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
Posterior chamber
Vitreous humor
Retina
Macula
Fovea Centralis
Choroid
Graphic courtesy of National Eye Institute, National Institutes of Health
Fovea
The center of the
macula and gives
the sharpest
vision
Graphic courtesy of National Eye Institute, National Institutes of Health
Anatomy
Fundus
Optic Nerve
Optic Disc
Extraocular
Muscles
Graphic courtesy of National Eye Institute, National Institutes of Health
Extraocular Muscles
Superior Oblique
Superior Rectus
Superior Oblique
Trochlea
Medial Rectus
Lateral
Rectus
Lateral
Rectus
Inferior
Oblique
Inferior Rectus
Inferior
Oblique
Extraocular Muscles
Muscle
Direction of eye movement
Superior Rectus
Upwards and inwards
Inferior Rectus
Downwards and outwards
Internal (medial)
Rectus
Inwards
External (lateral)
Rectus
Outward
Superior Oblique
Downwards and inwards
Inferior Oblique
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
A scene as it might be viewed by
a person with cataract.
Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)
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
(SC)
Peripheral
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
O.D.
B.C.R
7.89
S.C.R./W
8.90 /.3
I.C.R./W
P.C.R./W
110.9 /.3
O.Z.D.
8.0
Dia
9.2
Power
- 2.50
C.T.
.16
Blend
Med
Tint
Blue
Dot O.D.

Additional Information
 Rejected
 Accepted
Reason for return/reorder
Specifications Verified
Date
O.S.
7.81
8.80 /.3
10.8 /.3
8.0
9.2
- 2.50
.16
Med
Blue
O.D.
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
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
+1D
-1D
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
Intermediate
Viewing Zone
Near 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
B
A
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
Fitting
Shapes
Fitting Suggestions
Oval
Normal
May wear most any type
Oblong
Long Face
Deep frame
Low temple attachment
Round
Wide Face
Contrasting
Shapes
Square
Base down
triangle
Inverted
Triangle
Diamond
Erect (basedown triangular
face
Inverted
(base up)
triangular
face
Contrasting
Shapes
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
SPH
Jane Doe
CYL
OD
DEC
In
+1.00 - 0.25
2/23/01
Date
AXIS
PRISM
PLASTIC
GLASS
Out
90
1/2 Δ BU
SV
FDA Tested
1/2 Δ BD
Pup
Dist
RND
EXEC
ST 28
LENT
TRIFOCAL
OS
+1.00 - 1.00
95
Seg
Ht.
Width
A
D +2.00 20
D
+2.00 20
Set
F.P.D.
F
R
A
M
E
S
Size
58
ACCT:
A
28
Insert
Total
R
R
Dist
Near
L
L
66
62
Lens Shape
B
ED
LOC UNCUT
OTHER
Edge
Rimless
Grove
Drill
Metal
ZYL
BDG Temp
Style
Color
16
145
Safilo
Gray
Titanium 109 OT30
REMARK
SUPPLY
TRAY#
Colour
PINK
1
2
3
GREEN
1
2
3
GRAY
1
2
3
BROWN
1
2
3
OTHER:
1
2
3
GRADIENT TO
 Lite
RX LENS
MISC
TAX
TOTAL
DATE
INVOICE
$
 Clear
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)
What’s
Does anything make it better?
wrong?
(relief)
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