What Is the NBEO? The Optometry Board Exams Explained (Parts I, II, III, TMOD, ISE, LSPE)

NBEO — the National Board of Examiners in Optometry — is the testing organization for optometric licensure.

It dates to 1951 and describes its exams as universally accepted for optometric licensure in the United States.

NBEO does not license anyone.

There is no national optometry license: each of the 51 US jurisdictions sets its own requirements, and the typical baseline is an ACOE-accredited OD degree plus passing the NBEO licensure exams.

Once you have passed Part I, Part II, Part III and TMOD, and your school has confirmed your graduation, NBEO issues a certificate, usually printed and mailed within 12 weeks.

That certificate is easy to misread.

NBEO is explicit that its certificate is not board certification, and it points candidates who want board certification to the American Board of Optometry.

NBEO ran its own board-certification program once and discontinued it on February 1, 2019, citing low participation; the American Board of Certification in Medical Optometry is the medical-optometry counterpart.

If you are weighing these exams against the career they unlock, the optometrist career guide covers the role itself — the daily work, practice settings and modes of practice.

The licensure sequence is three core exams — Part I ABS, Part II PAM and Part III PEPS — with TMOD built into Part II.

Two skill exams, the ISE and the LSPE, sit beside the sequence as separate entry-into-the-profession exams under the same NBEO attempt rules.

• Part I ABS (Applied Basic Science) — the basic-science exam, with content across anatomy, biochemistry and physiology, immunology, microbiology and pathology, optics and pharmacology.
• Part II PAM — a case-based exam: candidates work through cases of 3–6 items each, for a total of 350 items, approximately 120 of them TMOD items. You receive an overall PAM pass/fail and a separate TMOD pass/fail.
• TMOD (Treatment and Management of Ocular Disease) — the ocular-disease treatment portion, embedded in Part II or taken stand-alone; a candidate who passed PAM overall but failed the TMOD portion can register for stand-alone TMOD.
• Part III PEPS — the clinical skills exam: 12 stations, 10 patient-encounter stations with standardized patients plus 2 clinical skills stations, completed in a 4.5-hour session and fully audio/video recorded.
• ISE — the Injections Skill Examination: one clinical skill on a simulated arm, demonstrated within a 15-minute period, covering preparation and performance of an IV injection for fluorescein angiography and an intramuscular injection of epinephrine.
• LSPE — the laser and surgical procedures exam, a hybrid of clinical skills and multiple choice with two sections, Laser and Surgical, registered and taken separately. Laser Section skills are selective laser trabeculoplasty, laser peripheral iridotomy and YAG capsulotomy; the Surgical Section covers suturing and chalazion excision. In July 2026 NBEO publicly urged Kentucky’s board (the KBOE) to make LSPE passage a prerequisite for performing optometric laser and surgical procedures — as of that statement, Kentucky did not require it.
• ACMO (Advanced Competence in Medical Optometry) — not part of the licensure sequence. NBEO developed it in 2005 at the request of the National Association of VA Optometrists, and the American Board of Certification in Medical Optometry uses passing it in its board certification.
• OSLE — the Online State Law Exam, a service NBEO has offered since January 2010 to administer state boards’ own optometry jurisprudence exams. It is not a national exam: whether you owe a law exam, and which one, is your state board’s decision.

Where the exams happen splits two ways.

Part I ABS, Part II PAM/TMOD and ACMO run on computer at up to 200 Pearson VUE test centers, and switching to another Pearson center is free with at least one business day’s notice.

Part III PEPS, the ISE and the LSPE run only at NBEO’s National Center of Clinical Testing in Optometry (NCCTO) in Charlotte, North Carolina.

The sequence is also bounded.

Under NBEO’s Six-Time Limit Policy, candidates must pass each entry exam within the first six attempts, and any started exam counts as an attempt.

Part I ABS opens first.

Students at an ACOE-accredited (or preliminarily approved) OD program may sit it beginning with the March administration of their third professional year.

Everything else in the licensure sequence waits for the graduation year: Part II PAM/TMOD, Part III PEPS, the ISE and the LSPE all become available during the academic year you graduate.

Within those limits, the order is yours.

NBEO lets candidates take its exams in any order once they are eligible — Part II before Part I, if that is how the schedule falls.

The LSPE’s eligibility reaches beyond students: NBEO offers it to fourth-year optometric students, optometric residents and practicing ODs.

Not every candidate comes through an accredited US program.

If you are not a student or graduate of an ACOE-accredited program — foreign-trained ODs, for example — NBEO requires sponsorship by a state optometry board or an ACOE-accredited program before you can sit its exams.

ARBO notes that every US optometry school offers an ACOE-accredited program, plus two in Canada, and that there are no accredited OD programs outside the US and Canada.

Timing matters most if you are heading to a residency.

NBEO transmits scores automatically to ORMatch, the optometry residency match, and registering with ORMatch requires the OE Tracker number NBEO issues.

Because PEPS scores take 6–8 weeks to process, NBEO recommends testing before January: a January PEPS date produces scores in March, possibly after Match Day.

The score report is the bridge between NBEO and the licensing boards.

There is no national license to unlock: all 51 jurisdictions license optometrists themselves, and NBEO’s job ends where the board’s begins.

For students, NBEO submits scores to the state boards selected at registration only after two things happen: the candidate has passed every NBEO part those boards require, and NBEO has received graduation verification from the school.

Up to five board selections are free, and one free cumulative report also goes to the candidate’s school if the candidate authorizes it.

Candidates who are no longer students order board reports instead, and NBEO processes those within 7 business days.

Scores themselves do not expire at NBEO.

Individual state boards may have their own rules on how recent scores must be, so check the board you are applying to.

State law exams are the other half of the handoff.

Ten states delivered their law exams through NBEO’s OSLE as of October 2026, per NBEO’s published list.

The state board, not NBEO, sets the pass mark and releases those scores, and OSLE results do not appear on the NBEO score report.

The split between exam and license has real edges.

In a July 16, 2026 statement, NBEO said it had identified 30 people granted Kentucky optometry licenses under a special waiver without passing one or more NBEO parts, and that a Kentucky license — unlike other states’ — is not evidence of NBEO passage.

The same split is why verification exists as a service.

An employer can check which NBEO exams a candidate took, when, and with what pass/fail result, for a $60 fee with the candidate’s signed release; NBEO does not track license status, so the license check belongs to the state board.

NBEO publishes its fees by administration year.

The amounts below are for administrations beginning August 2026, as published on optometry.org in October 2026.

Budget without counting on help from NBEO: it offers no financial assistance or fee waivers for its exams.

The OSLE fee and the late registration fee are non-refundable.

Registration works differently for the clinical exams.

PEPS, the ISE and the LSPE are scheduled continuously at the NCCTO for the administration beginning August 2026; PEPS registration closes 30 days before the exam date, and the ISE and LSPE close 7 days before.

Plan around two hard rules.

First, an exam cannot be moved to a different administration — if your date stops working, you withdraw.

Second, the refund window is short.

For Part I, Part II/TMOD and ACMO, written notice 30 or more days before the first test date gets a full refund.

Notice by the withdrawal deadline 14 days out gets the fee back minus a 20% service fee, and after that the whole fee is forfeited.

Start with what passing means.

Part I ABS and Part II PAM are scaled from 100 to 900, and anything above 300 is a passing score; Part III PEPS reports only pass or fail.

There is no curve moving that standard.

NBEO does not grade on a curve or prescribe that a certain number of candidates pass or fail, and it statistically equates exam forms for difficulty.

We did not find an official national pass-rate table on NBEO’s site in our October 2026 review, so we can’t quote one here; if NBEO has published national figures since, they would appear on optometry.org.

Treat any single national number you meet secondhand with care.

You will also see pass rates from two other places, and the two sets count different people.

Optometry schools publish first-time-taker NBEO pass rates in outcome disclosures that use ACOE-mandated language, and those figures include all first-time takers regardless of graduation status.

ASCO’s published rates are limited to candidates who have graduated, so the two sets of figures differ even for the same exams.

Career information, not licensing, legal, medical, clinical or billing advice. Exam names, fees and rules are NBEO’s to change; confirm current requirements with NBEO at optometry.org and with the state board of optometry where you plan to practice.