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Structure of Examination

In a significant development for the EBO, negative marking has been adopted for the MCQ paper since the 2010 Diploma Examination. This means that a negative mark (-0.5) will be applied in the case of an incorrect or double marked answer (when both true and false are ticked; when true and don’t know are ticked; when false and don’t know are ticked) or triple marked answered (when all options are ticked). Choosing the ‘don’t know’ option will result in a score of 0 points. One point can be earned for each correct answer.

As research in the field has shown, the application of negative marking WILL NOT result in a decrease of candidates’ chances to be successful at EBOD. Instead this research measures a reduction simply in the frequency of ‘wild guessing’ in the exam. The success rate of EBOD in the past has been stable over the years. Indeed, EBO aims to improve the (statistical) reliability of the examination (by reducing wild guesses), without influencing the pass rate (approximately 90 percent), also when negative marking for incorrect answers was adopted.

I. The Written Paper (MCQ Exam)

The paper is composed of 52 multiple choice questions (MCQs) which cover any basic science, medical or surgical topic relevant to the practice of ophthalmology, particularly in the following fields:

  • Optics, Refraction and Contact Lenses
  • Paediatric Ophthalmology and Strabismus
  • External, Corneal and Adnexal disease
  • Glaucoma, Cataract and Refractive Surgery
  • Retina, Vitreous and Uvea
  • Neuro-ophthalmology
  • Orbital Disease and Oculoplastic Surgery
  • General Medicine relevant to Ophthalmology
  • Ophthalmic Pathology, Microbiology and Immunology
  • Pharmacology and Therapeutics

The MCQs consist of a stem followed by five statements, each of which needs to be judged as ‘true’ or ‘false’ and you may opt for ‘don’t know’ if necessary. Hence, 260 answers will be required. The languages available are English. Answers are scored as outlined above.

Examples from fields 1 through 5:

1. The age of onset of presbyopic symptoms: from EBOD 2004, field 1

  • A) Is earlier for a patient with a small amplitude of accommodation
  • B) Is earlier for a hyperopic patient who wears contact lenses rather than spectacles
  • C) Is earlier for a myopic patient who wears contact lenses rather than spectacles
  • D) Is earlier for a myopic than a hyperopic patient who wears spectacles with full distance correction
  • E) Is earlier for a short than a tall patient

Answers: A) TRUE; B) FALSE; C) TRUE; D) FALSE; E) TRUE

 

2. Regarding accommodative spasm: from EBOD 2004, field 1

  • A) It typically causes pseudohyperopia
  • B) It does not occur in truly myopic patients
  • C) It is suggested by an apparently small accommodative amplitude (relative to age)
  • D) It is confirmed by a large difference between manifest and cycloplegic refraction
  • E) It is managed by gradually adding minus to (or reducing plus from) the prescription

Answers: A) FALSE; B) FALSE; C) TRUE; D) TRUE; E) TRUE

 

3. Near visual acuity is disproportionately reduced compared with distance acuity in: from EBOD 2004, field 1

  • A) Age-related macular degeneration
  • B) Posterior subcapsular cataract
  • C) Advanced glaucomatous optic neuropathy
  • D) Amblyopia
  • E) High myopia

Answers: A) TRUE; B) FALSE; C) TRUE; D) FALSE; E) FALSE

 

4. A 5-year old boy, tall for his age with long thin fingers and hyperextensible finger joints, presents with bilaterally subluxated lenses, one down and in and the other up and out. Both parents are normal and there is no family history: from EBOD 2003, field 2

  • A) The most likely diagnosis is Weill-Marchesani syndrome
  • B) An electroretinogram is indicated
  • C) Visual acuity is best helped by aphakic or phakic spectacle correction based on retinoscopy and subjective refinement
  • D) In the differential diagnosis an autosomal recessive disease such as homocystinuria should not be considered
  • E) An echocardiogram should be performed

Answers: A) FALSE; B) FALSE; C) TRUE; D) FALSE; E) TRUE

 

5. In 6th cranial nerve palsy: from EBOD 2004, field 2

  • A) The cover test can show an esophoria for near and an esotropia for distance
  • B) The double vision is horizontal and the images are crossed
  • C) A lesion involving the 6th nerve nucleus will result in an ipsilateral horizontal gaze palsy and a lower motor neurone 7th nerve palsy
  • D) Additional involvement of the ipsilateral 3rd, 4th and 5th cranial nerves indicates cavernous sinus involvement
  • E) The choice of surgery depends on whether there is demonstrable lateral rectus function present

Answers: A) TRUE; B) FALSE; C) TRUE; D) TRUE; E) TRUE

 

6. Bullous keratopathy: from EBOD 2004, field 3

  • A) Is an inherited disease of the corneal epithelium
  • B) Is often painful
  • C) Is rarely associated with visual loss
  • D) May require penetrating keratoplasty
  • E) Starts in early childhood

Answers: A) FALSE; B) TRUE; C) FALSE; D) TRUE; E) FALSE

 

7. Which is/are true of keratoconus: from EBOD 2004, field 3

  • A) The disease is inherited as an X-linked recessive trait
  • B) Increasing irregular astigmatism is a common finding
  • C) The main progression of the disease usually occurs after the age of 40
  • D) Laser Assisted in situ Keratomileusis (LASIK) is a main treatment option for severe keratoconus
  • E) When good visual acuity is no longer achieved with glasses, rigid gas-permeable contact lenses may be an option

Answers: A) FALSE; B) TRUE; C) FALSE; D) FALSE; E) TRUE

 

8. Congenital ocular syphilis is characterised by: from EBOD 2004, field 3

  • A) An epaulette followed by a salmon patch in the acute phase
  • B) Hutchinson’s teeth and a saddle nose
  • C) Loss of corneal sensation
  • D) Superficial vascularisation of the cornea
  • E) Corneal steepening

Answers: A) TRUE; B) TRUE; C) FALSE; D) FALSE; E) FALSE

 

9. Patients with the exfoliation syndrome (pseudoexfoliation) are more likely to develop: from EBOD 2004, field 4

  • A) Chronic open-angle glaucoma
  • B) Hyphaemas
  • C) Capsular rather than zonular rupture during cataract surgery
  • D) Asteroid hyalosis
  • E) Iris pigment dispersion

Answers: A) TRUE; B) FALSE; C) FALSE; D) FALSE; E) TRUE

 

10. In the iridocorneal endothelial syndrome (ICE): from EBOD 2004, field 4

  • A) Iris atrophy in Chandler’s syndrome is severe
  • B) Peripheral anterior synechiae are commonly found
  • C) Glaucoma is usually bilateral
  • D) It is caused by proliferation of corneal endothelial cells over the iris
  • E) Filtering surgery usually is not effective

Answers: A) FALSE; B) TRUE; C) FALSE; D) TRUE; E) FALSE

 

11. Angioid streaks: from EBOD 2004, field 5

  • A) Are caused by crack-like dehiscences (breaks) in the retina
  • B) Are usually concentric with the optic disc
  • C) Are seen in sickle cell disease
  • D) Are associated with systemic disease in about 50% of cases
  • E) May be complicated by choroidal neovascularisation

Answers: A) FALSE; B) FALSE; C) TRUE; D) TRUE; E) TRUE

 

12. Retinoblastoma: from EBOD 2004, field 5

  • A) Is caused by mutations in a tumour suppressor gene
  • B) When familial is always bilateral
  • C) Exophytic tumours spread into the vitreous cavity
  • D) Trilateral disease indicates associated pituitary tumours
  • E) Tumours characterised by Flexner-Wintersteiner rosettes are more differentiated

Answers: A) TRUE; B) FALSE; C) FALSE; D) FALSE; E) TRUE

 

II. The Oral Examination (Viva-Voce Exam)

Four separate vivas of 15 min each will be conducted by four panels of two examiners. Language is English but, whenever possible (French and German are the only languages for which this can be guaranteed), at least one examiner in each pair will be chosen to speak and understand, in case of difficulty, the candidate’s native tongue.

The viva voce panels are:

  • Optics, Refraction, Strabismus, Pediatric ophthalmology and Neuro-ophthalmology
  • Cornea, External Diseases, Orbit and Ocular Adnexa
  • Glaucoma, Cataract and Refractive Surgery
  • Posterior Segment, Ocular Inflammation and Uveitis

The Viva Voces will cover developmental, dystrophic, degenerative, inflammatory, infectious, toxic, traumatic, neoplastic, and vascular diseases affecting the eye and its surrounding structures. In all panels candidates should be able to discuss preventive ophthalmology, medicolegal aspects of ocular disease and European contributions to ophthalmology.

In each panels emphasis will be placed upon the following:
Data Acquisition: Recognition by the candidate in presented material of abnormalities and diseases that affect the eye, ocular adnexae and the visual pathways.

Diagnosis: The ability of the candidate to synthesize clinical, laboratory and histopathological data in order to arrive at a correct diagnosis and differential diagnosis.

Treatment: Candidates will be expected to provide a reasonable and appropriate plan for medical and surgical management of patients with the conditions depicted or described.

Detailed information about the viva voce procedure and schedule is sent to all candidates after registration for the examination.



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