Case Analysis - Final (Random Questions)

33 Questions | By Mchllmijares | Updated: Mar 20, 2022 | Attempts: 78

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Questions and Answers

1.

According to Dr. Lu most senile cataracts will cause a hyperopic shift unless the cataract is a Nuclear Sclerotic Cataract.
- A.
  
  True
- B.
  
  False
2.

Which of the following would not be appropriate in the treatment of a mild to moderate ( 1+ /2+) senile cataract? In this scenario you patient is not complaining about their vision affecting their activities of daily living.
- A.
  
  Adjust the SRx to deal with the anisometropia, or hyperopic/myopic shift.
- B.
  
  Provide patient education on their new glasses and the progression of their cataract.
- C.
  
  Require a yearly DFE to monitor progression
- D.
  
  Begin having the patient return for DFEs every 6 months and refer them for cataract extraction
- E.
  
  Perform a RAM/PAM if the patient is not correctable to 20/20 to assess retinal function
3.

Which of the following statements would you NOT use during patient education for a mild to moderate ( 1+ /2+) senile cataract? Your plan for that patient consisted only of adjusting their Rx.
- A.
  
  Explain to the patient that although they may be used to their Rx usually being stable now we may see a change more frequently.
- B.
  
  Advise patient to RTC 1 year for PCE/DFE.
- C.
  
  Advise the patient that they can't drive anymore and you will report them to the DMV as unfit to drive.
- D.
  
  Provide education on sensitivity to glare, difficulty seeing in dim lighting and the gradual decrease in vision which will take place over the following years.
4.

Uncorrected refractive error can present with symptoms that are very similar to symptoms people can present with when they have accommodative or vergence problems. It can also have a direct impact on accommodative data and vergence data.
- A.
  
  True
- B.
  
  False
5.

What is the accommodative demand for a person with emmetropia at a near distance of 40cm?
- A.
  
  0
- B.
  
  1.50
- C.
  
  2.50
- D.
  
  2.00
6.

What is the accommodative demand for a person with myopia (-4.00 OU) at a near distance of 40cm when they DO have their correction on?
- A.
  
  -1.50
- B.
  
  0
- C.
  
  2.50
- D.
  
  2.00
7.

According to Dr. Huang when you correct a myope, they have to accommodate _____ (more or less) to see up close. When you correct a hyperope, they have to accommodate ____(more or less) to see up close.
8.

Regarding accommodative demand which of the following is a concern when correcting a myope?
- A.
  
  If a myopes' amplitudes are low and you correct them for distance, they might now have problems up close.
- B.
  
  When you fully correct the myope you give them more accommodative power and can cause convergence excess
- C.
  
  You decrease accommodation by adding minus lenses
- D.
  
  You decrease the patient's negative fusional vergence
9.

When performing the NRA/PRA how do we evaluate the accommodative system?
- A.
  
  Accommodative Amplitude
- B.
  
  Relative Accommodation
- C.
  
  Accommodative Response
- D.
  
  Accommodative Facility
10.

Which statement is TRUE regarding the push-up method?
- A.
  
  It measures relative accommodation
- B.
  
  It should be performed with the patient's best correction in place, therefore ideally you would perform it with the manifest refraction in place.
- C.
  
  It should only be done binocularly
- D.
  
  It should be done with an add in place.
- E.
  
  The expected amplitudes for a 48 yo will be roughly 12.5
11.

Which of the following statements regarding the Binocular cross cyl (BCC) is FALSE/NOT TRUE?
- A.
  
  It measures the accommodative response and you expect values +0.50 + or - 0.50D
- B.
  
  : It is a subjective test, so it’s difficult for children to understand
- C.
  
  Latent Hyperopes will overaccommodate at both distance and near so they show a lead
- D.
  
  Lag (PLUS) means their accommodative response is behind the stimulus
12.

Why might a patient show a lead in accommodation?
- A.
  
  Presbyopia
- B.
  
  Accommodative spasm
- C.
  
  Latent Hyperopia
- D.
  
  Over-minused Rx
13.

Which statement regarding NRA/PRA is false?
- A.
  
  The patient must maintain convergence at a particular level while you change the accommodative response.
- B.
  
  NRA tests the ability to relax accommodation and increase PFV.
- C.
  
  PRA tests the ability to stimulate accommodation and increase PFV.
- D.
  
  How much the NRA changes depends on the AC/A ratio
- E.
  
  People with a low PRA have difficulty relaxing accommodation and difficulty increasing PFV (convergence)
14.

Which statement is false?
- A.
  
  Symptoms that are commonly seen in patients with accommodative and vergence problems are blurry vision, double, headaches, eyestrain, words on a page might look like they’re moving around, they feel sleepy, they don’t want to do near work. Most of these things occur when they are doing prolonged near work toward the end of the day when their eyes are really tired.
- B.
  
  Signs you may find during an exam that may suggest accommodative insufficiency (AI)include: Increased accommodative amplitude, low BCC, increased PRA
- C.
  
  People with accommodative problems can still have diplopia, but blur is the hallmark sign and diplopia with vergence.
- D.
  
  Accommodative insufficiency (AI) is a condition when the patient has difficulty stimulating accommodation
15.

If the NRA is greater than +2.50 it means you have _______ (overminused or underminused) the myope or _______ (underplussed or overplussed) the hyperope.
16.

If your patient is a MYOPE and you put on glasses to correct their myopia they accommodate _____ (more or less) and become ______ (less or more) EXO
17.

If your patient has an Rx OU of -2.00 and a 10XP without their glasses and a AC/A ratio of 8/1 what happens when they put their glasses on.
- A.
  
  26XP
- B.
  
  18XP
- C.
  
  2XP
- D.
  
  6EP
- E.
  
  Ortho
18.

This is the most common type of senile cataract. It is the result of normal aging changes in the nucleus of the lens. Patients will report a blur at distance and if they are hyperopic they will often report that their vision " has gotten better and they don't need their glasses anymore". What cataract does this patient most likely have?
- A.
  
  Posterior subcapsular cataract
- B.
  
  Christmas tree cataract
- C.
  
  Nuclear sclerotic cataract
- D.
  
  Anterior subcapsular cataract
19.

Which of the following is not a symptom associated with Cortical cataracts.
- A.
  
  May cause monocular diplopia
- B.
  
  They may report mild to severe sensitivity to glare
- C.
  
  Difficulty seeing in reduced ambient lighting (night driving)
- D.
  
  Near vision is worse than distance vision
20.

While performing an exam you see spoke-like opacities on the anterior cortex. Your patient has been complaining of increased difficulty while driving at hight. What type of cataract does this patient most likely have?
- A.
  
  Posterior subcapsular cataract
- B.
  
  Anterior subcapsular cataract
- C.
  
  Christmas tree cataract
- D.
  
  Cortical cataract
21.

Anterior subcapsular cataract may result from steriod use or diabetes
- A.
  
  True
- B.
  
  False
22.

Which statement is false?
- A.
  
  70% of worker accidents result from flying or falling objects or sparks striking the eye
- B.
  
  OSHA requires sideshields whenever there is potential for injury from flying objects
- C.
  
  Color vision tests produce valid results only when administered under the appropriate lighting conditions (standard illuminant "C")
- D.
  
  High impact safety lenses carry a warning label
23.

Which of the following is not one of the requirements for basic impact safety lenses?
- A.
  
  The minimum edge thickness of 2.5mm
- B.
  
  Center thickness > or equal to 3.0mm except for lenses with a power of > or equal to +3.00D
- C.
  
  The lens is tested with a 1/4'' steel ball dropped from 50''
- D.
  
  It bears a warning label stating that the lens is basic impact, not high impact,
24.

Which of the following descriptions of different types of F803 sport protectors is not correct?
- A.
  
  Type III has a full or partial face shield
- B.
  
  Type 1: Front piece molded as one unit (lenses and frame are together)
- C.
  
  Type II: Lenses are separate from the frame front (lenses may be plano or prescription)
25.

Which statement is false?
- A.
  
  High impact resistant lenses are optional for sports.
- B.
  
  Computer eyestrain affects more than 70% of approximately 143 million Americans who work on a computer on a daily basis
- C.
  
  Neck and shoulder pain along with headaches are common signs of computer vision problems
- D.
  
  The pixel formation on computers causes eyes to drift to the resting point of accommodation