Patient History and Ophthalmic Examination Techniques Flashcards
7 cards from real COT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient History and Ophthalmic Examination Techniques flashcards as text
A patient reports seeing halos around lights at night. Which historical finding would most increase concern for acute angle-closure glaucoma?
Answer: Episodes of severe headache and nausea accompanying the visual symptoms
Acute angle-closure glaucoma classically presents with halos around lights accompanied by severe headache, nausea, and eye pain due to a sudden rise in intraocular pressure.
When performing confrontation visual field testing, the technician covers the patient's left eye and asks them to look at the technician's nose. What is the technician's corresponding eye doing?
Answer: The technician covers their own right eye
In confrontation fields, the technician covers the eye mirrored to the patient's covered eye — patient's left eye covered, technician covers their own right eye — so each tests the same field quadrant.
A patient with diabetes reports fluctuating vision that worsens after meals. The technician should note this as likely related to:
Answer: Osmotic lens changes from blood glucose fluctuations
Fluctuating blood glucose levels cause osmotic shifts in the crystalline lens, temporarily altering its refractive index and producing transient blurred vision.
During slit-lamp examination, the technician uses a narrow slit beam directed obliquely to evaluate the anterior chamber depth. This technique is called:
Answer: Van Herick grading
The Van Herick technique uses a narrow oblique slit beam at the limbus to estimate the peripheral anterior chamber depth as a ratio of corneal thickness, helping screen for occludable angles.
A patient is unable to read the 20/400 letter on the Snellen chart. The next step in assessing visual acuity should be:
Answer: Test counting fingers at progressively shorter distances
When a patient cannot see the largest Snellen optotype, vision is tested by counting fingers (CF), then hand motion (HM), then light perception (LP) to characterize the level of visual function.
Which medication class in a patient's history most directly requires documentation because it can cause a pigmentary retinopathy detectable on examination?
Answer: Hydroxychloroquine (Plaquenil)
Hydroxychloroquine can cause a bull's-eye maculopathy and must be documented so baseline and annual retinal screening can be performed per dosing guidelines.
A patient reports a sudden painless loss of vision in one eye described as 'a curtain coming down.' This history is most consistent with:
Answer: Rhegmatogenous retinal detachment
A 'curtain' or 'shadow' descending over the visual field is the classic description of a rhegmatogenous retinal detachment as it progresses to involve the macula.