MOC PQA Optometrist flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pinhole acuity improvement

Improvement in visual acuity through a pinhole indicates uncorrected refractive error rather than a pathological cause, because the small aperture reduces blur circles.

Amsler grid purpose

Amsler grid testing detects central visual field defects such as metamorphopsia and scotomas, which may indicate macular disease requiring prompt dilated examination.

Swinging flashlight test

The swinging flashlight test compares direct and consensual pupillary responses; a relative afferent pupillary defect suggests asymmetric optic nerve dysfunction.

Cover test interpretation

Movement on uncovering indicates a phoria; movement while the cover is in place indicates a tropia. The test requires the patient to fixate on a target.

Goldmann applanation calibration

The Goldmann tonometer converts 1 gram of force over a 3.06 millimeter diameter area to 1 millimeter of mercury; central corneal thickness affects accuracy.

Retinoscopy working distance

At a 50 centimeter working distance, 2.00 diopters of with-motion is subtracted from the gross finding to obtain the net refraction at infinity.

Schiascopy neutrality

Neutrality is the point of reversal where neither with nor against motion is seen; adding plus lens power shifts toward against motion.

Keratometry refractive index

Keratometry uses a refractive index of 1.3375 to convert anterior corneal curvature to dioptric power, yielding an average corneal power near 43 diopters.

OCT nerve fiber layer thickness

Average retinal nerve fiber layer thickness measured by OCT is about 100 micrometers; an interocular difference of 10 micrometers or more warrants glaucoma evaluation.

Humphrey 24-2 test pattern

The 24-2 pattern tests 54 points on a 6 degree grid within the central 24 degrees, providing a standard field for glaucoma detection and monitoring.

Gonioscopy grading

Gonioscopy grades the anterior chamber angle by the deepest visible structure, from Schwalbe line through trabecular meshwork to ciliary body band.

Autorefraction limitations

Autorefraction provides a starting point only; it tends to over-minus in young patients due to accommodative tone, so fogging before subjective refinement is standard.

Wet versus dry AMD

Dry AMD shows drusen and geographic atrophy; wet AMD involves choroidal neovascularization with subretinal fluid, hemorrhage, or pigment epithelial detachment, requiring urgent referral.

Diabetic retinopathy grading

Mild nonproliferative shows microaneurysms only; moderate adds hemorrhages and exudates; severe shows venous beading or intraretinal microvascular abnormalities in multiple quadrants.

Primary open-angle glaucoma

Primary open-angle glaucoma shows characteristic optic disc cupping with corresponding field loss in an open angle; intraocular pressure may be normal in up to one third of cases.

Anterior uveitis signs

Anterior uveitis presents with ciliary flush, cells and flare in the anterior chamber, and photophobia; HLA-B27 and sarcoidosis are common systemic associations.

Retinal detachment warning signs

Flashes and floaters plus a curtain-like field defect suggest retinal detachment; a visible tear with subretinal fluid requires same-day referral.

Giant cell arteritis red flags

Age over 50 with new headache, jaw claudication, and elevated erythrocyte sedimentation rate suggests giant cell arteritis; vision loss can be permanent, so treat as an emergency.

Keratoconus clinical signs

Keratoconus shows inferior steepening, scissoring on retinoscopy, and Fleischer ring; corneal cross-linking slows progression in younger patients.

Tropicamide duration

Tropicamide 1 percent dilates the pupil for 4 to 6 hours and provides mild cycloplegia, making it suitable for routine fundus examination.

Cyclopentolate duration

Cyclopentolate 1 percent produces cycloplegia lasting about 24 hours and is commonly used for cycloplegic refraction in children.

Atropine cycloplegia duration

Atropine 1 percent produces cycloplegia lasting up to 2 weeks and is reserved for cases requiring prolonged pupillary dilation or cycloplegia.

Prostaglandin analog mechanism

Prostaglandin analogs such as latanoprost lower intraocular pressure by increasing uveoscleral outflow and commonly cause iris darkening and eyelash growth.

Timolol contraindications

Timolol, a beta blocker, is contraindicated in asthma and heart block because it can cause bronchospasm and bradycardia.

Topical anesthetic risks

Topical anesthetics are for diagnostic use only; chronic use causes corneal toxicity and can mask infection, so they should not be dispensed for home use.

PDSA cycle

The Plan-Do-Study-Act cycle is the standard quality improvement framework: plan a change, test it, analyze results, and act on findings.

Root cause analysis trigger

A root cause analysis is triggered by a sentinel event, such as a wrong-site procedure or a medication error resulting in harm.

Instrument disinfection standards

Tonometer prisms and contact lenses require approved disinfection between patients; alcohol alone is insufficient for some pathogens, so follow manufacturer guidance.

Informed consent elements

Informed consent requires disclosure of diagnosis, proposed treatment, alternatives, risks, and the patient's right to refuse.

Confidentiality exceptions

Patient confidentiality is protected by law; disclosure without consent is permitted only for legal reporting, imminent harm, or court order.

Diabetic retinopathy screening timing

Diabetic retinopathy screening begins at diagnosis for type 2 diabetes and 5 years after diagnosis for type 1 diabetes.

AREDS2 formulation

The AREDS2 formulation with lutein and zeaxanthin slows progression of intermediate age-related macular degeneration and is recommended for affected patients.