Certified Ophthalmic Medical Technologist (COMT) Practice Exam

In which situation would a modified pilocarpine solution be used for diagnosis?

1. To check for glaucoma

2. To determine optic nerve damage

3. To diagnose an efferent defect

4. To assess diabetic retinopathy

The correct answer is: To diagnose an efferent defect

A modified pilocarpine solution is employed primarily to diagnose an efferent defect, particularly in cases where there is a suspected issue with the parasympathetic innervation of the pupil. Pilocarpine is a miotic agent that stimulates the iris sphincter muscle, causing pupil constriction. In the presence of an efferent defect (like in Horner's syndrome), a much lower concentration of pilocarpine will produce a significant response in the affected eye compared to a normal eye, allowing clinicians to confirm the diagnosis. In contrast, the other options pertain to different diagnostic evaluations. Checking for glaucoma typically involves measuring intraocular pressure and examining the optic nerve head for damage, while examining optic nerve damage relies on other forms of diagnostic imaging rather than pharmacological testing. Assessment of diabetic retinopathy usually involves a dilated eye exam and imaging techniques, rather than the use of specific agents like pilocarpine. Each of these conditions requires different diagnostic methodologies unsuitable for confirming an efferent defect.