American Board of Optometry Exam Guide

The American Board of Optometry Exam Guide is provided as a reference for candidates and includes scheduling information, exam day information, admittance and accommodations policies, exam outline, scoring and retake policy, violation issues and frequently asked questions.

Click on the headings below to access information on each topic. For questions regarding the contents of this guide please contact ABO.

About the Exam

The American Board of Optometry board certification exam is a multiple-choice, computer-based test emphasizing patient assessment and management. The examination focuses on clinical knowledge and skills, not didactic details, and is administered at Prometric Test Centers worldwide.

The 220-item examination is broken into two sections. The General Practice section consists of 160 multiple choice questions – 140 of these questions are scored and 20 questions are non-scored, pilot questions. You are allotted four hours for this section. An optional break of up to one hour occurs upon completion of the General Practice section.

After the break you will be prompted to select your second section, one of three Areas of Emphasis: Additional General Practice, Ocular Disease, or Contact Lenses.  The Areas of Emphasis sections consist of 60 multiple choice questions – 50 scored questions and 10 non-scored, pilot questions. You will be allotted one and a half hours for this section.

You may review items at any time while you are in a section, but once you complete or "time out" of that section, you will not be permitted to go back to review or change answers. When you have completed both sections, you will be prompted to fill out a brief survey.

Please note that all questions are weighted equally, and the exam is scored as a complete unit. You will not know which items are scored items and which are non-scored, pilot items. Neither your board certification nor your printed certificate will denote your Area of Emphasis selection.

View overview of exam performance »

Scheduling Your Exam

Once you have registered and paid for the examination, you can select your testing date, time and location. We strongly urge candidates to select a date and location as early as possible to avoid competition with other Prometric testing clients.

The Prometric website allows you to check seat availability prior to selecting date and location. Seats are assigned on a first come, first served basis.

Within 24 hours of making your selection, you will receive a Prometric confirmation e-mail containing your date and location. Note that you must select a test date and location by the 30th of the month in which you are taking the exam (January or July). Not all test centers may be available on all exam dates.

Test Center Locations

United States, U.S. territories and Canada

Prometric provides testing in approximately 330 U.S. locations, as well as 13 in Canada, and several other international sites. The full list of locations is available on the Prometric website and is updated for each exam. For current testing center locations, visit the Prometric website and click “Locate a Test Center.”

International Test Centers

ABO and Prometric offer testing at several international locations. Prometric's network of international test centers provides the same high level of security, candidate verification and secure exam administration as its U.S. testing locations. To search for available international locations, visit the Prometric website, click “Locate a Test Center,” and select a country.

Rescheduling Your Exam

Candidates who need to reschedule an exam date or location may do so through the Prometric website. To reschedule, enter the Exam Confirmation Number from your Test Center Selection e-mail. You may reschedule an exam appointment at no cost if done 31 or more days prior to your scheduled exam date. Rescheduling between 7 and 30 days prior to your scheduled date results in a $25 change fee. Attempting to reschedule fewer than 7 days prior to the scheduled date results in automatic withdrawal from the exam, and a $200 cancellation fee.

Canceling Your Exam

If you choose to withdraw from the exam, you must do so on the Prometric website. To avoid a change fee, you must withdraw at least 31 days prior to your scheduled exam date. Withdrawing from the exam between 7 and 30 days prior to your scheduled date results in a change fee of $25. Withdrawing fewer than 7 days prior to your scheduled date results in a cancellation fee of $200.

Prometric Regulations

ABO exam Candidates must adhere to all Prometric regulations while in the test center.

  • During an exam, candidates are monitored continuously via video, physical walk-through, and observation window. All testing sessions are video and audio recorded.
  • You must present valid, unexpired identification in order to take your test. Validity and number of IDs required are predetermined by the test sponsor.
  • Each time you leave the exam room, you must sign out on the test center roster. You must sign back in and show your ID to the Test Center Administrator (TCA) to be readmitted to the test room.
  • You are prohibited from communicating, publishing, reproducing, or transmitting any part of your test, in any form or by any means, verbal or written, for any purpose.
  • You must not talk to other candidates or refer to their screens, testing materials, or written notes in the test room.
  • You must not use written notes, published materials, or other testing aids, except those allowed by your test sponsor. (The TCA will refer to the applicable client practice for allowances.)
  • You are allowed to bring soft ear plugs or center-supplied tissues into the test room.
  • Clothing and jewelry items worn in the test room must remain on you at all times. Removed clothing or jewelry must be stored in your locker.
  • You must not bring any unauthorized items into the testing room. Such items include, but are not limited to, outerwear, hats, food, drinks, purses, briefcases, notebooks, pagers, watches, cellular telephones, recording devices, and photographic equipment. Weapons are not allowed at any Prometric Testing Center. You will be asked to empty and turn your pockets inside out prior to every entry into the test room to confirm that you are not in possession of prohibited items.
  • You must return all materials issued to you by the TCA at the end of your test.
  • You must comply with the policy of your test sponsor regarding the use of phones during scheduled breaks in your test.
  • Your test may have either scheduled or unscheduled breaks that are determined by your test sponsor. The TCA can inform you what is permitted during these breaks.
  • Repeated or lengthy departures from the test room for unscheduled breaks will be reported by the TCA.
  • During a break, if you need an item stored in your test center locker, such as food or medicine, you must inform the TCA before you retrieve the item. You are not allowed to access any prohibited item, as defined by the client practice applicable for the test you are taking.
  • You must conduct yourself in a civil manner at all times on the premises of the testing center. Abusive behavior toward the TCA or any other test center staff may result in criminal prosecution.
  • To protect the privacy of all testers, the TCA neither confirms nor denies whether any particular individual is scheduled or present at the test center.
  • Persons not scheduled to take a test are not permitted to wait in the test center.
Exam Day Information

Candidates should expect to receive confirmation and reminder e-mails from the following Prometric address:  Adding this to an e-mail address book will ensure receipt of these e-mails.

Candidates should report to the assigned test center at least 30 minutes prior to the appointment time. This allows time for the registration process, which includes verifying ID, signature, emptying of pockets, metal detector wanding, photo, and fingerprint scan. A candidate arriving 30 minutes or more after a scheduled appointment time will be considered tardy and will not be admitted to the exam.

Prometric is responsible for ensuring that all candidates test under the same conditions. Test security plays a major role in ensuring that no candidate has an advantage over another. The company is contractually responsible to the American Board of Optometry for the security of exam content. Prometric makes a continuous effort to provide the best and fairest testing conditions possible.

Candidates must bring one form of positive identification to the test center. The ID must be a government-issued, non-expired ID, containing both a photo and signature. The ID must be a driver's license, passport, or state or county identification card. The name on the ID must be the same as the name on the e-mail confirmation received by the candidate. Employee IDs, work badges, school IDs, and credit cards are NOT acceptable. A candidate presenting an expired ID, or one that does not match his or her name of record with the ABO, will not be admitted to the exam. Change fee and cancellation fee rules apply.

If the candidate's primary ID is government-issued and includes a photo but no signature, such as a military ID, he or she will be asked to provide a second ID that contains a signature. The second ID must have the candidate's name pre-printed exactly as it appears on his or her exam reservation.

Candidates are required to have a digital photo taken at check-in and provide a fingerprint to enter and exit the test center.

Candidates also will be scanned with a metal detector to ensure that they are not carrying prohibited items. All candidates must comply with this important security protocol to ensure testing security.

Personal items such as cellular phones, handheld computers, personal digital assistants, timepieces, other electronic devices, pagers, writing instruments, paper, purses, hats, bags, books, and notes are not allowed in the testing room.  We strongly encourage candidates to leave them at home or in the car. If a candidate takes any of these items into the examination room, even by accident, he or she risks invalidation of the entire examination.

If a sweater or jacket is needed in the exam room, it must be worn at all times. Store all other personal items in a locker at the testing center. Candidates are NOT permitted to remove any examination materials from the test center or make written notes of the contents of the exam. Candidates violating these rules will have their tests voided and may face additional consequences.

Candidates found to be in violation of any exam rule will be notified immediately and will not be able to continue testing. The test administrator will submit a detailed written report with any supporting documentation directly to ABO for review. A final ruling on the violation will be made after a thorough ABO investigation.

During an active exam, candidates may not use telephones, leave the examination center except for a scheduled break, or communicate with one another in any way.  Candidates may not discuss the content of the exam with anyone during or following the testing period. Candidates who do so will have their tests voided and may face additional consequences.

Candidates can request erasable note boards and markers at their testing stations. These must be turned in at the conclusion of the exam. No other writing instrument or paper is permitted in the exam room.

ABO candidates may be testing with others using computer keyboards to type their answers. Keyboard noise can be minimized with ear plugs or headphones, available at the test center.

Sample Schedule for an 8:00 am exam appointment

7:30 to 8:00 | Registration, ID verification, and seating

8:00 to 8:15 | Review of ABO rules, exam tutorial, and instructions for General Practice section

8:15 | Begin General Practice section, 160 multiple choice questions (4 hours)

12:15 | Scheduled optional break* (1 hour)

1:15 | Introduction to and selection of  Area of Emphasis section, 60 multiple choice questions (1.5 hours)

2:45 | Brief post-exam survey (10 minutes)

2:55 | End of exam day

* Scheduled optional breaks:  Candidates may take all, part or none of the optional break time. Unused break time cannot be applied to testing time and is forfeited if unused. If a candidate inadvertently bypasses the break period by incorrectly responding to prompts, break time is forfeited.

NOTE: All exam sections are timed. Once each section is completed, voluntarily ended, or timed out, that section cannot be accessed again.

Permitted Items

The following items are allowed in the exam room.  All other personal items must be stored in a locker.

  • Eyeglasses
  • Hearing aids
  • Earplugs
  • Neck brace or collar
  • Insulin pump
  • Sweaters, sweatshirts, and blazers, only if worn at all times. If removed, these items must be placed in a locker.
  • Pillows for back or neck support due to injury. Requires advance notification and inspection; contact us for more information.
  • Motorized cart or wheelchair
  • Crutches, cane or walker
  • Religious headwear, scarf or hat
  • Transcutaneous electrical nerve stimulation (TENS) unit
  • Wearable medical monitors without bloodletting
  • Chair or footstool to support injured leg. Requires advance notification and inspection; contact us for more information.

The following items are provided by Prometric:

  • Tissues
  • Dry erase board and marker
  • Calculator on each computer

Items that must be stored in the locker or left with the test center administrator:

  • Cough drops and throat lozenges
  • Oral medication
  • Antacids
  • Source of rapid glucose
  • Chewing gum
  • Eye drops
  • Diabetic test equipment such as glucose monitor
  • Lip balm
  • Candy as substitute for smoking, or to relieve test anxiety
  • Asthma puff inhaler

If a candidate brings into the testing room an item that is not on the list of permitted comfort aids, he or she will be dismissed from the exam and forfeit all fees paid.

Study Materials and Special Accommodations

The American Board of Optometry does not provide exam review courses or materials. The General Practice and Areas of Emphasis outlines provide lists of topics covered by the examination. Candidates may wish to review references that are considered the standard of care, such as the American Optometric Association's Optometric Clinical Practice Guidelines, the American Academy of Ophthalmology's Preferred Practice Patterns or The Wills Eye Manual.

Special Accommodations

The American Board of Optometry provides reasonable accommodations in accordance with the Americans with Disabilities Act (ADA) and the ADA Amendments Act of 2008 (ADAAA) for individuals with documented disabilities who demonstrate a need for accommodation. In accordance with these Acts, ABO does not discriminate against individuals with disabilities in providing access to its examination program.

No candidate will be offered an accommodation that would compromise the examination’s ability to accurately test for the skills and knowledge it measures.  No auxiliary aid or service will be provided that will fundamentally alter the examination or result in an undue burden to ABO.

General Guidelines for Disabilities

The following guidelines assist the applicant in documenting a need for accommodation based on an impairment that substantially limits one or more major life activities. The candidate must initiate a request for accommodation by contacting the ABO at  or 314-983-4226. The candidate also should contact ABO for a release of information form relative to an accommodation request. Documentation submitted in support of a request may be referred by the ABO to experts in the appropriate field of disability for an impartial professional review. Accommodation requests by a third party such as an evaluator or program director cannot be honored.

  • Documentation of disability assists the ABO in determining reasonable accommodation, which is provided on a case-by-case basis. If submitted documentation is incomplete or does not support the request, the applicant will be asked to provide additional documentation. The cost of obtaining all documentation is borne by the applicant.
  • Documentation supporting a request for accommodation must be submitted early enough to allow ABO sufficient time to review the request and implement reasonable accommodation.
  • Documentation must be provided by a licensed or otherwise properly credentialed professional who has undergone appropriate and comprehensive training, has relevant experience, and has no personal relationship with the individual being evaluated. The individual making the diagnosis must be qualified to do so (e.g., an orthopedic limitation can be documented by a physician, but not a licensed psychologist).
  • Documentation must be typed or printed on official letterhead with the name, title, professional credentials, address, phone number, and signature of the evaluator, and the date of the report.

Documentation must be current. Because reasonable accommodation is based on the impact of the candidate’s disability on the testing activity, it is important that the individual provide recent documentation. Manifestations of a disability may vary over time and in different settings, so supporting documentation must be no more than three years old.

Candidate must submit a detailed, comprehensive written report from his or her treating professional, describing the disability or medical condition. The report also must explain the need for the requested accommodation. The report and accompanying documentation should clearly state the following:

  • A specific, professionally recognized diagnosis of the disability or medical condition using diagnostic codes from the Diagnostic and Statistical Manual of Mental Disorders (DSM) or other professionally recognized formulation.
  • A description of functional limitation(s) resulting from the diagnosed disability or medical condition, including any major life activity limited by the disability.
  • A description of the specific diagnostic criteria and diagnostic tests used, including date(s) of evaluation, specific test results and a detailed interpretation of those results. This description must include results of diagnostic procedures and tests, and should include relevant educational, developmental, and medical history.
  • A recommendation of specific accommodations and/or assistive devices the candidate needs for the ABO examination, and a detailed explanation of why these accommodations or devices are necessary.

Send documentation to:
American Board of Optometry
243 N. Lindbergh Boulevard
Saint Louis, MO 63141

Documentation must be received no later than 30 days before the start of the examination period. After that date, requests that are incomplete for any reason will not be processed, and the candidate will be required to take the board certification exam under normal testing conditions or reschedule for a future examination.

View list of special accommodations available at Prometric Testing Centers » 

Exam Outline

The examination consists of 220 items, divided into two sections, General Practice and Area of Emphasis. The following outlines provide a detailed overview of the topic areas covered in the exam and the percentage of questions pertaining to each topic area. You may print the outlines as reference to use in preparing for the examination.

General Practice Outline
Area of Emphasis Additional General Practice Outline
Area of Emphasis Contact Lenses Outline
Area of Emphasis Ocular Disease Outline

Exam Format and Sample Questions

The board certification exam is administered in a computer-based format. Key points concerning this format are outlined below.

  1. Extensive familiarity with computers is not required, but candidates should be able to use a computer keyboard and mouse.
  2. There is a brief orientation before the exam, allowing candidates to re-familiarize themselves with the exam process.
  3. The examination is proctored by staff from Prometric, American Board of Optometry’s testing partner.  Prometric simultaneously administers numerous exams. Its testing center staff is present strictly for registration and security purposes and does not provide assistance navigating the exam or resolving candidate errors. Candidates must read on-screen instructions carefully in order to respond correctly. Failing to do so may result in loss of exam time or break time, which cannot be altered by Prometric staff.
  4. Candidates can navigate forward and backward through the exam; mark items for further review; and review answered, unanswered and marked questions. They must be reviewed or changed prior to expiration of time for each section. Once an exam section is ended by the candidate, or the exam has timed out, candidates cannot return to questions in that section. The screen features a timer in the top right corner showing time remaining for the current exam section. A list of completed questions, incomplete questions, and marked items can be accessed by clicking “Review” at the bottom of the exam screen. From the Review screen, candidates can:
    • Click “Review All” to return to question one.
    • Click “Review Incomplete” to return to the first incomplete or unanswered question.
    • Click “Review Marked” to return to the first question marked for review.
    • Double-click any of the numbered questions to return to that question. When a candidate selects “Review All,” “Incomplete” or “Marked,” the “Next” button takes the candidate to the next question of that type.  End the exam section by clicking “End.”  After selecting “End,” the candidate will be unable to return to any of the questions in that section. Note: Candidate will be asked to confirm that he or she truly wishes to end the exam section. Clicking “No” returns the candidate to the Review screen for further review of that section.
  5. The optional scheduled break begins when the candidate completes or ends the General Practice section. Once the clock has started for the break period, candidates can use all of the break time, or click “Next” to end the break and start the Areas of Emphasis section. Time allotted for the break is indicated by the clock in the upper right corner of the exam screen. If a candidate clicks “Next” to end the break and move to the Area of Emphasis questions, a pop-up message asks the candidate to confirm. Carefully read all messages on the screen to avoid bypassing the scheduled break.

Questions not answered are counted as incorrect. No extra time is allotted for completion of questions, nor will there be any refund of the exam fee or credit toward future fees.

Sample Questions

1. A 65-year-old presents for a yearly examination to check the progress of previously diagnosed cataracts. Medical history is positive for COPD and Adult Onset DM. BCVA is OD 20/30 and OS 20/25.  IOPs are OD 23 mmHg and OS 24 mmHg. The optic nerves show inferior notching of both discs with early superior arcuate scotomas OU. Which of the following glaucoma medications is most appropriate?

A. Cosopt (dorzolamide/timolol)

B. Combigan (brimonidine/timolol)

C. Simbrinza (brinzolamide/brimonidine)

D. Carteolol (carteolol)

2. A patient presents with a four-day history of a red, irritated right eye that has just developed lid swelling.  The patient states that a friend had “pink eye” last week.  What other finding is most likely to confirm the proper diagnosis?

A. Positive RPS adenodetector

B. Presence of a preauricular node

C. High fever

D. Papillary response

3. A patient being followed for cataracts now complains of significant difficulty driving at night, and glare around lights.  Slit lamp examination reveals 2+ NS OU.  Topography reveals 1.5 diopters of corneal cylinder in both eyes.  Goals are discussed, and it is ascertained that the patient would like to be able to see clearly at distance but does not mind wearing readers up close.  Which of the following is the most appropriate IOL recommendation for this patient?

A. Crystalens

B. Toric lens

C. Monofocal lens

D. Restor lens

4. A 7th grader presents for her first eye examination with complaints of being unable to clearly see the board in school. Her school performance and grades are good. BCVA is 20/200 OD and OS. Pupil testing and fundus examination are normal. Which of the following tests is most likely to confirm your suspected diagnosis?

A. Color vision

B. Phorias

C. Confrontation fields


5. A 58-year-old is very disturbed about the sudden onset of a large floater in the right eye. Examination confirms a PVD and normal peripheral retina with no holes or tears. The next time this patient should be examined is in:

A. 1 day

B. 1 week

C. 6 weeks

D. 6 months

6. A patient presents with a history of vision loss in the right eye three years ago. The fundus exam is performed. (See exhibit)

Fundus Exam Eye

What is the diagnosis?

A. Central serous retinopathy

B. Epiretinal membrane

C. Geographic atrophy with disciform scar

D. RPE detachment from toxoplasmosis

7. A patient presents with a history of a red eye one year ago that was treated with unspecified drops. The patient advises that vision never came back completely. Slit lamp examination of the right eye was normal. The left eye is shown in the exhibit.

Red Eye

Which of the following is most likely abnormal in this patient?

A. Pachymetry

B. Specular microscopy

C. Rose Bengal staining

D. Corneal sensitivity

8. An 84-year-old patient presents with sudden vision loss in the right eye.  BCVA is OD 20/50 and OS 20/25 with early NS OU. Fundus exam of the right eye reveals a swollen disc. The most appropriate test to order to determine the etiology of the underlying condition is:





9. The parent of a 3-year-old child notices that the child’s eyes are crossing during near activities. Cover test reveals 3∆ esophoria at distance, 12∆ esotropia at near. Manifest refraction yields OD +3.00 SPH 20/25, OS +4.50 SPH 20/50. Cycloplegic refraction is OD +4.00 SPH, OS +5.50 SPH. Which of the following options is the appropriate treatment for this patient?

A. No treatment at this time. Recheck in one year.

B. Rx OD +3.00 SPH, OS +4.50 SPH. Patch OD 2 hours per day.

C. Rx OD +4.00 SPH, OS +5.50 SPH. Patch OD 2 hours per day.

D. Rx OD +4.00 SPH, OS +5.50 SPH. Patch OD full time.

Exam Results and Retake Policy

Exam results will be available approximately six to eight weeks following the last day of the testing month. Candidates will receive an email from ABO when their examination results have been posted to the Learning Plan page. Candidates will also receive a written letter from the ABO. Each question is analyzed to establish the percentage of candidates with the minimum level of certifiable knowledge who would answer the question correctly. This psychometric process allows us to establish the cut score for the examination.

Re-taking the Exam

Candidates who fail the examination will be given the opportunity to take it again. There is no limit to the number of times a qualified candidate may take the examination. A registration is valid only for the board certification examination for which you have registered. Full fees are charged for each examination.



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