Practice Test
1. Which of the follwoing medications may affect successful contact lens wear?
a. antacids
b. antihistamines
c. aspirin
d. laxatives
2. Which term refers to a sensitivity to light?
a. presbyopia
b. photophobia
c. pannus
d. ptosis
3. Ks of 42.50@180/40.50@090 is an example of what type of astigmatism?
a. with-the-rule astigmatism
b. lenticular Astigmatism
c. against-the-rule Astigmatism
d. irregular Astigmatism
4. The cornea receives nutrients from: 1. Aqueous Humor, 2. Tear, 3. Limbal Blood Vessels, 4. Orbicularis occuli
a. 1, 3, 4
b. 2, 3
c. 1, 2, 3
d. 3, 4
5. The increased loss of ability of the crystalline lens to accommodate is called
a. presbyopia
b. myopia
c. hyperopia
d. aphakia
6. Which instrument can provide simultaneous information about the cornea, lids, conjunctiva, lashes, contact lens surface, and fit?
a. radiuscope
b. corneoscope
c. slit lamp
d. keratometer
7. The precorneal tear film is composed of three layers. They are:
a. lysozyme, oil, lacrimal
b. sebaceous, mucoid, BAK
c. lipid, aqueous, mucin
d. water, mucoid, lysozyme
8. Transpose -4.50 +1.25 x094 into minus cylinder form
a. -3.25 -1.25 x004
b. -3.25 -1.25 x094
c. -4.50 -1.25 x004
d. -5.75 -1.25 x004
9. The average pH value of the human tear is
a. 6.6
b. 7.4
c. 7.8
d. 10.0
10. If the manufacturer's guidelines suggest a minimum of 4 hours for disinfection, what would you suggest to the patient?
a. never leave lenses in disinfecants overnight
b. 2-3 hours is probably enough
c. use surfactant cleaner and preserved saline
d. a minimum of 4 hours is required
11. The main supply of oxygen to the corneal epithelium is derived from the
a. stroma
b. collagen fibrils
c. basal membrane
d. tear film
12. What is the term for the condition in which there is loss of vision without any apparent disease to the eye?
a. amblyopia
b. aniridia
c. astigmatism
d. aphakia
13. Which auxiliary trial lens will extend the kertaometer to approximately 30.00D?
a. +1.00D
b. +1.25D
c. -1.00D
d. -1.50D
14. Which step should be performed first when taking keratometer measurements?
a. rotate the drum to reflect the cylinder axis
b. adjust the patient so that they are comfortable
c. focus the eyepiece
d. cover the patient's eye that is not being measured
15. With Ks: 44.00@180/44.50@090 and Rx -3.00 -2.50 x180, what kind of astigmatism is present?
a. lenticular astigmatism
b. against-the-rule astigmatism
c. irregular astigmatism
d. oblique astigmatism
16. Ocular signs of aging include: 1. Tear film abnormalities, 2. Reduced lid elasticity, 3. Lens opacities, 4. Loss of accommodation
a. 1
b. 1, 3
c. 2, 4
d. All of the above
17. Transpose +1.50 +1.00 x075 into minus cylinder form.
a. +1.50 -1.00 x075
b. +2.50 -1.00 x075
c. +2.50 -1.00 x165
d. +2.50 -1.00 x175
18. The precorneal tear film provides 1. A smooth optical surface, 2. Metabolic nutrients to the epithelium, 3. Oxygen to the endothelium, 4. Limbal hyperemia
a. 1, 3
b. 1, 2
c. 2, 3
d. 3, 4
19. The cornea has five distinct layers. In order from anterior (front) to posterior (back), they are:
a. Epithelium, Descemet's Membrane, Stroma, Bowman's Membrane, Endothelium
b. Endothelium, Stroma, Bowman's Membrane, Descemet's Membrane, Epithelium
c. Epithelium, Bowman's Membrane, Stroma, Descemet's Membrane, Endothelium
d. Endothelium, Bowman's Membrane, Stroma, Descemet's Membrane, Epithelium
20. The normal cornea is transparent due to the pump action creating proper fluid balance. What layer of the cornea is most responsible for maintaining this function?
a. Endothelium
b. Basal membrane
c. Epithelium
d. Bowman's Membrane
21. A normal tear break-up time is
a. 6-7 seconds
b. 10-12 seconds
c. less than 5 seconds
d. none of the above
22. A white haze in the peripheral corneal stroma which does not stain and is often seen in the elderly is known as
a. neovascularization
b. dellen
c. arcus senilus
d. Fuch's dystrophy
23. Patients with keratitis sicca are more prone to
a. secondary infections
b. loss of eyelashes
c. losing their contact lenses
d. steepening corneas
24. Upon removal of the crystalline lens, the patient is
a. aphakic
b. myopia
c. hyperopic
d. astigmatic
25. The following prescription represents what? OD: +2.00 = 20/20, OS: -3.00 -2.00 x180 = 20/20
a. presbyopia
b. anisometropia
c. amblyopia
d. emmetropia
26. The above patient will best acheieve stereopsis with which of the following modalities?
a. contact lenses
b. spectacles
c. IOL
d. scleral lenses
27. Tom's spectacles with a power of -12.00 +0.50 x090 sit 10mm in front of his cornea. The likely soft conact lens prescription for Tom would be:
a. -10.50 D
b. -11.75D
c. -12.00D
d. -12.50D
28. The keratometer is an instrument used to measure
a. corneal curvature
b. lens power
c. lens diameter
d. lens thickness
29. An instrument used to evaluate corneal irregularity by reflecting concentric circles from the patient's cornea is called a
a. Burton lamp
b. con-ta-chek
c. topogometer
d. Placido's disk
30. Which auxiliary trial lens will extend the keratometer to approximately 61.00D?
a. -1.25D
b. +1.25D
c. -1.50D
d. +1.50D
31. Wearing lenses in high altitudes and dry environments may result in complaints of all but the following:
a. photophobia
b. chalazion
c. grittiness
d. burning sensation
32. Patients with which of the following occupations can successfully wear contact lenses?
a. arc welders
b. firefighters
c. teachers
d. all of the above
33. Transient keratometric mire distortion is usually due to
a. precorneal tear film
b. prolonged rigid lens wear
c. prolonged soft lens wear
d. irregular corneal astigmatism
34. In against-the-rule astigmatism, the steepest corneal meridian
a. is at or near 180 degrees
b. is at or near 135 degrees
c. is at or near 90 degrees
d. is at or near 45 degrees
35. Irregular mires on a keratometer may be indicative of
a. dry eyes or excessive mucoid secretions
b. keratoconus
c. contact lens induced corneal warpage
d. all of the above
36. In an alignment lid attachment RGP fit, the fluorescein pattern should show:
a. apical clearance and 360 degrees of bearing in the mid-periphery
b. a thin, even layer of fluorescein and less than 180 degrees of bearing in the mid-periphery
c. apical bearing and tear pooling inferiorly
d. apical bearing and maximum edge lift
37. In an RGP wearer, an arcuate stain on the cornea may be due to
a. failure to close the lids completely when blinking
b. a lens fit that is excessively flat
c. poorly blended secondary curves
d. solution sensitivity
38. In a Schirmer I test
a. the patient shoudl produce sufficient tears to saturate the paper strip in 3 minutes
b. an anesthetic drop is instilled in the eye to eliminate reflex tearing
c. fluorescein must be instilled in the eye to measure tear film break-up time
d. a patient with an unanesthetized eye and normal tear output should wet at least 15mm of the filter paper in 5 minutes.
39. In a Schirmer II test,
a. break-up time must be at least 10 seconds if a patient is to be a successful contact lens wearer
b. an anesthetic drop is instilled before the Schirmer strip is inserted to eliminate the reflex tearing caused by the filter paper
c. a normal reading guarantees that the patient is producing sufficient tears for successful contact lens wear
d. if the patient wets the entire Schirmer strip, they have xerosis and should not wear contact lenses
40. Rose bengal testing
a. is usually not necessary because the same information can be obtained by Schirmer testing
b. will stain devitalized conjunctival epithelial cells brightly
c. will only stain healthy epithelial cells
d. can be used to evaluate RGP lens fits instead of fluorescein
41. When evaluating tear film break-up time
a. rose bengal will give a more accurate reading than fluorescein
b. fluorescein should be instilled in the eye and the patient not allowed to blink until a reading is taken
c. a break-up time of less than 10 seconds may preclude success with contact lenses
d. the patient is seated at the keratometer, fluorescein is instilled in the eye, and the patient told to blink to spread the fluorescein evenly across the cornea before timing is begun
42. The preservative in contact lens solutions
a. must demonstrate efficacy in killing bacterial, viral, and fungal microorganisms
b. is usually a mercury component, such as thimerosal
c. must kill all microorganisms on a contact lens in a 4 hour soak period
d. is formulated to keep microorganisms from multiplying in a bottle of contact lens solution after it has been opened
43. A patient wearing a high horizontal primatic correction for a motility problem
a. will be able to have the same amount of prism added to the contact lens to control their strabismus
b. may experience diplopia when fit with contact lenses
c. will probably not need any prismatic correction with contact lenses since they sit directly on the eye
d. may develop nystagmus with contact lenses unless the prism is added
44. A pre-presbyopia myopia patient who is still able to read with single vision glasses may find that
a. they are unable to see fine print when fit with contact lenses
b. if the vertex distance is reduced, near vision will be clearer
c. monovision is impossible to adapt to
d. it is even more difficult to see the computer than to read with contact lenses that contain their distance prescription
45. Amy's +8.50D spectacles sit 12mm from the cornea. The power of a soft contact lens for Amy, properly vertexed, would be
a. +8.00D
b. +8.50D
c. +9.50D
d. +11.00D
46. Which of the following choices would work best for the patient's visual needs, give then following information:
K: 44.00@180/45.25@090, Rx: -3.00 +0.25 x090
a. RGP lens: 45.25 -3.00
b. RGP lens with toric posterior curves
c. soft toric lens
d. spherical soft lens
47. Which of the following set of lens specifications would best simulate an intrapalpebral RGP fitting given the following information: Ks 42.00@180/43.00@090, Rx -2.00 -1.00 x180. Upper lid positions 2mm above the superior limbus
a. 42.50 -3.00 8.5
b. 42.00 -2.00 9.5
c. 41.50 -1.50 8.5
d. 41.50 -1.50 9.5
48. Which contact lens would best correct a patient's visual needs, given the following: Ks 46.00@180/45.50@090, Rx -3.00 -1.50 x090
a. soft spherical lens
b. a soft toric lens
c. a back surface toric RGP lens
d. a front surface toric RGP lens
49. Which of the following material components has the highest gas permeability
a. fluorine
b. PMMA
c. butyrate
d. silicone
50. When documenting in a patient's chart on a new-fitting recheck, which of the following are not necessary?
a. visual acuity with the new lenses
b. notation of wearing time in lenses today
c. any concerns from the patient
d. sister's lens type that has caused no problem
51. Application of fluorescein should be used in which of the following situations?
a. evaluaton of a rigid gas permeable lens fit
b. evaluation of a soft contact lens parameters
c. evaluation of vascularization of the cornea
d. evaluation of rigid gas permeable lens over-refraction
52. If the diagnostic rigid gas permeable lens placed on the eye results in minimal movement, which of the following will increase the movement on the lens ordered for the patient:
a. decreasing overall lens diameter
b. increasing overall diameter
c. increasing optic zone diameter
d. increasing sagittal depth
53. If a soft contact lens decenters laterally, exposing a portion of the patient's limbus, what change in parameters would improve this situation?
a. decreasing lens diameter
b. increasing lens diameter
c. flattening the base curve
d. increasing the center thickness
54. When evaluating a diagnostic soft lens on a patient, you notice that movement is sluggish after only a few minutes. Which of the following changes would you make to the lenses that are ordered for the patient?
a. increase overall lens diameter
b. steepen base curve
c. flatten base curve
d. add -0.50D to the lens power
55. Which of the following lens designs would provide the best visual result for this patient: Ks: 43.00@180/46.00@090, Rx -3.00 sphere
a. soft toric lenses
b. spherical rigid gas permeable with increased center thickness
c. truncated rigid gas permeable lens
d. soft spherical lens
56. Which edge design is recommended for a +15.00D aphakic RGP lens?
a. hyperflange
b. lenticular myoflange
c. concentric design
d. intrapalpebral design
57. Which of the following lens designs would provide the best visual acuity result for this patient? Ks: 42.00@180/42.50@090, Rx -3.50 -1.75 x180
a. spherical rigid gas permeable lens
b. spherical soft lens
c. soft toric lens
d. back surface toric rigid gas permeable lens
58. What Rx would be ordered for a rigid gas permeable lens fit "on K?" Ks 43.00@180/44.00@090, Rx -3.00 +1.00 x090
a. -1.00D
b. -2.00D
c. -3.00D
d. -4.00D
59. To aid in the positioning of a rigid prism ballast lens riding too low and slipping underneath the lower lid, which of the following might be helpful?
a. hyperflange
b. more prism
c. truncation
d. thinner edge design
60. The following gas permeable diagnostic lens is placed on a patient's eye: 43.50 -2.00 9.2. An over-refraction is performed with the following results: plano +1.50 x095. Which of the following lens parameters would you order:
a. 43.50/ -0.50 -1.50 x005/ 9.2
b. 43.50/ -2.00 -1.50 x005/ 9.2
c. 43.50/ pl -1.50 x095/ 9.2
d. 43.50/ pl +1.50 x005/ 9.2
61. The following soft lens is placed on a patient's eye: 8.8/ -4.00/ 14.0. An over-refraction is performed resulting in -0.75D sphere. Which of the following lens parameters would you order for the patient?
a. 8.8 -3.25 14.0
b. 8.8 -4.00 14.0
c. 8.8 -4.75 14.0
d. 8.8 -5.25 14.0
62. In an RGP lens, a poorly finished transitional zone between the optic zone and the lens edge can be evaluated by:
a. radiuscope
b. lensometer
c. profile analyzer
d. contacto gauge
63. During the diagnostic evaluation of the following patient, the lens rotates 10 degrees to the right. Which of the following lens parameters would you order for the patient? Patient's refraction -2.00 -1.00 x170, Diagnostic lens 8.7 -2.50 -1.00 x170
a. 8.7/ -2.50 -1.00 x160
b. 8.7/ -2.50 -1.00 x170
c. 8.7/ -2.50 -1.00 x180
d. 8.7/ -2.50 -1.00 x010
64. Which of the following lens design would not provide a good visual acuity result for this patient? Ks: 42.50@180/44.00@090, Rx -2.50 +1.50 x090
a. soft toric lens
b. soft spherical lens
c. spherical rigid gas permeable lens
d. aspheric rigid gas permeable
65. An excellent material for a patient with keratoconus would be
a. polymacon
b. crofilcon a
c. bufilcon a
d. fluorosilicone acrylate
66. A prism ballast RGP lens requires how much prism for proper orientation
a. 0.75-1.50D
b. +3.00D at 6 oclock
c. 1.50-3.00D
d. Always 0.75D
67. Which of the floowing could be considered in the fitting of a keratoconus patient: 1. Aspheric, 2. McGuire, 3. Soper, 4. Tangent Streak
a. 1, 2
b. 2, 3
c. 3, 4
d. 1, 2, 3
68. The following soft lens is placed on a patient's eye: 8.4-2.00 14.2. An over-refraction is performed with the following results: -1.00 -0.50 x074. Which of the following lens parameters would you order for the patient?
a. 8.4/ -2.00 14.2
b. 8.4/ -2.75 14.2
c. 8.4/ -3.25 14.2
d. 8.4/ -3.75 14.2
69. Given the following information: Ks 45.00@180/44.00@090. Rx: -3.00 +1.00 x180. Which of the following set of lens specification, would best simulate an intrapalpebral rigid lens fitting?
a. 43.50/ -1.50/ 8.5
b. 43.50/ -1.50/ 9.5
c. 44.50/ -2.00/ 8.5
d. 44.50/ -2.50/ 8.5
70. Given the following information, which ofthe following set of lens specifications would best simulate a lid attachment rigid lens fitting? Ks: 42.00@180/43.00@090, Rx -2.00 -0.87 x180. Upper lid positioned 2mm below the superior limbus.
a. 41.50/ -1.50/ 9.5
b. 42.50/ -2.50/ 8.5
c. 43.00/ -2.50/ 9.5
d. 43.00/ -3.00/ 8.2
71. Which of the following bifocal designs represents a translating design?
a. diffraction design
b. crecent design
c. reverse centrad design
d. concentric design
72. Given the following information, which of the listed rigid lens designs would you order to best correct this patient's vision? K: 42.00@180/45.00@090, Rx: -3.00 -2.25 x180
a. 42.00/45.00/ -3.00 -2.25 (Rx form)
b. 42.00/ -3.00 -2.75 x177 prism ballast
c. 42.00/ -3.00
d. 45.00/ -3.00
73. The performance of a soft toric lens depends on: 1. Corneal topography, 2. Lid shape, 3. Lid positioning, 4. Lid tightness
a. 1
b. 1, 3
c. 2, 3
d. all of the above
74. Given the following information, which of the following RGP lens designs would you order to best correct this patient's vision: Ks: 45.00@180/42.00@090, Rx: -2.00 -4.25 x090
a. 45.00/ -2.00
b. 42.00/ -2.00 -4.25 x090/ prism ballast
c. 42.00/ -2.00
d. 42.00/45.00/ -2.00/-5.75
75. Given the following information, which of the following RGP lens designs will best correct the patient's vision? Ks: 42.50 @180/42.50@090, Rx: -3.00 -1.00 x090
a. bitoric design
b. anterior toric design
c. spherical design
d. soper cone design
76. Given the following refraction and K readings, select the correct base curve and power recordings (drum readings): Ks: 44.00@180/41.00@090, Rx: -1.00 -3.00 x090
a. 41.00/44.00 -1.00/-3.00
b. 41.00/44.00 -1.00/-4.00
c. 41.00/44.00 -4.00/-1.00
d. 44.00/41.00 -1.00/-3.00
77. Which of the following is not necessary to consider when fitting RGP aphakic contact lenses?
a. vertex distance
b. minus-carrier lenticular designs
c. proper lens centration
d. hyperflange designs
78. A bifocal lens in which the power gradually changes from the central area of the lens to the periphery is known as
a. an aspheric lens
b. a juxtapositioned lens
c. a monocentric lens
d. a crecent lens
79. An aphakic patient with K readings of 40.50@180/41.25@090, large palpebral fissures and flaccid lower lids is a good candidate for:
a. a single cut
b. a myoflange lenticular
c. a hyperflange lenticular
d. a back toric
80. The patient has an HVID of 12.5mm. The best choice for initial soft lens diameter would be:
a. 13.0mm
b. 13.5mm
c. 14.5mm
d. 15.5mm
81. A single cut aphakic lens is best suited for patients with _____ apertures and _____ corneas.
a. small/ flat
b. small/ steep
c. large/ flat
d. large/ steep
82. Where is the pwoer curve on a spin-cast soft lens?
a. the front surface
b. the back surface
c. within the lens
d. around the edge
83. Keratoconus and penetrating keratoplasty fittings are best accomplished by which of the following methods:
a. nomogram
b. Ks and Rx
d. diagnostic fitting
d. molded impression
84. The following ametropia frequently results in high riding rigid lenses:
a. high myopia
b. high hyperopia
c. aphakia
d. presbyopia
85. A good example of a bifocal contact lens that may rotate without vision impairment is
a. aspheric
b. executive
c. fused crescent
d. translating
86. A toric soft lens will correct
a. residual astigmatism
b. moderate astigmatism (greater than 2.00D)
c. low astigmatism (0.75-2.00D)
d. all of the above
87. A lens fitted for keratoconus should
a. flatten the apex
b. ride high
c. align the apex
d. ride low
88. Therapeutic soft lenses should be fit with minimal movement in which case?
a. keratitis sicca
b. trichiasis
c. recurrent erosion
d. keratoconus
89. The best option for patients with giant papillary conjunctivitis, or those who are cooks or hairdressers is
a. tinted soft lenses
b. disposable lenses for daily wear only
c. traditional soft lenses that are replaced on an annual basis
d. extended wear lenses
90. Which of the following is a translating bifocal lens design?
a. concentric
b. aspheric
c. diffractive
d. segmented
91. Prism ballast, double slab-off, and peri-ballast are all what type of lens design?
a. soft toric
b. bifocal
c. therapeutic
d. spherical
92. In choosing the diameter of a soft lens, what is the general rule of thumb?
a. 1.0mm larger than HVID
b. 2.0mm larger than HVID
c. 3.0mm larger than HVID
d. none of the above
93. Given Ks 42.00@170/43.00@080 and Rx -3.00 -1.00 x170, the follwing diagnostic soft lens was used: 8.8/ -3.00 -1.00 x180. During the diagnostic evaluation, the above lens rotated 10 degrees clockwise. The lens ordered should have an axis of:
a. 10 degrees
b. 160 degrees
c. 170 degrees
d. 180 degrees
94. Which of the following statements is correct?
a. high Dk RGP lenses have greater stability and deposit resistance than lower Dk materials
b. use of an enzymatic cleaner is mandatory with fluoro-silicone acrylate materials
c. fluoro-silicone acrylate materials have "non-stick" qualities that enable patients to blink protein and other deposits off the lens surface
d. silicone acrylate materials have a positively charged surface that repels lipid and protein deposits
95. Given: Ks 42.00@180/42.00@090, Rx -3.00 -2.00 x180
a. a back surface toric RGP lens will probably be necessary to acheive optimum visual acuity
b. a bitoric RGP lens will probably be necessary to acheive optimum visual acuity
c. a soft spherical lens will provide the best fit and visual acuity because the patient has a spherical cornea
d. a front surface toric RGP lens will probably be necessary to correct the patient's residual astigmatism
96. A patient's K readings are 43.50@180/41.50@090. A spherical RGP lens can be expected to:
a. displaced down and in or down and out with each blink
b. position under the upper lid to provide a superior lid attachment, alignment fit
c. lock on to the cornea nasally or temporally
d. establish a fulcrum at 3 and 9 oclock in the horizonal meridian
97. Which special RGP lesn design would be beneficial for the patient, given the following information: Ks: 44.00@180/46.50@090, Rx -11.00 +2.50 x090
a. hyperflange
b. back toric design
c. thick edge design
d. myoflange
98. During the diagnostic evaluation of the following patient, the lens rotates 10 degrees to the left. Which of the following lens parameters would you order for the patient? Refraction: -3.00 -1.25 x160. Diagnostic lens: 8.4/ -3.00 -1.25 x180/ 14.5
a. 8.4/ -3.00 -1.25 x160/ 14.5
b. 8.4/ -3.00 -1.25 x170/ 14.5
c. 8.4/ -3.00 -1.25 x180/ 14.5
d. 8.4/ -3.00 -1.25 x010/ 14.5
99. A patient is diagnostically fit with a rigid gas permeable lens with the following parameters: 42.50/ -3.00/ 9.5. If you wish to flatten the lens to cornea relationship, which of the following lenses would you order?
a. 42.00/ -2.50/ 10.0
b. 42.50/ -3.00/ 9.0
c. 43.00/ -3.50/ 9.5
d. 43.50/ -3.50/ 9.0
100. Contact lenses are most often specified in
a. back vertex power
b. spherocylinder power
c. power in situ
d. posterior apical radius
101. The tolerance for the overall lens diameter according to the ANSI standards is:
a. +/- 0.005mm
b. +/- 0.05mm
c. +/- 0.01mm
d. +/- 0.1mm
102. All of the following will enable the practitioner to verify the overall rigid gas permeable lens diameter except:
a. slot gauge
b. shadowgraph
c. measuring magnifier
d. radiuscope
103. Placing the concave side of a rigid gas permeable lens against the lens stop of the lensometer, will provide you with which of the following
a. back vertex power
b. front vertex power
c. best vertex power
d. closest vertex power
104. An instrument that allows simultaneous verification of lens diameter, optic zone width, and peripheral curve width is
a. measuring magnifier
b. ophthalmometer
c. profile analyzer
d. radiuscope
105. Assessment of the quality of the peripheral curves (blends) of a rigid contact lens is acheived by the use of the
a. profile analyzer
b. shadowgraph
c. keratometer
d. Burton lamp
106. The instrument used for magnificaiton of the edge of a rigid contact lens is a
a. keratometer
b. shadowgraph
c. profile analyzer
d. v-groove gauge
107. The tolerance for lens power under +/- 10.00D is
a. 0.12D
b. 0.25D
c. 0.37D
d. 0.50
108. A warped lens will show _____ base curve(s) on the radiuscope and a _____ power on the lensometer.
a. one/ spherical
b. two sphero-cylindrical
c. one/ sphero-cylindrical
d. two/ spherical
109. Which of the following will not measure contact lens parameters?
a. keratometer
b. radiuscope
c. Burton lamp
d. thickness gauge
110.. Prolonged periods of reading in contact lenses may lead to lens discomfort due to:
a. decreased blinking
b. corneal temperature changes
c. accommodative response
d. neovascularization
111. Which oft he following statements is most accurate:
a. routine cosmetic daily wear patients should be seen at 3 month intervals for a contact len evaluation
b. patients with a history of GPC should be refit with disposable soft lenses and followed on a bi-weekly basis for 6 months
c. new soft lens fits should be seen at one week, one month, three months, and 6 months from the time of their initial fit, then every 6-12 months.
d. patients who are weaing RGP lenses after penetrating keratoplasty need fewer follow-up visits than keratoconus patients because their corneas are now spherical.
112. Which of the following materials would least likley require a weekly enzymatic cleaner?
a. PMMA
b. hydrophilic
c. HEMA
d. silicone acrylate
113. Which type of lens would best satisfy the following patient's visual needs given the following information: K: 43.00@160/44.00@075, 3+ distortion, Rx: -2.00 +1.00 x075
a. spherical soft lens
b. soft toric lens
c. soft bifocal lens
d. spherical RGP lens
114. A rigid contact lens measures +15.00 BVP. The FVP will measure
a. a lesser dioptric reading
b. a greater dioptric reading
c. an identical dioptric reading
d. an astigmatic reading
115. Which of the following preservatives has a low incidence of ocular sensitivity with soft contact lenses?
a. sorbic acid
b. chlorbutanol
c. benzakonium chloride
d. thimerosal
116. Patients who are fit with lenses that will be worn overnight on a flexible or entended wear basis:
a. should be seen as early as possible in the morning for follow-up of overnight wear
b. should have their follow-up visits late in the day to evaluate their lenses and identify problems related to overnight wear
c. should be scheduled for a follow-up visit 2 weeks after the initial fitting
d. will need minimal follow-up if they have worn daily wear lenses successfully.
117. The base curve of a rigid lens was ordered 7.84mm and was received 7.94mm. This lens is _____ than ordered,
a. 0.50D steeper
b. 1.00D steeper
c. 0.50D flatter
d. 1.00D flatter
118. One might utilize which of the following lens designs given the following information: Ks: 46.00@075/48.50@165 +2 distortoin, Rx: -7.00 -3.50 x165. Irregular retinoscopy reflexes
a. Soper keratoconus design
b. myoflange design
c. front surface toric RGP design
d. Mandell design
119. Given the following information: Ks: 42.50@180/44.50@090, Rx: -3.50 -2.50 x090, select the lens power if the lens is ordered 0.50D steeper than K
a. -3.50D
b. -4.00D
c. -4.75D
d. -6.00D
120. The FDA has recommended that extended wear contact lenses be worn for a maximum of
a. 7 days
b. 14 days
c. 30 days
d. 45 days
121. Which of the following preservatives is a mercury based compound?
a. sorbic acid
b. thimerosal
c. benzalkonium chloride
d. polyquad
122. Carol's contact lenses are fit on flat K. Her refraction is -5.00 +2.00 x090. What is the power of her contact lens?
a. -3.00 D
b. -4.00D
c. -5.00D
d. -7.00D
123. When verifying a rigid lens on a radiuscope, you notice that the mires are not in focus in all principle meridians. This might indicate a: 1. Warped lens, 2. Back toric lens, 3. Bitoric lens, 4. Front toric lens
a. 1
b. 1, 3
c. 2, 4
d. 1, 2,3
124. Which of the following may cause a soft lens to need to be replaced more often?
a. chemical disinfection
b. enzymatic cleaning
c. heat disinfection
d. nightly cleaning
125. Which of the following is a preservative found in soft contact lens solutions?
a. chlorbutanol
b. polyquad
c. banzalkonium chloride
d. benzyl alcohol
126. Which of the following hobbies and activities should be discussed with patients?
a. long periods of computer work
b. long periods of reading
c. long periods of driving
d. all of the above
127. Conventional daily wear soft contact lenses, properly cared for, should be replaced at least
a. quarterly
b. yearly
c. every two years
d. when they hurt
128. Which of the following is a non-approved wetting solution that is quite safe for patients to use?
a. salive
b. toothpaste
c. dish soap
d. none of the above
129. Which medication should not be used with soft contact lenses, as it will turn the lens brown?
a. antacids
b. epinephrine
c. digitalis
d. insulin
130. If a soft contact lens becomes adherent to the cornea, the patient should:
a. irrigate the eye profusely with warm water until the lens becomes loose.
b. pinch the lens off the eye by placing the thumb and forefinger at 3 and 9 oclock on the cornea and squeezing to break the suction
c. irrigate the eye with saline or rewetting drops until the lens begins to move freely again
d. use a DMV sunction cup to remove the lens
131. Poor RGP insertion or recentering techniques may result in
a. 3 and 9 oclock staining
b. the lack of a fulcrum at 3 and 9 oclock
c. arcuate staining
d. coalesced SPK centrally
132. When can Johnny, a 12 year old new contact lens wearer, comfortably be sent home with new lenses?
a. when the mom has worn for years
b. when he can remove the lenses by himself
c. when he can insert and remove the lenses by himself
d. when he promises to remove the lenses daily
133. The purpose of a combination wetting/ soaking RGP solution is to:
a. maintain lens surface wettability
b. disinfect the lens
c. cushion the lens during insertion
d. all of the above
134. Enzymatic cleaning of soft lenses is important in
a. preventing the development of GPC
b. preventing the lens from shrinking and tightening
c. maintaining the hydration of the lens
d. all of the above
135. Which of he following statements about eye make-up is correct?
a. eyeliner should be applied to the innner margin of the eyelids behind the lashes
b. eyeliner and mascara should be replaced every 3-6 months to avoid contamination
c. mascara should be applied to the base of the lashes only
d. eye makeup should be applied before inserting contact lenses
136. Which of the following is not considered a normal adaptive response to soft lenses
a. awareness of the lenses in the eye
b. awareness of bright sunlight
c. slight itching sensation
d. lenses feeling "hot" in the late afternoon
137. Which of the following statements is correct?
a. if patients touch the tip of a solution container to their skin or eyelashes, they should wash the tip wth soap and water
b. if a soft contact lens dries out, it should be immersed in warm water until it softens
c. disinfecting solutions should be "topped off" nightly and changed weekly
d. solution containers should always be capped after use to prevent contamination
138. Thermal disinfection of soft lenses
a. extends the life of the contact lenses since it kills microorganisms better than chemicals
b. can be done by boiling the lens case in a pot of water for one hour if a thermal disinfection unit is not available
c. is effective against acanthamoeba cysts and trophozites
d. does not require prior cleaning with a surfactant since it kills microorganisms so effectively
139. Hydrogen peroxide care systems
a. should not be used to disinfect FDA Group IV lenses
b. is more effective against viruses and fungi than most chemical disinfection systems
c. does not require a red tip on its container, since it does not cause permanent damage if accidently instilled into the eye
d. takes a minimum of two hours to be decomposed into water and oxygen
140. Which of the following cannot be used to measure the diameter of a rigid lens?
a. profile analyzer
b. measuring magnifier
c. diameter gauge
d. shadowgraph
141. Use of a Wratten #12 or Tiffen yellow filter is important in evaluating the fluorescein pattern of patients with RGP lenses because
a. many patients are wearing lenses containing UV inhibitors that block fluorescein
b. there will be too much fluorescence if a filter is not used
c. 3 and 9 oclock staining will not show up if the filter is not placed
d. the filter will help to identify patients with corneal warpage
142. If fluorescein evaluation reveals apical staining, it could be due to
a. a lens that is too flat and loose
b. a lens that is too steep and tight
c. corneal edema
d. all of the above
143. Newly fitted extended wear patients should have their first recheck in
a. 24 hours
b. 3 days
c. 2 weeks
d. 3 weeks
144. If an adapted contact lens wearer complains of a sidden onset of discomfort, the technician should suspect
a. a change in corneal curvature
b. giant papillary conjunctivitis
c. a damaged contact lens
d. tight lens syndrome
145. If an RGP lens fails to provide acceptable visual acuity, the fitter should first
a. flatten the lens to cornea relationship
b. have a sphero-cylindrical overrefraction performed to see if the reduced acuity is due to residual astigmatism
c. refit the patient with a soft lens
d. use a lens with a higher Dk/L value
146. According to the FDA, disposable contact lenses that are removed nightly should be discarded after
a. 1 week
b. 2 weeks
c. 1 month
d when they appear cloudy or hurt the patient
147. 3 and 9 oclock staining in RGP lens wearers can best be eliminated by
a. reducing center and edge thickness and teaching the patient to blink completely
b. adding a minus carrier to the lens
c. using preservative-free saline instead of RGP wetting/ soaking solution
d. using a single-cut rather than a multicurve lens design
148. Circumcorneal injection in a soft lens wearer may be a sign of
a. tight lens syndrome
b. solution sensitivity
c. keratitis
d. all of the above
149. A technician can perform a preliminary evaluation of soft contact lens movement by
a. observing the movement of the lens edge in relation to the position of a conjunctival vessel
b. having the patient look up and blink
c. observing movement and lens lag in upward and lateral gaze with a penlight
d. all of the above
150. Which of the following statements concerning lens movement is not correct:
a. a tight lens may cause blanching of the limbal vessels
b. a tight lens may cause scleral indectation
c. a loose lens may cause blurred vision immediatley following a blink
d. a loose lens will be considerably more comfortable than a tight lens
151. Which of the following modifications to a rigid gas permeable lens cannot be made in the office?
a. blending of peripheral curves
b. addition of minus power
c. polishing lens surface
d. change the base curve
152. In-office polishing of the anterior surface of a rigid gas permeable lens surface will provide many benefits to the patient. Which of the following is not a benefit of polishing the lens in the office?
a. cleaner lens surface
b. increased lens comfort
c. thinner lens edge
d. removal of scratches on the lens surface
153. What is the most important feature of an in-office modification unit?
a. easy to clean
b. variable speed motor
c. has a removable cover
d. manufacturer's warranty
154. If a patient with exophthalmic eyes due to thyroid eye disease requires a toric lens
1. It will be forcibly expelled from the eye due to the bulging eyeball
2. It may dehydrate excessively due to the lid retraction and dry eye condition that often accompanies thyroid eye disease
3. Stability will be difficult to maintain since there are no lid forces to keep the lens in position
4, The "watermelon seed" principle will help to keep the lens in position
a. 1, 2
b. 2, 3
c. 1, 2, 3, 4
d. none of the above
155. Which of the following is not a characteristic of edema?
a. smoky vision
b. spectacle blur
c. increase in K readings
d. peripheral flare
156. Which of the following is not used when blending peripheral curves in the office?
a. slot gauge
b. radius tools
c. polishing compound
d. suction cups or a spinner tool
157. The slit lamp illumination that gives an overall view of the cornea but limits detail is
a. sclerotic scatter
b. diffuse
c. specular reflection
d. oscillatory
158. When keratometric mires reflected off a soft contact lens are only clear when the wearer blinks, the lens fit is too
a. small
b. large
c. steep
d. flat
159. Gross corneal edema, which manifests clinically as central corneal haze, is verified by slit lamp using sclerotic scatter illumination. What specific technique does the examiner use to see this condition?
a. the naked eye and an angle between the slit lamp beam and the eye of 90 degrees
b. the blue cobalt filter of the slit lamp and an angle of about 45 degrees
c. the green filter of the slit lamp with high magnification
d. high magnification and an angle between the beam and scope of 180 degrees
160. When inspecting the blend on the bevel of an RGP lens,
a. the lens must be held so the reflection of light on the anterior surface of the lens falls centrally on the lens
b. the fluorescent tube should be behind and below the examiner
c. an ideal blend should show a J-shaped or ski pattern in a smooth curve
d. in order to get the reflection continuous to the edge of the lens it must never be tilted
161. Diffuse central punctate staining is an indication of
a. a foreign body under the lens
b. lens flare
c. tight lens
d. excessively wide transitional zone
162. Sandy returns to your office after being fit with soft contact lenses. She has complaints of the lenses becoming uncomfortable and burning as the day progresses. What might be the reason?
a. the lens is too small
b. the lens is too flat
c. the lens is too tight
d. the lens is the wrong color
163. With a rigid contact lens in place, a fluorescein pattern shows a concentration of fluorescein inferiorly and superiorly beneath the lens. Which one of the following types of astigmatism is represented by this pattern?
a. lenticular astigmatism
b. residual astigmatism
c. against-the-rule astigmatism
d. with-the-rule astigmatism
164. Mary is wearing a rigid gas permeable lens with a base curve of 43.50D and a power of +2.75D. She requires a -0.75D sphere over this lens. If you wish to order her a new lens with a curve of 43.00D, what will the new power be?
a. +1.50D
b. +2.00D
c. +2.50D
d. +3.00D
165. FDA Group I soft lenses
a. have a water content greater than 50% and a non-ionic lens surface
b. have a water content greater than 50% and an ionic lens surface
c. have a water content lower than 50% and a non-ionic lens surface
d. have a water content lower than 50% and an ionic lens surface
166. Which type of slit lamp illumination will allow you to determine corneal thickening, thinning, and distortion and depth of foreign bodies or opacities in the cornea?
a. diffuse illumination
b. optic section
c. retro-illumination
d. conical beam
167. Corneal edema is observed infeiorly under a prism ballast toric soft lens. What is the probably cause?
a. lens is too tight
b. corneal oxygen demand is too low for this lens
c. lens is too loose
d. prism thickness is too great
168. A soft lens has edge lift when observed on the cornea. How can this be corrected?
a. steepen the base curve
b. decrease the diameter
c. flatten the base curve
d. change the edge design
169. In evaluating a soft lens with either keratometry mires or retinoscopic reflex, you detect distortion immediately after the blink followed by clear mires. This is caused by:
a. a steep fitting lens
b. a properly fitting lens
c. a flat fitting lens
d. a tight fitting lens
170. Which of the following statements is correct?
a. extended wear soft lenses are extremely fragile and thererfore a poor choice for paitents wishing to wear lenses on a daily wear basis.
b. FDA Group IV lenses have a negatively charged surface that attracts positively charged tear film, proteins, and lipids
c. silicone acrylate RGP lenses contain a Teflon-like substance that gives their surfaces non-stick qualities
d. adding greater amounts of silicone to RGP materials increases both their oxygen transmission and base curve stability
171. Which type of slit lamp illumination is used for observing tear break up time?
a. diffuse illumination
b. optic section
c. direct illumination
d. retroillumination
172. A non-wetting rigid gas permeable lens may cause
a. hazy, filmy vision
b. lens awareness
c. dryness or grittiness
d. all of the above
173. Causes of lens flexure may include 1. Pressure exerted by the upper lid, 2. High Dk lens materials, 3. Apical clearance lens design, 4. Against the rule toricity
a. 1, 3
b. 2, 4
c. 2
d. all of the above
174. When evaluating fluorescein patterns, a special filter must be used with
a. silicone acrylates
b. PMMA
c. polymers with a UV blocker
d. HEMA
175. A normal fitting standard thickness soft contact lens will exhibit
a. three point touch (apex and periphery)
b. apical clearance
c. edge stand-off
d. none of the above
176. Which of the following could cause a patient's rigid contact lens to displace frequently? 1. Excessive posterior peripheral curve, 2. Insufficient peripheral curve, 3. Steep base curve relationship 4. Flat base curve relationship
a. 1, 4
b. 2, 3
c. 1
d. 2, 4
177. Among the following choices, which is the latest lens design for keratoconus?
a. Soper design
b. McGuire design
c. Aspheric design
d. Rose K design
178. A soft contact lens that is too loose may show all of the following except
a. edge stand off
b. limbal compression
c. excessive lens movement
d. distorted retinoscopy directly after blinking
179. A patient with a high degree of with-the-rule astigmatism fitted with a spherical rigid gas permeable lens will show touch
a. on the horizontal meridian
b. on the vertical meridian
c. on the oblique meridian
d. on the residual meridian
180. A rigid lens showing apical touch is an indication of
a. a steep fit
b. an interpalpebral fit
c. a flat fit
d. an astigmatic fit
181. A rigid lens showing excessive apical pooling is an indication of
a. a steep fit
b. an alignment fit
c. a flat fit
d. as astigmatic fit
182. Contact lenses that have a non-spherical back surface are called
a. ashperic lenses
b. tricurve lenses
c. truncated lenses
d. spherical lenses
183. A rigid lens showing central vaulting is indicative of
a. apical clearance fit
b. an alignment fit
c. a flat fit
d. none of the above
184. A rigid lens showing a band-shaped area of touch on the flattest meridian is an indication of
a. a steep fit
b. an alignment fit
c. a flat fit
d. an astigmatic fit
185. When there is a slight pooling of fluorescein in the peripheral curve portion of a rigid lens it indicates
a. a tight lens
b. slight edge lift
c. a toric lens
d. slight lens warpage
186 Refering to question 93, once the correctly ordered lens has been dispensed, the rotational marks should settle at
a. 6 oclock
b. 10 degrees clockwise
c. 10 degrees counterclockwise
d. none of the above
187. On a compromised cornea, such as a one that has undergone a corneal graft what lens characteristic would be most beneficial
a. high wetting angle
b. high Dk/L
c. electric blue color for glare
d. lenticular design
188. What two design changes might be helpful in centering a high riding myopic lens? 1. Flattening the base curve relationship, 2. Myoflange lenticular, 3. Hyperflange lenticular, 4. Prism ballast
a. 1, 2
b. 1, 3
c. 2, 3
d. 3, 4
189. Rigid gas permeable lens flexure may be eliminated by
a. reducing sagittal vaulting
b. increasing center thickness
c. choosing a lower Dk material
d. all of the above
190. A low riding high plus lens on a 40.00@180/40.75@090 cornea could be correct with
a. a myoflange lenticular
b. a hyperflange lenticular
c. a single cut
d. a panafocal
191. Mike, a welder whose Rx is -6.00 +2.00 x180, has been advised to trade his PMMA lenses of 20 years for a modality that allows more oxygen to the cornea. The first lens of choice would be
a. soft spherical lens
b. low to mid Dk RGP
c. high Dk RGP
d. aspheric lens
192. A technique for correcting a high riding rigid minus lens may be to use a
a. flatter lens
b. larger lens
c. minus carrier lenticular lens
d. prism ballast lens
193. Advantages of a myoflange versus a single cut high plus lens include1. Reduced center thickness, 2. Increased optical zone, 3. Reduced weight
a. 1
b. 1, 2
c. 2, 3
d. 1, 2, 3
194. To increase tear exchange with a rigid gas permeable lens, all of the following should be attempted except:
a. reduce the overall lens diameter
b. flatten the peripheral curves
c. increase the sagittal depth
d. decrease the optic zone
195. Which of the following polishing compounds should not be used with gas permeable lenses?
a. Sil O2 Care
b. Silvo
c. Alox PG
d. X Pal
196. In order to create a smooth blend between the intermediate and peripheral curve of the following contact lens, which radius tool should be used? CPC 7.50mm (45.00D), IPC 8.50mm, PPC 10.50mm
a. 8.5mm
b. 9.5mm
c. 10.2mm
d. 11.5mm
197. To correct a flat fitting rigid gas permeable lens, you should:
a. enlarge the optical zone
b. decrease the optical zone
c. decrease the sagittal depth
d. decrease the lens diameter
198. After building up her wearing time, Jennifer returned for an afternoon recheck after eight hours of lens wear. The lenses moved <0.5mm and her complaints were minimal, except for late afternoon burning. Which would you suspect?
a. loose lens
b. lens too large
c. wrong polymer
d. tight lens
199. Which of the following will not increase the movement of a tight fitting rigid gas permeable lens?
a. enlarge the posterior optic zone
b. decrease the posterior optic zone
c. decrease the sagittal vaulting
d. none of the above
200. Which of the following is not important to document in medical records for contact lens patients?
a. care systems the patient is using
b. lens parameters and materials
c. care system the patient had problems with
d. location at which the patient was originally taught insertion and removal