IJCAHPO CRT Certified Retina Technician

A retina patient reports sudden onset of many new floaters and brief flashes in one eye. What history detail is most important to document before alerting the ophthalmologist?

• AWhether symptoms began suddenly and whether a curtain or field loss is present
• BThe brand of artificial tears the patient has used for dryness during the past week
• CThe patient's preferred pharmacy for future refills
• DWhether the patient has ever worn progressive lenses

Before an intravitreal anti-VEGF visit, which medication history is most relevant to document for the physician?

• AUse of over-the-counter reading glasses purchased at a pharmacy within the past year
• BRecent anticoagulant or antiplatelet use such as warfarin, apixaban, aspirin, or clopidog…
• CPast use of topical lubricating drops only
• DUse of a daily multivitamin taken for general health without any ocular symptoms

A patient with diabetic retinopathy asks why the clinic asks about A1c and blood pressure. How should the technician handle this during history intake?

• ATell the patient eye findings alone determine retinopathy and systemic history is unrelat…
• BAdvise the patient to change diabetes medication before imaging
• CDocument A1c, blood-pressure history, and medical follow-up because systemic control affe…
• DSkip the systemic questions because blood-sugar and blood-pressure management belong to p…

During intake for fluorescein angiography, the patient says, "I once got hives after a dye test." What is the best technician response?

• AReassure the patient that fluorescein never causes allergic reactions
• BProceed with the dye injection as planned because a remote episode of hives is not releva…
• CDelete the allergy field if the patient cannot name the dye
• DDocument the reaction in detail and alert the supervising provider before any dye is given

A patient says the right eye is blurry, but the referral note says left eye. What should the technician do first?

• AClarify the patient's report, document it, and flag the laterality discrepancy for the te…
• BChange the referral note to match the patient's statement without comment
• CAssume the referral note is correct because the referring office examined the patient bef…
• DTest only the left eye to avoid delaying clinic flow

A postoperative retinal detachment patient calls 2 days after scleral buckle surgery reporting increasing pain, nausea, and halos. Which action is most appropriate?

• ASchedule the next routine appointment because halos are expected after any retina surgery
• BRecord onset, severity, and operative eye, and route the call per urgent clinic protocol
• CTell the patient to stop all prescribed drops and call back tomorrow
• DDocument only "post-op discomfort" because detailed triage is the physician's role

Which family-history question is most relevant for a patient being evaluated for possible age-related macular degeneration?

• ADid anyone in your family wear contact lenses?
• BDo any relatives prefer bifocals over progressive lenses?
• CHave any close relatives been diagnosed with macular degeneration or central vision loss?
• DHas anyone in your family been treated for seasonal allergies such as hay fever every spr…

A new retina patient had injections elsewhere but does not know the medication name. What is the best documentation step?

• AEnter "no prior treatment" because the drug name is unknown
• BAsk the patient to pick the most likely drug name from a list so the chart looks complete
• CRecord both eyes as treated to avoid underdocumenting care
• DDocument approximate dates and treated eye, and request prior records per office policy

A patient scheduled for angiography nods during instructions but answers unrelatedly in another language. What should the technician do?

• AUse approved interpreter services and verify understanding before continuing preparation
• BAsk the patient's minor grandchild in the waiting room to translate the consent discussion
• CProceed because nodding indicates adequate understanding
• DSkip documentation because language access is administrative, not clinical

Which review-of-systems finding should be highlighted for the ophthalmologist in a patient with new retinal hemorrhages?

• AMild seasonal sneezing that improves with over-the-counter antihistamine tablets
• BRecent severe hypertension or blood-pressure medication nonadherence
• CPreference for large-print books
• DHistory of childhood chickenpox

A patient with macular disease reads 20/80 uncorrected and 20/40 through pinhole. What does the pinhole result most directly suggest?

• AThe macula is healthy because pinhole testing improved the measured vision level
• BThe patient does not need a retina evaluation
• CSome reduced acuity may be due to uncorrected refractive error
• DThe visual acuity measurement should be discarded

A patient with central geographic atrophy cannot see the beginning of a Snellen line but reads letters when looking slightly away. What should the technician do?

• AInsist that the patient look directly at the center of each letter even when no letters a…
• BRecord the acuity as no light perception
• CMove immediately to color plates and skip acuity
• DEncourage consistent eccentric viewing and document the method used during acuity testing

Why is near vision often documented in a retina clinic patient with suspected macular disease?

• ANear tasks can reveal functional central-vision complaints relevant to macular disease
• BNear vision testing replaces the need for a dilated retinal examination by the physician
• CNear vision proves whether intraocular pressure is normal
• DNear vision determines whether fluorescein is contraindicated

A patient reports that straight lines look wavy on an Amsler grid in the right eye. How should the technician document this?

• ATell the patient the finding confirms wet macular degeneration
• BRecord the eye tested and distortion location, and notify the provider per workflow
• CIgnore the result if distance acuity is unchanged
• DDocument the test as "Amsler normal" because the patient could see all of the grid lines

A patient with diabetic macular edema has stable high-contrast acuity but reports worse night driving and difficulty seeing steps. What is most useful to document?

• AThat the patient is malingering because Snellen acuity is unchanged
• BThat the retina is stable and no imaging is needed
• CFunctional contrast complaints, which high-contrast acuity testing may not capture
• DThat cataract is the only condition capable of causing glare and night-driving difficulty

When a patient cannot read the largest letter on the distance chart, what is an appropriate next acuity step?

• ARecord 20/20 because the chart cannot be used
• BSkip further vision testing and simply document "unable to test" without another attempt
• CUse tonometry as a substitute for acuity
• DMove the patient closer or use counting fingers, hand motion, or light perception

A retina patient complains of decreased color intensity in one eye. What is the technician's best role?

• APerform ordered color-vision testing by eye and document the symptom for clinician review
• BExplain to the patient that color symptoms are never related to retinal or optic-nerve di…
• CChoose a diagnosis based on whether red appears darker
• DStart treatment for optic neuritis

Yesterday's outside acuity was 20/50, but today the follow-up injection patient tests 20/100. What should the technician do?

• AAssume the outside acuity record was measured incorrectly and delete it from the comparis…
• BRepeat testing with correction and pinhole, document conditions, and alert the provider
• CAverage the two values and record 20/75
• DTell the patient the disease has progressed

A patient with flashes reports a new shadow in the superior field. What is the best technician action?

• ATell the patient that the retina has detached in the superior quadrant and needs surgery
• BIgnore confrontation testing because only automated fields matter
• CDocument the described field location clearly and alert the provider promptly
• DDocument that the complaint is impossible because superior symptoms cannot involve retina

During confrontation visual-field testing, what instruction helps produce the most reliable screening result?

• AFollow the moving target with your eyes wherever it travels during the test
• BClose both eyes whenever the target disappears
• CGuess only after I tell you the target location
• DKeep looking at my eye or nose and tell me when you first see the target

An automated field printout shows many fixation losses and false positives. What should the technician recognize?

• AReliability indices limit interpretation, and the test may need coaching or repeating
• BThe field is automatically normal because reliability is poor
• CThe technician should edit the printout so the unreliable points are removed before filing
• DFalse positives prove the patient has retinal detachment

A patient with a known macular scar performs a central 10-2 field. Which finding would be most consistent with that history?

• AA complete bitemporal hemianopia that precisely respects the vertical midline in both eyes
• BA dense central or paracentral scotoma corresponding to damaged central retina
• CUniform peripheral constriction caused entirely by eyelid position artifact
• DA nasal step defect of the type typically attributed to optic disc swelling

Which pupil finding should be promptly documented and reported during retina intake?

• AEqual brisk pupils in both eyes
• BPupils that are slightly larger than baseline after dilating drops were given
• CA new relative afferent pupillary defect in the symptomatic eye
• DPupils that constrict normally to near effort

A patient was dilated at an outside office 1 hour ago and arrives with unequal pupils. What should the technician do?

• AAssume a neurologic emergency and call a code before asking about any recent drops
• BIgnore the unequal pupils because dilating drops always affect both eyes exactly equally
• CReverse the dilation without physician direction
• DAsk about prior drops, document timing and agents, and inform the provider in context

When performing the swinging-flashlight test, which technique is most appropriate?

• ABriefly illuminate each eye with a consistent light and compare direct and consensual res…
• BHold the light steadily on one eye for several minutes before switching over to the other…
• CAsk the patient to track the light across the room
• DPerform the test only after both eyes are fully dilated

After dilation, a patient reports severe eye pain, headache, nausea, and blurred halos. What should the technician do?

• AReassure the patient that these symptoms are a normal, expected effect of dilating drops
• BAlert the ophthalmologist immediately and document the symptoms and time of onset
• CSend the patient home with sunglasses only
• DMeasure visual acuity next week

A patient has poor direct constriction when light is shined in the right eye, but both pupils constrict well when light is shined in the left eye. What pattern is suggested?

• AEfferent paralysis of both pupils
• BNormal physiologic response
• CReduced afferent input from the right eye
• DMechanical iris blockage in the left eye only

A patient with sudden painless vision loss has count-fingers vision and a marked RAPD in that eye. What is the technician's priority?

• AFinish the entire routine imaging protocol before mentioning the findings to anyone
• BReassure the patient that RAPD is caused by dry eye
• CPatch the eye and reschedule for refraction
• DDocument the acuity and pupil results and notify the ophthalmologist immediately

How should a technician document pupil findings most clearly?

• ARecord size, light reaction, RAPD status, and whether drops were used for each eye
• BWrite only "pupils okay"
• CDocument the pupil sizes measured after dilation but omit the time the drops were instill…
• DRecord the same pupil size for both eyes if they look similar

Before applanation tonometry, what safety step is essential?

• AUse the same tonometer tip all day as long as every patient appears asymptomatic
• BDisinfect the tonometer tip according to manufacturer and clinic protocol
• CMeasure pressure before confirming patient identity
• DSkip hand hygiene if gloves are worn

After an intravitreal injection, the patient reports severe pain and vision dimming. What should the technician do?

• ATell the patient that pressure checks are never needed after routine injections
• BGive pressure-lowering medication independently
• CNotify the provider promptly and prepare for ordered vision and IOP assessment
• DDismiss the complaint because irritation is always expected

A Goldmann applanation reading seems unexpectedly high in a patient squeezing tightly. What is the best technician response?

• ARecord the highest number without comment
• BPress down harder on the eyelid to hold the eye open while taking the measurement
• CTell the patient they definitely have glaucoma
• DCoach relaxation, reposition the patient, and repeat or document the difficulty

A patient presents after blunt trauma with a peaked pupil and possible open globe. What should the technician do regarding tonometry?

• AAvoid pressure on the eye and immediately notify the ophthalmologist
• BPerform applanation tonometry so a baseline IOP is documented in the chart
• CUse digital pressure estimation through the eyelid
• DApply a tight pressure patch and continue with the routine workup

A retina patient reports new double vision after scleral buckle surgery. What should the technician include in the workup?

• ATell the patient that double vision cannot occur as a result of retinal surgery
• BDocument the diplopia and perform ordered motility assessment by gaze position
• CSkip motility because retina visits only require posterior imaging
• DPrescribe prism to relieve symptoms

A patient with diabetes has new binocular horizontal diplopia and limited abduction of one eye. What is the technician's best action?

• ATell the patient it is a harmless refractive problem
• BCover the affected eye with a patch and send the patient home without provider review
• CDocument the limitation, confirm the diplopia is binocular, and alert the provider
• DPerform fluorescein angiography before reporting diplopia

A dense vitreous hemorrhage prevents fundus view. Why might the ophthalmologist order a B-scan ultrasound?

• ATo measure eyeglass prescription
• BTo replace the patient history that would normally be collected at check-in
• CTo sterilize the ocular surface
• DTo assess the retina and vitreous when the optical view is blocked

During B-scan imaging for suspected retinal detachment, why are multiple gain settings and gaze positions useful?

• AThey help characterize membrane mobility and attachments beyond one static image
• BThey make all echoes disappear for a cleaner report
• CThey allow the technician to issue a diagnosis without any physician review of the images
• DThey eliminate the need to label laterality