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Low vision--not just AMD, part 2.

The second part in this VRICS series explores the provision of optical and non-optical low vision aids and the conditions for which they may be used.

Course code: C-35670 | Deadline: May 9, 2014

Learning objectives

To be able to respond to clinical findings (Group 2.2.5)

To be able to dispense complex lens forms where appropriate (Group 4.1.5)

To be able to identify complex low vision aids and understand their usage in practice (Group 4.2.2)

To be able to recognise the manifestations of ocular disease (Group 6.1.2)

MORE INFORMATION

* EXAM QUESTIONS Under the new enhanced CET rules of the GOC, answers to MCQs for this exam must be submitted online. Please visit www.optometry.co.uk/cet/exams and complete by midnight on May 9, 2014. You will be unable to submit exams after this date. Answers will be published on www.optometry.co.uk/cet/exam-archive and CET points will be uploaded every two weeks. You will then need to log into your CET portfolio by clicking on "MyGOC" on the GOC website (www.optical.org) to confirm your points.

* REFLECTIVE LEARNING Having completed this CET exam, consider whether you feel more confident in your clinical skills --how will you change the way you practice? How will you use this information to improve your work for patient benefit?

A

01 The spectacles shown in the image are designed to help compensate for aniseikonia. In the case illustrated would you expect that:

a The uncorrected left retinal image is larger than the right

b The uncorrected right retinal image is larger than the left

c The refraction is the same in both eyes

d Both a and c are correct

02 Which of the following statements relating to aniseikonia is correct?

a Basic (or intrinsic) aniseikonia could be induced by different refractive powers used in each eye used for the correction of anisometropia

b Basic (or intrinsic) aniseikonia could be induced by differing axial lengths of the two eyes or disruption of the retinal photoreceptor mosaic

c Aniseikonia can only be considered clinically significant if the image size differential between the two eyes is over 4%

d Anisophoria is more likely to be induced by contact lens correction of aniseikonia than by spectacle correction

03 The subjective effects of aniseikonia can be demonstrated by creating an afocal telescope in the trial frame. To achieve 10% magnification using a pair of trial lenses separated by 12mm you would place:

a A -8.25DS lens in the rear cell and a +7.50DS lens in the front cell

b A +8.25DS lens in the rear cell and a -7.50DS lens in the front cell

c A -7.50DS lens in the rear cell and a +8.25DS lens in the front cell

d A +7.50DS lens in the rear cell and a -8.25DS lens in the front cell

B

04 The lens design shown would be described as:

a Achromatic

b Iseikonic

c Aplanatic

d Galilean

05 Lens designs of this type when used as low vision aids are most commonly:

a A pair of plano-convex lenses with convex surfaces facing inwards separated by an air gap

b A pair of plano-convex lenses with plano surfaces bonded together

c A pair of plano-convex lenses with convex surfaces facing outwards separated by an air gap

d A plano-concave lens bonded to a plano-convex lens

06 Ideally, lens designs of this type should produce an image free of:

a Chromatic aberration and coma

b Spherical aberration and coma

c Spherical aberration and oblique astigmatism

d Oblique astigmatism and coma

C

07 Which of the following statements most accurately applies to the image shown?

a The image shows a distance telescopic system

b The image shows a near telescopic system

c The spectacles shown may be used for driving

d These systems consist of modified Galilean design with negative power added to the objective component

08 Compared to a single spectacle lens of equivalent magnification, this telescopic lens design will give:

a A shorter working distance with a wider longitudinal field

b A longer working distance with a narrower longitudinal field

c A longer working distance with a wider longitudinal field

d A longer working distance with a wider lateral field

09 A binocular telescopic spectacle design could be considered if:

a The two eyes are of relatively even acuity, with a magnification requirement of between 2x and 5x

b The two eyes are of relatively even acuity and a greater depth of field is required than provided by a single lens design

c The two eyes are of uneven acuity with a magnification requirement of between 4x and 8x for the worse eye

d A wider effective field of view is required than a single lens design in high magnification (over 8x or 32DS)

D

These spectacles were made for an otherwise healthy six-year-old female patient with moderate myopia, early cataract, extreme photophobia and night-blindness.

10 From the image shown would the tint be identified as:

a A Norville PLS 450 filter

b A 95% absorption brown tint

c A Rayban G15 tint

d A Corning CPF 450 filter

11 From the information given, a working diagnosis might be:

a Rod monochromatism

b Enhanced S-cone syndrome

c Marfans syndrome

d Juvenile Bests macular dystrophy

12 Which of the following statements about the condition identified is incorrect?

a It is also termed Goldman-Favre syndrome

b Sensitivity to blue light is a characteristic

c The condition is autosomal recessive

d The condition is autosomal dominant

MORE INFORMATION

References to aid completion Visit www.optometry.co.uk/clinical, click on the article title and then on 'references' to download.

Kevin McNally BSc (Hons), MCOptom, FBDO (Hons), LVA

Kevin McNally is a registered optometrist and dispensing optician with an Honours Fellowship in low vision. He has worked as a clinical low vision specialist for 30 years, establishing one of the UK's first multi-disciplinary low vision services at Hinchbrooke Hospital NHS Trust in 1985. He designs and manufactures bespoke spectacle low vision aids and is a visiting lecturer in low vision at the University of West Indies Optometry School in Trinidad.
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Title Annotation:1 CET POINT
Author:McNally, Kevin
Publication:Optometry Today
Geographic Code:4EUUK
Date:Mar 14, 2014
Words:1033
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