CPOA Ocular Pharmacology 3 — Questions and Answers
Question 1: When instilling eye drops, the para-optometric assistant should have the patient look in which direction?
- Straight ahead
- Down toward the nose
- Up toward the ceiling (Correct answer)
- To the left
Correct answer: Up toward the ceiling
Looking upward moves the cornea superiorly, allowing drops to be placed safely into the inferior conjunctival fornix without touching the cornea.
Question 2: Which dye is used in conjunction with a Wood's lamp or cobalt blue filter to assess corneal abrasions?
- Rose bengal
- Lissamine green
- Sodium fluorescein (Correct answer)
- Indocyanine green
Correct answer: Sodium fluorescein
Sodium fluorescein fluoresces bright green under cobalt blue light, highlighting areas of disrupted corneal epithelium.
Question 3: A patient is taking a topical beta-blocker for glaucoma and has asthma. The primary concern is:
- Increased IOP
- Bronchospasm (Correct answer)
- Hyperglycemia
- Tachycardia
Correct answer: Bronchospasm
Beta-blockers can cause bronchospasm in patients with asthma or COPD because they block beta-2 receptors in bronchial smooth muscle.
Question 4: Rose bengal dye is used primarily to stain which type of ocular tissue?
- Healthy corneal endothelium
- Devitalized (dead or degenerated) epithelial cells (Correct answer)
- Aqueous humor
- Vitreous
Correct answer: Devitalized (dead or degenerated) epithelial cells
Rose bengal stains devitalized, dead, or degenerated conjunctival and corneal epithelial cells, aiding in the diagnosis of dry eye and viral keratitis.
Question 5: Which route of ocular drug administration provides the highest intraocular drug concentration?
- Topical eye drops
- Intravitreal injection (Correct answer)
- Oral systemic
- Subconjunctival injection
Correct answer: Intravitreal injection
Intravitreal injections deliver medication directly into the vitreous cavity, achieving the highest concentration at the posterior segment target tissue.
Question 6: Phenylephrine 2.5% is used as a mydriatic agent. Its mechanism of action is:
- Anticholinergic — blocks iris sphincter
- Alpha-adrenergic agonist — stimulates iris dilator (Correct answer)
- Beta-adrenergic agonist — relaxes ciliary muscle
- Cholinergic — stimulates dilator
Correct answer: Alpha-adrenergic agonist — stimulates iris dilator
Phenylephrine stimulates alpha-1 adrenergic receptors on the iris dilator muscle, causing pupil dilation without cycloplegia.
Question 7: What is the appropriate action to minimize systemic absorption after instilling eye drops?
- Have the patient blink rapidly
- Apply gentle nasolacrimal occlusion for 1-2 minutes (Correct answer)
- Ask the patient to tilt head back
- Irrigate the eye with saline immediately
Correct answer: Apply gentle nasolacrimal occlusion for 1-2 minutes
Pressing on the nasolacrimal duct (punctal occlusion) reduces drainage into the nasal mucosa, decreasing systemic absorption and side effects.
CPOA Ocular Pharmacology 3
When instilling eye drops, the para-optometric assistant should have the patient look in which direction?