Free sample
Try 7 IGOEE-style sample questions
Five General MCQ items and a short TPAO case, written like the real exam. Choose an answer, check it, and read why each option is right or wrong. No account needed.
On the real exam you get about 69 seconds per General MCQ item and 81 seconds per TPAO item. Members practise at that pace in timed blocks and full-length mocks.
General MCQAnterior segment and contact lensesQuestion 1 of 7
A 52-year-old woman developed a right facial palsy 3 days ago. She can't fully close her right eye (2 mm lagophthalmos), it feels gritty, and there is inferior punctate staining with fluorescein. Bell's phenomenon is good. Her physician is managing the palsy. What is the most appropriate ocular management?
- APreservative-free tears by day, ointment at night, and taping the lid closed for sleep
- BA bandage contact lens worn continuously, day and night, until the facial nerve palsy recovers
- CTopical prednisolone acetate 1% four times daily to settle the corneal inflammation
- DNo eye treatment, since a good Bell's phenomenon fully protects the cornea at night
Show the answer and explanation
Answer: A. Exposure keratopathy from incomplete closure is treated by keeping the surface wet and covered: frequent preservative-free tears, ointment and lid taping (or a moisture chamber) at night. Refer for a lid weight or tarsorrhaphy if the cornea breaks down despite this, or if corneal sensation is reduced.
- B. A bandage lens can dry out on an exposed eye and raises the risk of infection; it isn't first-line.
- C. This is a drying problem, not inflammation; a steroid adds risk without helping.
- D. Bell's phenomenon helps, but the inferior staining shows the cornea is already drying.
Based on: Standard management of exposure keratopathy (CAO and AAO cornea guidance)
General MCQRefractive error and spectaclesQuestion 2 of 7
A presbyope wears OD −1.00 DS and OS −4.00 DS with a +2.00 add in bifocals. She reads through the segments about 10 mm below the distance optical centres. What vertical prismatic imbalance does she meet at reading level?
- A1Δ
- B3Δ
- C4Δ
- D5Δ
Show the answer and explanation
Answer: B. Prentice's rule: prism (Δ) = decentration (cm) × power (D). At 1 cm below the optical centres, the right lens gives 1Δ and the left 4Δ, both base down; the equal adds cancel. The imbalance is 3Δ, more than most people tolerate (about 1–1.5Δ). Consider a slab-off on the more minus (left) lens, or contact lenses.
- A. That is the prism in the right lens alone.
- C. That is the prism in the left lens alone.
- D. That adds the two lenses instead of taking the difference.
Based on: Prentice's rule (prism = decentration in cm × lens power in D)
General MCQOther causes of vision lossQuestion 3 of 7
A 17-year-old who started minocycline for acne 3 months ago has daily headaches and brief greying of vision when she stands up. VA is 20/20 OU, colour vision is normal, and both optic discs are swollen with obscured vessels at the margins. Blood pressure is 118/74. What is the most appropriate next step?
- AReassure her that normal acuity rules out anything serious, and review her in 3 months
- BDiagnose bilateral optic neuritis and start prednisolone acetate drops four times daily
- CDiagnose buried optic disc drusen and repeat the photos and B-scan in 6 months
- DSame-day referral for papilledema work-up, and tell her physician about the minocycline
Show the answer and explanation
Answer: D. Bilateral disc swelling is papilledema until proven otherwise: it needs urgent imaging to exclude a mass or venous sinus thrombosis, then a lumbar puncture. Tetracyclines such as minocycline and doxycycline can cause raised intracranial pressure, and the physician will usually stop the drug. Acuity stays normal until late; transient obscurations are a warning sign.
- A. Acuity is preserved until late in papilledema; waiting risks permanent field loss.
- B. Optic neuritis is usually painful with reduced acuity, colour vision and an RAPD, and topical steroids don't treat it.
- C. Obscured vessels and transient obscurations point to true swelling; drusen can't be assumed without imaging now.
Based on: Recognized drug-induced intracranial hypertension (tetracyclines); urgent work-up of bilateral disc swelling
General MCQCollaborative care, law and ethicsQuestion 4 of 7
Your office emailed a patient's eye examination report to the wrong family physician's clinic. Under Ontario's Personal Health Information Protection Act (PHIPA), what must you do?
- ANothing, as long as the other clinic is also a health care provider bound by PHIPA
- BReport it to the police, as an unauthorized disclosure is a criminal offence
- CContain it, tell the patient at the first reasonable opportunity, and log it
- DTell the patient only if she asks where her report was sent
Show the answer and explanation
Answer: C. PHIPA requires a custodian to notify the individual at the first reasonable opportunity when their health information is used or disclosed without authority. Contain it first (ask the recipient to securely delete it and confirm), document it, and report to the Information and Privacy Commissioner of Ontario when the breach meets the reporting criteria.
- A. Sending it to the wrong clinic is still an unauthorized disclosure.
- B. It's a privacy breach handled under PHIPA and the College's standards, not a police matter.
- D. Notification is required, not optional.
Based on: Ontario Personal Health Information Protection Act, 2004 (PHIPA), s. 12(2) notice of theft, loss or unauthorized use or disclosure
General MCQBinocular vision and pediatricsQuestion 5 of 7
Parents of a 6-year-old with low hyperopia (+0.75 D) ask how to lower her risk of becoming myopic. Which advice is best supported by evidence?
- AMore time outdoors, about 2 hours a day, with regular breaks from close work
- BWear low-plus reading glasses for all close work, to reduce her focusing effort
- CAvoid all screens until she is 10, since screen time is the main cause of myopia
- DDo daily eye exercises, such as near–far focusing drills, to strengthen accommodation
Show the answer and explanation
Answer: A. Trials in children show that extra daylight time outdoors (around 2 hours a day) reduces the onset of myopia. Breaks from sustained near work are sensible. Low hyperopia is a normal reserve at age 6; monitor her refraction and discuss myopia control if she becomes myopic.
- B. Plus lenses for near haven't been shown to prevent myopia in children who aren't myopic.
- C. Near work is linked with myopia, but outdoor time is the strongest protective factor; avoiding all screens isn't needed.
- D. Eye exercises don't prevent myopia.
Based on: Randomized trials of outdoor time and myopia onset in children; CAO guidance on myopia management
TPAO case: Itchy eyes every spring in a contact lens wearer
- Patient
- Ms. R, 28
- History
- Itchy, watery, red eyes every spring for years, worse outdoors. Wears daily disposable soft lenses. Seasonal rhinitis.
- Findings
- VA 20/20 OU. Bilateral conjunctival hyperemia and mild chemosis, fine papillae on the upper tarsus, clear corneas, no discharge, no preauricular nodes.
- Medications
- Fluticasone nasal spray in spring
- Allergies
- None known. Not pregnant.
TPAOTreatment selectionQuestion 6 of 7
Which treatment is most appropriate first?
- APrednisolone acetate 1% four times daily for the whole allergy season
- BOlopatadine 0.1% twice daily, at least 10 minutes before lens insertion
- CNaphazoline decongestant drops four times daily for as long as needed
- DTobramycin drops four times daily for 1 week, in case of infection
Show the answer and explanation
Answer: B. A dual-action antihistamine and mast cell stabilizer (olopatadine, ketotifen or bepotastine, all on Ontario's Schedule 1) relieves itch quickly and prevents mediator release. Daily disposables suit her; she should put drops in before the lenses (or after removing them) and use cold compresses and preservative-free tears to rinse allergens.
- A. Months of a potent steroid risk raised IOP and cataract; steroids are for short bursts in severe disease.
- C. Decongestants cause rebound redness with regular use and do little for itch.
- D. There's no sign of infection.
Based on: O. Reg. 112/11 Schedule 1 (topical anti-allergic agents); standard management of seasonal allergic conjunctivitis
TPAOMechanism of actionQuestion 7 of 7
How does olopatadine work?
- AIt inhibits cyclo-oxygenase and prostaglandin synthesis
- BIt suppresses T-cell activation by inhibiting calcineurin
- CIt blocks H1 receptors and stabilizes mast cells
- DIt constricts conjunctival blood vessels through alpha receptors
Show the answer and explanation
Answer: C. Olopatadine is an H1-receptor antagonist, so it relieves itch within minutes, and it also stabilizes mast cells, reducing release of histamine and other mediators with regular use.
- A. That describes NSAIDs such as ketorolac.
- B. That describes cyclosporine and tacrolimus.
- D. That describes decongestants such as naphazoline.
Based on: Pharmacology of olopatadine (H1 antagonist and mast cell stabilizer)