NBEO Part III study guide
NBEO Part III · Work through your exam, one topic at a time.
Part III of the NBEO series is the Clinical Skills Examination (CSE), the performance-based stage of optometric licensure in the United States. Where the earlier computer-based parts test knowledge, Part III asks you to demonstrate it: you rotate through timed stations and perform procedures on standardized patients, instruments, and clinical models while examiners score your technique, sequencing, and communication. The NBEO Part III study guide has 11 sections and about 3,377 words.
01Patient History and Interviewing
The history station evaluates whether you can obtain a complete, organized history and respond to patient cues within a time limit. You are scored on the questions you ask, the order you ask them in, and the empathy you show while asking.
372 words, about 2 min02Visual Acuity and Refraction Procedures
Standard distance acuity is measured at 20 ft (6 m). Occlude the fellow eye without pressing on the globe, and verify the patient is not peeking.
332 words, about 2 min03Binocular Vision and Ocular Motility Testing
The cover test is the backbone of strabismus evaluation. With the patient fixating a distance target, cover one eye and watch the uncovered eye: movement from a deviated position toward fixation indicates a tropia.
321 words, about 2 min04Anterior Segment Evaluation and Slit Lamp Techniques
Align the patient's canthus with the height marker, forehead against the band, chin in the rest. Set the interpupillary distance, begin at low magnification with diffuse illumination, and focus with the joystick before increasing magnification.
306 words, about 2 min05Posterior Segment and Fundus Evaluation
Dilate when the clinical question requires it, such as diabetes, flashes and floaters, or suspected detachment. Tropicamide 1% with phenylephrine 2.5% is standard; check the angle first if the patient is at risk for closure.
327 words, about 2 min06Intraocular Pressure and Glaucoma Assessment
Anesthetize with proparacaine, stain with sodium fluorescein, and align the mires so their inner edges just touch, the standard endpoint. Calibrate the tonometer and record the time and instrument used.
286 words, about 1 min07Visual Field Assessment
Automated static perimetry (Humphrey 24-2 or 30-2, SITA Standard or Fast) is standard for glaucoma. The 24-2 tests 54 points within the central 24 degrees at 6-degree spacing; the 10-2 is used for advanced or macular disease.
293 words, about 1 min08Contact Lens Fitting and Evaluation
Start with keratometry, horizontal visible iris diameter, palpebral aperture, and tear film. Soft lenses typically have base curves of 8.0 to 9.5 mm and diameters of 13.8 to 14.5 mm; a good fit shows centration, full corneal coverage, 0.2 to 0.5 mm of movement on blink, and resistance on the push-up test.
275 words, about 1 min09Ophthalmic Optics and Lensometry
Neutralize the distance portion first: sphere, then cylinder axis, then cylinder power; then the near add. Confirm the optical center and measure binocular and monocular pupillary distances.
288 words, about 1 min10Ocular Pharmacology and Medication Administration
Topical drops are the mainstay. Wash hands, have the patient look up, pull the lower lid down to form a cul-de-sac, instill one drop without touching the tip to the eye or lashes, and apply punctal occlusion for 1 to 2 minutes.
283 words, about 1 min11Patient Communication, Professionalism, and Safety
Introduce yourself, wash your hands where the patient can see, confirm identity and the reason for the visit, and explain each step before performing it. Use open body language, sit at eye level, and avoid jargon ("pressure in the eye" rather than "intraocular hypertension").
294 words, about 1 min