JCAHPO Patient Evaluation 3 — Questions and Answers
Question 1: A 45-year-old patient can no longer read comfortably without reading glasses. This age-related change in near vision is known as:
- Myopia
- Presbyopia (Correct answer)
- Hyperopia
- Astigmatism
Correct answer: Presbyopia
Presbyopia is the age-related loss of accommodative amplitude due to decreased flexibility of the crystalline lens, typically becoming symptomatic in the mid-40s.
Question 2: When measuring intraocular pressure with a Goldmann applanation tonometer, the examiner adjusts the force until the inner edges of two fluorescent semicircles:
- Overlap completely
- Just touch at their inner margins (Correct answer)
- Are separated by a full semicircle width
- Align at their outer edges
Correct answer: Just touch at their inner margins
The endpoint for Goldmann applanation tonometry is when the inner edges of the mires just touch, corresponding to a 3.06 mm applanated area.
Question 3: Which ocular motility test uses a red lens over one eye to help identify the type and degree of strabismus?
- Cover-uncover test
- Maddox rod test (Correct answer)
- Hirschberg test
- Stereoacuity test
Correct answer: Maddox rod test
The Maddox rod test uses a grooved red lens to separate images and help quantify and characterize heterophorias and heterotropias.
Question 4: During history taking, a patient reports halos around lights at night. This symptom is most associated with:
- Retinal detachment
- Corneal edema or cataracts (Correct answer)
- Optic neuritis
- Macular degeneration
Correct answer: Corneal edema or cataracts
Halos around lights are classically associated with corneal edema (as in acute angle-closure glaucoma) or nuclear sclerotic cataracts scattering incoming light.
Question 5: The normal range of intraocular pressure measured by applanation tonometry is approximately:
- 5–10 mmHg
- 10–21 mmHg (Correct answer)
- 22–30 mmHg
- 30–40 mmHg
Correct answer: 10–21 mmHg
The statistically normal IOP range is 10–21 mmHg (mean ~16 mmHg), though glaucomatous damage can occur at any IOP.
Question 6: A patient is referred for an Esterman visual field test. This test is specifically designed to assess:
- Macular function in low vision
- Functional visual field for driving eligibility (Correct answer)
- Glaucomatous nerve fiber layer loss
- Color vision deficiencies
Correct answer: Functional visual field for driving eligibility
The Esterman binocular visual field is used to evaluate functional vision for activities such as driving and disability assessments.
Question 7: Which finding on cover test indicates a manifest strabismus (tropia) rather than a latent deviation (phoria)?
- The eye moves when the cover is removed
- The eye moves when the cover is placed over it (Correct answer)
- Both eyes remain stationary throughout the test
- The patient reports diplopia only when fatigued
Correct answer: The eye moves when the cover is placed over it
In a manifest tropia, the deviated eye will move to take up fixation when the dominant eye is covered, indicating the deviation is present without fusion demand.
JCAHPO Patient Evaluation 3
A 45-year-old patient can no longer read comfortably without reading glasses.
This age-related change in near vision is known as: