COT Patient History and Ophthalmic Examination Techniques 1 — Questions and Answers
Question 1: When documenting a patient's chief complaint, which element is MOST important to record first?
- Duration of symptoms
- Onset, location, duration, character, and associated symptoms (Correct answer)
- Family history of eye disease
- Current medications
Correct answer: Onset, location, duration, character, and associated symptoms
A thorough chief complaint includes onset, location, duration, character, associated symptoms, relieving/aggravating factors, and prior treatments (OLDCART framework).
Question 2: During confrontation visual field testing, the examiner's visual field serves as the:
- Control for comparison with the patient's field (Correct answer)
- Measure of the patient's peripheral vision
- Baseline for automated perimetry
- Reference for color vision testing
Correct answer: Control for comparison with the patient's field
Confrontation testing compares the patient's peripheral visual field to the examiner's field, which serves as the normal reference standard.
Question 3: The cover-uncover test primarily detects which type of ocular deviation?
- Phoria (latent deviation)
- Tropia (manifest deviation) (Correct answer)
- Hyperopia
- Anisometropia
Correct answer: Tropia (manifest deviation)
The cover-uncover test detects tropias (manifest strabismus) by observing whether the uncovered eye moves to take up fixation when the fellow eye is covered.
Question 4: When measuring visual acuity with a Snellen chart at 20 feet, a patient reads the 20/40 line. This means the patient can read at 20 feet what a person with normal vision can read at:
- 10 feet
- 20 feet
- 40 feet (Correct answer)
- 80 feet
Correct answer: 40 feet
Snellen notation 20/40 means the patient reads at 20 feet what a normally-sighted person can read at 40 feet, indicating reduced visual acuity.
Question 5: Amsler grid testing is used primarily to detect defects in which area of the visual field?
- Peripheral visual field
- Central 10–20 degrees (Correct answer)
- Superior quadrant
- Nasal field
Correct answer: Central 10–20 degrees
The Amsler grid tests the central 10–20 degrees of vision and is sensitive to metamorphopsia and scotomas associated with macular disease.
Question 6: Which test is used to evaluate the relative afferent pupillary defect (RAPD)?
- Cover test
- Swinging flashlight test (Correct answer)
- Hirschberg test
- Worth 4-dot test
Correct answer: Swinging flashlight test
The swinging flashlight test compares the direct and consensual pupillary light responses in each eye and detects RAPD when the pupil dilates as the light swings to the affected eye.
COT Patient History and Ophthalmic Examination Techniques 1
When documenting a patient's chief complaint, which element is MOST important to record first?