COT Ocular Disease Recognition and Pathology

Question 1

A patient presents with sudden onset of severe eye pain, nausea, blurred vision, and halos around lights. Examination reveals a steamy cornea and a mid-dilated, non-reactive pupil. These findings are MOST consistent with:

Accepted Answer

Acute angle-closure glaucoma

Answer

Acute angle-closure glaucoma presents with sudden severe eye pain, nausea/vomiting, corneal edema (steamy appearance), and a mid-dilated non-reactive pupil due to markedly elevated intraocular pressure. This is an ocular emergency requiring immediate treatment.

Question 2

Drusen deposits located beneath the retinal pigment epithelium (RPE) are a hallmark finding of:

Accepted Answer

Age-related macular degeneration (AMD)

Answer

Drusen are extracellular deposits beneath the RPE that are the earliest clinical sign of age-related macular degeneration. Small hard drusen have low risk of progression, while large soft drusen are associated with higher risk of progression to advanced AMD.

Question 3

A patient describes a 'curtain coming across' their peripheral vision with associated flashing lights. These symptoms are MOST suggestive of:

Accepted Answer

Retinal detachment

Answer

A 'curtain' or 'shadow' moving across the visual field combined with photopsia (flashing lights) is classic for rhegmatogenous retinal detachment. The flashes result from vitreoretinal traction, and the curtain represents the area of detached retina. This is an ocular emergency.

Question 4

Cotton-wool spots seen on fundus examination are caused by:

Accepted Answer

Ischemic infarction of the nerve fiber layer causing axoplasmic stasis

Answer

Cotton-wool spots represent focal ischemic infarctions of the retinal nerve fiber layer that cause axoplasmic stasis. They appear white and fluffy on fundus exam and are commonly seen in diabetic retinopathy, hypertensive retinopathy, and HIV retinopathy.

Question 5

A pterygium is BEST described as:

Accepted Answer

A fibrovascular growth of conjunctival tissue that invades and grows across the cornea

Answer

A pterygium is a fibrovascular proliferation of conjunctival tissue that extends from the bulbar conjunctiva across the limbus onto the corneal surface. It differs from a pinguecula, which is a similar yellow deposit that does not cross the limbus. UV exposure is the primary risk factor.

COT - Certified Ophthalmic Technician Practice Test

COT - Certified Ophthalmic Technician Practice Test

COT Ocular Disease Recognition and Pathology