JCAHPO Assisting with Interventions & Procedures 2 — Questions and Answers
Question 1: During a laser trabeculoplasty procedure, what is the primary role of the ophthalmic assistant?
- Adjust the laser power settings independently
- Position and stabilize the gonioscopy lens on the patient's eye (Correct answer)
- Perform the laser application on the trabecular meshwork
- Interpret the intraocular pressure readings post-procedure
Correct answer: Position and stabilize the gonioscopy lens on the patient's eye
The ophthalmic assistant's role during laser trabeculoplasty is to assist with patient positioning and stabilize the gonioscopy lens as directed by the physician.
Question 2: A patient is scheduled for a pneumatic retinopexy. Which positioning instruction is most critical post-procedure?
- Lie flat on the back for 24 hours
- Maintain a specific head position to keep the gas bubble over the retinal break (Correct answer)
- Avoid all head movement for one week
- Sleep in an upright seated position indefinitely
Correct answer: Maintain a specific head position to keep the gas bubble over the retinal break
After pneumatic retinopexy, the patient must maintain a specific head position so the intraocular gas bubble tamponades the retinal break.
Question 3: Which instrument is used to measure the axial length of the eye prior to cataract surgery for IOL power calculation?
- Pachymeter
- A-scan ultrasonography or optical biometry (Correct answer)
- Specular microscope
- Slit-lamp biomicroscope
Correct answer: A-scan ultrasonography or optical biometry
A-scan ultrasonography or optical biometry (e.g., IOLMaster) measures axial length, which is essential for calculating intraocular lens power.
Question 4: When assisting with a chalazion excision, the assistant should be prepared to provide which of the following?
- A chalazion clamp, curet, and local anesthetic (Correct answer)
- A vitrectomy probe and endoilluminator
- A cryoprobe and freezing agent
- A speculum and suturing needles only
Correct answer: A chalazion clamp, curet, and local anesthetic
Chalazion excision requires a chalazion clamp to stabilize and evert the lid, a curet to remove the contents, and local anesthetic for patient comfort.
Question 5: Before assisting with an intravitreal injection, the assistant should verify which critical step?
- That the patient has fasted for four hours
- That the correct medication, concentration, and dose are confirmed (Correct answer)
- That the patient's pupils are maximally dilated
- That a scleral buckle is available on the instrument tray
Correct answer: That the correct medication, concentration, and dose are confirmed
Confirming the correct medication, concentration, and dose is a mandatory safety check before any intravitreal injection to prevent medication errors.
Question 6: During phacoemulsification cataract surgery, what does the 'irrigation/aspiration (I/A)' handpiece primarily do?
- Emulsifies the hard nucleus using ultrasonic energy
- Removes residual cortical lens material after nucleus extraction (Correct answer)
- Creates the initial corneal incision
- Folds and inserts the intraocular lens into the capsular bag
Correct answer: Removes residual cortical lens material after nucleus extraction
The I/A handpiece irrigates with balanced salt solution and aspirates residual soft cortical material from the capsular bag after the nucleus has been removed.
Question 7: A patient undergoing fluorescein angiography suddenly reports nausea and develops hives. What is the most appropriate immediate action?
- Continue the procedure and note the reaction in the chart
- Stop the injection, notify the physician immediately, and prepare for anaphylaxis management (Correct answer)
- Administer oral antihistamines and resume the study
- Dim the room lights and have the patient lie down, then continue
Correct answer: Stop the injection, notify the physician immediately, and prepare for anaphylaxis management
Nausea with urticaria (hives) following fluorescein injection indicates a systemic allergic reaction; the procedure must stop immediately and the physician must be alerted for potential anaphylaxis treatment.
JCAHPO Assisting with Interventions & Procedures 2
During a laser trabeculoplasty procedure, what is the primary role of the ophthalmic assistant?