. 4 BO test is used for ocular alignment, such as in microstrabismus syndrome. Bagolini lenses are used for ARC. W4D is used for sensory status.
Which of the following receptor types are involved in development of Glaucoma? (PICK 2)
A/D. Alpha 1 and Beta 2 receptors in the eye are the targets for topical glaucoma meds. B1 receptors are located in the heart. Alpha 2 are located in the brain and peripheral nerves.
A/D. Alpha 1 and Beta 2 receptors in the eye are the targets for topical glaucoma meds. B1 receptors are located in the heart. Alpha 2 are located in the brain and peripheral nerves.
Which of the following statements is FALSE regarding rigid, gas-permeable 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.
In which of the following would you expect to find telangiectasia? (PICK 3)
A,B,D: Telangiectasia is a critical finding in Coat’s, BCC, and ocular rosacea. Although these may begin to appear as we age, it is important to rule out these conditions on assessment. Molluscum appears as an umbilicated nodule without telangiectasia.
A,B,D: Telangiectasia is a critical finding in Coat’s, BCC, and ocular rosacea. Although these may begin to appear as we age, it is important to rule out these conditions on assessment. Molluscum appears as an umbilicated nodule without telangiectasia.
Which of the following is NOT expected of a person going into anaphylactic shock?
E. One would not expect bronchodilation but rather bronchospasm. The list of signs of anaphylactic shock include, but not limited to: hypotension, tachycardia, sneezing, itching, wheezing, bronchospasm, nausea, vomiting, diarrhea, urticaria, pruritus, headache, syncope, and/or seizure.
E. One would not expect bronchodilation but rather bronchospasm. The list of signs of anaphylactic shock include, but not limited to: hypotension, tachycardia, sneezing, itching, wheezing, bronchospasm, nausea, vomiting, diarrhea, urticaria, pruritus, headache, syncope, and/or seizure.
All of the following are possible side effects of Hydrochlorothiazide, EXCEPT:
B. It is not a HYPEROPIC shift but rather a MYOPIC shift. The remaining options are correct. Of note, the dry eye is from decreased secretion from the lacrimal gland.
B. It is not a HYPEROPIC shift but rather a MYOPIC shift. The remaining options are correct. Of note, the dry eye is from decreased secretion from the lacrimal gland.
Combigan, a glaucoma topical medication, is a combination of which two topical drugs?
B. Combigan is composed of Timolol (B-blocker) and Brimonidine (Alpha agonist). Cosopt is a combination of Timolol (B-blocker) and Dorzolamide (CAI). Latanoprost (PG) and Netarsudil (Rho Kinase inhibitor) make up a newer glaucoma medication, Rhopressa. Brinzolamide (CAI) and Brimonidine (Alpha agonist) compose Simbrinza.
B. Combigan is composed of Timolol (B-blocker) and Brimonidine (Alpha agonist). Cosopt is a combination of Timolol (B-blocker) and Dorzolamide (CAI). Latanoprost (PG) and Netarsudil (Rho Kinase inhibitor) make up a newer glaucoma medication, Rhopressa. Brinzolamide (CAI) and Brimonidine (Alpha agonist) compose Simbrinza.
How does the osmotic gradient lead to aqueous humor production?
B. This is an example of active secretion.
B. This is an example of active secretion.
A patient presents with a pharmacologically dilated pupil and reduced visual acuity. The patient’s acuity is limited by which of the following?
B. Spherical aberrations are the cause of distortion and reduced acuity in a dilated pupil. Small, miotic pupils are affected by diffraction although miotic pupils do increase depth of focus.
B. Spherical aberrations are the cause of distortion and reduced acuity in a dilated pupil. Small, miotic pupils are affected by diffraction although miotic pupils do increase depth of focus.
Of the following refractive errors, which is most likely to develop into amblyopia if left untreated?
D is the correct response, having hyperopic aniso > 1.00
Diopter can lead to amblyopia in the eye with higher prescription, in this case OS which is +7.00.
Norms include:
ANISO: H >1.00, A >1.50, M >3.00; ISO: H >5, A >2.50, M >8.
D is the correct response, having hyperopic aniso > 1.00
Diopter can lead to amblyopia in the eye with higher prescription, in this case OS which is +7.00.
Norms include:
ANISO: H >1.00, A >1.50, M >3.00; ISO: H >5, A >2.50, M >8.
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 mechanism of action of Nexium – a drug commonly used in the treatment of GERD?
C. Nexium and its sister drug Prilosec are classified as Proton Pump Inhibitors. PPIs function by inhibiting H+/K+ ATPase proton pumps.These medications are used in treatment of peptic ulcer disease and GERD.
C. Nexium and its sister drug Prilosec are classified as Proton Pump Inhibitors. PPIs function by inhibiting H+/K+ ATPase proton pumps.These medications are used in treatment of peptic ulcer disease and GERD.
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.
Which of the following topical drugs works by inhibiting T-cell activation by stopping production of interleukin-2?
A. Restasis, used in the treatment of dry eye, works by ceasing production of IL-2 leading to inhibition of T-cell activation. This is one of the final steps of the dry eye cascade.
A. Restasis, used in the treatment of dry eye, works by ceasing production of IL-2 leading to inhibition of T-cell activation. This is one of the final steps of the dry eye cascade.
Which of the following medications inhibit bacterial synthesis by binding the 50s subunit of bacterial ribosomes?
C. Azithromycin is classified as a Macrolide. Recall “Buy AT 30, CEL at 50”. CEL stands for Chloramphenicol, Erythromycin (Macrolides), and Lincomycin. These meds target the 50s subunit. Doxycycline and Gentamicin target the 30s subunit. Sulfacetamide is a sulfonamide that inhibits DHP synthase.
C. Azithromycin is classified as a Macrolide. Recall “Buy AT 30, CEL at 50”. CEL stands for Chloramphenicol, Erythromycin (Macrolides), and Lincomycin. These meds target the 50s subunit. Doxycycline and Gentamicin target the 30s subunit. Sulfacetamide is a sulfonamide that inhibits DHP synthase.
If the furthest distance a patient can see clearly is 50 cm in front of the eye, what is the refractive correction you expect this patient will need?
E. -2.00 D. A far point that is reduced from infinity is more indicative for myopia. Using the equation 1/0.5m = 2.00 D. A +2.00 eye requires -2.00 D to return the far point to infinity.
E. -2.00 D. A far point that is reduced from infinity is more indicative for myopia. Using the equation 1/0.5m = 2.00 D. A +2.00 eye requires -2.00 D to return the far point to infinity.
All of the following medications must be taken with an empty stomach, EXCEPT:
B. Doxycycline must be digested after eating/with food. To recall, “PAT your stomach” for drug classes that must be taken with an empty stomach and include: Penicillins, Azithromycin (Macrolides), and Tetracycline. This is a trick question as Doxycycline, a Tetracycline, is the one exception that must be taken with food.
B. Doxycycline must be digested after eating/with food. To recall, “PAT your stomach” for drug classes that must be taken with an empty stomach and include: Penicillins, Azithromycin (Macrolides), and Tetracycline. This is a trick question as Doxycycline, a Tetracycline, is the one exception that must be taken with food.
You perform retinoscopy on a patient with astigmatism. You neutralize the vertical meridian at +2.00 D and the horizontal meridian at +1.50 D. Your working distance is 50 cm. What is the patient’s refractive error?
C. Accounting for your working distance (50cm = -2.00 D), the 90 (or vertical) meridian is plano while the 180 (or horizontal meridian) is -0.50 D. Using the most plus meridian as the sphere, the prescription should be plano -0.50 x 090.
C. Accounting for your working distance (50cm = -2.00 D), the 90 (or vertical) meridian is plano while the 180 (or horizontal meridian) is -0.50 D. Using the most plus meridian as the sphere, the prescription should be plano -0.50 x 090.
Congenital Syphilis Triad is defined by which of the following? (PICK 3)
A,C,D: The Congenital Syphilis triad consists of Hutchinson’s teeth (small and widely spaced), deafness, and interstitial keratitis. The remaining options are associated with HSV.
A,C,D: The Congenital Syphilis triad consists of Hutchinson’s teeth (small and widely spaced), deafness, and interstitial keratitis. The remaining options are associated with HSV.
All of the following prevent histamine stimulation of gastric sedation by blocking H2 receptors, EXCEPT:
A. Loratidine is a second generation antihistamine. This question is here to demonstrate the mechanism of action of H2 blockers in treatment of stomach ulcers and acid reflux. We are also taught to remember H2 blockers from the “-tidine”. Here is one exception, do not forget on test day.
A. Loratidine is a second generation antihistamine. This question is here to demonstrate the mechanism of action of H2 blockers in treatment of stomach ulcers and acid reflux. We are also taught to remember H2 blockers from the “-tidine”. Here is one exception, do not forget on test day.
What is the clinical triad of carotid-cavernous fistula (CCF)? (PICK 3)
B,C,D: The clinical triad for CCF is chemosis, pulsatile proptosis (the globe appearing to pulse in and out of the orbit), and ocular bruit (the sound of blood “whooshing” in the eye). CCF results from an abnormal communication of the vascular system within the cavernous sinus. It is most commonly caused by head trauma and can lead to elevated IOP, diplopia, and sensation loss of the face.
B,C,D: The clinical triad for CCF is chemosis, pulsatile proptosis (the globe appearing to pulse in and out of the orbit), and ocular bruit (the sound of blood “whooshing” in the eye). CCF results from an abnormal communication of the vascular system within the cavernous sinus. It is most commonly caused by head trauma and can lead to elevated IOP, diplopia, and sensation loss of the face.
Which of the following findings is NOT indicative of a convergence insufficiency?
D. One would expect a low NRA. This is due to the reduced fusional vergence needed to keep eyes aligned. All other findings can be found in a CI patient. Other findings include: reduced positive fusional vergence, and a low lag/lead of accommodation.
D. One would expect a low NRA. This is due to the reduced fusional vergence needed to keep eyes aligned. All other findings can be found in a CI patient. Other findings include: reduced positive fusional vergence, and a low lag/lead of accommodation.
Where do orbital fractures most often occur?
A. The most common site of an orbital fracture is the maxillary bone; the posterior medial portion of the floor. The palatine and zygomatic bones are the other two bones that compose the floor of the orbit. Ethmoid and lamina papyracea are interchangeable and represent the THINNEST bone in the orbit. This bone prevents infections from moving into the sinuses.
A. The most common site of an orbital fracture is the maxillary bone; the posterior medial portion of the floor. The palatine and zygomatic bones are the other two bones that compose the floor of the orbit. Ethmoid and lamina papyracea are interchangeable and represent the THINNEST bone in the orbit. This bone prevents infections from moving into the sinuses.
“Barrel” distortion of an image is created when looking through what type of lens?
C. A barrel distortion is created by a minus lens. A plus power lens creates a pincushion effect. The other two options are distractors.
C. A barrel distortion is created by a minus lens. A plus power lens creates a pincushion effect. The other two options are distractors.
Which of the following ocular side effects are most commonly seen with topical NSAID or topical anesthetic use?
C. Corneal melts are most common with either topical NSAIDs or anesthetics. Delayed wound healing is related to steroid use. Skin darkening is a side effect of prostaglandin analogs. Follicular conjunctivitis is an uncommon finding with Brimonidine and CL solutions.
C. Corneal melts are most common with either topical NSAIDs or anesthetics. Delayed wound healing is related to steroid use. Skin darkening is a side effect of prostaglandin analogs. Follicular conjunctivitis is an uncommon finding with Brimonidine and CL solutions.
The critical period for ocular development ends at ___.
D. The Critical Period for development of clear, binocular vision is between 7 and 8 years of age. This is why it is critical to provide thorough eye examinations to young children. The earlier the diagnosis, the better outcome to treatment.
D. The Critical Period for development of clear, binocular vision is between 7 and 8 years of age. This is why it is critical to provide thorough eye examinations to young children. The earlier the diagnosis, the better outcome to treatment.
Which of the following pathways controls reflexive head movement in response to visual stimuli?
D. Trigeminothalamic pathway is responsible for reflexive head movement in response to stimuli. The medial lemniscus pathway carries information regarding touch, pressure, and vibration from the body. The spinothalamic pathway carries pain and temperature information from the body.
D. Trigeminothalamic pathway is responsible for reflexive head movement in response to stimuli. The medial lemniscus pathway carries information regarding touch, pressure, and vibration from the body. The spinothalamic pathway carries pain and temperature information from the body.
All of the following medications may lead to development of anterior subcapsular cataracts, EXCEPT:
A. Durezol, a steroid, is most likely to cause a PSC rather than ASC. To recall, “I made ‘A PACT’ with ASC”: -Azines, Pilocarpine, Amiodarone, CAIs, Trimethoprim.
A. Durezol, a steroid, is most likely to cause a PSC rather than ASC. To recall, “I made ‘A PACT’ with ASC”: -Azines, Pilocarpine, Amiodarone, CAIs, Trimethoprim.
_______ is used in newborns as a prophylaxis for Gonococcal Ophthalmia Neonatorum.
A. Erythromycin is applied topically for newborns to prevent opthalmia neonatorum.
A. Erythromycin is applied topically for newborns to prevent opthalmia neonatorum.
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.
Which of the following medications is used often in treatment of conditions such as Chalazia, Macular edema, and Grave’s Disease?
B. Triamcinolone, also known as Kenalog, is a steroid that is used in the treatment of many conditions. Including those in the questions, Kenalog is also used in treatment of Posterior Uveitis, Dermatoses, Multiple Sclerosis, and Arthritis. Chronic use can cause depigmentation of the eyelid in dark-skinned individuals.
B. Triamcinolone, also known as Kenalog, is a steroid that is used in the treatment of many conditions. Including those in the questions, Kenalog is also used in treatment of Posterior Uveitis, Dermatoses, Multiple Sclerosis, and Arthritis. Chronic use can cause depigmentation of the eyelid in dark-skinned individuals.
Which of the following is the most common primary malignant brain tumor?
A. The most common primary malignant brain tumor is the glioblastoma multiforme. Meningiomas are the most common benign brain tumor. Schwannoma are rare tumorsof the schwann cells (the myelinating cell of the peripheral nervous system). Pituitary adenomas are infamous for causing bitemporal hemianopia or junctional scotomas.Acoustic neuromas affect CN8 with some ocular manifestations.
A. The most common primary malignant brain tumor is the glioblastoma multiforme. Meningiomas are the most common benign brain tumor. Schwannoma are rare tumorsof the schwann cells (the myelinating cell of the peripheral nervous system). Pituitary adenomas are infamous for causing bitemporal hemianopia or junctional scotomas.Acoustic neuromas affect CN8 with some ocular manifestations.
All of the following are adverse effects from chronic use of Phenothiazines, EXCEPT:
B. Phenothiazines, a class of Antipsychotics, function as dopamine receptor antagonists (anti dopamine). Adverse effects include: Parkinson-like symptoms (recall TRAP), Pigmentation effects (pigment on endo, ASC, and HYPERpigmentation of RPE), Oculogyric Crisis.
B. Phenothiazines, a class of Antipsychotics, function as dopamine receptor antagonists (anti dopamine). Adverse effects include: Parkinson-like symptoms (recall TRAP), Pigmentation effects (pigment on endo, ASC, and HYPERpigmentation of RPE), Oculogyric Crisis.
Which cranial nerves exit from the pons? (PICK 2)
C, D. CN III and IV exit from the midbrain. CN V, VI, VII, VII exit from the pons. The remaining cranial nerves exit from the medulla.
C, D. CN III and IV exit from the midbrain. CN V, VI, VII, VII exit from the pons. The remaining cranial nerves exit from the medulla.
What is the mechanism of action of the drug class, Sulfonamides?
B. Sulfonamides act by inhibiting DHP synthase, the first step of folic acid synthesis. Trimethoprim, Methotrexate, and Pyrimethamine all act by inhibiting DHF reductase, the second step of folic acid synthesis. Aminoglycasides and Tetracyclines function by binding and inhibiting 30s subunits. Penicillins and Cephalosporins inhibit transpeptidase.
B. Sulfonamides act by inhibiting DHP synthase, the first step of folic acid synthesis. Trimethoprim, Methotrexate, and Pyrimethamine all act by inhibiting DHF reductase, the second step of folic acid synthesis. Aminoglycasides and Tetracyclines function by binding and inhibiting 30s subunits. Penicillins and Cephalosporins inhibit transpeptidase.
A 10 yo patient presents with complaints of double vision on lateral gaze. On examination of extraocular muscles, you note the patient cannot abduct their right eye past midline with a narrowing of palpebral aperture on adduction of the same eye. Which of the following is the most likely tentative diagnosis?
C. Duane retraction syndrome Type 1 as there is only an issue of aBDuction of the right eye. To remember, recall that you “count the D’s” to determine the diagnosis.
C. Duane retraction syndrome Type 1 as there is only an issue of aBDuction of the right eye. To remember, recall that you “count the D’s” to determine the diagnosis.
What test of color vision is able to distinguish between dichromats and anomalous trichromats?
D. The Nagel Anomaloscope is the only color vision test that is able to distinguish between dichromats and anomalous trichromats. The Farnsworth and HRR are able to diagnosis both b/y and r/g color defects but cannot distinguish between the two above. Ishihara can only diagnose red-green defects.
D. The Nagel Anomaloscope is the only color vision test that is able to distinguish between dichromats and anomalous trichromats. The Farnsworth and HRR are able to diagnosis both b/y and r/g color defects but cannot distinguish between the two above. Ishihara can only diagnose red-green defects.
All of the following are perinatal infections that cause fetal anomalies, and even death, EXCEPT:
D. LON is NOT considered a perinatal infection as it is transmitted through maternal mitochondrial DNA. The acronym for this group of infections is TORCH: Toxoplasmosis, Other (Hep B, syphilis, varicella, HIV), Rubella, Cytomegalovirus, and Herpes Simplex.
D. LON is NOT considered a perinatal infection as it is transmitted through maternal mitochondrial DNA. The acronym for this group of infections is TORCH: Toxoplasmosis, Other (Hep B, syphilis, varicella, HIV), Rubella, Cytomegalovirus, and Herpes Simplex.
In which part of the retina do detachments most often occur?
B. Most tears, holes, and detachments occur in the superior temporal region of the retina.
B. Most tears, holes, and detachments occur in the superior temporal region of the retina.
Which of the following is an irreversible, indirect cholinergic agonist used in the diagnosis and treatment of accommodative esotropia?
D. Echothiophate, an irreversible drug, is used to diagnose and treat accommodative ET. Pilocarpine is reversible and considered a direct cholinergic agonist. The “-stigmine” drugs are used in the treatment of Myasthenia Gravis. Edrophonium is used to test for MG.
D. Echothiophate, an irreversible drug, is used to diagnose and treat accommodative ET. Pilocarpine is reversible and considered a direct cholinergic agonist. The “-stigmine” drugs are used in the treatment of Myasthenia Gravis. Edrophonium is used to test for MG.
Which of the following drains the most blood from the uvea?
A: Vortex veins are responsible for draining most of the blood from the eye. There are often 4-6 vortex veins in each eye noted at mid-periphery.
A: Vortex veins are responsible for draining most of the blood from the eye. There are often 4-6 vortex veins in each eye noted at mid-periphery.
Which of the following statements regarding amblyopia is FALSE?
B. Anisometropic hyperopia is more likely to cause amblyopia as one eye never receives a clear image. In patient with aniso myopia, there is a point of clarity for either refractive error. Strabismus first presents with diplopia but with time can become suppressed. Eso = nasal, Exo = temporal. Deep amblyopia is considered 20/100 – 20/400.
B. Anisometropic hyperopia is more likely to cause amblyopia as one eye never receives a clear image. In patient with aniso myopia, there is a point of clarity for either refractive error. Strabismus first presents with diplopia but with time can become suppressed. Eso = nasal, Exo = temporal. Deep amblyopia is considered 20/100 – 20/400.
Scleromalacia Perforans refers to which of the following types of scleritis?
D. Necrotizing without inflammation. This is a unique form of Scleritis where the patient presents with minimal pain and injection. Often associated with rheumatoid arthritis, SP leads to scleral thinning that gives a blue appearance.
D. Necrotizing without inflammation. This is a unique form of Scleritis where the patient presents with minimal pain and injection. Often associated with rheumatoid arthritis, SP leads to scleral thinning that gives a blue appearance.
Which of the following represents the weakest point of vitreal attachment?
A: The weakest point of attachment is found at the macula. From weakest to strongest: Retinal vessels, Macula, Optic Nerve, Posterior lens, Ora Serrata/Vitreal Base. A PVD is most likely to occur at the base.
A: The weakest point of attachment is found at the macula. From weakest to strongest: Retinal vessels, Macula, Optic Nerve, Posterior lens, Ora Serrata/Vitreal Base. A PVD is most likely to occur at the base.
All of the following medications have reversible effects, EXCEPT:
B. Clopidogrel, also known as Plavix, is an anticoagulant that functions by inhibiting ADP receptors on platelet cell membranes. This receptor is critical for platelet aggregation and clot formation.
B. Clopidogrel, also known as Plavix, is an anticoagulant that functions by inhibiting ADP receptors on platelet cell membranes. This receptor is critical for platelet aggregation and clot formation.
Which of the following β-blockers is β1 selective and known for having neuroprotective qualities?
B. Betaxolol is β1 selective with limited β2 activity. It is also known for neuroprotective qualities although there is limited clinical evidence. Recall that Betaxolol is cardioselective. The remaining options are non-selective.
B. Betaxolol is β1 selective with limited β2 activity. It is also known for neuroprotective qualities although there is limited clinical evidence. Recall that Betaxolol is cardioselective. The remaining options are non-selective.
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.
Which of the following is FALSE regarding BIO when compared to the direct ophthalmoscope?
C. When compared to a direct ophthalmoscope, the BIO has a larger field of view, larger depth of focus, SMALLER magnification, and an inverted image.
C. When compared to a direct ophthalmoscope, the BIO has a larger field of view, larger depth of focus, SMALLER magnification, and an inverted image.
Which ocular muscle begins its course at the maxillary bone?
B: Inferior Oblique is the only muscle to originate from maxillary bone.
B: Inferior Oblique is the only muscle to originate from maxillary bone.
Transpose the following prescription: -2.00 -2.00 x 180
B. -4.00 +2.00 x 090. To transpose, first move the total cylindrical value to the spherical portion. In this example, -2.00 + (-2.00) = -4.00. Once you have the sphere, reverse the symbol of the DC and flip the axis of the original equation.
B. -4.00 +2.00 x 090. To transpose, first move the total cylindrical value to the spherical portion. In this example, -2.00 + (-2.00) = -4.00. Once you have the sphere, reverse the symbol of the DC and flip the axis of the original equation.
You perform the Bruckner test on a young patient and note unequal red reflexes. The darker reflex may indicate which of the following? (PICK 2)
A/D. Both media opacities and higher refractive error at a longer test distance can both present with darker reflexes. The deviated eye in strabismus, as well as higher refractive error at 1 meter and retinoblastoma, present with brighter reflexes.
A/D. Both media opacities and higher refractive error at a longer test distance can both present with darker reflexes. The deviated eye in strabismus, as well as higher refractive error at 1 meter and retinoblastoma, present with brighter reflexes.
Which of the following systemic conditions is NOT associated with early cataract development?
A. Osteogenesis imperfecta is NOT associated with presenile cataracts. Recall “MAD Mr. Wilson develops early Cataracts”. The “C” stands for calcium issues.
A. Osteogenesis imperfecta is NOT associated with presenile cataracts. Recall “MAD Mr. Wilson develops early Cataracts”. The “C” stands for calcium issues.
All of the following are features of a trapped inferior rectus except:
C. In the case of a trapped inferior rectus, you would expect a POSITIVE forced duction. To perform a duction exam, you anesthetize the patient’s eye and use forceps (or two Q Tips) to move the eye. If the eye moves, it is most likely a palsy as the muscles are not restricted. This is a NEGATIVE forced duction. Limited upgaze and diplopia are due to the inferior rectus being stuck in a down position (no slack to move up). Hypoesthesia comes from possible damage to the infraorbital nerve. Crepitus is the “crunching” sound from bone fragments rubbing against the other.
C. In the case of a trapped inferior rectus, you would expect a POSITIVE forced duction. To perform a duction exam, you anesthetize the patient’s eye and use forceps (or two Q Tips) to move the eye. If the eye moves, it is most likely a palsy as the muscles are not restricted. This is a NEGATIVE forced duction. Limited upgaze and diplopia are due to the inferior rectus being stuck in a down position (no slack to move up). Hypoesthesia comes from possible damage to the infraorbital nerve. Crepitus is the “crunching” sound from bone fragments rubbing against the other.
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 on-ionin. Group 2 is high water content and non-ionic. 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 on-ionin. Group 2 is high water content and non-ionic. 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 ganglia does NOT contain parasympathetic synapses?
B. The superior cervical ganglion contains SYMPATHETIC synapses only.
B. The superior cervical ganglion contains SYMPATHETIC synapses only.
Which of the following statements regarding saccades is INCORRECT?
C. Undershooting is the most common saccadic error. Recall that saccades are rapid, yoked eye movements to quickly move an image to the fovea. These eye movements are important in reading and spotting tasks.
C. Undershooting is the most common saccadic error. Recall that saccades are rapid, yoked eye movements to quickly move an image to the fovea. These eye movements are important in reading and spotting tasks.
What changes to Vmax and the Lineweaver-Burk Plot would you expect when a ligand binds to an allosteric site on the same target molecule as the substrate?
C. In this example of non-competitive inhibition, one would expect Vmax to decrease, Km to remain constant, and the Lineweaver-Burk plot to shift upwards. In competitive inhibition, the ligand will bind to the active site in place of the substrate. This will cause Vmax to remain constant, Km to increase, and the plot to shift to the right.
C. In this example of non-competitive inhibition, one would expect Vmax to decrease, Km to remain constant, and the Lineweaver-Burk plot to shift upwards. In competitive inhibition, the ligand will bind to the active site in place of the substrate. This will cause Vmax to remain constant, Km to increase, and the plot to shift to the right.
Which Cranial Nerve is responsible for opening the eye?
B: CNII, the oculomotor nerve, is responsible for innervating the levator muscle. CN VII, the facial nerve, closes the eye. CN I is the olfactory nerve. CN II is the optic nerve, CN IV is the trochlear nerve.
B: CNII, the oculomotor nerve, is responsible for innervating the levator muscle. CN VII, the facial nerve, closes the eye. CN I is the olfactory nerve. CN II is the optic nerve, CN IV is the trochlear nerve.
What is the approximate length of the adult eye?
D. The average human eye is about 24mm in length.
D. The average human eye is about 24mm in length.
Most topical eye drops are formulated as ______.
A. Most topical eye drops are formulated as WEAK BASES. This is for better penetration and bioavailability of the medicated drop.
A. Most topical eye drops are formulated as WEAK BASES. This is for better penetration and bioavailability of the medicated drop.