Certified Paraoptometric Assistant Review Course CPOA

1. Certified Paraoptometric Assistant Review Course CPOA

2. Provision The Self Study Course for Paraoptometric Assistants and Technicians, Self Assessment Examination, and the AOA PS CPOA Review Course are not prerequisites for taking the paraoptometric certification examination given by the Commission on Paraoptometric Certification (CPC). Using these study materials and/or taking the CPOA Review course does not guarantee passing the paraoptometric certification examination given by the CPC. Attending the CPOA Review Course is not a substitute for studying for the paraoptometric certification examination given by the CPC. This course is designed to review previously acquired knowledge.

3. This review course is not intended to be a substitute for responsible study and preparation for the CPOA test.

4. Outline • Office Operations (13%) • Ophthalmic Optics and Dispensing (20%) • Testing and Procedures (20%) • Special Procedures (17%) • Refractive Status of the Eye and Binocularity (13%) • Basic Ocular Anatomy and Physiology (17%)

5. Office Operations (13%)

6. Office Procedures Office Procedures Manual “Official rulebook of the practice” Used to clarify the policies of the practice

7. Filing Systems Alphabetical Simplest and most widely used Numerical Decreased chance of misfiling Cross index card required Records Management

8. Recall Systems Types of Patient Recall Pre-appoint (most effective) Postcard or letter Computerized Recall list generated Email

9. Record Corrections Recording errors can happen - What to do? Draw a single line through the error Initial Example: Monday, June 29, 3008 sjm 2008 Never, never erase to completely remove

10. Confidentiality What is HIPAA? Health Information Portability & Accountability Act Minimum Necessary Principle Requires office to take reasonable steps to limit the use or disclosure of, and request for, PHI to the minimum necessary to accomplish intended purpose

11. HIPAARegulations Confidentiality Safeguards Release of records Legal record of ownership Release of records Computer use

12. Patient Handling Telephone Techniques Greeting Taking messages Handling requests for information Handling complaints Making appointments Confirming appointments

13. Patient Flow Control the appointment schedule Have thorough knowledge of different types of appointments and time required by each doctor for specific appointments

14. Public Relations Types of correspondence and brochures “Welcome to the practice” Referral letters Consultation letters School reports Legal reports Patient information pamphlet

15. Patient Handling Triage Categories Emergency - immediate Urgent - 12-24 hours Routine - next available appointment Ask questions to determine

16. Bookkeeping Procedures Accounts Receivable Accounts Payable Petty cash

17. Banking Procedures Deposits Reconciling bank statements

18. Office Finances Presentation of fees Do not apologize Collection of fees Cash, check or credit card?

19. Professional Issues Role and function of the eye care professional Delegation Certification vs. licensure

20. Liability and Malpractice Paraoptometrics are: Responsible to provide the highest level of service possible Protected under the employing doctor of optometry’s malpractice insurance

21. Conduct, Confidentiality & Ethics To keep the patient’s visual welfare uppermost at all times To strive to see that no person shall lack for visual care To conduct ourselves as exemplary citizens To promote and maintain cordial and unselfish relationships with members of our profession Excerpts from “Code of Ethics” adopted by the House of Delegates of the AOA June 28, 1944, Modified in 2005

22. Hygiene & Infection Control Asepsis Hand washing Instrument disinfection Contact lens disinfection Cross-contamination Sterilization

23. Ophthalmic Optics & Dispensing(20%)

24. Prescriptions Components Sphere, cylinder, axis Add power Prism Prism base direction

25. Ordering should include: Whether on order form or online ordering

26. Optical Cross Optical cross is a diagram that denotes the dioptric power in the two principal meridians of a lens. Hint: Think of the value of the numbers as they are read off of the lensometer wheel.

27. Lens Clock Readings Example Front Lens Surface Back Lens Surface +8.00 -5.00 Image from Sharp- Trawick +8.00 -3.00

28. Optical Cross Optical Cross Results Plus cylinder notation: +3.00 +2.00 x 090 Minus cylinder notation: +5.00 -2.00 x 180 + 3.00 + 5.00 Hint: The sphere is “married” to the axis; the cylinder is the distance between the numbers on the cross

29. Prescriptions: Transposition Transposition Combine the sphere and cylinder power mathematically Change the sign of the cylinder Change the axis by 90 degrees Hint: When combining positive and negative numbers, think in terms of money. Example: -2.00 combined with +0.50 If you are $2.00 “in the hole” and you deposit $0.50, what is your balance? Answer: $1.50 “in the hole”, or -1.50.

30. Prescriptions: Transposition -1.00 +2.00 X 160 +1.25 -0.75 x 030 Plano +1.00 x 090 +1.00 -2.00 x 070 +0.50 +0.75 x 120 +1.00 -1.00 x 180 Transposition Examples

31. Prescriptions: Decentration Decentration calculations Eye size plus distance between lenses minus patient’s PD divided by 2. Example: Eye size = 58 +16 = 74 Patient’s PD = 62 74 – 62 = 12 12 divided by 2 = 6

32. Prescriptions: Vertex Power Vertex Distance- distance between the ophthalmic lens and the front of the patient’s eye Effective Power- change in the prescription when the distance varies from the normally refracted 13.5mm distance to where the patient wears the RX. Concerned with high Rx’s (-/+ 4.00)

33. Prescriptions: Vertex Power Vertex distance and effective power Lenses gain minus or lose plus power as they are moved closer to the eye. Conversely lenses gain plus or lose minus as they are moved away from the eye.

34. Instruments used for verification • Lensometer • Lens power and • axis location • Presence, amount • and direction of • prism • Caliper • Lens thickness

35. Instruments used for verification • Colmascope or Polariscope • Progressive add markings • Geneva Lens Clock • Base curve

36. Prescriptions: Prentice’s Formula Prentice’s Prism Formula – if the patient is not looking through the optical center of the lens that has power, they are looking through prism Optical Center Induced Prism

37. What Does Prism Do? Displaces light Light bends toward base Image displaced toward apex

38. Verification of Prism Determine optical center of lens Compare with patient’s pupillary distance for horizontal prism (base in or base out) Compare with patient’s line of sight (LOS) for vertical prism (base up or base down)

39. To Determine Base Direction

40. Prescriptions: Prentice’s Formula Prentice’s Prism Formula Prism = power x decentration (in cm) Prism = lens power (in diopters) multiplied by d in cm (Where d = amount the patient PD varies from the major reference point in cm) EX: -4.00(power) x .5cm (decentration in cm) = 2 prism diopters

41. Optics: Light Rays Rays move from left to right Converging Rays Diverging Rays

42. Prescriptions: Focal Length Calculations Formula: f (in meters) = 1/D Focal length in meters (f) = 1 / D (reciprocal of power in diopters) • Example: The focal length of 2.00 D lens: • f = 1 / 2.00 D f = .5 meter

43. Major Reference Point The optical center of each lens Also referred to as “prism reference point” Point of intersection of the sphere indicators and cylinder indicators during lensometry

44. Prescription: Prism Prescribed when the two eyes do not align properly Can be induced when the optical centers of the lenses do not line up with the patient’s PD Prentice’s Rule- used to calculate induced prism

45. Lenses: Convex & Concave Plus lenses – prisms stacked base to base Minus lenses – prisms stacked apex to apex

46. Lens Forms Convex Concave

47. Spherical Lens A lens with the same curvature across the surface

48. Toric/Cylindrical Lens A lens that differs in curvature across the surface Flat Meridian Steep Meridian

49. Base Curve The measure of the general shape of the lens Used to determine lens power

50. Prescription Forms Plus cylinder Cylinder is ground on front of lens -2.00 + 1.25 x 090 Minus cylinder Cylinder is ground on back of lens Most typically used form -0.75 – 1.25 x 180