NBEO - National Board of Examiners in Optometry Anterior Segment Disease Questions and Answers

Question 1

A 28-year-old female presents with a painful, red, light-sensitive left eye for the past two days.
Slit lamp examination reveals circumlimbal injection, 2+ anterior chamber cells, fine keratic precipitates (KPs) on the endothelium, and a miotic pupil.
Intraocular pressure is normal.
What is the MOST appropriate initial treatment plan?

Accepted Answer

Topical corticosteroid and a cycloplegic agent

Answer

Topical antibiotic and a warm compress

Answer

Oral antiviral medication and artificial tears

Answer

Topical NSAID and referral for blood work

Question 2

A 45-year-old male contact lens wearer complains of severe unilateral eye pain, photophobia, and watery discharge that began this morning. Slit lamp examination with fluorescein dye reveals a branching, linear epithelial defect with distinct terminal bulbs. Which of the following is the most likely diagnosis?

Accepted Answer

Herpes Simplex Virus (HSV) dendritic keratitis

Answer

Acanthamoeba keratitis

Answer

Fungal keratitis

Answer

Pseudomonal ulcer

Question 3

A 19-year-old patient reports needing frequent updates to their glasses prescription over the last two years. They complain of distorted vision and significant glare at night. Retinoscopy reveals a 'scissoring' reflex, and keratometry shows steep corneal curvatures with significant astigmatism. Which of the following is the MOST likely underlying condition?

Accepted Answer

Keratoconus

Answer

Pellucid marginal degeneration

Answer

Corneal warpage from contact lens wear

Answer

Fuchs' endothelial dystrophy

Question 4

A 72-year-old patient is found to have white, flaky material on the pupillary margin and anterior lens capsule of the right eye during a routine exam. Gonioscopy reveals a hyperpigmented trabecular meshwork. This patient is at a significantly increased risk for developing which of the following conditions?

Accepted Answer

Secondary open-angle glaucoma

Answer

Angle-closure glaucoma

Answer

Uveitic glaucoma

Answer

Neovascular glaucoma

Question 5

Which of the following clinical findings is most useful for differentiating allergic conjunctivitis from viral conjunctivitis?

Accepted Answer

Patient complaint of significant itching

Answer

Presence of watery discharge

Answer

Bilateral eye redness (hyperemia)

Answer

Follicular response on the palpebral conjunctiva

Question 6

A 55-year-old patient presents with chronic symptoms of burning, grittiness, and fluctuating vision. Examination reveals telangiectatic vessels on the eyelid margins, inspissated meibomian glands with frothy tear film, and a rapid tear break-up time. What is the MOST appropriate initial management strategy for this condition?

Accepted Answer

Instruction on warm compresses, lid massage, and eyelid hygiene

Answer

Long-term topical antibiotic therapy

Answer

A short course of a potent topical steroid

Answer

Prescription of oral acetazolamide