CLINICAL KNOWLEDGE NEWEST VERSION
ACTUAL 140 2026 FINAL ASSESSMENT PAPER
CLINICAL PRACTICE COMPETENCIES
COMPREHENSIVE QUESTIONS AND ANSWERS
VERIFIED A+
◉ optic cup/disk ratio. Answer: cup should not be more than 1/2
size of the disc diameter
if larger, consider glaucoma
◉ retinal vessels. Answer: arteries brighter red and narrower than
veins; A:V ratio = 2:3 or 4:5
◉ abnormal retinal vessels findings. Answer: cotton wool spots are
associated with DM & HTN
◉ fovea centralis. Answer: lies in center of macula
2.5mm reflective area that is slightly darker
,◉ macular degeneration. Answer: deterioration of central portion of
vision; leading cause of vision loss
◉ Drusen sign. Answer: physical finding with macular degeneration
◉ snellen eye chart, 20/20 meaning?. Answer: the patient can see at
20 feet what the normal person can see at 20 feet
the larger the denominator, the poorer the patient's vision***
◉ hyperopia. Answer: farsightedness
"when hyper can go FAR"
◉ myopia. Answer: nearsightedness
"My = me = near me"
◉ presbyopia. Answer: impaired vision as a result of aging, difficulty
maintaining clear focus at a near distance due to less flexibility of
crystalline lens & weak ciliary muscles
,◉ arcus senilis. Answer: cloudy appearance of the cornea with
gray/white arc or circle around limbus d/t DEPOSITION of LIPID
MATERIAL
no effect on vision
permanent, does not go away with decrease in lipids
◉ pterygium. Answer: raised, wedge-shaped growth of thin,
noncancerous tissue over conjunctiva
◉ pterygium RF. Answer: desert/sun exposure
◉ hordeolum & cause. Answer: aka stye
acute inflamm, affecting eyelid caused by staph aureus
◉ hordeolum s/sx. Answer: abrupt onset w/ pain and erythema of
eyelid
H = hurt
localized, tender mass
, ◉ hordeolum tx. Answer: hot compresses QID x10mins
PO abx if needed for preseptal cellulitis (clindamycin or Bactrim plus
Agumentin or cefpodoxime or cefdinir)
◉ hordeolum - when to refer. Answer: Refer to ophtho if not
resolved in 2 days**
◉ chalazion. Answer: beady nodule on eye lid; infection or retention
cyst of a meibomian gland usually on upper eyelid
◉ chalazion s/sx. Answer: PAINLESS apart from tenderness from
localized swelling
sensitivity to light, increased tearing, astigmatism if very large
◉ chalazion tx. Answer: warm compresses
refer for surgical removal
◉ blepharitis & cause. Answer: staph infection or seborrheic
dermatitis of lid edge
ACTUAL 140 2026 FINAL ASSESSMENT PAPER
CLINICAL PRACTICE COMPETENCIES
COMPREHENSIVE QUESTIONS AND ANSWERS
VERIFIED A+
◉ optic cup/disk ratio. Answer: cup should not be more than 1/2
size of the disc diameter
if larger, consider glaucoma
◉ retinal vessels. Answer: arteries brighter red and narrower than
veins; A:V ratio = 2:3 or 4:5
◉ abnormal retinal vessels findings. Answer: cotton wool spots are
associated with DM & HTN
◉ fovea centralis. Answer: lies in center of macula
2.5mm reflective area that is slightly darker
,◉ macular degeneration. Answer: deterioration of central portion of
vision; leading cause of vision loss
◉ Drusen sign. Answer: physical finding with macular degeneration
◉ snellen eye chart, 20/20 meaning?. Answer: the patient can see at
20 feet what the normal person can see at 20 feet
the larger the denominator, the poorer the patient's vision***
◉ hyperopia. Answer: farsightedness
"when hyper can go FAR"
◉ myopia. Answer: nearsightedness
"My = me = near me"
◉ presbyopia. Answer: impaired vision as a result of aging, difficulty
maintaining clear focus at a near distance due to less flexibility of
crystalline lens & weak ciliary muscles
,◉ arcus senilis. Answer: cloudy appearance of the cornea with
gray/white arc or circle around limbus d/t DEPOSITION of LIPID
MATERIAL
no effect on vision
permanent, does not go away with decrease in lipids
◉ pterygium. Answer: raised, wedge-shaped growth of thin,
noncancerous tissue over conjunctiva
◉ pterygium RF. Answer: desert/sun exposure
◉ hordeolum & cause. Answer: aka stye
acute inflamm, affecting eyelid caused by staph aureus
◉ hordeolum s/sx. Answer: abrupt onset w/ pain and erythema of
eyelid
H = hurt
localized, tender mass
, ◉ hordeolum tx. Answer: hot compresses QID x10mins
PO abx if needed for preseptal cellulitis (clindamycin or Bactrim plus
Agumentin or cefpodoxime or cefdinir)
◉ hordeolum - when to refer. Answer: Refer to ophtho if not
resolved in 2 days**
◉ chalazion. Answer: beady nodule on eye lid; infection or retention
cyst of a meibomian gland usually on upper eyelid
◉ chalazion s/sx. Answer: PAINLESS apart from tenderness from
localized swelling
sensitivity to light, increased tearing, astigmatism if very large
◉ chalazion tx. Answer: warm compresses
refer for surgical removal
◉ blepharitis & cause. Answer: staph infection or seborrheic
dermatitis of lid edge
