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Part II PAM · Patient Assessment and Management

Patient Assessmentand Management.

Part II is built from patient cases and leans hard on diagnosis and treatment. TMOD, the treatment and management of ocular disease, is scored inside it.

Practice Part IIBuild a Part II plan

At a glance

Part II PAM

Items
350
Sessions
2 × 175
Time
3.5 h
TMOD
About 120
Where
Pearson
When
Apr · Dec

Next exam: Dec 1 or 3, 2026

Format

How Part IIis built.

One day, two sessions, 350 items, all hung on patient cases. Here is what to expect, including TMOD.

NBEO's Part II page

The numbers

350Items
Case-based: each case carries 3 to 6 items, with a heavy emphasis on diagnosis and treatment.
2 × 175Sessions
Two sessions of 175 items, taken in one day.
3.5 hTime
Per session, about 72 seconds an item.
About 120TMOD
About 120 of the 350 items are TMOD items, with their own score and pass/fail decision.
PearsonWhere
Computer-based at Pearson test centers.
Apr · DecWhen
Offered every April and December. A stand-alone TMOD exam is also available.

  • 01

    Case-based

    Each case gives a patient story, history and examination findings, followed by 3 to 6 items about that patient.

  • 02

    Diagnosis and treatment

    NBEO puts particular weight on diagnosis and treatment, so most items ask what the condition is and what to do next.

  • 03

    Images and results

    Many cases include clinical images and test results to interpret, from fundus photographs to visual fields and OCT.

  • 04

    TMOD inside

    About 120 of the 350 items are TMOD items. They count toward your PAM score and also produce a separate TMOD score and pass/fail decision.

  • 05

    Pacing

    175 items in 3.5 hours is 72 seconds each. Time spent reading a case well pays off across all of its items.

  • 06

    Stand-alone TMOD

    Candidates who pass PAM overall but not its TMOD portion can sit the stand-alone TMOD exam: 120 items in one session.

Reading a case

How a caseis built.

Part II gives you a patient, then asks several questions about them. Read the case once, carefully, and let it carry you through every item.

Sample case3 items
Patient
58-year-old woman
Chief complaint
Blurry vision in the right eye for 3 weeks
History
Type 2 diabetes for 12 years, last HbA1c 9.1%; hypertension
VA
OD 20/50, OS 20/25
Fundus OD
Microaneurysms, dot-blot hemorrhages, a ring of hard exudates near the fovea
OCT OD
Center-involving retinal thickening with intraretinal fluid
  1. 1What is the most likely diagnosis?
  2. 2What is the most appropriate management?
  3. 3Which counseling point matters most for her long-term outcome?

  1. 1Who and why

    Age, sex and the chief complaint frame your differential before you read a single finding.

  2. 2History that matters

    Systemic disease, medications and family history usually point toward the answer.

  3. 3Findings to interpret

    Acuity, pressures, slit lamp and fundus findings, often with an image or a scan.

  4. 4Several items, one patient

    Each item asks something different: the diagnosis, the next test, the treatment, follow-up or education.

Content

What Part IIcovers.

Eye health, disease and trauma make up most of Part II. These are the areas our planner and question bank use, with the share of study time the planner gives each one.

  • Anterior segment disease

    Lids, conjunctiva, cornea and uvea: keratitis, conjunctivitis, dry eye and uveitis cases.

    Planner share16%

  • Posterior segment disease

    Retina, vitreous and choroid: AMD, diabetic retinopathy, vascular occlusions and detachments.

    Planner share14%

  • Therapeutics and TMOD

    Drug choice, dosing, side effects and contraindications for the treatment items scored as TMOD.

    Planner share14%

  • Glaucoma

    Open-angle and angle-closure diagnosis, staging, target pressure and treatment choices.

    Planner share12%

  • Systemic disease

    Ocular signs of diabetes, hypertension, autoimmune disease, arteritis and drug toxicity.

    Planner share9%

  • Refraction and low vision

    Ametropia, presbyopic adds, spectacle complaints and low vision management.

    Planner share9%

  • Neuro-ophthalmic disease

    Optic neuropathies, disc edema, cranial nerve palsies, pupils and field defects.

    Planner share8%

  • Contact lenses

    Fitting, toric and specialty lenses, and complications such as GPC and keratitis.

    Planner share7%

  • Binocular vision and pediatrics

    Amblyopia, strabismus, vergence and accommodative disorders in children and adults.

    Planner share7%

  • Trauma and emergencies

    Chemical burns, hyphema, open globe and the other same-day emergencies.

    Planner share4%

Strategy

How to preparefor Part II.

Clinical reasoning is a skill you build with reps. These five habits make every practice case count.

  1. 1

    Read the findings, then commit

    Form a working diagnosis from the history and findings before you look at the choices, then use the choices to confirm it.

  2. 2

    Answer the question asked

    Most likely diagnosis, next step and best treatment are different questions about the same patient. Notice which one you are answering.

  3. 3

    Know the emergencies cold

    Central retinal artery occlusion, giant cell arteritis, a pupil-involving third nerve palsy, angle closure and chemical burns. The next step is never a routine recheck.

  4. 4

    Make TMOD a daily habit

    For every condition you study, learn the drug class, dose, side effects and contraindications. About a third of PAM counts toward TMOD.

  5. 5

    Simulate the day

    Two 175-item sessions with a break between them. Do at least one full run before the exam.

Key dates

When to sitPart II.

Register through NBEO, then book your seat with Pearson as early as you can.

Upcoming exam dates
Exam dateRegister byScores releasedNotes
Dec 1 or 3, 2026Nov 17, 2026Jan 22, 2027Stand-alone TMOD on Dec 3
Apr 6, 2027Mar 23, 2027May 28, 2027Stand-alone TMOD the same day
Dec 7 or 8, 2027Nov 23, 2027Jan 28, 2028Stand-alone TMOD on Dec 7

From NBEO's 2026 to 2027 exam calendar. NBEO notes that dates can change.

Check the official calendar

Part II PAM question bank

20 questions with full explanations

Practice in tutor modeTimed at exam pace

Study notes

High-yield notes for Part II.Read, then practice.

Get started

One caseat a time.

Work through Part II cases in tutor mode, with the reasoning behind every answer, or run them against the clock.

Practice Part IIBuild a Part II plan