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A comprehensive overview of visual standards for various professions, including driving, firefighting, and the armed forces. It also covers key concepts in eye care, such as visual acuity, refractive errors, and eye protection. Numerous practice questions and answers, making it a valuable resource for students and professionals in the field of optometry and ophthalmology.
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What are visual standards for cars and motorcycles? − Answer✔✔−Uncorrected VA no worse than 6/12 better eye − license allowed if adequate correction with specs, Corrected VA no worse than 6/24. 110 degrees horizontally with 10 degrees above and below midline, scotoma within 20 degrees of fixation
What are the visual standards for a HGV? − Answer✔✔−Uncorrected VA is worse than 6/9 in better eye or 6/18 either eye − conditional license if correctable. Visual field 140 degrees within 10 degrees above and below the midline, no field loss/scotoma, hemianopia, quadrantanopia likely to impede driving
What are the visual standards for a train driver? − Answer✔✔−Can't be worse than 6/9 in best eye, can't be worse than 6/ either eye. No visual field defect, not monocular, normal colour vision, no diplopia
What are the visual standards for an electrician? − Answer✔✔−Adequate colour vision − anomalous colour vision may be acceptable, D15 test.
What are category A conditions for firefighters? − Answer✔✔−BCVA less than 6/9 binocularly, less than 6/18 either eye, uncorrected distance less than 6/36 binocularly, BC NVA less than N5, visual fields less than 120 degrees in the horizontal field each eye, protan defect, significant deutan defect, retinal detachment, diplopia, night blindness, corneal scarring, monocular vision
What are category B conditions for firefighters? − Answer✔✔−Mild deutan defect, cataracts, progressive or recurring eye disease
What are visual standards for the police? − Answer✔✔−May need good colour vision and no refractive surgery − needs referring to specialist if either of these criteria met
If an occupational patient fails ishihara what is the next step? − Answer✔✔−Occupational lantern test
What bifocal seg is for hypermetropes and why? − Answer✔✔−Round segs, less prismatic effect at near
What sizes are D segs available in? − Answer✔✔−25,28,35,40,
What size are R segs available in? − Answer✔✔−22,24,25,28,30,38,40,
What is the equation for calculating inset? − Answer✔✔−Mono distance CD − mono near CD
What is the equation for calculating different sized round segs? − Answer✔✔−D1−D2 = 2xdp/add
What is slab off? − Answer✔✔−Removes base down prism from the lower part of the more negative lens.
Name 7 types of eye protection. − Answer✔✔−Eyecup goggles, eyeshield, faceshield, safety clip ons, spectacle eye protector, wide vision goggle, wide vision spectacles
What is the LTF of grade 0 tinted specs? − Answer✔✔−80%−100%
What is the LTF of grade 1 tinted specs? − Answer✔✔−43%−80%
What is the LTF of grade 2 tinted specs? − Answer✔✔−18%−43%
What is the LTF of grade 3 tinted specs? − Answer✔✔−8% − 18%
What is the formula for calculating true surface power? − Answer✔✔−Ftrue = Fnom x (ntrue−1)/(nnom−1)
What is n for nominal index on lens measure? − Answer✔✔−1.
What are the different plate designs in an Ishihara test? − Answer✔✔−Demonstration, Transformation, Vanishing, Hidden, Diagnostic
What can the D15 test be used for? − Answer✔✔−Classifying type of a defect
What is the purpose of 100 hue test? − Answer✔✔−Classifying type and severity
What is Sheard's criterion? − Answer✔✔−Fusional reserve must be at least 2 x demand. Prism needed = 2/3(phoria) − 1/3(BO to blur)
What is the 1:1 Rule? − Answer✔✔−Base in recovery should be at least equal to the amount of esophoria, base out prism needed = (esophoria − BI recovery)/
What is Percival's rule? − Answer✔✔−Comfort zone is in the middle third of the width of clear single vision, prism needed = 1/3(Greater of lateral range blur limit BI or BO) − 2/3(less of lateral range blur limit)
When will patients adopt a face turn? − Answer✔✔−Horizontal deviation
In a left lateral rectus palsy what head turn would be expected and why? − Answer✔✔−Head will be turned to the left which deviates the eyes to the right away from muscle weakness
When will a px adopt an elevation or depression? − Answer✔✔−In A or V patterns
What is a base out prism test? − Answer✔✔−20 base out prism in front of one eye, other eye should shift to take up fixation then first eye take up compensatory movement.
Which intermittent esotropias require surgery? − Answer✔✔−Near, distance, cyclic, non specific
How would you manage a constant esotropia with an accommodative element? − Answer✔✔−Order full rx, treat amblyopia, surgery if cosmetically poor
What will be the appearance of a 4th palsy? − Answer✔✔−Eye hypertropic and esotropic
What is the hallmark of a convergence excess esophoria? − Answer✔✔−Greater at near than distance
What is the hallmark of divergence weakness esophoria? − Answer✔✔−Greater at distance than near
What is the hallmark of a convergence weakeness exo? − Answer✔✔−Greater at near with convergence insufficiency
What is the hallmark of divergence excess exo? − Answer✔✔−Greater at distance than near
What are typical fusional reserves for base out near fixation? − Answer✔✔−30−35D
What are typical fusional reserves for base in near fixation? − Answer✔✔−12−14D
What are typical fusional reserves for base out distance fixation? − Answer✔✔−20−25D
What are typical fusional reserves for base in distance fixation? − Answer✔✔−6−8D
What are typical fusional reserves for vertical base? − Answer✔✔−2−4D
How do you perform fusional reserves? − Answer✔✔−Introduce prism gradually, record blur / break / recovery
What are exercises to improve esophoria and what is the aim? − Answer✔✔−Aim to improve negative relative convergence − stereograms, bar reading and fusional reserve exercises
What are the exercises to improve exophoria and what is the aim? − Answer✔✔−Aim to improce positive relative convergence with stereograms, fusional exercises
How many Australians have diabetes? − Answer✔✔−1.7 million
What % of diabetes is type 2? 90% − Answer✔✔−90%
What is type 1 diabetes? − Answer✔✔−Immune mediated destruction of B cells
What is type 2 diabetes? B cell dysfunction and insulin resistance − Answer✔✔−B cell dysfunction and insulin resistance
Who is at risk of type 2 diabetes? − Answer✔✔−>40, waistline >80cmF/>94cmM, south Asian or African descent, polycystic ovaries, gestational diabetes, mental illness medication
How is type 2 diabetes diagnosed? − Answer✔✔−Venous plasma glucose >11.1mmol/l, >7.0mmol/l fasting, HbA1c 48 mmol/mol (6.5%)
Name diabetic meds types: − Answer✔✔−Metformin, Thiazolidenediones (pioglitazone), suplhonylureas (gliclazide), meglitinides, DPP−4 inhibitors (sitagliptin), glucosidase inhibitors
What is prevalence of DR after two decades? − Answer✔✔−100% type 1, 60% type 2
What are the consequences of microvascular occlusion in DR? − Answer✔✔−Hypoxia −> IRMA and NV
What are the consequences of microvascular leakage in DR? Haems, plasma leakage −> oedema and exudates − Answer✔✔−Haems, plasma leakage −> oedema and exudates
What is R1? − Answer✔✔−Flame, dot haems, singular blot haem
What is R2? − Answer✔✔−CWS, exudates, IRMA, venous changes, x2 blot haems
10918? − Answer✔✔−Second consultation
0921? − Answer✔✔−CL consultation NOT VALID IF WEARING FOR COSMETIC, WORK, SOCIAL, SPORTING OR PSYCHOLOGICAL PURPOSES
10931−10933? − Answer✔✔−Domiciliary
10940 and 10941? − Answer✔✔−Visual fields testing
10942? − Answer✔✔−Low Vision Assessment
10943? − Answer✔✔−Children's vision assessment aged 3−
10944? − Answer✔✔−FB removal
What is the standard for Australian / NZ sunglasses? − Answer✔✔−AS/NZS 1067
What is the standard mark for welding protection? − Answer✔✔−AS/NZS 1338.
What is the standard mark for filters against UV? − Answer✔✔−AS/NZS 1338.
What is the standard mark for protection against IR radiation? − Answer✔✔−1338.
What is the minimum a px records should be kept for? − Answer✔✔−7 years or until the age of 25, whichever is the longest
Which state quotes a minimum of 10 years? − Answer✔✔−Western Australia
What is the ocular marking HT? − Answer✔✔−Heat tempered
What is the ocular marking CT? − Answer✔✔−Chemically tempered
What letters would be on a medium impact device? − Answer✔✔−I and F
What letters would be on a high impact device? − Answer✔✔−V and B
What letter would be on an extra high impact device? − Answer✔✔−A
What letters would be on specs for molten metals or hot solids? − Answer✔✔−M or 9
What causes a high AC/A ratio? − Answer✔✔−Accommodative esotropia
What causes a low AC/A ration? − Answer✔✔−More exotropic at near
What is the relationship between Ks and corneal astigmatism? − Answer✔✔−0.1mm = 0.50 astigmatism
What can be done to amend an RGP with high decentration? − Answer✔✔−Reduce lens thickness, reduce total diameter, may have excessive amounts WTR astigmatism − back surface toric
How can lens movement be increased? − Answer✔✔−Increase BOZR, Decrease BOZD, Decrease TD
A px presents with irritated lens, mucus and excessive lens movements as well as lens deposits, investigation shows papillae and follicles on both upper lids and superior corneal staining. What is the cause and management? − Answer✔✔−CLIPC − Cease lens wear, change lens material to lower modulus and more frequent replacement plan, cold compress, reduce WT, improve hygiene, sodium cromglycate
What is the incidence of post−cat endophthalmitis? − Answer✔✔−0.1%
What is the incidence of retinal detachment post−cat? − Answer✔✔−0.7−3.6%
What is the incidence of raised IOP post−cats? − Answer✔✔−8%
What % of men are deuteranomolous? − Answer✔✔−5%
What is the incidence of PSCLO post−cats? − Answer✔✔−8%
What are type 1 R−G defects? − Answer✔✔−Associated with reduced VA and central field defect. Caused by cone and RPE dystrophies − Stargardts, Chloroquine dystrophy
What are type 2 R−G defects? − Answer✔✔−Acquired retinal ganglion cell disease, optic neuropathy
What are type 3 defects? − Answer✔✔−Blue−yellow, reduced sensitivity or peripheral field defects − rod dystrophies, retinal vascular disorders, peripheral retinal lesions, retinal nerve fibre defects, macula oedema,
What are causes of Roth spots? − Answer✔✔−Endocarditis, leukaemia, anaemia, anoxia, CO poisoning, hypertensive retinopathy, pre−eclampsia, diabetic retinopathy, neonatal birth trauma, shaken baby syndrome
What are side effects of cocaine? − Answer✔✔−ACG, reduced vision, CV defects, visual hallucinations, photosensitivity, reduced pupil reactions to light and mydriasis, paralysis of accommodation, exophthalmos, optic neuritis, madarosis, iritis, retinal haems, CRAO
How is CMO treated? − Answer✔✔−CAI and steroids, ketorolac (NSAID)
What are non−optometric treatment options for keratoconus? − Answer✔✔−Keratoplasty (penetrating or deep lamellar), collagen cross linking
What are the advantages and disadvantages of DALK? − Answer✔✔−Advantages − no risk of endothelial rejection, less astigmatism and a structurally stronger, increased availability of graft material Disadvantages: difficult and time consuming, high risk of perforated cornea, interface haze
What are the advantages and disadvantages of collagen cross linking? − Answer✔✔−Can be used in early to moderate keratoconus, helps to prevent keratoconus worsening, side effects include: punctate keratitis, corneal epithelium defect, haziness, dry eye, photophobia
What are the advantages and disadvantages of penetrating keratoplasty? − Answer✔✔−Advantages: simpler technique, faster Disadvantages: higher rate of rejection.high astigmatism, more sutures, neovasc, longer visual rehabilitation
What are the stages of treatment for a chemical injury? − Answer✔✔−EMERGENCY: Irrigate eye for 15−30 minutes, double eversion of lids, debridement of necrotic areas of epithelium, MEDICAL TREATMENT: mild (grade 1 and 2) treated with short course of topical steroids, cycloplegic and prophylactic antibiotics for 7 days: steroids, ascorbic acid, citric acid, tetracyclines. SURGERY: Early surgery to revascularise limbus, Late surgery depend on damage
What are the causes of diplopia in a blow out fracture? − Answer✔✔−Haemorrhage and oedema, mechanical entrapment, direct injury to an extraocular muscle
What are possible complications of blunt trauma? − Answer✔✔−Corneal abrasion, acute corneal oedema, tears in Descemet's membrane, hyphaema, miosis, pigment imprinting, iridodialysis, ciliary shock, cataract, lens subluxation, lens dislocation, globe rupture, PVD, retinal detachment, choroidal rupture, commotion retina, optic neuropathy, optic nerve avulsion
How is hyphaema treated? − Answer✔✔−Tranexamic acid 25mg/kg t.i.d, mydriasis with atropine, monitor IOP
How are foreign bodies managed? − Answer✔✔−Removed with a sterile needle, magnetic removal for matellic bodies, a burr to treat rust rings, antibiotic, cycloplegie and ketorolac
What medication can cause a vortex keratopathy? − Answer✔✔−Hydroxychloroquine, amiodarone
What is treatment for CRVO? − Answer✔✔−Cannulation, IV triamcinolone for chronic macula oedema, optic nerve sheathotomy to decompress the central retinal vein.
What are the three types of emboli and their appearance? − Answer✔✔−Cholesterol − golden crystals usually at arteriolar bifurcations. Calcific − aorta or carotid artery plaques, white, non−scintillating close to the disc. Fibrin−platelet − dull grey elongated particles may fill lumen, associated with TIA.
What medical investigation is required with patients with emboli? − Answer✔✔−Pulse (to detect AF), blood pressure, carotid elevation, ECG, Blood − ESR and full blood count, fasting glucose, lipids
In a BRAO would you expect hypo or hyper fluorescence of the affected area? − Answer✔✔−Hypofluorescnce
What is the prognosis of a CRAO? − Answer✔✔−Very poor.
What are the treatments options for CRAO? − Answer✔✔−Ocular massage, anterior chamber paracentesis, intravenous acetazolamide.
What are differential diagnosis of retinal flecks: − Answer✔✔−ARMD, Stargardt, Fundus Flavimaculatus, Alport Syndrome, Familial Dominant Drusen, Benign flecked retina
What are the associations of CSR? − Answer✔✔−Young, M>F, type A personality, stress, hypertension, alcohol, steroid use, lupus, organ transplantation, gastro−oesphagael reflux
What are common causes of uveitis? − Answer✔✔−Spondylitis, Psoriatic arthiritis, Juvenile arthiritis, rheumatid arthititis, ulcerative colitis, Crohn's disease, sarcoidosis, kidney disease, Behcet syndrome, VKH, toxoplasmosis, toxocariasis, CMV, HIV, Herpes simplex, congenital rubella, herpes varicella zoster,
What are treatment options for uveitis? − Answer✔✔−Mydriatics − tropicamide, cyclopentolate, phenylephrine, homatropine, atropine, topical steroids, periocular steroids, systemic steroids if non− responsive to topical treatment. Antimetabolites− methotrexate Immune modulators − cyclosporine (Behcet),
Differentiate AAION and NAAION − Answer✔✔−AAION and NAAION are very simular in there ocular presentations. ON involvment, haemorrhages, vessesl tortuous, RAPD
AAION is often more sever symptoms
NAAION associated with transient loss of vision
AAION associated with GCA
AAION accounts for 5−10% (10) of anterior ischemic optic neuropathies (AION) and is caused by inflammation and subsequent thrombosis of the short posterior ciliary arteries (SPCA's)
Differentiate BRVO AND CRVO − Answer✔✔−CRVO − thrombus of central retinal vein near lamina cribosa
BRVO − thrombus at arterioveinous crossing point from atherosclerosis
Risk Factors for CRVO? − Answer✔✔−Hypertension, open angle glaucoma, diabetes mellitus
Risk Factors for BRVO? − Answer✔✔−Hypertension, cardiovascular disease, open angle glaucoma, and high body mass index (not diabetes mellitus
What is often the presentation of BRVO CRVO? − Answer✔✔−variable degrees of intraretinal hemorrhage, cotton wool spots, macular edema, subretinal fluid, collateral vessels (chronic), iris and retinal neovascularization, dilated and tortuous veins, and ghost vessels.
What are treatments for BRVO/CRVO, medical and surgical? − Answer✔✔−Anti Veg F panretinal
photocoagulation
Describe how you would apply Sheards Criteroius − Answer✔✔−Best for EXO Best for EXO
patients
LASEK (laser epithelial keratomileusis) − trephine to make a cut in the epithelium which is then peeled back to expose the Bowman's layer of the cornea.
Who would LASEK be more suitable for? − Answer✔✔−People who may experience trauma (Boxer, fighter pilots) as it can be done again
Who would LASIK be more suitable for? − Answer✔✔−Higher Rx's and shorter recovery
3 types of laser surgery? − Answer✔✔−Wavefront LASIK. Computer imaging provides the surgeon with a three dimensional map of the patients eye. This allows more accuracy with the procedure and a higher chance of the patient obtaining 20/20 vision post−operation.
Standard LASIK. This involves reshaping the tissue of the cornea using a laser. Access to the cornea is obtained by cuttinga flap in the outer layer to allow the laser entry.
Epi−LASIK. Here the surgeon cuts a thin layer from the cornea to allow him or her to reshape it using the laser. Sometimes the layer is replaced or it may be removed completely. The patient is provided with a soft contact lense to allow the cornea to heal unharmed.
Describe Nafl − Answer✔✔−permeates into the intercellular space associated with any epithelial cellular disruption.
Wratten #12 yellow filter
contact lens related − mechanical, exposure, metabolic, toxic, allergic and infections
Describe Lissamine Green − Answer✔✔−Lissamine green is an acidic, synthetically produced, organic dye that has been historically used in food products.
Lissamine green stains dead and degenerate cells, yet does not stain healthy epithelial cells
Describe Rose bengal − Answer✔✔−stains dead and devitalized cells, as well as mucus, and should be observed using a white light source
What is a normal amount of hyperopia for a 0−3 month year old? − Answer✔✔−+2.00 D
What is a normal amount of hyperopia for a 3−12 month year old? − Answer✔✔−+1.38 D
How much astigmatism do infants loose between 9−12 months? − Answer✔✔−2/
How much anisometropia may not cause amblyopia? − Answer✔✔−<2.00D
There less <50 % change of emetropisation if there is how much myopia at 3 months old? − Answer✔✔−−5.
Younger eyes usually show what type of astigamatism? − Answer✔✔−WTR
OLder eyes tend to show what type of astigmatism? − Answer✔✔−ATR
WTR has the steepest meridian horizontal or vertical? − Answer✔✔−Vertical (− cyl @ 180)
Hyperopic less likely to emetropise if there is what astigmatism? − Answer✔✔−ATR
How often should you review a newly prescribed young high hyperope? − Answer✔✔−4−6 weeks
If >3.50 of hyperopia then how much you should you presribe (unless in school) − Answer✔✔−1.00 D less than lowest meridian
If more than 2.50 astig how much should you prescribe? − Answer✔✔−1/
If < −5.00 in first year how much should you undercorrect the child to allow for emetropisation? − Answer✔✔−2.00D