CPO Review 9-4-2014 - Compatibility Mode...OD – oculus dexter, right eye OS – oculus sinister, left eye OU – oculus uterque, both eyes Rootword blephar eyelid chrom color conjuctiv

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Certified Paraoptometric (CPO)

Review Course

ProvisionThe Self Study Course for Paraoptometric Assistants and Technicians, Self Assessment Examination, and the AOA PRC 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 paraoptometriccertification 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© 2014 by The American Optometric AssociationAll 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.

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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

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Anatomy Lacrimal Gland

Excretory Ducts

Superior Punctum

Inferior Punctum

Inferior Canaliculus

Nasolacrimal Duct

Lacrimal Sac

Nasal Cavity

Superior Canaliculus

Graphic courtesy of National Eye Institute, National Institutes of Health (NEI)

Anatomy

Cornea

Anterior chamber

Iris

Pupil

Crystalline lens

Accommodation

Ciliary Muscle


Anatomy


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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

Anatomy

Fundus

Optic Nerve

Optic Disc

Extraocular

Muscles


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Extraocular Muscles

Medial Rectus

Lateral Rectus

Superior Rectus

Lateral Rectus

Inferior RectusInferior Oblique

Inferior Oblique

Superior ObliqueSuperior ObliqueTrochlea

Direction of eye movement

Elevation, Intorsion, and Adduction

Depression, Extorsion and Adduction

Adduction (toward the nose)

Abduction (away from the nose)

Intorsion, Depression and Abduction

Muscle

Superior Rectus

Inferior Rectus

Internal (medial) Rectus

External (lateral) Rectus

Superior Oblique

Inferior Oblique Extorsion, Elevation, and Abduction

Extraocular Muscles

Common Eye Disorders

Accommodation

Cataract

Aphakia & Pseudophakia

Glaucoma

Keratoconus

Macular Degeneration

Diabetic Retinophathy

Floaters

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Cataract

Image courtesy of Eyemaginations

Cataract

Anatomy of an eye with a cataract


Normal Vision

A scene as it might be viewed bya person with cataract.


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Glaucoma


Keratoconus

Images courtesy of Eyemaginations

Macular Degeneration


Image courtesy EYEmaginations

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Diabetic Retinopathy


Retinal Detachment


Floaters


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Common Eye Disorders

BlepharitisConjunctivitisSubconjunctival hemorrhagePingueculaHordeolumChalazion

Blepharitis


Conjunctivitis


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Subconjunctival Hemorrhage


Pinguecula


Ptygerium


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Hordeolum (Sty)


Chalazion


Chalazion


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Prefixes, Suffixes, and Root Words

Prefixes

Suffixes

Root words

Direction terms

O.D. ‐ O.S. ‐ O.U.

Which is which?

OD – oculus dexter, right eye

OS – oculus sinister, left eye

OU – oculus uterque, both eyes

Rootword

blephar eyelid chrom color conjuctiv conjunctiva cor,core,pupil pupil corne,kera cornea dipl two, couble irid, iri irsi ocul, ophthalm eye orth straight opt vision papill elevation path disease phot light retin retina scler sclera ton tension, pressure

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Prefix A, an without

Ab away

Ad to, toward

Aniso different

Bi two

Di two

Ex away from, out of

Hyper excessive, above, over

Hypo under, below

Intra within

Para beside, beyond, around

Retro backward

Sub under, below

Suffixectomy cutting out

ia diseased or abnormal

itis inflammation

meter measurer

ologist one who studies or practices

ology study of

oma tumor, swelling

osis vision condition

pathy disease

scope instrument use for exam

al, ic, ous pertaining to

DirectionalityAnterior

Posterior

Superior

Inferior

Medial

Lateral

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Cataract Surgery

Opening the lens

Phacoemulsification

IOL in capsule bag


Intraocular Lenses

Iris Fixated

Posterior Chamber


Ocular Pharmacology

Diagnostic agents

Therapeutic agents


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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 Principlesand Procedures

(37%)

The Eye Examination

Case history

Demographic information

Chief complaint

Review of systems (eye and general health)

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The Eye ExaminationVisual 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


The Eye Examination

Retinoscopy

Auto‐refractor

Subjective Refraction

Phoropter

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The Eye Examination

Ophthalmoscopy

Pupil dilation

Direct

Binocular indirect

Non-Contact Tonometer

The Eye Examination

Binocular Vision

Visual Field

Biomicroscopy

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Slit Lamp


Visual Field Analyzer

Corneal Topography

Measurement of the

• curvature of the

anterior cornea surface.

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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


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Myopic Eye

Image courtesy of R. Johnson, CPOT

Hyperopic Eye

Image courtesy of R. Johnson, CPOT

Astigmatism


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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

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Contact Lenses

Soft Contact Lenses

Rigid Contact Lenses

Contact Lenses

Contact LensesParameters

Base curve radius

Lens power

Overall diameter

Optical zone diameter

Peripheral curves

Edge & center thickness

Tint

Ordering

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Contact Lens DesignOverall 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 DoeSpecifications Ordered Specifications VerifiedDate 2/23/01 Date

O.D. O.S. O.D. O.S.B.C.R 7.89 7.81 B.C.R

S.C.R./W 8.90 /.3 8.80 /.3 S.C.R./W

I.C.R./W I.C.R./W

P.C.R./W 110.9 /.3 10.8 /.3 P.C.R./W

O.Z.D. 8.0 8.0 O.Z.D.

Dia 9.2 9.2 Dia

Power - 2.50 - 2.50 Power

C.T. .16 .16 C.T.

Blend Med Med Blend

Tint Blue Blue Tint

Dot O.D. Verified byAdditional Information

Accepted Rejected Returned for Credit Date ReturnedReason for return/reorder

Blood Pressure

Sphygmomanometer and stethoscope Systolic Pressure Diastolic pressure Taking blood pressure

reading

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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 PrescriptionDiopter ‐ 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

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The Ophthalmic Prescription

- 1 D

+ 1 D

1 meter

Ophthalmic Lenses

Types of Lenses

Single vision

Spherical

Planocylindrical

Spherocylindrical

Multifocal

• Bifocal, trifocal, progressive addition

Ophthalmic LensesTrifocal Lenses (Executive)

7mm17mm

28mm

Bifocal Lenses (FT‐28, D‐28)

Progressive Addition Lenses

Aberration Zones

Near ViewingZone Intermediate

Viewing Zone

Distant Viewing Zone

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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

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Frame Boxing

Frame size & measurements

Boxing system

• “A” dimension

• “B” dimension

• Effective diameter

• Distance between lenses

Frame Boxing

Boxing System

B

A

DBL

ED

Frame Materials

Plastic

Metal

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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 CriteriaBasicFacial Shapes

FittingShapes

Fitting Suggestions

Oval Normal May wear most any type

Oblong Long Face

Contrasting

Deep frameLow temple attachment

Round

SquareWide Face Shapes Narrow frame

High temple attachment

Base downtriangle

Erect (base-down triangular

face

Contrasting

Fit to largest part of lowerfacial areaDark colors or bolderlooks

InvertedTriangle

Diamond

Inverted(base up)triangularface

Shapes Unobtrusive frame (metal or rimless)

Light or medium weight frameLighter colorRound lens shapeDelicate characteristics of frame for women

Ophthalmic Dispensing

Pupillary distance measurement

Seg height

Ordering

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Pupillary Distance

Pupillometer

Measuring Segment Heights

Bifocal Seg Height Trifocal Seg Height

Ordering

Jones Optical5209 South Penn

Oklahoma City, OK 73109

638-7889

Patient Jane Doe Date 2/23/01SPH CYL AXIS DEC PRISM PLASTIC GLASS

OD In Out

+1.00 - 0.25 90 1/2 ∆ BU SV FDA TestedOS

+1.00 - 1.00 95 1/2 ∆ BD RND

Seg Ht. Width Insert Total Pup Dist EXEC LENTR R Dist Near

+2.00 20ST 28 TRIFOCAL

L L

ADD

+2.00 2028 66 62 OTHER

Set Lens Shape Edge Colour

F.P.D. A B ED LOC UNCUT

Rimless Grove Drill Metal ZYL

Size BDG Temp Style ColorFRAMES

58 16 145 SafiloTitanium 109

GrayOT30

PINK

GREEN

GRAY

BROWN

OTHER:

GRADIENT TO

1

1

1

1

1

Lite

2

2

2

2

2

3

3

3

3

3

Clear

ACCT: REMARK SUPPLY TRAY#RX LENS $MISCTAXTOTALDATEINVOICE

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Basic Frame Adjustments

Fitting triangle

Frame height

Vertex distance

Face form

Pantoscopic angle

Retroscopic angle

Temple adjustment

Basic Adjustments

Fitting Triangle

Pantoscopic Angle

4 mm

Optical center

Optical center

Correct

Wrong

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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

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Telephone Techiques

Be courteous

Be professional

Making AppointmentsBe 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)

Does anything make it better?

(relief)

What’s wrong?

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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

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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

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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

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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

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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 TipsGet 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.

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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 Resource Center (PRC) may

assist with questions concerning PRC Enrollment, 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

Documents

CPO Review 9-4-2014 - Compatibility Mode...OD – oculus dexter, right eye OS – oculus sinister, left eye OU – oculus uterque, both eyes Rootword blephar eyelid chrom color conjuctiv