QUESTION BANK FINAL

301 17. The power of the ciliary muscle to contract is called ................ a]Physical accommodation b]Range of accommodation c]physiologicalaccommodation Ans : c]physiological accommodation 18.During accommodation................... a] ciliary muscles constrict b] ciliary muscles relax c]pupil relax Ans : a] ciliary muscles constrict 19.Accommodation is maximum in ………. a] Childhood b] adulthood c] Middle age d] old age Ans : a] Childhood 20. The amount of hypermetropia that may be overcome by an effort of accommodation in ………. a ]Latent HM b]Facultative HM c.] Manifest HM d.] None of the above Ans :d] None of the above III . FILL IN THE BLANKS : 1. Accommodation is the mechanism by which the eye changes ------ by altering the shape of lens Ans: refractive error REFRACTION DEPARTMENT-CBE

302 2.The essential feature of accommodation is an increase in the ......of the lens which affects mainly the..... Surface Ans : curvature, anterior 3.Ability of the lens to alter its shape is called …............ Ans: physical accommodation 4. Physical accommodation is measured in ------- Ans : diopters 5.The power of------ to contract is called physiological accommodation Ans : ciliary muscle 6.Distance between the far point of accommodation and near point of accommodation is known as ------- Ans : range of accommodation 7.Dioptric Difference between the far point of accommodation and near point of accommodation is known as ……… Ans : Amplitude of accommodation 8.The clear image at maximum distance from the eye is called ---- point of accommodation Ans : far

303 9.Emmetropia has far point of accommodation at ------- Ans : infinity 10.The clear image at the closest distance from the eye is called ---- Ans : near point of accommodation 11.---------is a measure of maximum ability to stimulate accommodation while maintaining clear single binocular vision Ans : PRA 12.PRA tested using --- lens & NRA lens is tested using ---- lens Ans : minus, plus 13.Inner changes during accommodation----------- Ans : ciliary muscle constriction, increase in curvature of anterior surface of lens 14. The pupil constriction reduces -----------aberration Ans : spherical 15.Accommodation is helped by ----- Ans : lens, ciliary muscles 16.Lens decreases in -------- diameter center of lens--------- during Ans : accommodation, equatorial,protrudes forward REFRACTION DEPARTMENT-CBE

304 17.Relative flattening takes place at the ----- of the lens Ans : periphery 18.During act of accommodation lens increases its ------ Ans : thickness 19.As age advances the amplitude of accommodation ---- Ans : decreases 20. At the age of 40 a normal person cannot read when the reading material is about -------- cm away from the eye is called ---------- Ans : 33, presbyopia 21.------ Patient will accommodate continuously to see a clear image Ans : hypermetropia 22.Excessive accommodation will result in ----- Ans : pseudo myopia 23.The---------causes blurry distance vision after prolonged near work Ans : accommodative spasm 24.-------- Patient has clear near vision and no need for accommodation Ans : myopic

305 25.In hypermetropia range of accommodation is -------- Ans : normal 26.In hypermetropia amplitude of accommodation is ------ Ans : greater 27.In myopia range of accommodation is --------- Ans : less 28.In myopia amplitude of accommodation is -------- Ans : shorter 29.The two ways to control accommodation is ------&-------- Ans : cycloplegia , fogging method 30.Cycloplegic drops have temporary ---------- effect on ciliary muscle Ans : paralyzing 31.Cycloplegic refraction is necessary in ----- children especially for ------ Ans : young, hypermetropia 32.--------- is a good cycloplegic Ans : cyclopentolate REFRACTION DEPARTMENT-CBE

306 33.----------- drops acts up to two days Ans : Homatropine 34.------- Acts up to 2 weeks or even more than 21 days and also used as therapeutically Ans : atropine 35.Fogging method is used to control accommodation during ----- refraction Ans : manifest 36.Fogging is done by increasing ---- lens Ans : convex spherical 37.------- is associated with excessive convergence & is found most frequently in younger people Ans : excessive 38.The accommodative amplitude is consistently lower than what is normal for his/her age is called ----- Ans : premature presbyopia 39.What are the drugs that paralysis accommodation ---- &---- Ans : atropine, homatropine 40.Paralysis of accommodation is due to -----------&-------- Ans : paralysis of oculomotor nerve, paralysis of ciliary muscle

307 41.-------, ------, ------- are orthoptic exercise given as treatment Ans : prism glass Base Out , convex glass, accommodative flippers 42.------ is a Symptom caused by accommodative fatigue Ans : blurred near vision 43.The ability of accommodation and convergence can be measured by …………… Ans : Royal Air Force Ruler 44.Part of the hypermetropia which Cannot be corrected by accommodation is known as----- Ans : absolute hypermetropia 45.……..drops used to paralyze the ciliary muscle Ans : cycloplegic 46.The ……. Of accommodation decrease with age Ans : amplitude 47. Paralysis of oculomotor nerve results in paralysis of----------- Ans : accommodation 48.Cyclopentalate is a good ……… drug Ans : Cycloplegic REFRACTION DEPARTMENT-CBE

308 49.During accommodation anterior surface of the lens ……Its curvature 50.Ciliary muscles help in ……… Ans : accommodation 51.Far point of an eye is that point in space that is conjugate with fovea when................ is relax. Ans : accommodation 52.…….. myopia is false appearance of myopia. Ans : Pseudo 53.Range of accommodation decreases with----- Ans : age 54.The ability of accommodation and convergence can be measured by --------- Ans : RAF ruler 55.Fogging is used to control ……………… Ans : accommodation 56.Insufficiency of accommodation leads to........…presbyopia Ans : premature 57.The distance between the near point and far point iscalled ….............. Ans : range of accommodation

309 58.The different between the near point and far point is called ….............. Ans : amplitude of accommodation 59.The depth of field and depth of focus are markedly influenced by the …............. Ans : diameter of the pupil 60.Accommodation is the result of charge in the form of the lens brought about by contraction of the ………….. Ans : ciliary muscle 61. The relaxation theory was first proporsed by……… and elaborated by …… Ans : thomas young , Helmholtz in 1885 62.Refractive index of the lens ……….. Ans : 1.39 63.The physiological anterior lenticonus thus formed has a ………….. Ans : short radius of curvature and high refraction 64.Average reaction time for far- to – near accommodation is 0.64seconds Near ......... Ans : far 0.56 seconds 65.The choroid stretched forward by the..... Ans : ciliary muscle contraction 66.Accommodation changes is ………… Ans : age related REFRACTION DEPARTMENT-CBE

310 67. ………. used in accommodation and convergence Ans : RAF 68. NPA abbreviation …………….. Ans : near point of accommodation 69.Presbyopia is physiological………… Ans : insufficiency of accommodation 70. Insufficiency of accommodation causes ……………. Ans : 1. premature sclerosis lens 2. Weaknes of ciliary muscles 71.Weakness of ciliary muscles local causes is …….. Ans : primary open angle glaucoma 72.NRA abbreviation………… Ans : Negative portion of relative accommodation 73. PRA abbreviation……….. Ans : positive portion of relative accommodation 74. Accommodation treatment ………. Ans : 1. orthoptic excercise, 2. + lens, 3. prism glass base out

311 75.Lens remains in unaccommodative forms is ……… Ans : 1. elastic force of the lens, 2. elastic elements of ciliary body, 3. Thoughness of zonuuls and capasuls 76.Accommodation is helped by ………… Ans : 1. elasticity of lens, 2. contraction of ciliary muscles, 3. Plasticity of the capsuls and zonuless 77.Physical accommodation expression of the actual physical deformation of the lens and it is measured in……… Ans : diopter 78.Amplitude of accommodation in hypermetropia……….. Ans : greater 79.Range of accommodation in hypermetropia ………. Ans : same 80.myopic patient amplitude of accommodation is ………. Ans : shorter 81.Myopic patient range of accommodation is ………… Ans : less REFRACTION DEPARTMENT-CBE

312 82.The distance object can see clearly is called………. Ans : far point of accommodation 83.The ……….. can be seen clearly is called near point of accommodation Ans : near object 84.Drugs causing paralyzing accommodation ........……….. Ans : atropine, homatropine 85. ………. is usually associated with excessive convergence Ans : Excessive accommodation 86. Spasm of accommodation is………. Ans : Pseudo myopia 87.Types of accommodation………. Ans : physical accommodation, physiological accommodation 88. Main causes of presbyopia is insufficiency of ----------------- Ans : Insufficiency Of Accommodation 89.A measure of maximum ability to stimulate accommodation is called ……. Ans : PRA 90.A measure of maximum ability to relax accommodation is called …….. Ans : NRA

313 91.Changes in the eye during accommodation………. Ans : Inner changes, ocular chages 92.Inner changes are …………… Ans : 1. ciliary muscles constrict 2.anterior surface of the lens increase its curvature which increase the dioptric power of the crystaline lens 93. Other changes:…………… Ans : 1. The pupil constrict, 2.Both eyes will convergence 94.Cyclopent effect last for ………. Ans : 2 to 3 days 95.Atropine effect last for …….... Ans : up to two weeks 96.Homotropine effect last for …........ Ans : up to two days 97.How many types in anomalies of accommodation….. Ans : 4 REFRACTION DEPARTMENT-CBE

314 98.Anomalies of accommodation types, ………. Ans : 1. Excessive , 2. Insufficiency , 3. Spasm of accommodation 4. In sustained accommodation 99.The power of the ciliary muscles to contract is called………. Ans : physiological accommodation 100.The ability of the lens to alter its shape is called ……. Ans : physical accommodation 101. Physical accommodation is measurement in……… Ans : dioptre 102. Physiological accommodation is measured in ……… Ans : unit 103.Accommodation is the mechanism by which the eye changes refractive error by ….. Ans : altering the shape of its crystalline lens 104. Two types of accommodation are……… Ans : Physical accommodation, Physiological accommodation 105.Characteristic features of accommodation are ………. Ans : Amplitude of accommodation, Range of accommodation

315 106.Definition of Range of accommodation is ……… Ans : Distance between the far point of accommodation and near point of accommodation 107.Definition of Amplitude of accommodation is……… Ans : The diopteric difference between the far point of accommodation and near point of accommodation 108.The clear image at maximum distance from the eye is called……….. Ans : Far point of accommodation. 109.The clear image at closest distance from the eye is called ………. Ans : Near point of accommodation. 110.Definition of PRA is a ……….. Ans : measure of maximum ability to stimulate accommodation while maintaining clear binocular vision 111. Definition of NRA is ……….. Ans : a measure of maximum ability to relax accommodation while maintaining clear single binocular vision 112. PRA is tested by……….. Ans : Minus lens (or) concave lens 113. NRA is tested by ……… Ans : Plus lens (or) Convex lens REFRACTION DEPARTMENT-CBE

316 114.Inner changes in accommodation are ………… Ans : Ciliary muscle constriction, Increase the anterior surface of the lens curvature, Increase the diopteric power of the lens. 115. Other changes in accommodation are ……. Ans : Pupils constrict, Both eyes converged. 116.Accommodation is helped by ………… Ans : Elasticity of lens, Contraction of ciliary muscles, Plasticity of the capsules & zonules. 117.In hypermetropia range of accommodation is normal, Amplitude of accommodation is …………….. Ans : greater 118.In myopia range of accommodation is ……. Amplitude of accommodation is…… ………… Ans : less, shorter 119.Two ways of controlling accommodation are …….. Ans : Cycloplegia, Fogging method. 120. Pseudo myopia is due to………… Ans : Excessive accommodation 121.Cycloplegics used to…………...... Ans : paralyse the ciliary muscle and dilate the pupil

317 122. Range of accommodation -------------in Hypermetropia Ans : Normal 123. Near point of accommodation is also called --------- Ans : Range Of Accommodation 124. Far point of accommodation is called as----------- Ans : Amplitude Of Accommodation 125. ……….is used to control accommodation during manifest refraction. Ans : Fogging method 126. …………. due to Insufficiency of accommodation. Ans : Premature presbyopia 127.Paralysis of accommodation due to……………. Ans : Paralysis of oculomotor nerve, Paralysis of ciliary muscle 128.Insufficiency of accommodation causesare……….. Ans : lenticular origin, ciliary origin 129.The difficulty in changing focus from distance to near and near to distance is called ……….. ……….. Ans : Inertia of accommodation REFRACTION DEPARTMENT-CBE

318 130.Treatment of accommodation:……. Ans : Prism glasses (Base out), Convex lens, Accommodation flipper 131.The nearest point at which small objects can be seen clearly is called …. Ans : near point (or) Punctum proximum 132.The distance point at which small objects can be seen clearly is called….,.. Ans :Far point (or) Punctum Remotum 133.In hypermetropic eye far point is ……. Ans : behind the eye 134.In myopic eye far point is …….......... Ans : in front of the eye 135. Range of accommodation is -----------in myopia Ans : Less 136.Snakes and Frogs have a mechanism to ……….. Ans : move the lens forward for near vision. 137.Causes of premature of presbyopia: ………….. Ans : Uncorrected hypermetropia, chronic simple glaucoma, presenile weakness of ciliary muscle, premature sclerosis of the lens.

319 138. Presbyopia is treated by………… Ans : convex lens. 139.In sufficiency of accommodation is caused by …………. Ans : premature sclerosis of lens, weakness of ciliary muscle 140. If the paralysis of accommodation is permanent we give……… Ans : convex lens for near vision 141. AC/A ratio formula is…………….. Ans : ∆g-∆d/D,(∆g = Prism without glass, ∆d = Prism with glass, D = Diopter of the lens 142. Excessive of accommodation is caused by ……….. Ans : young hypermetropes,Young myopes, Astigmatic error, Presbyopes 143. Causes of spasm of accommodation ………… Ans : Drug induced spasm, Spontaneous spasm, Iridocyclitis, Spasm of near reflex 144. Macropsia may occur due to………… Ans : optical illusion 145. Dark glasses are effective in reducing the ……… Ans : glare REFRACTION DEPARTMENT-CBE

320 146. AC/A ratio normal value ………. Ans : 4-6∆D 147. The physical accommodation is measured in ---------------- Ans : Diopter 148.The ability of the lens to alter its shape is called --------------- Ans : Physical accommodation 149.------------is the distance between the far point of accommodation and near point of accommodation Ans : Range Of Accommodation 150...........is measured in diopters Ans : Physical accommodation 151.The accommodation due to the contraction of the ciliary’s muscle is called ---- ------------ Ans : Physiological accommodation 152 . Near point of accommodation is measured in ---------- Ans : mm 153. Average reaction time for near to far accommodation is ---------------- Ans : physiological insufficiency of accommodation

321 154. Accommodation weakness is treated by ---------------------- Ans : Prism Glasses, Accommodative Flipper 155. Atropine drug effect is presents up to --------------- Ans : 2 Weeks 156. Near point of accommodation is measured with ------------ Ans : RAF Ruler 157. -------drug is used to paralysis the accommodation Ans : cycloplegic IV. TRUE OR FALSE : 1.Near point ruler use for convergence Ans : True 2.Lens alteration in shape inverse the divergent power of the eye, the focus can be altered as &when required Ans : False 3.Physiological accommodation is one type of anomalies of accommodation Ans : False 4.RAF ruler consists of square metal rod long 3cm Ans : False REFRACTION DEPARTMENT-CBE

322 5.Near point convergence normal range 6-8cm Ans : True 6.Convergence and divergence and vertical can be measured with prism Ans : True 7.Convergence measured with base in prism Ans : False 8.Divergence is measured with base out prism Ans : False 9.Vertical vergence is measured using vertical prism bar Ans : True 10.When one eye diverges, if WTDT is present Ans : False 11.The normal positive fusion amplitude for near 15PD Ans : False 12.The normal negative fusion amplitude for distance 15PD Ans : True 13.Divergence is measured with base out prism Ans : False

323 14.Vertical vergence is measured using vertical prism bar Ans : True 15.Divergence normal fusion amplitude for near 12-14D Ans : True 16.Divergence normal fusion amplitude for distance 5-7 D Ans : True 17.Vertical vergence amplitude near and distance 12D Ans : False 18.WFDT is designed to use at distance only Ans : False 19.WFDT right eye wearing red &green goggles for left eye Ans : True 20.There are three types of accommodation declines with age Ans : True 21.Cycloplegic drops have a temporary paralyzing effect on ciliary muscle Ans : True 22. Asthenopia is not a symptom of accommodation insufficiency Ans : False REFRACTION DEPARTMENT-CBE

324 23.WFDT is designed use at distance 33cm Ans : False 24.WFDTright eye wearing red &green goggles for left eye Ans : True 25.Distance stereo acuity book name RANDOT Ans : True 26.Normal range of TNO book is 30 sec of arc Ans : True 27.BSV is abnormal so stereopsis is abnormal Ans : True 28.BSV is normal & stereopsis is abnormal Ans : False 29.RAF ruler is push up method Ans : True 30. Giddiness is a symptom of convergence Ans : False 31.Treatment for Convergence insufficiency is orthoptic exercises Ans : True

325 32.Dot card is used to improve convergence Ans : True 33.If Corneal reflex falls nasal to pupil is esotropia Ans : False 34.Accommodation is the mechanism by which eye changes its size Ans : False 35.There are three types of accommodation Ans : False 36.The amplitude of accommodation declines with age Ans : True 37.Cycloplegic drops have a temporary paralyzing effect on ciliary muscle Ans : True 38.Asthenopia is not a symptom of accommodation insufficiency Ans : True 39.The power of the lens to contract is called physical accommodation Ans : False 40.The power of the lens to change its shape is called physical accommodation Ans : false 41.Headache in the frontal area is due to convergence deficiency REFRACTION DEPARTMENT-CBE

326 Ans : True 42.Cycloplegic drops have a temporary paralysing effect on ciliary muscle. Ans : True 43.The amplitude of accommodation does not change with age. Ans : False 44.Accommodation is the mechanism by which the lens changes its shape. Ans : True 45. Accommodation is the mechanism by which the eye changes its size Ans : False V. UNSCRAMBLE WORDS : 1. GOLEGSG - Goggles 2. ERVCENGEONC - Convergence 3. DAITONCCAOMMO - Accommodation 4. ERAUQS - Square 5. VERIDENGCE - Divergence 6. TIERVACL - Vertical 7. SIRSMP - Prisms 8. MLPAIUTED - Amplitude 9. OLIAPIDP - Diplopia 10. OHPICTROTRECXEICSE - Orthoptic exercise

11. UPSSIONPERS - Suppression 327 12. NAERTLAIVET - Alternative 13. SINRUTENSMT - Instrument 3 14. ROOTSEIPA - Esotropia 6 15. OOXTREIPA - Exotropia 19 16. ODARNT - Randot 11 17. EEROPSSIST - Stereopsis 17 1 VI. MATCH THE FOLLOWING : 10 5 1. NRA - Controlling 4 accommodation 9 2. PRA - 15PD 13 Cycloplegic 2 3. Fogging method - Convergence Presbyopia 4. Pseudo myopia - Plus lens Orthoptic Exercise 5. NPC normal range - 8cm-6cm Excessive 6. Distance fusion (B.O) - accommodation 7. Near fusion (B.I) - 40cm 2 RED Light 8. RAF rule - Minus lens 9. TNO test - Convergence - 10. insufficiency - 11. Dot card - 12. WFDT present REFRACTION DEPARTMENT-CBE

328 13. Left eye suppression - Push up method 8 30PD 7 14. Right eye suppression - 3 GREEN Lights 14 TNOBOOK 15 15. Near stereo acuity - RANDOT BOOK 16 4 Dots present 12 16. Distance stereo acuity - Dioptre 18 17. 40years - 18. Amplitude - Controlling 19. accommodation - VII. ENGLISH TO TAMIL : - கநர்மவற இவணவு - ைசீ ்சு 1. Positive fusion - எதிர்மவற இவணவு 2. Amplitude - இலக்கு 3. Negative fusion - இரட்வைபார்வை 4. Target - வைகயாப்ைர்கள் 5. Diplopia - கண்ணாடி 6. Diopters - தற்கபாது 7. Goggles - அைக்குமுவற 8. Present - மாற்று அைக்குமுவற 9. Suppression 10. Alternate suppression

11. Crossed diplopia 329 12. Instrument 13. Push up method - குறுக்கு இரட்வைபார்வை 14. Eye strain - கருைி 15. Intermittent diploia - புஷ் அப் முவற 16. History - கண் சிரமம் 17. Nasal - இவைப்பட்ை இரட்வைபார்வை 18. Decreased - ைரலாறு 19. Hypermetropia - நாசி - குவறந்தது 20. Esotropia - தூரப் பார்வை 21. Exotropia ஒரு கண்கணா (அ) 22. Cover இருகண்களுகமா மூக்கு 23. Uncover - 24. Fixation கநாக்கித் திரும்பி இருக்கும் 25. Convergence நிவல - கண்கள் சைளிப்புறமா இருக்கும் - கைர் - சைளிப்படுத்த - நிர்ணயம் - குைிதல் REFRACTION DEPARTMENT-CBE

330 - தங்குமிைம் - சதுரம் 26. Accommodation - கைறுபாடு 27. Square - சசங்குத்து 28. Divergence - கிவைமட்ை 29. Vertical - முப்பட்ைக கண்ணாடி 30. Horizontal 31. Prism VIII. GIVE THE REASON : 1. For emmetropia, far point is at infinity 2.Excessive accommodation is mostly needed for young people .Why? 3.Cycloplegic refraction is important in children why? IX. ANSWER VERY BRIEFLY : 1.What is atropine therapy? Ans : Topical atropine is used to dilate pupil and paralayze accommodation 2.During accommodation, the pupil constricts. Why? Ans : To eliminate peripheral rays and to reduce spherical aberration

331 3. Define accommodation Ans : Ability of the lens to change to adjust its shape to form both near and far objects X. TWO MARK QUESTIONS : 1.Define -Accommodation Page no :40 (Manual ) 2.Write about the Mechanism of accommodation Page no :40 (Manual ) 3.Define -Physical accommodation Page no :40 (Manual ) 4.Define -Physiological accommodation Page no :40 (Manual ) 5.Write about the Range of accommodation Page no :40 (Manual ) 6.Write about the Amplitude of accommodation Page no :40 (Manual ) 7.What is Far Point of accommodation? Page no :40 (Manual ) REFRACTION DEPARTMENT-CBE

332 8.What is Near Point of accommodation? Page no :40 (Manual ) 9.What is Positive portion of relative accommodation (PRA?) Page no :40 (Manual 10.What is Negative portion of relative accommodation (NRA?) Page no :40 (Manual ) 11.Write about the changes in eye during accommodation Page no :40 (Manual ) 12.What is the diopter of Amplitude of accommodation with age? Page no :41 (Manual ) 13.How to Control accommodation Page no :41 (Manual ) 14.Define –cycloplegic Page no :41 (Manual ) 15.Define-Fogging Page no :42 (Manual ) 16.Types of anomalies of accommodation Page no :42 (Manual )

333 17.Define -Excessive accommodation Page no :42 (Manual ) 18.Define-Spasm of accommodation Page no :42 (Manual ) 19.Define -Insufficiency of accommodation Page no :42 (Manual ) 20.Define -Ill sustained accommodation Page no :42 (Manual ) 21.Define -Inertia of accommodation Page no :42 (Manual ) 22.What are the symptoms of Anomalies of accommodation? Page no :42 (Manual ) 23.Write about the Paralysis of accommodation Page no :42 (Manual ) 24.What is the treatment of Anomalies of accommodation? Page no :42 (Manual ) 25.What is the accommodation? Page no :41 (Manual ) REFRACTION DEPARTMENT-CBE

334 Page no :41 (Manual ) Page no :40 (Manual ) 26.What is amplitude of accommodation? Page no :36 (Manual ) 27.What is stimulus deprivation give one example? 28.What is reason of amblyopia? XI. FIVE MARK QUESTIONS : 1.Explain about the anomalies of accommodation Page no :42 (Manual ) 2.Explain about the Accommodation Page no :40 (Manual ) 3.Explain about the changes in accommodation with age? Page no :41 (Manual ) 4.How to control accommodation ? differentiate between the cycloplegic drops what is fogging method? Page no :41 (Manual )

335 5.Define accommodation and discuss its mechanism. Explain the anomalies of accommodation? Page no :42 (Manual ) XII. MISSING WORDS : 1. -O-V-RGE-CE - Convergence 2. A---MM-DA-I- - - Accommodation 3. D-VER- -N-E - Divergence 4. --L-T-DE - Amplitude 5. V--T--AL - Vertical 6. -I-LO—A - Diplopia 7. P-ES—T - Present 8. S--OPT-P---E - Synoptophore 9. R--D-T - Randot 10. O-T-OP--C - Orthoptic 11. E--EN--AL - Essential 12. I--ER--S - Inverses 13. --YS-C-L - Physical 14. C--T—CT - Contract 15. A—O—ODA—ON - Accommodation 16. .-N-I—T- - Infinity REFRACTION DEPARTMENT-CBE

336 - Elasticity - Periphery 17. E—S-IC-T- - Individual 18. -EI—E-Y - Refraction 19. -N-IV—U-A- - - Pseudo Myopia 20. ---R-C-I-N - Cycloplegia 21. -S—D---O-I- - Fogging Method 22. C—L-P-E—A - Hypermetropia 23. -O—I-G—T-OD - Temporary 24. --P—M-T-O—A - Paralysis 25. -E-P—A-Y - Necessary 26. P—A—S-S - Homotropine 27. N—E—A-Y - Objective 28. -O-O-R—I-E - Spherical 29. O—E-T—E - Diminish 30. S—E-I-AL - Premature 31. D—N-SH 32. P—M-T-R - XIII .CORRECT SENTENCE : 1. The ability of the lens to alter , its size is called physical accommodation. Ans : Shape

337 2. The power of the ciliary muscle to contract is called physical accommodation Ans : Physiological 3. Myopic patients have not clear near vision Ans : Clear 4. The clear image at closet distance from the eye is called Far point of accommodation Ans : Near point 5. Asthenopia is not a symptom of accommodation insufficiency. Ans : Symptoms Worksheet 1.How Does Accommodation Change with Age ?Explain REFRACTION DEPARTMENT-CBE

338 2.Explain the changes during accommodation? 3.Blurred vision , Micropsia, Diplopia are symptoms of ………………? 4.Write the etiology of Accommodative spasm?

339 REFRACTION DEPARTMENT-CBE

340 CHAPTER - 7 CLINICAL REFRACTION

341 CHAPTER - 7 CLINICAL REFRACTION CONTENTS Evaluation of retinoscopy Types of retinoscope Design of self illuminationretinoscope Principle Characteristics of moving retinal reflex Working lens Correcting lens Working distance Neutralization Finding power and axis Subjective refraction Pre requisite for subjective testing Optical function of trial set accessories Step of subjective refraction Starting point Control of accommodation REFRACTION DEPARTMENT-CBE

342 Astigmatic correction Monocular spherical end point Binocular balance I. ABBREVATION: 1. FP - Far Point 2. PH - Pin Hole 3. MR - Maddox Rod Jackson Cross 4. JCC - Cylinder 5. B.B - Binocular Balancing II. CHOOSE THE BEST ANSWER : 1. Retnioscopy is a......... methodof measuring the optical power ofthe eye A] subjective b] objective c] reflection Ans : b] objective 2. ...... Types of retinoscope A] 2 b] 5 c] 3 Ans : A] 2 3. ....... Types of retinoscope system A] 2 b] 5 c] 3 Ans : A] 2

343 4. Emetropia far point is ............. A] beyond infinity b] infinity c] between infinity Ans : b] infinity 5. In low degrees of refractive error the movement of reflex …..... A] fast b] slow c] oblique Ans : A] fast 6. Hypermetropiaandemetropiapatient the retinoscopereflex seen in ……. Direction A] same b] opposite c] dull Ans : A] same 7. A retinoscope is used to illuminatethe.......of the eye A] inside b] out side c] up Ans : A] inside 8. Retinoscope reduces ...,by quickly determine the appropriate correcting lens A] refraction time b] refractive error c] a&b Ans : c] a&b 9. Retinoscopy proves …........ When patients cannot co operate A] invaluable b] valuable c] infants Ans : A] invaluable REFRACTION DEPARTMENT-CBE

344 10. In........,........ Designed the streak retinoscope with rotating bulb to turn the streak to all ocular meridian A] 1920, jack c. Copeland b] 1859, sir william c] 1873, cuignet Ans : A] 1920, Jack C. Copeland 11. Other nameof mirror retinoscopeis ........Retinoscope[a] A] reflecting b] streak c] spot Ans : A] reflecting 12. Mirror retinoscope is ........and the most commonly A] expensive b] inexpensive c] popular Ans : b] inexpensive 13. Central aperture of the mirror retinoscope is ....... in diameter A] 3 – 4 mm b] 2 – 4 mm c] 1 – 4 mm Ans : A] 3 – 4 mm 14. ......retinoscope is costly and easy to handling A] self illuminated b] reflecting c] a &b Ans : A] self illuminated 15. .........Retinoscope projects light as a small circular beam on the retina A] spot b] streak c] mirror Ans : A] spot 16. Retinoscope projects streak reflex on the retina …….

A] spot b] streak c] mirror 345 Ans : b] streak 17. Current source is provided by a battery handle ...... in retinoscope A] 1.5v to 2.5v b] 2.5v to 3.5v c] a &b Ans : b] 2.5v to 3.5v 18. Principle inretinoscopeis ………… stages A] 1 b] 2 c] 3 Ans : c] 3 19. This turning sleeve and rotating the light streak is called ....... A] meridian control b] minimum control c] maximum control Ans : A] meridian control 20. The far point of emmetropiais ......... A] infinity b] beyond infinity c] between infinity Ans : A] infinity 21. The hypermetropia far point ............. A] infinity b] beyond infinity c] between infinity Ans : b] beyond infinity REFRACTION DEPARTMENT-CBE

346 22. The myopia far point ............... A] infinity b] beyond infinity c] between infinity Ans : c] between infinity 23. Focusing sleeve is also called ……....... Control A] vergence b] divergence c] a &b Ans : A] vergence 24. High degree of refractive error , reflex movement will be ……...... A] fast b] slow c] oblique Ans : b] slow 25. How many types of retinal reflex present …….. A] 3 b] 4 c] 2 Ans : A] 3 26. Wide, narrow indicates what characteristic of retinal reflex …… A] speed b] width c] brilliance Ans : b] width 27. Bright , dull indicates what characteristic of retinal reflex …… A] speed b] width c] brilliance Ans : c] brilliance

347 28. Plus lens ……..... Fp towards the eye A] pull b] push c] none Ans : A] pull 29. Minus lens........fp away from the eye A] pull b] push c] none Ans : b] push 30. Normal working distance 67cm. If we reduce working distance by 20cm , the dioptric power will be ……… A] 0.50d b] 0.75 d c] 1.d Ans : A] 0.50d 31. When both principle meridians require thesame correcting power ……. A] sphere b] cylinder c] a, b Ans : A] sphere Identify the optical cross for the following prescription prescription : +1.0cyl 90º [b] +1.5 b. + 1.5 REFRACTION DEPARTMENT-CBE

348 +0.5 +2.5 c. + 1.5 D. + 1.0 + 1.5 Ans : A] sphere 32. Neutralization with movementadd plus lens and subtract…… lens A] minus b] plus c] a,b Ans : A] minus 34. Neutralization against the movement is seen add...... Lens subtract the …… lens A] minus,plus b] plus, minus c] a,b Ans :A] minus,plus 35. How many types of pinhole ........... A] 6 b] 3 c] 4 Ans : A] 6 36. Ideal pinhole invented year.......... A] lebenshon, 1950 b] lebo son 1985 c] michaels, 1985 Ans : A] lebenshon, 1950 37. Ideal pinhole size....... mm A] 1.20 b] 1.30 c] 1.32

349 38. Multiple pinhole invented year …….. Ans : c] 1.32 A] lebenson, 1950 b] lebonson1985 c] michaels, 1985 Ans : c] michaels, 1985 39. Subjective refraction introduced by ……. c] Michaels in 1985 A] polasky in 1991 b] lebonson in 1985 Ans : A] polasky in 1991 40. Small pinhole size ....... mm c] 1.30mm Ans : b] 1mm A] 0.75mm b] 1mm 41. Large pinhole size greaterthen...... Mm A] 0.75mm b]2mm c] 1.30mm Ans : b]2mm 42. Optical function of stenopicslit......... A] power verified b] astigmatic shadow c] a,b Ans : c] a,b 43. Stenopicslit is used to measure the ……….. Distance A] length b] width c] vertex distance Ans : c] vertex distance REFRACTION DEPARTMENT-CBE

350 44. The steno pic slit consists of a aperture ………. A] triangular b] rectangular c] oval Ans : b] rectangular 45. Stenopic slit width ,length....... ,........ A] 0.5mm , 15mm b] 0.5mm , 0.1mm – 15 mm c] a,b Ans : b] 0.5mm , 0.1mm – 15 mm 46. Red and green lenses are preliminary used assessments at ........ A] binocularity b] uniocularity c] duction Ans : A] binocularity 47. How many test is uses red and green lenses …….. A] 3 b] 4 c] 5 Ans : A] 3 48. The glasses of maddox rod is....... Red A] cylindrical b] tinted c] photochromatic Ans : b] tinted 49. The maddox rod is series of powerful........ Cylindrical lenses A] convex b] concave c] aspheric Ans : A] convex