100+ Free OSC Practice Questions

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Which tonometer is best when bedside testing without topical anesthetic is needed?

Schiötz

Goldmann

iCare

Perkins

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2026 Statistics

Key Facts: OSC Exam

125

Open-book MCQ

IJCAHPO OSC

14 days

Window

After exam start

~$250-395

Exam Fee

IJCAHPO

Open Book

Format

Reference materials allowed

IJCAHPO OSC is the ophthalmic scribe credential. 125 MCQ open-book over 14-day window. Master ophthalmic abbreviations (OD/OS/OU, c/d), Goldmann tonometry (gold standard 10-21 mmHg normal), Humphrey VF interpretation, glaucoma drop classes (PGAs/beta-blockers/alpha-2/CAIs/Rho kinase), anti-VEGF for wet AMD, scribe scope (documents under MD; does NOT diagnose/prescribe).

Sample OSC Practice Questions

Try these sample questions to test your OSC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1How many distinct layers make up the cornea?

A.3

B.4

C.5

D.6

Explanation: The cornea has 5 layers from anterior to posterior: epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium.

2Which extraocular muscle is innervated by cranial nerve IV (trochlear)?

A.Lateral rectus

B.Superior oblique

C.Inferior oblique

D.Medial rectus

Explanation: The superior oblique is innervated by CN IV (trochlear). The mnemonic LR6SO4 reminds us that the lateral rectus is CN VI and the superior oblique is CN IV; all others are CN III.

3Which structure is responsible for the sharpest central visual acuity?

A.Optic disc

B.Fovea

C.Peripheral retina

D.Ciliary body

Explanation: The fovea, located within the macula, contains the highest density of cone photoreceptors and provides the sharpest central vision.

4Which muscle closes the eyelid and is innervated by cranial nerve VII?

A.Levator palpebrae superioris

B.Müller muscle

C.Orbicularis oculi

D.Superior tarsal muscle

Explanation: The orbicularis oculi closes the eyelid and is innervated by the facial nerve (CN VII). Bell's palsy can impair eyelid closure.

5What is the correct path of tears from the puncta to the nose?

A.Puncta -> nasolacrimal duct -> lacrimal sac -> canaliculi -> inferior meatus

B.Puncta -> canaliculi -> lacrimal sac -> nasolacrimal duct -> inferior meatus

C.Lacrimal sac -> puncta -> canaliculi -> nasolacrimal duct -> superior meatus

D.Canaliculi -> puncta -> nasolacrimal duct -> lacrimal sac -> middle meatus

Explanation: Tears drain from puncta into canaliculi, then to the lacrimal sac, down the nasolacrimal duct, and finally into the inferior meatus of the nose.

6Which extraocular muscle abducts the eye?

A.Medial rectus

B.Lateral rectus

C.Superior oblique

D.Inferior rectus

Explanation: The lateral rectus abducts the eye (turns it outward) and is innervated by CN VI (abducens).

7Denervation of Müller's muscle results in which finding seen in Horner syndrome?

A.Complete ptosis

B.Mild ptosis (1-2 mm)

C.Proptosis

D.Ectropion

Explanation: Müller's muscle is sympathetically innervated and provides 1-2 mm of lid elevation. Loss of sympathetic input (Horner syndrome) causes mild ptosis.

8How many extraocular muscles control eye movement in each eye?

A.4

B.5

C.6

D.7

Explanation: There are 6 extraocular muscles per eye: 4 rectus muscles (superior, inferior, medial, lateral) and 2 oblique muscles (superior and inferior).

9The crystalline lens is suspended in place by which structures?

A.Ciliary processes via zonules

B.Iris stroma

C.Trabecular meshwork

D.Vitreous fibrils

Explanation: The crystalline lens is suspended by zonular fibers that attach to the ciliary body, allowing accommodation through ciliary muscle contraction and relaxation.

10Which retinal layer is the outermost (closest to the vitreous)?

A.Retinal pigment epithelium

B.Photoreceptor layer

C.Nerve fiber layer

D.Outer nuclear layer

Explanation: The retina has 10 layers; the nerve fiber layer (NFL) is the innermost layer relative to the choroid but the outermost as viewed from the vitreous side, lying closest to the vitreous.

About the OSC Exam

IJCAHPO credential for ophthalmic scribes — documentation specialists working under MD supervision in eye-care practices. 125-MCQ open-book exam with 14-day completion window. Covers ophthalmic anatomy, EHR documentation (SOAP, ICD-10, CPT), history taking, ophthalmic abbreviations (VA/OS/OD/OU/IOP), instruments and tests (slit lamp, tonometer, OCT, VF, fundus camera), pharmacology (glaucoma drops, mydriatics), terminology, and patient services.

Questions

125 scored questions

Time Limit

14-day window

Passing Score

Scaled (IJCAHPO-set)

Exam Fee

~$250-395 (IJCAHPO)

OSC Exam Content Outline

15%

Ophthalmic Anatomy

Globe, eyelid, lacrimal, EOMs, retina, optic nerve, macula

15%

EHR Documentation

SOAP, ICD-10, CPT (92002/004/012/014), scribe role boundaries

15%

Ophthalmic Abbreviations

VA, OS/OD/OU, IOP, EOM, VF, c/d, FU, PERRLA, DFE

15%

Instruments & Tests

Slit lamp, tonometer (Goldmann/Tono-Pen/iCare), OCT, VF (Humphrey), fundus camera, pachymetry

10%

Pharmacology

Glaucoma drops (PGAs, BB, alpha-2, CAI, RKi), mydriatics, anti-VEGF

10%

History Taking

CC, HPI, PMH, ocular history, family history

10%

Terminology

Cataract, glaucoma, AMD, DR; phaco, vitrectomy, trabeculectomy

10%

Patient Services & Supplemental

Patient flow, scheduling, billing basics, HIPAA

How to Pass the OSC Exam

What You Need to Know

Passing score: Scaled (IJCAHPO-set)
Exam length: 125 questions
Time limit: 14-day window
Exam fee: ~$250-395

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

OSC Study Tips from Top Performers

1Master ophthalmic abbreviations — high-yield: OD/OS/OU, IOP, c/d, EOM, VF, DFE, PERRLA

2Memorize glaucoma drop classes and once-nightly PGA dosing pattern

3Drill EHR documentation: SOAP structure, scribe role boundaries (no diagnosis/prescription/signing)

4Know normal IOP 10-21 mmHg by Goldmann (gold standard); other tonometers Tono-Pen, iCare (no anesthesia)

5Build open-book reference sheets for fast 14-day window completion

Frequently Asked Questions

What does the scribe do vs what does the MD do?

Scribe DOCUMENTS in real time UNDER physician supervision. Scribe scope: enters chief complaint, HPI, exam findings as dictated/observed, orders as ordered by MD, copies imaging into note, records assessment/plan as MD states. Scribe does NOT: see patients independently, make medical decisions, diagnose, prescribe, perform procedures, sign orders. Scribe documentation must be authenticated by MD signature. Many EHRs auto-attribute the scribe in audit trail (Joint Commission requirement).

What does c/d ratio mean?

c/d = cup-to-disc ratio. Measures the central depression (cup) of the optic nerve head relative to the total disc diameter. Normal c/d: 0.3-0.5. Suspicious for glaucoma: c/d ≥0.6, asymmetry between eyes >0.2, focal notching, or disc hemorrhage. Documented as horizontal × vertical (e.g., "0.4 × 0.5") or simply "c/d 0.5". Tracked over time — increase suggests glaucoma progression.

How are glaucoma eye drops classified?

Major glaucoma drop classes (most-to-least prescribed): (1) Prostaglandin analogs (PGAs) — latanoprost, bimatoprost, travoprost, latanoprostene bunod (Vyzulta) — once nightly, increase outflow, first-line. (2) Beta-blockers — timolol, betaxolol — reduce production, contraindicated asthma/COPD/bradycardia. (3) Alpha-2 agonists — brimonidine. (4) CAIs — dorzolamide drop, brinzolamide drop, oral acetazolamide. (5) Rho kinase inhibitors — netarsudil. (6) Combinations (Cosopt, Combigan, Simbrinza, Rocklatan).

How should I study for IJCAHPO OSC?

Plan 40-80 hours over 6-8 weeks. The exam is OPEN-BOOK with a 14-day window — focus on knowing WHERE to find information rather than memorizing. Master ophthalmic abbreviations + anatomy, EHR documentation conventions, glaucoma drop classes, common ICD-10 (H00-H59) and CPT (92002-92014) codes, and scribe scope boundaries. Build personal reference sheets organized by exam category for fast lookup during the open-book exam.