NBEO Part 1 Exam Newest 2025/2026 Complete
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A 63-year old female is seen at your office with a chief concern of blurry vision in
the morning that takes about an hour to resolve before she can see clearly again.
Biomicroscopy reveals endothelial guttata. You correctly diagnose her with
moderate Fuch's dystrophy. Which ophthalmic drop would be of MOST benefit to
her? - CORRECT ANSWER-Sodium chloride is a topical hyperosmotic agent
used to relieve stromal edema caused by endothelial decompensation. Topical
steroids work well to decrease swelling caused by inflammation. In the above
case, the corneal edema is not mitigated by an inflammatory response.
Tobramycin and Vigamox would be of no benefit since there is no active infection,
and prescribing either of these would only lead to corneal toxicity or increased
pathogen resistance over time.
A 32-year old female is seen at your office complaining of a recent onset of
blurred vision, only at a distance. A thorough case history reveals that she
recently began taking a new medication which you correctly assume has induced
myopia. Which of the following medications is MOST likely to be the culprit? -
CORRECT ANSWER-Isotretinoin, birth control pills, and diuretics, among many
other drugs, can cause myopia in some patients. Myopia mostly likely results from
,corneal swelling, which steepens the curvature of the cornea. Drugs that cause
swelling of the lens, accommodative spasm, or edema of the ciliary body will also
result in myopia. A reduction in the dose of the medication or cessation of the
offending drug will usually result in reversal of nearsightedness. Fish oil, Tylenol,
and Tums have not been shown to have a correlation with transient myopia
development.
An increased rate of molecular movement down its respective concentration
gradient via help from carrier proteins refers to which type of transportation? -
CORRECT ANSWER-Facilitated diffusion is described as the net movement of
molecules down its concentration gradient whose rate of diffusion is increased via
the use of carrier proteins. Passive diffusion refers to the movement of molecules
through a plasma membrane from an area of high concentration to an area of low
concentration without the use of carrier molecules. Active transport implies the
movement of material against its respective concentration gradient. This type of
transport requires energy and enlists the use of specific carrier proteins. Lastly,
group translocation is defined as the chemical modification of a molecule while it
is being transported into a cell; for example, sugars are often phosphorylated
during transportation.
A 24-year old female patient presents at your office complaining of side effects
that began when she started using Patanol to treat her ocular allergies. She
reports complete compliance with her eye drop administration. Which of the
following symptoms is MOST likely associated with olopatadine (Patanol) use? -
,CORRECT ANSWER-Topical antihistamines and mast cell stabilizers such as
Patanol (olopatadine) are commonly prescribed to relieve the symptoms
associated with ocular allergies. They are a very effective class of medication due
to their dual action mechanisms. Topical antihistamines that possess this dual
action are olopatadine (Patanol), ketotifen fumarate (Zaditor), azelastine
(Optivar), and epinastine (Elestat). The aforementioned drops serve to alleviate
itching and redness by blocking H1 receptors as well as inhibiting mast cell and
basophil degranulation. Side effects of topical antihistamine/mast cell stabilizers
include stinging upon instillation, headaches, and adverse taste (don't forget to
inform your patients about punctual occlusion!). Tachycardia, depression,
gastrointestinal discomfort, and visual hallucinations have not been reported with
Patanol use.
A deficiency of which vitamin leads to prolonged dark adaptation? - CORRECT
ANSWER-A deficiency of vitamin A causes prolonged dark adaptation. Vitamin A
is classified as a retinoid, and its active form is retinol. Retinol is necessary for the
formation of rhodopsin, a pigment used by rods. Rods are most active in
situations with dim illumination. Less rhodopsin results in fewer rods being able
to respond in low levels of light, causing prolonged dark adaption.
+1.50-1.50 x 090 is required to neutralize a reflex in retinoscopy with a working
distance of 50 cm. What is the resulting NET retinoscopy finding? - CORRECT
ANSWER-A working distance of 50 cm creates a divergent wave of 2.00 D that is
neutralized by retinoscopy in addition to the patient's refractive error. Therefore,
, + 2.00 D must be subtracted from the spherical portion of the findings. To
determine how much to subtract from the gross findings, one must first calculate
the reciprocal of the working distance in meters. In our case, 1/0.5 = 2. Therefore
+1.50 (the spherical gross findings) -2 = -0.50-1.50 x 090. Remember NET is the
final result, this is found after the working distance has been accounted for by
subtracting the working distance from the spherical portion of the findings.
A ray of light traveling in water (n=1.33) strikes a flat, transparent surface (n=
1.59) at an angle of 32 degrees from the normal. What is the angle of refraction? -
CORRECT ANSWER-Snell's law of refraction states that when light travels
through a material that possesses an index of refraction greater than 1.0, the light
rays change direction and become bent (or refracted). Snell's law is depicted as
the following: n sin i= n' sin i' where n= the index of refraction of the first medium,
i= the angle of incidence, n'= the index of the second medium, and i' = the angle
of the refracted ray. All angles are measured with respect to the normal, which
lies perpendicular to the interface between the different media. For the above
example, 1.33(sin 32)=1.59 sin i', solving for i'= 26.31 degrees. It is important to
commit the index of refraction of water to memory; it is 1.33.
A central retinal artery occlusion (CRAO) causes tremendous damage to the
retina. How will the electroretinogram (ERG) of a person who has suffered a CRAO
be affected? - CORRECT ANSWER-A central retinal artery occlusion will cause a
loss of the b-wave which is formed by responses from the bipolar and Muller cells,
both of which are nourished by the central retinal artery. The a-wave results from
Questions and Correct Detailed Answers Already
Graded A+|Assured Success
A 63-year old female is seen at your office with a chief concern of blurry vision in
the morning that takes about an hour to resolve before she can see clearly again.
Biomicroscopy reveals endothelial guttata. You correctly diagnose her with
moderate Fuch's dystrophy. Which ophthalmic drop would be of MOST benefit to
her? - CORRECT ANSWER-Sodium chloride is a topical hyperosmotic agent
used to relieve stromal edema caused by endothelial decompensation. Topical
steroids work well to decrease swelling caused by inflammation. In the above
case, the corneal edema is not mitigated by an inflammatory response.
Tobramycin and Vigamox would be of no benefit since there is no active infection,
and prescribing either of these would only lead to corneal toxicity or increased
pathogen resistance over time.
A 32-year old female is seen at your office complaining of a recent onset of
blurred vision, only at a distance. A thorough case history reveals that she
recently began taking a new medication which you correctly assume has induced
myopia. Which of the following medications is MOST likely to be the culprit? -
CORRECT ANSWER-Isotretinoin, birth control pills, and diuretics, among many
other drugs, can cause myopia in some patients. Myopia mostly likely results from
,corneal swelling, which steepens the curvature of the cornea. Drugs that cause
swelling of the lens, accommodative spasm, or edema of the ciliary body will also
result in myopia. A reduction in the dose of the medication or cessation of the
offending drug will usually result in reversal of nearsightedness. Fish oil, Tylenol,
and Tums have not been shown to have a correlation with transient myopia
development.
An increased rate of molecular movement down its respective concentration
gradient via help from carrier proteins refers to which type of transportation? -
CORRECT ANSWER-Facilitated diffusion is described as the net movement of
molecules down its concentration gradient whose rate of diffusion is increased via
the use of carrier proteins. Passive diffusion refers to the movement of molecules
through a plasma membrane from an area of high concentration to an area of low
concentration without the use of carrier molecules. Active transport implies the
movement of material against its respective concentration gradient. This type of
transport requires energy and enlists the use of specific carrier proteins. Lastly,
group translocation is defined as the chemical modification of a molecule while it
is being transported into a cell; for example, sugars are often phosphorylated
during transportation.
A 24-year old female patient presents at your office complaining of side effects
that began when she started using Patanol to treat her ocular allergies. She
reports complete compliance with her eye drop administration. Which of the
following symptoms is MOST likely associated with olopatadine (Patanol) use? -
,CORRECT ANSWER-Topical antihistamines and mast cell stabilizers such as
Patanol (olopatadine) are commonly prescribed to relieve the symptoms
associated with ocular allergies. They are a very effective class of medication due
to their dual action mechanisms. Topical antihistamines that possess this dual
action are olopatadine (Patanol), ketotifen fumarate (Zaditor), azelastine
(Optivar), and epinastine (Elestat). The aforementioned drops serve to alleviate
itching and redness by blocking H1 receptors as well as inhibiting mast cell and
basophil degranulation. Side effects of topical antihistamine/mast cell stabilizers
include stinging upon instillation, headaches, and adverse taste (don't forget to
inform your patients about punctual occlusion!). Tachycardia, depression,
gastrointestinal discomfort, and visual hallucinations have not been reported with
Patanol use.
A deficiency of which vitamin leads to prolonged dark adaptation? - CORRECT
ANSWER-A deficiency of vitamin A causes prolonged dark adaptation. Vitamin A
is classified as a retinoid, and its active form is retinol. Retinol is necessary for the
formation of rhodopsin, a pigment used by rods. Rods are most active in
situations with dim illumination. Less rhodopsin results in fewer rods being able
to respond in low levels of light, causing prolonged dark adaption.
+1.50-1.50 x 090 is required to neutralize a reflex in retinoscopy with a working
distance of 50 cm. What is the resulting NET retinoscopy finding? - CORRECT
ANSWER-A working distance of 50 cm creates a divergent wave of 2.00 D that is
neutralized by retinoscopy in addition to the patient's refractive error. Therefore,
, + 2.00 D must be subtracted from the spherical portion of the findings. To
determine how much to subtract from the gross findings, one must first calculate
the reciprocal of the working distance in meters. In our case, 1/0.5 = 2. Therefore
+1.50 (the spherical gross findings) -2 = -0.50-1.50 x 090. Remember NET is the
final result, this is found after the working distance has been accounted for by
subtracting the working distance from the spherical portion of the findings.
A ray of light traveling in water (n=1.33) strikes a flat, transparent surface (n=
1.59) at an angle of 32 degrees from the normal. What is the angle of refraction? -
CORRECT ANSWER-Snell's law of refraction states that when light travels
through a material that possesses an index of refraction greater than 1.0, the light
rays change direction and become bent (or refracted). Snell's law is depicted as
the following: n sin i= n' sin i' where n= the index of refraction of the first medium,
i= the angle of incidence, n'= the index of the second medium, and i' = the angle
of the refracted ray. All angles are measured with respect to the normal, which
lies perpendicular to the interface between the different media. For the above
example, 1.33(sin 32)=1.59 sin i', solving for i'= 26.31 degrees. It is important to
commit the index of refraction of water to memory; it is 1.33.
A central retinal artery occlusion (CRAO) causes tremendous damage to the
retina. How will the electroretinogram (ERG) of a person who has suffered a CRAO
be affected? - CORRECT ANSWER-A central retinal artery occlusion will cause a
loss of the b-wave which is formed by responses from the bipolar and Muller cells,
both of which are nourished by the central retinal artery. The a-wave results from
