Mixed Deck — All AOA Topics Flashcards

Bitemporal hemianopia is most commonly caused by a lesion at which anatomical location?

Answer: Optic chiasm

Bitemporal hemianopia results from compression of the crossing nasal fibers at the optic chiasm, most often by a pituitary adenoma.

Which anti-VEGF agent is FDA-approved for neovascular (wet) AMD treatment by intravitreal injection?

Answer: Aflibercept (Eylea) and ranibizumab both approved

Both aflibercept (Eylea) and ranibizumab (Lucentis) are FDA-approved for neovascular AMD; bevacizumab is widely used off-label due to cost differences.

The ciliary muscle contraction during accommodation causes which change to the crystalline lens?

Answer: The lens becomes more convex as zonular tension decreases

When the ciliary muscle contracts, it moves anteriorly and inward, releasing zonular tension and allowing the elastic lens to assume a more spherical (convex) shape, increasing its power for near focus.

Topical antihistamine-mast cell stabilizer combinations (e.g., olopatadine) are first-line treatment for:

Answer: Allergic conjunctivitis

Dual-acting antihistamine/mast cell stabilizers like olopatadine block H1 receptors and prevent mast cell degranulation, providing rapid and sustained relief from allergic conjunctivitis symptoms.

Low vision rehabilitation is indicated when a patient's best-corrected visual acuity is:

Answer: 20/70 or worse in the better eye with reduced functional ability

Low vision rehabilitation is appropriate for patients with best-corrected VA of 20/70 or worse that limits daily functioning and cannot be further improved by optical correction or treatment.

The vitreous humor is composed primarily of which substance?

Answer: Hyaluronic acid and collagen fibrils

The vitreous is approximately 99% water, with the structural framework provided by a network of hyaluronic acid (providing viscosity) and collagen fibrils (type II and IX).

Normal tension glaucoma (NTG) is characterized by glaucomatous optic nerve damage occurring with:

Answer: IOP consistently within the statistically normal range (≤21 mmHg)

NTG shows progressive glaucomatous optic nerve damage and visual field loss despite IOP never exceeding the statistical upper limit of normal, suggesting pressure-independent mechanisms.

Strabismus surgery for constant exotropia primarily aims to:

Answer: Realign the visual axes to restore binocular vision potential

Strabismus surgery repositions the extraocular muscles to realign the eyes, creating the opportunity for binocular fusion and stereopsis to develop or be restored.

Age-related changes to the accommodative system include all of the following EXCEPT:

Answer: Reduction in corneal refractive power

Presbyopia is caused by lens nuclear hardening, reduced ciliary muscle efficiency, and lens capsule changes — corneal curvature is not a significant factor in presbyopia development.

Which condition is a primary indication for fitting a patient with rigid gas-permeable lenses instead of soft lenses?

Answer: Keratoconus with irregular astigmatism

RGP lenses mask irregular corneal surface and provide superior optical quality for keratoconus patients, unlike soft lenses that drape the irregular surface.

What type of insurance would cover the cost of replacing expensive ophthalmic equipment damaged by a fire?

Answer: Property insurance

Property insurance covers the loss or damage to business property, including ophthalmic equipment, due to events like fire.

Which cranial nerve innervates the lateral rectus muscle?

Answer: CN VI (Abducens)

The abducens nerve (CN VI) exclusively innervates the lateral rectus muscle, which abducts the eye.

Convergence insufficiency is best defined as:

Answer: Reduced near point of convergence and low positive fusional vergence at near

CI is diagnosed by a receded near point of convergence (>6–8 cm) combined with reduced positive fusional vergence reserves at near and associated asthenopic symptoms.

The 'sunset glow fundus' appearance is classically associated with which condition?

Answer: Vogt-Koyanagi-Harada syndrome

VKH syndrome causes bilateral granulomatous panuveitis with depigmentation of the choroid, producing the characteristic orange-red 'sunset glow' fundus appearance.

The power of a thin lens required to correct a 4D myope is:

Answer: -4.00 D

To move the far point from 25 cm in front of the eye to optical infinity, a diverging lens of -4.00 D (focal length -25 cm) is required.

Anisometropia is defined as a difference in refractive error between the two eyes greater than:

Answer: 1.00 D

A clinically significant difference of ≥1.00 D in spherical equivalent between the two eyes is the commonly used threshold for anisometropia.

Extended wear contact lenses are most associated with which serious complication?

Answer: Microbial keratitis

Extended (overnight) wear dramatically increases the risk of microbial keratitis, particularly from Pseudomonas aeruginosa and Acanthamoeba.

Silicone hydrogel lenses have largely replaced conventional hydrogel lenses because they offer:

Answer: Higher oxygen permeability with similar or better comfort

Silicone hydrogel materials achieve Dk values 5–6× higher than conventional hydrogels, reducing hypoxic complications while maintaining wearable comfort.

The aqueous humor is primarily produced by which ocular structure?

Answer: Ciliary body epithelium

The non-pigmented epithelium of the ciliary body actively secretes aqueous humor into the posterior chamber.

Which layer of the retina contains the cell bodies of the photoreceptors?

Answer: Outer nuclear layer

The outer nuclear layer contains the cell bodies (nuclei) of the rod and cone photoreceptors.