NBEO Ocular Motility Practice Test

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• Intorsion/extorsion movements rotate around which axis?
• A decompensated phoria is more commonly associated with which type of deviation?
• Which law explains yoked muscles?
• Which form of nystagmus is characterized by an elevation and intorsion of one eye with depression and extorsion of the fellow eye?
• Which test is most diagnostic for convergence insufficiency?
• In a patient with a right superior oblique palsy, the head is typically tilted to which side to reduce diplopia?
• In distinguishing cyclovertical (vertical) muscle palsy from a horizontal palsy, which combination of signs is most informative?
• Which phenomenon primarily explains why the secondary deviation will always be greater than the primary deviation for a patient with a non-comitant deviation?
• Which mechanical issue is most likely to produce a positive forced duction test in an eye movement exam following trauma?
• What is considered the only standardized DIRECT observation test of saccades?
• Incomitancy refers to a deviation that changes with gaze. Which statement best describes its clinical significance?
• What is the purpose of the Maddox rod test in motility assessment?
• Rotational testing assesses function of which vestibular structure?
• What is a synoptophore and how is it used in ocular motility assessment?
• In an ocular motility exam, how can myasthenia gravis present, and what features help differentiate it from a nerve palsy?
• Oculocephalic testing is also known as which maneuver?
• During Hess-Lancaster testing, which eye should wear the red lens when evaluating the primary deviation?
• Describe internuclear ophthalmoplegia (INO) and its typical motility findings.
• Duane's Retraction syndrome Type 3 is defined by which limitation?
• What is the secondary action of the inferior oblique?
• Which test primarily assesses the vestibulo-ocular reflex?
• The deviation of the paretic eye when the normal eye is fixating is known as the ___________ deviation.
• Which axis corresponds to horizontal gaze shifts (abduction/adduction)?
• In ocular motility testing, which statement correctly contrasts ductions with versions?
• The primary action of the superior oblique occurs when it is positioned __ degrees medial to the line of sight.
• What does the accommodative convergence to accommodation (AC/A) ratio represent, and what is a simple method to estimate it?
• Which muscle has excyclotorsion as its secondary action?
• CORE stands for which combination of physiologic nystagmus types?
• Which of the following is NOT true regarding Duane's Retraction syndrome?
• How does the Maddox rod test differentiate a cyclovertical deviation from a simple vertical misalignment?
• Oscillopsia is characterized by the sensation of which of the following?
• Which term refers to the broad category of eye movement abnormalities including fixation, saccades, and pursuits?
• A patient has an isolated abduction deficit in the right eye; which muscle is most likely restricted?
• Which statement is NOT true regarding congenital nystagmus?
• What term describes general abnormalities in fixation, saccades, and pursuits?
• Which finding on an ocular motility exam most strongly suggests a mechanical restriction rather than a nerve palsy?
• What is a null point and how does it influence management decisions in ocular motility disorders?
• In myasthenia gravis, which sign is typically preserved that helps distinguish it from nerve palsy?
• Which characteristic best describes saccades?
• A non-comitant deviation occurs when the position of gaze is greater than how many prism diopters difference?
• Internuclear ophthalmoplegia commonly results from a lesion in which structure?
• In Hess-Lancaster testing, which flashlight color is typically given to the patient to match the examiner's light?
• A patient presents with a right abduction deficit. What is the expected direction of their compensatory head turn?
• In binocular function testing, what role does the synoptophore play?
• Which law explains yoked muscles between eyes?
• In order to prevent blurring of the image during a saccade, vision is suppressed by the cortex which is known as _______________.
• How would you differentiate central from peripheral vestibular nystagmus on examination?
• Which form is associated with dorsal midbrain syndrome?
• Which law states that for any position of gaze, the eye has a unique orientation in 3 dimensions in space?
• After finishing rotation in rotational testing, the initial slow eye movement is in which direction relative to the rotation?
• What is the tertiary action of the inferior rectus?
• Which of the following eye movements are considered conjugate eye movements?
• In binocular vision assessment, which statement best describes what the Worth 4-dot test can reveal about a patient?
• What is the typical localization of a right superior oblique palsy when vertical diplopia worsens with head tilt to the right?
• What is the name of the most common pursuit abnormality that presents as step-like eye movements?
• What is the vestibulo-ocular reflex (VOR) and how is it assessed clinically?
• Which axis corresponds to torsional movements (intorsion/extorsion)?
• What is the primary purpose of vergence facility testing in binocular vision assessment?
• Which term describes when both eyes rotate about the z axis to the left during versions?
• Damage to the right frontal eye fields will most likely cause a defect of saccades in which direction?
• Which stimulus primarily drives fusional vergence when viewing a target?
• A positive forced duction test most strongly indicates which type of issue?
• Which eye movement involves rotation of a single eye?
• Which term describes a binocular movement where both eyes rotate about the z axis to the left during versions?
• How does age impact NPC and vergence testing expectations in NBEO?
• Are versions a conjugate or disconjugate eye movement?
• End-point nystagmus is physiological.
• The deviation of the normal eye when the paretic eye is fixating is known as the ____________ deviation.
• What does Bagolini lens testing reveal about binocular alignment?
• What is the primary clinical purpose of Parks three-step test?
• Name three objective tests used to evaluate binocular function without relying on subjective patient input.
• Which region of the brain sends information to the cortex in order to initiate a saccade?
• Which muscle has abduction as its tertiary action?
• Which muscle has elevation as its secondary action?
• Which test mainly evaluates pursuits?
• In caloric testing, cold water poured into the right ear produces which direction of nystagmus?
• The null point is the direction of gaze where nystagmus has the lowest amplitude.
• In a patient with a superior oblique (SO) palsy, which direction does the patient typically tilt their head to compensate?
• A classic clinical presentation of a right superior oblique palsy includes which combination?
• Which disease is associated with ocular flutter and opsoclonus?
• What syndrome is also known as Superior Oblique tendon sheath syndrome?
• OKR and OKN describe different gaze-stabilizing mechanisms; which statement correctly differentiates them?
• The primary action of the superior rectus occurs when it is positioned __ degrees away from the midline.
• A hypertropia is seen in the right eye in primary gaze and becomes more pronounced when looking to the left and tilting the head to the right. Which EOM is most likely involved?
• Define saccades and pursuits and identify their neural substrates.
• CN IV innervates which muscle?
• Congenital nystagmus may present in which forms?
• Which of the following describes when both eyes rotate about the y axis and the upper portion of their eyes rotate to the right during versions?
• What is the tertiary action of the superior oblique?
• Are vergences a conjugate or disconjugate eye movement?
• A lesion in the left frontal eye fields would most likely cause a defect in saccades toward which direction?
• Which axis travels through the line of sight in Listing's Plane?
• Which phenomenon describes the brain's temporary suppression of vision to maintain a clear image during rapid eye movements?
• In Hess-Lancaster testing, what color light does the examiner project onto the screen to be matched?
• Which form is most similar to end-point nystagmus but includes additional ocular motor abnormalities?
• Duane's Retraction syndrome Type 2 is defined by which limitation?
• A Type 1 Duane's Retraction syndrome is characterized by which limitation?
• What description best defines nystagmus?
• Which test is used to evaluate pursuit ability by tracing eye movements on a chart?
• Which of the following describes when both eyes rotate about the y axis and the upper portion of their eyes rotate to the left during versions?
• Versions are binocular eye movements; how are they tested?
• Which movement is a conjugate movement?
• Which region is primarily involved in the initiation of saccades?
• CN IV palsy hallmark: hypertropia of the affected eye.
• Pupil involvement in CN III palsy indicates which of the following?
• Which reflex has the shorter latency, VOR or OKN?
• Describe the classic pattern of a CN III palsy on primary gaze and the typical movement limitation.
• A negative forced duction test most strongly indicates which type of issue?
• Which reflex is responsible for maintaining an image on the fovea with prolonged head movements (>30 seconds)?
• Damage to the right parietal lobe will most likely cause a pursuit deficit toward which direction?
• Which of the following are alternative tests used to assess suppression in binocular vision besides Worth 4-dot?
• What clinical feature is most characteristic of a superior oblique palsy?
• Which finding is most consistent with a neurogenic motility deficit?
• Which statement about objective binocular testing is true?
• Which type of vergence is clinically measured as a distance phoria?
• In the pulse-step model, which statement describes the pulse component?
• Which statement best captures the general principle of prism correction for diplopia in strabismus?
• Elevation movements in Listing's Plane rotate about which axis?
• In caloric testing, warm water poured into the right ear produces which direction of nystagmus?
• What is the purpose of the cover test in a motility exam?
• What is the main stimulus that initiates accommodative vergence?
• Which mechanism primarily stabilizes visual images during rapid head movements?
• In jerk nystagmus, naming is based on the direction of which phase?
• Which of the following is NOT true regarding Brown's Syndrome?
• Which test elicits nystagmus by moving the visual scene around the patient?
• Caloric testing uses which of the following substances?
• Which vergence type is the primary driver of distance alignment in the absence of activation by accommodation or disparity cues?
• Gaze-evoked nystagmus is considered physiological or pathological?
• In horizontal gaze to the right, the right lateral rectus and which muscle of the left eye are yoked?
• Which cranial nerves innervate the six extraocular muscles?
• Which reflex maintains an image on the fovea while an object moves but the head stays still?
• Vertigo is best described as which of the following sensations?
• Which muscles are innervated by CN III?
• Which statement correctly differentiates OKR from OKN?
• Which diagnostic step is most appropriate to detect anisometropia-related diplopia?
• Which form increases in velocity when one eye is occluded and is commonly associated with infantile esotropia?
• In an inferior oblique (IO) palsy, which head tilt direction does the patient typically adopt to compensate?
• Prism adaptation is used in ocular motility management for which scenario?
• Which statement about Hess-Lancaster testing is true?
• What pattern would indicate incomitancy in strabismus?
• Near Point of Convergence testing in diplopia evaluation is used to assess which aspect?
• NOT true regarding the vestibulo-ocular reflex (VOR)?
• Convergence and divergence eye movements rotate around which axis in Listing's Plane?
• Which reflex is primarily responsible for stabilizing vision during head rotation by producing compensatory eye movements?
• Which term describes the step-like pursuit movements used to follow a moving object?
• What information does the Worth 4-dot test provide in binocular vision assessment?
• Forced duction test distinguishes paralytic from restrictive strabismus. Which statement is correct?
• Which of the following lists the classical Park's 3-step findings for a patient with a left superior oblique palsy?
• What is the main stimulus that initiates fusional vergence?
• End-point nystagmus is considered physiological or pathological?
• In differentiating CNS cause from ocular myogenic in new diplopia, which feature would prompt urgent imaging?
• Abduction/adduction movements around which axis?
• In the pulse-step model of ocular motility, which component is primarily responsible for the speed of the eye movement?
• Which law states reciprocal innervation between agonist and antagonist EOMs of the same eye?
• Which type of nystagmus is more associated with a vertical component?
• Brown's syndrome is best described by which statement?
• Which two clinical signs most strongly suggest a vertical muscle palsy (cyclovertical) rather than a horizontal palsy?
• How is the alternate cover test interpreted?
• Which of the following is LEAST likely to cause a positive forced duction test?
• In Hess-Lancaster testing, which setup correctly describes the relation between the patient's flashlight color and the examiner's projection?
• Latent nystagmus is commonly associated with infantile esotropia.
• In Listing's Plane, which axis is vertical?
• List three red flags that would prompt urgent neuroimaging in a patient with new diplopia.
• Which term describes when both eyes rotate about the z axis to the right during versions?
• What is the secondary action of the inferior rectus?
• What is the secondary action of the superior rectus?
• What is a Hess-Lancaster projection test and what does it map?
• What is the secondary action of the superior oblique?
• During Hess-Lancaster testing, which eye should wear the red lens when evaluating the secondary deviation?
• In the workup of a new diplopia, how would you differentiate a central nervous system cause from a purely ocular myogenic process?
• Which is NOT a main type of vergence?
• Which statement correctly distinguishes positive fusional vergence from negative fusional vergence and the testing method?
• Which testing demonstrates mechanical restriction via a positive forced duction test?
• Which type of OKN may be absent in infants due to underdeveloped cortical regions of the brain?
• What key historical clues help differentiate diplopia due to myasthenia gravis from a decompensated strabismus?
• Which of the following describes the correct prism placement for testing PFV and NFV?
• In a non-comitant deviation, will the primary or secondary deviation always be greater?
• Which three components are evaluated in Parks three-step test?
• Are versions monocular or binocular?
• During Bielschowsky head tilt test, which finding indicates likely left superior oblique palsy?
• Which finding may indicate convergence insufficiency or divergent excess?
• Describe the near point of convergence (NPC) test and typical normal values.
• CN VI innervates which muscle?
• Are ductions monocular or binocular?
• In diplopia mapping with prisms, which method is commonly used to dissociate the eyes and determine prism values?
• Which of the following brain regions is NOT primarily involved in the initiation of saccades?
• In Park's 3-Step test for a left CN IV palsy, which is the first step?
• For convergence-retraction syndrome, is the convergence/retraction component the fast phase or slow phase?
• Which term describes a rightward gaze?
• Explain suppression and its importance in planning treatment for strabismus.
• Which of the following is NOT an unintentional eye movement used to prevent the Troxler effect?
• Which statement about prism adaptation is true?
• What is primarily responsible for controlling pursuits?
• Opsoclonus is defined as an almost constant series of involuntary conjugate saccades. Which term describes this condition?
• How can anisometropia contribute to diplopia, and what testing helps detect it?
• Which muscle has excyclotorsion as its secondary action?
• Spasmus nutans presents within 4-12 months after birth and is often accompanied by compensatory head nodding.
• Which form of nystagmus is typically accompanied by compensatory head nodding?
• Which condition is NOT typically considered among common differential diagnoses for adult-onset diplopia with incomitant strabismus?
• What is Duane retraction syndrome and how does it present on motility testing?
• Ocular flutter and opsoclonus are primarily associated with ____________.
• Which law states that agonist and antagonist EOMs of the same eye are reciprocally innervated?
• In Listing's Plane, which axis is horizontal?
• The neutral point is the direction of gaze where nystagmus changes direction.
• Which form is most associated with dorsal midbrain syndrome?
• How does thyroid eye disease typically affect ocular motility?
• Which phenomenon describes the fading of peripheral images when the eye is fixated on a central object?
• Which condition is commonly associated with congenital nystagmus?
• What is the tertiary action of the inferior oblique?
• Which movements involve both eyes moving in the same direction?
• In the pulse-step model, which component is primarily responsible for maintaining an eccentric eye position after movement?
• What is the tertiary action of the superior rectus?
• _______________ is an advanced form of ocular flutter that appears as an almost constant series of involuntary conjugate saccades.
• Park's 3-step test is used to evaluate palsy of which cranial nerve?
• What is comitant strabismus and give an example; how is it confirmed on exam?
• Ductions are monocular eye movements with the other eye fixating. How is this movement typically tested in a clinical motility exam?
• What is the Bagolini lenses test primarily used to assess?
• What is monocular diplopia and how can you determine if diplopia is monocular or binocular?
• What is a common initial management step for symptomatic diplopia due to decompensated strabismus in adults?
• Which term describes a leftward version?
• Outline a practical sequence for a basic ocular motility exam in a patient presenting with diplopia.
• What does Bielschowsky head tilt test help localize in cyclovertical palsies?
• How does convergence insufficiency present and which tests are most diagnostic?