Ophthalmology Exam Description

Physicians certifying in Ophthalmology must successfully complete a computer-based (written) and oral examination. The oral component is taken after the candidate has passed the written examination.

Written Examination

The written certification examination consists of 200 multiple-choice items and is administered over a four-hour session. Each question has four potential responses, but only one correct answer. Each response to a question is scored as correct or not correct.

The outline below provides details of the subject areas (domains) covered on the examinations and the approximate number of items from each area. This domain listing is provided to help candidates prepare for the examination and is based on a comprehensive practice analysis of the key topics and knowledge in the specialty, as identified by practitioners, instructors, and other leaders in Ophthalmology. Candidates should review this outline carefully and focus study on the areas listed. Each item on the examination is linked to a specific domain. The information in the outline is meant to serve as a study aid only and not as a guarantee of success in taking the examination.

Domain # of Questions on Exam
1 Anatomy 9
2 Contact Lenses 5
3 Cornea 10
4 Electrophysiology 1
5 External Disease 10
6 Eyelids 9
7 General Medicine (Diabetes, Hypertension, etc.) 8
8 Glaucoma 10
9 Immunology 3
10 Intraocular Inflammation & Uveitis 7
11 Intraocular Tumors 3
12 Keratorefractive Surgery 5
13 Lacrimal Apparatus 6
14 Lasers 7
15 Lens and Cataracts 10
16 Microbiology 4
17 Neuro-Ophthalmology 6
18 Ocular Drug Toxicity 6
19 Ocular Examination and Diagnostic Tests 10
20 Ocular Manifestations of Systemic Disease 8
21 Ocular Trauma 6
22 Ophthalmic Pathology 4
23 Optics and Refraction 8
24 Orbit 5
25 Pediatric Ophthalmology 6
26 Pharmacology 6
27 Physiology 4
28 Radiology and Imaging 3
29 Retina 9
30 Strabismus 6
31 Vitreous 6


A candidate should focus their examination preparation on the content provided in the examination blueprint. The reference list is not meant to be a list of comprehensive study materials but rather to aid candidates who may wish to prepare more in a specific area of the examination blueprint that they may not be as familiar with. You may wish to use the study materials to prepare for the written certification examination. All items appearing on examinations have been written based on the material presented in these study references

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Examination Administration

Click here for ABPS Examination Schedule Information

Examination Results

Candidates will receive score reports indicating their pass/fail status on the written examination. Candidates who fail are provided a breakdown of their performance by subject content domains. ABPS sends examination results to candidates within 60 days of the last day of the administration window. Each examination is scored against predetermined standards of acceptable performance, utilizing modified Angoff procedures for establishing the minimum acceptable scores. A candidate who is successful in passing the written certification examination is then approved to take the oral examination at the next administration.

Retaking Examinations

A candidate may take the written examination as many as three times to attain a passing score. Candidates who are not successful in passing the examination within the number of allowable attempts may reapply for certification by completing a new application and meeting all the eligibility requirements in effect at the time the new application is submitted.

Accommodations for Religious Reasons and Disabilities

Click here to see the complete policy for accommodations.

Oral Examination

The Oral Certification Examination in Ophthalmology is an opportunity for the Board to examine your ability to diagnose and treat patients requiring medical, surgical, and refractive ophthalmic care. The cases you will be presented will be based upon real or hypothetical patients. For each case you will be given a brief history of the patient’s present symptoms or complaints. You may need to probe for more information, develop a differential diagnosis, request laboratory tests or diagnostic examinations. You will be expected to describe the treatment process. Additionally, the examinee may be questioned regarding the risks related to a treatment process or what other treatment options might be considered.

The examination consists of four or more cases. For each case study a threshold score has been established. The threshold score represents the minimum passing score that is expected of a practicing physician in Ophthalmology. The threshold score for each case has been established prior to its administration. Board Diplomates in Ophthalmology, with the guidance of a psychometrician, have estimated the expected minimal performance for each area within each case. These minimal performance expectations are combined to obtain the minimum expected score on a case.

For each case, an examinee is scored in several areas. An examinee’s performance is typically scored in each of the following areas:

  • History of the patient—The examinee is expected to probe for the history of the patient (e.g., onset/course/location/associated symptoms, allergies, medications, past medical history; social/family history, surgical history, and psychological history)
  • Physical examination—The examinee is expected to request information about specific aspects of the patient’s physical condition (e.g., neck, chest, heart, back, neurological, skin, abdomen, musculoskeletal, and other areas applicable to the case)
  • Requested laboratory tests and diagnostic examinations—The examinee will order appropriate laboratory tests and diagnostic examinations; the examinee will be provided the results.
  • Diagnosis of the patient—The examinee will be expected to propose a differential diagnosis/diagnoses for the case presented.
  • Management of the patient—The examinee will indicate what treatment is recommended, including non-operative, operative, and post-operative management. The examinee may be asked to provide a rationale.
  • Disposition/Pathophysiology—The examinee may be presented with follow-up conditions of the patient, including complications—to which the examinee will be asked to recommend appropriate actions; or the examinee may be asked to describe possible complications/outcomes and appropriate corrective actions. Additionally, other related questions regarding the patients condition may be asked.

A candidate’s score on any one case is completely independent of his or her score on any other case. To pass, the examinee must minimally obtain a total score (sum of the scores from all cases) that equals or exceeds the sum of the threshold scores for the cases. Therefore, it is possible that an examinee may score less than the threshold score for one case, but still pass the examination, provided he or she scores well on the remainder of the cases to offset the lower score.

The four or more cases presented will address a variety of situations. No two cases will address exactly the same topic. Topics presented to the examinee may include, but not limited to:

  • Refraction and Contact Lenses
  • Glaucoma
  • Cataracts
  • Neuroophthalmology
  • Retina & Orbits
  • Lids & Orbits
  • Pediatrics & Strabismus
  • Cornea and External Disease
  • Uveitis
  • Intraocular Tumors
  • Pathology

The results of the examinee’s performance on the Oral Examination are mailed within 45 days of the examination. A careful review of the scoring and analyses of the results are conducted after the examination and before issuing reports, to verify the accuracy and validity of the results.  A candidate who is successful in passing the written certification examination is then certified and attains Diplomate status within ABPS and AAPS.

Examinees who fail to pass an Oral Examination have the opportunity to take an examination consisting of three different cases at the next scheduled administration. At the current time, an examinee is permitted no more than three attempts to pass the Oral Examination.


Save the Date
House of Delegates & Annual Scientific Meeting
Innovation & Overcoming Challenges
June 10-15, 2022
Patient Care Is Our Priority

Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine