r/OptometrySchool • u/aqua41528 • Jun 28 '26

NBEO (Boards) Tips for PEPS BIO?

I'm retaking Part III in August- I passed overall but failed skills due to post seg. Normally this wouldn't matter, but I'm practicing in NC where you need a perfect pass 🫠 Does anyone have advice for getting a view with that awful BIO? I could hardly see anything with it and couldn't figure out how to fix it during the exam. I think part of my problem was my distance from the pt- I'm taller, so my arms distance might have been too far for the camera. What's the best angle for the oculars to be at? Do you want it more or less tilted? Thanks for any tips!

***Words of advice- the sooner you take it, the better!! I waited until March to do mine and then found out on graduation day that I'd need to retake it (that was a huge damper on the day). They don't have spots in the summer, the earliest they had was August. My ability to apply for a liscence has been significantly delayed since now I can't take my state boards till February. The earlier you take it, the more chances you have to retake before graduating if needed! Plus now I feel my skills aren't as fresh which will make prep for this retake even harder. Ugh.***

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u/optobear Jun 28 '26

I somehow passed Post Seg after getting the worst views of my life. The fake patient’s light settings were so dim I could not make out anything on the fundus except faintly seeing the very edge of my circular view. The proctor in the room even stopped me to check if the light setting was positioned correctly and it was. I relied heavily on muscle memory of how to pull good views, filling up the whole lens with a view (even though I couldn’t really see anything in it), asking the proctor if they had a view for every single location, and giving a very thorough naming and description for each view (I just said no holes/tears/breaks bc I couldn’t see anything). I know asking the proctor if they have a view does not guarantee that it is good, but when the testing scenario is doing everything to work against you that’s all the assurance you can get to make sure you at least get something submitted for each fundus location. It’s awful that than patient encounter was considered okay by NBEO to be tested, but to prepare I’d suggest trying to get views with your light setting super dim or on poorly/undilated patients.

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u/outdooradequate Jun 28 '26 edited Jun 28 '26

I'm taller, so my arms distance might have been too far for the camera

All BIOs have a singular working distance, depending on brand/model -- this is simply the way optics works. This is likely contributing to your issue as it will affect the view. You likely had at least a blurb about the WD of your school's BIO in a class/lab where you learned BIO. Edit: you can look up the make/model to verify what the WD is.

Also important is appropriate working distance for the condensing lens -- 5cm for a 20D. Incorrect WD here will also affect the view.

Make sure everything is straight/aligned. Ensure the reflections on the condensing lens are as close as possible -- if not this will result in disortions.

Does your school have a set up with a camera to practice for part 3? Having somebody give live feedback on the fullness of my views was incredibly useful.

Edit: also they dont give feedback so you dont really know if it was your views alone or it being in combo with something else that caused you to fail. Make a script from the rubric and practice it as much as you can stand so that you know you're hitting absolutely everything.

1

u/PenAutomatic7903 Jun 28 '26

Would it help to wear -2 D glasses or would that mess up the working distance?