NCLE ADVANCED
CERTIFICATION EXAM
The answer is C.
A back surface toric lens is created with a toric back surface and a spherical
front surface. The toric back surface is what causes the two base curves to be
found when verifying the lens with a radiuscope. The lensometer reads sphero-
cylindrical because the toricity generated on the posterior surface of a back
surface toric lens manifests through to the front surface. - ANSWERS-If a rigid
gas permeable lens is a back surface toric, it will read out on the radiuscope and
lensometer as follows:
A. One base curve, sphero-cylin drical power
B. Two base curves, sphere power only
C. Two base curves, sphero-cylindrical power
D. One base curve, sphere power only
The answer is B.
A complete professional follow-up should consist of a Subjective verbal
communication with the patient (S), critical Objective observation by the
contact lens professional (0), educated Assessment (A) and a well defined Plan
of action (P). The subjective examination enables patients to describe their
symptoms and wearing experiences and help the fitter to develop a course of
action for follow-up. The objective exam includes visual acuity, over-refraction,
slit lamp examination with lenses in situ and after lens removal, follow-up
refraction, follow-up keratometry and lens inspection. Assessment involves
collecting all of the data from the subjective and objective examinations and
,using it to formulate a conclusion. The plan will summarize the patient's needs
and serve as a review at the next follow-up visit. - ANSWERS-184. When
conducting a follow-up contact lens exam, the SOAP method is useful for
consistent check-ups . This acronym stands for:
A. Selection, Observations, Assessment, Payment
B. Subjective exam, Objective exam, Assessment, Plan
C. Slit Lamp, Over-refract, Acuity, Performance
D. Stain Often And Properly
The answer is A.
A new extended wear lens patient should be checked within the first 24 hours of
sleeping in the lens. After that, the patient should not need to be checked daily,
but should be able to have his follow up schedule slowly lengthened. The
patient, however, should always be checked every 3 to 6 months. - ANSWERS-
185. An appropriate follow-up schedule for either a new soft or rigid gas
permeable extended wear lens wearer would be:
A. 24 hours, 3 days, 1 week, 1 month, every 3 to 6 months after
B. 24hours, 48hours,72hours, 1month, 6months after
C. 1 week, 1 month, 6 months after
D. 24 hours, 1 month, 6 months, 1 year
The answer is A.
There is a prismatic effect from spectacles that occurs when the patient's eyes
converge on a near image. When a nearsighted person converges through a
concave lens, the prismatic effect of the lens creates base in prism, which moves
,the image nasally when the patient views near objects. This effect enables the
individual to use less accommodation with spectacles than with contact lenses.
The opposite effect occurs with farsighted patients, who will require less
accommodation with contact lenses than with spectacles. - ANSWERS-186. A
nearsighted person will feel lack of accommodation from presbyopia:
A. Earlier with contact lenses
B. Earlier with spectacles
C. Simultaneously with contact lenses and spectacles
D. Not at all with contact lenses
The answer is B.
Pachymetry is considered the definitive tool for measuring corneal thickness.
Specular microscopy will assess the morphologic changes in the corneal
endothelium. Corneoscopy is a method of interpreting the corneal curvature. A
thickness gauge measures the thickness of a rigid contact lens. - ANSWERS-
187. Which of the following methods best measures corneal thickness?
A. Specular microscopy
B. Pachymetry
C. Corneoscopy
D. Thickness gauge
The answer is D.
Overnight wear of lenses has been shown to significantly increase a patient's
risk of developing infections or ulcers. Use of homemade saline and / or tap
water has also been associated with the acanthamoeba infection and should be
, discouraged for all contact lens wearers. - ANSWERS-188. Which of the
following are increased risk factors for the development of corneal infiltrates
and ulcers in soft contact lens patients?
A. Overnight wear of contact lenses
B. Use of homemade saline
C. Tap water use
D. All of the above
The answer is D.
Depending on the severity of the case, a number of actions could be taken. If a
reaction to preservatives is suspected, it is important that the preservative be
completely eliminated from the patient's care routine. This is best achieved by
using a preservative-free care system, such as an oxidative system, replacing the
lenses (which may have some of the preservative still within them) or perhaps
discontinuing the lenses to allow the cornea to "heal". - ANSWERS-189. It is
suspected that a patient is suffering from a severe reaction to the preservatives
in a chemical care system. Which of these steps would least likely alleviate the
problem?
A. Change to an oxidative care system
B. Discontinue lens wear until symptoms resolve
C. Replace the contact lenses
D. Prescribe a preservative-free lubricant
The answer is C.
CERTIFICATION EXAM
The answer is C.
A back surface toric lens is created with a toric back surface and a spherical
front surface. The toric back surface is what causes the two base curves to be
found when verifying the lens with a radiuscope. The lensometer reads sphero-
cylindrical because the toricity generated on the posterior surface of a back
surface toric lens manifests through to the front surface. - ANSWERS-If a rigid
gas permeable lens is a back surface toric, it will read out on the radiuscope and
lensometer as follows:
A. One base curve, sphero-cylin drical power
B. Two base curves, sphere power only
C. Two base curves, sphero-cylindrical power
D. One base curve, sphere power only
The answer is B.
A complete professional follow-up should consist of a Subjective verbal
communication with the patient (S), critical Objective observation by the
contact lens professional (0), educated Assessment (A) and a well defined Plan
of action (P). The subjective examination enables patients to describe their
symptoms and wearing experiences and help the fitter to develop a course of
action for follow-up. The objective exam includes visual acuity, over-refraction,
slit lamp examination with lenses in situ and after lens removal, follow-up
refraction, follow-up keratometry and lens inspection. Assessment involves
collecting all of the data from the subjective and objective examinations and
,using it to formulate a conclusion. The plan will summarize the patient's needs
and serve as a review at the next follow-up visit. - ANSWERS-184. When
conducting a follow-up contact lens exam, the SOAP method is useful for
consistent check-ups . This acronym stands for:
A. Selection, Observations, Assessment, Payment
B. Subjective exam, Objective exam, Assessment, Plan
C. Slit Lamp, Over-refract, Acuity, Performance
D. Stain Often And Properly
The answer is A.
A new extended wear lens patient should be checked within the first 24 hours of
sleeping in the lens. After that, the patient should not need to be checked daily,
but should be able to have his follow up schedule slowly lengthened. The
patient, however, should always be checked every 3 to 6 months. - ANSWERS-
185. An appropriate follow-up schedule for either a new soft or rigid gas
permeable extended wear lens wearer would be:
A. 24 hours, 3 days, 1 week, 1 month, every 3 to 6 months after
B. 24hours, 48hours,72hours, 1month, 6months after
C. 1 week, 1 month, 6 months after
D. 24 hours, 1 month, 6 months, 1 year
The answer is A.
There is a prismatic effect from spectacles that occurs when the patient's eyes
converge on a near image. When a nearsighted person converges through a
concave lens, the prismatic effect of the lens creates base in prism, which moves
,the image nasally when the patient views near objects. This effect enables the
individual to use less accommodation with spectacles than with contact lenses.
The opposite effect occurs with farsighted patients, who will require less
accommodation with contact lenses than with spectacles. - ANSWERS-186. A
nearsighted person will feel lack of accommodation from presbyopia:
A. Earlier with contact lenses
B. Earlier with spectacles
C. Simultaneously with contact lenses and spectacles
D. Not at all with contact lenses
The answer is B.
Pachymetry is considered the definitive tool for measuring corneal thickness.
Specular microscopy will assess the morphologic changes in the corneal
endothelium. Corneoscopy is a method of interpreting the corneal curvature. A
thickness gauge measures the thickness of a rigid contact lens. - ANSWERS-
187. Which of the following methods best measures corneal thickness?
A. Specular microscopy
B. Pachymetry
C. Corneoscopy
D. Thickness gauge
The answer is D.
Overnight wear of lenses has been shown to significantly increase a patient's
risk of developing infections or ulcers. Use of homemade saline and / or tap
water has also been associated with the acanthamoeba infection and should be
, discouraged for all contact lens wearers. - ANSWERS-188. Which of the
following are increased risk factors for the development of corneal infiltrates
and ulcers in soft contact lens patients?
A. Overnight wear of contact lenses
B. Use of homemade saline
C. Tap water use
D. All of the above
The answer is D.
Depending on the severity of the case, a number of actions could be taken. If a
reaction to preservatives is suspected, it is important that the preservative be
completely eliminated from the patient's care routine. This is best achieved by
using a preservative-free care system, such as an oxidative system, replacing the
lenses (which may have some of the preservative still within them) or perhaps
discontinuing the lenses to allow the cornea to "heal". - ANSWERS-189. It is
suspected that a patient is suffering from a severe reaction to the preservatives
in a chemical care system. Which of these steps would least likely alleviate the
problem?
A. Change to an oxidative care system
B. Discontinue lens wear until symptoms resolve
C. Replace the contact lenses
D. Prescribe a preservative-free lubricant
The answer is C.
