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North Carolina Optometrist — Requirements & Free Practice

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Licenses, application pathways and examination requirements

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Intern Permit

Temporary, limited, supervised optometry practice; previously called Provisional License.

Licensing authority: North Carolina State Board of Examiners in Optometry

Initial Intern Permit

All of the following:

Education
Academically qualified accredited O.D.; completion of all academic graduation requirements qualifies even where the school withholds the degree pending NBEO passes.
Examination timing
Have active applications for the next NC clinical practicum and each missing NBEO part; qualifying national examinations may already be passed, registered for the next administration, or awaiting results.
Fees
Initial permit $300, consecutive extensions $100 as stated in the policy.
Practice limits
Temporary, limited, supervised practice; identify as intern, no independent provider scheduling or marketing, no telemedicine. Injections require ISE pass and appropriately certified personal supervisor.
Supervisor
Approved North Carolina supervising optometrist in good standing with five years of NC licensure, subject to the Executive Director residency/equivalent-experience exception. Supervisor physically present at registered NC location, independently confirms patient findings and signs prescriptions.
Term
Six months or clinical results announcement, whichever first; at most two consecutive renewals and participation in the next eligible clinical examination and missing NBEO administrations.
Intern Permit for an optometrist licensed elsewhere

All of the following:

Education
Academically qualified accredited O.D.; completion of all academic graduation requirements qualifies even where the school withholds the degree pending NBEO passes.
Examination timing
Have active applications for the next NC clinical practicum and each missing NBEO part; qualifying national examinations may already be passed, registered for the next administration, or awaiting results.
Fees
Initial permit $300, consecutive extensions $100 as stated in the policy.
Other licences
Active other-state/jurisdiction licence and good standing in every licensing jurisdiction; disclose restrictions, discipline, surrender and pending investigations.
Practice limits
Temporary, limited, supervised practice; identify as intern, no independent provider scheduling or marketing, no telemedicine. Injections require ISE pass and appropriately certified personal supervisor.
Supervisor
Approved North Carolina supervising optometrist in good standing with five years of NC licensure, subject to the Executive Director residency/equivalent-experience exception. Supervisor physically present at registered NC location, independently confirms patient findings and signs prescriptions.
Term
Six months or clinical results announcement, whichever first; at most two consecutive renewals and participation in the next eligible clinical examination and missing NBEO administrations.
Consecutive renewal of an Intern Permit

All of the following:

Education
Academically qualified accredited O.D.; completion of all academic graduation requirements qualifies even where the school withholds the degree pending NBEO passes.
Examination timing
Have active applications for the next NC clinical practicum and each missing NBEO part; qualifying national examinations may already be passed, registered for the next administration, or awaiting results.
Fees
Initial permit $300, consecutive extensions $100 as stated in the policy.
Practice limits
Temporary, limited, supervised practice; identify as intern, no independent provider scheduling or marketing, no telemedicine. Injections require ISE pass and appropriately certified personal supervisor.
Renewal
Renew immediately after results; take the next eligible Board exam, register/take missing NBEO examinations, and respect the two-renewal maximum; good-cause reconsideration is discretionary.
Supervisor
Approved North Carolina supervising optometrist in good standing with five years of NC licensure, subject to the Executive Director residency/equivalent-experience exception. Supervisor physically present at registered NC location, independently confirms patient findings and signs prescriptions.
Term
Six months or clinical results announcement, whichever first; at most two consecutive renewals and participation in the next eligible clinical examination and missing NBEO administrations.

License to Practice Optometry

Licensing authority: North Carolina State Board of Examiners in Optometry

Annual renewal of active optometry licence
No examination is required for this applicant pathway.
Continuing education
25 annual Board-approved hours, including at least 12 certified clinical/pharmacology/therapeutic hours; at most six self-study hours and four practice-administration hours; Board hardship waivers apply.
Renewal
Submit electronic renewal application and fee by December 31; late fee begins January 1 and practise without applied-for renewal is unauthorized after January 31.

Official no-examination sources

Effective from 2026-09-22.

Delinquent renewal to active status within the renewal year
No examination is required for this applicant pathway.
Renewal
Submit renewal and late fees and satisfy active continuing education requirements.
Time limit
Renewal remains available only through December 31 of that renewal year; after February 1 practice without renewal is unauthorized.

Official no-examination sources

Effective from 2026-09-22.

Licensure under federal military portability
No examination is required for this applicant pathway.
Covered licence
Service member or spouse with covered optometry licence who relocates to NC for military service due to military orders.
Documentation
Military orders, marriage proof for spouse, notarized statutory affidavit and good-standing evidence for every relevant licence; Board may require lawful background check.
Fee
No fee.
Practice
Full NC optometry scope; covered other-state licence must remain in good standing; submit to Board practice, disciplinary and CE authority.
Renewal
Standard annual NC renewal and continued covered-licence good-standing verification; validity is not solely tied to military orders.

Official no-examination sources

Effective from 2026-09-22.

Annual renewal of federal military portability licence
No examination is required for this applicant pathway.
Continuity
Licence remains valid while covered licence is in good standing, rather than only during military orders.
Renewal
Complete standard Board annual renewal, CE and continued covered other-state good-standing verification.

Official no-examination sources

Effective from 2026-09-22.

Restoration of maintained inactive licence to active practice
North Carolina Clinical Practicum Examination (practice unavailable)
Board discretion
The Board may require additional CE, CPDO self-assessment, or the clinical examination; passage is conditional on the Board exercising that discretion.
Continuing education
Show CE for inactive years or request competency-based waiver; provide history of professional activities, reasons for inactivity/return and relevant health circumstances.
Cpdo
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Inactive licence
Licence was maintained by annual inactive renewals; permanently expired licences are ineligible.
Initial licensure by examination

All of the following:

Application
Submit the Board application and fee, photo, birth certificate, educational transcript, recommendations, applicable licence verification and required course completion; meet the announced deadlines.
Clinical passing grade
Average clinical practicum grade at least 75 and no part below 60 under 21 NCAC 42B .0110.
Education
Graduate of an accredited optometry college or approved university optometry department; foreign-trained applicants must obtain the qualifying accredited O.D. education.
Graduation year
National examination requirements follow examinations offered in the graduation year; the Board accepts historical Part III CSE passes as prior evidence of the discontinued examination. Current PEPS applies where CSE was not previously passed. ISE remains required; TMOD is conditional on availability when the applicant took Part II.
Minimum age
At least 18 when the examination application is filed.
Moral character
Good moral character and required evidence.
Qualifying scores
Direct NBEO official score release before clinical application approval. All required sections must show P; PEPS Skills and Patient Encounters must each pass.
Permanent military trained licensure through substantial equivalency review

All of the following:

Clinical discretion
Clinical practicum is a named Board assessment option under .0114; an applicant may be excused when alternative competency evidence satisfies the Board.
Documentation
Military status evidence, DD214 for veterans, educational credentials, other-licence verification, three recommendations and practice/experience documentation.
Fee
No initial application/licensing fee under G.S. 93B-15.1(k).
Ise exception
Board current substantial-equivalency pathway expressly does not require ISE score.
Military qualifications
Qualifying military occupational specialty, equivalent testing/training/experience, two of preceding five years active practice and no disqualifying acts; Board determines equivalence.
National scores
Current Board military application lists educational credentials and NBEO scores, including ISE except the substantial-equivalency exception. Historical passes and graduation-year conditions apply.
Permanent licensure for spouse of active military personnel

All of the following:

Clinical discretion
Clinical practicum is a named Board assessment option under .0114; an applicant may be excused when alternative competency evidence satisfies the Board.
Competence
Board may assess through clinical practicum, CE or qualifying recent experience; two-of-five-year experience applies as determined by the Board.
Documentation
Military status evidence, DD214 for veterans, educational credentials, other-licence verification, three recommendations and practice/experience documentation.
Existing licence
Current other-jurisdiction licence with equivalent or higher standards, good standing, and no disqualifying acts.
Fee
No initial application/licensing fee under G.S. 93B-15.1(k).
Marriage
Proof of marriage to active U.S. military member.
National scores
Current Board military application lists educational credentials and NBEO scores, including ISE except the substantial-equivalency exception. Historical passes and graduation-year conditions apply.
Licensing practitioners of other states under G.S. 90 118.5
North Carolina Clinical Practicum Examination (practice unavailable)
Board implementation statement
{"sources":[{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Applicant FAQ, reciprocity and endorsement statement","name":"Faq","quote":"Do you offer reciprocity or licensure by endorsement?\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nNo. To practice in North Carolina, you must \n\ntake and pass the North Carolina licensing exam\n\n; the Board states it \n\ndoes not have a reciprocity/endorsement policy\n\n.\n\n\n\n\n*Start Here for Application Details*","sourceFile":{"sha256":"32ccc806df7c865686dc2fd4ed0dfc0e706c51712e9a11d7045ac8d549447090"},"url":"https://www.ncoptometry.org/frequently-asked-questions-faq/applicant-faq","version":"Current Board implementing page, verified September 30, 2026; applicable requirements corroborated by the governing law and dated policies"},{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"NBEO Requirements: checklist and Part III CSE replacement","name":"Nbeo","quote":"Passing scores on Part I, II, and III*\n\n\n\n\n\nIf you have not previously passed Part III CSE before it was discontinued, you will need to have a passing score on Part III PEPS (Replacing Part III NBEO CSE)\n\n\n\n\n\nA passing score is required for each of the following sections even if you have an overall passing score on PEPS. \n\n\n\n\n\nSkills \n\n\n\n\n\nPatient Encounters\n\n\n\n\n\nIf you have failed one of the sections \n\nabove\n\n,  but passed overall, you will require a letter from this Board sent to the NBEO on your behalf to facilitate your retake. Please email \n\n\nSamantha@ncoptometry.org\n\n\n with your request and include your OE Tracker Number. \n\n\n\n\n\n\n\n\n\nPassing score on Part II TMOD*\n\n\n\n\n\nPassing score on Part III ISE*\n\n\n\n\n\n*The NBEO gives a P/F along with the numeral. To meet the requirement, all sections must have a 'P'","sourceFile":{"sha256":"c800b7bc19e2fffeac70ccbe16d4f3ae845b549c2f3f4d73e606c542d42b8c47"},"url":"https://www.ncoptometry.org/examinations/nbeo-requirements","version":"NBEO Requirements, updated 12/23/24"}],"value":"The statute limits examinations to the clinical practicum. The Board FAQ nevertheless denies an endorsement policy and its generic checklist demands NBEO passes; these lower-ranked statements remain applicant-facing conditions."}
Discipline
No pending disciplinary proceeding or unresolved complaint; home-board certificate addresses character and criminal/professional charges.
Documentation
Home-board certification submitted within six months of issue, accompanied by accredited optometry diploma evidence.
Existing license
Current active valid optometry licence in another state, with equivalent or higher licensing standards.
Practice
Active competent practitioner in good standing who practised at least three of the five preceding years.
New licensure after permanent expiration
North Carolina Clinical Practicum Examination (practice unavailable)
Expiration
More than one renewal year elapsed without renewal; prior licence cannot be renewed.
New application
Apply anew and successfully complete the Board clinical practicum; Board evaluates proficiency and moral character under G.S. 90-118.7.
Reexamination following failure of the clinical practicum

All of the following:

Application
Submit the Board application and fee, photo, birth certificate, educational transcript, recommendations, applicable licence verification and required course completion; meet the announced deadlines.
Clinical passing grade
Average clinical practicum grade at least 75 and no part below 60 under 21 NCAC 42B .0110.
Education
Graduate of an accredited optometry college or approved university optometry department; foreign-trained applicants must obtain the qualifying accredited O.D. education.
Graduation year
National examination requirements follow examinations offered in the graduation year; the Board accepts historical Part III CSE passes as prior evidence of the discontinued examination. Current PEPS applies where CSE was not previously passed. ISE remains required; TMOD is conditional on availability when the applicant took Part II.
Minimum age
At least 18 when the examination application is filed.
Moral character
Good moral character and required evidence.
Qualifying scores
Direct NBEO official score release before clinical application approval. All required sections must show P; PEPS Skills and Patient Encounters must each pass.
Repeat application
A completed repeat application and fee are due 60 days before the examination; school transcripts, birth certificate and previously submitted NBEO scores need not be resubmitted.
Third failure
After three clinical failures, complete at least one academic year of Board-approved clinical optometry study and submit proof before reapplying.
Restoration of revoked, deprived or disciplinarily surrendered licence
North Carolina Clinical Practicum Examination (practice unavailable)
Board discretion
The Board may require additional CE, CPDO self-assessment, or the clinical examination; passage is conditional on the Board exercising that discretion.
Cpdo
{"sources":[{"carrierClass":"implementation","checkedAt":"2026-09-30","locator":"Part B, discretionary conditions including CPDO and clinical examination","name":"Restore","quote":"The Board may impose such terms and conditions upon an applicant for restoration of \n\ntheir\n\n \n\nlicense as the Board in its discretion deems appropriate, in order to assure that the optometrist is qualified to practice in North Carolina by education, training, and experience, and is mentally and physically capable of safely practicing optometry. Such terms and conditions may include, but are not limited to:\n\n\n\n\n\nRequiring that the applicant obtain continuing education credits equivalent to or some portion of the number of credits required by the Board for the years \n\nsuch\n\n \n\nlicense was revoked.\n\n\n\n\n\nRequiring that the applicant complete the NBEO CPDO Self-Assessment Evaluation (National Board of Examiners in Optometry – Continued Professional Development in Optometry Self Assessment Evaluation)\n\n\n\n\n\nThe Board also may determine that the optometrist has not demonstrated current educational and clinical experience, and may require that \n\nthey\n\n \n\ninstead take the Board’s clinical examination.","sourceFile":{"sha256":"676ff77112ff727c8ff356096ccd8bfcd5858378008f0a14ab6f9c62221526e7"},"url":"https://www.ncoptometry.org/board-policies/reinstatement-or-restoration-of-license","version":"Reinstatement or Restoration Policy, amended 11/10/2022"}],"value":"The currently published restoration policy expressly permits the Board to require the NBEO Continued Professional Development in Optometry (CPDO) Self-Assessment Evaluation. The supplied nationwide context has no CPDO version; its current offering status was not established from the owner endpoint. It is retained here rather than replaced with a different examination."}
Reformation
Written licence and revocation history, reasons for return, evidence of reformation, professional activities, health records/releases where relevant; formal or informal Board hearing and discretionary restoration/monitoring.

Provisional Academic License

Licensing authority: North Carolina State Board of Examiners in Optometry

Initial Provisional Academic License

All of the following:

Clinical examination
Register and take or retake the next eligible NC clinical practicum.
Employment
Full-time clinical optometrist employed by a physically NC-located Board-approved optometry school with ACOE accreditation or Stage 2 accreditation application status.
Existing licences
All licences in good standing; disclose restrictions, surrender, discipline and investigations.
Fees
$300 initial and $100 for consecutive renewals as stated by the policy.
National examinations
NBEO I, II with TMOD and III skills/patient encounters, or parts offered in the graduation year; ISE is required to qualify for the full clinical practicum rather than as a pre-issuance academic requirement. Register for missing examinations at their next administration.
Practice limits
University clinics and grounds under university umbrella; actively enrolled students and formally appointed faculty; no greater scope than prior licence, no telemedicine. Injections require ISE pass and certified sponsor oversight.
Sponsorship
NC licensed faculty sponsor in good standing, five years of licensure subject to residency/equivalent-experience exception; both parties apply and acknowledge responsibility. Sponsor initially observes and thereafter provides appropriate chart oversight.
Term
Six months or clinical results, whichever first, at most two consecutive renewals contingent on next examination participation.
Consecutive renewal of a Provisional Academic License

All of the following:

Clinical examination
Register and take or retake the next eligible NC clinical practicum.
Employment
Full-time clinical optometrist employed by a physically NC-located Board-approved optometry school with ACOE accreditation or Stage 2 accreditation application status.
Existing licences
All licences in good standing; disclose restrictions, surrender, discipline and investigations.
Fees
$300 initial and $100 for consecutive renewals as stated by the policy.
National examinations
NBEO I, II with TMOD and III skills/patient encounters, or parts offered in the graduation year; ISE is required to qualify for the full clinical practicum rather than as a pre-issuance academic requirement. Register for missing examinations at their next administration.
Practice limits
University clinics and grounds under university umbrella; actively enrolled students and formally appointed faculty; no greater scope than prior licence, no telemedicine. Injections require ISE pass and certified sponsor oversight.
Sponsorship
NC licensed faculty sponsor in good standing, five years of licensure subject to residency/equivalent-experience exception; both parties apply and acknowledge responsibility. Sponsor initially observes and thereafter provides appropriate chart oversight.
Term
Six months or clinical results, whichever first, at most two consecutive renewals contingent on next examination participation.

North Carolina Clinical Practicum Examination

Examination outline
  • Adnexa/Lids/ Lacrimal/Conjunctiva/Cornea/Cataract
    • Acute External or Internal Hordeolum
    • Chalazion and Recurrent Chalazion
    • Lid Myokymia
    • Canaliculitis
    • Dacryocystitis
    • Dacryoadenitis
    • Congenital and Acquired Nasolacrimal Duct Obstruction
    • Contact Dermatitis (differentiate from viral conjunctivitis like EKC)
    • Cutaneous Herpes Simplex Virus
    • Recurrent Corneal Erosion (RCE)
    • Band Keratopathy
    • Dry Eye Disease - Keratitis Sicca, Meibomian Gland Disease, Sjogren’s Syndrome
    • Corneal Dystrophies
    • Corneal Dystrophies / Epithelial Dystrophy – ABMD/EBMD
    • Corneal Dystrophies / Corneal Stromal Dystrophies –
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Central Crystalline,
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Granular,
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Lattice,
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Macular,
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Meesmann's,
    • Corneal Stromal Dystrophies / Corneal Dystrophies / Reis-Buckler
    • Corneal Dystrophies / Fuch's Endothelial Dystrophy (Guttata)
    • Discussion: Important to all the Corneal Dystrophies is understanding genetic testing and knowing how to order and interpret genetic testing results and to make or confirm his/her diagnosis.
    • Preseptal Cellulitis
    • Orbital Cellulitis (Know how to differentiate Preseptal from Orbital Cellulitis and what the differentiating signs and symptoms are between the two)
    • Post-operative - PRK slowed epithelial Healing (diabetes)
    • Post-operative LASIK
    • Post-operative LASIK / Epithelial sloughing – Basement Membrane Dystrophy
    • Post-operative LASIK / Flap Slip
    • Post-operative LASIK / DLK
    • Post-operative LASIK / Epithelial Ingrowth with or without flap melt
    • Post-operative LASIK / Decentered Ablation following laser based refractive surgery
    • Post-operative LASIK / Induced Corneal Ectasia
    • Post-operative cataract surgery
    • Post-operative cataract surgery / Keratitis
    • Post-operative cataract surgery / Bullous Keratopathy – associated with endothelial cell loss
    • Post-operative cataract surgery / IOL Displacement
    • Post-operative cataract surgery / Endophthalmitis
    • Dellen and sequelae
    • Ocular Pemphigoid
    • Keratoconus / Keratoglobus
    • Epidemic Keratoconjunctivitis
    • Hemorrhagic Conjunctivitis
    • Pharyngoconjunctival Fever
    • Non – infectious Corneal Infiltrate
    • Staphylococcal Blepharitis with Marginal Ulcer / Chronic Meibomianitis
    • Superior Limbic Keratoconjunctivitis (SLK)
    • Thygeson's SPK
    • Vernal Keratoconjunctivitis
    • Cataracts – Nuclear Sclerosis, Cortical, Posterior Subcapsular, Hypermature
  • Diabetes
    • Presentations of Undiagnosed and Previously Diagnosed Conditions
    • Presentations of Unilateral (or greater severity in one eye) of Diabetic Retinopathy and related etiologies
    • Presentations of retinal conditions that Diabetes predisposes a patient to
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy / Understanding of disease states, pathophysiology, testing, treatments, progression and and prognosis.
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy / Understanding of ocular treatments and side effects/complications of treatment
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy / Understanding of appropriate monitoring of the patient undergoing a specific treatment.
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy / Understanding key eye research studies that led to establishing staging and treatment criteria
    • Diabetes Mellitus (Type 1 and Type 2) w/ and w/o Diabetic Retinopathy / Understanding of Classification and Criteria for staging of:
    • Classification and Criteria for staging / Non-Proliferative Diabetic Retinopathy (NPDR)
    • Classification and Criteria for staging / Proliferative Diabetic Retinopathy (PDR)
    • Classification and Criteria for staging / Clinically Significant Diabetic Macular Edema (CSDME)
    • Understanding of Associated Conditions:as well as pathophysiology and treatment/monitoring interval for those conditions:
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Refractive Changes
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Neuropathies
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Nerve palsies
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Glaucoma
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Retinal Detachment
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Cataracts
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Dry Eye
    • Associated Conditions: pathophysiology and treatment/monitoring interval / Etc.
  • Glaucoma (Primary, Secondary, and Angle Closure Glaucoma)
    • Ocular Hypertension/Glaucoma Suspect
    • Primary Open Angle Glaucoma
    • Normal-tension Glaucoma
    • Angle Recession/Angle Recession Glaucoma
    • Pseudoexfoliation/Pseudoexfoliative Glaucoma
    • Neovascular Glaucoma
    • Glaucomatocyclitic Crisis
    • Hemolytic and Ghost Cell Glaucoma
    • Malignant Glaucoma
    • Choroidal Detachment Following Glaucoma Filtering Surgery
    • Normotensive Glaucoma following corneal thinning refractive surgery
    • Narrow Angle/Acute Angle Closure Glaucoma
    • Phacolytic Glaucoma
    • Pharmacologically Induced Glaucoma
    • Pigmentary Glaucoma
    • Post-operative Elevated IOP
    • Post-operative Malignant Glaucoma
    • Blebitis
    • Uveitis-Glaucoma-Hyphema (UGH) Syndrome
    • Uveitic Glaucoma
    • Discussion:
    • The candidate needs to understand low and high risk (risk criteria for developing) for all types of Glaucoma
    • The candidate needs to understand mechanisms and pathogenesis, staging of disease, when to begin treatment, treatment options and modalities available (observation, laser, pharmacological and surgery, etc.)
    • The candidate needs to understand key eye research studies that led to establishing staging and treatment criteria
  • Infectious Keratitis
    • Acanthamoeba
    • Fungal Keratitis
    • HSK: Epithelial or Stromal
    • Neurotrophic Corneal Ulcer
    • Staphylococcal Central Corneal Ulcer
    • Streptococcal Central Corneal Ulcer
    • Pseudomonas Corneal Ulcer
    • Gonococcal Corneal Ulcer
    • Discussion: A patient presents to your clinic with unilateral discomfort/pain, redness and possible blurred vision. Evaluation shows some sort of corneal staining pattern. This should set the ball rolling with the following steps for assessment of the patient’s condition:
    • Subjective:
    • Discussion / Subjective / When did this start?
    • Discussion / Subjective / Is it getting better or worse?
    • Discussion / Subjective / Did you scratch or get something in your eye, if so, what, CLs wearer, etc.?
    • Discussion / Subjective / Any discharge, if so, what type and how much?
    • Discussion / Subjective / Did you put any drops in your eye, if so, what?
    • Discussion / Subjective / other questions as appropriate for the case and the patient’s previous responses
    • Objective:
    • Discussion / Objective / Assess other ocular vital signs as appropriate
    • Discussion / Objective / SLE – extensive evaluation of the lids, conjunctiva, cornea and anterior chamber. Evaluation of the cornea should include the lesion’s appearance and size, staining pattern with appropriate stain type, depth of lesion relative to the full corneal thickness, border and margins of the lesion, etc. (understanding the patient’s symptoms and signs, considering such things as pain, discharge, appearance of the lesion is vital in making the preliminary assessment)
    • Discussion / Objective / Other tests as indicated by the presentation of the case can be done
    • Discussion / Objective / Appropriate stains and dyes should be utilized to determine the infectious organism.
    • Appropriate stains and dyes / Discussion / Objective / Gram stain
    • Appropriate stains and dyes / Discussion / Objective / Calcofluor-white
    • Appropriate stains and dyes / Discussion / Objective / Giemsa stain
    • Appropriate stains and dyes / Discussion / Objective / Acid-fast stain
    • Discussion / Objective / Culturing the lesion – you should know why you are culturing the lesion; specimen collection techniques and culture media must be understood. It is always a good idea to run a full panel of cultures because your presumptive diagnosis could be incorrect and corneal presentations can be confusing. However, you should know and understand which infectious agents grow on which culture media and why. This should include the following medias:
    • Culture media / Discussion / Objective / Blood culture media
    • Culture media / Discussion / Objective / Chocolate culture media
    • Culture media / Discussion / Objective / Thioglycollate broth
    • Culture media / Discussion / Objective / Sabouraud culture media
    • Culture media / Discussion / Objective / Non nutrient agar with E Coli overlay
    • Culture media / Discussion / Objective / Viral cultures
    • Assessment: Based on the information obtained above, you should have made at least a preliminary diagnosis. While you may not know the specific pathogen, you should have some idea if the pathogen is bacterial, fungal, viral, amoeba or other. Knowing it takes a couple of days before culture and sensitivity results come back from the lab, you now need to manage the patient.
    • Plan:
    • Discussion / Plan / If you have what appears to be a bacterial central corneal ulcer with discharge, your options for treatment would likely be antibiotics. (Always remember to consider patient allergies before you start any antibiotic.) In this case you should know when fortified antibiotics are indicated. If so, the following could be considered: You should also know how the fortified are prescribed including dosage:
    • Discussion / Plan / Possible Fortified Antibiotics:
    • Possible Fortified Antibiotics / Discussion / Plan / Vancomycin (Gram +)
    • Possible Fortified Antibiotics / Discussion / Plan / Cefazolin (Gram +)
    • Possible Fortified Antibiotics / Discussion / Plan / Amikacin (Gram -)
    • Possible Fortified Antibiotics / Discussion / Plan / Tobramycin (Gram -)
    • Possible Fortified Antibiotics / Discussion / Plan / Gentamicin (Gram -)
    • Discussion / Plan / Other non-fortified topical antibiotics
    • Other non-fortified topical antibiotics / Discussion / Plan / Fluoroquinolones – not fortified.
    • Other non-fortified topical antibiotics / Discussion / Plan / Azithromycin
    • Other non-fortified topical antibiotics / Discussion / Plan / Trimethoprim/sulfamethoxazole
    • Discussion / Plan / Fungal, viral or otherwise, consider the appropriate anti-infective drug(s) and dose for the condition you suspect
    • Discussion / Plan / Other instructions to the patient, including setting the appropriate follow up appointment
    • Discussion: For the following bacteria, you should know the type of bacteria (gram + or -), characteristics of the bacteria such as their virulence, how antibiotics specifically work to eliminate the bacteria (bactericidal or bacteriostatic), what antibiotics they are traditionally sensitive to and why: Bacterial Cases
    • Bacterial Cases / Staphylococcus aureus
    • Bacterial Cases / Streptococcus pneumoniae
    • Bacterial Cases / Neisseria gonorrhea
    • Bacterial Cases / Pseudomonas aeruginosa
    • Other Bacteria with notable virulence
    • Other Bacteria with notable virulence / Corynebacterium diphtheriae
    • Other Bacteria with notable virulence / Listeria monocytogene]
    • Other Bacteria with notable virulence / Haemophilus aegyptius
  • Neuro-Ocular
    • Headaches
    • Headaches / Tension
    • Headaches / Cluster
    • Headaches / Migraine (Common, Classic and Acephalgic)
    • Headaches / Vascular or Neurological associated
    • Amiodarone Optic Neuropathy with or without Vortex Keratopathy
    • Pupil Abnormalities
    • Pupil Abnormalities / Adie's Tonic Pupil
    • Pupil Abnormalities / Horner's Syndrome
    • Pupil Abnormalities / Argyll Robertson Syndrome
    • Isolated 3rd Nerve Palsy - Pupil Involved
    • Isolated 3rd Nerve Palsy - Pupil Spared
    • Isolated 4th Nerve Palsy
    • Isolated 6th Nerve Palsy
    • Bell's Palsy / 7th Nerve Palsy – Central or Peripheral
    • Ischemic Optic Neuropathy
    • Ischemic Optic Neuropathy / Nonarteritic
    • Ischemic Optic Neuropathy / Arteritic
    • Transient Vision Loss / Amaurosis Fugax - Unilateral or Bilateral
    • Giant Cell Arteritis (GCA) / Temporal Arteritis
    • Cavernous Sinus Syndrome / Carotid Cavernous Fistula
    • Cerebral Space Occupying Lesion – Benign or Malignant
    • Cerebrovascular Accident – Involving Visual Pathway
    • Cerebrovascular Accident Midbrain (Pons / Medullary) Lesion
    • Cavernous Sinus Syndrome / Carotid Cavernous Fistula
    • Cerebral Space Occupying Lesion - Benign or Malignant
    • Cerebrovascular Accident – Midbrain (Pons / Medullary) Lesion
    • Cerebrovascular Accident - Visual Pathway
    • Drusen of the Optic Nerve
    • Essential Blepharospasm (Considering denervation therapy)
    • Nystagmus - Congenital or Acquired
    • Internuclear Ophthalmoplegia
    • Orbital Pseudotumor / Orbital Myositis
    • Papilledema
    • Papillitis / Optic Neuritis not demyelinating
    • PituitaryTumor
    • Pseudotumor Cerebri / Idiopathic Intracranial Hypertension (IIH)
    • Retrobulbar Optic Neuritis with or without Multiple Sclerosis
    • Toxic / Metabolic Neuropathy
    • Vertebrobasilar Artery Insufficiency
  • Ocular Manifestations of Systemic Disease
    • Chlamydial Inclusion
    • Collagen Vascular Disease – Rheumatoid Arthritis
    • Collagen Vascular Disease – Systemic Lupus Erythematosus (SLE)
    • Episcleritis – recurrent
    • Graves Ophthalmopathy
    • Leukemia
    • Lyme Disease
    • Marfan Syndrome
    • Myasthenia Gravis
    • Ocular Ischemic Disease
    • Ocular Manifestations of Pregnancy
    • Orbital Cellulitis
    • Scleritis – Initial or Recurrent - anterior and posterior scleritis, necrotizing and non-necrotizing scleritis
    • Sickle Cell Disease
    • Sjogren's Syndrome with severe dry eye / filamentary keratitis (how diagnosed)
    • Stevens Johnson Syndrome
    • Transient Vision Loss/Amaurosis Fugax/TIA – Unilateral or Bilateral
    • Discussion:
    • The candidate needs to understand the pathophysiology of each specific diagnosis and understand why the disease causes eye findings.
    • If a diagnosis or confirmatory diagnosis is made by specific testing, the candidate needs to know current testing protocols – example: a Tensilon test for MG is no longer performed, know the current diagnostic testing.
    • The candidate needs to know current treatment protocols – example: the current treatment for Thyroid Eye Disease is Tepezza – know its mechanism of action and side effects
  • Ocular Tumors
    • Basal Cell Carcinoma of Eyelid
    • Sebaceous Gland Carcinoma of the Eyelid
    • Squamous Cell Carcinoma of Eyelid
    • Squamous Cell Carcinoma of the Conjunctiva
    • Lacrimal Gland Mass / Chronic Dacryoadenitis
    • Conjunctival / Corneal Intraepithelial Neoplasia
    • Conjunctival / Orbital Lymphoma
    • Iris Cyst / Malignant Melanoma of the Iris
    • Kaposi Sarcoma
    • Malignant Melanoma of the Choroid
    • Orbital Tumor - Differentiating between Primary or Metastatic
    • Posterior Segment Metastatic Tumors in Adults
    • Retinoblastoma
    • Discussion:
    • The candidate needs to:
    • understand and be able to describe the morphology of external lesions using medical terminology
    • know the pathophysiology of tumors – at which cellular layer or from which type of cells are these tumors developing – examples: basal or squamous layer of the epithelium, melanocytes of choroid, or iris stroma, etc.
    • be familiar with specific genetic mutations or infections that can cause some of these tumors such as:
    • Genetic mutations or infections / Retinoblastoma - tumor suppressor gene mutation
    • Genetic mutations or infections / Herpes Simplex infection followed by compromised immune system
    • Genetic mutations or infections / Kaposi Sarcoma - genetic predisposition that causes neoplasm of vascular endothelium
    • know what diagnostic tools are available for further evaluating the internal characteristics or other features of these tumors? Understand how to interpret any data from these tests. A-scan, B-scan, anterior seg OCT, FA, UBM (ultrasound biomicroscopy), CT scan, MRI, fine needle aspiration biopsy, etc.
    • know characteristics that differentiate benign vs. malignant lesions .
    • Benign versus malignant lesions / understand the potential of malignant lesions to metastasize and if the the risk is high for metastasis
    • Benign versus malignant lesions / understand how and why lesions metastasize
    • Benign versus malignant lesions / understand typical patterns of metastasis - where specific lesions are likely to metastasize in the body - examples: spread of tumor cells in subarachnoid space and into the brain; spread of tumor cells through blood or lymph system to liver, orbit, brain, etc.
    • Benign versus malignant lesions / know which lesions invade the sclera or the cornea - why is that significant and how can you determine if that has occurred - example Conjunctival CIN
    • know which lesions have systemic associations - examples: Kaposi sarcoma and AIDS. Squamous cell carcinoma of eyelid and conjunctiva and HPV
    • certain lesions may have clinical characteristics to suggest being malignant - know the clinical signs that suggest a malignant lesion before a biopsy is considered - examples:. size, symptoms, presence of SRF, features on a-scan, b-scan, thickness, elevation, etc.
    • know the difference between lesions that develop from a preexisting benign condition or develop de novo i.e. new mutations without a preexisting condition - example: actinic keratosis developing into a squamous cell CA. If the lesion developed from a precursor, what actually happened so that it is now considered malignant and no longer benign?
    • know the risk factors for developing certain tumors - examples: genetic predisposition, UV, smoking, certain chemical exposure, light eyes/skin, systemic conditions, history of radiation exposure, history of other malignant lesions elsewhere, age, etc.
    • know when genetic counseling would be recommended
    • know to whom and when a referral should be made - examples: PCP/internist, Infectious disease, dermatology, oncology, etc.
    • know when to consider the need for a patient to have a systemic work-up for metastatic disease - examples: blood work, PET scan, MRI, etc. - if provided a radiological image, be able to interpret the image - example: be able to differentiate hilar adenopathy in sarcoidosis vs. TB findings or lung CA
    • understand how lesions, primary or metastatic, are treated
    • Treatment of primary or metastatic lesions / "excision" is not adequate - you need to know the basics of surgical techniques such as in mohs surgery.
    • Treatment of primary or metastatic lesions / the need for systemic or topical treatments including drugs and the basics for different types of radiation treatments.
  • Trauma
    • Thermal / Ultraviolet Keratopathy
    • Acid Burn with Corneal Involvement
    • Alkaline Burn with Corneal Involvement
    • Conjunctival Foreign Body
    • Corneal Foreign Body with Rust Ring
    • Corneal Abrasion
    • Corneal Abrasion / Non vegetative
    • Corneal Abrasion / Vegetative
    • Eyelid Laceration w/wo involvement of Lacrimal Drainage System or Levator
    • Conjunctival Laceration
    • Corneal Laceration (mid stroma requiring sutures)
    • Traumatic Iritis
    • Intraocular Foreign Body
    • Intraocular Foreign Body / Intraocular Foreign Body without Iris Prolapse or Incarceration
    • Intraocular Foreign Body / Intraorbital Foreign Body
    • Discussion: Critical: knowing appropriate tests to run, specifically CT scan and how to interpret
    • Orbital Blow-out Fracture
    • Penetrating Ocular Injury with or without
    • Penetrating Ocular Injury / Iris prolapse (+seidel)
    • Penetrating Ocular Injury / Vitreous prolapse
    • Hyphema
    • Hyphema / Post-operative
    • Hyphema / Traumatic
    • Traumatic Choroidal Rupture
    • Traumatic Retrobulbar Hemorrhage
    • Commotio Retinae
  • Uveitis
    • Idiopathic Iritis
    • Behcet's
    • Fuch's Heterochromic
    • Herpes Zoster Ophthalmicus
    • Recalcitrant Uveitis - HZV Ophthalmicus, etc.
    • Juvenile Idiopathic Arthritis
    • Intermediate and Posterior Uveitis - Pars Planitis
    • Posterior Uveitis secondary to AIDS with or without Kaposi Sarcoma
    • Post – op Anterior Uveitis
    • Post – op Hypopyon
    • Reactive Arthritis
    • Sarcoidosis
    • Sympathetic Ophthalmia
    • Toxoplasmosis
    • Uveitis – Ankylosing Spondylitis
    • Uveitis Associated with Acquired Syphilis with IK
    • Uveitis Associated with Tuberculosis
    • Uveitis Associated with Lyme Disease
    • Uveitis Associated with Systemic Lupus
    • Uveitis Associated with Crohn’s Disease
    • UVeitis Associated with Ulcerative Colitis
    • Uveitis Associated with Kawasaki disease
    • Uveitis Associated with Inflammatory Bowel Disease
    • Traumatic Uveitis
    • Uveitis- Candidiasis/Aspergillus
    • Uveitis Associated with Medication usage (Cidofovir, Rifabutin, Bisphosphonates, Brimonidine, Tyrosine kinase inhibitors)
    • Discussion:
    • Understanding and being able to differentiate between clinical presentations of non-granulomatous and granulomatous uveitis and be able to identify which systemic conditions present in each category
    • Understand and differentiate:
    • Discussion / Understand and differentiate / Anterior Chamber KP patterns - focal, central, disciform, Arlt’s triangle, stellate or diffuse, peripheral (rare)
    • Discussion / Understand and differentiate / Lesions - focal, multifocal, disseminated or diffuse
    • Discussion / Understand and differentiate / Associated findings - synechiae, fibrin and nodules
    • Discussion / Understand and differentiate / Chronology/duration of condition (acute, chronic, recurrent)
    • Discussion / Understand and differentiate / Understand anatomical location of uveitis, anterior/intermediate/posterior/panuveitis including subcategories iritis, posterior cyclitis, pars planitis, hyalitis, retinitis, retinochoroiditis, chorioretinitis, endophthalmitis
    • Discussion / Understand and differentiate / Complications of Uveitis including cataracts, high IOP, synechia, secondary glaucomas, CME, macular pucker, optic nerve swelling/damage detached retina, etc.
    • Underlying etiologies - understand the pathophysiology of underlying various systemic etiologies causing various forms of inflammatory uveitis
    • Understanding the indications for ordering and interpretation of labs, testing, and imaging when necessary to diagnose the underlying etiologies of the various forms of uveitis (KNOW YOUR LABS and IMAGING) - example: in Sarcoidosis be able to differentiate x-ray findings from other systemic pulmonary diseases
    • Understanding the treatment and management of both the systemic and ocular uveitic conditions
    • The Medscape article:”Uveitis Classification” is a good resource for review: https://emedicine.medscape.com/article/1208936-overview#a7
  • Vitreoretinal
    • Age Related Macular Degeneration (ARMD) dry/non-neovascular
    • Age Related Macular Degeneration (ARMD) wet/neovascular
    • Non-Age Related Non-Traumatic Maculopathy
    • Non-Age Related Non-Traumatic Maculopathy / Coloboma
    • Non-Age Related Non-Traumatic Maculopathy / Best vitelliform macular dystrophy
    • Non-Age Related Non-Traumatic Maculopathy / Stargardt maculopathy
    • Branch Retinal Artery Occlusion (BRAO)
    • Branch Retinal Vein Occlusion (BRVO)
    • Central Retinal Artery Occlusion (CRAO)
    • Central Retinal Vein Occlusion (CRVO)
    • Central Serous Choroidopathy
    • Chloroquine / Hydroxychloroquine Retinopathy
    • CME Associated with Cataract Surgery
    • Endophthalmitis
    • Endophthalmitis / Endogenous
    • Endophthalmitis / Exogenous
    • High Myopia with Retinal Degeneration (peripheral or macular) post staphyloma
    • Hypertensive Retinopathy secondary to chronic hypertension
    • Hypertensive Retinopathy secondary to malignant hypertension
    • Ocular Albinism
    • Optic Pit with Serous Detachment
    • Post-operative Hypotony with and without choroidal detachment
    • Post-operative Retinal Detachment
    • Preretinal or Vitreous Hemorrhage following High Suction Surgery (Lasik)
    • Posterior Vitreous Detachment (PVD) - Partial or Complete with or without Photopsia
    • Retinal Dialysis
    • Retinal Tear /Horseshoe Retinal Tear / Retinal Break
    • Presumed Ocular Histoplasmosis Syndrome (POHS)
    • Retinitis Pigmentosa
    • Retinoschisis
    • Rhegmatogenous Retinal Detachment
    • Tractional Retinal Detachment
    • Vitreoretinal-Macular Traction / Epiretinal Membrane / Macular Hole
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

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

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