COT Optometry 4 — Questions and Answers
Question 1: A patient's manifest refraction is +1.00 D but cycloplegic refraction shows +3.00 D. The hidden +2.00 D is called:
- Absolute hyperopia
- Latent hyperopia (Correct answer)
- Facultative hyperopia
- Manifest hyperopia
Correct answer: Latent hyperopia
Latent hyperopia is the portion of hyperopia that is masked by accommodative tone and only revealed under cycloplegia.
Question 2: The amplitude of accommodation formula using the push-up method calculates accommodation from the near point distance. If the near point is 10 cm, the amplitude is:
- 4 D
- 10 D (Correct answer)
- 100 D
- 0.1 D
Correct answer: 10 D
Amplitude of accommodation = 1/near point distance in meters = 1/0.10 m = 10 D.
Question 3: Which condition is characterized by an increase in the refractive index of the crystalline lens, typically seen in early nuclear cataracts?
- Index myopia (Correct answer)
- Curvature myopia
- Axial myopia
- Positional myopia
Correct answer: Index myopia
Index myopia occurs when the refractive index of the lens nucleus increases (as in early nuclear sclerosis), increasing its converging power.
Question 4: What is the standard working distance used in retinoscopy, and what lens does the examiner add to neutralize this distance?
- 50 cm / +2.00 D (Correct answer)
- 67 cm / +1.50 D
- 100 cm / +1.00 D
- 33 cm / +3.00 D
Correct answer: 50 cm / +2.00 D
The standard retinoscopy working distance is 67 cm (adding +1.50 D) or 50 cm (adding +2.00 D); 67 cm/+1.50 D is most common in the US.
Question 5: Which term describes the difference in refractive error between the two eyes?
- Amblyopia
- Aniseikonia
- Anisometropia (Correct answer)
- Antimetropia
Correct answer: Anisometropia
Anisometropia is the condition in which the two eyes have significantly different refractive errors, which can cause amblyopia if present during visual development.
Question 6: A patient reports that straight lines appear wavy or distorted. This symptom is called:
- Photopsia
- Metamorphopsia (Correct answer)
- Diplopia
- Micropsia
Correct answer: Metamorphopsia
Metamorphopsia is the perception of distorted or wavy images and is commonly associated with macular disease such as epiretinal membrane or AMD.
Question 7: During a cover test, the uncovered eye makes an outward movement to pick up fixation. This indicates:
- Esotropia (Correct answer)
- Exotropia
- Hypertropia
- Orthophoria
Correct answer: Esotropia
When the uncovered eye moves outward to fixate, the covered eye was deviated inward (esotropia), a constant convergent strabismus.
COT Optometry 4
A patient's manifest refraction is +1.00 D but cycloplegic refraction shows +3.00 D.
The hidden +2.00 D is called: