NBEO Ocular Motility Practice Test

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