CPO CPO Clinical Principles and Procedures 2

Question 1

A patient with keratoconus is scheduled for a topography measurement.
During the procedure, the technician notices the mires are significantly distorted and cannot be aligned properly.
What is the most appropriate immediate action?

Accepted Answer

Reposition the patient's head and reinstruct them on fixation, then attempt the measurement again.

Answer

Record the readings as 'unobtainable' and inform the doctor.

Answer

Switch to a manual keratometer to get an approximate reading.

Answer

Instill a lubricating eye drop and wait five minutes before reattempting the measurement.

Question 2

When performing indentation gonioscopy with a 4-mirror lens, pressing gently on the cornea can help differentiate between appositional and synechial angle closure. If the angle opens upon indentation, what does this signify?

Accepted Answer

Appositional angle closure due to pupillary block.

Answer

The presence of a plateau iris configuration.

Answer

Permanent peripheral anterior synechiae (PAS).

Answer

Pigment dispersion syndrome.

Question 3

A 68-year-old patient reports a sudden, painless 'curtain' or 'shadow' in their inferior visual field that started one hour ago. Visual acuity is 20/200 in the affected eye. Which of the following pre-testing procedures is most critical to perform urgently before the patient sees the optometrist?

Accepted Answer

Confrontation visual fields.

Answer

Stereo acuity testing to assess binocularity.

Answer

Color vision testing with Ishihara plates.

Answer

Automated refraction.

Question 4

During pachymetry measurement prior to refractive surgery, a reading of 495 microns is obtained. How does this finding potentially impact the patient's candidacy for the procedure?

Accepted Answer

It indicates a thinner-than-average cornea, which may limit the amount of tissue that can be ablated.

Answer

It is a normal corneal thickness and has no impact on candidacy.

Answer

It indicates the cornea is thicker than average, making the patient an ideal candidate.

Answer

It suggests the presence of corneal edema, requiring further investigation.

Question 5

Which of the following is an essential step when preparing a patient for fundus photography, but is NOT typically required for standard automated perimetry?

Accepted Answer

Instilling mydriatic drops to dilate the pupil.

Answer

Obtaining informed consent for the procedure.

Answer

Patching one eye to improve fixation.

Answer

Explaining the importance of not blinking during the test.

Question 6

A patient with a history of recurrent corneal erosions is being evaluated. The optometrist orders a test to assess the health and density of the corneal endothelial cells. Which instrument would the paraoptometric be expected to use for this procedure?

Accepted Answer

Specular Microscope

Answer

Optical Coherence Tomographer (OCT)

Answer

Pachymeter

Answer

Corneal Topographer