NBEO Part III study plan

NBEO Part III · Give each week a clear focus.

8 weeks · About 7 hours per week

Week 1

Visual Acuity and Refraction Procedures & Ophthalmic Optics and Lensometry

Perform and narrate a full subjective refraction sequence (sphere, cylinder, axis, binocular balance) on a partner in under 15 minutes
Demonstrate streak retinoscopy on a schematic eye and on a partner, correctly neutralizing both meridians and recording the working-distance correction
Read and verify 20 lens powers with a manual lensometer, including spherocylinders, prism, and axis orientation, to within 0.125 D
Explain and demonstrate vertex distance conversion and its effect on high-power lenses
Convert 15 prescriptions between plus-cylinder and minus-cylinder notation without error

A timed video or self-scored checklist log of 5 complete refractions plus 20 lensometry readings with a written error tally

Week 2

Set up and align a slit lamp from scratch, adjusting illumination, magnification, and patient positioning independently
Execute diffuse, direct focal, retroillumination, sclerotic scatter, and Van Herick techniques on 10 patients or partners
Grade corneal edema, cells and flare, and anterior chamber angle depth using standardized scales
Prepare and instill topical anesthetic, fluorescein, and mydriatic drops with correct technique and documentation
State the mechanism, concentration, and key contraindication for each topical diagnostic drug used in the exam room

A completed slit lamp technique checklist for 10 examinations with anterior chamber grading recorded for each

Week 3

Measure and record cover test at distance and near, including alternate cover, with prism neutralization of deviations
Perform near point of convergence, vergence ranges, and stereopsis testing and interpret results against normative values
Administer a confrontation visual field and grade the result, then explain when it triggers formal perimetry
Set up and run a 24-2 SITA Standard visual field, coaching the patient for reliable fixation and catch trials
Interpret reliability indices and identify glaucomatous versus neurologic field patterns in 10 sample printouts

A written interpretation of 10 visual field printouts (5 glaucomatous, 5 neurologic or artifact) with reliability assessment for each

Week 4

Perform direct ophthalmoscopy on 10 undilated and dilated eyes, describing disc, cup, macula, vessels, and periphery systematically
Grade cup-to-disc ratio and identify glaucomatous disc features such as rim thinning, notching, and hemorrhage
Measure intraocular pressure by Goldmann applanation with correct mire alignment, fluorescein dosing, and calibration checks
Perform and interpret a four-mirror gonioscopy examination using the Shaffer grading system
Explain the indications and technique for dilated fundus examination and recognize when dilation is contraindicated

A fundus drawing and IOP record for 10 eyes, including cup-to-disc ratio and gonioscopy grade for each

Week 5

Collect keratometry, refraction, and corneal topography data and select an appropriate initial soft lens parameter set
Evaluate soft lens fit by centration, coverage, movement, and push-up test, and document the fit assessment
Teach a patient proper insertion, removal, and care system use, and verify understanding with teach-back
Deliver a full informed-consent conversation covering risks, alternatives, and after-hours contact procedures
Demonstrate hand hygiene, instrument disinfection, and safe handling of body fluids during a simulated exam

A complete contact lens fitting record and a scored teach-back and informed-consent role-play with a partner

Week 6

Conduct a structured case history covering chief complaint, ocular history, medical history, medications, and family history in under 10 minutes
Ask targeted follow-up questions that convert a vague complaint into a specific differential
Adapt interview technique for pediatric, elderly, hearing-impaired, and non-English-speaking patients
Document a case history in a problem-oriented format suitable for a clinical record
Identify red-flag symptoms that require urgent referral and state the appropriate action for each

Three written case histories from role-played patients, each with a problem list and differential, reviewed against a rubric

Week 7

Run a complete integrated entrance-to-exit examination sequence on a partner within 45 minutes
Recover smoothly from a missed finding by re-sequencing the exam without losing time
Perform retinoscopy, refraction, cover test, and slit lamp in one continuous flow with correct handoffs
Narrate clinical findings aloud while performing each procedure as required in a practical exam format

Two full timed mock practical examinations with a checklist score and a written list of three fixes for the next attempt

Week 8

Rotate through every domain in 15-minute stations to rebuild retention across all 11 areas
Re-drill the weakest three procedures identified in week 7 until performed correctly twice in a row
Rehearse professional communication, infection control, and emergency response scenarios under time pressure
Complete a final self-assessment and list remaining gaps with a plan for the week before the exam

A full-length mock practical with station-by-station scores and a one-page gap-closing plan

Week 2: Can set up the slit lamp, complete five illumination techniques, and grade anterior chamber findings without prompting

Week 4: Can measure IOP by Goldmann applanation, grade the optic disc, and interpret a visual field printout independently

Week 6: Can take a complete case history and fit and evaluate a soft contact lens with documented parameters

Week 8: Completes a full timed mock practical with all stations scored and a written remediation plan