Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What is the best diagnostic test to assess the range of visual acuity in a patient with Multiple Sclerosis?

1. Fundus photography

2. Visual field testing

3. Visual evoked potential (VEP)

4. Optical coherence tomography (OCT)

The correct answer is: Visual evoked potential (VEP)

The best diagnostic test to assess the range of visual acuity in a patient with Multiple Sclerosis (MS) is the Visual Evoked Potential (VEP) test. VEP is particularly beneficial in evaluating the function of the visual pathways, including the optic nerve, which can be affected in patients with MS. The test measures the electrical activity in the brain in response to visual stimuli, allowing healthcare providers to determine if the optic nerve has been compromised, often manifesting as delayed signal transmission in MS patients. In Multiple Sclerosis, demyelination of the optic nerves can lead to varying degrees of visual impairment, even when the patient's visual acuity might appear normal during a clinical examination. VEP can detect these subtle dysfunctions that are not always evident through other assessment methods. While visual field testing is helpful for assessing peripheral vision and detecting scotomas, VEP provides more specific information regarding the integrity of the visual pathway. Fundus photography is primarily used to visualize the retina and optic nerve head but does not provide objective data on visual pathway function. Optical coherence tomography (OCT) evaluates the thickness of the retinal nerve fiber layer and can reveal atrophy associated with MS but does not directly assess the functional status of the visual pathways like VEP does