AOC Clinical Procedures and Protocols 3 — Questions and Answers
Question 1: In performing cycloplegic refraction in children, which agent provides the most complete cycloplegia with the longest duration?
- Tropicamide 1%
- Cyclopentolate 1%
- Atropine 1% (Correct answer)
- Homatropine 5%
Correct answer: Atropine 1%
Atropine 1% produces the most complete and longest-lasting cycloplegia, often used for children with high hyperopia or accommodative esotropia.
Question 2: During the measurement of fusional vergence amplitudes, a patient first reports blur at a certain prism value. This blur point represents the limit of which function?
- Motor fusion (Correct answer)
- Sensory fusion
- Accommodative convergence
- Negative fusional vergence
Correct answer: Motor fusion
The blur point during fusional vergence testing indicates the limit of motor fusion before decompensation of the vergence system occurs.
Question 3: A Maddox rod placed before the right eye in a patient with orthophoria will cause the patient to see:
- A circle of light with the fixation light
- A red line through the fixation light (Correct answer)
- Two separate fixation lights
- A red dot superimposed on the fixation light
Correct answer: A red line through the fixation light
The Maddox rod converts a point source of light into a streak line perpendicular to the rod's cylinders, allowing dissociation and phoria measurement.
Question 4: The four-diopter prism base-out test is used to detect:
- Central suppression scotoma (Correct answer)
- Vertical muscle palsies
- Accommodative spasm
- Aniseikonia
Correct answer: Central suppression scotoma
The 4Δ base-out test identifies a small central suppression scotoma by observing whether both eyes make the expected versional and fusional movements.
Question 5: When recording a strabismus measurement using the prism and alternate cover test, SC and CC notations refer to:
- Superior/inferior corrections
- Spectacle correction and contact lens correction
- Without and with spectacle correction (Correct answer)
- Scotopic and cone-mediated conditions
Correct answer: Without and with spectacle correction
SC (sine correctione) means without correction and CC (cum correctione) means with correction, used when documenting refraction's effect on the deviation.
Question 6: A patient with a superior oblique palsy would most likely show a hyperdeviation that increases in which gaze position?
- Ipsilateral elevation and abduction
- Contralateral depression and adduction
- Contralateral elevation and adduction (Correct answer)
- Primary position only
Correct answer: Contralateral elevation and adduction
Superior oblique palsy produces the greatest hyperdeviation in contralateral gaze (adduction of the affected eye) and ipsilateral head tilt (Park's three-step test).
Question 7: When using a red lens dissociation test in a patient with diplopia, the red image is seen to the patient's right. This indicates the right image is from which eye?
- The right eye, indicating crossed diplopia
- The left eye, indicating crossed diplopia
- The right eye, indicating uncrossed diplopia
- The left eye, indicating uncrossed diplopia (Correct answer)
Correct answer: The left eye, indicating uncrossed diplopia
With a red lens over the right eye, a red image perceived on the patient's right indicates the image originates from the right eye, constituting uncrossed (homonymous) diplopia.
AOC Clinical Procedures and Protocols 3
In performing cycloplegic refraction in children, which agent provides the most complete cycloplegia with the longest duration?