COT Patient History and Ophthalmic Examination Techniques 4

Question 1

A patient reports seeing halos around lights at night. Which historical finding would most increase concern for acute angle-closure glaucoma?

Accepted Answer

Episodes of severe headache and nausea accompanying the visual symptoms

Answer

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.

Question 2

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?

Accepted Answer

The technician covers their own right eye

Answer

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.

Question 3

A patient with diabetes reports fluctuating vision that worsens after meals. The technician should note this as likely related to:

Accepted Answer

Osmotic lens changes from blood glucose fluctuations

Answer

Fluctuating blood glucose levels cause osmotic shifts in the crystalline lens, temporarily altering its refractive index and producing transient blurred vision.

Question 4

During slit-lamp examination, the technician uses a narrow slit beam directed obliquely to evaluate the anterior chamber depth. This technique is called:

Accepted Answer

Van Herick grading

Answer

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.

Question 5

A patient is unable to read the 20/400 letter on the Snellen chart. The next step in assessing visual acuity should be:

Accepted Answer

Test counting fingers at progressively shorter distances

Answer

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.

COT - Certified Ophthalmic Technician Practice Test

COT - Certified Ophthalmic Technician Practice Test

COT Patient History and Ophthalmic Examination Techniques 4