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PRETEST True or False

_____ 1. Refraction refers to the bending of light rays so that they can be focused on the retina. 

_____ 2. A person who is farsighted has a condition known as myopia.

 _____ 3. An optometrist can perform eye surgery. 

_____ 4. The Snellen eye test is conducted at a distance of 20 feet.

 _____ 5. The Snellen eye chart should be positioned at the medical assistant’s eye level. 

_____ 6. An eye instillation may be performed to treat an eye infection.

 _____ 7. Conjunctivitis caused by a bacterium is not contagious.

 _____ 8. The most specific type of hearing test is the tuning fork test.

 _____ 9. Serous otitis media can result in a conductive hearing loss.

 _____ 10. An ear instillation may be performed to treat an ear infection.

POSTTEST True or False

_____ 1. A person who cannot see objects close up has a condition known as amblyopia.

 _____ 2. Visual acuity refers to sharpness of vision. 

_____ 3. Presbyopia is a decrease in the elasticity of the lens due to the aging process. 

_____ 4. An optician fills prescriptions for eyeglasses. 

_____ 5. The Snellen Big E chart is used with school-age children. 

_____ 6. The most common color vision defects are congenital in nature.

_____ 7. The external auditory canal of an adult is straightened by pulling the ear downward and backward.

_____ 8. The range of frequencies for normal speech is 300-4000 Hz.

 _____ 9. Intense noise can result in a sensorineural hearing loss. 

_____ 10. Tympanometry is used to diagnose patients with auditory nerve damage.

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KEY TERM ASSESSMENT

A. Definitions Directions:

B. Match each key term with its definition.

_____ 1. Astigmatism 

 _____ 2. Audiometer 

_____ 3. Canthus

 _____ 4. Cerumen 

_____ 5. Hyperopia 

_____ 6. Impacted 

_____ 7. Instillation 

_____ 8. Irrigation

 _____ 9. Myopia 

_____ 10. Otoscope

 _____ 11. Presbyopia 

_____ 12. Refraction

_____ 13. Tympanic membrane                                 

A. The washing of a body canal with a flowing solution

B. A decrease in the elasticity of the lens that occurs with aging, resulting in a decreased ability to focus on close objects

C. Farsightedness

D. The deflection or bending of light rays by a lens

E. The junction of the eyelids at either corner of the eye

F. Nearsightedness

G. The dropping of a liquid into a body cavity

H. An instrument for examining the external ear canal and tympanic membrane

I. Earwax

J. An instrument used to quantitatively measure hearing acuity for the various frequencies of sound waves

K. A thin, semitransparent membrane located between the external ear canal and the middle ear that receives and transmits sound waves

L. A refractive error that causes distorted, blurred vision for both near and far objects due to a cornea that is oval-shaped 

M. Wedged firmly together so as to be immovable

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EVALUATION OF LEARNING

Directions: Fill in each blank with the correct answer. 

1. What is visual acuity? 

2. What type of symptoms might be experienced with myopia? 

3. What methods can be used to correct myopia? 

4. What causes an individual with astigmatism to have distorted, blurred vision? 

5. Describe what each of the following eye professionals is qualified to perform. a. Ophthalmologist 

b. Optometrist 

c. Optician 

6. What condition can be detected by measuring distance visual acuity? 

7. What type of patient would warrant use of the Snellen Big E eye chart? (Give two examples

8. Explain the significance of the top number and bottom number next to each line of letters on the Snellen eye chart.

9. List two conditions that can be detected by measuring near visual acuity. 

10. Explain the difference between congenital and acquired color vision defects. 

11. What is a polychromatic plate? 

12. List three reasons for performing eye irrigation. 

13. List three reasons for performing eye instillation. 

14. What is the range of frequencies for normal speech? 

15. List five conditions that may cause conductive hearing loss. 

16. List four conditions that may result in sensorineural hearing loss. 

17. What information is obtained through audiometry? 

18. What information is obtained through tympanometry?

19. List three reasons for performing ear irrigation. 

20. List three reasons for performing ear instillation. 

21. Explain how impacted cerumen is removed from the ear. 

22. Explain how to straighten the external auditory canal in an adult and in children 3 years old or younger. 

CRITICAL THINKING ACTIVITIES 

A. Measuring Distance Visual Acuity

For each of the following situations, write C if the technique is correct and I if the technique is incorrect.

 _____ 1. The patient is not given an opportunity to study the Snellen chart before beginning the test.

 _____ 2. The Snellen chart is positioned at the medical assistant’s eye level. 

_____ 3. The patient is instructed to use his or her hand to cover the eye that is not being tested.

 _____ 4. The medical assistant instructs the patient to close the eye that is not being tested.

 _____ 5. The first line that the medical assistant asks the patient to identify is the 20/20 line.

_____ 6. The medical assistant observes the patient for signs of squinting or leaning forward during the test.

B. Interpreting Visual Acuity Results

1. A patient has a distance visual acuity reading of 20/30 in the right eye. Using this information, answer the following questions.

a. How far was the patient from the eye chart? 

b. At what distance would a person with normal acuity be able to read this line? 

2. A patient has a distance visual acuity reading of 20/10 in the left eye. Using this information, answer the following questions: 

a. How far was the patient from the eye chart? 

b. At what distance would a person with normal acuity be able to read this line? 

C. Documenting Visual Acuity Results 

Properly document the distance visual acuity results in the spaces provided. In all cases, the line indicated is the smallest line the patient could read at a distance of 20 feet. 

1. The patient read the line marked 20/30 with the right eye with two errors; with the left eye, the patient read the line marked 20/30 with one error. The patient was wearing corrective lenses. 

2. The patient read the line marked 20/20 with the right eye with one error; with the left eye, the patient read the line marked 20/20 with no errors. The patient was wearing corrective lenses. 

3. The patient read the line marked 20/40 with the right eye with two errors; with the left eye, the patient read the line marked 20/30 with one error. The patient exhibited squinting and frowning during the test. The patient was not wearing corrective lenses.

4. The patient read the line marked 20/15 with the right eye with no errors; with the left eye, the patient read the line marked 20/20 with one error. The patient was not wearing corrective lenses. 

D. Ear Procedures

Explain the principle for each of the following procedures. 

Ear Irrigation

1. Positioning the patient’s head so that it is tilted toward the affected ear 

2. Cleansing the outer ear before irrigating 

3. Straightening the external auditory canal 

4. Injecting the irrigating solution toward the roof of the ear canal 

5. Making sure not to obstruct the canal opening 

Ear Instillation 

6. Positioning the patient’s head so that it is tilted toward the unaffected ear 

7. Instructing the patient to lie on the unaffected side after the instillation 

8. Placing a cotton wick in the patient’s ear 

E. Dear Gabby

Gabby has a middle ear infection and is not feeling well. She wants you to fill in for her. In the space pro-vided, respond to the following letter.

Dear Gabby:

I am dating the sweetest and dearest man. “Mike” has only one flaw. He likes loud music. He had those big boom boxes installed in his car. When we drive somewhere in his car, he blasts the music. Sometimes, when we are driving down a street, people even turn around to see where the loud music is coming from. The music hurts my ears, and I cannot think straight. My ears even start ringing when we go on a trip. When I am talking to Mike, he says I mumble, and I have to speak extra loud around him. I keep telling Mike that the loud music is going to damage our hearing, but he says that we are way too young for that and that only old people have trouble hearing. Please help me Gabby, because I love going on trips with Mike, but not if my ears hurt afterward.

Signed, Ears Are Ringing

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