The National Board of Examiners in Optometry (NBEO) administers a three-part licensing examination that every optometry graduate must pass before entering clinical practice. Part I tests foundational basic science knowledge, Part II covers applied clinical sciences, and Part III evaluates hands-on patient assessment and management skills through standardized patient encounters. Our free NBEO practice test PDF gives you a representative sample of the question styles and content domains tested across all three parts.
Preparing with realistic practice questions is one of the most effective strategies for NBEO success. This PDF compiles high-yield questions covering anatomy, pharmacology, ocular disease, binocular vision, contact lens management, and low vision — aligned with the current NBEO blueprint. Download the PDF below and use it alongside your clinical rotations and didactic review to identify weak areas before exam day.
Part I of the NBEO examination tests the scientific knowledge that underlies clinical optometric practice. The eight subject areas examined are anatomy, physiology, biochemistry, microbiology, pharmacology, pathology, public health, and systemic disease. Anatomy questions focus on ocular structures — the cornea, lens, retina, extraocular muscles, and visual pathways — as well as the cranial nerves relevant to vision and eye movement. Physiology covers the mechanisms of accommodation, aqueous humor dynamics, and retinal signal transduction. Biochemistry questions frequently address tear film composition, lens metabolism, and the biochemical basis of common ocular conditions such as cataracts and macular degeneration. Microbiology tests knowledge of the bacteria, viruses, fungi, and parasites that cause ocular infections, while pharmacology emphasizes topical and systemic drug classes used in optometry including glaucoma medications, mydriatics, cycloplegics, and anti-infective agents.
Part II shifts the focus from pure science to applied clinical knowledge. Ocular disease is the highest-weight domain, covering the diagnosis and management of glaucoma, age-related macular degeneration, diabetic retinopathy, anterior segment disease, uveitis, and neuro-ophthalmic conditions. Binocular vision questions address strabismus evaluation, amblyopia management, vergence and accommodative disorders, and the principles of orthoptic therapy. Contact lens content includes patient selection criteria, lens fitting techniques for soft and rigid gas-permeable lenses, orthokeratology, and management of contact lens-related complications. Low vision rehabilitation questions focus on assessment methods, magnification devices, and strategies for maximizing functional vision in patients with irreversible vision loss. A strong command of clinical procedures — including slit lamp examination, tonometry, visual field interpretation, and fundus evaluation — is essential for performing well on Part II.
Part III is the only NBEO examination component that evaluates hands-on clinical competency. Conducted as a standardized patient encounter (PAM), this exam places candidates in simulated clinical scenarios where they must take a case history, perform relevant examinations, interpret diagnostic data, formulate a differential diagnosis, and communicate a management plan. Examiners evaluate clinical reasoning and the candidate's ability to integrate findings into coherent patient care decisions. Common scenarios include patients presenting with new-onset diplopia, sudden vision loss, red eye with discharge, or progressive peripheral field loss. Candidates must demonstrate proper technique, patient communication, and knowledge of when to refer to other medical specialties. Preparation for Part III should include extensive supervised clinical experience and mock patient encounter practice with faculty feedback.
The NBEO uses a criterion-referenced standard-setting process to establish passing scores for each part, meaning the passing threshold is based on the performance level expected of a minimally competent entry-level optometrist rather than on the performance of the candidate cohort. Passing scores are reported as scaled scores, and candidates receive a score report indicating both an overall result and subject-area performance feedback. Candidates who fail any part may retake it; however, there are limits on the number of retake attempts and mandatory waiting periods between attempts that vary by state board requirements and NBEO policy. Most state licensing boards require passage of all three NBEO parts (or equivalent) as a condition of licensure, and some states impose additional jurisprudence requirements. Candidates are advised to check both NBEO policies and their specific state board requirements well in advance of their exam registration deadlines.
In addition to this free PDF, PracticeTestGeeks offers interactive NBEO practice tests that simulate the exam environment with timed question sets, instant answer feedback, and detailed explanations. Online practice helps you build the test-taking speed and stamina needed for each part of the NBEO, and lets you track which subject areas need the most attention before exam day.