NBEO Part 3 PEPS– Clinical Skills Study
Guide & Exam Preparation with Answers
Question 1
Staph Marginal Keratitis - Education
Correct Answer
You have a condition called Staph marginal keratitis. The natural bacteria that exist
on your eyelids 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.
Question 2
Herpes Simplex Keratitis (HSV) - Education
Correct Answer
You have a viral infection of your cornea. You may also experience cold sores, as it is
caused by the same virus that leads to those. This infection may recur in the future
as the virus lies dormant in your body and can re-activate. I'm going to put you on
an antiviral and I'd like to see you back in 5-7 days to make sure it is healing well. I
also rcmnd using PFATs for comfort. If this happens again, RTO. We may need to
keep you on a low dose antiviral long term if this keeps happening.
Question 3
Chalazion - Treatment
Correct Answer
Warm compresses with lid massage bid-qid, Lid scrubs, PFATs
Question 4
ONH Drusen - FU
Correct Answer
q 6-12 mo
Page 1 of 64
,Question 5
Adult Inclusion Conjunctivitis - FU
Correct Answer
2-3 days
Question 6
RP - Testing
Correct Answer
Fundus photo, Mac OCT, FAF (ONH drusen), ERG, EOG, Goldmann VF, Genetic
testing for RPE-65
Question 7
AMD - FU
Correct Answer
Dry - 6-12 months. Wet - 1 mo or after release from retina
Question 8
Optic Neuritis - Education
Correct Answer
You have a condition called optic neuritis. This means that the optic nerve
connecting your eye to your brain is swollen, leading to your blurry vision. Your
vision will return after the swelling has gone down. However, this kind of swelling is
often associated with MS. MS is an autoimmune disease in which your body's own
immune system attacks your tissues and nervous system. It's important that we refer
you for an MRI and to a neurologist to help make that diagnosis. I'd like to see you
back in 1 month, and we'll check your vision every 3-6 months from here on out.
Question 9
RCE/EBMD - FU
Correct Answer
1 day for BCL, Otherwise 3-4 weeks
Page 2 of 64
,Question 10
Pterygium - Testing
Correct Answer
NaFl, A-seg photo to document growth
Question 11
GPC - Testing
Correct Answer
NaFl, Lid eversion
Question 12
RP - Education
Correct Answer
You have a genetic condition called RP that leads to progressive vision loss over
time. Your peripheral and night vision is lost first, and you may slowly lose your
central vision as well. You are also more prone to developing cataracts and swelling
in the retina, which can impact the vision. First we want to refer you for genetic
testing to see if you are a candidate for gene therapy. Vitamin A has also been
found to help slow down progression. I also want to refer you to a low vision
specialist and occupational therapists, as they can get you devices and training that
can help you see and navigate the world better. I'd like to see you every 6-12
months, but RTO sooner if your vision worsens suddenly.
Question 13
Adie Tonic Pupil - Treatment
Correct Answer
0.125% Pilocarpine bid-qid to help with accommodation and cosmesis, Cosmetic CL,
sunglasses
Page 3 of 64
, Question 14
OHTN - FU
Correct Answer
RTC 4 weeks after starting med for IOP (esp PG or β-blocker), otherwise RTC 3-6
months for repeat IOP
Question 15
Non-Granulomatous Uveitis - Testing
Correct Answer
NaFl, Anterior chamber evaluation, Macular OCT, DFE, Gonio, Bloodwork if bilateral
or recurrent (HLAB27, ANA, RF, ESR, CRP, Lyme antibody titer (ELISA))
Question 16
CSR - Testing
Correct Answer
Mac-OCT, IVFA (smoke-stack)
Question 17
CHRPE - Education
Correct Answer
You have a CHRPE, which is a pigmented area of the retina and a benign finding
that you were likely born with. We'll continue to monitor it yearly.
Question 18
Hypertensive Ret - FU
Correct Answer
2-3 months
Page 4 of 64
Guide & Exam Preparation with Answers
Question 1
Staph Marginal Keratitis - Education
Correct Answer
You have a condition called Staph marginal keratitis. The natural bacteria that exist
on your eyelids 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.
Question 2
Herpes Simplex Keratitis (HSV) - Education
Correct Answer
You have a viral infection of your cornea. You may also experience cold sores, as it is
caused by the same virus that leads to those. This infection may recur in the future
as the virus lies dormant in your body and can re-activate. I'm going to put you on
an antiviral and I'd like to see you back in 5-7 days to make sure it is healing well. I
also rcmnd using PFATs for comfort. If this happens again, RTO. We may need to
keep you on a low dose antiviral long term if this keeps happening.
Question 3
Chalazion - Treatment
Correct Answer
Warm compresses with lid massage bid-qid, Lid scrubs, PFATs
Question 4
ONH Drusen - FU
Correct Answer
q 6-12 mo
Page 1 of 64
,Question 5
Adult Inclusion Conjunctivitis - FU
Correct Answer
2-3 days
Question 6
RP - Testing
Correct Answer
Fundus photo, Mac OCT, FAF (ONH drusen), ERG, EOG, Goldmann VF, Genetic
testing for RPE-65
Question 7
AMD - FU
Correct Answer
Dry - 6-12 months. Wet - 1 mo or after release from retina
Question 8
Optic Neuritis - Education
Correct Answer
You have a condition called optic neuritis. This means that the optic nerve
connecting your eye to your brain is swollen, leading to your blurry vision. Your
vision will return after the swelling has gone down. However, this kind of swelling is
often associated with MS. MS is an autoimmune disease in which your body's own
immune system attacks your tissues and nervous system. It's important that we refer
you for an MRI and to a neurologist to help make that diagnosis. I'd like to see you
back in 1 month, and we'll check your vision every 3-6 months from here on out.
Question 9
RCE/EBMD - FU
Correct Answer
1 day for BCL, Otherwise 3-4 weeks
Page 2 of 64
,Question 10
Pterygium - Testing
Correct Answer
NaFl, A-seg photo to document growth
Question 11
GPC - Testing
Correct Answer
NaFl, Lid eversion
Question 12
RP - Education
Correct Answer
You have a genetic condition called RP that leads to progressive vision loss over
time. Your peripheral and night vision is lost first, and you may slowly lose your
central vision as well. You are also more prone to developing cataracts and swelling
in the retina, which can impact the vision. First we want to refer you for genetic
testing to see if you are a candidate for gene therapy. Vitamin A has also been
found to help slow down progression. I also want to refer you to a low vision
specialist and occupational therapists, as they can get you devices and training that
can help you see and navigate the world better. I'd like to see you every 6-12
months, but RTO sooner if your vision worsens suddenly.
Question 13
Adie Tonic Pupil - Treatment
Correct Answer
0.125% Pilocarpine bid-qid to help with accommodation and cosmesis, Cosmetic CL,
sunglasses
Page 3 of 64
, Question 14
OHTN - FU
Correct Answer
RTC 4 weeks after starting med for IOP (esp PG or β-blocker), otherwise RTC 3-6
months for repeat IOP
Question 15
Non-Granulomatous Uveitis - Testing
Correct Answer
NaFl, Anterior chamber evaluation, Macular OCT, DFE, Gonio, Bloodwork if bilateral
or recurrent (HLAB27, ANA, RF, ESR, CRP, Lyme antibody titer (ELISA))
Question 16
CSR - Testing
Correct Answer
Mac-OCT, IVFA (smoke-stack)
Question 17
CHRPE - Education
Correct Answer
You have a CHRPE, which is a pigmented area of the retina and a benign finding
that you were likely born with. We'll continue to monitor it yearly.
Question 18
Hypertensive Ret - FU
Correct Answer
2-3 months
Page 4 of 64
