ABO Practice Test

This page is for ophthalmology residency graduates preparing for American Board of Ophthalmology certification, which starts with the 250-question Written Qualifying Examination and ends with a virtual Oral Examination. It offers free practice sets by subspecialty topic, worked example questions with explanations, and a study plan to use alongside the official ABO material. Practice with the free ABO - American Board of Ophthalmology practice test on PracticeTestGeeks (7 questions with answer explanations).

Free ABO - American Board of Ophthalmology Study Tools

Interactive ABO - American Board of Ophthalmology resources on PracticeTestGeeks, free to start:

• Free ABO Glaucoma Questions and Answers — 7 questions with answer explanations
• ABO - American Board of Ophthalmology flashcards — review key terms and concepts card by card
• ABO - American Board of Ophthalmology study guide — topic-by-topic overview of what the exam covers
• ABO - American Board of Ophthalmology cheat sheet — one-page printable summary for last-minute review

ABO Exam at a Glance

What the ABO is and how it works

According to American Board of Ophthalmology, “Candidates begin the certification process by completing a 250-multiple-choice-question examination known as the Written Qualifying Examination (WQE).”^[1]

American Board of Ophthalmology certification is the process by which ophthalmologists who have completed an accredited residency show they meet the board's standard. Candidates begin with the Written Qualifying Examination (WQE), a 250-multiple-choice-question test. It is computer-based at Pearson test centers and given on one day each fall. Pearson describes a five-hour testing period that includes a tutorial and break time, so 5 hours is the figure to plan around.

The Oral Examination follows. The ABO says it is presently administered online and is a unique face-to-face examination. Passing it makes a candidate a diplomate and brings a 10-year, time-limited certificate. After that, diplomates stay current through Continuing Certification.

Under the ABO's Board Eligibility Policy, approved applicants have up to 7 years from residency graduation to complete the process. Both examinations carry a fee of $2,250, according to the ABO exams page.

This page does not list scoring methods, passing standards or retake limits, because we have not verified them. Those details can change, so read the current policies on the ABO website and in the ABO Portal before you register. Our practice questions are written by us with AI tools. They are not real exam questions and do not predict what appears on test day.

Worked examples: how to reason through ABO questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: A patient presents with a classic dendritic ulcer on the cornea, which is pathognomonic for herpes simplex virus (HSV) keratitis. What is the standard-of-care first-line treatment?

1. Topical corticosteroids
2. Oral acyclovir
3. Topical ganciclovir or trifluridine
4. Intravenous ceftriaxone

Answer: C. Topical ganciclovir or trifluridine

Explanation:

A dendritic ulcer is the typical sign of active epithelial herpes simplex keratitis, and the infection is in the corneal epithelium, so a topical antiviral is the standard first-line treatment. Ganciclovir gel or trifluridine drops act directly where the virus is replicating.

Topical corticosteroids are wrong for active epithelial disease because they can suppress local immunity and let the ulcer enlarge. Oral acyclovir does work and is often used as an alternative or adjunct, but it is not the best answer when the question asks for the standard first-line choice for the ulcer itself. Intravenous ceftriaxone treats bacterial infection and has no effect on a virus.

Rule to remember: match the drug class to the organism, and avoid steroids alone in active epithelial herpetic disease.

Example 2

Question: Which gene is most strongly associated with pseudoexfoliation syndrome?

1. MYOC
2. CYP1B1
3. LOXL1
4. OPTN

Answer: C. LOXL1

Explanation:

LOXL1 is the correct answer. It encodes lysyl oxidase-like 1, an enzyme involved in elastin cross-linking, and variants in it are the major genetic risk factor for pseudoexfoliation syndrome. That fits the disease, which involves abnormal extracellular fibrillar material.

MYOC, the myocilin gene, is linked to juvenile and some adult-onset primary open-angle glaucoma, not pseudoexfoliation. CYP1B1 is associated with primary congenital glaucoma. OPTN, the optineurin gene, is linked to some cases of normal-tension glaucoma. Each wrong option is a real glaucoma gene, which is why this question tests whether you can match gene to condition.

Rule to remember: build a short table of glaucoma genes and the exact condition each one belongs to, then quiz yourself on it.

Example 3

Question: What did the ZAP trial show about prophylactic laser iridotomy in Chinese primary angle closure suspects?

1. It prevented most cases of angle-closure glaucoma
2. It worsened outcomes by causing cataract
3. It was more effective than clear lens extraction
4. Benefit was modest and the overall risk of progression was low, so routine widespread LPI was not supported

Answer: D. Benefit was modest and the overall risk of progression was low, so routine widespread LPI was not supported

Explanation:

The correct answer is that benefit was modest and the overall risk of progression was low, so routine widespread laser peripheral iridotomy was not supported. In the trial, untreated primary angle closure suspects mostly did not progress, so treating everyone exposes many eyes to a procedure they would not have needed.

The option saying it prevented most cases of angle-closure glaucoma overstates the effect. The option saying it worsened outcomes by causing cataract is not what the trial reported. The option saying it beat clear lens extraction describes a comparison this trial did not make.

Rule to remember: for screening and prophylaxis questions, weigh the absolute risk of the disease without treatment against the cost and harm of treating everyone.

How to use these practice tests

Start with the official ABO material so you know the format, dates, policies and content outline you are working toward. Then use our sets to find weak spots instead of trying to read everything again.

1. Take a short set in each subspecialty topic, such as Glaucoma, Retina and Vitreous and Optics and Refraction, and note which ones feel slow or uncertain.
2. For every miss, read the explanation, then write the rule it teaches in your own words. Keep those notes in one place.
3. Return to the weak topics, for example Cornea and External Disease, Neuro-Ophthalmology or Uveitis, and check your reasoning against your notes before you check the answer.
4. Close to the written exam, do longer mixed sessions with a timer so you get used to sitting for the 5-hour testing period.
5. Once you have a date for the Oral Examination, practise explaining your clinical reasoning out loud, since the format is a face-to-face conversation.

Treat our questions as practice for reasoning, not as a preview of real items.

Sources & last verified

1. American Board of Ophthalmology — number of questions, validity, renewal, delivery (official source). “Candidates begin the certification process by completing a 250-multiple-choice-question examination known as the Written Qualifying Examination (WQE).” Verified Oct 24, 2026.
2. pearsonvue.com — time limit (official source). “a five-hour testing period that includes a tutorial and break time” Verified Oct 24, 2026.
3. American Board of Ophthalmology — exam fee, registration opens, registration deadline, next exam date (official source). “Fee: $2,250” Verified Oct 24, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.