Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What additional test should be performed if a patient reports seeing lines crossing when driving at night?

1. Dynamic retinoscopy

2. Cover testing at true infinity

3. Near visual acuity test

4. Visual field testing

The correct answer is: Cover testing at true infinity

In the context of a patient experiencing visual disturbances such as seeing lines crossing while driving at night, the most relevant additional test to conduct is cover testing at true infinity. This test evaluates the patient's ability to maintain proper alignment and fusion of the eyes when viewing distant objects, which can be particularly essential in assessing conditions like strabismus or other binocular vision disorders that could exacerbate visual symptoms under low-light conditions. Cover testing reveals how well the eyes work together to focus on a target, especially at long distances, where clarity and alignment are critical for safe driving at night. Given that the symptom involves visual disturbances during night-time driving, understanding how the eyes align and function together is pivotal in diagnosing any underlying issues that may contribute to the patient’s complaints, such as diplopia or other forms of visual inconsistency while in motion. Other options may have relevance to visual assessment but do not directly address the specific issue of alignment under conditions of low light where the patient is experiencing this symptom. Therefore, while cover testing at true infinity provides insight into binocular coordination and could pinpoint issues directly related to the reported symptoms, the other tests would not focus on the same crucial aspects of distance vision and binocular alignment necessary in this scenario.