CERTIFIED RETINAL ANGIOGRAPHER EXAM
2026 PROFESSIONAL PREPARATION
WORKBOOK
◉ Melanin. Answer: Pigment in the Iris that creates the color of the
Iris and lies on top if its muscle fiber. The absence of this pigment is
a blue eye where the color is created by visualizing the muscular
tissue itself. Thin layers of yellow colored pigment on top of the
muscle fiber produces a grey, green, or hazel appearance. Heavier
deposits result in a brown eye.
◉ Iris sphincter. Answer: A thin band of muscle located on the inner
rim of the Iris, responsible for making the pupil smaller when it
constricts.
◉ Iris dilator. Answer: Responds to the brains signal of lowered light
levels to dilate the pupil. This dilator is a large group of radial
muscle tissue, when this group constricts, the Iris dilates.
◉ Penlight exam. Answer: Tests the pupillary reflex of the eyes as a
quick and easy way to determine brain health and is vitally used by
Emergency services of unconscious/ head injury patients. This is
because each eye is connected to one side of the brain. Left eye to
right hemisphere, right eye to left hemisphere.
,◉ Afferent Pupillary Defect. Answer: Any time the two pupils don't
react in tandem (together) which can indicate damage in retinal
processing or optic nerve head damage. If a penlight is shined into
the right eye, the left and right iris's should constrict equally and
symmetrically. Swinging the light to the other eye should maintain
this constriction.
◉ Lens (Transparent/ Crystalline). Answer: Helps to refract or bend
the light as it enters the eye. Responsible for 30% of the eyes total
refractive power.
◉ Accommodation. Answer: The adjustment of the lens to focus on
close or near objects. This is achieved by the contraction of
suspensory ligaments called zonules.
◉ Zonules. Answer: Project outward from the ciliary body and
attach to the lens capsule which contains the lens. When the ciliary
body contracts, these pull on the lens capsule, which changes the
lens shape to provide for subject distance changes.
◉ Presbyopia. Answer: Condition that comes about as we age where
the lens loses elastic capability, resulting in an inability to focus on
closer objects and a loss of accommodation. Requires magnifying
glasses or combination glasses (bifocals) to fit. Condition typically
occurs by mid 40's.
, ◉ Cataracts. Answer: Slow opacification (decrease in transparency)
of one or more areas of the crystalline lens.
◉ Ciliary body. Answer: Located just behind the Iris. Provides
accommodation, produces aqueous humor which provides nutrients
and oxygen and removes waste.
◉ Ciliary processes. Answer: Fingerlike projections of ciliary muscle
in the lens that contract to tug the zonules, providing
accommodation.
◉ Aqueous humor. Answer: Produced by the Ciliary body, a
nourishing fluid which flows from the posterior chamber to the
anterior chamber to support the lens and cornea. Provides nutrients
and oxygen and removes waste. Regulation and outflow directly
relates to the intraocular pressure of the globe.
◉ Glaucoma. Answer: Damage to to optic nerve causes by prolonged
periods of high intraocular pressure.
◉ Flow of Aqueous Humor. Answer: Secreted into the posterior
chamber, space between Iris and in front of the ciliary body. Then
flows around the Iris and out the pupil into the anterior chamber to
drain at the edge of the iris (anterior chamber angle) through the
trabecular meshwork. Finally draining into Schlemm's canal and into
the episcleral veins.
2026 PROFESSIONAL PREPARATION
WORKBOOK
◉ Melanin. Answer: Pigment in the Iris that creates the color of the
Iris and lies on top if its muscle fiber. The absence of this pigment is
a blue eye where the color is created by visualizing the muscular
tissue itself. Thin layers of yellow colored pigment on top of the
muscle fiber produces a grey, green, or hazel appearance. Heavier
deposits result in a brown eye.
◉ Iris sphincter. Answer: A thin band of muscle located on the inner
rim of the Iris, responsible for making the pupil smaller when it
constricts.
◉ Iris dilator. Answer: Responds to the brains signal of lowered light
levels to dilate the pupil. This dilator is a large group of radial
muscle tissue, when this group constricts, the Iris dilates.
◉ Penlight exam. Answer: Tests the pupillary reflex of the eyes as a
quick and easy way to determine brain health and is vitally used by
Emergency services of unconscious/ head injury patients. This is
because each eye is connected to one side of the brain. Left eye to
right hemisphere, right eye to left hemisphere.
,◉ Afferent Pupillary Defect. Answer: Any time the two pupils don't
react in tandem (together) which can indicate damage in retinal
processing or optic nerve head damage. If a penlight is shined into
the right eye, the left and right iris's should constrict equally and
symmetrically. Swinging the light to the other eye should maintain
this constriction.
◉ Lens (Transparent/ Crystalline). Answer: Helps to refract or bend
the light as it enters the eye. Responsible for 30% of the eyes total
refractive power.
◉ Accommodation. Answer: The adjustment of the lens to focus on
close or near objects. This is achieved by the contraction of
suspensory ligaments called zonules.
◉ Zonules. Answer: Project outward from the ciliary body and
attach to the lens capsule which contains the lens. When the ciliary
body contracts, these pull on the lens capsule, which changes the
lens shape to provide for subject distance changes.
◉ Presbyopia. Answer: Condition that comes about as we age where
the lens loses elastic capability, resulting in an inability to focus on
closer objects and a loss of accommodation. Requires magnifying
glasses or combination glasses (bifocals) to fit. Condition typically
occurs by mid 40's.
, ◉ Cataracts. Answer: Slow opacification (decrease in transparency)
of one or more areas of the crystalline lens.
◉ Ciliary body. Answer: Located just behind the Iris. Provides
accommodation, produces aqueous humor which provides nutrients
and oxygen and removes waste.
◉ Ciliary processes. Answer: Fingerlike projections of ciliary muscle
in the lens that contract to tug the zonules, providing
accommodation.
◉ Aqueous humor. Answer: Produced by the Ciliary body, a
nourishing fluid which flows from the posterior chamber to the
anterior chamber to support the lens and cornea. Provides nutrients
and oxygen and removes waste. Regulation and outflow directly
relates to the intraocular pressure of the globe.
◉ Glaucoma. Answer: Damage to to optic nerve causes by prolonged
periods of high intraocular pressure.
◉ Flow of Aqueous Humor. Answer: Secreted into the posterior
chamber, space between Iris and in front of the ciliary body. Then
flows around the Iris and out the pupil into the anterior chamber to
drain at the edge of the iris (anterior chamber angle) through the
trabecular meshwork. Finally draining into Schlemm's canal and into
the episcleral veins.
