OPTOMETRY COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
PACK 2026
▶ Direct Response. Answer: Monitoring the pupil response (constriction)
of the eye that is being directly stimulated (light in the eye) by the sensory
input.
▶ Consensual Response. Answer: Monitoring the pupil response of the
eye that is not being stimulated by the sensory input.
▶ Decussation of the Eye. Answer: Crossing in the shape of an X
connecting corresponding parts of the brain.
▶ Swinging Flashlight Test. Answer: Compares the afferent system of the
right eye vs. the left eye. Check pupillary response in a dim room checking
each eye for 2-3 seconds 1-2 inches away from the eye. If one pupil dilates
and remains dilated, there is a Relative Afferent Defect.
▶ PERRL - APD. Answer: Pupils Equal, Round, React to Light, No
Afferent Pupillary Defect
▶ Anisocoria. Answer: Unequal pupil sizes with varied causes ranging
from benign to life threatening (found in less than 4% of the population
>1mm). Estimated 20-40% population have a physiologic (benign)
difference of <1 mm between the right and left pupil.
▶ Adie's Tonic Pupil. Answer: Tonic pupil will not constrict in light due to
damage of the ciliary ganglion. Anisocoria appears GREATER IN THE
LIGHT.
▶ Horner's Syndrome. Answer: TRIAD: Ptosis (drooping of the eyelid),
Miosis (excessive constriction of the pupil of the eye), and
anhydrosis/Anhidrosis (inability to sweat normally). Caused by interruption
of the sympathetic pathway to the eye, problem GREATER IN THE DARK.
, ▶ Visual Field. Answer: Entire area of space that a person can see at one
time (patient's peripheral or side vision).
▶ Visual Pathway. Answer: The series of cells/synapses that visual
information takes from being processed as light in the retina into a chemical
signal that synapses throughout the brain resulting in complex processing
within the visual cortex located in the occipital lobe.
▶ 4 Distinct Quadrants of the Visual Field. Answer: Superior Temporal OD
(Rt Eye), Inferior Temporal (OD), Superior Temporal OS (Lt Eye), Inferior
Temporal OS (Lt Eye). Overlap occurs in the nasal region. Each quadrant
of the visual field is processed within a specific area of the brain.
▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
EXAM QUESTIONS AND ANSWERS
PACK 2026
▶ Direct Response. Answer: Monitoring the pupil response (constriction)
of the eye that is being directly stimulated (light in the eye) by the sensory
input.
▶ Consensual Response. Answer: Monitoring the pupil response of the
eye that is not being stimulated by the sensory input.
▶ Decussation of the Eye. Answer: Crossing in the shape of an X
connecting corresponding parts of the brain.
▶ Swinging Flashlight Test. Answer: Compares the afferent system of the
right eye vs. the left eye. Check pupillary response in a dim room checking
each eye for 2-3 seconds 1-2 inches away from the eye. If one pupil dilates
and remains dilated, there is a Relative Afferent Defect.
▶ PERRL - APD. Answer: Pupils Equal, Round, React to Light, No
Afferent Pupillary Defect
▶ Anisocoria. Answer: Unequal pupil sizes with varied causes ranging
from benign to life threatening (found in less than 4% of the population
>1mm). Estimated 20-40% population have a physiologic (benign)
difference of <1 mm between the right and left pupil.
▶ Adie's Tonic Pupil. Answer: Tonic pupil will not constrict in light due to
damage of the ciliary ganglion. Anisocoria appears GREATER IN THE
LIGHT.
▶ Horner's Syndrome. Answer: TRIAD: Ptosis (drooping of the eyelid),
Miosis (excessive constriction of the pupil of the eye), and
anhydrosis/Anhidrosis (inability to sweat normally). Caused by interruption
of the sympathetic pathway to the eye, problem GREATER IN THE DARK.
, ▶ Visual Field. Answer: Entire area of space that a person can see at one
time (patient's peripheral or side vision).
▶ Visual Pathway. Answer: The series of cells/synapses that visual
information takes from being processed as light in the retina into a chemical
signal that synapses throughout the brain resulting in complex processing
within the visual cortex located in the occipital lobe.
▶ 4 Distinct Quadrants of the Visual Field. Answer: Superior Temporal OD
(Rt Eye), Inferior Temporal (OD), Superior Temporal OS (Lt Eye), Inferior
Temporal OS (Lt Eye). Overlap occurs in the nasal region. Each quadrant
of the visual field is processed within a specific area of the brain.
▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
