OPHTHALMOLOGY CERTIFICATION
EXAM QUESTIONS AND VERIFIED
ANSWERS 2026
▶ PERRL - APD. Answer: Pupils Equal, Round, React to Light, No
Afferent Pupillary Defect
▶ Anisocoria. Answer: Unequal pupil sizes with varied causes ranging
from benign to life threatening (found in less than 4% of the population
>1mm). Estimated 20-40% population have a physiologic (benign)
difference of <1 mm between the right and left pupil.
▶ Adie's Tonic Pupil. Answer: Tonic pupil will not constrict in light due to
damage of the ciliary ganglion. Anisocoria appears GREATER IN THE
LIGHT.
▶ Horner's Syndrome. Answer: TRIAD: Ptosis (drooping of the eyelid),
Miosis (excessive constriction of the pupil of the eye), and
anhydrosis/Anhidrosis (inability to sweat normally). Caused by interruption
of the sympathetic pathway to the eye, problem GREATER IN THE DARK.
▶ Visual Field. Answer: Entire area of space that a person can see at one
time (patient's peripheral or side vision).
▶ Visual Pathway. Answer: The series of cells/synapses that visual
information takes from being processed as light in the retina into a chemical
signal that synapses throughout the brain resulting in complex processing
within the visual cortex located in the occipital lobe.
▶ 4 Distinct Quadrants of the Visual Field. Answer: Superior Temporal OD
(Rt Eye), Inferior Temporal (OD), Superior Temporal OS (Lt Eye), Inferior
Temporal OS (Lt Eye). Overlap occurs in the nasal region. Each quadrant
of the visual field is processed within a specific area of the brain.
, ▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
▶ Ocular Health Exam: Posterior Portion of the Eye. Answer: Slit Lamp
with Specialized Lenses, Binocular Indirect Ophthalmoscope, Direct
Opthalmoscope
▶ Expected Findings for the Lips/Lashes (Anterior Structures). Answer: -
Symmetric Rt Eye vs. Lt Eye
-Smooth, uniform skin
-Clean without debris
-Complete lid closure with no exposure of the globe
▶ Ptosis. Answer: Drooping upper eye lid - possible causes Horner
syndrome, myasthenia gravis, superior eyelid or oribatl malignancy,
congenital myogenic ptosis, cranial nerve III palsy. If it is acute onset ptosis
with diplopia (double vision) - STAT REFERRAL.
EXAM QUESTIONS AND VERIFIED
ANSWERS 2026
▶ PERRL - APD. Answer: Pupils Equal, Round, React to Light, No
Afferent Pupillary Defect
▶ Anisocoria. Answer: Unequal pupil sizes with varied causes ranging
from benign to life threatening (found in less than 4% of the population
>1mm). Estimated 20-40% population have a physiologic (benign)
difference of <1 mm between the right and left pupil.
▶ Adie's Tonic Pupil. Answer: Tonic pupil will not constrict in light due to
damage of the ciliary ganglion. Anisocoria appears GREATER IN THE
LIGHT.
▶ Horner's Syndrome. Answer: TRIAD: Ptosis (drooping of the eyelid),
Miosis (excessive constriction of the pupil of the eye), and
anhydrosis/Anhidrosis (inability to sweat normally). Caused by interruption
of the sympathetic pathway to the eye, problem GREATER IN THE DARK.
▶ Visual Field. Answer: Entire area of space that a person can see at one
time (patient's peripheral or side vision).
▶ Visual Pathway. Answer: The series of cells/synapses that visual
information takes from being processed as light in the retina into a chemical
signal that synapses throughout the brain resulting in complex processing
within the visual cortex located in the occipital lobe.
▶ 4 Distinct Quadrants of the Visual Field. Answer: Superior Temporal OD
(Rt Eye), Inferior Temporal (OD), Superior Temporal OS (Lt Eye), Inferior
Temporal OS (Lt Eye). Overlap occurs in the nasal region. Each quadrant
of the visual field is processed within a specific area of the brain.
, ▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
▶ Ocular Health Exam: Posterior Portion of the Eye. Answer: Slit Lamp
with Specialized Lenses, Binocular Indirect Ophthalmoscope, Direct
Opthalmoscope
▶ Expected Findings for the Lips/Lashes (Anterior Structures). Answer: -
Symmetric Rt Eye vs. Lt Eye
-Smooth, uniform skin
-Clean without debris
-Complete lid closure with no exposure of the globe
▶ Ptosis. Answer: Drooping upper eye lid - possible causes Horner
syndrome, myasthenia gravis, superior eyelid or oribatl malignancy,
congenital myogenic ptosis, cranial nerve III palsy. If it is acute onset ptosis
with diplopia (double vision) - STAT REFERRAL.
