Oral Board Exam:  Content Outline

The ABO provides a lot of useful information on their website about the oral board exam, including a video demonstrating some sample cases, as well as a practice question.  They've recently provided a content outline that provides some general organization for the information tested.

While there are some resources out there to study for the oral board exam, there really are only a few (which I've discussed in a previous article).  So, I've decided to provide a very loosely-suggested content outline in case you're trying to figure out what conditions to study for the oral board exam.

As I was thinking about how I would come up with this list of topics, I realized that I should probably explain my rationale for the list, as well as offer suggestions for creating your own list.  So before I share my content list (which I will release by section so that the articles don't get super long), here is my introduction for what conditions to include on this study list.  But first, the disclaimers!

Disclaimers

Although I've personally taken the oral board exam once, I am not intentionally reproducing any of the questions from memory.  Part of the reason why I'm documenting my rationale for the content list is to demonstrate that my method is systematic and logical; any similarity to the actual oral board exam is completely coincidental.

Additionally, this list will likely include topics that have been listed or published in proprietary works.  While I am using multiple sources as my reference material (which has and will continue to be cited as appropriate), I am not intentionally listing only material covered by any particular source in an attempt to reproduce its content.  Because the subject matter in ophthalmology is finite and specific, most likely most or all of the topics in any particular source will be listed.  However, I will be applying my personal organization and classification to this list.  Any similarity to existing lists is coincidental.

Finally, while I will be fairly systematic in my approach to determining the appropriate subjects to include in my content outline, this is not going to be a comprehensive list.  Since I do not have any actual knowledge about what is going to be on the oral board exam for any given test period, it is very possible for you to be tested on some findings that I did not include in my list.  Feel free to use the outline as a starting point for your own list.

As a final disclosure, I do not write questions for any of the official assessment exams.  I am a member of the AAO Resident Self-Assessment Task Force, which is geared towards helping to develop better self-assessment tools for residents.  But because I do not actually know what is going to be on the oral board exam (I wouldn't be able to work on this site if I did), take everything I put in the outline with a grain of salt - I chose these conditions using the criteria I listed in the Introduction, but there is no guarantee that this list is comprehensive or all-inclusive.

How I Created This List

I used several criteria when I was making this list.  In addition to using the various textbooks I've collected over the years, I also wanted to think through what types of questions I would think are "testable."  So here are the different criteria I used for making my list (it'll probably look similar to how I think up practice multiple choice questions):

  1. Common conditions.  As you might suspect, you should probably know how to manage common ophthalmic conditions.  As far as I can tell, there are no trick questions - the oral board exam seems to genuinely be trying to assess how well we can think through issues we would most likely see in a comprehensive ophthalmology practice.  That's both good (you don't have to bother memorizing minutiae about a particular disease's genetic structure) and bad (if you don't remember how to manage a chalazion when you're on the spot, it might be a bit embarrassing...).
  2. Life-threatening or sight-threatening conditions.  Another question that the oral board exam is trying to answer is, "are you likely going to miss anything bad?"  After all, it does no good to recognize the pathology of follicular conjunctivitis but misdiagnose the underlying cause (follicular conjunctivitis is probably not that great of an example).  Having a systematic approach to determining your DDx and structuring your management plan accordingly can be very helpful.
  3. Conditions with many images.  I hope I'm not overstating the obvious that the oral board exam is very image-intensive.  Most prompts will be accompanied by at least 1 image, and often there are follow-up ancillary tests and neuroimaging.  If there are many different things we do to evaluate a particular condition, I added it to the list.
  4. Multidisciplinary conditions.  Because you're expected to manage patients of all subspecialties of ophthalmology, conditions that may typically involve multiple subspecialties, like retina + glaucoma, etc. are also conditions I wanted to include.  I'm sure that there are also plenty of less complicated cases to work through, but I figured that if I could manage complicated cases, I could talk through the simpler ones too.  Ophthalmology also has some overlap with different aspects of general medicine and neurology, so knowing when and who to refer to appropriately is important to discuss (like referring to rheumatology for certain uveitic conditions, referral to neurology in MS or myasthenia gravis, etc.)
  5. Characteristic physical findings.  There are some basic exam findings that you have to be able to recognize, such as follicular conjunctivitis or stromal keratitis where you are likely expected to be able to think through the differential diagnosis.
  6. Sequelae and surgical complications.  Since ophthalmology is a heavily surgical specialty, it's important to be able to manage any and all surgical complications.  Additionally, it's important to be able to manage sequelae of different eye diseases, knowing when it's appropriate to manage conditions medically and when to manage them surgically.

Suggestions For Making Your Own Content Outline

Perhaps, when you take a look at my outline, you'll want to create your own outline.  I would encourage you to, at the very least, adapt what's been made and make it your own.  Here are some suggestions on how you might go about figuring out your own content outline (in case you're wondering how to get started):

  1. Look at some pre-made resources.  In addition to the outline I will post here, there are several other books and apps that can be helpful in starting your list.  Consider looking at resources specific for the oral board exam, or more general resources (such as these websites) for starters.
  2. Make your list large and broad initially, then cut stuff out as you go.  It's easier to start comprehensively and shrink a list (it is for me anyways).  I think it'd be much harder to try to think up new topics to add to a partially complete list.
  3. Start organized.  One of the fascinating things about studying is that all of us remember things slightly differently; while there may be some general similarities in how we categorize diseases, it might be sorted in our minds differently.  I think it's easier to start with some organization rather than collecting the cases first - but that's just me.
  4. Recognize what you're strong at and what you're weak at.  This one is pretty obvious, but definitely spend more time studying the cases you're not as comfortable with.
  5. The optics questions are less calculation-based, more conceptual-based.  So while you might have to do some basic math (like calculating spherical equivalents or contact lens stuff), it will be fairly simple on the math side.  On your list of questions, be sure to include more conceptual optics questions.

What do you think about my rationale?  Do you have an outline that you would like to share?  Feel free to contact us!


Anterior Segment Of The Eye

Anterior Segment Trauma

  • Acute hyphema
  • Iridodialysis
  • Cyclodialysis
  • Intraocular foreign body
    • Siderosis
    • Chalcosis
  • Blunt trauma
    • Vossius ring
  • Traumatic cataract
  • Open globe

Glaucoma

  • Angle closure glaucomas
    • Primary angle closure glaucoma
      • Acute angle closure glaucoma
      • Plateau iris
    • Secondary angle closure glaucoma
      • Neovascular glaucoma
      • Phacomorphic glaucoma
      • Drug-induced angle closure glaucoma
      • Iridocorneal endothelial (ICE) syndrome
      • Epithelial downgrowth
      • Aqueous misdirection syndrome
  • Open angle glaucomas
    • Primary open angle glaucoma
      • Glaucoma suspect
      • Ocular hypertension
      • Normal tension glaucoma
    • Secondary open angle glaucomas
      • Pseudoexfoliation syndrome
      • Pigmentary dispersion syndrome
      • Uveitic glaucoma
        • Fuchs heterochromic iridocyclitis
        • Glaucomatocyclitic crisis (Posner-Schlossman syndrome)
      • Increased episcleral venous pressure
        • Sturge-Weber syndrome
        • Arterovenous fistula
        • Thyroid eye disease
        • Orbital varix
        • Retrobulbar tumor
      • Lens-induced glaucoma
        • Phacolytic glaucoma
        • Phacoantigenic glaucoma
        • Lens particle glaucoma
      • Post-traumatic glaucoma
        • Angle recession glaucoma
        • Ghost cell glaucoma
        • Hemolytic glaucoma
      • UGH syndrome
      • Steroid-induced glaucoma
      • Schwartz-Matsuo syndrome
  • Surgical management of glaucoma and surgical complications
    • Trabeculectomy
      • Blebitis
      • Ocular hypotony
    • Aqueous shunts
    • Laser trabeculoplasty
    • MIGS
    • Goniotomy and trabeculotomy

Anterior Uveitis (Iridocyclitis)

  • Acute anterior uveitis
    • HLA-B27
    • Behcet’s
    • Sarcoidosis
    • Herpetic iridocyclitis
  • Chronic anterior uveitis
    • Juvenile idiopathic arthritis
    • Fuchs heterochromic iridocyclitis

Iris Diseases

  • Iris coloboma
  • Aniridia
  • Iris melanoma
  • Iris nevus

Lens

  • Congenital lens abnormalities
    • Congenital lamellar and polar cataracts
    • Lenticonus
    • Microspherophakia
    • Weill-Marchesani syndrome
    • Rubella-associated cataract
    • Lowe syndrome
  • Ectopia lentis
  • Metabolic cataracts
    • Diabetic cataracts
    • Galactosemia oil-droplet cataracts
    • Myotonic dystrophy “christmas tree” cataracts
    • Wilson disease “sunflower” cataracts
  • Age-related cataracts
  • Other causes of cataracts (e.g., secondary PSC cataracts)
  • Preoperative, perioperative, and postoperative considerations

External Disease and Adnexa

Eyelids and Face

  • Eyelid trauma
  • Non-neoplastic eyelid lesions
    • Chalazion/hordeolum
    • Xanthelasma
  • Eyelid neoplasms
    • Benign
      • Squamous papilloma
      • Seborrheic keratosis
      • Actinic keratosis
      • Freckle
      • Eyelid nevus
      • Nevus of Ota
      • Syringoma
      • Capillary hemangioma
      • Port wine stain (nevus flammeus)
      • Pyogenic granuloma
      • Plexiform neurofibroma
    • Malignant
      • Basal cell carcinoma of the eyelid
      • Keratoacanthoma
      • Squamous cell carcinoma of the eyelid
      • Sebaceous cell carcinoma of the eyelid
      • Melanoma of the eyelid
  • Eyelash Disorders
    • Trichiasis
    • Madarosis
    • Poliosis
  • Allergic Disorders
    • Atopic dermatitis
    • Contact dermatitis
  • Infections
    • Molluscum contagiosum
    • Herpes zoster ophthalmicus
    • Blepharitis
    • Angular blepharitis
    • Ocular rosacea
    • Preseptal cellulitis
  • Ptosis
  • Ectropion
  • Entropion
  • Floppy eyelid syndrome

Lacrimal System

  • Workup of epiphora
    • Conjunctivochalasis
    • Punctal stenosis
    • Canalicular obstruction
    • Acquired nasolacrimal duct obstruction
    • Dacryolithiasis
  • Lacrimal system infections
    • Canaliculitis
    • Dacryocystitis

Conjunctiva

  • Allergic conjunctivitis
    • Follicular conjunctivitis
    • Papillary conjunctivitis
      • Vernal keratoconjunctivitis
      • Atopic keratoconjunctivitis
      • Contact lens conjunctivitis
  • Bacterial conjunctivitis
    • Trachoma
    • Acute bacterial conjunctivitis
    • Adult chlamydial conjunctivitis
  • Other conjunctivitis
    • Stevens-Johnson syndrome
    • Ocular cicatricial pemphigoid
    • Ligneous conjunctivitis
    • Superior limbic keratoconjunctivitis
    • Parinaud oculoglandular syndrome
  • Conjunctival degenerations
    • Pinguecula
    • Pterygium
    • Concretions
    • Pyogenic granuloma
  • Conjunctival neoplasias
    • Benign
      • Conjunctival squamous papilloma
      • Benign acquired melanosis
      • Ocular melanocytosis
      • Conjunctival nevus
      • Epibulbar dermoid
    • Premalignant
      • Conjunctival intraepithelial neoplasia
      • Primary acquired melanosis
    • Malignant
      • Conjunctival squamous cell carcinoma
      • Conjunctival melanoma
      • Conjunctival lymphoma
  • Subconjunctival hemorrhage
  • Conjunctival surgery
    • Pterygium surgery

Cornea

  • Corneal trauma
    • Thermal injury
    • Alkali burns
    • Acid burns
    • Corneal foreign body
    • Corneal abrasion
    • Corneal penetrating/perforating injury
  • Dry eye syndrome
  • Infectious keratitis
    • Bacterial keratitis
    • Viral keratitis
      • Herpes simplex keratitis
      • Herpes zoster keratitis
    • Fungal keratitis
    • Acanthamoeba keratitis
    • Infectious crystalline keratopathy
  • Noninfectious keratopathy
    • Inflammatory keratitis
      • Phlyctenulosis
      • Marginal keratitis
      • Mooren ulcer
      • Peripheral ulcerative keratopathy
      • Thygeson superficial punctate keratitis
      • Interstitial keratitis
        • Congenital syphilis
        • Herpes simplex stromal keratitis
        • Cogan syndrome
        • Onchocerciasis
      • Neurotrophic keratopathy
      • Exposure keratopathy
      • Terrien marginal degeneration
      • Filamentary keratopathy
      • Recurrent corneal epithelial erosion
      • Xerophthalmia/vitamin A deficiency
      • Calcific band keratopathy
      • Wilson’s disease (copper deposition)
      • Corneal verticillata
  • Corneal ectasias
    • Keratoconus
    • Pellucid marginal degeneration
  • Corneal dystrophies
    • Anterior basement membrane dystrophy
    • Fuchs endothelial corneal dystrophy
  • Corneal neoplasias
    • Corneal intraepithelial neoplasia
    • Corneal squamous cell carcinoma
  • Corneal surgery
    • Corneal transplants
      • Penetrating keratoplasty
      • Lamellar keratoplasty
      • Endothelial keratoplasty
    • Other corneal surgery
      • Superficial keratectomy
      • Phototherapeutic keratectomy
    • Post-surgical corneal complications
      • Pseudophakic bullous keratopathy
      • “Phaco burn”
      • Descemet detachment

Sclera

  • Scleritis
  • Blue sclera

Neuro-Ophthalmology

Afferent Disease

  • Optic Neuropathies
    • Pseudopapilledema
    • Papilledema/IIH
    • Optic neuritis
    • Ischemic
      • NAION
      • AAION/GCA
    • Toxic
    • Hereditary
      • LHON
    • Nutritional
    • Compressive
      • Optic nerve sheath meningioma
      • Optic nerve glioma
    • Neuroretinitis
    • Congenital
      • Optic nerve hypoplasia
      • Optic nerve pit
      • Morning glory anomaly
    • Optic atrophy
  • Chiasmal disease
    • Pituitary adenoma
  • Retrochiasmal disease
  • Transient Visual Loss
    • Amaurosis fugax
    • Migraine auras

Efferent Disease

  • Pupils
    • Anisocoria
      • Horner’s syndrome
      • Adie’s tonic pupil
      • Pharmacologic
  • Supranuclear and internuclear causes of diplopia
    • Internuclear ophthalmoplegia
    • One and a half syndrome
    • Eight and a half syndrome
  • Cranial nerve palsies
    • 3rd nerve palsy
    • 4th nerve palsy
    • 6th nerve palsy
    • Bell’s palsy (7th nerve palsy)
  • Orbital apex syndrome
  • Myasthenia gravis
  • Chronic progressive external ophthalmoplegia (CPEO) and Kearns-Sayre syndrome
  • Nystagmus
  • Aberrant regeneration syndromes
  • Dorsal midbrain syndrome
  • Blepharospasm and hemifacial spasm

Orbital Disease

  • Trauma
    • Arteriovenous fistulas
    • Orbital floor fractures
    • Blow-out fractures
    • Retrobulbar hemorrhage
  • Infectious Orbital Diseases
    • Preseptal cellulitis
    • Orbital cellulitis
  • Inflammatory Orbital Diseases
    • Thyroid eye disease
    • Orbital Inflammatory Syndrome
    • Tolosa-Hunt syndrome
  • Neoplastic Orbital Diseases
    • Vascular Tumors
      • Capillary hemangioma
      • Cavernous hemangioma
      • Hemangiopericytoma
    • Mesenchymal Tumors
      • Rhabdomyosarcoma
    • Lymphoproliferative Tumors
      • Orbital lymphoma
    • Lacrimal Gland Tumors
      • Pleomorphic adenoma
      • Adenoid cystic carcinoma
    • Metastatic Tumors
      • Neuroblastoma
      • Leukemia
      • Breast cancer
  • Orbital surgery
    • Enucleation
    • Evisceration
    • Exenteration
    • Management of anophthalmic socket

Optics, Visual Physiology and Correction of Refractive ERrors

Optics

  •  
  • Accommodative amplitude and how to calculate it
  • Things that affect accommodation
  • Causes of irregular astigmatism
  • Prisms in clinical practice

Visual Physiology

Correction of Refractive Errors

Pediatric Ophthalmology

Amblyopia

  • Types of amblyopia
  • Management of amblyopia

Evaluation of vision in children

  • Evaluation of decreased vision in children

Pediatric orbital and eyelid disorders

  • Blepharophimosis syndrome

Pediatric inflammatory and infectious diseases

  • Congenital rubella syndrome
  • Congenital syphilis
  • Ophthalmia neonatorum

Pediatric lacrimal system disorders

  • Nasolacrimal duct obstruction
  • Dacryocele

Pediatric corneal disorders

  • Axenfeld-Rieger syndrome
  • Peters anomaly
  • Sclerocornea

Pediatric iris disorders

  • Iris coloboma
  • Juvenile xanthogranuloma

Pediatric glaucoma

Pediatric cataracts

Pediatric uveitis

  • Juvenile idiopathic arthritis

Pediatric retinal and choroidal disorders

  • Early-onset retinal disease
    • Persistent fetal vasculature
    • Retinopathy of prematurity
    • Coats disease
    • Leber’s congenital amaurosis
  • Hereditary retinal dystrophies
    • Stargardt’s disease
    • Best vitelliform dystrophy
  • Albinism
  • Congenital hypertrophy of the retinal pigment epithelium (CHRPE)
  • Combined hamartoma of the retina and retinal pigment epithelium
  • Retinoblastoma

Childhood nystagmus

  • Congenital motor and sensory nystagmus
  • Periodic alternating nystagmus
  • Latent nystagmus
  • Spasmus nutans
  • Opsoclonus

Systemic syndromes

  • Goldenhar syndrome
  • Phakomatoses
    • Neurofibromatosis type 1
    • Neurofibromatosis type 2
    • Tuberous sclerosis
    • von Hippel-Lindau disease
    • Sturge-Weber syndrome
    • Ataxia-telangiectasia
    • Incontinentia pigmenti
    • Wyburn-Mason syndrome
  • Craniosynostoses
    • Crouzon syndrome
    • Apert syndrome
  • Fetal alcohol syndrome

Pediatric trauma

  • Shaken baby syndrome
  • Management of ocular trauma in children

Strabismus

Techniques for evaluating strabismus

  • Calculating AC/A ratio
  • Adaptive mechanisms for strabismus in children and adults

Esotropia

  • Congenital/Infantile esotropia
  • Accommodative esotropia
  • Divergence insufficiency

Exotropia

  • Intermittent exotropia
  • Infantile exotropia
  • Convergence insufficiency

Special forms of strabismus

  • Duane syndrome
  • Brown syndrome

Strabismus surgery

  • Complications with anesthesia
  • Oculocardiac reflex
  • Malignant hyperthermia