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SCFHS Classification Exam – Optometrist (Specialist): free practice test

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Practice test questions with answers and explanations

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01A patient reads the 6/12 line on a Snellen chart at 6 m. What minimum angle of resolution (MAR) does this acuity represent?

Practice question Unit: Clinical Visual Optics

  1. A0.5 minutes of arc

    0.5 is the decimal acuity, not the angle of resolution.

  2. B1 minute of arc

    1 minute of arc corresponds to 6/6, not 6/12.

  3. C2 minutes of arc ✓ Correct answer

    MAR is the reciprocal of the Snellen fraction: 12/6 = 2 minutes of arc (logMAR 0.30).

  4. D10 minutes of arc

    10 minutes is the overall height of a 6/12 letter, not the detail (stroke) size.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 1: Clinical Visual Optics, p. 2; Bennett and Rabbett's Clinical Visual Optics, chapter: Visual acuity and contrast sensitivity

02During a duochrome test, Khalid reports that the letters on the red background are clearer than those on the green. What does this indicate about his current correction?

Practice question Unit: Clinical Visual Optics

  1. AThe eye is under-corrected for myopia and needs more minus ✓ Correct answer

    Longitudinal chromatic aberration places red focus nearest the retina when the eye is relatively myopic, so red clearer means more minus is needed.

  2. BThe cylinder axis is misaligned and needs refining with the cross cylinder

    The duochrome tests spherical focus; it does not identify cylinder axis errors.

  3. CHe has a colour vision defect affecting the long-wavelength cones

    The test relies on wavelength-dependent focus, and it works even in most colour-deficient patients.

  4. DThe eye is over-minused and the minus power should be reduced

    Over-minus pushes the image behind the retina, which makes the green side clearer, not the red.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 1: Clinical Visual Optics, p. 2; Bennett and Rabbett's Clinical Visual Optics, chapter: Ocular aberrations

03Fatimah, 68, has misty morning vision that clears by afternoon. Specular microscopy shows a low endothelial cell count with guttae. Which function of the failing layer explains her symptoms?

Practice question Unit: Ocular Anatomy and Physiology

  1. ASecreting the mucin layer of the tear film

    Mucin is produced mainly by conjunctival goblet cells, not the endothelium.

  2. BProviding sensory innervation to the cornea

    Corneal nerves come from the ophthalmic division of the trigeminal nerve and end in the epithelium.

  3. CProducing aqueous humour for corneal nutrition

    Aqueous is produced by the ciliary epithelium; the endothelium only regulates fluid passage.

  4. DPumping fluid out of the stroma ✓ Correct answer

    The endothelial pump keeps the stroma relatively dehydrated; when it fails, overnight oedema causes morning haze.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 2: Ocular Anatomy and Physiology, p. 2; Grosvenor, Primary Care Optometry, chapter: The Ocular Health Examination

04During the Worth four-dot test (red filter over the right eye, green over the left), Yousef reports seeing only two red lights at near. What does this mean?

Practice question Unit: Binocular Vision

  1. ADiplopia from a manifest deviation at near

    Diplopia gives five lights, two red and three green.

  2. BSuppression of the right eye

    Right-eye suppression would leave three green lights.

  3. CNormal fusion with a dominant right eye

    Fusion gives four lights, with the white one coloured by the dominant eye.

  4. DSuppression of the left eye ✓ Correct answer

    Only the right eye's red view is seen, so the left (green-filtered) eye is suppressed.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 3: Binocular Vision, p. 2; Grosvenor, Primary Care Optometry, chapter: The Binocular Vision Examination

05Working at 50 cm without lenses, you see "against" motion in all meridians of Reem's eye. What can you conclude?

Practice question Unit: Refraction

  1. AShe is emmetropic, and the motion is an artefact

    An emmetrope shows with motion at 50 cm without a lens.

  2. BShe is hyperopic by at least 2.00 D

    Hyperopia gives with motion at any working distance.

  3. CShe is myopic by more than 2.00 D ✓ Correct answer

    Against motion means the far point lies in front of the 50 cm sight-hole, so myopia exceeds 2.00 D.

  4. DShe has myopia of less than 2.00 D

    Myopia under 2.00 D still shows with motion at 50 cm.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 4: Refraction, p. 2; Bennett and Rabbett's Clinical Visual Optics, chapter: Retinoscopy (skiascopy)

06On assessing Lama's new soft lens, you see almost no movement on blinking, a poor push-up test and a ring of conjunctival indentation after removal. What change is indicated?

Practice question Unit: Contact Lenses

  1. ANo change; this is an ideal fit

    An ideal soft lens moves about 0.2–0.4 mm and pushes up easily.

  2. BA flatter base curve ✓ Correct answer

    These are signs of a tight fit; a flatter BOZR (or smaller TD) loosens the lens.

  3. CA steeper base curve

    Steepening would tighten the lens further.

  4. DA larger total diameter

    A larger lens usually fits tighter.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 5: Contact Lenses, p. 2; Mannis et al., Contact Lenses in Ophthalmic Practice, chapter: Fitting Spherical Hydrophilic Soft Contact Lenses for Daily and Extended Wear

07Which corneal finding is characteristic of herpes simplex epithelial keratitis?

Practice question Unit: Ocular Disease

  1. AA ring infiltrate

    This suggests Acanthamoeba.

  2. BA dendritic ulcer ✓ Correct answer

    A branching ulcer with terminal bulbs stains with fluorescein.

  3. CVortex keratopathy

    This is drug-related deposition.

  4. DCorneal guttata

    These are endothelial in Fuchs dystrophy.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 6: Ocular Disease, p. 2; Grosvenor, Primary Care Optometry, chapter: The Ocular Health Examination

08Parents think 1-year-old Mishal's eyes cross. He has wide epicanthal folds, the corneal reflexes are centred and the cover test shows no movement. What is the diagnosis?

Practice question Unit: Pediatric Optometry

  1. APseudo-esotropia ✓ Correct answer

    Broad folds hide nasal sclera; alignment is normal.

  2. BInfantile esotropia

    The cover test would show movement.

  3. CAccommodative esotropia

    This shows a true deviation.

  4. DSixth nerve palsy

    Abduction would be limited.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 7: Pediatric Optometry, p. 2; Grosvenor, Primary Care Optometry, chapter: Anomalies of Binocular Vision

09Mr. Saleh, 72, says he can now read without his glasses, but distance vision is worse. Refraction shows a myopic shift. What is the likely cause?

Practice question Unit: Geriatric Optometry

  1. ADry AMD

    Dry macular degeneration affects retinal function rather than producing this characteristic lens-related refractive shift.

  2. BNuclear cataract ✓ Correct answer

    Nuclear sclerosis raises lens refractive power and can cause a myopic shift with temporary unaided near improvement.

  3. CCortical cataract

    Cortical cataract commonly causes glare and spoke-like opacities, not the classic nuclear second-sight pattern.

  4. DPtosis

    Ptosis can obstruct vision but does not explain a measured myopic refractive shift.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 8: Geriatric Optometry, p. 2; Grosvenor, Primary Care Optometry, chapter: Age-Related Vision Loss

10After a stroke, Mr. Yusuf has a right homonymous hemianopia. He reads English left to right. Which task is likely hardest?

Practice question Unit: Low Vision Practice

  1. AFinding the next line

    Returning to the beginning of a new line is more affected by loss of the left visual field.

  2. BSeeing in sunlight

    Light sensitivity is not the principal deficit caused by this right-sided field loss.

  3. CSeeing colours

    Homonymous hemianopia is a field defect; colour discrimination is not its defining deficit.

  4. DReading along a line ✓ Correct answer

    The missing right field obscures upcoming text during left-to-right reading and disrupts forward reading saccades.

Reference: SCFHS Optometrist Specialist Examination Content Guideline (2024), Section 9: Low Vision Practice, p. 2; Grosvenor, Primary Care Optometry, chapter: Care of the Vision-Impaired Patient

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