1.
Which of the following is NOT a physiological change associated with ACUTE lack of oxygen to the cornea?
Correct Answer
A. Corneal neovascularization
Explanation
Corneal neovascularization is the growth of new blood vessels in the cornea, which is a response to chronic lack of oxygen. In acute lack of oxygen, the cornea does not have enough time to develop new blood vessels, so corneal neovascularization is not a physiological change associated with it. The other options, stromal edema, epithelial microcysts, and endothelial folds, are all physiological changes that can occur in response to acute lack of oxygen to the cornea.
2.
Choose the true statement (2)
Correct Answer(s)
A. The contact lens case should be replaced every 1-3 months
B. Before insertion or removal, it is best to use mild soaps that do not contain deodorants, creams, lanolin, or oils.
Explanation
The given answer is correct because it includes two true statements. The first statement states that the contact lens case should be replaced every 1-3 months, which is important for maintaining good hygiene and preventing the buildup of bacteria. The second statement advises using mild soaps without certain ingredients for insertion or removal of contact lenses, which helps to avoid irritation or damage to the eyes.
3.
Which of the following is a correct technique regarding hygiene and contact lenses?
Correct Answer
A. Emptying the case, rinsing with disinfecting solution, and letting it air dry.
Explanation
Emptying the case, rinsing with disinfecting solution, and letting it air dry is a correct technique regarding hygiene and contact lenses. This process helps to remove any debris or bacteria from the case, ensuring that the lenses are stored in a clean and safe environment. Replacing a contact lens case every 4-6 months is also a good practice to prevent the buildup of bacteria. Using hand sanitizer before insertion can help to minimize the risk of introducing bacteria to the eyes. However, digitally scrubbing the case with tap water is not recommended as it may introduce contaminants and potentially damage the case.
4.
Incomplete blinks in Hydrogen contact lens wear are linked to?
Correct Answer(s)
A. Increased fluorescein staining
C. Increased lens deposition
Explanation
Incomplete blinks in Hydrogen contact lens wear can lead to increased fluorescein staining and increased lens deposition. When a person does not fully close their eyelids during a blink, the tears that normally spread across the surface of the eye and contact lens are not distributed evenly. This can result in areas of the eye and lens being exposed to less tears, leading to increased fluorescein staining. Additionally, incomplete blinks can also cause a buildup of debris and proteins on the lens, increasing lens deposition.
5.
Which of the following is FALSE regarding corneal curvature:
Correct Answer
A. Corneal curvature is flattest at its apex
Explanation
The corneal curvature is not flattest at its apex. The cornea is actually steepest at its apex, which is the center of the cornea. As the cornea transitions into the sclera, it gradually flattens. The corneal curvature and scleral curvature are usually not the same, as the sclera has a different shape and curvature compared to the cornea. Additionally, the cornea does not have a perfect spherical curvature at any location, as it has a slightly asymmetrical shape.
6.
A patient comes in for a contact lens exam. The patient complains that her vision through the lens is not as good as it used to be. She is wearing the contact lenses to the exam so you examine them through the slit lamp. You see what looks like orange/red rust spots on the lens. What is the deposit on the lens and what is the most likely reason those spots are on her contacts?
Correct Answer(s)
A. Iron deposition
B. Using tap water on the contact lenses
Explanation
The orange/red rust spots on the patient's contact lenses are most likely caused by iron deposition. This could be due to the patient using tap water on the contact lenses, as tap water often contains minerals such as iron that can leave deposits on the lenses.
7.
Which of the following are NOT true regarding corneal topography?
Correct Answer
A. A superior shift on the topograpHer is indicative of keratoconus.
Explanation
A superior shift on the topographer is not indicative of keratoconus. Keratoconus is a condition characterized by a cone-shaped bulge in the cornea, which causes vision problems. A superior shift on the topographer refers to a displacement of the corneal shape towards the superior (upper) part of the eye. This shift can be caused by various factors, such as eyelid pressure or contact lens wear, and is not specific to keratoconus. Therefore, a superior shift on the topographer is not a reliable indicator of keratoconus.
8.
What are contraindications for soft contact lenses? (Select 3)
Correct Answer(s)
A. Autoimmune disease
B. Antihistamine use
C. Irregular astigmatism
Explanation
The correct answer is autoimmune disease, antihistamine use, and irregular astigmatism. Autoimmune diseases can cause inflammation and dryness in the eyes, making them unsuitable for wearing soft contact lenses. Antihistamines can also cause dryness in the eyes, which can lead to discomfort when wearing contact lenses. Irregular astigmatism refers to an irregularly shaped cornea, which can cause vision distortion and make it difficult for soft contact lenses to fit properly. Occasional wear is not a contraindication for soft contact lenses, as long as proper care and hygiene are maintained.
9.
You would expect to see a large lateral lag in a lens with which of the following characteristics?
Correct Answer
A. Loose fitting
Explanation
A loose fitting lens refers to a lens that does not fit tightly on the eye. When a lens is loose, it tends to move more easily and can cause a large lateral lag. Lateral lag refers to the sideways movement of the lens when the eye moves. Therefore, a lens with a loose fitting is expected to have a large lateral lag.
10.
Which systemic condition is associated with dry eyes? (multiple select)
Correct Answer(s)
A. Keratoconjunctivitis sicca
B. Rheumatoid arthritis
C. Thyroid conditions
Explanation
Keratoconjunctivitis sicca, also known as dry eye syndrome, is a systemic condition associated with dry eyes. Rheumatoid arthritis, an autoimmune disease, can also cause dry eyes as a result of inflammation. Thyroid conditions, such as hypothyroidism or Graves' disease, can lead to dry eye symptoms due to hormonal imbalances. High blood pressure, however, is not directly associated with dry eyes.
11.
All of the following are characteristics of POOR contact lens candidates EXCEPT:
Correct Answer
A. High refractive errors
Explanation
The given question asks for a characteristic that is not associated with poor contact lens candidates. The correct answer is "high refractive errors." This means that individuals with high refractive errors can still be suitable candidates for contact lenses. The other options, such as dry eyes, tobacco smokers, and medications, are commonly considered as factors that may make someone a poor candidate for contact lenses.
12.
Which of the following statements about soft toric CLs are TRUE (select 3):
Correct Answer(s)
A. Astigmats see WORSE in Soft toric lenses than GPs
B. Oblique axis degrades VA more than ATR or WTR
C. Soft toric CLs start at -0.75DC
13.
Which three components are evaluated when checking the physical fit of the lens?
Correct Answer
A. Movement, Centration, Coverage
Explanation
When checking the physical fit of a lens, three components are evaluated: movement, centration, and coverage. Movement refers to the ability of the lens to move slightly on the eye with each blink, ensuring comfort and proper tear exchange. Centration refers to the position of the lens on the cornea, ensuring optimal visual acuity and minimizing potential complications. Coverage refers to the extent to which the lens covers the cornea, ensuring proper alignment and stability. These three components are crucial in determining the suitability and effectiveness of a lens for a specific individual.
14.
A patient comes into your office and is complaining of stinging upon insertion of their contact lenses with noticeable injection. The patient is currently using Re-Nu Fresh contact lens solution. Which of the following is the best option of care for your patient?
Correct Answer
A. Recommend using Opti-Free PureMoist by Alcon to replace current contact solution.
Explanation
The patient is experiencing stinging and injection upon insertion of their contact lenses, indicating that their current contact lens solution may be causing irritation. The best option of care would be to recommend using Opti-Free PureMoist by Alcon to replace the current contact solution. This solution is known for its moisturizing properties and is designed to provide comfort and hydration for contact lens wearers. By switching to Opti-Free PureMoist, the patient may experience less stinging and irritation during lens insertion.
15.
Regarding magnification effects, myopes (select 2)
Correct Answer(s)
A. Often report things look larger with CLs
B. Will have less minification with CLs
Explanation
Myopes, or nearsighted individuals, often report things looking larger with contact lenses (CLs) because the lenses correct their blurry vision, making objects appear clearer and closer. Additionally, myopes will have less minification with CLs, meaning that objects will not appear smaller as they would without corrective lenses.
16.
All of the following are true EXCEPT:
Correct Answer
A. The stimulus to accommodate in hyperopes increases as a lens is moved toward the eye
Explanation
The stimulus to accommodate in hyperopes does not increase as a lens is moved toward the eye. This statement is incorrect because hyperopes have difficulty focusing on near objects due to their shorter eyeball length, so the stimulus to accommodate actually decreases as a lens is moved closer to the eye. Hyperopes require converging lenses (BO) to help them focus on near objects.
17.
Which of the following are true? (Select 2)
Correct Answer(s)
A. A myope will need more power with spec than contact lens
C. The "edge lift" with rigid lenses allows for tear exchange and better capillary attration
Explanation
A myope will need more power with spectacles than contact lenses because spectacles are positioned further from the eye, resulting in a greater need for corrective power. The "edge lift" with rigid lenses allows for tear exchange and better capillary attraction, which improves comfort and overall eye health.
18.
Which of the following are true regarding binocular and accommodative status? (select 2)
Correct Answer(s)
A. Myopes must accommodate and converge more with CLs than specs
B. Hyperopes must accommodate and converge less with CLs than specs
Explanation
Myopes, who have nearsightedness, need to accommodate and converge more with contact lenses (CLs) compared to wearing spectacles. This is because contact lenses sit directly on the eye, causing the myopic eye to exert more effort to focus on near objects. On the other hand, hyperopes, who have farsightedness, need to accommodate and converge less with contact lenses compared to wearing spectacles. This is because contact lenses correct the hyperopic eye's focusing power, reducing the need for accommodation and convergence. Therefore, the statement that myopes must accommodate and converge more with CLs than specs and hyperopes must accommodate and converge less with CLs than specs is correct.
19.
What are possible contraindication for contact lens wear? (select 2)
Correct Answer(s)
A. Corneal infiltrates
B. Fuchs endothelial dystropHy
Explanation
Possible contraindications for contact lens wear include corneal infiltrates and Fuchs endothelial dystrophy. Corneal infiltrates refer to the presence of white blood cells in the cornea, which can be a sign of infection or inflammation. Fuchs endothelial dystrophy is a progressive disease that affects the cells lining the inner layer of the cornea, leading to vision problems. Both of these conditions can potentially worsen with contact lens wear, making it important to avoid wearing contact lenses in these cases.
20.
What is the number one reason for a pt to discontinue cl wear?
Correct Answer
A. Poor tear film
Explanation
Poor tear film is the number one reason for a patient to discontinue contact lens wear. This is because a healthy tear film is essential for maintaining the comfort and clarity of contact lenses. If the tear film is inadequate, it can lead to dryness, discomfort, and irritation, making it difficult for the patient to continue wearing contact lenses. Without proper tear film, the lenses may not fit properly on the eyes, causing further discomfort and potential damage to the cornea. Therefore, addressing and improving tear film quality is crucial for successful and comfortable contact lens wear.
21.
A pt comes to your office for a cl exam. during the sle you see 0.5 mm of lumbal neovascularization. what should you do?
Correct Answer
A. Monitor to prevent further neovascularization
Explanation
Based on the given information, the correct answer is to monitor the patient to prevent further neovascularization. Neovascularization refers to the growth of new blood vessels, which can be a sign of an underlying condition or a complication related to contact lens wear. By monitoring the patient regularly, the healthcare professional can assess the progression of the neovascularization and take appropriate actions if necessary, such as adjusting the contact lens fit, changing the material, or advising the patient to discontinue contact lens wear. Simply doing nothing may lead to worsening of the condition, so monitoring is essential.
22.
Pachymetry is a measurement of ______ and is used to assess _____.
Correct Answer
A. Corneal thickness; corneal edema
Explanation
Pachymetry is a measurement of corneal thickness and is used to assess corneal edema. This means that pachymetry is used to determine the thickness of the cornea, which can be an indicator of corneal edema, a condition characterized by swelling of the cornea. By measuring corneal thickness, pachymetry can help in diagnosing and monitoring corneal edema.
23.
What is true about curvature map
Correct Answer
A. All of the above are true
Explanation
The statement "all of the above are true" indicates that all the statements provided about the curvature map are correct. This means that the sagittal map assumes the center of the radius of that curvature is always on a central axis, the tangential curvature does not assume where the center of the radius is, and the mean curvature eliminates corneal astigmatism in order to highlight underlying features.
24.
Which of the following is NOT a tear film surface abnormality?
Correct Answer
A. Acne rosacea
Explanation
Acne rosacea is a chronic skin condition that primarily affects the face, causing redness, pimples, and visible blood vessels. It is not a tear film surface abnormality because it does not directly affect the tear film or its production. Tear film surface abnormalities typically involve issues with the composition or stability of the tear film, such as dry eye syndrome or meibomian gland dysfunction. Therefore, acne rosacea is the correct answer as it does not fit the criteria of a tear film surface abnormality.
25.
Which of the following statements about mucin is correct?
Correct Answer
A. A mucin deficiency can result in dry spots in the tear film
Explanation
inner layer is glycocalyx produced by epithelial cells
outer is goblet cells, manz glands and crypts of henle
insufficent tear meniscus: aq deficiency
26.
Which of the following management techniques can cure dry eye?
Correct Answer
A. None of the above
Explanation
you're not likely to cure the problem
27.
Which of the following will be the best type of lens for a first time wearer pt -2.00OD -2.25 OS with year round allergies
Correct Answer
A. Dailies total 1
Explanation
daily disposables are ideal for allergies, heavy depositors, and occasional wearers
28.
A patient comes in complaining about their contact lenses. During the exam, you notice protein build up on their lenses. What possible FDA grouping could these contact lenses be? (select 2)
Correct Answer(s)
B. Group 2
D. Group 4
Explanation
Contact lenses are classified by the FDA into four groups based on their level of risk. Group 2 includes daily wear soft contact lenses, which are the most commonly used type and are typically replaced on a regular basis. Protein buildup on these lenses may occur due to extended wear or improper cleaning. Group 4 includes extended wear lenses, which are designed for continuous wear for a specified period, increasing the risk of protein accumulation. Therefore, both Group 2 and Group 4 contact lenses may exhibit protein buildup.
29.
Select the following true statements about protein deposits. (select 2)
Correct Answer(s)
B. Seen as a whitish haze across the surface of the lens
C. Most common deposit type
Explanation
common inorganic:Jelly bumps
30.
Which of the following is true of soft contact lenses?
Correct Answer
D. Sihys have a greater dk with high silicone content and low water content
Explanation
H in hema: hydro so high water content
31.
What is the major source of oxygen for the endothelium?
Correct Answer
A. Aqueous
Explanation
The major source of oxygen for the endothelium is the aqueous humor. The aqueous humor is a clear fluid that fills the front portion of the eye, between the cornea and the lens. It provides nutrients and oxygen to the cornea and the endothelium, which is the innermost layer of the cornea. This oxygen supply is crucial for maintaining the health and function of the endothelium, which plays a vital role in maintaining the transparency and clarity of the cornea.
32.
Which of the following symptoms would be seen in a patient whose cornea has less oxygen consumption (due to CL abuse) (select 2)
Correct Answer(s)
A. Microcysts present
C. Endothelial folding
Explanation
A patient with less oxygen consumption in the cornea due to contact lens abuse may exhibit microcysts and endothelial folding. Microcysts are small fluid-filled spaces that form within the cornea as a result of chronic hypoxia, which occurs when the cornea does not receive enough oxygen. Endothelial folding refers to the folding or pleating of the endothelial layer of the cornea, which can also be caused by prolonged hypoxia. These symptoms are indicative of corneal damage and can be seen in patients who abuse contact lenses by wearing them for extended periods without proper oxygenation.
33.
Which of the following is incorrect?
Correct Answer
D. Each time the lenses are inserted, the case should be disinfected and air dried
Explanation
While it's important to regularly clean and disinfect contact lens cases, it's not necessary to disinfect and air dry the case each time the lenses are inserted. Instead, the case should be cleaned and disinfected regularly as per the manufacturer's instructions, typically at least once a day, and replaced every few months.
34.
Your pt asks for some tips regarding insertion and removal. You tell them all of the following except
Correct Answer
A. You should use OptiFree solution if you are allergic to Polyquad.
Explanation
optifree has polyquad in it
35.
Which of the following statements are incorrect regarding soft contact lens care and solutions? (select 2)
Correct Answer(s)
B. Oxidative disinfection is very effective in disinfection and protein removal, but decreases lens life expectancy
D. Stinging upon contact lens insertion, itch and injection are common signs of solution sensitivity most often caused by preservatives in oxidative disinfectant solution
Explanation
oxidation is effective but does not affect lens life expectancy
oxidative solution does not use preservatives (h202 oxidized to h20)
36.
A contact lens wearer comes to your office complaining of red, painful eyes for past 2 days and is very worried about an Internet article saying it could be "an amoeba". Upon thorough case history, you find out the pair of contact lenses are 4 months old and patient sleeps in them 5 days out of the week. In addition, the patient uses a saline solution to clean the lenses, reports no tap water is ever used to clean, doesn't swim/shower in contacts. What should be thought of immediately BEFORE a SLE? (SELECT 2)
Correct Answer(s)
B. Educate patient about saline solutions not having ability to disinfect, to switch to multipurpose solutions, and proper lens hygiene.
E. Assume bacterial infection, treat accordingly.
Explanation
saline= cheap acanthamoeba= more likely when swim in lenses
37.
Which of the following statement is true regarding oxidative disinfection in soft contact lens?
Correct Answer
D. Disadvantages include cost and punctate keratitis
Explanation
effective, no preservatives, neutralization in 4-6 hrs
38.
A patient is approved for a 1 year supply of Acuvue Oasys biweekly contact lenses. If each box contains 6 contact lenses, how many boxes need to be ordered to fulfill this request?
Correct Answer
C. 8 boxes total
Explanation
(4weeks/mo)(12 mo/yr)= 48 wks/yr (1 cl/2wk)(48 wk)= 24 cl (24 cl)(1 box/6cl)= 4 boxes/eye 8 boxes total
39.
All of the following are true about soft contact lens material except:
Correct Answer
B. Group 3 includes many disposable or planned replacement lenses
Explanation
group 4 include many disposable or planned replacement lenses
40.
A pt is asking about the advantages of soft cl, which of the following would you mention? (2)
Correct Answer(s)
A. Initial comfort
D. Hard to dislodge
Explanation
The advantages of soft contact lenses include initial comfort and being hard to dislodge. Soft lenses are known for their comfort, as they are made from flexible materials that conform to the shape of the eye. Additionally, they have a lower risk of dislodging compared to rigid lenses, making them more convenient and secure for wearers.
41.
Which of the following are changes than occur in the corneal stroma due to contact lens wear? (pick 2)
Correct Answer(s)
B. Lactic acid accumulation
D. Acidosis
Explanation
lactic acid accumulation, acidosis, thinning, neo, keratocyte loss, microdots
42.
Select the correct statements about soft cls
Correct Answer
D. Clear vision occurs as the eye remains open for a loose lens
Explanation
centration is primary gaze not blinking
43.
Which of the following is not a characteristic of a tight lens?
Correct Answer
B. Blur vision occurs after a full bliimk
Explanation
A tight lens is typically associated with clear vision immediately after a blink, little to no movement or lag, and the ability to buckle or wrinkle centrally. However, blur vision occurring after a full blink is not a characteristic of a tight lens.
44.
What should you not do if you have a loose lens
Correct Answer
C. Change to a smaller diameter
Explanation
If you have a loose lens, changing to a smaller diameter would not be the correct solution. A smaller diameter would only make the lens fit even looser, potentially causing discomfort and poor vision. Instead, you should consider changing to a larger diameter to ensure a better fit and stability for the lens.
45.
Which contact lens stabilization technique would you expect to have a thicker inferior portion of the lens with reduced O2 transmissibility in the thick zone and use gravity and lid force to put the lens in position?
Correct Answer
B. Prism balast
Explanation
Prism balast is the contact lens stabilization technique that would have a thicker inferior portion of the lens with reduced O2 transmissibility in the thick zone and use gravity and lid force to put the lens in position.
46.
Considering the Correct RX is dispensed, All of the following are CAUSES of Foggy/Hazy Vision in “Contact Lens” EXCEPT:
Correct Answer
A. Pt re
Explanation
b,c, and d are due to user error or environment
47.
Longstanding contact lens wearers are most likely to notice all of the following tear film changes EXCEPT:
Correct Answer
D. Increased tear pH
Explanation
Longstanding contact lens wearers may experience various changes in their tear film due to the prolonged use of lenses. These changes can include a decreased tear meniscus, decreased tear break-up time (TBUT), and decreased levels of phospholipids. However, increased tear pH is not typically observed in longstanding contact lens wearers.
48.
What causes excessive movement when wearing soft contact lenses?
Correct Answer
A. Deposited lenses
Explanation
Excessive movement when wearing soft contact lenses can be caused by deposited lenses. Deposits can accumulate on the surface of the lenses over time, causing them to become less smooth and slippery. This can lead to increased friction between the lenses and the eye, resulting in excessive movement. Regular cleaning and proper maintenance of the lenses can help prevent deposits from building up and minimize this issue.
49.
Which of the following tests are used to evaluate the quantity of the tear film? (multiple select)
Correct Answer(s)
B. Schirmer test
D. pHenol red thread test
Explanation
The Schirmer test and the phenol red thread test are both used to evaluate the quantity of the tear film. The Schirmer test measures the amount of tears produced by placing a small strip of filter paper inside the lower eyelid, while the phenol red thread test measures tear production by using a thread that changes color when it comes into contact with tears. Both tests are commonly used in ophthalmology to assess tear production and diagnose conditions such as dry eye syndrome.
50.
Which sources contribute the most oxygen to the cornea when the eye is CLOSED?
Correct Answer
D. Two of the above
Explanation
PC=Aq>LV
the aq and palpebral conj each suuply roughly the same amount of oxygen