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Exam Review

Key Facts: CRA Exam

175

Written Exam Questions

2 hours

465–490 nm

FA Exciter Filter

520–530 nm barrier filter

8–12 s

Choroidal Flush Timing

OPS FA blueprint

$590

Non-Member Exam Fee

OPS BOC 2026

3 years

Recertification Interval

15 CECs required

805/830 nm

ICG Wavelengths

Excitation/emission

The CRA written exam has 175 questions in 2 hours. Topics span FA/ICG physics, phase timing, retinal disease patterns, camera systems, and safety. Eligibility requires active ophthalmic imaging employment and qualifying work example submission. Recertification is every 3 years with 15 CECs. The OPS BOC has administered this credential since 1979 with NCCA accreditation.

Sample CRA Practice Questions

Try these sample questions to review concepts for the CRA exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 175+ question experience with AI tutoring.

1Which retinal layer is primarily responsible for converting light into electrical signals?

A.Retinal pigment epithelium (RPE)

B.Photoreceptor layer (rods and cones)

C.Inner plexiform layer

D.Ganglion cell layer

Explanation: Rods and cones (photoreceptors) are the light-sensitive cells that perform phototransduction, converting photons into neural signals. The RPE supports photoreceptors but does not itself perform primary light detection.

2The fovea centralis is the area of highest visual acuity because it contains a high density of:

A.Rods only

B.Cones only

C.Rods and cones equally

D.Ganglion cells only

Explanation: The fovea is a cone-dense pit at the center of the macula. Rods are absent from the foveal center. This cone concentration provides maximum color vision and visual acuity.

3The choroid is a vascular layer located between the:

A.Cornea and iris

B.Iris and lens

C.Retina and sclera

D.Vitreous and retina

Explanation: The choroid lies between the retina (inner) and sclera (outer), supplying the outer retinal layers including photoreceptors via the choriocapillaris.

4Which structure forms the blood–retinal barrier on the outer side of the retina?

A.Bruch's membrane

B.Inner limiting membrane

C.Retinal pigment epithelium (RPE)

D.Choriocapillaris endothelium

Explanation: Tight junctions between RPE cells form the outer blood-retinal barrier between the choroid and outer retina.

5The optic disc is the site where:

A.The foveal pit reaches maximum depth

B.Retinal nerve fibers exit as the optic nerve

C.The choriocapillaris ends abruptly

D.The macula is anatomically centered

Explanation: The optic disc is the exit point of all retinal ganglion cell axons forming the optic nerve. It has no photoreceptors, creating a physiological blind spot.

6The vitreous humor occupies which compartment of the eye?

A.Between cornea and iris

B.Between iris and lens

C.Inside the crystalline lens

D.Between lens and retina

Explanation: The vitreous humor fills the large posterior segment of the eye between the posterior lens surface and the retina, providing structural support.

7The macula lutea derives its yellow color from the presence of:

A.Hemoglobin

B.Xanthophyll pigments (lutein and zeaxanthin)

C.Melanin in the RPE only

D.Fluorescein accumulation

Explanation: Lutein and zeaxanthin are xanthophyll carotenoids concentrated in the macula, filtering short-wavelength blue light and protecting photoreceptors.

8Bruch's membrane is located between the:

A.RPE and choriocapillaris

B.Photoreceptors and RPE

C.Inner nuclear layer and IPL

D.Ganglion cell layer and nerve fiber layer

Explanation: Bruch's membrane is a thin extracellular matrix sheet between the RPE basal lamina and the choriocapillaris. It plays a role in AMD pathogenesis.

9The central retinal artery is the primary blood supply to which retinal layers?

A.Outer retina including photoreceptors

B.Inner retinal layers (GCL through INL)

C.Choroid and RPE

D.All retinal layers equally

Explanation: The central retinal artery (a branch of the ophthalmic artery) supplies the inner retinal layers from the ganglion cell layer to the inner nuclear layer. The outer retina relies on the choroidal circulation.

10In fluorescein angiography, the inner blood–retinal barrier is formed by tight junctions between:

A.RPE cells

B.Retinal vascular endothelial cells

C.Müller cells

D.Pericytes

Explanation: Tight junctions between retinal capillary endothelial cells form the inner blood–retinal barrier, preventing fluorescein from leaking into the retina under normal conditions.

About the CRA Exam

The CRA credential validates competency in fundus photography and retinal angiography. The certification requires submission of qualifying work examples and successful completion of the single written examination (175 MCQ, 2 hours) after the portfolio (30 color images plus four angiograms), employment letter, and CPR certificate are accepted as eligibility requirements. Topics cover fluorescein and ICG angiography principles, retinal anatomy, disease pattern interpretation, camera systems, and patient safety. Recertification is required every 3 years via 15 continuing education credits.

Exam sponsor: Ophthalmic Photographers' Society Board of Certification (OPS BOC). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

175 questions

Time Limit

2 hours, closed book, at Prometric test centers (CRA Program Guide v15.1). There is no separate practical or image-review exam; the 30-image portfolio is an eligibility requirement reviewed before the written exam.

Passing Score

OPS BOC scaled passing standard

Exam / Certification Fees

$285-590

Exam sponsor website

Reported exam pass rate: Not publicly published. active clinical imaging experience correlates with success Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

16%

Anatomy, Physiology, and Pathology of the Eye

Ocular anatomy, retinal and choroidal circulation, blood-retinal barriers, and the angiographic appearance of common retinal and choroidal diseases (28 items)

Patient Management and Patient/Operator Safety

Patient preparation, consent, history, adverse reaction recognition and response, CPR, universal precautions, and HIPAA (10 items)

10%

General Photography

Digital imaging principles: resolution, bit depth, dynamic range, gain, color management, artifacts, and image processing (18 items)

Data and Image Management

DICOM, PACS, EMR integration, archiving, backup, and network security for ophthalmic images (7 items)

23%

Fundus Photography (Fundus Camera and Scanning Laser Ophthalmoscope)

Camera operation, fields of view, stereo technique, alignment and focus, image quality faults, and SLO principles (40 items)

Monochromatic Imaging and Fundus Autofluorescence

Monochromatic filters and wavelengths, red-free imaging, blue and infrared autofluorescence (9 items)

25%

Fluorescein Angiography (Fundus Camera or SLO)

Filters, phase timing, hyper- and hypofluorescence mechanisms, capture technique, and interpretation of common patterns (43 items)

Indocyanine Green (ICG) Angiography

ICG dye properties, infrared imaging principles, and applications in choroidal imaging (5 items)

Pharmacology

Sodium fluorescein and ICG dye properties, dosing, contraindications, mydriatics, anesthetics, and adverse reactions (9 items)

Other Imaging Technology

OCT, OCT angiography, anterior segment imaging, non-mydriatic and ultra-wide field systems (6 items)

Preparing for the CRA Exam

What You Need to Know

Passing score: OPS BOC scaled passing standard
Exam length: 175 questions
Time limit: 2 hours, closed book, at Prometric test centers (CRA Program Guide v15.1). There is no separate practical or image-review exam; the 30-image portfolio is an eligibility requirement reviewed before the written exam.
Exam / certification fees: $285-590 Official sources

Using Our Practice Resources

Work through all 175 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

CRA: Suggested Study Strategy

1Memorize FA phase timing: arm-to-retina 10–15 s, choroidal flush at about 10–12 s, arterial phase 1–2 s later, peak fluorescence 30–35 s, mid phase 2–4 min, late phase 5+ min

2Know the 465–490 nm blue exciter / 520–530 nm barrier filter pair for FA and the 805 nm absorption / 830 nm emission peaks for ICG

3Understand the four FA hyperfluorescence mechanisms: transmission (window) defect, leakage, staining, and pooling, plus the autofluorescence and pseudofluorescence artifacts

4Learn the two FA hypofluorescence patterns: blockage vs. filling defect (ischemia)

5Study disease-specific FA patterns: CSCR smokestack, CME petaloid, CNV lacy network, APMPPE dark-then-bright

6Review ICG advantages for choroidal imaging: protein binding, NIR penetration, PCV polyp detection

7Know the standard sodium fluorescein dose (500 mg IV), excretion route (renal), and urine discoloration duration (24–36 h)

8Understand anaphylaxis management: IM epinephrine first-line, O2, IV fluids, antihistamines adjunct

9Practice image quality troubleshooting: corneal fluorescence artifact, specular reflection, focus technique

10Review OPS BOC recertification: 15 CECs every 3 years, 5 from official OPS/BOC sources

Frequently Asked Questions

What is the OPS CRA certification?

The Certified Retinal Angiographer (CRA) is a professional credential awarded by the Ophthalmic Photographers' Society Board of Certification (OPS BOC) since 1979. It validates competency in fundus photography and fluorescein/ICG retinal angiography. The BOC is NCCA-accredited. Certification requires an accepted 30-image portfolio, a two-year employment letter, and a CPR certificate as eligibility requirements, followed by one written exam of 175 multiple-choice questions.

What are the CRA eligibility requirements?

Candidates must be actively employed in an ophthalmic imaging role and submit a portfolio of 30 color images plus four fluorescein angiograms of different patients (three showing pathology), an employer letter verifying two years of employment as a retinal angiographer, and a current CPR certificate. OPS membership is encouraged but not required.

How many questions are on the CRA written exam?

The CRA written exam contains 175 multiple-choice questions, each with four answer options. Candidates have 2 hours to complete it. The written exam is the only examination; the image portfolio is reviewed as an eligibility requirement before the exam, and there is no separate practical exam (CRA Program Guide v15.1).

What topics are covered on the CRA exam?

The CRA exam covers fundus photography and fluorescein angiography (principles, phase timing, filter pairs, interpretation), ICG angiography, retinal disease patterns (AMD, diabetic retinopathy, vascular occlusions, CSCR, and others), camera systems, pharmacology, image management, and patient and workflow safety.

How much does the CRA exam cost?

The CRA exam fee for non-OPS members is $590, which includes a 1-year OPS membership. Retesting fees are $285 per component. OPS member fees are lower. Contact OPS BOC for current fee schedules.

How long is CRA certification valid?

CRA certification is valid for 3 years. Recertification requires accumulating 15 continuing education credits (CECs) within each 3-year interval, with at least 5 CECs from official OPS or OPS BOC-approved courses and workshops.

How should I prepare for the CRA exam?

Study the OPS CRA Program Guide and focus on FA/ICG physics, phase timing, interpretation patterns (leakage, staining, pooling, window defects, blockage), retinal disease FA findings, and camera operation. Gain hands-on experience with fundus cameras and angiographic interpretation. Practice image review with real case series. Plan for 8–14 weeks of structured study.