NBEO - National Board of Examiners in Optometry Binocular Vision and Pediatrics Questions and Answers

Question 1

A 4-year-old boy presents with a constant, large-angle esotropia that his parents report has been present since he was 4 months old.
He cross-fixates, and visual acuity is equal in both eyes.
Cycloplegic refraction reveals +1.50 D sphere in both eyes.
Which of the following is the MOST likely diagnosis?

Accepted Answer

Infantile esotropia

Answer

Accommodative esotropia

Answer

Intermittent exotropia

Answer

Sensory esotropia

Question 2

A 9-year-old complains of headaches, intermittent blurred vision, and losing her place while reading. Clinical testing reveals a receded near point of convergence (NPC) to 15 cm break / 20 cm recovery, reduced positive fusional vergence (PFV) at near, and an exophoria of 10 prism diopters at near. What is the MOST appropriate initial management?

Accepted Answer

Office-based vision therapy

Answer

Surgical consultation for lateral rectus recession

Answer

Prescription of base-in prism for near work

Answer

Full-time occlusion of the non-dominant eye

Question 3

According to the Amblyopia Treatment Studies (ATS), which of the following is an effective initial treatment for a 5-year-old child with moderate amblyopia (20/80) due to strabismus?

Accepted Answer

Daily patching of the sound eye for 2 hours

Answer

Full-time occlusion of the sound eye

Answer

Prescription of spectacles alone for 6 months

Answer

Weekend-only patching of the amblyopic eye

Question 4

A 6-year-old child with intermittent exotropia (X(T)) is asymptomatic, but the deviation is manifest more than 50% of the time. Which of the following is a common non-surgical management option used to improve control of the deviation and potentially delay surgery?

Accepted Answer

Over-minus lens therapy

Answer

Base-in prism glasses

Answer

High plus lenses to stimulate accommodation

Answer

Binasal occlusion

Question 5

A 4-year-old child is undergoing a binocular vision evaluation. Using the Randot Preschool Stereoacuity Test, what level of stereoacuity would be considered within the normal range for this age?

Accepted Answer

70 seconds of arc

Answer

400 seconds of arc

Answer

200 seconds of arc

Answer

20 seconds of arc

Question 6

A 3-year-old presents with esotropia that is greater at near (30 PD) than at distance (15 PD), even after full hyperopic correction of +4.00 D OU is prescribed. This is a classic presentation of accommodative esotropia with a high AC/A ratio. Which of the following is the most appropriate next step in optical management?

Accepted Answer

Prescribe bifocal lenses with a near add

Answer

Prescribe base-out prism in a single vision lens

Answer

Increase the single vision plus prescription

Answer

Recommend immediate surgical correction