Tonometry and Glaucoma Flashcards
6 cards from real COA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Tonometry and Glaucoma flashcards as text
A visual field test shows a dense arcuate scotoma extending from the blind spot in the superior field of the right eye. This is MOST consistent with which condition?
Answer: Optic nerve fiber layer damage from glaucoma
Arcuate (Bjerrum) scotomas follow the curved path of nerve fiber bundles from the optic disc and are the hallmark visual field defect of glaucomatous optic nerve damage.
Gonioscopy is performed to directly evaluate which ocular structure?
Answer: The anterior chamber drainage angle
Gonioscopy uses a contact lens with mirrors to allow direct visualization of the iridocorneal angle — the drainage structure that cannot be seen directly due to total internal reflection at the corneal surface.
When the COA performs tonometry and the reading is unexpectedly high (e.g., 35 mmHg) in one eye, what is the MOST appropriate immediate action?
Answer: Document the finding and immediately inform the supervising physician
An IOP of 35 mmHg is significantly elevated and requires prompt physician evaluation. The COA's role is to accurately document and alert the supervising physician — not to diagnose or independently treat.
Which class of topical medications is the MOST commonly prescribed first-line treatment for primary open-angle glaucoma?
Answer: Prostaglandin analogues (e.g., latanoprost, bimatoprost)
Prostaglandin analogues are the most commonly used first-line medications for POAG due to their once-daily dosing, potent IOP reduction (25–35%), and favorable side effect profile compared to other classes.
Automated perimetry (e.g., Humphrey Visual Field test) measures threshold sensitivity at numerous test locations. Which program is specifically designed for glaucoma monitoring?
Answer: Central 24-2 or 30-2 threshold test
The Humphrey 24-2 (central 24 degrees, 2-degree grid offset) and 30-2 programs test the central visual field in a pattern that closely matches glaucomatous nerve fiber bundle defect patterns, making them the standard for glaucoma monitoring.
A patient being treated for glaucoma with topical beta-blocker drops complains of fatigue and shortness of breath. The COA should:
Answer: Document the symptoms and inform the physician, as systemic absorption may be causing cardiovascular/respiratory side effects
Topical beta-blockers can be systemically absorbed via the nasolacrimal system and cause cardiorespiratory side effects including bradycardia, bronchospasm, and fatigue — particularly dangerous in patients with asthma, COPD, or cardiac conduction disorders.