Certified Ophthalmic Medical Technologist (COMT) Practice Exam

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What specific observation indicates that a patient has a tropia during the cover test?

  1. Consistent eye alignment

  2. Movement of the uncovered eye

  3. Fatigue during testing

  4. Uncontrolled blinking

The correct answer is: Movement of the uncovered eye

The observation that indicates a patient has a tropia during the cover test is the movement of the uncovered eye. Tropia refers to misalignment of the eyes that is always present, even when the patient is not trying to focus on a target. When one eye is covered during the test, it is expected that the other eye remains fixed on the target. If the uncovered eye moves to fixate on the target once the other eye is covered, this is a clear indication of a tropia. The movement demonstrates that the eye was deviated when both eyes were open and that it is now attempting to align with the visual target. This response confirms the presence of a misalignment issue that is a characteristic of a tropia. The other considerations do not directly indicate the presence of a tropia. Consistent eye alignment would suggest that there is no tropia present. Fatigue during testing can affect performance but does not provide a definitive indication of misalignment. Uncontrolled blinking may occur for various reasons unrelated to eye alignment and therefore cannot be used as a specific indicator of a tropia.