Transcript CPO Review Course - Nebraska Optometric Association
Certified Paraoptometric Review Course CPO
Provision
The
Self Study Course for Paraoptometric Assistants and Technicians, Self Assessment Examination,
and the AOA PS CPO Review Course are not prerequisites for taking the paraoptometric certification examination given by the Commission on Paraoptometric Certification (CPC). Using these study materials and/or taking the CPO Review course does not guarantee passing the paraoptometric certification examination given by the CPC. Attending the CPO Review Course is not a substitute for studying for the paraoptometric certification examination given by the CPC. This course is designed to review previously acquired knowledge.
This review course is not intended to be a substitute for responsible study and preparation for the CPO test.
Copyright© 2010 by The American Optometric Association All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.
Certified Paraoptometric
A person who has attained national recognition via certification by demonstrating an understanding of the concepts used in optometric care. The CPO has demonstrated competence by a didactic examination and is on-the-job trained.
Basic Science (29%)
Anatomy
External Eye Structures
Eyelids
Lacrimal Gland
Lacrimal Duct
Nasolacrimal Duct
Conjunctiva
Palpebral
Bulbar
Fornix
Anatomy
Lacrimal Gland Superior Punctum Superior Canaliculus Lacrimal Sac Excretory Ducts Inferior Punctum Inferior Canaliculus Nasolacrimal Duct
Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
Nasal Cavity
Anatomy
Cornea
Anterior chamber
Iris
Pupil
Crystalline lens
Accommodation
Ciliary Muscle Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
Anatomy
Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
Anatomy
Graphic courtesy of National Eye Institute, National Institutes of Health
Posterior chamber
Vitreous humor
Retina
Macula
Fovea Centralis
Choroid
Fovea
The center of the macula and gives the sharpest vision Graphic courtesy of National Eye Institute, National Institutes of Health
Anatomy
Graphic courtesy of National Eye Institute, National Institutes of Health
Fundus
Optic Nerve
Optic Disc
Extraocular Muscles
Extraocular Muscles
Superior Oblique Superior Rectus Trochlea Medial Rectus Superior Oblique Lateral Rectus Lateral Rectus Inferior Oblique Inferior Rectus Inferior Oblique
Extraocular Muscles
Muscle Superior Rectus Inferior Rectus Internal (medial) Rectus External (lateral) Rectus Superior Oblique Inferior Oblique Direction of eye movement Upwards and inwards Downwards and outwards Inwards Outward Downwards and inwards Upwards and outwards
Common Eye Disorders
Accommodation
Cataract
Aphakia & Pseudophakia
Glaucoma
Keratoconus
Macular Degeneration
Diabetic Retinophathy
Floaters
Cataract
Image courtesy of Eyemaginations
Cataract
Anatomy of an eye with a cataract
Image courtesy of Eyemaginations
Normal Vision
Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
A scene as it might be viewed by a person with cataract.
Glaucoma
Graphic courtesy of National Eye Institute, National Institutes of Health
Kertaconus
Images courtesy of Eyemaginations
Macular Degeneration
Graphic courtesy of National Eye Institute, National Institutes of Health (NEI) Image courtesy EYEmaginations
Diabetic Retinopathy
Image courtesy of Eyemaginations
Retinal Detachment
Images courtesy of Eyemaginations
Floaters
Images courtesy of Eyemaginations
Common Eye Disorders
Blepharitis
Conjunctivitis
Subconjunctival hemorrhage
Pinguecula
Hordeolum
Chalazion
Blepharitis
Image courtesy of Eyemaginations
Conjunctivitis
Image courtesy of Eyemaginations
Subconjunctival Hemorrhage Images courtesy of Eyemaginations
Pinguecula
Images courtesy of Eyemaginations
Ptygerium
Images courtesy of Eyemaginations
Hordeolum (Sty)
Images courtesy of Eyemaginations
Chalazion
Image courtesy of Eyemaginations
Chalazion
Image courtesy of Eyemaginations
Prefixes, Suffixes, Root Words
Prefixes
Suffixes
Root words - pages 44 - 45
Direction terms
O.D. - O.S. - O.U.
Which is which?
OD – oculus dexter, right eye
OS – oculus sinister, left eye
OU – oculus uniter, both eyes
Rootword
blephar chrom conjuctiv cor,core,pupil corne,kera dipl irid, iri ocul, ophthalm orth opt papill path phot retin scler ton eyelid color conjunctiva pupil cornea two, couble irsi eye straight vision optic nerve head disease light retina sclera tension, pressure
Prefix
A, an Ab Ad Aniso Bi Di Ex Hyper Hypo Intra Para Retro Sub without away to,toward different two two away from, out of excessive, above, over under, below within beside, beyond, around backward under, below
Suffix
ectomy ia itis meter ologist ology oma osis pathy scope al, ic, ous cutting out diseased or abnormal inflammation measurer one who studies or practices study of tumor, swelling vision condition disease instrument use for exam pertaining to
Directionality
Anterior
Posterior
Superior
Inferior
Medial
Lateral
Cataract Surgery
Opening the lens
Phacoemulsification
IOL in capsule bag
Image courtesy of Eyemaginations
Intraocular Lenses
Posterior Chamber Iris Fixated
Image courtesy of Eyemaginations
Ocular Pharmacology
Diagnostic agents
Therapeutic agents Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
Ocular Pharmacology
Mydriatic- dilates the pupil
Miotic- constricts the pupil
Cycloplegic- paralyzes the ciliary muscle
Dyes or Stains- adhere to damaged or diseased cells of the cornea and conjunctiva
Clinical Principals and Procedures (37%)
The Eye Examination
Case history Demographic information Chief complaint Review of systems (eye and general health)
The Eye Examination
Visual acuity is how well the eye can see form and detail.
Snellen Fraction
Test distance
Distance at which letter is standardized to be read Image courtesy of Mary Dunn, CPOT
The Eye Examination
Keratometry
Measures the curvature of the cornea
Response from the patient not needed to perform = objective test Image courtesy of Mary Dunn, CPOT
The Eye Examination
Retinoscopy
Auto-refractor
Subjective Refraction
Phoropter
The Eye Examination
Ophthalmoscopy
Pupil dilation
Direct
Binocular indirect
Non-Contact Tonometer
The Eye Examination
Binocular Vision
Visual Field
Biomicroscopy
Slit Lamp
Image courtesy of Mary Dunn, CPOT
Visual Fields Analyzer
Visual Field Analyzer
Corneal Topography
Measurement of the curvature of the anterior cornea surface.
Optical Coherence Tomography (OCT)
Used to obtain cross-sectional retinal images Image courtesy of R. Reed, OD
Refractive Status
Emmetropia Ametropia Myopia Hyperopia Astigmatism Presbyopia
Emmetropic Eye
Images courtesy of Eyemaginations
Myopic Eye
Image courtesy of R. Johnson, CPOT
Hyperopic Eye
Image courtesy of R. Johnson, CPOT
Astigmatism
Images courtesy of Eyemaginations
Presbyopia
Image courtesy of AOA
Accommodation
Focusing from far to near Focusing from near to far Crystalline lens Cilary Body Zonules
Contact Lenses
Soft contact lenses Rigid contact lenses Care & handling Patient education
Images courtesy of EYEmaginations
Contact Lenses
Rigid Contact Lenses Soft Contact Lenses
Contact Lenses
Contact Lenses
Parameters
Base curve radius
Lens power
Overall diameter
Optical zone diameter
Peripheral curves
Edge & center thickness
Tint
Ordering
Contact Lens Design
Overall Diameter (OAD) Optical Zone OZ Secondary Curve Curve (PC) Secondary Curve Width (SCW) Peripheral Curve Width (PCW)
Ordering
CONTACT LENS ORDER FORM
Patient Name:
John Doe
Specifications Ordered Date
2/23/01
B.C.R
S.C.R./W O.D.
7.89
8.90 /.3
I.C.R./W P.C.R./W O.Z.D.
Dia Power C.T.
Blend Tint Dot O.D.
110.9 /.3
8.0
9.2
-
2.50
.16
Med Blue
Additional Information O.S.
7.81
8.80 /.3
10.8 /.3
8.0
9.2
2.50
.16
Med Blue
Accepted Rejected Reason for return/reorder Specifications Verified Date B.C.R
S.C.R./W I.C.R./W P.C.R./W O.Z.D.
Dia Power C.T.
Blend Tint Verified by Returned for Credit O.D.
Date Returned O.S.
Blood Pressure
Sphygmomanometer and stethoscope Systolic Pressure Diastolic pressure Taking blood pressure reading
Ophthalmic Optics and Dispensing (22%)
Ophthalmic Lens Components Components Sphere Cylinder Axis Add power Prism Prism base direction
- 2.00 - 0.75 x 090 + 2.00
The Ophthalmic Prescription
Diopter - unit of measure for optical lenses.
Based on fact that a 1 diopter lens will focus parallel light at 1 meter.
Plus Lenses
Minus Lenses
The Ophthalmic Prescription 1 meter + 1 D - 1 D
Ophthalmic Lenses
Types of Lenses
Single vision
Spherical
Planocylindrical
Spherocylindrical
Multifocal
Bifocal, trifocal, progressive addition
Ophthalmic Lenses
Bifocal Lenses (FT-28, D-28) Trifocal Lenses (Executive)
7mm 17mm 28mm
Progressive Addition Lenses Distant Viewing Zone Near Viewing Intermediate Zone Viewing Zone Aberration Zones
Ophthalmic Lens Materials
Lens Materials
Glass
Plastic (CR-39)
Polycarbonate
High index
Trivex
Verification
Neutralization
Lensometer- measures the lens power Image courtesy Marco
Frame Anatomy
Frame front
Eyewire
Bridge
Hinge
Nosepads
Temples
Frame Boxing
Frame size & measurements
Boxing system
“A” dimension
“B” dimension
Effective diameter
Distance between lenses
Frame Boxing
Boxing System DBL ED A B
Frame Materials
Plastic
Metal
Frame Selection
Frame fit is most important
Frame width equal face width
Longer face, deeper the frame can be
Bridge fit important
Temples need to be long enough for a proper bend
Cosmetic concerns
Cosmetic Criteria
Basic Facial Shapes
Oval Oblong Round Square Base down triangle Inverted Triangle Diamond
Fitting Shapes
Normal Long Face Wide Face Erect (base down triangular face Inverted (base up) triangular face Contrasting Shapes Contrasting Shapes
Fitting Suggestions
May wear most any type Deep frame Low temple attachment Narrow frame High temple attachment Fit to largest part of lower facial area Dark colors or bolder looks Unobtrusive frame (metal or rimless) Light or medium weight frame Lighter color Round lens shape Delicate characteristics of frame for women
Ophthalmic Dispensing
Pupillary distance measurement
Seg height
Ordering
Pupillary Distance
Pupillometer
Measuring Segment Heights
Bifocal Seg Height Trifocal Seg Height
Ordering
Jones Optical 5209 South Penn Oklahoma City, OK 73109 638-7889
Patient
OD
SPH
Jane Doe
CYL AXIS In DEC Out PRISM
+1.00
-
0.25
90 1/2
Δ
BU
OS
A D D F R A M E S
+1.00
Seg
+2.00 20 +2.00 20
Set F.P.D.
Size
58
ACCT: -
1.00
A Ht.
BDG
16
B
95
Width
28
ED Temp
145
REMARK R L Insert Lens Shape R L Total LOC UNCUT
1/2
Style
Safilo Titanium 109
SUPPLY Pup Dist
66
Δ
BD
Rimless Grove Drill Metal ZYL Edge Color
Gray OT30
Dist Near
62
TRAY# Date
2/23/01
SV PLASTIC RND EXEC ST
28
OTHER PINK GREEN GRAY BROWN OTHER: GRADIENT TO GLASS FDA Tested LENT TRIFOCAL Colour 1 1 1 1 1 Lite 2 2 2 2 2 3 3 3 3 3 Clear RX LENS MISC TAX TOTAL DATE INVOICE $
Basic Frame Adjustments
Fitting triangle
Frame height
Vertex distance
Face form
Pantoscopic angle
Retroscopic angle
Temple adjustment
Basic Adjustments
Fitting Triangle
Pantoscopic Angle
Correct
4 mm Optical center
Wrong
Optical center
Professional Issues (13%)
Eyecare Specialists & Ancillary Personnel
Optometrist
Ophthalmologist
Paraoptometric
Ophthalmic Medical Personnel
Optician
Practice Management
Telephone Techniques
Appointments
Record Filing Systems
Alphabetical
Numerical
Recalls
Telephone Techiques
Be courteous
Be professional
Making Appointments
Be knowledgeable on the doctor’s time needs
Triage
What kind of problem are you having?
How long has it been going on? (onset/duration)
Is it getting worse? (severity)
Does it affect your vision? (associated symptoms)
Does anything make it better? (relief) What’s wrong?
Fee Presentation
Present fees in a professional manner
Be prepared to explain the fee structure
Will this be cash, check, or credit card?
Collections
Most efficient method is
at the time the service is rendered
Third Party Payments
Be knowledgeable of third party programs in which your office is enrolled
Coverage may be
Vision Care
Major Medical
Both
HIPAA
What is HIPAA?
Health Information Portability & Accountability Act
Applies to disclosure after April 14, 2003
It is the law
HIPAA
Use and Disclosure
Use: the sharing, employment, application, utilization, examination or analysis of Protected Health Information (PHI) within the covered entity
Disclosure: the sharing or release of PHI in any manner outside the covered entity
HIPAA
HIPAA Privacy Rule
This rule overlaps Privacy Act of 1974
Individuals have the right to receive an accounting of disclosures of PHI made by your office with the exceptions of:
Treatment
Payment
Healthcare Operations
Accounting must include disclosures made in the past six years of request date
HIPAA
Minimum Necessary Principle
Requires office to take reasonable steps to limit the use or disclosure of, and request for, PHI to the minimum necessary to accomplish intended purpose
HIPAA
Implementing Standard
Identify those in your office who need access to PHI to do their job
Further identify anyone else who may need access
Create policies and procedures for routine disclosures to achieve purpose of disclosure
Limit the PHI disclosed by developing criteria
Review request on individual basis against criteria
HIPAA
Considerations Prior to Disclosure
Patient notification before release
Mutually agreed upon alternative communications
Mutually agreed upon authorizations
Potential or serious threat or imminent danger to patient or public
Authority of requestor
Minimum amount of information necessary for purpose
Can information be de-identified
Documentation of release
The Test…..
Computer-based Testing Paper and Pencil Testing http:// www.aoa.org/x8565.xml
A Little Anxiety Is Ok
How To Study
Become interactive with material
flash cards
notes
tape record notes
study groups
Study environment
floral scented candles or potpourri facilitates learning (strange but true)
wake up your body, wake up your mind walk, sit on edge of chair
How To Study
Study pace - preview material, study, break, review
Do not study for more than 2 hours at a time
Use travel time to study
Test Taking Tips
Get plenty of rest the night before - important in this meeting environment.
Arrive a little early for test- look for test room today.
A little anxiety is OK - it makes us perform better.
Know the time limit and be aware of time throughout the test. Manage your time.
Read the directions carefully.
Test Taking Tips
Realize there may be questions you do not know the answer. There should not be many but we tend to remember them.
Your first impression for an answer is usually the best.
Memory dump - at beginning of test write down the facts you want to remember.
Make a mark at the margin on questions you want to return to.
Multiple Choice Questions
Essentially are true/false questions arranged in groups.
Only one alternative is totally correct.
Eliminate obvious false choices.
Of remainder pick the alternative that answers most fully all aspects of the question.
Only change your first answer if you have a very good reason - i.e. read questions incorrectly.
What’s Next?
Today
Lightly review the material
Get a good night’s sleep
Arrive a little early to test
Future
Look for details about the CPOA test - begin studying the Self-Study Course for Paraoptometric
Assistants and Technicians
Questions?
Study Materials The AOA Paraoptometric Section (PS) may assist with questions concerning PS Membership, staff development, and study materials 800-365-2219 ext. 4108 Certification The Commission on Paraoptometric Certification may assist with questions concerning examinations, certification, and re-certification 800-365-2219 ext. 4210