NBEO Part 3 - PEPS TEST QUESTIONS AND
CORRECT ANSWERS UPDATED
Question 1
OIS - Education
Correct Answer
You have a condition called venous stasis retinopathy, or Ocular Ischemic Syndrome.
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 once a month for the next 6
months to make sure there are no lasting complications from this such as glaucoma.
Question 2
OIS - Testing and orders
Correct Answer
Mac OCT (retinal atrophy, thinner choroid), IVFA (delayed filling), Gonio (if been
about a month), BP
Order Carotid doppler, Carotid auscultation, MRI/MRA of neck
Question 3
CSR - Education
Correct Answer
You have fluid buildup in the macula leading to blurry vision. This can be caused by
OTC/Rx steroid use, viagra, stress, or pregnancy. This should resolve on its own or
with the d/c of steroid/viagra or end of pregnancy. If due to stress, it is important to
find ways to relax on a daily basis (yoga, meditation, journaling, etc.). I'd like to see
you back in 6 weeks to monitor
Page 1 of 77
,Question 4
Myasthenia Gravis - FU
Correct Answer
4 months
Question 5
PAM - Testing
Correct Answer
A-Seg photo (flat, brown, (-) cysts)
Question 6
Pterygium - Education
Correct Answer
You have a growth on the white part of your eye that is caused by sun exposure. It is
beginning to grow onto the cornea, which may impact your vision down the line. It
is important to wear UV protection when outside to prevent it from getting worse. If
it starts to grow into the center of your cornea, or if you need cataract surgery, it
will need to be removed surgically. Until then, I'll continue to monitor it yearly.
Question 7
Xanthelasma - Treatment
Correct Answer
Refer to PCP for management of high cholesterol; Removal with bichloracetic or
trichloracetic acid, tobradex ointment tid x 1 week
Question 8
Canaliculitis - Symptoms, signs, and testing
Correct Answer
Sx: watering, redness, tender nasally
S: pouting puncta, focal nasal injection, punctal discharge
Tx: NaFl, Punctal expression (mucoid/concretion discharge)
Page 2 of 77
,Question 9
Blepharitis - Treatment
Correct Answer
Lid scrubs, hot compresses for 10-15 min qd, PFATs, hypochlorous acid spray,
omega-3 diet, XDEMVY bid for 6 weeks if demodex
Question 10
ONH Drusen -Symptoms and signs
Correct Answer
Sx: none
S: ON that is not round, could look edematous, but it is not.
Question 11
Dacryocystitis - Education
Correct Answer
You have an infection in the drainage system of your eye that helps drain your tears.
This may have been caused by a blockage in the drainage system, which then got
infected over time. I am going to have you use warm compresses at home four
times per day and take an oral antibiotic. I'd like to see you back in 1-2 days to
make sure the infection is improving. In 1-2 weeks, I'd like for you to RTO so that I
can perform a D&I that will flush out the blockage and prevent this from happening
again.
Question 12
OHTN - Treatment
Correct Answer
Monitor if <24, consider tx if 24-30, tx if >30; Start with latanoprost 0.05% qhs ou
Question 13
NLDO - FU
Correct Answer
1 month
Page 3 of 77
, Question 14
Macular hole -symptoms and signs at diff. stages
Correct Answer
Sx: Reduced VA, metamorphopsia, central scotoma
S: Different stages 1: impending -VMT, loss of foveal depression, small yellow foveal
spot or ring; 2: VMT, <400 micron break, decreased VA; 3: VMT, >400 microns
break, fluid cuff, VA 20/100 or worse; 4: PVD complete, yellow at base
Question 15
AACG - Treatment
Correct Answer
3 drops, 1 drop every 15 min (Apraclonidine 0.5%, Timolol 0.5%, Dorzolamide 2%) -
&/OR - Acetazolamide PO 250mg x2. Recheck IOP in 1 hour and repeat drops if still
high. Once the cornea is clear, perform LPI. Send home on Acetazolamide 250mg
bid and Timolol 0.5% bid
Question 16
Bacterial Conjunctivitis - Education
Correct Answer
You have a bacterial infection of the front part of your eye. I'm going to recommend
you use this antibiotic eye drop four times per day and I'd like to see you back in 2
days to make sure it is resolving. Make sure to have good hand washing hygiene
and try not to touch the eye to avoid spreading the infection.
Question 17
Staph Marginal Keratitis - Education
Correct Answer
You have a condition called Staph marginal keratitis. The bacteria that exist on your
eyelids as part of your normal flora are causing an inflammatory reaction on your
cornea. This can lead to frequent styes, as well as scarring on the cornea. I'm going
to recommend you use an antibiotic and steroid drop, as well as lid scrubs and
warm compresses. If this continues to occur, we may put you on a low dose oral
antibiotic long term.
Page 4 of 77
CORRECT ANSWERS UPDATED
Question 1
OIS - Education
Correct Answer
You have a condition called venous stasis retinopathy, or Ocular Ischemic Syndrome.
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 once a month for the next 6
months to make sure there are no lasting complications from this such as glaucoma.
Question 2
OIS - Testing and orders
Correct Answer
Mac OCT (retinal atrophy, thinner choroid), IVFA (delayed filling), Gonio (if been
about a month), BP
Order Carotid doppler, Carotid auscultation, MRI/MRA of neck
Question 3
CSR - Education
Correct Answer
You have fluid buildup in the macula leading to blurry vision. This can be caused by
OTC/Rx steroid use, viagra, stress, or pregnancy. This should resolve on its own or
with the d/c of steroid/viagra or end of pregnancy. If due to stress, it is important to
find ways to relax on a daily basis (yoga, meditation, journaling, etc.). I'd like to see
you back in 6 weeks to monitor
Page 1 of 77
,Question 4
Myasthenia Gravis - FU
Correct Answer
4 months
Question 5
PAM - Testing
Correct Answer
A-Seg photo (flat, brown, (-) cysts)
Question 6
Pterygium - Education
Correct Answer
You have a growth on the white part of your eye that is caused by sun exposure. It is
beginning to grow onto the cornea, which may impact your vision down the line. It
is important to wear UV protection when outside to prevent it from getting worse. If
it starts to grow into the center of your cornea, or if you need cataract surgery, it
will need to be removed surgically. Until then, I'll continue to monitor it yearly.
Question 7
Xanthelasma - Treatment
Correct Answer
Refer to PCP for management of high cholesterol; Removal with bichloracetic or
trichloracetic acid, tobradex ointment tid x 1 week
Question 8
Canaliculitis - Symptoms, signs, and testing
Correct Answer
Sx: watering, redness, tender nasally
S: pouting puncta, focal nasal injection, punctal discharge
Tx: NaFl, Punctal expression (mucoid/concretion discharge)
Page 2 of 77
,Question 9
Blepharitis - Treatment
Correct Answer
Lid scrubs, hot compresses for 10-15 min qd, PFATs, hypochlorous acid spray,
omega-3 diet, XDEMVY bid for 6 weeks if demodex
Question 10
ONH Drusen -Symptoms and signs
Correct Answer
Sx: none
S: ON that is not round, could look edematous, but it is not.
Question 11
Dacryocystitis - Education
Correct Answer
You have an infection in the drainage system of your eye that helps drain your tears.
This may have been caused by a blockage in the drainage system, which then got
infected over time. I am going to have you use warm compresses at home four
times per day and take an oral antibiotic. I'd like to see you back in 1-2 days to
make sure the infection is improving. In 1-2 weeks, I'd like for you to RTO so that I
can perform a D&I that will flush out the blockage and prevent this from happening
again.
Question 12
OHTN - Treatment
Correct Answer
Monitor if <24, consider tx if 24-30, tx if >30; Start with latanoprost 0.05% qhs ou
Question 13
NLDO - FU
Correct Answer
1 month
Page 3 of 77
, Question 14
Macular hole -symptoms and signs at diff. stages
Correct Answer
Sx: Reduced VA, metamorphopsia, central scotoma
S: Different stages 1: impending -VMT, loss of foveal depression, small yellow foveal
spot or ring; 2: VMT, <400 micron break, decreased VA; 3: VMT, >400 microns
break, fluid cuff, VA 20/100 or worse; 4: PVD complete, yellow at base
Question 15
AACG - Treatment
Correct Answer
3 drops, 1 drop every 15 min (Apraclonidine 0.5%, Timolol 0.5%, Dorzolamide 2%) -
&/OR - Acetazolamide PO 250mg x2. Recheck IOP in 1 hour and repeat drops if still
high. Once the cornea is clear, perform LPI. Send home on Acetazolamide 250mg
bid and Timolol 0.5% bid
Question 16
Bacterial Conjunctivitis - Education
Correct Answer
You have a bacterial infection of the front part of your eye. I'm going to recommend
you use this antibiotic eye drop four times per day and I'd like to see you back in 2
days to make sure it is resolving. Make sure to have good hand washing hygiene
and try not to touch the eye to avoid spreading the infection.
Question 17
Staph Marginal Keratitis - Education
Correct Answer
You have a condition called Staph marginal keratitis. The bacteria that exist on your
eyelids as part of your normal flora are causing an inflammatory reaction on your
cornea. This can lead to frequent styes, as well as scarring on the cornea. I'm going
to recommend you use an antibiotic and steroid drop, as well as lid scrubs and
warm compresses. If this continues to occur, we may put you on a low dose oral
antibiotic long term.
Page 4 of 77
