AOC Emergency Response Procedures 2

Question 1

A patient in the orthoptic clinic develops sudden onset diplopia with ptosis and a dilated pupil. What is the most critical diagnosis to rule out first?

Accepted Answer

Posterior communicating artery aneurysm

Answer

A dilated pupil with ptosis and diplopia is the classic triad for a posterior communicating artery aneurysm, a life-threatening emergency requiring immediate neurosurgical evaluation.

Question 2

During a pediatric vision exam, a child suddenly becomes unresponsive and begins convulsing. After calling for help, what is the orthoptist's immediate priority?

Accepted Answer

Time the seizure and protect the airway

Answer

Timing the seizure and protecting the airway by positioning the child safely are the immediate priorities; restraining or inserting objects in the mouth are contraindicated.

Question 3

A patient reports sudden painless monocular vision loss described as a 'curtain coming down' from above. Which emergency condition is most likely?

Accepted Answer

Rhegmatogenous retinal detachment

Answer

A descending curtain of visual loss is the hallmark symptom of a superior rhegmatogenous retinal detachment involving the macula, requiring urgent surgical referral.

Question 4

When a patient experiences anaphylaxis after topical eye drop administration, what is the first-line emergency medication?

Accepted Answer

Intramuscular epinephrine

Answer

Intramuscular epinephrine (typically to the lateral thigh) is the first-line treatment for anaphylaxis and must be administered before antihistamines or steroids.

Question 5

A patient receiving cycloplegic drops suddenly complains of severe eye pain, nausea, and sees halos around lights. What emergency is occurring?

Accepted Answer

Acute angle-closure glaucoma

Answer

Cycloplegic agents can precipitate acute angle-closure glaucoma in anatomically predisposed eyes by dilating the pupil and blocking the trabecular meshwork.

(AOC) American Orthoptic Council Practice Test

(AOC) American Orthoptic Council Practice Test

AOC Emergency Response Procedures 2