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Indiana Optometrist — Requirements & Free Practice

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Optometric Legend Drug Certificate

Certificate for therapeutic legend drugs; an optometry license is an applicant condition.

Licensing authority: Indiana Optometry Board · Application information

Initial optometric legend drug certification
Treatment and Management of Ocular Disease (TMOD)
Application
Submit the certificate application and $20 fee.
Education
Provide approved ocular pharmacology education from a school or college of optometry or medicine.
Optometry license
Hold an Indiana optometry license to hold the certificate; the application may be submitted while the optometry license application is pending. Limited-license applicants must independently meet IC 25-24-3-12, -13 and -15.
Tmod
Submit the NBEO score report certifying successful completion of TMOD.
Reinstatement of legend after lapse, over three years
No examination is required for this applicant pathway.
Active license
Hold the active primary optometry license and satisfy the underlying certificate or prescribing qualifications.
Application
Submit the renewal or reinstatement application.
Continuing education
For the legend-drug certificate, provide the required continuing-education completion evidence; any lapse remediation and additional training are determined by the Board.
Fees
Pay the current renewal and applicable reinstatement fees; the Board lists $40 for a legend-drug certificate and $120 for a Tramadol-only CSR at three years or more.
Lapse
The registration or certificate is more than three years delinquent under IC 25-1-8-6(d).

Official no-examination sources

Effective from 2026-09-22.

Reinstatement of legend after lapse, up to three years
No examination is required for this applicant pathway.
Active license
Hold the active primary optometry license and satisfy the underlying certificate or prescribing qualifications.
Application
Submit the renewal or reinstatement application.
Continuing education
For the legend-drug certificate, provide the required continuing-education completion evidence; any lapse remediation and additional training are determined by the Board.
Fees
Pay the current renewal and applicable reinstatement fees; the Board lists $40 for a legend-drug certificate and $120 for a Tramadol-only CSR at three years or more.
Lapse
The registration or certificate is three years or less delinquent under IC 25-1-8-6(c).

Official no-examination sources

Effective from 2026-09-22.

Routine legend drug certificate renewal
No examination is required for this applicant pathway.
Active license
Renew concurrently with the active optometry license; an inactive license cannot support certificate renewal.
Continuing education
Complete twenty additional hours of approved legend-drug continuing education, separate from the twenty hours for optometry license renewal.
Fee
Pay the $20 certificate renewal fee; expiration is April 1 of even-numbered years.

Official no-examination sources

Effective from 2026-09-22.

Optometrist License

Ordinary license to practice optometry; examination, endorsement and statutory reciprocity are distinct initial issuance pathways. Volunteer registry participation under IC 25-22.5-15 and IC 34-30-13-1.2 uses an existing active license and provides civil immunity; it is not a separate practice license.

Licensing authority: Indiana Optometry Board · Application information

Restoration after child support suspension
No examination is required for this applicant pathway.
Bureau notice
For the bureau-order process, the Board acts upon the bureau's statutory notice of compliance or payment arrangements.
Court order
For a court-ordered suspension, obtain and have the Board receive the reinstatement order from the court that imposed it.
Other requirements
Keep the underlying license renewal requirements and other valid restrictions satisfied.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement under IC 25 24 1 3(d)
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Celmo
A valid CELMO certificate may substitute for educational proof under 852 IAC 1-1.1-5; it does not itself waive the examination requirements.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Existing license
Hold a license in another state whose requirements the Board finds equivalent; the applicant bears the burden of establishing equivalence.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Historic part iii
The Board instructions provide additional review for applicants licensed by examination before 1994 who did not take and pass NBEO Part III; provide the other jurisdiction's official examination evidence and establish equivalent requirements.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Other state examination
Submit each endorsing state's official examination subjects, format, pass/fail criteria and scores; these are conditions, not examinations owned by Indiana.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Prior board failure
The statutory endorsement pathway is unavailable following a prior failure of an examination given or approved by the Board.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
Licensure by examination
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
Reactivation of inactive optometry license
No examination is required for this applicant pathway.
Application
Submit the renewal form and $50 activation fee.
Continuing education
Submit certificates for the continuing education required for each year or portion of a year the license was inactive.

Official no-examination sources

Effective from 2026-09-22.

Military spouse or dependent with qualifying other jurisdiction license
Indiana Optometry Jurisprudence Examination (practice unavailable)
Competency
Demonstrate competence through methods determined by the Board; its general optometrist instruction identifies the jurisprudence examination.
Conduct
Have no disqualifying act, remain in good standing without discipline, and have no pending complaint or investigation concerning unprofessional conduct or an alleged crime.
Existing license
Hold a current equivalent-or-higher license from another jurisdiction for at least one year.
Fees
Pay the required Board fees.
Jurisprudence
Pass the written jurisprudence examination with a score of at least 75; additional unspecified competence methods are conditions.
Military status
Be the spouse or statutory dependent of a military service member.
Military service applicant, military other license
No examination is required for this applicant pathway.
Board instruction
The general Board page states: All applicants for licensure as an optometrist must pass a written jurisprudence examination. The jurisprudence examination will cover the optometry statute and rules, located on the bottom of the Optometry Home page. IC 25-1-17-4 states an exhaustive notwithstanding-any-other-law issuance pathway without an examination requirement, which governs this route.
Conduct
Have no act that would justify refusal, suspension or revocation in Indiana.
Equivalency review
Relevant military experience is credited and the Board considers the American Council on Education evaluation guide under IC 25-1-17-6.
Fees
Pay the required Board fees.
Investigation
Have no pending occupational-board complaint or investigation concerning unprofessional conduct or an alleged crime.
Military status
Be a military service applicant as defined in IC 25-1-17-2.
Qualification
Hold a current license in another jurisdiction whose requirements are equivalent to or exceed the Board's, and have held it for at least one year.

Official no-examination sources

Effective from 2026-09-22.

Military service applicant, military training
No examination is required for this applicant pathway.
Board instruction
The general Board page states: All applicants for licensure as an optometrist must pass a written jurisprudence examination. The jurisprudence examination will cover the optometry statute and rules, located on the bottom of the Optometry Home page. IC 25-1-17-4 states an exhaustive notwithstanding-any-other-law issuance pathway without an examination requirement, which governs this route.
Conduct
Have no act that would justify refusal, suspension or revocation in Indiana.
Equivalency review
Relevant military experience is credited and the Board considers the American Council on Education evaluation guide under IC 25-1-17-6.
Fees
Pay the required Board fees.
Investigation
Have no pending occupational-board complaint or investigation concerning unprofessional conduct or an alleged crime.
Military status
Be a military service applicant as defined in IC 25-1-17-2.
Qualification
Complete a military program of training, receive a military occupational specialty, and perform in that specialty at a level substantially equivalent to or exceeding the applicable academic or experience requirements.

Official no-examination sources

Effective from 2026-09-22.

Military applicant based on qualifying work in an unlicensed occupation
No examination is required for this applicant pathway.
Board instruction
The Board's general jurisprudence instruction states: All applicants for licensure as an optometrist must pass a written jurisprudence examination. The jurisprudence examination will cover the optometry statute and rules, located on the bottom of the Optometry Home page. IC 25-1-17-5.5 supplies the exhaustive notwithstanding-any-other-law conditions for this pathway.
Conduct
Have no disqualifying act, be in good standing without discipline, and have no pending occupational-board complaint or investigation concerning unprofessional conduct or an alleged crime.
Fees
Pay the Board fees.
Military status
Be a military member, military spouse or statutory dependent.
Qualification
Have worked at least three years in another state that does not license the lawful occupation, where Indiana licenses an occupation the Board determines has a similar scope. No determination that a particular jurisdiction qualifies is assumed.

Official no-examination sources

Effective from 2026-09-22.

New licensure after revocation, endorsement
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Celmo
A valid CELMO certificate may substitute for educational proof under 852 IAC 1-1.1-5; it does not itself waive the examination requirements.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Existing license
Hold a license in another state whose requirements the Board finds equivalent; the applicant bears the burden of establishing equivalence.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Historic part iii
The Board instructions provide additional review for applicants licensed by examination before 1994 who did not take and pass NBEO Part III; provide the other jurisdiction's official examination evidence and establish equivalent requirements.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Other state examination
Submit each endorsing state's official examination subjects, format, pass/fail criteria and scores; these are conditions, not examinations owned by Indiana.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Prior board failure
The statutory endorsement pathway is unavailable following a prior failure of an examination given or approved by the Board.
Prior revocation
A revoked license cannot be reinstated under IC 25-1-9-12; wait seven years after revocation before applying for a new license. The Board must determine eligibility and fitness.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
New licensure after revocation, examination
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Prior revocation
A revoked license cannot be reinstated under IC 25-1-9-12; wait seven years after revocation before applying for a new license. The Board must determine eligibility and fitness.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
Reinstatement after lapse of more than three years
Indiana Optometry Jurisprudence Examination (practice unavailable)
Application
Submit a reinstatement application and appear personally before the Board.
Board remediation
Complete remediation or additional training the Board determines appropriate.
Continuing education
Submit continuing-education completion certificates covering the expired period or fulfill the statutory deficiency requirements.
Discretionary examinations
The Board may require the identified Law Examination and/or an examination administered by NBEO. The latter slot names no particular NBEO part or section; it remains an applicant condition until the Board specifies it. Retaking the Law Examination is discretionary, not mandatory for every applicant.
Fees
Pay the current renewal fee of $134 and initial application fee of $200, totaling $334.
Lapse
The license is more than three years delinquent under IC 25-1-8-6(d).
Other licenses
Provide verification of other state licenses held.
Scope
Ordinary active practice requires completion of reinstatement.
Work history
Submit a work-history letter or resume covering work since expiration.
Reinstatement after lapse of three years or less
No examination is required for this applicant pathway.
Application
Submit a completed renewal application.
Board investigation
IC 25-1-8-8 permits a limited delay and Board action concerning evidence of misconduct.
Board three year instruction
The Board page labels its more demanding process "Expired Three (3) Years or more"; at exactly three years the statute's three-years-or-less rule controls. The Board page nevertheless directs the applicant to provide CE certificates, work history, other-license verification and a personal appearance.
Continuing education
Provide the sworn continuing-education compliance statement or meet the education-deficiency requirements under IC 25-1-4-5 and -6.
Fees
Pay the current renewal fee and reinstatement fee.
Lapse
The license is three years or less delinquent, including exactly three years under IC 25-1-8-6(c).

Official no-examination sources

Effective from 2026-09-22.

Routine active license renewal
No examination is required for this applicant pathway.
Continuing education
Complete twenty hours of approved continuing education for each biennial renewal; satisfy IC 25-24-1-14.1 and 852 IAC 1-16-1 exemptions and evidence requirements. Retain completion certificates for three years.
Expiration
Optometry licenses expire April 1 of even-numbered years; pay the $134 active renewal fee, including university support.
Military expedition
The Board expedites issuance or renewal for a military spouse or dependent assigned through the member to a duty station in Indiana under IC 25-1-17-11.
Military extension
Qualifying active-duty service outside Indiana permits a renewal and continuing-education extension of 180 days after discharge or release; a related illness, injury or disability may support a Board extension up to 365 days under IC 25-1-12-6.

Official no-examination sources

Effective from 2026-09-22.

Removal of probationary license limitations
No examination is required for this applicant pathway.
Hearing
After a hearing, the Board must find the deficiency that required disciplinary action has been remedied before removing limitations.
Renewal
Maintain the underlying optometry license and its renewal requirements.

Official no-examination sources

Effective from 2026-09-22.

Licensure by reciprocity under IC 25 1 21
Indiana Optometry Jurisprudence Examination (practice unavailable)
Application
Pay $200, complete the criminal history check and submit disclosures, name-change evidence and the current license verification directly from the issuing authority.
Conduct
No disqualifying acts, discipline, pending unprofessional-conduct complaint or investigation; submit the statutory good-standing and disciplinary-history affidavit.
Existing license
Hold a current unlimited license or certificate in another United States state or statutory jurisdiction. Show equivalent or higher requirements, or satisfy the alternative prior-state minimum education, applicable work experience and clinical supervision, and any examination required by that jurisdiction. Such unidentified other-jurisdiction examinations are conditions.
Jurisprudence
IC 25-1-21-5(6) permits the Board to require the Indiana law examination, and its current reciprocity checklist requires it; pass with at least 75.
Verification
Verify the remaining licenses in good standing before the first Indiana renewal.
Restoration of a voluntarily surrendered license
No examination is required for this applicant pathway.
Board approval
The surrender and reinstatement require Board approval.
Board conditions
Satisfy any conditions the Board imposes in the specific surrender or reinstatement order; the statute identifies no examination for this pathway.

Official no-examination sources

Effective from 2026-09-22.

Probationary Optometrist License

Board-imposed license conditions following relevant discipline, acts or unlicensed practice. IC 25-1-9 governs this Board; the rule also cites IC 25-1-11-19, whose statutory Board list does not include optometry.

Licensing authority: Indiana Optometry Board · Application information

Probationary classification of an existing optometrist license
No examination is required for this applicant pathway.
Basis
The Board may impose probation as a disciplinary sanction, or must impose the probationary status required by a child-support bureau order.
Compliance
Comply with the applicable disciplinary or child-support reporting, practice, education, service and payment-order requirements.
Existing license
Hold an optometry license.

Official no-examination sources

Effective from 2026-09-22.

Initial probationary licensure by endorsement
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Celmo
A valid CELMO certificate may substitute for educational proof under 852 IAC 1-1.1-5; it does not itself waive the examination requirements.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Existing license
Hold a license in another state whose requirements the Board finds equivalent; the applicant bears the burden of establishing equivalence.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Historic part iii
The Board instructions provide additional review for applicants licensed by examination before 1994 who did not take and pass NBEO Part III; provide the other jurisdiction's official examination evidence and establish equivalent requirements.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Other state examination
Submit each endorsing state's official examination subjects, format, pass/fail criteria and scores; these are conditions, not examinations owned by Indiana.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Prior board failure
The statutory endorsement pathway is unavailable following a prior failure of an examination given or approved by the Board.
Probation
The Board may issue a probationary license for relevant prior discipline, acts that would warrant discipline, or unlicensed practice. Comply with the Board's reporting, practice restrictions, education, service or rehabilitation conditions.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
Initial probationary licensure by examination
Application
Submit a verified Board application, the $200 nonrefundable fee, and requested disclosures, supporting court or malpractice documents and legal name-change evidence.
Application abandonment
An application missing requirements for one year is abandoned; a later application is new.
Background check
Complete the national criminal history background check required for initial optometrist licensure under IC 25-1-1.1-4 and IC 25-0.5-1-15.
Board non enforcement
The Board June 24, 2026 announcement states: On June 24, 2026, the Optometry Board approved the proposed rule, LSA #25-626 . With the non-Rule Policy ( https://iar.iga.in.gov/register/20251203-IR-852250731NRA ), listed under the 2024 and 2025 announcements, expiring as of September 1, 2026, and the final rule, once in effect, being retroactive to September 1, 2026, the board will not be enforcing the requirement for applicants to submit scores from the ISE and LSPE under the current rule located at 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 ( https://iar.iga.in.gov/code/2026/852/1 ). Applicants are only obligated to submit passing scores from Parts I, II, III and TMOD.
Education
Meet IC 25-24-2-1 qualifications and provide official optometry transcripts from an ACOE-accredited school; the Board adopts ACOE procedures and standards for school approval.
Failures
Four total NBEO failures may lead to additional training, evaluation or testing. A failed part not retaken and passed within two years may lead the Board to require all NBEO parts, examinations and tests again.
Graduation boundary
The rule applies to NBEO parts and examinations offered at the applicant's graduation. The currently registered examinations are retained; the applicant's graduation and passing-score history determine the applicable submissions.
Jurisprudence
After application approval, the Board sends the written jurisprudence examination; a score of at least 75 is passing.
Licensure verification
Provide verification of every other health-related registration, license or certification held.
Photograph
Provide one dated, signed passport-quality photograph taken within one year before application.
Probation
The Board may issue a probationary license for relevant prior discipline, acts that would warrant discipline, or unlicensed practice. Comply with the Board's reporting, practice restrictions, education, service or rehabilitation conditions.
Resuscitation
Provide current CPR or basic life support certification from the American Heart Association, American Red Cross or a Board-approved provider.
Score submission
Have official NBEO score reports sent directly to the Board, with passing scores.
Renewal while probationary
No examination is required for this applicant pathway.
Continuing education
Complete twenty hours of approved continuing education for each biennial renewal; satisfy IC 25-24-1-14.1 and 852 IAC 1-16-1 exemptions and evidence requirements. Retain completion certificates for three years.
Expiration
Optometry licenses expire April 1 of even-numbered years; pay the $134 active renewal fee, including university support.
Military expedition
The Board expedites issuance or renewal for a military spouse or dependent assigned through the member to a duty station in Indiana under IC 25-1-17-11.
Military extension
Qualifying active-duty service outside Indiana permits a renewal and continuing-education extension of 180 days after discharge or release; a related illness, injury or disability may support a Board extension up to 365 days under IC 25-1-12-6.
Probation
Continue to satisfy the conditions of the probationary order; renewal does not remove those conditions.

Official no-examination sources

Effective from 2026-09-22.

Treatment and Management of Ocular Disease (TMOD)

Provider
National Board of Examiners in Optometry (NBEO)
Format
Image-intensive, case-based examination; each patient case is followed by 3-6 related multiple-choice items with 3-10 answer options, single-answer or multiple-response. Offered as a stand-alone examination or as an embedded portion of the Part II PAM examination, with a separate TMOD score and pass/fail decision
Exam questions
120 items administered in a single session
Exam fee
$630 for the stand-alone TMOD (rates for examinations administered beginning August 2026); no separate registration when taken embedded in Part II PAM
Examination outline
  • Clinical Correlation of Basic Science Principles
    • Clinical Correlation of Basic Science Principles — Pathophysiology/etiology
    • Clinical Correlation of Basic Science Principles — anatomy
    • Clinical Correlation of Basic Science Principles — biochemistry
    • Clinical Correlation of Basic Science Principles — physiology
    • Clinical Correlation of Basic Science Principles — immunology/microbiology/pathology
    • Clinical Correlation of Basic Science Principles — optics
    • Clinical Correlation of Basic Science Principles — pharmacology
  • Diagnosis
    • Diagnosis — Most appropriate diagnosis
    • Related to Diagnosis — Indicate data supporting or correlating with diagnosis; correlation of possible additional data; or indicate additional data or next test needed
  • Treatment / Management
    • Treatment/Management — Most appropriate treatment/management
    • Related to Treatment/Management — Treatment mechanism, additional data needed to treat effectively, additional data or next test needed, patient education, follow-up, or prognosis
Examination sources

Indiana Optometry Jurisprudence Examination

Examination outline
  • IC 25-24-1 — Regulation of Optometrists ) Creation of Board
  • IC 25-24-2 — Further Licensing Requirements ) Establishment of Training Program and Special Fee
  • IC 25-24-3 — Optometric Legend Drugs
  • IC 25-1-0.1 — Effect of Certain Acts
  • IC 25-1-1.1 — Effect of Criminal Convictions on Licensed or Registered Persons
  • IC 25-1-1.2 — Effect of Delinquency in Child Support Payments on Licensed or Registered Persons
  • IC 25-1-2 — Renewal of Licenses Granted by State Agencies ) Notice of Expiration
  • IC 25-1-3 — Civil Immunity of Regulatory Agencies
  • IC 25-1-4 — Continuing Education
  • IC 25-1-5 — Professional Licensing Agency
  • IC 25-1-5.3 — Failure to Enact Licensure Rules
  • IC 25-1-7 — Investigation and Prosecution of Complaints Concerning Regulated Occupations
  • IC 25-1-8 — Occupational and Professional Licensure, Registration, and Certification Fees
  • IC 25-1-8.5 — Reporting of Health Care Entity Mergers and Acquisitions
  • IC 25-1-9 — Health Professions Standards of Practice
  • IC 25-1-9.1 — Out of Network Provider Referrals
  • IC 25-1-9.3 — Electronically Transmitted Prescriptions for Controlled Substances
  • IC 25-1-9.5 — Telehealth Services and Prescriptions
  • IC 25-1-9.7 — Prescribing and Dispensing of Opioids
  • IC 25-1-9.8 — Practitioner Good Faith Estimates
  • IC 25-1-10 — Direct Primary Care Agreements
  • IC 25-1-10.3 — Health Care Provider Advertising
  • IC 25-1-12 — Renewal of Licenses Held by Individuals in Military Service
  • IC 25-1-15 — Exemptions for Athletic Organization Practitioners Licensed in Other Jurisdictions
  • IC 25-1-16.5 — Public Agency Review of Occupational Regulations
  • IC 25-1-17 — Licensure of Individuals with Military Training; Licensure of Military Spouses
  • IC 25-1-19 — Scleral Tattooing
  • IC 25-1-20 — Effect of a State Disaster Emergency on Professional Disciplinary Action
  • IC 25-1-21 — Reciprocity for Health Care Professionals
  • IC 25-1-22 — Gender Transition Procedures for Minors
  • IC 25-0.5-1 — Initial License or Certificate Under IC 25-1-1.1-4
  • IC 25-0.5-2 — Permits, Licenses, Certificates of Registration, and Evidences of Authority Under IC 25-1-2-2.1
  • 852 IAC 1-1.1 — Qualifications of Applicants for an Optometry License and Certificate for an Indiana Optometric Legend Drug Certificate
  • 852 IAC 1-2.1 — Reciprocity
  • 852 IAC 1-3 — Rules of Practice
  • 852 IAC 1-5.1 — Duty Concerning Prescriptions in Optometric Practice
  • 852 IAC 1-6 — Professional Identification
  • 852 IAC 1-8 — Board Examination
  • 852 IAC 1-10 — Fees and Renewal Requirements
  • 852 IAC 1-11 — Competent Practice of Optometry; Standards
  • 852 IAC 1-12 — Professional Conduct; Standards
  • 852 IAC 1-13 — Revocation or Suspension of License
  • 852 IAC 1-14 — Reinstatement
  • 852 IAC 1-15 — Notification of Practice Location
  • 852 IAC 1-16 — Continuing Education for Renewal of License
  • 852 IAC 1-17 — Limited License
  • 852 IAC 1-18 — Convictions of Concern
Examination sources

Injections Skill Examination (ISE)

This assessment does not have a question bank.

Provider
National Board of Examiners in Optometry (NBEO); administered at the National Center of Clinical Testing in Optometry (NCCTO), Charlotte, NC
Format
Clinical skills examination: one injections skill made up of four procedures, audio and video recorded and scored by a remote examiner using a yes-no checklist evaluation form
Time limit
15-minute exam cycle
Passing score
Pass/fail against an overall cut-off requirement
Exam fee
$350 (rates for examinations administered beginning August 2026)
Examination sources

Laser and Surgical Procedures Examination (LSPE) — Laser Section

Provider
National Board of Examiners in Optometry (NBEO); administered at the National Center of Clinical Testing in Optometry (NCCTO), Charlotte, NC
Format
Hybrid section: a clinical skills portion (Selective Laser Trabeculoplasty, Peripheral Iridotomy, YAG Capsulotomy) followed by a computer-based multiple-choice portion; both portions must be passed
Exam questions
62 multiple-choice items: 50 scored and 12 unscored pre-test items
Time limit
40-minute clinical skills portion; 75-minute multiple-choice portion
Passing score
Pass/fail against the cut-off requirement; both the clinical skills portion and the multiple-choice portion must be passed
Exam fee
$1270 (rates for examinations administered beginning August 2026)
Examination outline
  • Selective Laser Trabeculoplasty (SLT) — multiple-choice portion 35% (approx. 18 items); clinical skills portion 31% (35%)
    • Selective Laser Trabeculoplasty (SLT) — the multiple-choice exam can include, but is not limited to: Indications; Contraindications; Complications; Equipment/Settings; Technique; Periprocedural care; Follow-up protocols; Mechanism of action; Efficacy/Outcomes
  • Laser Peripheral Iridotomy (PI) — multiple-choice portion 30% (approx. 15 items); clinical skills portion 31% (30%)
    • Laser Peripheral Iridotomy (PI) — the multiple-choice exam can include, but is not limited to: Indications; Contraindications; Complications; Equipment/Settings; Technique; Periprocedural care; Follow-up protocols; Mechanism of action; Efficacy/Outcomes
  • YAG Capsulotomy — multiple-choice portion 35% (approx. 18 items); clinical skills portion 38% (35%)
    • YAG Capsulotomy — the multiple-choice exam can include, but is not limited to: Indications (Capsular Phimosis; Posterior capsular opacity); Contraindications; Complications; Equipment/Settings; Technique; Periprocedural care; Follow-up protocols; Mechanism of action; Efficacy/Outcomes
Examination sources

Laser and Surgical Procedures Examination (LSPE) — Surgical Section

Provider
National Board of Examiners in Optometry (NBEO); administered at the National Center of Clinical Testing in Optometry (NCCTO), Charlotte, NC
Format
Hybrid section: a clinical skills portion (Suturing, Chalazion Excision) followed by a computer-based multiple-choice portion covering Suturing, Eyelid Surgery, Injections, and Anesthesia; both portions must be passed
Exam questions
62 multiple-choice items: 50 scored and 12 unscored pre-test items
Time limit
30-minute clinical skills portion; 75-minute multiple-choice portion
Passing score
Pass/fail against the cut-off requirement; both the clinical skills portion and the multiple-choice portion must be passed
Exam fee
$1270 (rates for examinations administered beginning August 2026)
Examination outline
  • Suturing — multiple-choice portion 19% (approx. 10 items) (19%)
    • Suturing — multiple-choice content area of the Surgical Section
  • Eyelid Surgery — multiple-choice portion 31% (approx. 16 items) (31%)
    • Eyelid Surgery — multiple-choice content area of the Surgical Section
  • Injections — multiple-choice portion 24% (approx. 12 items) (24%)
    • Injections — multiple-choice content area of the Surgical Section
  • Anesthesia — multiple-choice portion 26% (approx. 13 items) (26%)
    • Anesthesia — multiple-choice content area of the Surgical Section
Examination sources

Part I Applied Basic Science (ABS)

Provider
National Board of Examiners in Optometry (NBEO); delivered at Pearson testing centers
Format
One-day computer-based examination; most items require choosing the single best or correct answer, and approximately 10-15% are multiple-response items (2, 3, or 4 responses) scored as completely correct or incorrect with no partial credit
Exam questions
370 items: 350 scored items and 20 unscored (pre-test) items
Time limit
Two sessions of 185 items each, 4 hours per session; the first session includes an additional 15 minutes for a tutorial and non-disclosure agreement, with an optional break of up to 45 minutes between sessions
Passing score
Scaled score on a 100-900 scale; anything above 300 is a passing score
Exam fee
$1490 (rates for examinations administered beginning August 2026)
Examination outline
  • ANATOMY (Gross, Neuroanatomy, Histology, Developmental) — 12% - 18% of scored items (42 - 62 items)
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — A. Eyelid; 1. Anatomic boundaries; 2. Layers; 3. Muscles (actions); 4. Glands (secretions, functions); 5. Blood supply and drainage, lymphatic drainage; 6. Innervation
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — B. Eyebrow (structure and function)
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — C. Lacrimal system; 1. Lacrimal gland (structure, innervation, blood supply); 2. Accessory lacrimal glands (location, function); 3. Distribution of tears (role of eyelids); 4. Drainage of tears; nasolacrimal duct (cellular lining); lacrimal papillae (location); lacrimal puncta; canaliculi (relationship to Horner muscle); lacrimal sac (relationship to medial palpebral ligament, Horner muscle, orbicularis oculi; septum orbitale); 5. Lacrimal fossa (bony structure); 6. Nasolacrimal canal (bony composition, relationship to maxillary sinus)
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — D. Orbit; 1. Contents (extraocular muscles, nerves, blood vessels, fat compartments, fascia); 2. Anatomical relationships among orbital structures; 3. Bones of the orbit; 4. Foramina and openings of the orbit (location, contents)
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — E. Extraocular muscles; 1. Names; 2. Origins; 3. Insertions; 4. Innervations, blood supply; 5. Relationship to other orbital structures
    • Anatomy (Gross): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — F. Blood supply; 1. Branches of internal and external carotid arteries related to the orbit, eyelid, and upper face; 2. Branches of the internal and external jugular veins; 3. Dural sinuses
    • Anatomy (Gross): Conjunctiva / Cornea / Refractive Surgery — A. Cornea; 1. Normal dimensions including diameter, radii of curvature (anterior and posterior) and thickness (central and peripheral); 2. Epithelium (histology and ultrastructure); 3. Basal lamina (relationship to epithelium); 4. Anterior limiting lamina (Bowman layer): relationship to stroma, basal lamina, and epithelium; 5. Stroma (composition, ultrastructure); 6. Posterior limiting lamina (Descemet membrane): relationship to stroma and endothelium; 7. Endothelium (composition, ultrastructure); 8. Limbus; 9. Innervation; 10. Regeneration
    • Anatomy (Gross): Conjunctiva / Cornea / Refractive Surgery — B. Conjunctiva; 1. Location; 2. Composition (layers, cell types, glands, Palisades of Vogt); 3. Relationship to tarsal plate, extraocular muscles, sclera, fascia, bulbi (Tenon capsule), cornea; 4. Blood supply and venous drainage, lymphatic drainage; 5. Innervation; 6. Plica semilunaris (composition); 7. Caruncle (composition)
    • Anatomy (Gross): Lens / Cataract / IOL / Pre- & Post-Operative Care — A. Lens, zonule; 1. Zonule; 2. Location of lens; 3. Epithelium (capsule, ultrastructure); 4. Cortex (composition of lens fibers, ultrastructure); 5. Nuclei (various names and locations); 6. Sutures (location)
    • Anatomy (Gross): Episclera / Sclera / Anterior Uvea — A. Sclera; 1. Size; 2. Radius of curvature; 3. Thickness; 4. Color; 5. Relationship to conjunctiva, Tenon capsule, suprachoroidal space; 6. Emissaria (contents, location); 7. Composition; 8. Lamina cribrosa (structure)
    • Anatomy (Gross): Episclera / Sclera / Anterior Uvea — B. Anterior chamber and angle; 1. Shape and volume; 2. Boundaries; 3. Diameter and depth; 4. Trabecular meshwork (components, ultrastructure); 5. Juxtacanalicular tissue (components, ultrastructure); 6. Schlemm canal (location, size, ultrastructure of wall, afferent and efferent connections); 7. Scleral spur (composition, location); 8. Schwalbe line (composition, location)
    • Anatomy (Gross): Episclera / Sclera / Anterior Uvea — C. Iris; 1. Gross landmarks, zones; 2. Diameter; 3. Coloration (factors controlling); 4. Anterior border (composition, ultrastructure); 5. Stroma (composition); 6. Sphincter muscle (type, composition, innervation); 7. Anterior epithelium (ultrastructure); 8. Dilator muscle (type, composition, innervation); 9. Posterior epithelium (relationship to lens, anterior, epithelium, pupil margin); 10. Blood supply, venous drainage; 11. Innervation; 12. Size and location of pupil
    • Anatomy (Gross): Episclera / Sclera / Anterior Uvea — D. Posterior chamber; 1. Size and volume; 2. Boundaries
    • Anatomy (Gross): Episclera / Sclera / Anterior Uvea — E. Ciliary body; 1. Gross morphology; 2. Dimensions; 3. Relationships to sclera, anterior chamber, iris, posterior chamber, lens, and retina; 4. Pars plana (location, components); 5. Pars plicata (location, components); 6. Stroma (components); 7. Ciliary muscle (components, relations, actions, innervation); 8. Pigmented epithelium (basal lamina, ultrastructure); 9. Non-pigmented epithelium (basal lamina, ultrastructure, relationship to pigmented epithelium); 10. Blood supply and venous drainage; 11. Innervation
    • Anatomy (Gross): Vitreous / Retina / Choroid — A. Choroid; 1. Extent; 2. Thickness; 3. Relationship to lamina fusca of sclera; 4. Choriocapillaris (ultrastructure, type of capillaries); 5. Stroma; 6. Blood supply; 7. Venous drainage; 8. Innervation; 9. Bruch membrane (location, composition)
    • Anatomy (Gross): Vitreous / Retina / Choroid — B. Vitreous; 1. Volume; 2. Shape; 3. Attachments to retina and lens (ultrastructure); 4. Patellar fossa (location); 5. Anterior hyaloid (location); 6. Posterior hyaloid (location); 7. Cortex (composition); 8. Hyaloid canal (location, origin)
    • Anatomy (Gross): Vitreous / Retina / Choroid — C. Retina; 1. Layers (components of each ultrastructure); 2. Relationship between retinal pigment epithelium and Bruch membrane; 3. Relationship between retinal pigment epithelium and photoreceptor outer segments; 4. Synaptic connections within retina; 5. Glial cells (name, location, function); 6. Blood supply; 7. Anatomical areas (location, size, composition) of area centralis, parafovea, fovea, foveola, macula lutea, ora serrata (ultrastructure)
    • Anatomy (Gross): Optic Nerve / Neuro-Ophthalmic Pathways — A. Ocular and orbital nerves; 1. Cranial nerves I, III, IV, V, VI, VII (intracranial and extracranial course, branches, functions, tissue innervated); 2. Parasympathetic nerves (course, branches, tissue innervated); 3. Sympathetic nerves (course, branches, tissue innervated)
    • Anatomy (Gross): Optic Nerve / Neuro-Ophthalmic Pathways — B. Optic nerve; 1. Surface features; 2. Prelaminar portion (composition, blood supply); 3. Laminar portion (composition, blood supply); 4. Retrolaminar portion (composition, blood supply); 5. Central retinal artery and vein (location); 6. Optic disc/cup
    • Anatomy (Gross): Optic Nerve / Neuro-Ophthalmic Pathways — C. Visual pathway; 1. Localization of retinal fibers along visual pathway: optic nerve, chiasm, optic tract, lateral geniculate body, optic radiations, visual cortex; 2. Layers of lateral geniculate body (afferents, efferents); 3. Layers and areas of visual cortex; 4. Blood supply; 5. Anatomy related to visual pathology
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — A. Anterior chamber and angle
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — B. Ciliary body
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — C. Choroid
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — D. Vitreous
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — E. Retina
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — F. Optic nerve
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — G. Cornea
    • Anatomy (Gross): Glaucoma — Gross Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma (e.g., pigmentary dispersion glaucoma, pseudoexfoliation glaucoma, etc.) — H. Lens
    • Anatomy (Gross): Systemic Health — A. Head and neck; 1. Skull (e.g., bones, sutures, fossae, foramina); 2. Superficial and deep arteries, veins, and lymphatics; 3. Muscles of facial expression and mastication; 4. Muscles of the neck; 5. Peripheral nerve distributions; 6. Cervical triangles and their contents, root of neck, thyroid and parathyroid glands; 7. Salivary glands; 8. Nose; 9. Paranasal sinuses and their relations to the orbit and orbital contents; 10. Ear (e.g., outer ear, middle ear, walls, muscles, inner ear); 11. Dural venous sinuses; meninges; cerebrospinal fluid
    • Anatomy (Gross): Systemic Health — B. Thorax; 1. Lungs (e.g., lobes); 2. Pulmonary circulation; 3. Heart (e.g., surfaces); 4. Superior mediastinum (e.g., trachea, esophagus)
    • Anatomy (Gross): Systemic Health — C. Abdomen/Pelvis; 1. Liver (e.g., concept of portal system); 2. Accessory digestive organs (e.g., gallbladder, pancreas); 3. Other internal organs (e.g., spleen, kidney); 4. Gastrointestinal system (e.g., stomach)
    • Anatomy (Gross): Systemic Health — D. Systemic circulation of blood and lymph
    • Anatomy (Neuroanatomy): Systemic Health — A. Spinal cord; 1. Gray matter (e.g., nuclei, local reflex arcs); 2. White matter (e.g., ascending pathways, descending pathways); 3. Spinal nerves and sensory ganglia
    • Anatomy (Neuroanatomy): Systemic Health — B. Autonomic nervous system; 1. Parasympathetic (course, branches, functions, tissue innervated); 2. Sympathetic (course, branches, functions, tissue innervated); 3. Neurotransmitters (e.g., types, locations)
    • Anatomy (Neuroanatomy): Systemic Health — C. Medulla; 1. Level of motor decussation; 2. Level of sensory decussation; 3. Level of inferior olives; 4. Level of open medulla; 5. Dorsal and ventral cochlear nuclei; 6. Vestibular nuclei; 7. Glossopharyngeal nerve; 8. Vagus nerve; 9. Spinal accessory nerve; 10. Hypoglossal nerve
    • Anatomy (Neuroanatomy): Systemic Health — D. Pons; 1. Low or caudal pons; 2. Abducens nerve; 3. Mid pons; 4. Trigeminal nerve; 5. Facial nerve; 6. Vestibulocochlear nerve
    • Anatomy (Neuroanatomy): Systemic Health — E. Midbrain; 1. Level of inferior colliculus; 2. Trochlear nerve; 3. Level of superior colliculus; 4. Oculomotor nerve; 5. Level of pretectum (e.g., light reflex)
    • Anatomy (Neuroanatomy): Systemic Health — F. Diencephalon; 1. Dorsal thalamus; 2. Hypothalamus; 3. Epithalamus; 4. Subthalamus
    • Anatomy (Neuroanatomy): Systemic Health — G. Cerebrum; 1. Gray matter (e.g., cytoarchitecture (layers), Brodmann cortical areas); 2. White matter (e.g., projections, internal capsule, optic radiations, commissural fibers, associational fibers); 3. Functions
    • Anatomy (Neuroanatomy): Systemic Health — H. Cerebellum
    • Anatomy (Neuroanatomy): Systemic Health — I. Blood supply; 1. Surface arteries; 2. Circle of Willis and its branches
    • Anatomy (Histology): Systemic Health — A. Generalized cell; 1. Molecular components, unit membrane; 2. Organelles (e.g., plasma membrane, endoplasmic reticulum); 3. Inclusions (e.g., pigments); 4. Nucleus; 5. Cytoskeleton (e.g., microtubules)
    • Anatomy (Histology): Systemic Health — B. Tissue types; 1. Epithelium; a. Lining epithelium; i. Simple, stratified, pseudostratified; ii. Squamous, cuboid, columnar; iii. Surface specializations (e.g., microvilli); iv. Cell junctions (e.g., zonula occludens); v. Basal lamina; b. Secretory epithelium; i. Unicellular vs. multicellular; ii. Exocrine, endocrine, paracrine, autocrine; iii. Secretory unit, mode of secretion; iv. Connective tissue element; 2. Connective tissue; a. Connective tissue proper; i. Types: dense, loose, elastic, reticular; ii. Cells; iii. Fibers (e.g., collagen); iv. Matrix; b. Specialized connective tissues; i. Blood; a. Plasma; b. Cells; c. Platelets; ii. Bone; iii. Cartilage and synovial joints; iv. Fat: multilocular, unilocular; 3. Muscle; a. Smooth; b. Striated; c. Cardiac; d. Receptors (e.g., muscle spindles); 4. Nervous tissue; a. Neuron; b. Ganglia; c. Neural coverings (e.g., myelin, perineurium); d. Neuroglia; e. Synapse; f. Terminals
    • Anatomy (Histology): Systemic Health — C. Organ systems; 1. Integumentary system; a. Skin (e.g., layers, cell types, hair); b. Cutaneous glands: sebaceous, sweat; c. Receptors; i. Free nerve endings; ii. Encapsulated nerve endings (e.g., Pacinian corpuscles); 2. Cardiovascular system; a. Heart; i. Tissue layers; ii. Valves; iii. Conduction system; b. General histology of blood vessels; i. Capillaries; ii. Arteries; iii. Arterioles; iv. Veins; 3. Lymphatic system; a. Lymph vessels; b. Lymph nodes; c. Spleen; d. Thymus; e. Tonsils; f. Lymphatic tissue associated with mucous membrane; 4. Respiratory system; a. Nose; b. Paranasal air sinuses; c. Nasopharynx; d. Larynx; e. Trachea; f. Lungs; g. Blood vessels associated with the respiratory system; 5. Digestive system; a. Oral cavity; b. Esophagus; c. Stomach; d. Small intestine; e. Large intestine; f. Salivary glands; g. Pancreas; h. Liver, gallbladder; i. Blood vessels associated with the digestive system; 6. Urinary system; a. Kidney; b. Ureter, bladder, urethra; c. Blood vessels associated with the urinary system; 7. Endocrine system; a. Thyroid; b. Islets of Langerhans; c. Pituitary; d. Adrenal gland; e. Gonads
    • Anatomy (Histology): Systemic Health — D. Neurohistology; 1. Neural plate, neural fold, neural groove, neural tube, neural vesicles; 2. Derivatives of neural crest (e.g., ganglia, adrenal medulla); 3. Layers of neural tube (e.g., ependymal, mantle, marginal); 4. Degeneration and regeneration in the nervous system
    • Anatomy (Developmental): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — A. Orbit; 1. Development of bones of orbit (closure of sutures); 2. Abnormalities (faulty development of facial bones)
    • Anatomy (Developmental): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — B. Extraocular muscles; 1. Condensation of mesenchyme (bilateral condensation); 2. Motor innervation development; 3. Insertion of extraocular primordia into anterior sclera; 4. Late development
    • Anatomy (Developmental): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — C. Eyelid; 1. Tissue origin; 2. Lid folds; 3. Fusion of eyelid; 4. Ectodermal derivatives (skin, glands, conjunctiva); 5. Mesodermal derivatives (tarsus, orbital septum, orbicularis oculi, aponeurosis of levator, smooth muscle)
    • Anatomy (Developmental): Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — D. Lacrimal apparatus; 1. Tissue origin of lacrimal glands (main, accessory); 2. Tissue origin of lacrimal and nasal passages; 3. Abnormalities
    • Anatomy (Developmental): Conjunctiva / Cornea / Refractive Surgery — A. Conjunctiva; 1. Ectodermal specialization forming conjunctiva and glands
    • Anatomy (Developmental): Conjunctiva / Cornea / Refractive Surgery — B. Cornea; 1. Inductive mechanisms; 2. Ectodermal components (epithelium, primary stroma); 3. Mesenchymal components (waves); 4. Corneal nerve development (origin); 5. Factors affecting corneal size, curvature, transparency
    • Anatomy (Developmental): Lens / Cataract / IOL / Pre- & Post-Operative Care — A. Lens, zonules; 1. Zonules development; 2. Tissue origin; 3. Tissue induction and interaction (effect on development of vitreous, iris, cornea, retina); 4. Mechanism of lens fiber orientation; 5. Stages of lens development (lens placode, lens pit, lens vesicles); 6. Stages of lens fiber development; 7. Development nuclei (embryonic, fetal, infantile); 8. Zones of development of lens epithelium
    • Anatomy (Developmental): Episclera / Sclera / Anterior Uvea — A. Sclera; 1. Inductive mechanisms; 2. Tissue origin; 3. Comparison with cornea
    • Anatomy (Developmental): Episclera / Sclera / Anterior Uvea — B. Anterior chamber and angle; 1. Creation of anatomical space; 2. Factors that promote growth of anterior chamber; 3. Creation of angle (atrophy theory, cleavage theory, reorganization theory, rarefaction theory); 4. Differentiation of Schlemm canal, scleral spur, trabecular meshwork; 5. Endothelial membrane
    • Anatomy (Developmental): Episclera / Sclera / Anterior Uvea — C. Iris/Pupil; 1. Development of iris stroma (anterior leaf, posterior leaf); 2. Development of pars iridica retinae (epithelial layer); 3. Development of dilator and sphincter muscles; 4. Pupillary membrane (atrophy); 5. Cilio-iridic circulation; 6. Development of iris pigmentation
    • Anatomy (Developmental): Episclera / Sclera / Anterior Uvea — D. Posterior chamber
    • Anatomy (Developmental): Episclera / Sclera / Anterior Uvea — E. Ciliary body; 1. Tissue origin (mesoderm, neural crest); 2. Development of pars ciliaris retinae (epithelial layers); 3. Development of ciliary processes, ciliary muscles, ciliary vessels
    • Anatomy (Developmental): Vitreous / Retina / Choroid — A. Choroid; 1. Tissue origin (paraxial mesoderm, neural crest cells); 2. Development of choroidal vasculature (3 stages); 3. Development of Bruch membrane
    • Anatomy (Developmental): Vitreous / Retina / Choroid — B. Vitreous; 1. Primary vitreous (hyaloid canal, tissue origin, tissue characteristics); 2. Secondary vitreous (tissue origin, tissue characteristics); 3. Tertiary vitreous (tissue origin, tissue characteristics, hyaloid vasculature remnants)
    • Anatomy (Developmental): Vitreous / Retina / Choroid — C. Retina; 1. Development of optic cup; 2. Analogies between development of retina and central nervous system; 3. Fetal fissure (formation, function, fusion, failure to fuse); 4. Retinal differentiation (stages I, II, III, proliferation, migration, differentiation); 5. Macular differentiation; 6. Retinal circulation development (hyaloid system, central retinal artery/vein, hyaloid vasculature remnants); 7. Postnatal events
    • Anatomy (Developmental): Optic Nerve / Neuro-Ophthalmic Pathways — A. Optic nerve and visual pathway; 1. Developmental stages of lower visual pathway, before lateral geniculate body (differences crossed and uncrossed fibers); 2. Myelination of the visual pathway (lower visual pathways vs. upper visual pathway); 3. Relationship between development of upper visual pathway and central vision; 4. Physiological cupping
    • Anatomy (Developmental): Glaucoma — Developmental Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma — A. Anterior chamber and angle; 1. Creation of anatomical space; 2. Factors that promote growth of anterior chamber; 3. Creation of angle (atrophy theory, cleavage theory, reorganization theory, rarefaction theory); 4. Differentiation of Schlemm canal, scleral spur, trabecular meshwork; 5. Endothelial membrane
    • Anatomy (Developmental): Glaucoma — Developmental Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma — B. Iris/Pupil; 1. Development of iris stroma (anterior leaf, posterior leaf); 2. Development of pars iridica retinae (epithelial layer); 3. Development of dilator and sphincter muscles; 4. Pupillary membrane (atrophy); 5. Cilio-iridic circulation; 6. Development of iris pigmentation
    • Anatomy (Developmental): Glaucoma — Developmental Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma — C. Ciliary body; 1. Tissue origin (mesoderm, neural crest); 2. Development of pars ciliaris retinae (epithelial layers); 3. Development of ciliary processes, ciliary muscles, ciliary vessels
    • Anatomy (Developmental): Glaucoma — Developmental Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma — D. Retina; 1. Development of optic cup; 2. Analogies between development of retina and central nervous system; 3. Fetal fissure (formation, function, fusion, failure to fuse); 4. Retinal differentiation (stages I, II, III, proliferation, migration, differentiation); 5. Macular differentiation; 6. Retinal circulation development (hyaloid system, central retinal artery/vein, hyaloid vasculature remnants); 7. Postnatal events
    • Anatomy (Developmental): Glaucoma — Developmental Anatomy of the eye as it relates to primary open-angle glaucoma, angle-closure glaucoma, and secondary glaucoma — E. Optic nerve and visual pathway; 1. Developmental stages of lower visual pathway, before lateral geniculate body (differences between crossed and uncrossed fibers); 2. Myelination of the visual pathway (lower visual pathway vs. upper visual pathway); 3. Relationship between development of upper visual pathway and central vision; 4. Physiological cupping
  • BIOCHEMISTRY / PHYSIOLOGY — 10% - 14% of scored items (35 - 49 items)
    • Biochemistry: Systemic Health — A. Cellular biochemistry; 1. Compartmentalization; 2. Cell organelles; 3. Intracellular/extracellular; 4. Cell communication; 5. Bonds and molecular interactions
    • Biochemistry: Systemic Health — B. Proteins; 1. Structure and types; a. Alpha amino acids, peptide bond; b. Primary, secondary, tertiary, and quaternary structure; c. Multimers; d. Globular/fibrous; e. Enzymes; f. Antibodies; g. Connective-tissue/collagen; h. Hemoglobins; 2. Mechanism of enzyme action; a. Biocatalysis; b. Activation energy; c. Michaelis-Menten model (e.g., Michaels-Menten equation, Lineweaver-Burk plot); d. Allosteric interaction/positive and negative feedback modulation; e. Reversible covalent modification/enzyme cascades; f. Proteolytic activation; g. Stimulation and inhibition by control/regulatory proteins
    • Biochemistry: Systemic Health — C. Bioenergetics and energy storage; 1. Free energy/entropy/enthalpy/equilibrium; 2. Endergonic, exergonic, and coupled reactions; 3. Oxidation-reduction; 4. pH and Henderson-Hasselbalch equation, biological buffers; 5. ATP and other nucleotide phosphates; 6. NADH and FADH; 7. NADPH; 8. Acetyl CoA
    • Biochemistry: Systemic Health — D. Carbohydrate biochemistry; 1. Structure and function; a. Monosaccharides, oligosaccharides, polysaccharides; b. Glycosaminoglycans; c. Proteoglycans; d. Glycoproteins; 2. Glycolysis/glucose metabolism; 3. TCA cycle; 4. Pentose phosphate pathway; 5. Gluconeogenesis; 6. Glycogen synthesis, storage, and breakdown/utilization; 7. Electron transport system and oxidative phosphorylation; a. Mitochondrial structure/function/DNA; b. Electron transport/pH coupling
    • Biochemistry: Systemic Health — E. Lipid biochemistry; 1. Structure and function; a. Fatty acids/eicosanoids; b. Triacylglycerols; c. Phosphoglycerides; d. Sphingolipids; e. Sterol derivatives; f. Isoprenoids; 2. Digestion, absorption, and transport of lipids (e.g., types of lipoproteins); 3. Fatty acid metabolism (e.g., beta-oxidation, ketone bodies, gluconeogenesis); 4. Cholesterol and steroid metabolism; 5. Membrane biochemistry; a. Unit membrane/lipid bilayer; b. Fluid mosaic model; c. Membrane proteins and lipids/structure and function
    • Biochemistry: Systemic Health — F. Molecular biology; 1. DNA structure and function; a. Deoxynucleotides and synthesis; b. Base pairing/double helix; c. Genetic code/introns, exons; d. Chromosome structure; 2. RNA Structure and function; a. Ribonucleotides and synthesis; b. Messenger RNA synthesis and function; c. Ribosomal RNA synthesis and function; d. Transfer RNA synthesis and function; 3. DNA replication; 4. Protein synthesis; a. Ribosome function; b. Initiation, elongation, and termination; c. Post-translational medication/protein sorting; 5. Gene expression and regulation; 6. Mutations and repair; 7. Oncogenes/proto-oncogenes/tumor suppressor genes; 8. Tools of recombinant DNA technology (e.g., polymerase chain reaction, chromosome analysis, Southern blot); 9. Molecular therapy (e.g., gene therapy, anti-sense therapy); 10. Cell cycle; 11. Genomics; 12. Proteomics; 13. Apoptosis
    • Biochemistry: Systemic Health — G. Nutrition; 1. Digestion of proteins, carbohydrates, and lipids; 2. Essential amino acids; 3. Vitamins; a. Classification; b. Functions; 4. Minerals; 5. Oxygen toxicity/antioxidants/control of free radicals, peroxide, and superoxides
    • Physiology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — A. Eyelids; 1. Normal closure of eyelids (forced, spontaneous); 2. Blink reflexes (spontaneous, menace, auditory, touch, dazzle); 3. Role of eyelids in production, distribution, and drainage of tears; 4. Protective functions of eyelids; 5. Purposes and roles for vision
    • Physiology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — B. Tears and lacrimal apparatus; 1. Functions of tears; 2. Production of tears; a. Sources; b. Neural control; 3. Composition of tears; a. Electrolytes; b. Low molecular weight organics (glucose, amino acids); c. High molecular weight organics (proteins, lipids, glycoproteins); d. Cells; e. Physiological variations (e.g., aging, opening vs. closed eyes, contact lens wear) in tear constituents; 4. Tear film distribution, structure, and stability; 5. Elimination of tears:; a. Nasolacrimal drainage apparatus; b. Evaporation and absorption; 6. Physico-chemical properties of tears:; a. Osmotic pressure; b. pH and buffering; c. Temperature and viscosity
    • Physiology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — C. Extraocular muscles; 1. Vestibular control mechanisms; 2. Supranuclear control of eye movements; 3. Agonist-antagonist relationships; 4. Primary, secondary, and tertiary actions; 5. Fields of action; 6. Conduction and contraction
    • Physiology: Conjunctiva / Cornea / Refractive Surgery — A. Cornea; 1. Physical characteristics (water content, protein content, cells, resistance to trauma); 2. Permeability characteristics of various layers; 3. Metabolic characteristics of various layers; 4. Theories of corneal transparency; 5. Factors influencing corneal thickness/hydration (osmolarity of tears, integrity of epithelium and endothelium, epithelial and endothelial pumps); 6. Physiological parameters necessary to maintain corneal integrity (oxygen level, glucose level, pH, etc.); 7. Epithelial regeneration (normal and response to trauma); 8. Physiological characteristics of corneal nerves; 9. Aging changes of the cornea; 10. Corneal hysteresis
    • Physiology: Lens / Cataract / IOL / Pre- and Post-Operative Care — A. Lens; 1. Functions of lens; 2. Composition of lens; 3. Difference in composition between lens and aqueous; 4. Metabolism of lens (various pathways essential to the lens); 5. Types of lens proteins; 6. Factors which regulate size and solubility of lens proteins (vitamin C, glutathione); 7. Theories of lens transparency; 8. Mitotic activity of lens epithelium; 9. Aging changes in composition of the lens
    • Physiology: Episclera / Sclera / Anterior Uvea — A. Uvea; 1. Functions of ciliary body; 2. Functions of iris; 3. Functions of choroid; 4. Uveal blood flow: choroid, ciliary body, iris (unique characteristics of each, functions of each)
    • Physiology: Vitreous / Retina / Choroid — A. Vitreous; 1. Functions; 2. Compositions; 3. Metabolism; 4. Aging changes in composition; 5. Physical characteristics (volume, water content, transparency)
    • Physiology: Vitreous / Retina / Choroid — B. Retina; 1. Composition of disc outer segments; 2. Formation of disc outer segments (disc renewal, disc shedding); 3. Composition of visual pigments; 4. Formation of visual pigments; 5. Stages of visual cycle; 6. Photoreceptor electrophysiology (membrane potentials, dark current role of sodium, calcium, etc.); 7. Retinal neurotransmitters; 8. Function of bipolar, horizontal, amacrine and ganglion cells (receptive fields); 9. Retinal neural mechanisms of color vision (spatial, temporal, and chromatic); 10. Physiological relationship in the choroid and the retina, including retinal metabolism; 11. Retinal blood flow (unique characteristics, dual supply, functions)
    • Physiology: Optic Nerve / Neuro-Ophthalmic Pathways — A. Neurophysiology; 1. Integration of nerve signals (e.g., synaptic processes, reflexes, feedback, adaptation, and habituation); 2. Sensory coding (e.g., receptive field concept); 3. Somatosensory system; 4. Auditory system; 5. Vestibular system; 6. Motor pathways; 7. Autonomic nervous systems; 8. Significance of evoked potentials, CT and PET scanning, and MRI; 9. Plasticity
    • Physiology: Optic Nerve / Neuro-Ophthalmic Pathways — B. Visual pathway; 1. Function of lateral geniculate body; 2. Receptive fields of cells in lateral geniculate body (relationship to color vision, binocularity, space perception, etc.); 3. Function of visual cortex; 4. Receptive field properties (single cell properties); 5. Functional organization; 6. Physiology of binocular vision; 7. Mechanism of feature detection; 8. Gross electrical potentials; a. EOG; b. ERG; c. VEP (VER)
    • Physiology: Optic Nerve / Neuro-Ophthalmic Pathways — C. Pupillary pathways; 1. Sympathetic pathways to iris; 2. Parasympathetic pathway to iris; 3. Functional relationships between pupillary pathways and central nervous system
    • Physiology: Glaucoma — A. Intraocular pressure; 1. Methods of measurement; 2. Normative values; 3. Factors controlling aqueous production and outflow; 4. Nervous system regulation of IOP; 5. Factors influencing IOP (body position, corneal thickness, blood pressure); 6. Corneal hysteresis
    • Physiology: Glaucoma — B. Aqueous; 1. Functions of aqueous; 2. Volume, osmolarity, viscosity; 3. Formation (ultrafiltration, active transport); 4. Factors influencing rate of flow; 5. Composition; 6. Blood aqueous barriers (location, ultrastructure, function)
    • Physiology: Systemic Health — A. Cellular functions; 1. Cytoplasm and cytoskeleton (e.g., microtubules, microfilaments); 2. Functions of organelles (e.g., endoplasmic reticulum); 3. Intracellular and extracellular environment; 4. Membrane potential and transport mechanisms; 5. Membrane receptors and postreceptor events
    • Physiology: Systemic Health — B. Respiration; 1. Mechanics of breathing; 2. Gas exchange in the lungs; 3. Diffusion of oxygen and carbon dioxide; 4. Oxygen transport and hypoxia, carbon dioxide transport; 5. Regulation of respiratory rate; 6. Acid-base balance
    • Physiology: Systemic Health — C. Gastrointestinal activity; 1. Absorption; 2. Motility; 3. Nervous and hormonal regulation; 4. Associated structures (e.g., liver, pancreas, salivary glands)
    • Physiology: Systemic Health — D. Muscle; 1. Neuromuscular junctions; 2. Conduction and contraction; 3. Types of contraction (e.g., isometric, isotonic); 4. Reflex arc (e.g., muscle spindles, Golgi tendon organ); 5. Smooth muscle
    • Physiology: Systemic Health — E. Body fluids; 1. Composition of body fluids; 2. Control systems of the body (e.g., exchange of water and electrolytes between body compartments); 3. Regulation of volume and osmolarity of extracellular fluid
    • Physiology: Systemic Health — F. Renal system and body fluids; 1. Nephron, tubular reabsorption, and secretion; 2. Regulation of glomerular filtration; 3. Functional characteristics of renal blood vessels; 4. Renal regulatory mechanisms; 5. Renal control of blood pressure and water balance; 6. Renal control of plasma sodium and potassium levels; 7. Regulation of acid-base balance
    • Physiology: Systemic Health — G. Circulatory system; 1. Mechanical events of cardiac cycle; 2. Electrical activity of the heart (e.g., pacemaker potentials, action potentials, and spread of the activity); 3. Significance of EKG; 4. Hemodynamics (e.g., pressure and resistance relationships); 5. Regulation of blood flow and pressure (e.g., autonomic); 6. Lymph formation and function; 7. Blood and its functions (e.g., hemostasis); 8. Hemodynamic patterns (resistance, transmural pressure, flow rate, critical closing pressures); 9. Autoregulation; 10. Autonomic nervous system control
    • Physiology: Systemic Health — H. Endocrine system; 1. Hormones (e.g., synthesis, mechanism of action); 2. Hypothalamic control of pituitary gland; 3. Pituitary control of endocrine glands; 4. Functions and regulations of adrenal cortex (e.g., glucocorticoids, mineral corticoids); 5. Functions and regulation of adrenal medulla (e.g., epinephrine); 6. Functions and regulation of thyroid gland (e.g., TSH, T3, T4); 7. Functions and regulations of pancreatic insulin and glucagon; 8. Regulation of blood sugar levels; 9. Functions and regulation of vitamin D, parathyroid hormone, and calcitonin; 10. Functions and regulation of endorphin, enkephalin and growth hormone blood levels
    • Physiology: Systemic Health — I. Reproductive system; 1. Functions and regulation of reproductive hormones; 2. Pregnancy, birth, and lactation
    • Physiology: Systemic Health — J. Electrophysiology and the nerve cell; 1. Basis of resting potential (e.g., ionic balance, transport mechanisms); 2. Basis of action potential (e.g., ionic balance); 3. Action potential conduction; 4. Synapses, classification, transmission, neurotransmitters; 5. Membrane physiology, receptors, membrane channels; 6. Inhibitory and excitatory postsynaptic potentials (including concepts of spatial and temporal summation); 7. Strength-duration curve
  • IMMUNOLOGY / MICROBIOLOGY / PATHOLOGY — 22% - 30% of scored items (77 - 105 items)
    • Immunology: Systemic Health — A. Antigens, chemistry and origin
    • Immunology: Systemic Health — B. Antibodies; 1. Chemical structure; 2. Classification; 3. Immunological functions; 4. Genetics/clonal selection
    • Immunology: Systemic Health — C. Antigen-antibody interactions
    • Immunology: Systemic Health — D. Complement chemistry, function and pathways
    • Immunology: Systemic Health — E. Cytokines, origin and function
    • Immunology: Systemic Health — F. Nonspecific immunity; 1. Anatomical barriers; 2. Phagocytic cell types and inflammation; 3. Role of complement and antibody; 4. Interferon, lysozyme; 5. Natural killer cells
    • Immunology: Systemic Health — G. Specific immunity; 1. Cell types, markers, and function; 2. Cell-cell interactions in the immune response; 3. Humoral immunity; 4. Cellular immunity; 5. Primary and secondary immune responses
    • Immunology: Systemic Health — H. Tissue transplantation and graft rejection (mechanisms)
    • Immunology: Systemic Health — I. Autoimmunity
    • Immunology: Systemic Health — J. Tumor immunology
    • Microbiology: Systemic Health — A. Bacteriology; 1. Eukaryotic vs. prokaryotic cells; 2. Bacterial cell structures and cell wall morphology; a. Biochemical composition; b. Gram (+) vs. Gram (-) characteristics; c. Function in pathogenesis; 3. Physiological processes of bacterial growth; a. Life cycle; b. Anaerobic vs. aerobic; c. Spore formation; 4. Genetic mechanisms of bacteria; 5. Normal body flora; 6. Disease states, transmission, pathogenic mechanisms, symptoms, diagnosis, and immunity of infections by:; a. Gram (+) and Gram (-) cocci and rods; b. Spirochetes; c. Actinomycetes; d. Mycobacteria; e. Chlamydia; f. Rickettsia; g. Mycoplasma; 7. Laboratory isolation, culture, and identification of bacteria; 8. Procedures for antibiotic susceptibility testing; 9. Quality control/sterilization and disinfection
    • Microbiology: Systemic Health — B. Virology; 1. Virus particle chemistry and morphology; 2. Classification scheme for viruses; a. DNA vs. RNA types; b. Double-stranded vs. single-stranded; c. Envelopes; 3. Genetic mechanisms of viruses; 4. Viral replication in host cells; a. DNA and RNA viruses, with or without envelopes; 5. Disease states, transmission, pathogenic mechanisms, symptoms, diagnosis, and immunity of infections by viruses; 6. Laboratory isolation, culture, and identification of viruses; 7. Virus-like structures (e.g., prions)
    • Microbiology: Systemic Health — C. Mycology; 1. Biology of fungi; a. Yeast and mold morphology; b. Asexual and sexual reproduction/structures; 2. Disease states, transmission, pathogenic mechanisms, symptoms, diagnosis, and immunity of infections by:; a. Superficial mycoses; b. Cutaneous mycoses; c. Subcutaneous mycoses; d. Systemic mycoses; e. Opportunistic yeasts and molds; 3. Laboratory isolation, culture, and identification of fungi
    • Microbiology: Systemic Health — D. Parasitology; 1. Disease states, life cycles, transmission, pathogenic mechanisms, symptoms, diagnosis, and immunity of infections by protozoans, trematodes, cestodes, nematodes and arthropods; 2. Laboratory identification of parasites
    • Pathology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — A. Orbit, adnexa, lacrimal system; 1. Epidemiology, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic testing (applications and interpretations); 4. Pathophysiology and diagnosis
    • Pathology: Conjunctiva / Cornea / Refractive Surgery — A. Cornea/External Disease; 1. Epidemiology, genetics, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic and genetic testing (applications and interpretations); 4. Pathophysiology and diagnosis; 5. Contact lens selection and post-fitting complications; 6. Corneal surgery and procedures:; a. Refractive (e.g., LASIK, PRK, SMILE, intracorneal ring segments); b. Non-refractive (e.g., penetrating keratoplasty, DMEK, DSAEK, cross-linking, superficial keratectomy)
    • Pathology: Lens / Cataract / IOL / Pre- and Post-Operative Care — A. Lens/Cataract; 1. Epidemiology, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic testing (applications and interpretations); 4. Pathophysiology and diagnosis:; a. Cataract as a manifestation of ocular and systemic disease; 5. Cataract and clear lens extraction surgery:; a. Indications; b. Pre-operative measures; c. Intraocular lens selection; d. Procedure; e. Complications; 6. YAG capsulotomy:; a. Indications; b. Procedure; c. Complications
    • Pathology: Episclera / Sclera / Anterior Uvea — A. Uvea, Sclera/Episclera; 1. Epidemiology, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic testing (applications and interpretations); 4. Pathophysiology and diagnosis
    • Pathology: Vitreous / Retina / Choroid — A. Retina/Vitreous; 1. Epidemiology, genetics, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic and genetic testing (applications and interpretations); 4. Pathophysiology and diagnosis
    • Pathology: Optic Nerve / Neuro-Ophthalmic Pathways — A. Neuro-Ophthalmic disorders; 1. Epidemiology, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic testing (applications and interpretations); 4. Pathophysiology and diagnosis
    • Pathology: Glaucoma — A. Glaucoma; 1. Epidemiology, history, and symptom inventory; 2. Observation, inspection, recognition of signs, and techniques and skills; 3. Diagnostic testing (applications and interpretations); 4. Pathophysiology and diagnosis; 5. Glaucoma surgery:; a. Indications; b. Mechanisms; c. Co-management
    • Pathology: Systemic Health — A. General health; 1. Epidemiology; 2. Detailed history with regards to differential diagnosis of fatigue, weight loss, fever, headache, dizziness, and malaise; 3. Presentations involving abnormal body habitus and demeanor; 4. Physical developmental norms and standards for all ages; 5. Common systemic side effects of medications; 6. Principles of basic cardiac life support; 7. Preventive medicine; 8. Medical laboratory tests for screening; 9. Diagnostic testing and imaging; 10. Pathophysiology and diagnosis
    • Pathology: Systemic Health — B. Inflammation and repair; 1. Vascular and cellular changes in acute inflammation; 2. Causes of histological changes in chronic inflammation; 3. Causes and features of granulomatous inflammation; 4. Resolution of acute and chronic inflammation; 5. Events and local factors affecting wound healing and repair; 6. Systemic factors affecting the rate of wound healing
    • Pathology: Systemic Health — C. Immunologic system; 1. Epidemiology; 2. Symptoms and signs of immunologic conditions; a. Hypersensitivity disorders (Type I, II, III, IV); b. Autoimmune diseases (e.g., systemic lupus erythematosus, sarcoidosis, reactive arthritis); c. Immunodeficiency diseases (e.g., AIDS); 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — D. Host defenses and responses to infection; 1. PMN, macrophage and eosinophil function; 2. Chemotaxis, phagocytosis, and bacterial activity of these cells; 3. Role of antibody in phagocytosis and destruction of microorganisms
    • Pathology: Systemic Health — E. Cellular disease; 1. Cell injury (reversible and irreversible); 2. Morphological and functional changes associated with cell aging, injury, or death (by necrosis or apoptosis); 3. Cell cycle
    • Pathology: Systemic Health — F. Musculoskeletal system; 1. Epidemiology; 2. Symptoms and signs of the various arthritic syndromes (e.g., JRA, RA, ankylosing spondylitis); 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — G. Integumentary system; 1. Epidemiology; 2. Skin manifestation of systemic disorders; 3. Skin lesions in the phakomatoses; 4. Common dermatoses, including allergic manifestations; 5. Benign, premalignant, and malignant skin lesions; 6. Diagnostic testing and imaging; 7. Pathophysiology and diagnosis
    • Pathology: Systemic Health — H. Head and neck; 1. Epidemiology; 2. Symptoms and signs of diseases of the nasopharynx, sinuses, salivary glands, lymph nodes, carotid and temporal arteries, skin, and temporomandibular joint; 3. Auscultation of carotid arteries, skull and orbits for bruits and venous hum; 4. Potential significance of dysarthria, dysphagia, dysphonia, and hoarseness; 5. Diagnostic testing and imaging; 6. Pathophysiology and diagnosis
    • Pathology: Systemic Health — I. Genetic principles and disorders; 1. Chromosomal disorders (e.g., Down Syndrome); 2. Monogenic disorders; a. Autosomal dominant; b. Autosomal recessive; c. X-linked; 3. Multifactor disorders; 4. Mitochondrial disorders
    • Pathology: Systemic Health — J. Neoplasia; 1. Histogenesis of neoplasms; 2. Classification of neoplasms; 3. Causes of neoplasms; 4. Differences between benign and malignant tumors; 5. Effects of tumor on host, oncogenes, agents; 6. Genetics of neoplasia
    • Pathology: Systemic Health — K. Hematopoietic and lymphoid system; 1. Epidemiology; 2. Symptoms and signs of common blood disorders; a. Non-neoplastic disorders of blood cells; b. Neoplastic disorders of blood cells; c. Non-neoplastic disorders of lymph nodes; d. Neoplastic disorders of lymph nodes; 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — L. Respiratory system; 1. Epidemiology; 2. Symptoms and signs of respiratory disorders; a. Chronic obstructive pulmonary disease (COPD), emphysema, asthma, etc.; b. Infectious diseases of the lung; c. Neoplastic diseases of the lung; d. Interstitial diseases, including pneumoconiosis; 3. Significance of common respiratory symptoms (e.g., cough, hemoptysis, wheezing, shortness of breath); 4. Symptoms and signs of anaphylaxis; 5. Diagnostic testing and imaging; 6. Pathophysiology and diagnosis
    • Pathology: Systemic Health — M. Gastrointestinal system; 1. Epidemiology; 2. Symptoms and signs of common gastrointestinal disorders; a. Diseases of the esophagus (e.g., reflux, motility, disorders); b. Disorders of the stomach (e.g., gastritis, ulcers); c. Disorders of the intestines and colon (e.g., enteritis, colitis); d. Neoplastic disorders of the gastrointestinal tract; e. Diseases of the liver, biliary tract, and pancreas; 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — N. Cardiovascular system; 1. Epidemiology; 2. Risk factors for atherosclerotic heart disease; 3. Symptoms and signs of cardiovascular disease; a. Congestion, edema; b. Hemorrhage, shock; c. Thromboembolism; d. Systemic hypertension; e. Atherosclerosis; f. Aneurysms; g. Vasculitis; h. Coronary artery disease; i. Hypertensive heart disease; j. Bacterial infections and their nonsuppurative sequelae (e.g., rheumatic fever, glomerulonephritis, infective endocarditis); k. Cardiomyopathies; l. Congestive heart failure; 4. Diagnostic testing and imaging; 5. Pathophysiology and diagnosis
    • Pathology: Systemic Health — O. Endocrine/Metabolic system; 1. Epidemiology; 2. Symptoms and signs of endocrine disorders; a. Diabetes; b. Hyperthyroidism (e.g., Graves disease); c. Hypothyroidism; d. Goiters; e. Hyperparathyroidism; f. Hypoparathyroidism; g. Hyperpituitarism; h. Hypopituitarism; i. Hypercortisolism (e.g., Cushing disease); j. Hypocortisolism (e.g., Addison disease); k. Disorders of adrenal medulla (e.g., pheochromocytoma); 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — P. Nervous system and neuromuscular diseases; 1. Epidemiology; 2. Symptoms and signs associated with non-ocular neurological conditions; a. Cerebrovascular diseases; b. Headaches; c. Infectious diseases of the central nervous system; d. Nervous system neoplasms; e. Muscular atrophy, muscular dystrophy; f. Demyelinating diseases; g. Leukodystrophies, gangliosidoses; h. Neurodegenerative diseases (e.g., Alzheimer disease, Parkinson disease); i. Trauma, closed head injuries; j. Autoimmune disorders (e.g., myasthenia gravis); 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — Q. Renal and urogenital system; 1. Epidemiology; 2. Symptoms and signs of urogenital and renal disorders; a. Acute renal failure; b. Chronic renal failure; c. Glomerulonephritis; d. Pyelonephritis; e. Nephrotic syndrome; f. Diabetic nephropathy; g. Neoplasms of the urinary tract; h. Sexually transmitted diseases; i. Cystitis; 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — R. Reproductive system; 1. Epidemiology; 2. Pregnancy; a. Normal physiological changes; b. Pathological changes; 3. Complications of pregnancy (e.g., pre-eclampsia, eclampsia); 4. Implication of breast feeding; 5. Diagnostic testing and imaging; 6. Diseases/disorders; a. Neoplasms (including breast cancer); b. Disorders of the menstrual cycle; c. Disorders of the prostate; d. Erectile dysfunction
    • Pathology: Systemic Health — S. Nutrition; 1. Epidemiology; 2. Symptoms and signs of nutritional abnormalities; a. Malabsorption; b. Alcoholism; c. Vitamin deficiencies and toxicities; d. Trace minerals; e. Eating disorders; 3. Diagnostic testing and imaging; 4. Pathophysiology and diagnosis
    • Pathology: Systemic Health — T. Liver and biliary tract; 1. Epidemiology; 2. Symptoms and signs of liver disorders (e.g., cirrhosis, hepatitis, liver failure); 3. Biliary tract disorders; 4. Diagnostic testing and imaging; 5. Pathophysiology and diagnosis
    • Pathology: Systemic Health — U. Mental illness and behavioral disorders; 1. Epidemiology; 2. Symptoms and signs of mental illness (e.g., depression, suicide, anxiety, schizophrenia, bipolar disorder); 3. Symptoms and signs of behavioral disorders (e.g., substance abuse; child, spouse, and elder abuse); 4. Psychological tests; 5. Pathophysiology and diagnosis
    • Pathology: Systemic Health — V. Congenital/Hereditary conditions; 1. Epidemiology; 2. Symptoms and signs of common genetic disorders (e.g., Down syndrome, cystic fibrosis, congenital anomalies); 3. Symptoms and signs of common congenital disorders (e.g., fetal alcohol syndrome, rubella, syphilis, toxoplasmosis); 4. Diagnostic testing and imaging; 5. Pathophysiology and diagnosis
    • Pathology: Systemic Health — W. Anomalies of child development; 1. Clinical characteristics of children who deviate from expected patterns of development and epidemiology of developmental disorders
    • Pathology: Systemic Health — X. Anomalies of the aging adult; 1. Clinical characteristics of changes in perceptual functions (non-visual) associated with aging; a. Hearing; b. Coordination; c. Cognition; d. Psycho-social status
  • OPTICS (Geometrical, Physical, Ophthalmic, Physiological) — 31% - 35% of scored items (108 - 122 items)
    • Optics (Geometrical): Ametropia — A. Refraction at single spherical or plane surfaces; 1. Curvature and sagitta; 2. Refractive index and rectilinear propagation; 3. Vergence and dioptric power; 4. Object-image relationships, including apparent depth; 5. Ray tracing, nodal point, and nodal ray; 6. Lateral (translinear) and angular magnification; 7. Snell’s law of refraction
    • Optics (Geometrical): Ametropia — B. Thin lenses; 1. Vergence: dioptric and effective power; 2. Object-image relationships; 3. Lateral (translinear) and angular magnification; 4. Thin lens systems; 5. Prismatic effect (Prentice’s rule and prism effectivity); 6. Ray tracing, optical center, and optic axis
    • Optics (Geometrical): Ametropia — C. Thick lenses; 1. Cardinal points; 2. Vertex power and equivalent power; 3. Lateral (translinear) and angular magnification; 4. Reduced systems
    • Optics (Geometrical): Ametropia — D. Aberrations; 1. Spherical; 2. Coma; 3. Oblique astigmatism; 4. Curvature of field; 5. Distortion; 6. Chromatic (longitudinal and lateral)
    • Optics (Geometrical): Ametropia — E. Stops, pupils, and ports; 1. Entrance and exit pupils (size and location); 2. Depth of focus, depth of field, hyperfocal distance; 3. Field of view and half illumination
    • Optics (Geometrical): Ametropia — F. Spherocylindrical lenses; 1. Location of foci, image planes, principal meridians, and circle of least confusion; 2. Obliquely crossed spherocylindrical lenses; 3. Transposition; 4. Prismatic effect
    • Optics (Geometrical): Ametropia — G. Thin prisms; 1. Unit of measurement (prism diopter); 2. Prism deviation; 3. Combination of thin prisms; 4. Resolution of oblique prisms into horizontal and vertical components; 5. Total internal reflection
    • Optics (Geometrical): Ametropia — H. Ophthalmic and optical instruments
    • Optics (Geometrical): Ophthalmic Optics / Spectacles — A. Ophthalmic and optical instruments
    • Optics (Geometrical): Contact Lenses — A. Ophthalmic and optical instruments
    • Optics (Physical): Ametropia — A. Wave optics; 1. Characteristics of wave motion; 2. Classifications of the electromagnetic spectrum; 3. Total and partial coherence; 4. Diffraction (single slit, circular aperture, limits of resolution, zone plates); 5. Interference (double slit, multiple slits, thin film, anti-reflective coatings, holography); 6. Scattering (Rayleigh vs. Tyndall); 7. Dispersion
    • Optics (Physical): Ametropia — B. Interaction of light and matter; 1. Atomic energy levels, absorption, and emission line spectra; 2. Continuous spectra (black body radiator and gray body radiator characteristics); 3. Fluorescence (photons, energy levels); 4. Lasers (theory of operation, speckle pattern); 5. Spectral transmission
    • Optics (Physical): Ophthalmic Optics / Spectacles — A. Polarization; 1. Linearly polarized light; 2. Circular and elliptical polarization; 3. Polarization by reflection (glare reduction, Brewster’s law); 4. Effects of scattering on polarization; 5. Transmission through successive polarizers (stress analysis, Malus’ law)
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — A. Physical characteristics of ophthalmic lenses; 1. Geometry of lens surfaces (spherical, cylindrical, toric, aspheric); 2. Base curves (form of lenses); 3. Lens thickness (center, edge, gradients, iso-thickness curves); 4. Specification of lens size and shape; 5. Materials (refractive index, dispersion, hardness, specific gravity)
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — B. Reflection; 1. Planar and spherical reflection; 2. Proportion of light reflected from a surface (Fresnel’s law); 3. Focal power, focal length, and curvature; 4. Object-image relationships; 5. Magnification; 6. Lens/mirrors systems; 7. Ray tracing
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — C. Optical characteristics of ophthalmic lenses; 1. Locations of the relationships between the optic axis, optical center, geometric center, and major reference points; 2. Principles of corrected curve lens design; 3. Verification of lens prescriptions (lensometer, lens gauge, and hand neutralization); 4. Writing and transposing lens prescriptions; 5. Effect of lens tilt (spheres and spherocylinders about a principal meridian); 6. Effective power (for near and for changes in vertex distances); 7. Spectacle lens processing; 8. Spectacle magnification; a. Shape and power factors; b. Iseikonic lens design; 9. Methods of remedying reflections and ghost images
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — D. Ophthalmic prisms and prismatic effects of lenses; 1. Thickness difference across a prism; 2. Prismatic effects in the periphery of a lens (spheres, spherocylinders); 3. Decentration (prism from decentration, decentering to obtain prism, interpupillary distance); 4. Correction of vertical prism effect:; a. Slab off (front, back, top, bottom, reverse); b. Dissimilar segments; c. Prism segments; d. Multiple corrections; e. Contact lenses; f. Fresnel prisms; g. Fresnel Adds
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — E. Multifocal lenses; 1. Types (fused, 1-piece, progressive additions, and blended lenses); 2. Methods of producing Add powers; 3. Segment center location; 4. Differential displacement (jump); 5. Total displacement, horizontal and vertical imbalance; 6. Placement of distance and multifocal optical center; 7. Optical and physical characteristics of segments (design and calculations, progressive Adds, aberrations, surface characteristics); 8. Specifying multifocal height, size, shape, and location of segment
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — F. Physical characteristics and biological compatibility of frame materials
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — G. Fittings, adjustment, specification, and nomenclature of frames
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — H. Optical and frame consideration of high-powered lenses: aspheric, aspheric, and high refractive index materials
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — I. Absorptive lenses; 1. Specification of lens tints and absorptive coatings (including spectral transmission curves); 2. Characteristics of photochromic lenses; 3. Relationship between lens thickness and spectral transmission; 4. Special occupational requirements
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — J. Impact resistance; 1. Degrees of resistance of ophthalmic lens materials; 2. Methods of rendering materials impact resistant; 3. Methods of verifying impact resistance; 4. Performance of materials upon, and after, impact; 5. Specifications of occupational safety lenses
    • Optics (Ophthalmic): Ophthalmic Optics / Spectacles — K. Optical tolerances and physical requirements of ophthalmic lenses and frame materials (FDA, ANSI Z80 and Z87, OSHA)
    • Optics (Ophthalmic): Contact Lenses — A. Optical characteristics of contact lenses; 1. Surface characteristics of the lens and the cornea; 2. Specification of the lens (power, base curve, thickness, and edge characteristics); 3. Effective power considerations of the contact lenses; 4. Tear-lens optical considerations; 5. Prismatic effects; 6. Fabrication, inspection, and verification; 7. Lens types and materials; 8. Optical filters (photochromic lenses); 9. Optics of contact lenses: curves, zones, widths, and tear lens effects; sagittal depth; center edge thickness; flexure; asphericity and toric designs
    • Optics (Ophthalmic and Physiological): Low Vision — A. Epidemiology; 1. Causes of visual impairment; 2. Classification
    • Optics (Ophthalmic and Physiological): Low Vision — B. Examination and testing; 1. Visual acuity; 2. Special refraction techniques; 3. Visual fields; 4. Reading skills; 5. Effects of illumination; 6. Magnification determination; 7. In-office evaluation with low vision devices
    • Optics (Ophthalmic and Physiological): Low Vision — C. Management and rehabilitation; 1. Optical management:; a. Magnification, field of view, and working distance; b. Simple magnifiers; c. Telescopes; d. Loupes; e. Microscopes; 2. Electronic (digital) management:; a. Magnification, field of view, and working distance; 3. Orientation and mobility
    • Optics (Physiological): Ametropia — A. Refractive states: emmetropia, myopia, hyperopia, astigmatism, presbyopia, anisometropia; 1. Epidemiology, history, and symptoms inventory; 2. Observation and recognition of clinical signs, and techniques and skills including determination of:; a. Interpupillary distance; b. Visual acuity; c. Corneal curvature and thickness; d. Objective static and dynamic refractive status, including automatic refractive devices; e. Standard subjective refraction procedures, including astigmatic dials, crossed cylinders, stenopaic slit, fogging methods, bichrome and accommodation balance (equalization) techniques; f. Binocular subjective refraction procedures, including Turville infinity balance and vectographic (Polaroid) techniques; g. Cycloplegic subjective and objective techniques; h. Amplitude of accommodation; i. Trial lenses; j. PRA/NRA; k. Add powers; l. Refractive correction applications (e.g., LASIK); 3. Management of refractive states:; a. Optical; b. Surgical; c. Pharmacological; d. Myopia control
    • Optics (Physiological): Ametropia — B. Anomalies of refraction: aphakia, pseudophakia, and aniseikonia; 1. Epidemiology, history, and symptom inventory; 2. Observation and recognition of clinical signs and phenomena associated with aphakia and pseudophakia:; a. Magnification; b. Field of view; c. Spatial distortion; d. Convergence demands; e. Sensitivity to glare; f. Techniques and skills for determining, evaluating, and/or verifying:; i. Types and characteristics of intraocular lenses and aphakic spectacle and contact lenses; ii. Intraocular lens power; iii. Special refraction techniques; iv. Aphakic lens prescriptions; 3. Observation and recognition of clinical signs, and techniques and skills associated with aniseikonia including:; a. Detection of aniseikonia; b. Measurement of aniseikonia
    • Optics (Physiological): Ametropia — C. Schematic eye models; 1. Dioptric components; 2. Cardinal points, entrance and exit pupils; 3. Ametropia: far point, near point, correction; 4. Accommodation: amplitude and effectivity; 5. Astigmatism, including correction; 6. Retinal image size, spectacle magnification, and relative spectacle magnification
    • Optics (Physiological): Ametropia — D. Dioptrics of the eye; 1. Characteristics of components (curvature, thickness, separation, refractive indices, and axil length); 2. Reference angles and axes; 3. Catoptric (Purkinje) images; 4. Retinal image size; 5. Optical function of the pupil
    • Optics (Physiological): Ametropia — E. Image quality; 1. Aberrations (surgically induced, spherical, chromatic, coma, curvature, oblique astigmatism, distortion, wavefront sensing aberrometry); 2. Diffraction; 3. Stray light; 4. Point and line spread functions; 5. Resolving power; 6. Modulation transfer function (Fourier optics)
    • Optics (Physiological): Ametropia — F. Radiation and the eye; 1. Radiometry (radiant intensity, radiance, and irradiance); 2. Photometry (luminosity function, luminous intensity, luminance, and illuminance, Lambertian surfaces- cosine laws); 3. Spectral transmission of the ocular media; 4. Retinal illuminance; 5. Effects of incoherent radiation (e.g., infrared, visible, ultraviolet) on tissue:; a. Mechanisms of damage; b. Wavelength, energy levels, thresholds for reactions; c. Ophthalmic applications (e.g., intense pulsed light therapy (IPL), corneal cross-linking); d. Protective measures; 6. Effects of coherent radiation (lasers) on tissue:; a. Mechanisms of damage; b. Wavelength, energy levels, thresholds for reactions; c. Ophthalmic applications (argon, excimer, YAG, SLT, helium neon, holmium); d. Protective measures
    • Optics (Physiological): Contact Lenses — A. Basic theories and methods of fitting, and contact lens selection and designs
    • Optics (Physiological): Contact Lenses — B. Patient selection and post-fitting complications
    • Optics (Physiological): Accommodation / Vergence / Oculomotor Function — A. Eye movements; 1. Purpose of roles for vision; 2. Dynamics and kinematics; 3. Specification of direction of gaze and ocular orientation (torsion); 4. Reflex movements, including compensatory movements (e.g., vestibulo-ocular reflex, optokinetic nystagmus); 5. Small movements associated with steady fixation; 6. Versional movements (pursuits and saccades); 7. Vergence movements (tonic, accommodative, including models of accommodative/vergence interaction, fusional and proximal)
    • Optics (Physiological): Accommodation / Vergence / Oculomotor Function — B. Anomalies and eye movements; 1. Epidemiology, history, and symptom inventory; 2. Observation and recognition of clinical signs, and techniques and skills to test:; a. Comitance; b. Deviations and measurements thereof; c. Diplopia; d. Motor fusion; e. Paralytic syndromes; f. Fixation disparity; g. Nystagmus
    • Optics (Physiological): Accommodation / Vergence / Oculomotor Function — C. Accommodation and accommodative vergence; 1. Epidemiology, history, and symptom inventory; 2. Observation and recognition of clinical signs, and techniques and skills to test:; a. Amplitude range, facility of accommodation; b. Analysis of accommodation and vergence relationships; c. Vision therapy procedures, demands, and challenges; 3. Biomechanics of accommodative reflexes
    • Optics (Physiological): Accommodation / Vergence / Oculomotor Function — D. Pupils; 1. Purposes and roles for vision; 2. Dynamics of muscle action; 3. Biomechanics of pupillary reflexes; 4. Interrelationships between pupillary changes, accommodation, and convergence (the near reflex); 5. Factors affecting pupil size
    • Optics (Physiological): Amblyopia / Strabismus — A. Sensory anomalies of binocular vision/strabismus; 1. Epidemiology, history, and symptom inventory; 2. Observation and recognition of clinical signs, and techniques and skills to test:; a. Monocular fixation patterns; b. Amblyopia; c. Sensory fusion and stereopsis; d. Anomalous correspondence; e. Suppression
    • Optics (Physiological): Perceptual Function / Color Vision — A. Anomalies secondary to acquired neurological impairment; 1. Adaptations to clinical techniques and tests to allow the assessment of visual abilities of patients with acquired systemic conditions (CVA, multiple sclerosis, etc.) and traumatic brain injury (TBI), which results in neurological impairment and subsequent vision perceptual dysfunction:; a. Noncomitancy; b. Field loss and neglect; c. Loss of accommodation; d. Loss of fusion; e. Vision perception-motor deficiencies; 2. Modification of optometric management for the patient with acquired neurological impairment
    • Optics (Physiological): Perceptual Function / Color Vision — B. Space perception; 1. Direction and depth discrimination (monocular and binocular cues, oculocentric and egocentric localization); 2. Characteristics of sensory function (binocular interactions including summation, binocular suppression, and rivalry; corresponding points including horopter criteria); 3. Disturbances of perceived direction and distance (aniseikonia and amblyopia); 4. Sensory-motor interactions (fixation disparity, past pointing, visually guided behavior, body posture and perceived orientation, and self-motion)
    • Optics (Physiological): Perceptual Function / Color Vision — C. Form perception; 1. Static visual acuity (including test configurations, various acuity tasks, and factors influencing acuity including blur, intensity, and contrast); specification of visual acuity; 2. Spatial contrast sensitivity function (including factors influencing the function); 3. Illusions, constancies, and figure-ground relations; 4. Simultaneous contrast and spatial interactions (Mach bands)
    • Optics (Physiological): Perceptual Function / Color Vision — D. Light perception; 1. Detection characteristics at the absolute light threshold (including spectral, spatial, and temporal aspects); 2. Brightness difference thresholds at various adaptation levels (Weber’s and DeVries-Rose laws); specification of contrast; 3. Dark and light adaptation processes and theories; 4. Spatial and temporal summation characteristics (Ricco’s, Piper’s, and Bloch’s laws)
    • Optics (Physiological): Perceptual Function / Color Vision — E. Motion perception; 1. Factors involved in the detection of real and apparent motion, detection of displacements; 2. Motion after-effects; 3. Dynamic visual acuity, visual performances with a moving object, and visual performances with a moving observer
    • Optics (Physiological): Perceptual Function / Color Vision — F. Temporal perception; 1. Critical flicker fusion frequency, including factor influencing test object (size, location, and adaptation level); 2. Subfusional flicker phenomena (Bartley brightness enhancement); 3. Successive contrast and masking; 4. Temporal contrast sensitivity function; 5. Stabilized retinal images and monocular suppression (Troxler effect); 6. Saccadic suppression
    • Optics (Physiological): Perceptual Function / Color Vision — G. Entopic phenomena; 1. Characteristics and origin of various phenomena (involving the cornea, lens, and vitreous); 2. Vascular and circulatory phenomena (Purkinje tree, capillary circulation); 3. Phenomena associated with central vision (Maxwell spot, Haidinger brushes); 4. Phenomena associated with retinal distention or other forms of retinal activity (Moore lightning streaks, blue arcs of the retina, phosphenes)
    • Optics (Physiological): Perceptual Function / Color Vision — H. Color perception; 1. Chromatic discrimination (hue and saturation) for normal and defective color vision; 2. Color mixture and appearance; 3. Color contrast, constancy, and adaptation; 4. Color specification and colorimetry (CIE); 5. Spectral sensitivity of normal and defective color vision; 6. Mechanisms of color deficiencies; 7. Inherited anomalies of color vision:; a. Classification; b. Inheritance patterns; c. Color vision tests (e.g., pseudoisochromatic tests, arrangement tests, anomaloscope); 8. Acquired anomalies of color vision:; a. Classification; b. Etiology; c. Color vision tests; 9. Conditions for color vision testing; 10. Societal implication of color vision anomalies:; a. School; b. Vocational requirements; c. Patient interest; 11. Patient management strategies:; a. Counseling; b. Special aids
    • Optics (Physiological): Perceptual Function / Color Vision — I. Basic psychophysical methods and theory; 1. Measurement of absolute and difference thresholds; 2. Threshold determination (e.g., limits, adjustments, constant stimuli, forced choice, yes/no)
    • Optics (Physiological): Perceptual Function / Color Vision — J. Psychophysical scaling methods and theory
    • Optics (Physiological): Perceptual Function / Color Vision — K. Signal detection methods and theory
    • Optics (Physiological): Visual and Human Development — A. Vision development in the infant child; 1. Spatial vision; 2. Refractive error; 3. Color vision; 4. Spectral transmission of the ocular media; 5. Accommodation and convergence; 6. Light sensitivity; 7. Binocular vision and stereopsis; 8. Form reproduction and perception; 9. Temporal vision; 10. Visual fields; 11. Motion perception
    • Optics (Physiological): Visual and Human Development — B. Effects of early environmental restrictions; 1. Plasticity of the system; 2. Animal models; 3. Light and pattern deprivation; 4. Monocular and binocular deprivation; 5. Refractive error; 6. Strabismus; 7. Cataract
    • Optics (Physiological): Visual and Human Development — C. Changes in vision with aging; 1. Spatial vision; 2. Refractive error; 3. Color vision; 4. Spectral transmission of the ocular media; 5. Accommodation and convergence; 6. Light sensitivity; 7. Glare (disability and discomfort); 8. Dark adaptation, glare recovery; 9. Visual fields; 10. Temporal vision; 11. Oculomotor system; 12. Motion perception; 13. Visual attention
    • Optics (Physiological): Visual and Human Development — D. Vision perceptual-motor skills
    • Optics (Physiological): Visual and Human Development — E. Anomalies of child development; 1. Epidemiology: history and signs/symptoms manifest by patients in the age ranges noted below in (2); 2. Clinical techniques and tests to assess the development of an infant (birth to 18 months), toddler (18-36 months), preschooler (3-5 years), and school-age child; 3. Vision problems which may be associated with deviations from normal patterns of development; 4. Tests used by optometrists to determine a child’s level of visual-perceptual development, such as:; a. Visual attention and discrimination; b. Visual-motor integration; c. Intersensory integration; d. Bilateral integration and laterality
  • PHARMACOLOGY — 11% - 17% of scored items (40 - 60 items)
    • Pharmacology: Contact Lenses — A. Preparation used with contact lenses; 1. Preserved and non-preserved solutions; 2. Drug delivery systems
    • Pharmacology: Contact Lenses — B. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Accommodation / Vergence / Oculomotor Function — A. Autonomic and/or neuromuscular junction drugs; 1. Drugs affecting neurohumoral transmission: autonomic and somatic motor nervous systems; 2. Adrenergic agonists; 3. Adrenergic antagonists; 4. Cholinergic agonists; 5. Cholinergic antagonists; 6. Cholinesterase inhibitors; 7. Ganglionic agonists and antagonists; 8. Neuromuscular transmission agonists and antagonists
    • Pharmacology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — B. Anti-infective agents
    • Pharmacology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — C. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — D. Aesthetic/cosmetic agents
    • Pharmacology: Lids / Lashes / Lacrimal System / Ocular Adnexa / Orbit — E. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — B. Ocular anesthetics
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — C. Antihistamines
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — D. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — E. Lubricants and tear substitutes
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — F. Dyes; 1. Topical diagnostic agents
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — G. Hyperosmotic agents
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — H. Mast cell stabilizers
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — I. Vasoconstrictors
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — J. Immune modulators
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — K. Anti-infective agents
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — L. Nutritional supplements
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — M. Biologics
    • Pharmacology: Conjunctiva / Cornea / Refractive Surgery — N. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — B. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — C. Anti-infective agents
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — D. Lubricants and tear substitutes
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — E. Dyes; 1. Topical diagnostic agents; 2. Intraoperative agents
    • Pharmacology: Lens / Cataract / IOL / Pre- and Post-Operative Care — F. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Episclera / Sclera / Anterior Uvea — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Episclera / Sclera / Anterior Uvea — B. Mydriatics and cycloplegics
    • Pharmacology: Episclera / Sclera / Anterior Uvea — C. Miotics
    • Pharmacology: Episclera / Sclera / Anterior Uvea — D. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Episclera / Sclera / Anterior Uvea — E. Lubricants and tear substitutes
    • Pharmacology: Episclera / Sclera / Anterior Uvea — F. Dyes; 1. Topical diagnostic agents; 2. Intravenous agents
    • Pharmacology: Episclera / Sclera / Anterior Uvea — G. Vasoconstrictors
    • Pharmacology: Episclera / Sclera / Anterior Uvea — H. Indications/contraindications/side effects/ drug interactions
    • Pharmacology: Vitreous / Retina / Choroid — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Vitreous / Retina / Choroid — B. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Vitreous / Retina / Choroid — C. Anti-infective agents
    • Pharmacology: Vitreous / Retina / Choroid — D. Dyes; 1. Topical diagnostic agents; 2. Intravenous agents
    • Pharmacology: Vitreous / Retina / Choroid — E. Nutritional supplements
    • Pharmacology: Vitreous / Retina / Choroid — F. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Optic Nerve / Neuro-Ophthalmic Pathways — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Optic Nerve / Neuro-Ophthalmic Pathways — B. Mydriatics and cycloplegics
    • Pharmacology: Optic Nerve / Neuro-Ophthalmic Pathways — C. Miotics
    • Pharmacology: Optic Nerve / Neuro-Ophthalmic Pathways — D. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Optic Nerve / Neuro-Ophthalmic Pathways — E. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Glaucoma — A. General principles; 1. Factors affecting drug bioavailability; 2. Routes of administration; 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Glaucoma — B. Antiglaucoma agents
    • Pharmacology: Glaucoma — C. Hyperosmotic agents
    • Pharmacology: Glaucoma — D. Mydriatics and cycloplegics
    • Pharmacology: Glaucoma — E. Indications/contraindications/side effects/drug interactions
    • Pharmacology: Systemic Health — A. General principles; 1. Pharmacodynamics; a. Concept of receptors; b. Dose-response relationships; c. Routes of drug administration; 2. Pharmacokinetics; a. Absorption, distribution, metabolism, and excretion of drugs; b. Quantitative aspects; c. Influencing factors (e.g., age, gender, pathology, genetics, diet); 3. Mechanisms of action; 4. Preservatives
    • Pharmacology: Systemic Health — B. Autonomic and/or neuromuscular junction drugs; 1. Drugs affecting neurohumoral transmission: autonomic and somatic motor nervous systems; 2. Adrenergic agonists; 3. Adrenergic antagonists; 4. Cholinergic agonists; 5. Cholinergic antagonists; 6. Cholinesterase inhibitors; 7. Ganglionic agonists and antagonists; 8. Neuromuscular transmission agonists and antagonists
    • Pharmacology: Systemic Health — C. Autacoid agonists and antagonists
    • Pharmacology: Systemic Health — D. Drugs affecting the respiratory system; 1. Bronchodilators; 2. Mast cell stabilizers; 3. Mucolytics
    • Pharmacology: Systemic Health — E. Gastrointestinal agents
    • Pharmacology: Systemic Health — F. Chemotherapeutics agents; 1. Antimicrobial agents; a. Antiseptics and disinfectants; b. Antibacterial; c. Antifungal; d. Antiparasitic; 2. Antiviral agents; 3. Antineoplastic agents
    • Pharmacology: Systemic Health — G. Immunopharmacological agents
    • Pharmacology: Systemic Health — H. Anti-inflammatory agents; 1. Steroids; 2. Non-steroidals
    • Pharmacology: Systemic Health — I. Major drugs acting on the central nervous system; 1. Neurotransmitters; 2. Opioid and non-opioid analgesics; 3. Sedative hypnotics; 4. Anxiolytics; 5. Antipsychotics; 6. Antiparkinsonians; 7. Antidepressants; 8. Anticonvulsants; 9. Skeletal muscle relaxants; 10. Hallucinogens and drugs of abuse
    • Pharmacology: Systemic Health — J. General and local anesthetics
    • Pharmacology: Systemic Health — K. Major drugs acting on the endocrine system; 1. Adenohypophyseal hormones; 2. Thyroid and antithyroid drugs; 3. Insulin and synthetic antidiabetics; 4. Estrogens, progestins and androgens
    • Pharmacology: Systemic Health — L. Major cardiovascular drugs; 1. Antihypertensives; 2. Agents used to treat CHF (e.g., inotropic agents, vasodilators); 3. Antiarrhythmics; 4. Antianginal agents; 5. Anticoagulants and thrombolytics; 6. Antihyperlipidemic agents
    • Pharmacology: Systemic Health — M. Major drugs acting on the kidneys; 1. Diuretics; 2. Uricosuric agents
    • Pharmacology: Systemic Health — N. Nutritional supplements
    • Pharmacology: Systemic Health — O. Indications/contradictions/side effects/drug interactions
    • Pharmacology: Systemic Health — P. Drug use and metabolism in pregnancy and breast feeding
Examination sources

Part II Patient Assessment and Management (PAM)

Provider
National Board of Examiners in Optometry (NBEO); delivered at Pearson Testing Centers
Format
One-day computer-based, image-intensive, case-based examination; each patient case is followed by 3-6 related multiple-choice items with 3-10 answer options; items may be single-answer or multiple-response (up to 4 correct answers, all required for credit). Includes approximately 120 embedded TMOD items, reported as a separate TMOD breakout score and pass/fail decision
Exam questions
350 items
Time limit
Two sessions of 175 items each, 3.5 hours per session
Passing score
Scaled score on a 100-900 scale; anything above 300 is a passing score
Exam fee
$1490 (rates for examinations administered beginning August 2026)
Examination outline
  • Clinical Correlation of Basic Science Principles — 11% - 17% of items (40 - 60 items); includes embedded Treatment and Management of Ocular Disease (TMOD) items
    • Clinical Correlation of Basic Science Principles — Pathophysiology/etiology
    • Clinical Correlation of Basic Science Principles — anatomy
    • Clinical Correlation of Basic Science Principles — biochemistry
    • Clinical Correlation of Basic Science Principles — physiology
    • Clinical Correlation of Basic Science Principles — immunology/microbiology/pathology
    • Clinical Correlation of Basic Science Principles — optics
    • Clinical Correlation of Basic Science Principles — pharmacology
  • Diagnosis — 26% - 34% of items (90 - 120 items); includes embedded Treatment and Management of Ocular Disease (TMOD) items
    • Diagnosis — Most appropriate diagnosis
    • Related to Diagnosis — Indicate data supporting or correlating with diagnosis; correlation of possible additional data; or indicate additional data or next test needed
  • Treatment / Management — 40% - 57% of items (140 - 200 items); includes embedded Treatment and Management of Ocular Disease (TMOD) items
    • Treatment/Management — Most appropriate treatment/management
    • Related to Treatment/Management — Treatment mechanism, additional data needed to treat effectively, additional data or next test needed, patient education, follow-up, or prognosis
  • Legal Issues / Ethics / Public Health — 4% - 10% of items (15 - 35 items)
    • Legal Issues / Ethics — Licensure and governmental regulation of optometry, standards of professional ethics, doctor-patient relationship, professional liability
    • Public Health — Epidemiology, biostatistics and measurement, environmental vision, health care policy and administration
Examination sources

Part III Patient Encounters and Performance Skills (PEPS)

This assessment does not have a question bank.

Provider
National Board of Examiners in Optometry (NBEO); administered at the National Center of Clinical Testing in Optometry (NCCTO), Charlotte, NC
Format
12-station performance-based examination with standardized patients: 10 patient encounter stations and 2 performance skills stations; every station cycle is audio and video recorded; encounter notes and skills are scored by licensed optometrist examiners
Time limit
4.5-hour session; each exam cycle is 15 minutes with 3 minutes of observation time
Passing score
Pass/fail against an overall cut-off requirement; scale scores are not reported
Exam fee
$1490 (rates for examinations administered beginning August 2026)
Examination sources