Review of Cornea
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Myopia Regulation: Myth or Megatrend? - By Jerome A. Legerton & Brian Chou

Exam Questions

1. Why does ocular pathology linked to myopia have a significant public health impact?
    A. Myopic is one of the top three causes of legal blindness in the United States.
    B. Choroidal neovascularization related to myopia degeneration is unresponsive to off-label intravitreal Avastin (bevacizumab, Genentech) treatment.
    C. Patients with myopic retinal degeneration tend to have their vision loss extended over a much longer period of time than those with macular degeneration.
    D. Lost work-related productivity in the United States from retinal detachment is estimated at $4.8 billion per year.
2. Which of the following ocular pathologies is NOT generally associated with myopia?
    A. Lattice retinal degeneration.
    B. Choroidal neovascularization.
    C. Granulomatous uveitis.
    D. Retinal holes.
3. Regulation of myopia would most likely involve patients between the ages of:
    A. Two to five years.
    B. Six to 16 years.
    C. 17 to 21 years.
    D. 25 to 35 years.
4. Scientific evidence has found an association between the inhibition of childhood myopic progression and:
    A. Higher levels of outdoor activity.
    B. Bates eye exercises.
    C. Consumption of bilberry.
    D. Prolonged near work.
5. Recent research collectively suggests that hyperopic defocus in the retinal periphery can:
    A. Inhibit myopic progression.
    B. Inhibit hyperopic progression.
    C. Stimulate hyperopic progression.
    D. Stimulate myopic progression.
6. What is the established metric for determining successful inhibition of myopic progression?
    A. Decreased corneal curvature.
    B. Decreased anterior to posterior thickness of the crystalline lens.
    C. Change in vitreous chamber depth.
    D. Increased anterior chamber depth.
7. What confounded the results of several early studies that attempted to determine if spherical rigid contacts could slow myopic progression?
    A. Insufficient examination and follow-up protocols.
    B. Unsophisticated diagnostic technology and lack of qualified research personnel.
    C. Lack of patient participation and funding.
    D. Inadequate control of variables, incomplete follow-up and poor patient selection.
8. The results of the Contact Lens and Myopia Progression (CLAMP) study support the premise that:
    A. Practitioners should not prescribe spherical rigid contacts for controlling axial myopi
    B. Any reduction of myopia in rigid contact lens wearers indicates decreased vitreous chamber depth.
    C. Corneal reshaping effectively induces peripheral retinal defocus.
    D. Rigid contact lenses do not cause release of retinal neurotransmitters.
9. According to the literature, how does soft contact lens wear affect myopic progression?
    A. Undercorrection with soft contact lenses effectively controls myopic progression.
    B. Soft lens wear by children does not increase myopia compared to wearing eyeglasses.
    C. Soft contact lens wear significantly increases myopic progression.
    D. Soft contact lens wear causes corneal steepening compared to spectacle wear.
10. Regarding the undercorrection of myopia, which of the following statements is true?
    A. At least two studies have found that undercorrection increases myopic progression.
    B. Following the results of COMET, the National Eye Institute has endorsed progressive eyeglasses for myopia control.
    C. Asian children experience statistically significant reduction in axial myopic progression when undercorrected.
    D. One study proved the efficacy of undercorrection for controlling myopia in patients with accommodative lag, high AC/A and near-point esophoria.
11. Why is atropine therapy not routinely prescribed?
    A. It does not effectively control myopic progression.
    B. Studies demonstrate unclear and inconclusive results.
    C. Its side effects in children, as well as cosmesis, may hinder academic and social development.
    D. It is not available in the U.S.
12. Which drug is NOT currently under evaluation for myopia regulation?
    A. Pirenzepine.
    B. Bimatoprost.
    C. L-NAME.
    D. 7-methylxanthine.
13. Which of the following statements regarding vision training is TRUE?
    A. Previous research has demonstrated the efficacy of accommodative vision training for slowing myopic progression.
    B. An esophoric myopic must accommodate more to maintain single binocular vision.
    C. An elevated AC/A ratio was associated with myopia development, according to research by Donald O. Mutti, O.D., Ph.D.
    D. A low AC/A ratio prior to onset of myopia is predictive of rapid myopic progression, according to research by Jane Gwiazda, Ph.D., and colleagues.
14. Which concept currently holds the most promise for regulating myopic progression?
    A. Undercorrection with rigid contact lenses.
    B. Vision training.
    C. Prolonged outdoor activity.
    D. Non-surgical induction of peripheral myopic defocus.
15. How is corneal reshaping hypothesized to inhibit myopic progression?
    A. Creation of an oblate cornea focuses the central retinal image but causes peripheral retinal myopi
    B. Creation of a prolate cornea focuses the central retinal image but causes peripheral retinal hyperopia.
    C. Mechanical interaction of the rigid lens causes hypertrophy and stiffening of scleral collagen.
    D. Compression of the corneal epithelium releases inhibitory factors that limit vitreous chamber elongation.
16. Interim data from which study has NOT found a significant reduction in axial growth of the eye with corneal reshaping?
    A. Longitudinal Orthokeratology Research in Children (LORIC).
    B. Corneal Reshaping and Yearly Observation of Myopia (CRAYON).
    C. Stabilization of Myopia via Accelerated Reshaping Technologies (SMART).
    D. Atropine in the Treatment of Myopia (ATOM).
17. Which treatment is NOT expected to increase peripheral retinal myopia?
    A. LASIK.
    B. Multifocal soft contact lens.
    C. Corneal reshaping.
    D. Miotic eye drops.
18. If positive spherical aberration controls myopic eye growth by causing peripheral retinal myopia, which of the following statements is FALSE?
    A. Atropine and other cycloplegics could inhibit myopia because of the increase in spherical aberration induced by increasing pupil size.
    B. Multifocal soft contacts control myopic progression by addressing accommodative lag.
    C. Although not routinely performed on children, LASIK and its induced spherical aberration could inhibit myopic eye growth.
    D. Peripheral retinal myopia likely causes the release of cellular factors that modulate axial growth.
19. Which of the following is not a reason cited by the authors for preventing myopia?
    A. High prevalence of myopi
    B. Increased risk of associated pathology.
    C. Negative impact on quality of life.
    D. Correlation with psychiatric disorders.
20. What instrument might be LEAST useful in monitoring the efficacy of a treatment for myopia progression?
    A. Peripheral refractor.
    B. A-scan ultrasonographer.
    C. Wavefront aberrometer.
    D. Keratometer.

Evaluation Questions

21. The goal statement was achieved:
    A. Very Well
    B. Adequately
    C. Poor
22. The information presented was:
    A. Very Useful
    B. Useful
    C. Not Very Useful
23. The difficulty of the course was:
    A. Complex
    B. Appropriate
    C. Basic
24. Your knowledge of the subject was increased:
    A. Greatly
    B. Somewhat
    C. Hardly
25. The quality of the course was:
    A. Excellent
    B. Fair
    C. Poor

26. Comments on this program:


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