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National Certification Organization
for Opticians
NCLEAC National Contact Lens Examiners
Advanced Certification
NCLE - AC Advanced NCLE Certification
Exam
Course Title and Number: NCLEAC Advanced Certification Exam Exam Title: Advanced Certification Exam Exam Date: Exam 2025- 2026 Instructor: ____ [Insert Instructor’s Name] _______ Student Name: ___ [Insert Student’s Name] _____ Student ID: ____ [Insert Student ID] _____________
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NCLE-AC National Contact Lens Examiners
Advanced Certification
NCLE Basic Certification Exam
Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - 1 A patient calls indicating that they had bought a large quantity of disinfecting solutions while it was on sale. The expiration date on the bottle now indicates that the solution is out of date by two months. The solution has never been open. You should tell your patient: A. To throw the solution away and purchase new solution B. Use the solution since two months does not really constitute expired solutions C. The date is simply an inventory identification control item. Because the solution has never been opened, it is okay to use D. Because the solution has preservatives in it, it is okay to use:->> The answer is A. Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔 Ctrl + Click Here To 📑 ORDER NOW 📑 Follow Link 🤔 ORDER NOW 🤔 🎓 TO GET INSTANT EXPERT HELP 🎓 🤔 ORDER NOW 🤔
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- Acruate: Is a staining pattern that is indicative of poor insertion or recentering techniques.
- Decreased Blinking: Can result in discomfort from prolonged use in digital devices
- Lens Equilibration: When the CL reaches the same temperature as the tear film
- Buffering Agent: Is used to control tear pH, anytime the pH level of an ingredient or part is altered, it is called buffering
- What to do when a soft CL gets stuck to cornea: Irrigate the eye with oph- thalmic solutions until the lens becomes loose. never water
- Hydrogren Peroxide Systems: most effective way to remove deposits
- The primary source of oxygen for the cornea: Air
- The layer of the cornea that is most responsible for maintaining de- turgescene (dehydration): Deturgescene is that state of relative dehydration main- tained by the normal cornea that is necesary for transparency. Although Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com it is maintained in a lesser state by the epithelium being impermeable to water, the endothelium is most responsible thru the use of its own public transport system
- The corneal curvature of the limbus is very close to the approximate curvature of the: Sclera
- If a patient presents with keratitis sicca they are more likely to develop: A secondary infection
- The first line of defense in the protective system of the eye is formed by the: palpebrae
- The corneal layer that allows the cornea to be transparent due to the pump action it creates: Endothelium Normally, aqueas leaks slowly from the inside eye to the stroma. The endotheliums primary task is to pump this excess fluid out the stroma. Without this pumping action, the stroma would swell with water, became hazy and eventually opaque.
- The sagittal depth of a rigid gas permeable contact lens can be altered without changing the diameter by: Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com interacts with the lower lid and aids in lens positioning. Of the lens designs listed in the question, the only one that requires precise positioning of its optical portions is a translating bifocal lens.
- The mass of an aphakic rigid gas permeable contact lens can be reduced by making the lens design: A. Spherical B. Lenticular C. Tricurve D. Aspheric:->> The answer is B. A lenticular or myoflange design will decrease the mass of an aphakic lens as well as increase the edge profile, which allows it to interact more with the upper lid and aid in positioning of the lens.
- In order to tighten the fit of a rigid gas permeable lens you can: I. Increase the optical zone diameter
- Decrease the optical zone diameter
- Increase the overall lens diameter
- Use a prism ballasted lens design A. 3 only B. 1& Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com C. 2 only D. 2&3:->> The answer is B. Increasing the optical zone diameter and increasing the overall lens diameter will both tighten and steepen the relationship of the lens to the cornea. Decreasing the optic zone diameter will serve to flatten and loosen the lens to cornea relationship. Using a prism-ballasted lens design will not affect the lens to cornea relationship as it relates to sagittal depth.
- A high minus rigid gas permeable lens will be thin centrally with relatively thick edges. To reduce the edge thickness, and increase overall comfort, use: A. Aspheric peripheral curves B. A myoflange C. A higher Dk material D. A hyperflange:->> The answer is D. A hyperflange will decrease edge thickness as well as lens awareness. Aspheric peripheral curves change the posterior design of the lens but do not reduce edge thickness. A higher Dk material will not change the overall lens edge thickness. A myoflange will actually add thickness to the lens edge and is used for high plus lenses not high minus lenses.
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🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com located at or near the level of stroma are called: Striae - it has a unique shape, arrangment and spacing that are important in allowing light to pass through the cornea
- Average hvid: 11.5mm
- In ocular conditons such as , a theraputic soft lens fit with minimum movement would benefit the patient: Recurrent Erosion Exoopthalmus - protusion of eye Trichinios - is a disease from foodborne parasite Blepharitis
- is an inflammation of the eyelid Reccurent erosion - benefits from soft CL , theraputic
- The is a TRANSITIONAL ZONE between the cornea and the scelar tissue: Limbus
- Blink rate per min average 1: 15-18 blinks per min
- Primary function of the lipid layer: Prevent evaporation of the tear film
- The mucous layer of the precorneal tear film is secreted by the: Goblet cells
- The layer of the cornea comprises 10% of Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com corneal thickness usually heals within 24 hours and is highler regenerative: Epithelium
- In advance stages of corneal edema are created as the result of fluid accumulated between ruptures of the epithelium layer: Myocysts. The formation of myocysts in the corneal epithelium occurs when edema appears within or between cells and then debris filled cystic spaces are formed
- Most often seen in soft CL , is identified by the formation of papillae on the palpebral conjunctiva: GPC Giant Papillary Conjunctivitis
- Arcus Senilis: Common in older people as they age, it presents itself as a white ish haze in the peripheral corneal stroma. It is a collection of lipids and cholesterol that forms around the cornea, It appears as a white, light grey, or blueish ring
- Neovascularization: The blood vessels grow from preexisting limbal vessels
- The eye disease is the obstruction of the flow of aqueus humor out of the anterior chamber: Glaucoma
- Where are the opening of the meibomiam glands found?: in the eyelid margin Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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- Which lens design would provide the best visual acuity for a patient with the following information? K's 42.00@ 180/ 42.50@ Rx -6.75 +1.75 cx 90 A. Front surface toric rigid gas permeable B. Spherical rigid gas permeable C. Soft sphere D. Bitoric rigid gas permeable:->> The answer is A. The keratometer readings indicate the need for a spherical back surface, which would rule out the use of a bitoric lens. A soft spherical lens would not correct the moderate amount of refractive astigmatism that is present, nor would the spherical rigid gas permeable lens. A front surface toric RGP would best meet this patient's needs since it has a spherical back surface, but has a toric front surface which would correct the residual astigmatism.
- Which of the following describes the angle that the edge of a bead of water makes with the surface of a plastic? A. Wetting angle B. Surface angle C. Bead angle Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com D. Reflection angle:->> The answer is A. The wetting angle of a rigid gas permeable material describes how a fluid spreads over the surface. It is important to remember, however, that wetting angle is a description of the material outside of the patient's natural ocular environment. Within minutes of insertion, a rigid lens is encapsulated in the natural tear mucin and the wetting angle of the material is no longer important.
- If a patient has 1.50 D of refractive cylinder and keratometer readings of 44.00@ 180/ 44 .50 @ 90, a spherical rigid gas permeable lens will: A. Give the patient their best correctable vision B. Usually result in residual astigmatism C. Fit poorly D. Be uncomfortable:->> The answer is B. The back surface of a rigid lens will usually correct only the astigmatism that is found on the surface of the cornea. Therefore, when there is significantly more astigmatism in the refraction than on the surface of the cornea, residual astigmatism is anticipated.
- If a patient has spherical K readings of 43.50 and an Rx of -4.00 +1.75 cx 90, the patient has: Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
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- In order to steepen the base curve of a rigid gas permeable lens without changing the lens to cornea relationship, you would also need to: A. Decrease the optical zone diameter B. Decrease the center thickness C. Increase the overall lens diameter D. Increase the lens power:->> The answer is A. Decreasing the optical zone diameter while steepening the base curve of a rigid gas permeable lens will allow the lens to cornea relationship to remain the same, since decreasing the optical zone diameter loosens the lens to cornea relationship and steepen- ing the base curve tightens the relationship. Increasing the overall lens diameter also tightens the fit and will only exaggerate the change made to the lens to cornea relationship. Decreasing the center thickness or increasing the lens power will have no significant effect on the relationship of the lens to the cornea.
- To steepen the lens to cornea relationship of a rigid gas permeable lens you could : A. Increase overall diameter and decrease optical zone diameter B. Increase overall diameter and increase optical zone diameter Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com C. Increase optical zone diameter and decrease overall diameter D. Increase optical zone diameter and flatten base curve:->> The answer is B. Increasing the overall lens diameter or increasing the optical zone diameter will steepen the lens to cornea relationship. Conversely, decreasing the optical zone diameter, decreasing the overall lens diameter or flattening the base curve will loosen the relationship. If one change is made that tightens the relationship and another is made that loosens it, the changes will cancel each other out.
- Which is not an indication for modifying a rigid gas permeable lens? A. Corneal staining B. Poor lens position C. Discomfort D. Surface Wettability:->> The answer is D. Modification of rigid gas permeable lenses is a valuable skill and can increase a practitioner's success at RGP fitting. Many in-office modifications can be utilized to improve the positioning of a lens, reduce discomfort for the patient and eliminate corneal staining. Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com position superiorly are often lenses that have been designed with the apical alignment philosophy and have been fit flatter than the flattest keratometer reading in order to achieve this alignment. Lenses that are fit with apical clearance are fit steeper than the flattest corneal measurement and often will fit intrapalpebrally or centrally.
- Which of the following are visual systems used by rigid gas permeable bifocal lenses? A. Translating and hyperopic B. Simultaneous and instantaneous C. Simultaneous and alternating D. Truncated and prism ballasted:->> The answer is C. The two visual systems utilized by rigid gas permeable bifocals are simultaneous and alternating. With simultaneous vision systems, both near and far images are received by the retina at the same time. Concentric and aspheric bifocal lens designs utilize simulta- neous vision principles. With alternating vision systems, the lens will move on the eye, delivering the focal length that is in front of the pupil as the lens translates. Segmented bifocal lens designs fall into this category.
- Which of the following are methods for stabilizing the rotation of rigid bifocal contact lenses? Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔
🤔Hit Me UP__ Inbox Open 24/7 – 365 …...!!!! 🤔 Chat with us here: 🤔 Hybridgrades101@gmail.com A. Back surface toric and front surface toric B. Edge roll and polish C. Alternating and translating D. Truncation and prism ballast:->> The answer is D. Most translating or alternating rigid gas permeable bifocal lenses must be stabilized in order for the proper segment to align correctly with the pupil. Two methods of accomplishing this are by truncating and/ or prism ballasting the lens. In truncation, the bottom portion of the lens is removed, producing a straight edge that interacts ·with the lid and aligns the lens in its proper position. With prism ballasting, the bottom portion of the lens is made thicker than the top portion. Following the same principles as prism ballasting of a soft toric lens, the thicker portion of the lens will be forced from under the upper lid to an inferior position.
- To decrease the sagittal depth of a rigid gas permeable contact lens you can:
- Steepen the base curve
- Flatten the base curve
- Increasetheoveralldiameter
- Decrease the overall diameter A. 1and B. 1and Need Writing 🤔Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed🤔