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 Scantron test centers in the US and Canada.

The 160-question examination is comprised of 160 single-response, multiple choice questions. 140 of the questions are scored and 20 questions are non-scored, pilot questions. You are allotted four hours (240 minutes) for the exam. There are no scheduled breaks; unscheduled breaks are permitted but the timer will continue to count down.

Please note that all questions are weighted equally and you will not know which items are scored items and which are non-scored, pilot items. There is no penalty for incorrect answers, so you are encouraged to select an answer for every question.

View overview of exam performance »

Scheduling Your Exam

Once you have registered and paid for the examination, you will receive an email with instructions to 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 Scantron testing clients.

The Scantron 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 Scantron confirmation e-mail containing your date and location. Note that you must select a test date and location at least 5 days prior to the exam closing date. Not all test centers may be available on all exam dates.

Test Center Locations

United States, U.S. territories and Canada

Scantron provides testing at approximately 700 U.S. locations as well as Canada and US territories. The full list of locations is available on the Scantron website and is updated for each exam. For current testing center locations, visit https://www.scantron.com/test-site-cities/.

International Test Centers

At this time, ABO does not offer testing through Scantron's international testing locations.

Rescheduling or Canceling an Exam

Candidates who need to cancel or reschedule an exam date or location may do so by contacting Scantron. There is a $50 fee to reschedule any exam. Attempting to cancel or reschedule fewer than 7 days prior to the scheduled date may result in automatic withdrawal from the exam, and a $200 cancellation fee.

Exam Day Information

Candidates should expect to receive confirmation and reminder e-mails from Scantron that contain username, password and other important instructions for a successful testing experience.

On test day, 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, and other security measures. A candidate arriving 30 minutes or more after a scheduled appointment time will be considered tardy and will not be admitted to the exam.

Scantron 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. Scantron makes a continuous effort to provide the best and fairest testing conditions possible.

Exam Admission Requirements

  • Submit your confirmation notice to the proctor.
  • Bring a current, government-issued photo identification (ID) with signature (driver's license, immigration card, passport, U.S. passport card, state ID card, or military ID card). You will NOT be admitted without proper identification. Candidates who fail to provide proper identification will be considered a no-show and will forfeit exam fees.
  • In addition to the government-issued photo ID with signature, some exam programs require a second form of identification. Please review the "Additional Examination-Specific Information" section in your confirmation notice to see if a second identification is required.
  • Original documents are required.
  • Your first and last name on the confirmation notice must match the first and last name on your identification exactly.
  • Nicknames are not acceptable.
  • If you have more than one last name or a suffix listed on your government-issued photo ID, the same last names must be reflected on the confirmation notice.
  • Presenting name change documentation (marriage license, etc.) at the testing center is not acceptable. Name change documentation must be submitted at least one (1) week prior to your testing appointment if needed.

Prohibited Items 

  • Cameras, cell phones, optical readers, or other electronic devices that include the ability to photograph, photocopy, or otherwise copy test materials;
  • Notes, books, dictionaries, or language dictionaries (except as expressly permitted by the exam sponsor, see the Additional Examination Specific Information in your confirmation notice email if applicable);
  • Bookbags or luggage;
  • Purses or handbags;
  • iPods, mp3 players, tablets, headphones, or pagers;
  • Calculators, computers, PDAs, or other electronic devices with one or more memories;
  • Personal writing utensils such as pencils, pens, and highlighters;
  • Google and smart glasses (any glasses with electronics);
  • Watches, smart devices, and other jewelry except wedding or engagement rings;
  • Weapons;
  • Medicine, including cough drops (except as expressly permitted in advance),
  • Food and beverages; and
  • Coats and jackets.
  • Hats, hoods, or other headwear are not permitted in the examination room unless required for religious purposes. All items are subject to inspection by the proctor if suspicious behavior is detected.
  • Please note that sweaters and sweatshirts without pockets or hoods are permitted to be worn.

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, 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.

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 and sweatshirts 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. 

The following items are provided by Scantron:

  • 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 exam outline provides a list 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 info@abopt.org  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.

Scantron Regulations

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

  • Cell phones are NOT permitted in the exam room. Any candidate with a cell phone in the exam room will be dismissed from the exam room immediately and denied re-entry.
  • Smoking is NOT permitted at the exam site.
  • Food and beverages are NOT allowed in the exam area.
  • Personal items will NOT be allowed in the exam room and must be left outside of the exam room AT YOUR OWN RISK.
  • The proctor will provide a dry erase board or scratch paper and a pencil for making notes. No items or papers may be removed from the testing center. You may NOT bring your own scratch paper, etc.
  • Friends and relatives, including children, will NOT be allowed in the exam building.
  • Please refrain from wearing colognes or perfumes as scents may disturb others in the testing center.
  • Bring earplugs if you are sensitive to ambient noise. If you choose to bring earplugs, they will be subject to examination by the testing center staff.
  • Computer-based testing facilities offer exam services to multiple agencies. There may be other individuals in the testing room with you who are sitting for exams from different organizations. The rules for their exam may be slightly different than the rules for your exam in terms of exam time and what is and is not allowed at their station.
  • Computer-based tests are delivered via secure internet connections. Internet connections are subject to local internet providers. While it is not the norm, internet connections can, on occasion, be lost momentarily, requiring the proctor to log you back in to your exam. If you lose your internet connection, inform the proctor, who will assist you in logging back in to your exam. Upon logging back in to your exam you will resume at the first unanswered question. Your exam time remaining will be exactly the same as it was when the internet connection was lost.
  • Candidates are strictly prohibited from attempting to access any outside information, programs, or websites while testing.
Exam Outline

The examination consists of 160 multiple choice items; 140 of the questions are scored, 20 of the questions are unscored, pilot items. The outline provides an overview of the topic areas covered in the exam and the percentage of questions pertaining to each topic area. You may print the outline as a reference to use in preparing for the examination.

Examination 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 Scantron, American Board of Optometry’s testing partner.  Scantron 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, which cannot be altered by Scantron staff.

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

D. OCT

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:

A. CBC

B. CRP

C. ACE

D. HLA

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 scores for the March 2021 examination will be available on a candidate’s Learning Plan page and by mail within 30 days following the completion of the exam cycle. This allows time for the post-examination psychometric process that analyzes the performance of each test question and establishes the pass/fail cut score for the examination.

Re-taking the Exam

Candidates who fail the examination have an opportunity to take it again. There is no limit to the number of times a qualified candidate may take the examination, although full fees are charged for each examination and candidates must re-register in order to retake the exam.

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