NBEO PART 3 CORE MAIN EXAMS SET ALL
QUESTIONS AND ANSWERS SURE A+
✔✔Diabetic Ret - Testing - ✔✔Fundus photo, Mac OCT, IVFA (neo or perfusion
abnormalities), Gonio, A1C, BP
✔✔Diabetic Ret - Grading - ✔✔All stages may have CME. Mild - hemes. Moderate -
more hemes, CWS, or exudate. Severe - 4 quadrants of hemes, 2 of beading, 1 of
IRMA. Proliferative - NVD, NVE, NVI, or vitreous heme. High Risk Proliferative - NVD
>1/4 size of the nerve, or any NVD/NVE associated with pre-retinal or vitreous heme
✔✔Diabetic Ret - Treatment - ✔✔Refer for AntiVEGF for CME or NV, PRP for high risk
NV, Vitrectomy for persistent vitreous heme. Otherwise, Monitor.
✔✔Diabetic Ret - FU - ✔✔None - 12 mo. Mild - 6-9 mo. Moderate - 4-6 mo. Severe - 4-
6 mo. Proliferative - 2-3 mo.
✔✔Diabetic Ret - Education - ✔✔You have diabetic retinopathy. When your blood sugar
is high or fluctuating, it makes the small blood vessels in the back of the eye leaky.
Blood and protein start to leak out into the retina. It can also leak into the macula and
cause swelling, leading to blurry vision. I'm going to refer you to a retinal specialist - OR
- monitor. I'd like to see you in ___ months.
,✔✔Hypertensive Ret - Testing - ✔✔Fundus photo, BP, OCT-A, IVFA
✔✔Hypertensive Ret - Staging - ✔✔1 - Attenuation. 2 - AV crossing. 3 - CWS, hemes,
exudate, micro/macroaneurysms, VO/AO, neo, Elschnig spots. 4 - ONH edema,
macular star, venous engorgement.
✔✔Hypertensive Ret - Treatment - ✔✔Refer to PCP for better BP control. Refer to ER if
malignant HTN. Focal laser if leaking macroaneurysm
✔✔Hypertensive Ret - FU - ✔✔2-3 months
✔✔Hypertensive Ret - Education - ✔✔You have hypertensive retinopathy. Uncontrolled
high BP can lead to changes in the back of the eye such as bleeding, and can ultimately
cause vision loss if this continues long term. I'm going to refer you back to your PCP to
better control your BP.
✔✔RAO - Testing - ✔✔IVFA, gonio, BP, ESR/CRP/CBC, Carotid doppler, ECG
✔✔RAO - Treatment - ✔✔Refer for stroke workup, Refer to PCP for systemic
management, Monitor monthly for neovascularization. If recent onset, attempt gonio
massage, breathing into a paper bag, Acetazolamide 2 250mg tablets, Timolol 0.5%
q15 minutes.
✔✔RAO - FU - ✔✔q 3-4 weeks for next 6 mo to monitor for neovascularization if CRAO,
3-6 mo for BRAO
✔✔RAO - Education - ✔✔You have a RAO. A blockage in an artery in the back of your
eye has prevented blood flow and oxygen from reaching the retinal tissue. Without
blood flow, that tissue dyes off, leading to permanent vision loss. This may have been
caused by a blockage in your carotid artery or from heart valve disease. I want to send
you for urgent blood work and a carotid doppler to check for any blockages; if there is
an artery blockage in the back of the eye, there could also be one in the brain that could
lead to stroke. I also want you to FU with your PCP. I want to see you back in 1 month
to make sure there are no complications developing from this such as glaucoma.
✔✔RVO - Testing - ✔✔Mac OCT, IVFA, Gonio, BP, Lipid panel
✔✔RVO - Treatment - ✔✔Refer to PCP for cholesterol/BP management, Refer for
AntiVEGF, Monitor annually for neovascularization. Sector laser for NVE, Sector laser
and AntiVEGF for NVI, PPV for persistent vitreous heme.
✔✔RVO - FU - ✔✔q 3-4 weeks for next 6 mo. to monitor for neovascularization
, ✔✔RVO - Education - ✔✔You have a RVO. Due to either high blood pressure or
cholesterol, your arteries can become hardened. In the retina, those hard arteries can
compress a vein, leading to pooling of blood in the retina. It can also lead to swelling in
the macula, causing blurry vision. Your vision can improve with treatment, so I am
referring you for AntiVEGF injections to improve the swelling. I also want to refer you
back to your PCP for systemic management. I want to see you back in 1 month to make
sure there are no complications developing from this such as glaucoma.
✔✔OIS - Testing - ✔✔Mac OCT, IVFA, Gonio, BP, Carotid doppler, Carotid auscultation
✔✔OIS - Treatment - ✔✔Refer to PCP for systemic management. AntiVEGF for CME,
PRP and AntiVEGF for NVE/NVI, PPV for persistent vitreous heme.
✔✔OIS - FU - ✔✔q 3-4 weeks for next 6 mo. to monitor for neovascularization
✔✔OIS - Education - ✔✔You have a condition called venous stasis retinopathy, or OIS.
This is caused by a blockage in your carotid artery preventing adequate blood flow to
the retina. It presents as bleeding in the back of the eye, and it can eventually progress
to glaucoma. I need you to FU with your PCP to help manage your cholesterol/BP, and
I'm going to refer you for a carotid doppler to assess the blockage. I'm going to have
you follow up with me in 3-4 weeks for the next 6 months to make sure there are no
lasting complications from this such as glaucoma.
✔✔Lattice - Testing - ✔✔DFE with scleral depression
✔✔Lattice - Treatment - ✔✔Monitor, Barrier laser if holes develop, laser
photocoagulation, cryotherapy, or scleral buckle for RD
✔✔Lattice - FU - ✔✔6-12 mo
✔✔Lattice - Education - ✔✔You have some thinning and stretching of your retinal tissue
called lattice. This is very common with high prescriptions. Although lattice is a common
finding, it has a small risk of developing a hole or RD. You should watch out for any
flashing lights, new floaters, or missing parts of your vision. If that occurs, FU with us
immediately. Otherwise, we'll monitor you every 6-12 months.
✔✔ERM - Testing - ✔✔Mac OCT, Fundus photo, Amsler
✔✔ERM - Treatment - ✔✔Monitor, Amsler, Consider PPV with ILM peel if BCVA >20/40
or significant intraretinal cysts
✔✔ERM - FU - ✔✔6 - 12 mo
QUESTIONS AND ANSWERS SURE A+
✔✔Diabetic Ret - Testing - ✔✔Fundus photo, Mac OCT, IVFA (neo or perfusion
abnormalities), Gonio, A1C, BP
✔✔Diabetic Ret - Grading - ✔✔All stages may have CME. Mild - hemes. Moderate -
more hemes, CWS, or exudate. Severe - 4 quadrants of hemes, 2 of beading, 1 of
IRMA. Proliferative - NVD, NVE, NVI, or vitreous heme. High Risk Proliferative - NVD
>1/4 size of the nerve, or any NVD/NVE associated with pre-retinal or vitreous heme
✔✔Diabetic Ret - Treatment - ✔✔Refer for AntiVEGF for CME or NV, PRP for high risk
NV, Vitrectomy for persistent vitreous heme. Otherwise, Monitor.
✔✔Diabetic Ret - FU - ✔✔None - 12 mo. Mild - 6-9 mo. Moderate - 4-6 mo. Severe - 4-
6 mo. Proliferative - 2-3 mo.
✔✔Diabetic Ret - Education - ✔✔You have diabetic retinopathy. When your blood sugar
is high or fluctuating, it makes the small blood vessels in the back of the eye leaky.
Blood and protein start to leak out into the retina. It can also leak into the macula and
cause swelling, leading to blurry vision. I'm going to refer you to a retinal specialist - OR
- monitor. I'd like to see you in ___ months.
,✔✔Hypertensive Ret - Testing - ✔✔Fundus photo, BP, OCT-A, IVFA
✔✔Hypertensive Ret - Staging - ✔✔1 - Attenuation. 2 - AV crossing. 3 - CWS, hemes,
exudate, micro/macroaneurysms, VO/AO, neo, Elschnig spots. 4 - ONH edema,
macular star, venous engorgement.
✔✔Hypertensive Ret - Treatment - ✔✔Refer to PCP for better BP control. Refer to ER if
malignant HTN. Focal laser if leaking macroaneurysm
✔✔Hypertensive Ret - FU - ✔✔2-3 months
✔✔Hypertensive Ret - Education - ✔✔You have hypertensive retinopathy. Uncontrolled
high BP can lead to changes in the back of the eye such as bleeding, and can ultimately
cause vision loss if this continues long term. I'm going to refer you back to your PCP to
better control your BP.
✔✔RAO - Testing - ✔✔IVFA, gonio, BP, ESR/CRP/CBC, Carotid doppler, ECG
✔✔RAO - Treatment - ✔✔Refer for stroke workup, Refer to PCP for systemic
management, Monitor monthly for neovascularization. If recent onset, attempt gonio
massage, breathing into a paper bag, Acetazolamide 2 250mg tablets, Timolol 0.5%
q15 minutes.
✔✔RAO - FU - ✔✔q 3-4 weeks for next 6 mo to monitor for neovascularization if CRAO,
3-6 mo for BRAO
✔✔RAO - Education - ✔✔You have a RAO. A blockage in an artery in the back of your
eye has prevented blood flow and oxygen from reaching the retinal tissue. Without
blood flow, that tissue dyes off, leading to permanent vision loss. This may have been
caused by a blockage in your carotid artery or from heart valve disease. I want to send
you for urgent blood work and a carotid doppler to check for any blockages; if there is
an artery blockage in the back of the eye, there could also be one in the brain that could
lead to stroke. I also want you to FU with your PCP. I want to see you back in 1 month
to make sure there are no complications developing from this such as glaucoma.
✔✔RVO - Testing - ✔✔Mac OCT, IVFA, Gonio, BP, Lipid panel
✔✔RVO - Treatment - ✔✔Refer to PCP for cholesterol/BP management, Refer for
AntiVEGF, Monitor annually for neovascularization. Sector laser for NVE, Sector laser
and AntiVEGF for NVI, PPV for persistent vitreous heme.
✔✔RVO - FU - ✔✔q 3-4 weeks for next 6 mo. to monitor for neovascularization
, ✔✔RVO - Education - ✔✔You have a RVO. Due to either high blood pressure or
cholesterol, your arteries can become hardened. In the retina, those hard arteries can
compress a vein, leading to pooling of blood in the retina. It can also lead to swelling in
the macula, causing blurry vision. Your vision can improve with treatment, so I am
referring you for AntiVEGF injections to improve the swelling. I also want to refer you
back to your PCP for systemic management. I want to see you back in 1 month to make
sure there are no complications developing from this such as glaucoma.
✔✔OIS - Testing - ✔✔Mac OCT, IVFA, Gonio, BP, Carotid doppler, Carotid auscultation
✔✔OIS - Treatment - ✔✔Refer to PCP for systemic management. AntiVEGF for CME,
PRP and AntiVEGF for NVE/NVI, PPV for persistent vitreous heme.
✔✔OIS - FU - ✔✔q 3-4 weeks for next 6 mo. to monitor for neovascularization
✔✔OIS - Education - ✔✔You have a condition called venous stasis retinopathy, or OIS.
This is caused by a blockage in your carotid artery preventing adequate blood flow to
the retina. It presents as bleeding in the back of the eye, and it can eventually progress
to glaucoma. I need you to FU with your PCP to help manage your cholesterol/BP, and
I'm going to refer you for a carotid doppler to assess the blockage. I'm going to have
you follow up with me in 3-4 weeks for the next 6 months to make sure there are no
lasting complications from this such as glaucoma.
✔✔Lattice - Testing - ✔✔DFE with scleral depression
✔✔Lattice - Treatment - ✔✔Monitor, Barrier laser if holes develop, laser
photocoagulation, cryotherapy, or scleral buckle for RD
✔✔Lattice - FU - ✔✔6-12 mo
✔✔Lattice - Education - ✔✔You have some thinning and stretching of your retinal tissue
called lattice. This is very common with high prescriptions. Although lattice is a common
finding, it has a small risk of developing a hole or RD. You should watch out for any
flashing lights, new floaters, or missing parts of your vision. If that occurs, FU with us
immediately. Otherwise, we'll monitor you every 6-12 months.
✔✔ERM - Testing - ✔✔Mac OCT, Fundus photo, Amsler
✔✔ERM - Treatment - ✔✔Monitor, Amsler, Consider PPV with ILM peel if BCVA >20/40
or significant intraretinal cysts
✔✔ERM - FU - ✔✔6 - 12 mo
