Opt 222B Concept Questions For Final

Front 1

What does occupational optometry emphasize?

Back 1

Emphasis on WORK environment:
- visual system
- visual performance
- eye safety
- eye health

Front 2

What is the goal of occupational optometry?

Back 2

1. Prevent work-related eye injuries, diseases, and vision disorders.
2. Improve on the job performance

Front 3

What are 5 occupational services OD's provide?

Back 3

1. Comprehensive occupational exam (occupational Hx, task analysis, external & internal eye health assessment, binocular assessment, job safety)
2. Supplemental occupational exam (site visit, visual demand on job)
3. Personal Protective Equipment/Eyewear (PPE) services
4. Industrial vision screenings
5. Pre-placement exams

Front 4

What are 4 factors to consider in the proper SELECTION of dress & safety eyewear?

Back 4

1. Eye placement
2. Vertex distance
3. Lens size
4. Field of view

Front 5

What are 4 factors to consider in the DESIGN of LENSES for dress & safety eyewear?

Back 5

1. Material
2. Base curve
3. Lens DRP/NRP placement
4. Impact resistance

Front 6

What standards are dress, safety, and sport eyewear governed by?

Back 6

Dress -- ANSI Z80.5 (1997) Requirements for Ophthalmic Frames

Safety -- ANSI Z87.1 (2003) Practice for Occupational & Educational Eye & Face Protection

Sport -- Not governed by ANSI, but by ASTN F803.3.

Front 7

What is the leading cause of monocular blindness in the US?

Back 7

Eye injuries

1-2.4 million eye injuries in the US per year
~1.7 million visits to Dr. offices for injuries
~1,500 lose sight due to injury
~40,000 have visual impairment
Annual cost for inpatient hospital care related to ocular injuries >$210 million

Front 8

___% of injuries occur in individuals under the age of ___

Back 8

>57% of injuries occur in individuals under the age of 30

Front 9

Typical profile of patient with ocular injury

Back 9

1. Male
2. Under 25 years of age (55%)
3. Non-whites
4. Lower economic groups
5. Lower education
6. Injury occurred at home (40%)
7. Construction (63%) or automotive (18%) occupation
8. From blunt instrument (31%)

Front 10

Consumer product-related injury: average ___ out of every 10,000 Americans

Back 10

7.8 out of 10,000

Front 11

Most common cause of consumer product-related ocular injury

Back 11

Welding

Front 12

Most common consumer product-related ocular injury

Back 12

Contusions or abrasions (40%)

FB injuries (18%)
Dermatitis, conjunctivitis (11%)

Front 13

___% of eye injuries are preventable

Back 13

90%

Front 14

Most frequent cause for injury in the workplace due to ____?

Back 14

Not wearing protective or appropriate eyewear

Front 15

Components of a basic or survey occupational history

Back 15

1. Current/past job
2. Exposure to hazards (radiation, noise, chemicals, fumes, dusts, biologic agents)
3. Visual Sx related to work situation
4. Visual Sx present before current work situation
5. Co-worker Sx (work or environmental-related)

Front 16

Components of a more detailed diagnostic occupational history

Back 16

1. Detailed list of all jobs
2. Identify all places of employment and products manufactured
3. Describe all detail operations on job site
4. Co-worker difficulties in similar setting

Front 17

Things to look at in a task analysis

Back 17

1. Job description
2. Working distance
3. Work movement
4. Work area size
5. Visual attention requirements
6. Work/surround illumination
7. Color discrimination requirements
8. Stereo acuity requirements
9. Work position surface
10. Eye and vision hazards
11. Size of task details
12. Peripheral requirements

Front 18

Difference between regulations and standards?

Back 18

Unlike standards, regulations are ENFORCEABLE and REQUIRED by LAW.

Standards are formed by any individual, group, company, etc. and just serve for standardization/frame of reference, quality control, and public protection. They are volntary, not enforceable/regulatory, and are just "good practice policy."

Front 19

Examples of Regulations and Standards

Back 19

Regulations -- FDA (impact resistance requirement), OSHA (safety in industries, adopts ANSI Z87.1 standards), and ADA (equal opportunity and accessibility for disabled)

Standards -- ANSI, ASTM, ISO standards (ISO has effect of international law)

Front 20

If OSHA adopted ANSI Z87.1 standards, what does that mean?

Back 20

The ANSI Z87.1 standard is usually not required by law or enforceable, but since OSHA is a federal act and has adopted it, it becomes law too.

Front 21

Which ANSI standard governs recommendations for Rx ophthalmic lenses?

Back 21

Z80.1

Front 22

Which ANSI standard governs non-Rx sunglasses & fashion eyewear (e.g. tints)?

Back 22

Z80.3

Front 23

Which ANSI standard governs dress ophthalmic frames?

Back 23

Z80.5

Front 24

Which ANSI standard governs occupation/educational eye/face protection?

Back 24

Z87.1

Front 25

Which ASTM standard governs eye protectors for slected sports (racket sports, women's lacrosse, baseball)

Back 25

ASTM F803-03

Front 26

What is the general content of ANSI Z80.1 (2005)? (3 things)

Back 26

1. Definitions (add power, cylinder axis, etc etc)
2. Optical tolerances
3. Test methods (measuring power, prism, BC, impact resistance)

Front 27

What are the areas of major changes between the 2005 and 1999 version of ANSI Z80.1?

Back 27

1. Refractive power tolerances on PALs
2. Cylinder axis tolerance relaxed

Front 28

ANSI Z80.1 (2005) Optical Tolerances:

Power

Back 28

± 0.13 D up to 6.50 D
± 2% above 6.50 D

Power tolerance on HIGHEST POWER meridian

Front 29

ANSI Z80.1 (2005) Optical Tolerances:

Cylinder Power

Back 29

± 0.13 D up to 2.00 DC
± 0.15 D from 2.00 to 4.50 DC
± 4% above 4.50 DC

Front 30

ANSI Z80.1 (2005) Optical Tolerances:

Cylinder Axis

Back 30

The lower the cyl power, the higher the range. The higher the cyl power, the more accurate the axis should be.

± 14° if ≤ 0.25 DC
± 7° if > 0.25 to ≤ 0.50 DC
± 5° if > 0.50 to ≤ 0.75 DC
± 3° if > 0.75 to ≤ 1.50 DC
± 2° if > 1.50 DC

Front 31

ANSI Z80.1 (2005) Optical Tolerances:

Prism Imbalance (mounted lenses)

Back 31

• Vertical: 0.33Δ (0 to ± 3.375 D)
○ 1 mm variance between lenses if > ±3.375 D

• Horizontal: 0.65Δ (0 to ± 2.75 D)
○ Max 2.5 mm variance if > ± 2.75 D

Front 32

ANSI Z80.1 (2005) Optical Tolerances:

IPD

Back 32

± 2.5 mm

Front 33

ANSI Z80.1 (2005) Optical Tolerances:

Base Curve

Back 33

± 0.75 D (ONLY if BC was originally specified)

Front 34

ANSI Z80.1 (2005) Optical Tolerances:

Warpage (mounted lens)

Back 34

1 D

Front 35

ANSI Z80.1 (2005) Optical Tolerances:

Center Thickness

Back 35

± 0.3 mm

But remember current Z80.1 does not have a CT requirement, only an impact resistance requirement.

Front 36

ANSI Z80.1 (2005) Optical Tolerances:

NIPD

Back 36

± 2.5 mm
(multifocals)

Front 37

ANSI Z80.1 (2005) Optical Tolerances:

PAL Fitting Cross

Back 37

± 1.0 mm

Front 38

ANSI Z80.1 (2005) Optical Tolerances:

Segment Height

Back 38

± 1.0 mm

Front 39

ANSI Z80.1 (2005) Optical Tolerances:

Segment Size

Back 39

± 0.5 mm

Front 40

ANSI Z80.1 (2005) Optical Tolerances:

Add Power

Back 40

± 0.12 D up to 4.00 D
± 0.18 D over 4.00 D

Front 41

What is the current ANSI standard on thickness?

Back 41

NO thickness guideline currently. But must pass FDA's DBT. Federal gov't denied CA the exemption to current guideline.

Front 42

What aspects of non-Rx sunglasses and fashion eyewear does ANSI Z80.3 (2001) address? (3 things)

Back 42

1. Light attenuation
2. Transmittance properties, UV, traffic signal
3. Flammability of fashion wear frame & lenses

Front 43

ANSI Z80.3 (2001) Tolerances:

Refractive Power

Back 43

For plano lens +1/8 D, -1/4 D
No greater than 3/16 D difference between both lenses

Front 44

ANSI Z80.3 (2001) Tolerances:

Astigmatic power

Back 44

No greater than 1/8 DC per lens

Front 45

ANSI Z80.3 (2001) Tolerances:

Prism power

Back 45

No greater than 1/4pd per lens

Front 46

What does the CA DMV VC§ 23120 state?

Back 46

"no person shall operate a vehicle while wearing glasses having a temple width of 1/2 inch or more if any part of such temple extends below the horizontal center of the lens so as to interfere with lateral vision."

Front 47

ANSI Z80.5 (2004) tolerances for ophthalmic frames

Back 47

1. Lens retention by frame (shall not be dislodged by minimum energy equivalent to DBT)
2. Frame bevel angle no grater than 110°
3. Does not obstruct visual field
4. Metal frame made of corrosion-resistant material
5. Frame flammability (will not ignite when heated for 15 min at 200°C)
6. Marking & stamping of frame

Front 48

According to the FTC, when must eye care providers (ECPs) give their customers a copy of their Rx?

Back 48

Eyeglass Rx -- at the conclusion of their exam

CL Rx -- at conclusion of exam or completion of fitting process

Front 49

California Code of Regulations regarding Consumer Notice

Back 49

Consumer Notice must be posted in a conspicuous place and state the legal requirements regarding release of all Rx's.

Front 50

California Code of Regulations regarding patient receipts

Back 50

Receipt must show:
1. Patient name
2. OD license #
3. Location of practice
4. Description & cost of all goods and services patient was charged for

Front 51

California Code of Regulations regarding Rx release and expiration date

Back 51

Rx release must have:
1. Patient's name
2. Rx
3. Date of issuance
4. Expiration date (no less than 2-4 years unless circumstances dictate otherwise)
5. Prescriber's name, address, telephone, license #, signature

Front 52

What are the requirements of an employer regulated by OSHA? (3 things)

Back 52

1. Perform work hazard assessment
2. Equipment selection
3. Proper training (PPE, proper size, intended use)

Front 53

What are the general OSHA requirements of industrial safety eyewear? (5 things)

Back 53

1. Appropriate eye or face protection against hazards
2. Proper side protection (detachable OK)
3. Rx incorporated in design, or worn over Rx lenses without disturbing proper positioning (cannot put side shields on own dresswear frames)
4. Eye & face PPE must be distinctly marked to identify manufacturer
5. Filter lenses must have shade number appropriate for work performed with injurious light radiation

Front 54

ANSI Z87.1 (2003) Standards:

Lens thickness

Back 54

Most safety Rx: 3.0 mm CT/ET

If > +3.00DS, edge may be 2.5 mm if it meets i mpact test

Plano Rx safety eyewear -- 3.0 to 3.8 mm thick

Plano polycarbonate -- 2.0 mm thickness allowed

Front 55

ANSI Z87.1 (2003) Standards:

Lens impact

Back 55

1" steel ball dropped from 50" onto horizontal front surface - lens shall not break

Front 56

ANSI Z87.1 (2003) Standards:

Lens retention test

Back 56

Lens must not be displaced from frame

Front 57

ANSI Z87.1 (2003) Standards:

Basic Impact Lenses

Back 57

- 3.0 mm thickness
- No "+" laser mark
- Pass industrial DBT (1" steel ball, 50")
- All glass lenses tested
- Plastic lenses batch-tested

Front 58

ANSI Z87.1 (2003) Standards:

High Impact Lenses

Back 58

- 2.0 mm thickness (minimum)
- Must have "+" laser mark at 90° or superior-temporal and pass high velocity impact test (1/4" steel ball at 150 fps)
- Rx lenses not individually tested

Front 59

ANSI Z87.1 (2003) Standards:

Singer needle test

Back 59

A Singer #25 needle must not pierce lens surface if dropped from 50"

Front 60

ANSI Z87.1 (2003) Standards:

Rx

Back 60

Follows Z80.1 tolerances

Cannot mix safety lens with dress frame or vice versa

Front 61

ANSI Z87.1 (2003) Standards:

Tinted lenses

Back 61

Must meet Z87.1 standards for min/max visible light transmittance and max UV & IR radiation transmittance

Shade # must be clearly identified

Transmission between R & L lens must be within 10% of each other

Photochromic lenses must be monogrammed with letter "v"

Lenses tinted for special purpose situations must be monogrammed with letter "s"

Front 62

Shade # Equations

Back 62

Shade # = 7/3 OD + 1
OD = -log T (transmittance)

Higher shade # --> darker lenses
Shade #s usually range 1.5 to 14

Front 63

ANSI Z87.1 (2003) Standards:

Lens markings

Back 63

Manufacturer and shade number. Marking at 90° or superior temporal.

1. Non-plano Basic Impact: e.g. "w 2.5"

2. Non-plano High Impact: e.g. "w+2.5"

Front 64

ANSI Z87.1 (2003) Standards:

Absorptive lenses (occupational use)

Back 64

Must absorb both UV & IR radiation and transmit primarily in mid-spectrum (lenses are bluish-green or greenish-yellow)

Front 65

ANSI Z87.1 (2003) Standards:

Frame

Back 65

1. Must have a "lip" behind lens
2. Lens inserted from FRONT
3. Must bear Z87-2 logo
4. Must have A, DBL, and temple length on frame
5. Must meet high mass, low velocity test (1" diameter pointed projectile dropped thru 51.2" tube)
6. Must meet low mass, high velocity impact test (1/4" steel ball at 150 fps shot at front and side)
6. Must meet flammability and corrosion standard (ASTM test method - shall not burn more than 3"/min, boiled in 10% NaCl)

Front 66

ANSI Z87.1 (2003) Standards:

Radiation

Back 66

Must use safety eyewear under appropriate helmet or face-shield

Front 67

2 categories of welding lenses

Back 67

1. Class I -- General purpose (significant UV & IR reduction)

2. Class II -- Specific for reduction of sodium D-line radiance (589.3 nm)
- addition of didymum (good UV& IR protection + 589 nm protection)

Front 68

Define dichroic and what kind of lens is it a property of?

Back 68

Dichroic = exhibits different colors under various light sources.

Characteristic of didymium lenses:
Incandescent lighting = rose-brown color
Fluorescent lighting = greenish-blue color

Front 69

Properties of didymium lenses

Back 69

1. Dichroic color
2. Cerium oxide + didymium
3. Occupational lens for glass blowers
4. Filters out yellow flame (Sodium Flare) -- absorbs in 570-590 nm range
5. Only available in ONE-PIECE multifocal lenses

Front 70

Shade # of most industrial lenses

What shade # should you wear to watch a solar eclipse?

Back 70

~3-4

Solar eclipse: 5 or greater

Front 71

List 5 protective devices

Back 71

1. Safety spectacles
2. Chipping goggles
3. Impact or dust goggles
4. Chemical goggles
5. Plastic face shield

Front 72

5 requirements of eye protection

Back 72

1. Protect against specific hazards encountered in workplace
2. Reasonably comfortable to wear
3. Not restrict vision or movement
4. Durable & easy to clean/disinfect
5. Not interfere with function of other required PPE (e.g. respirators)

Front 73

A serious eye injury takes place every ____ min in the US

Back 73

27 min

Front 74

Name 6 segment styles used in occupational lenses other than the usual BF and TF.

Back 74

1. Double Round
2. Double Flat Top
3. Double Executive
4. Executive/Flat Top
5. CRT Executive
6. Quadrifocal

Front 75

Segment separation between double segments (double FT or double round)

Back 75

13.0 mm usually

CR-39 DD28,35 = 14 mm
CR-39 DR22,25,28 = 14 mm

Front 76

Which segment styles are available in PLASTIC only?

Back 76

1. Executive/FT
2. CRT Executive
3. CRT DataLite

Front 77

Which segment styles are available in GLASS only?

Back 77

1. Quadrifocal
2. Ribbon

Front 78

For the double FT, what seg sizes are available in glass? Plastic?

Back 78

Glass: DD22, DD25, DD28, DD35

CR-39: DD25, DD28, DD35

Front 79

Add availability of glass double FT

Back 79

DD25 +4.00
DD28 +5.00
DD35 +3.00

Front 80

Add availability of glass double round

Back 80

up to +5.00

Front 81

Standard separation of double executive

Back 81

14 mm

Front 82

Add availability of double executive

Back 82

up to +3.00

Upper add usually +0.50 to +0.75 weaker

Front 83

Difference between double executive & executive trifocal

Back 83

DE: double solid ledge (ledge sticks out) and 13 mm separation

Exec. TF: staircase ledge and 7 mm separation

Front 84

Where do you fit the executive line for an Executive/FT (Sola ED or Orcolite F/D)?

Back 84

At pupil CENTER

Front 85

Where do you fit the TF line for CRT Executive or CRT DataLite?

Back 85

At pupil TOP

Front 86

Trifocal special options

Back 86

FT 14x35 (50 or 66%)
CT 10x40 (66%)

Front 87

Segment separation in quadrifocal

Back 87

13 mm

Front 88

Quadrifocal seg size options

Back 88

7x25, 7x28, 7x35

GLASS ONLY

Front 89

Where do you fit the TF line for quadrifocal?

Back 89

At pupil LOWER border

Front 90

Ribbon segment size options

Back 90

9x22, 9x25
14x22, 14x25

GLASS ONLY
Available in photochromic PGX

Front 91

Available add for "Spot"/Golfer's Classic Round Seg (typically 15mm)

Back 91

+30 D

Front 92

Goal of sports vision

Back 92

To improve visual fitness to enhance sports performance

(VA, eye-hand coordination, depth perception, visual attention, reaction time, peripheral vision)

Front 93

Leading cause of sports eye injuries in 5-15 yo? 15-25 yo? 25-64 yo?

Back 93

5-15 yo: baseball
15-25 yo: basketball
25-64 yo: racquetball, basketball, baseball

Front 94

Sports frames requirements

Back 94

1. Fully cover orbital region
2. Proper contact at bridge & tmples
3. Beveled (so lens expulsion is not towards eye)
4. Fits properly
5. Follows ASTM standards

Front 95

ASTM F803-3 Types

Back 95

Type I -- Face masks & polycarbonate shields (bulky and uncomfortable)

Type II -- Lensless eyeguard with narrow opening (no longer safe for racquetball)

Type III -- Bubble lens with uniform frame construction (very curved lens causes distortion; no Rx)

Type IV -- Eyeguards with lenses (polycarb lens/frame and sports strap; most widely used today)

Front 96

Swim goggles - available powers (for Hilco)

Back 96

-8.00 to +8.00 (use spherical equivalent and round up)

0.50 steps for low Rx
1.00 steps for high Rx

Front 97

2 Nike Maxsight tints

Back 97

1. Gray-green (for sports in bright sunlight; enhances mid-portion of spectrum and some longer wavelengths)

2. Amber (for fast moving ball sports; selectively filters blue-green portion of spectrum)

Front 98

Sports-related eyewear - name 5 sports and lens considerations

Back 98

1. Water sports (UV, polarizing, goggles lens curvature)
2. Skiing (PC, UV, polarizing)
3. Scuba-diving (glass, plano front surface)
4. Court-related sports (PC, UV, goggle with sports strap)
5. Cycling (PC, UV, wrap-around)

Front 99

Professional liability

Back 99

1. Misdiagnosis
2. Negligence
3. Medical malpractice

Front 100

Materials liability

Back 100

1. Negligence (failure to prescribe most impact-resistant lens material, failure to warn of risk of injury from alternative lens materials, failure to inspect and verify order)

2. Frame liability (negligence, idiosyncratic responses, improper safety frame, improper sports frame)

3. Product liability (defective design, defective warnings or directions ,defective inspection)

Front 101

Burden of defective product is on who?

Back 101

The producer (manufacturer)

Front 102

According to Dr. Hoenig, ____% of children computer users are in need of eye care

Back 102

20-30%

Front 103

AOA definition of Computer Vision Syndrome (CVS)

Back 103

The complex of eye and vision problems related to near work which are experienced during or related to computer use

Front 104

Visual contributors to CVS (6 things)

Back 104

1. RE
2. BV
3. Accommodation
4. ZCSBV
5. Dry eyes
6. Spectacle lens design

Front 105

Definition of Cumulative Trauma Disorders (CTD)

Back 105

Any physical disorder that develops from or is aggravated by the cumulative application of biomechanical stressors to tissues and joints. Soft tissue become irritated or inflamed.

Aka repetitive motion or repetitive strain injury

Front 106

Environment/Ergonomic Contributors

Back 106

1. VDT location
2. VDT screen reflections
3. VDT screen placement
4. VDT screen (flicker, contrast)
5. Monitor output
6. Overhead lighting
7. External lighting
8. Window glare
9. Office environment (heating/AC)
10. Work station (table, chair)

Front 107

Spectacle lens designs for computer usage

Back 107

1. Single vision
2. BF (int/near)
3. TF (14x35, E/D [Sola] or F/D)
4. Occupational progressives (aka OPLs or NVFs) -- AO Technica, Sola Access, Zeiss Gradal RD

Front 108

Tints and coatings for computer usage

Back 108

1. Tints of little value (pink maybe more comfortable with fluorescent lighting)

2. UV coating unnecessary

3. ARC coating reduces reflections from glasses from overhead lighting --> increase transmission

Front 109

AO Technica:

1. Add power at fitting cross?
2. Where is full distance Rx?
3. Where is full near Rx?
4. Which PD do you measure for fitting?
5. Lens markings?

Back 109

AO Technica:

1. Add power at fitting cross? 50%
2. Where is full distance Rx? 12 mm up
3. Where is full near Rx? 16 mm down
4. Which PD do you measure for fitting? DISTANCE monocular PDs
5. Lens markings? "AOT"

Front 110

Sola Access:

1. What backoffs are available for which add powers?
2. Corridor length?
3. Right & left lens?
4. Lens markings?
5. Fitting considerations (PD, seg height)?

Back 110

Sola Access:

1. What backoffs are available for which add powers? +0.75 for add powers up to +1.50; +1.25 for add powers over +1.50 (Sola Continuum is +1.00 backoff)
2. Corridor length? 10 mm
3. Right & left lens? No R&L lens
4. Lens markings? "AC" for CR-39 and "AP" for polycarb
5. Fitting considerations (PD, seg height)? NEAR PD, seg height to pupil center minus 5 mm, "Rx calculated for near", specify backoff

Front 111

Zeiss Gradal RD:

1. Distance increased by ___?
2. Lens materials available?
3. Lens markings?
4. Recommended fitting height?
5. Ordering considerations?

Back 111

Zeiss Gradal RD:

1. Distance increased by ___? +0.50
2. Lens materials available? CR-39 & hi-index glass
3. Lens markings? "RD"
4. Recommended fitting height? 25 mm
5. Ordering considerations? Order full distance & add (lab adjusts power)