Ask the Examiner: Non EEA

If you are currently working towards the College of Optometrists’ Examination for Non-EEA Optometrists, you may be interested in our Facebook Study Group: Optometrists: Non-EEA and in the UK!.

The objectives of the group are promote discussion between past and present candidates, share exam tips, experiences and ideas.

In addition, we are now hosting an online discussion:  ‘Ask the NonEEA Examiner’ threads for candidates to ask questions direct to our team of College of Optometrist’s Examiners.

Comments

  1. JAN CROOKS says:

    I am trying top understand when I would do refractive modification to manage symptomatic phorias, I have read about adding spheres to eliminate any movement of the lines when doing fixation disparity. Would you add spheres then initially, plus if sop and minus if xop instead of adding prisms initially if it was a young person, if they are symptomatic even if you have given the full eg cyclo prescription as children are unlikely to be symptomatic in the first place?

  2. Hi Jan – thanks for the question. I have forwarded it on to the examiners. Which books / resources are you using to study? One of my questions to you would be what type of phoria you are investigating. Am assuming horizontal. Think about each type Convergence weakness, divergence excess etc. Remember Fixation Disparity is measuring the associated phoria too. Will get back soon.

  3. My experience is that manipulating the prescription more than +/-0.50DS is likely to give rise to blur or asthenopia. If you can’t align the markers with such small tweaks in the Rx, then move on to prisms. If they have their full cyclo Rx, then that would suggest that the DV will certainly be blurred if you increase their plus. Not sure what you mean in your last line re: children and symptoms. Young children tend not to report symptoms, and equally, their responses on something like a Mallet unit can be questionable too, so in any case it is not something that requires treatment in the early years.

  4. Recommended reading for BV:
    Bruce Evans: Pickwell’s Binocular Vision Anomalies, and Eye Essentials (for a quicker read, although currently out of print – there may be a few second hand ones).

    Have just launched a new bookshopswap service – lets see how that goes 🙂

  5. What should prompt you to do a colour vision test other than on young boys? With what symptoms or conditions mentioned is this a necessary or helpful test to do?

  6. You need to differentiate between acquired and congenital first.

    Congenital Anomalies – Dichromats and anomalous trichromats

    These are inherited. Think about r/g defects in boys but the important thing here is to consider the line of inheritance. Ask patietns who has had a colour vision defect in the family and establish where they are in the family tree. Don’t assume that its just boys you need to test – I had two sisters recently, both with congenital colour vision defects. A first for me, after 20+ years of practicing, and quite possibly the last too.

    Dont forget the monochromats. Inheritance is not the same as it is for the dichromats / anomalous trichromats.

    Some would argue that doing a CV test on all children as a baseline is good practice but there you need to consider what it is you are establishing and why.

    Acquired.

    Anything retinal goes here. There are a host of retinal and neurological conditions, drug toxicities etc that can affect colour vision. Many of the defect are reversible and also think of associated vf defects and reduced va. Test monocularly but be careful of the test you need – it needs to be more sensitive and specific than the Ishihara for example as many acquired defects are blue/yellow in origin.

    I think it is time to dust an old Colour Vision lecture and upload the notes for you to look through. On its way, just give me a day or so to find it.

  7. Hello
    I’m studying contact lenses , struggling a little bit with the therapeutic lens use Which is the best choice for different conditions and what considerations should we pay attention to when ordering trials for such patients. Eg, if RGP, what kind of RGP for keratoconous? To what extent is that important for the exam?
    Many thanks

  8. Thanks Maha,
    I shall get one of our CL examiners to answer this. meantime however, given the time and nature of the exam, I would keep to the basics. There wont be that much time to go into detail on what you would fit for a keratoconic, other than RGP better when the VA is no longer acceptable with a soft lens due to uncorrected irregular astigmatism..

  9. Hello,
    I have been asked a question on what causes the loss of vision in Acute Closed Angle Glaucoma and I cannot seem to have the right answer to it. I am a bit confused, is the cause of the loss of vision due to the corneal haze or is it associated with the high IOP?

  10. Hi Val,

    The answer is yes and yes.

    The corneal haze will cause blurred vision and any prolonged IOP will damage the optic nerve.

    J

    • The concern for immediate visual loss in acute angle closure glaucoma is from the raised IOP above the pressure of the retinal veins (usually 30mmHg+) resulting in a venous occlusion.
      NKH

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