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NBEO PART 1 EXAM NEWEST 2026-2027 ACTUAL EXAM
WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS, EXAMS OF NURSING
A 12-year old male is sitting in your waiting room while his mother undergoes her annual eye
exam. While waiting, he eats a candy bar containing peanuts, and, as luck would have it, he is
deathly allergic to nuts. To counter anaphylactic shock, what would be the BEST course of
action? - - ANS✔️--Anaphylactic shock is defined as a severe, multi-system, type I
hypersensitive, acute allergic reaction that may be life-threatening. Signs of an allergic reaction
include tingling, itching, hives, swelling of lips and tongue, constriction of the airway,
vasodilation, myocardial depression, and a decrease in blood pressure. The EpiPen is injected
intramuscularly to the upper lateral thigh to ensure rapid delivery. Epinephrine (Adrenaline)
activates both alpha and beta adrenergic receptors causing an increase in peripheral vascular
resistance and allowing for an increase in blood pressure and coronary artery perfusion.
Adrenaline also serves to reverse vasodilation and decrease urticaria and angioedema. For
severe, life-threatening reactions, Benadryl (diphenhydramine) will not work quickly enough.
Topical antihistamines have little if any systemic absorption and therefore will not be effective in
,2|Page
counteracting the anaphylaxis. While oral steroids may be useful in the post-management of
anaphylactic shock, they will not yield the desired immediate response.
An elderly patient presents in your office with decreased visual acuity. He remarks that he can
read better without his glasses and his refraction denotes a large myopic shift. Dilated fundus
exam is unremarkable. Which of the following slit lamp findings would MOST likely explain the
above findings?
Bilateral corneal arcus
Bilateral limbal girdle of Vogt
Bilateral 3+ nuclear sclerosis of the lens
Bilateral crocodile shagreen - - ANS✔️--Nuclear sclerosis is caused by changes to the optical
clarity of the lens. As we age, proteins precipitate out of the lens matrix, causing the lens to
become cloudy and altering its density. As time passes, the lens will also begin to change color
from clear to a yellow/brown in a process called lens brunescence. Cataracts also generally cause
a myopic shift with an increase in against-the-rule astigmatism, leading to decreased distance
vision but improved near vision.
Corneal arcus is caused by lipid deposition in the peripheral cornea. There remains a
characteristic clear zone between the lipid and the limbus. Arcus does not generally interfere
with vision.
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Crocodile shagreen and limbal girdle of Vogt are also benign corneal findings commonly seen in
the elderly. Crocodile shagreen appears in the peripheral cornea as polygonal white opacities.
Limbal girdle of Vogt is noted at the 3 o'clock and 9 o'clock interpalpebral positions as white
crescent-shaped opacities.
Long-term use of corticosteroids can lead to the formation of which of the following types of
cataract?
Nuclear sclerotic
Posterior subcapsular
Cortical
Anterior subcapsular - - ANS✔️--The possible formation of posterior subcapsular cataracts (PSC)
is a common concern in patients undergoing long-term treatment with corticosteroid therapy.
PSCs have been associated with the use of systemic, topical, ophthalmic, topical dermatologic,
nasal aerosol, and inhalation type steroids. This relationship is likely dose-dependent, and the
usual time from beginning steroid treatment to the onset of lens changes is 1 year (with a dosage
of 10 mg/day of prednisone) but has been observed in as short as 2 months with as little as 5
mg/day. Patients with PSC formation may complain of an increase in light sensitivity,
photophobia, glare, or difficulty reading. If visual acuity is notably decreased, surgical removal
of the lens may be warranted.
Berger's space is created by an interval between which two structures?
The posterior surface of the cornea and the anterior face of the iris
The anterior face of the lens and the posterior surface of the iris
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The equator of the lens and the ciliary body
The posterior face of the lens and the anterior vitreous - - ANS✔️--Berger's space is created by
the separation between the posterior face of the lens and the anterior face of the vitreous.
The space between the equator of the lens and the ciliary body is known as the circumlental
space.
Patients with a history of homocystinuria are MOST likely to experience crystalline lens
subluxation in which of the following directions?
Down and outward
Up and outward
Down and inward
Up and inward - - ANS✔️--Common ocular sequelae that have been associated with a diagnosis
of homocystinuria include ectopia lentis (bilateral crystalline lens subluxation), retinal
detachment, and secondary glaucoma. In most cases of ectopia lentis, the lens is more likely to
be displaced downward and inward in homocystinuria (as compared to upward and outward in
Marfan's syndrome). Additionally, in homocystinuria, the lens zonules are markedly abnormal,
the lens does not accommodate, and up to 1/3 of the cases of lens subluxation eventually
completely dislocate into the vitreous or anterior chamber. Due to the severity of systemic and
cardiovascular complications associated with homocystinuria (thrombosis and occlusion),
patients presenting with ectopia lentis should be screened for this disease using the sodium
nitroprusside test to measure homocysteine in the urine.
NBEO PART 1 EXAM NEWEST 2026-2027 ACTUAL EXAM
WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS, EXAMS OF NURSING
A 12-year old male is sitting in your waiting room while his mother undergoes her annual eye
exam. While waiting, he eats a candy bar containing peanuts, and, as luck would have it, he is
deathly allergic to nuts. To counter anaphylactic shock, what would be the BEST course of
action? - - ANS✔️--Anaphylactic shock is defined as a severe, multi-system, type I
hypersensitive, acute allergic reaction that may be life-threatening. Signs of an allergic reaction
include tingling, itching, hives, swelling of lips and tongue, constriction of the airway,
vasodilation, myocardial depression, and a decrease in blood pressure. The EpiPen is injected
intramuscularly to the upper lateral thigh to ensure rapid delivery. Epinephrine (Adrenaline)
activates both alpha and beta adrenergic receptors causing an increase in peripheral vascular
resistance and allowing for an increase in blood pressure and coronary artery perfusion.
Adrenaline also serves to reverse vasodilation and decrease urticaria and angioedema. For
severe, life-threatening reactions, Benadryl (diphenhydramine) will not work quickly enough.
Topical antihistamines have little if any systemic absorption and therefore will not be effective in
,2|Page
counteracting the anaphylaxis. While oral steroids may be useful in the post-management of
anaphylactic shock, they will not yield the desired immediate response.
An elderly patient presents in your office with decreased visual acuity. He remarks that he can
read better without his glasses and his refraction denotes a large myopic shift. Dilated fundus
exam is unremarkable. Which of the following slit lamp findings would MOST likely explain the
above findings?
Bilateral corneal arcus
Bilateral limbal girdle of Vogt
Bilateral 3+ nuclear sclerosis of the lens
Bilateral crocodile shagreen - - ANS✔️--Nuclear sclerosis is caused by changes to the optical
clarity of the lens. As we age, proteins precipitate out of the lens matrix, causing the lens to
become cloudy and altering its density. As time passes, the lens will also begin to change color
from clear to a yellow/brown in a process called lens brunescence. Cataracts also generally cause
a myopic shift with an increase in against-the-rule astigmatism, leading to decreased distance
vision but improved near vision.
Corneal arcus is caused by lipid deposition in the peripheral cornea. There remains a
characteristic clear zone between the lipid and the limbus. Arcus does not generally interfere
with vision.
,3|Page
Crocodile shagreen and limbal girdle of Vogt are also benign corneal findings commonly seen in
the elderly. Crocodile shagreen appears in the peripheral cornea as polygonal white opacities.
Limbal girdle of Vogt is noted at the 3 o'clock and 9 o'clock interpalpebral positions as white
crescent-shaped opacities.
Long-term use of corticosteroids can lead to the formation of which of the following types of
cataract?
Nuclear sclerotic
Posterior subcapsular
Cortical
Anterior subcapsular - - ANS✔️--The possible formation of posterior subcapsular cataracts (PSC)
is a common concern in patients undergoing long-term treatment with corticosteroid therapy.
PSCs have been associated with the use of systemic, topical, ophthalmic, topical dermatologic,
nasal aerosol, and inhalation type steroids. This relationship is likely dose-dependent, and the
usual time from beginning steroid treatment to the onset of lens changes is 1 year (with a dosage
of 10 mg/day of prednisone) but has been observed in as short as 2 months with as little as 5
mg/day. Patients with PSC formation may complain of an increase in light sensitivity,
photophobia, glare, or difficulty reading. If visual acuity is notably decreased, surgical removal
of the lens may be warranted.
Berger's space is created by an interval between which two structures?
The posterior surface of the cornea and the anterior face of the iris
The anterior face of the lens and the posterior surface of the iris
, 4|Page
The equator of the lens and the ciliary body
The posterior face of the lens and the anterior vitreous - - ANS✔️--Berger's space is created by
the separation between the posterior face of the lens and the anterior face of the vitreous.
The space between the equator of the lens and the ciliary body is known as the circumlental
space.
Patients with a history of homocystinuria are MOST likely to experience crystalline lens
subluxation in which of the following directions?
Down and outward
Up and outward
Down and inward
Up and inward - - ANS✔️--Common ocular sequelae that have been associated with a diagnosis
of homocystinuria include ectopia lentis (bilateral crystalline lens subluxation), retinal
detachment, and secondary glaucoma. In most cases of ectopia lentis, the lens is more likely to
be displaced downward and inward in homocystinuria (as compared to upward and outward in
Marfan's syndrome). Additionally, in homocystinuria, the lens zonules are markedly abnormal,
the lens does not accommodate, and up to 1/3 of the cases of lens subluxation eventually
completely dislocate into the vitreous or anterior chamber. Due to the severity of systemic and
cardiovascular complications associated with homocystinuria (thrombosis and occlusion),
patients presenting with ectopia lentis should be screened for this disease using the sodium
nitroprusside test to measure homocysteine in the urine.
