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119 Cards in this Set

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Upon initial insertion of a GP lens the patient complains about flare. To correct this problem the fitter should choose a lens with a/an

Increased optical zone

The principal advantage of a minus carrier CTL in fitting high hyperopes (hyperopia) is that it:

Usually centers better

In using fluorescein to evaluate the fit of a rigid lens of 9.0mm diameter on a typical eye a correct statement is that

Apical area, mid-peripheral area, and the lens edges be assessed

Want full coverage for the fluorescein

A toric soft lens with a prescription of -2.00-1.25x120 has the axis resting at the 5 o'clock position what should the new axis be when the lens is ordered?

90 degrees

Think LARS



30 degrees =1 hour


15 degrees = 30 minutes

Patients with high riding lenses often have:

Aphakia

High riding = thickness

A patient has the prescription Plano -1.25x170 and "k" readings of 42.50/42.50 to achieve the best visual acuity in fluoresilicone acrylate material the Should be

Front Toric

SACARA

One way to eliminate silicone hydrogel edge fluting is to use a material with a :

Lower water content

Edge fluting = water too much

A patient wearing a toric soft lens with the parameters -1.50-1.25x180 has an over refraction of -0.75+0.50x90 a new lens should be ordered with which parameters?

-1.75-0.75x180

If CTL needs over refraction the PT is not seeing well .... minus form transpose .... take old rx CTL + OR

One way to eliminate silicone hydrogel edge fluting is to use a material with a

Low water content

The evaluation of a rigid lens detects bubbles centrally minimal lens movement, and poor tear exchange which of the following lens changes would be more appropriate

Reduce the diameter

Given the following information:


"K" :41.00@180/44.50@090


Spectacle Rx: -2.00-1.50x090



A contact lens fitter should be alert to which of the following problems?

Residual Astigmatism

Sacara

A therapeutic lens with minimal movement should be used for which of the following conditions?

Recurrent corneal erosion

If a well fitted diagnostic lens has a -3.00 power and the over refraction at 12mm is -2.00 the correct lens power to order is:

-5.00

A soft lens patient has a spectacle correction of +8.50D at a vertex of 12mm what would be the most appropriate sphere power

+9.50D

The appearance of transient bubbles near the periphery of a contact lens is indicative of:

Flat posterior peripheral curves

Which curve would a fitter modify to allow more tear flow under the edge of a rigid lens

Posterior peripheral curve

When a silicone hydrogel lens is used as a cushion between the cornea and a GP lens it is called

Bandage lens fitting

When a soft diagnostic lens is too flat, it may demonstrate:

Edge standoff

While being fitted with a diagnostic soft lens a patient reports variable visual acuity with excessive lid sensation the most probable cx for these symptoms is a lens that is too

Loose

When working with rigid contact lenses fitters often use fluorescein to evaluate the:

Lens/cornea relationship

A fluorescein pattern that has a black area over the corneal apex and a diffuse green area in the periphery normally indicates:

Flat fit

While performing fluorescein evaluation of a diagnostic rigid lens on a patient with 3.00 diopter of With-the -rule astigmatism a fitter observes absence of fluorescein horizontally pooling of fluorescein vertically and air bubbles under the inferior lens edge. The best lens type for this patient would be:

+4.75 D

For a PT with 1.25 diopters of with the rule astigmatism who is active outdoors and who operates heavy construction equipment the most appropriate type of CTL would be

Soft toric lens

Moving a +7.50 prescription from the spectacle plane to the corneal plane will require:

More plus power

Most soft multi focal lens designs will:

Permit light from both near and far fields to enter the pupil simultaneously

A PT wearing a -2.00 diagnostic soft lens has the best vision with an over refraction of -0.50x090 which of the following should be ordered

-2.25 sphere

Which of the following changes would improve a rigid contact lens fit that shows sluggish movement after 1 hour of wear

Reduce overall diameter

A rigid lens of 45.00 D/-4.00 provides 20/20 vision what power would be needed if the central posterior curve (base curve) is changed to 45.50 D ?

-4.50

What would be the most appropriate soft lens diameter for a PT whose HVID is 12mm?

14mm

IPCs are used to:

Provide a transition between the peripheral and BC

Intermediate curve

When using lid manipulation to assist in "pooping" a rigid lens off the eye the wearer should first make sure that the:

Lens is resting on the cornea where the fissure is widest

Centered before removal

To verify rigid CTL should always be performed by manipulation of the lens :

Through the upper or lower lens

A drop of liquid must be placed in the radiuscope lens holder in order to eliminate reflections from the:

Anterior surface of the lens

When rigid lenses are received from the manufacturer which of the following instruments is not needed for inspection and verification

Bimicroscope

The optical zone width of a GP lens can be assessed with a:

Magnifier with a millimeter grid

Which of the following should be used to determine if a soft lens is inverted ?

Taco test

Think FOOD!!

Which of the following disinfectant chemicals is safe to use with soft CTL

Polyquaternium

A lens that was ordered as 45.00 (7.50) -4.00 8.7 has been received as 45.50 (7.42) -4.25 8.7 in regard to this lens which of the following statements is corrected under ANSI standards

Neither the power nor BC is acceptable

When scheduling a follow up visit the fitter should instruct a daily CTL PT to:

Insert the lenses a minimum of 1/2 hour prior to appointment

A PT complains of pain upon lens insertion with excessive tearing and blurry vision. Fluorescein evaluation reveals zigzag linear corneal staining these signs and symptoms are most likely due to a :

Foreign body under the lens

The BC reading of a warped lens through a raidiuscope is most similar to that of a/an

Back toric lens

Upon insertion a well fitted hydrogel lens is repeatedly ejected from the eye the most likely cx of this problem is:

Lens eversion

During long periods between users rigid lenses should be stored in a

Dry state

During long periods between users rigid lenses should be stored in a

Dry state

If the BC of a rigid CTL was ordered as 7.80mm and the lens received measures 7.85 the lens is:!

0.25 D flatter than ordered

The instrument designed primarily to measure the BC of a CTL is the :

Radiuscope

With the rule corneal astigmatism with GP lens in place will show which of the following fluorescein patterns ?

Dark narrow band horizontally

Which of the following terms refers to new blood vessel formation entering the cornea from the limbus

Neovascularization

One function of GP lens soaking solution is to:

Increase the wetting angle of the lenses

It is recommended that after successful initial follow up visits the continuous / extended wear CTL PT should be seen

Semiannually, as soon as possible after awakening

Which of the following instruments can be used to measure both corneal curvature and the BC of a rigid CTL

Keratometer

A fitter is evaluating the visual acuity of a PT who is currently wearing multi focal soft lenses. For this PT over refraction is best done using:

A pinhole

Following the fitting and dispensing of any continuous wear CTL it is advisable to see the PT

The following morning

According to the U.S. food and drug administration the maximum time allowable for continuous wearing of silicone hydrogel lenses is

30 days

The BC of a rigid lens is usually verified with a :

Radiuscope

The most effective way to remove a soft CTL that has adhered to the cornea is to:

Irrigate the eye with lubricant until the lens moves freely then remove as usual

A daily wear soft lens PT should be scheduled to return for the first follow up visit in:

1 week

The most common technique for a PT to insert a rigid lens is to:

Place the lens directly on the cornea

The fitter can differentiate between a back toric lens and a bitoric lens by utilizing a:

Radiuscope

Which of the following solution preservatives may damage the surface of a diagnostic GP lens?

Isopropyl alcohol

Which of the following instruments is most commonly used to measure the diameter of the optical zone of a CTL

Measuring magnifier

Which of the following compounds would be best to use for adjusting or polishing GP lenses ??

Water soluble polish

Examining the reflection of a bare fluorescein tube on the surface of a GP lens is most often used to check:

Peripheral curve blends

The current ANSI standard tolerance for a spherical lens with a power of -5.00 is:

-/+0.13 D

In order to check the front vertex power of a CTL the lens should be placed in which of the following positions relative to the aperture of the lensometer

Convex side to the aperture

When a practice dispense the older solutions before the newer solutions it is called

First in first out inventory

A PT submits the prescription from a box of disposable lenses to a third party CTL distributor. This prescription is faxed to the original fitter for verification. If the fitter does not respond to this request the:

Third party distributor may fill the prescription after 8 business hours has elapsed

The fairness to CTL consumers act covers

Disposable lenses only

The most important procedures for preventing the spread of infections in healthcare offices is:

Wiping instruments with alcohol between users

The primary advantage to the practice of delivery of CTL from manufacturer to PT is that it :

Saves the office time and money

Under the fairness to CTL consumers act fee bundling of CTL solutions and fitting:

Is acceptable if the PT receives the prescription and has the option to purchase else where

The goal of occupational safety health and administration (osha) is to:

Eliminate work hazards through training in safety and the use of personal protective equipment

Diagnostic soft lenses in blister packs should be :

Dispensed to the PT or discarded after use

Which of the following is the primary function of ANSI?

Develop and publication of standards for many industries

The age discrimination in employment act of 1967 prohibits the employment discrimination of persons over the age of:

40

Evaluation instruments that touch PT skin lashes or lenses should be wiped after each use with:

Isopropyl alcohol

Which of the following is the mode of the slit lamp illumination used to view the early stages of microystic edema?

Retroillumination

Which of the following should be noted on the PT health history record as a temporary contraindication to the use of CTL

Acute conjunctivitis

A CTL wearer presents with acute red eyes the fitter would most likely ask the PT

"What lens are products have you been using ?"

Which of the following BC would loosen the fit of a 8.70 soft lens if the diameter is kept constant:

8.90

A PT returns for a recheck reporting a sudden sharp pain this morning upon insertion of a soft daily wear lens. The fitter should suspect

A damage lens

Which of the following is best detected by observing the cornea without the microscope when the beam of the slit lamp is focused directly on the limbus ?

Central corneal clouding

Edema

On a follow up visit a 20 year old myopic PT reports difficulty with near vision although distance vision is excellent. This PT is most likely :

Over corrected

A long term successful hydrogel CTL wearer suddenly develops dry eyes which of following is most likely to cx this problem

Use of antihistamines

Which part of the eyes is most sensitive to a rigid corneal CTL during the adaptation period

Lid

Which of the following changes is best able to improve oxygen transmissibility to a PT cornea

Increasing DK

O2 permeability

A PT who is wearing a GP lens complains of a "scratching sensation " the lens specifications are found to be accurate. Which of the following instruments would be most valuable in determining the cx of discomfort?

Measuring magnifier

A PT complains of reduced vision after a well fitted rigid lens has been polished by the fitter the fitter should

Check the quality of all lens parameters

Inadequate movement of a soft lens can be corrected by using a lens that:

Has a smaller diameter

With regard to a CTL examination the acronym SOAP stands for :

Subject, objective, assessment, plan

A GP lens wearer reports a scratchy feeling upon lens insertion; the discomfort increases with wearing time the most likely correction would be

Blending the junction zone

A new daily wearer of soft lenses returns for the first follow up visit with itching, burning, injected eyes. The most likely cx of these problems is

Solution reaction

A new corneal transplant who is wearing GP represents with injection, edema, and neovascularization at the graft juncture. The fitter should

Remove the lens and call the referring practitioner

Reducing the diameter of a minus lens results in:

A reduction in weight

To ensure follow up recall appointments it is important to

Reinforce the need for follow up care beginning with the initial CTL fitting appointment

If a soft lens wearer complains of awareness of the lens is the right eye only, and the right and left parameters are identical which of the following would be best for the fitter to do first

Put the lens in the right eye to see if the feeling subsided or alternates

Fluorescein that has been installed into the eye is best illuminated by using :

Cobalt blue filter

A silicone hydrogel soft lens is wearer presents with a superior arcuate lesion, this indicates

Epithelial splitting

Bedewing of the cornea occurs on which of the following corneal layers

Endothelium

Bedewing = blisters

What an office visit is documented in a PT record the final notation should be the :

Recommend time until PT next visit to office

During slit lamp evaluation on upward gaze a PT soft CTL move 0.5 to 1mm when PT blinks these lenses are

A good fit

Which layer of the tear film helps to prevent evaporation

Lipid layer

The most frequently used corneal CTL for a PT with keratoconus are

Specially designed cone lenses

A drooping of the upper eyelid is called

Ptosis

A PT has the following prescription:



Spectacle Rx +14.50 sph



This prescription is typical of which of the following conditions

Aphakia

Given the following "k" readings:



41.87@055/43.62@145



What optical condition does the PT have?

Oblique astigmatism

When a keratometer is being calibrated which of the following targets will provide the most reliable results ?

A set of steel balls of known radii

A spherical rigid CTL has

One continuous curve throughout the optical zone

A rigid CTL used to enhance color vision in PT who have color deficiencies is

Dark red

Soft lenses should be considered when the PT

Desires intermittent wear

A correct statement regarding epithelial cells is that they

Have the ability to reproduce

Upon completion of a CTL fitting, the best way to provide additional information to the PT on fees care systems and wearing schedules is by

Supplying PT with pamphlets and office hand outs

Which of the following slit lamp filters should be used for the best observation of neovascularization

Red free

For a PT who presents with traumatic aniridia, photophobia, and visual acuity potential of 20/25 the best lens would be an

Cosmetic iris lens with optics

Given the following keratometric reading



42.50@90/45.62 @180!



Which of the following types of astigmatism is indicated

Against the rule

Which of the following prescriptions indicates against the rule astigmatism


-4.50+1.00x075

Rose bengal stains areas of

Devitalized tissue

The normal cornea is NOT

Three layers thick

Which of the following characteristics is most likely to be exhibited by diabetic contact lens PT

Fluctuating vision