OCANZ Quiz Tim Questions and Answers 2023 with
complete solution
List and briefly discuss the major causes of visual impairment in Australia. List
and briefly discuss the major causes of visual impairment in developing
countries.
In Australia
1.AMD cause of 50% of all blindness-less common in developing countries due to lower
life expectancy
2.Glaucoma- 16% of blindness
3.Cataract-11% of blindness
3. Diabetic retinopathy (+ other= 20%)- Most common cause of visual impairment in
working age population
4. 3% uncorrected refractive error
Developing countries -uncorrected refractive errors, cataract- unavailable surgery,
trachoma- river water parasite, glaucoma
A teenage male attends your practice because he knows he is colour defective
and he has been told that there are some professions where restrictions are
placed on those with a colour vision problem. What advice would you give this
patient?
Careers with strict restrictions: ARMED SERVICES
POLICE
AIR TRAFFIC CONTROLER
FIRE SERVICES
Also have restrictions but candidate can work within some divisions: COMMERCIAL
PILOT
MARINE and MARINE PILOT etc;
TRAIN DRIVER
ELECTRICIAL ENGINERING
ELECTRICAL TRADES
COMMERCIAL ARTIST, HOSPITAL LABORATORY TECHNICIANS
PROFFESSIONAL TRANSPORT DRIVER- don't accept protanomaly- do accepy
deuteranomoly
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a) a patient with mild background retinopathy annual review
annual review
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
,a patient from whom you have just removed a superficial corneal foreign body
1/52 to check for signs of infection/inflammation and healing process
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
A patient with a branch retinal vein occlusion
3/12 review- check for '90-day glaucoma' rubeosis iridis/neovascularistion and macular
oedema
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a 6 year old child with hypermetropia and an alternating esotropia wear full
cycloplegic rx
review in 6 months if no amblyopia
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a patient with optic nerve head drusen
3 years with medicare?
Discuss the indications for gonioscopic assessment of a patients' anterior
chamber angle. Describe the structures you will see if the angle is open. (Open to
closed)
increased IOPs, CAG symptoms, retinal vein/artery occlusions, pseudoexfoliation/PDS,
pxs with glaucoma, anterior uveitis pxs with inc. IOPs, before dilation if van herick <
grade 2
ciliary body, scleral spur, Anterior/ posterior trabecular meshwork, schwalbes line,
Central visual field testing has an important role in the diagnosis of glaucoma.
What type of central field test would you use for a patient who was a glaucoma
suspect?
How would you determine whether the test was reliable?
What information would you concentrate on in the printout to help decide as to
whether the patient had glaucoma?
Humphreys visual field analyser- c24-2 full threshold
Fixation losses <20%
False positives <33%
False negatives < 33%
Glaucoma hemifield test, total deviation, pattern deviation type of loss present-
paracentral, arcuate, nasal step, generalised depression, temporal wedge
Discuss the ophthalmic drugs most commonly used for dilation. Include in your
answer their mode of action, duration and side effects. What patients should not
be dilated?
, Tropicamide 1%< anticholinergic, 4-6 hours risk of CAG, blurred vision,photophobia
Cylopentalate 1%< anticholinergic - 12-24hours risk of CAG, blurred vision,photophobia
Atropine 1%<
Homatropine 2%<
Pxs with iris fixed IOLs or pxs at risk of angle closure, pxs with known allergies to
mydriatic agents, downs syndrome pxs?
Define stereopsis. How would you measure stereopsis? What are normal values?
the perception of depth produced by the reception in the brain of visual stimuli from both
eyes in combination, combining areas in panums fusional area.
TNO dependent on age
5 years, 140 seconds:
5 1/2 years, 100 seconds;
6 years, 80 seconds;
7 years, 60 seconds;
9 years, 40 seconds.
Describe how you would assess whether a patient was suppressing an eye.
Check if Vas are equal/ history of amblyopia/strabismus/surgery/patching/cover test are
all useful factors to consider. Main test of suppression is worths 4 dot- if only 2-3 dots
are seen then one eye is supressed i.e eye with red filter should see green dots, eye
with green filter shot see red dot/ if unavailable can use mallet unit- polarisation filter
means one eye sees 12 and 3 o'clock lines, one eye sees 6 and 9 o'clock lines. If one
eye is suppressed only 2 of the four lines will be visible.
Dry eye is a common disorder of the tear film caused by tear deficiency or
excessive tear evaporation. What are the major causes of dry eye and how should
dry eye be assessed?
Causes of dry eye are related to:
• poor tear quality; i.e deficient lipid layer (MGD dysfunction- cause of 50% of dry eye),
deficient mucous layer (e.g stevens-johnson syndrome which effects goblet cells)
• insufficient tear production
• environmental factors (e.g VDU users, contact lens wearer, air conditioning)
• systemic disease (e.g sjogrens syndrome)
• lid anomalies (e.g ectropion, bells palsy where there is not a complete blink)
Ways dry eye can be assessed:
TBUT- instill fluorescein and observe using slit lamp
NITBUT- oberve distortion of keratometer mires
Schirmer
Phenol red thread
complete solution
List and briefly discuss the major causes of visual impairment in Australia. List
and briefly discuss the major causes of visual impairment in developing
countries.
In Australia
1.AMD cause of 50% of all blindness-less common in developing countries due to lower
life expectancy
2.Glaucoma- 16% of blindness
3.Cataract-11% of blindness
3. Diabetic retinopathy (+ other= 20%)- Most common cause of visual impairment in
working age population
4. 3% uncorrected refractive error
Developing countries -uncorrected refractive errors, cataract- unavailable surgery,
trachoma- river water parasite, glaucoma
A teenage male attends your practice because he knows he is colour defective
and he has been told that there are some professions where restrictions are
placed on those with a colour vision problem. What advice would you give this
patient?
Careers with strict restrictions: ARMED SERVICES
POLICE
AIR TRAFFIC CONTROLER
FIRE SERVICES
Also have restrictions but candidate can work within some divisions: COMMERCIAL
PILOT
MARINE and MARINE PILOT etc;
TRAIN DRIVER
ELECTRICIAL ENGINERING
ELECTRICAL TRADES
COMMERCIAL ARTIST, HOSPITAL LABORATORY TECHNICIANS
PROFFESSIONAL TRANSPORT DRIVER- don't accept protanomaly- do accepy
deuteranomoly
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a) a patient with mild background retinopathy annual review
annual review
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
,a patient from whom you have just removed a superficial corneal foreign body
1/52 to check for signs of infection/inflammation and healing process
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
A patient with a branch retinal vein occlusion
3/12 review- check for '90-day glaucoma' rubeosis iridis/neovascularistion and macular
oedema
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a 6 year old child with hypermetropia and an alternating esotropia wear full
cycloplegic rx
review in 6 months if no amblyopia
Indicate the review cycle you would recommend for the following patients
including your rationale behind the review cycle suggested
a patient with optic nerve head drusen
3 years with medicare?
Discuss the indications for gonioscopic assessment of a patients' anterior
chamber angle. Describe the structures you will see if the angle is open. (Open to
closed)
increased IOPs, CAG symptoms, retinal vein/artery occlusions, pseudoexfoliation/PDS,
pxs with glaucoma, anterior uveitis pxs with inc. IOPs, before dilation if van herick <
grade 2
ciliary body, scleral spur, Anterior/ posterior trabecular meshwork, schwalbes line,
Central visual field testing has an important role in the diagnosis of glaucoma.
What type of central field test would you use for a patient who was a glaucoma
suspect?
How would you determine whether the test was reliable?
What information would you concentrate on in the printout to help decide as to
whether the patient had glaucoma?
Humphreys visual field analyser- c24-2 full threshold
Fixation losses <20%
False positives <33%
False negatives < 33%
Glaucoma hemifield test, total deviation, pattern deviation type of loss present-
paracentral, arcuate, nasal step, generalised depression, temporal wedge
Discuss the ophthalmic drugs most commonly used for dilation. Include in your
answer their mode of action, duration and side effects. What patients should not
be dilated?
, Tropicamide 1%< anticholinergic, 4-6 hours risk of CAG, blurred vision,photophobia
Cylopentalate 1%< anticholinergic - 12-24hours risk of CAG, blurred vision,photophobia
Atropine 1%<
Homatropine 2%<
Pxs with iris fixed IOLs or pxs at risk of angle closure, pxs with known allergies to
mydriatic agents, downs syndrome pxs?
Define stereopsis. How would you measure stereopsis? What are normal values?
the perception of depth produced by the reception in the brain of visual stimuli from both
eyes in combination, combining areas in panums fusional area.
TNO dependent on age
5 years, 140 seconds:
5 1/2 years, 100 seconds;
6 years, 80 seconds;
7 years, 60 seconds;
9 years, 40 seconds.
Describe how you would assess whether a patient was suppressing an eye.
Check if Vas are equal/ history of amblyopia/strabismus/surgery/patching/cover test are
all useful factors to consider. Main test of suppression is worths 4 dot- if only 2-3 dots
are seen then one eye is supressed i.e eye with red filter should see green dots, eye
with green filter shot see red dot/ if unavailable can use mallet unit- polarisation filter
means one eye sees 12 and 3 o'clock lines, one eye sees 6 and 9 o'clock lines. If one
eye is suppressed only 2 of the four lines will be visible.
Dry eye is a common disorder of the tear film caused by tear deficiency or
excessive tear evaporation. What are the major causes of dry eye and how should
dry eye be assessed?
Causes of dry eye are related to:
• poor tear quality; i.e deficient lipid layer (MGD dysfunction- cause of 50% of dry eye),
deficient mucous layer (e.g stevens-johnson syndrome which effects goblet cells)
• insufficient tear production
• environmental factors (e.g VDU users, contact lens wearer, air conditioning)
• systemic disease (e.g sjogrens syndrome)
• lid anomalies (e.g ectropion, bells palsy where there is not a complete blink)
Ways dry eye can be assessed:
TBUT- instill fluorescein and observe using slit lamp
NITBUT- oberve distortion of keratometer mires
Schirmer
Phenol red thread
