100+ Free OCT-C Practice Questions

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Question 1

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When performing OCT imaging on a patient who has had macular laser photocoagulation, the technologist should anticipate:

Focal hyperreflective scars at the RPE/outer retinal level at laser impact sites with variable outer retinal disruption

Uniform thickening of the inner retinal layers at treated areas

Absent OCT signal in all layers at treated spots

No detectable change on OCT at laser spots

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Key Facts: OCT-C Exam

Passing Score

OPS BOC 0–100 scale

$465

Exam Fee

Non-member, includes 1-yr OPS

$220

Retest Fee

OPS BOC program guide

3 years

Recertification Cycle

OPS BOC

8 CECs

Recertification Credits

4+ OPS-approved required

Prometric

Testing Provider

Year-round centers

The OCT-C is awarded by the OPS Board of Certification to imaging professionals who pass a Prometric written exam and submit a qualifying OCT portfolio. The exam uses a 0–100 scaled score with a passing cut of 70. Exam fee is $465 for non-members (includes 1-year OPS membership); retest is $220. Recertification requires 8 CECs every 3 years (minimum 4 from OPS-approved sources). Topics span OCT physics, retinal anatomy and pathology, glaucoma OCT, OCTA, and artifact management.

Sample OCT-C Practice Questions

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

1OCT uses low-coherence interferometry to generate images. What property of light makes this technique possible?

A.High temporal coherence of laser diodes

B.Short coherence length of broad-bandwidth light sources

C.Polarization of infrared laser beams

D.Doppler frequency shift of reflected photons

Explanation: Low-coherence interferometry exploits the very short coherence length of broad-bandwidth light. Interference fringes only form when path lengths of reference and sample beams match within micrometers, enabling axial depth resolution of ~5–10 µm.

2Time-domain OCT (TD-OCT) achieves depth scanning by moving the reference mirror. What is its primary speed limitation compared with spectral-domain OCT?

A.Lower light source bandwidth

B.Sequential mechanical mirror position changes

C.Absence of a CCD detector array

D.Inability to detect infrared wavelengths

Explanation: TD-OCT requires the reference mirror to physically translate to each depth position sequentially, limiting A-scan rates to ~400 scans/second. Spectral-domain OCT acquires all depths simultaneously via Fourier transform, reaching >20,000 A-scans/second.

3Standard spectral-domain OCT (SD-OCT) typically operates at a center wavelength of approximately 840 nm. What tissue characteristic favors this wavelength for retinal imaging?

A.Maximum absorption by oxyhemoglobin

B.Optimal balance of water absorption and axial resolution

C.Minimum reflection from the vitreous

D.Peak fluorescence excitation of lipofuscin

Explanation: ~840 nm sits in a water absorption window where retinal tissue scatters more than it absorbs, giving adequate penetration through retina while maintaining ~5–7 µm axial resolution from broad source bandwidth.

4Swept-source OCT (SS-OCT) typically uses a ~1050 nm center wavelength. What primary advantage does this confer over 840 nm SD-OCT?

A.Better axial resolution in the inner retina

B.Deeper penetration through the RPE into the choroid

C.Higher lateral resolution at the fovea

D.Faster A-scan rates in all tissue types

Explanation: 1050 nm experiences less scattering and lower RPE melanin absorption, enabling imaging of choroidal vessels and sclera beyond the RPE — critical for choroidal thickness mapping and pachychoroid disease.

5In OCT terminology, a single depth profile of reflectivity along the beam axis is called:

A.B-scan

B.A-scan

C.Volume cube

D.En-face slice

Explanation: An A-scan is one axial depth profile of tissue reflectivity acquired from a single beam position. Multiple laterally displaced A-scans compose a B-scan cross-section.

6Axial resolution in OCT is primarily determined by:

A.Numerical aperture of the focusing objective

B.Coherence length of the light source

C.Scan speed of the galvanometer mirror

D.Signal-to-noise ratio of the detector

Explanation: Axial (depth) resolution equals approximately 0.44 λ²/Δλ (half-power coherence length). Broader source bandwidth (Δλ) produces shorter coherence length and finer axial resolution, independent of beam optics.

7Lateral resolution in retinal OCT is limited primarily by:

A.Source bandwidth

B.Pupil diameter and beam focus optics

C.Reference mirror position

D.CCD pixel size in the spectrometer

Explanation: Lateral resolution equals roughly λ/NA (NA set by pupil size and focal optics). A dilated pupil and optimized scan lens improve lateral resolution but cannot exceed diffraction limits (~15–20 µm clinically).

8A volume cube OCT acquisition covers 6 × 6 mm with 512 B-scans each containing 512 A-scans. What does this data set allow that a single cross-sectional B-scan cannot?

A.Higher axial resolution per A-scan

B.Three-dimensional reconstruction and en-face visualization at any depth

C.Longer total imaging depth range

D.Reduced motion artifact per B-scan

Explanation: A volume cube captures all three spatial dimensions, enabling en-face (C-scan) slabs at chosen depths, thickness maps, and 3-D rendering — impossible from a single 2-D B-scan.

9The innermost retinal boundary detectable by OCT corresponds to which anatomical structure?

A.Internal limiting membrane (ILM)

B.Nerve fiber layer (NFL)

C.Ganglion cell layer (GCL)

D.Inner plexiform layer (IPL)

Explanation: The ILM is the vitreoretinal interface — the highly reflective inner surface of the retina — and appears as the first bright hyperreflective line from the vitreal side on OCT B-scans.

10On SD-OCT, the ellipsoid zone (EZ) represents the reflective band corresponding to which photoreceptor substructure?

A.Inner segment/outer segment (IS/OS) junction of photoreceptors

B.Outer nuclear layer nuclei

C.External limiting membrane tight junctions

D.Bruch's membrane collagen matrix

Explanation: The EZ corresponds to the highly organized mitochondria-rich inner segment ellipsoid region at the IS/OS junction, producing a bright hyperreflective band. It was renamed from 'IS/OS line' in 2014 to reflect anatomical accuracy.

About the OCT-C Exam

The OCT-C certifies ophthalmic imaging professionals in optical coherence tomography acquisition, interpretation, and quality assurance. The exam covers OCT physics (low-coherence interferometry, SD-OCT, SS-OCT), retinal layer segmentation, macular pathology (AMD, DME, CSCR, vitreoretinal interface disorders), optic nerve and glaucoma OCT, OCTA principles, anterior segment OCT, and artifact recognition. Eligibility requires submission of a work example portfolio meeting OPS BOC standards plus completion of the written examination at a Prometric testing center.

Questions

100 scored questions

Time Limit

Per OPS BOC program guide (Prometric testing center)

Passing Score

70 scaled score (0–100 scale)

Exam Fee

$465 (non-member, includes 1-year OPS membership); $220 retest (OPS Board of Certification / Prometric)

OCT-C Exam Content Outline

~20%

OCT Physics and Instrumentation

Low-coherence interferometry, SD-OCT (840 nm) vs SS-OCT (1050 nm), axial and lateral resolution, A-scan, B-scan, volume cube, EDI-OCT, PS-OCT, DICOM-OPT archiving

~20%

Retinal Layer Segmentation and Normal Anatomy

ILM, NFL, GCL, IPL, INL, OPL, ONL, ELM, ellipsoid zone (EZ), interdigitation zone (IZ), RPE, Bruch's membrane, choroid; foveal contour, FAZ, RNFL quadrant norms

~25%

Macular and Retinal Pathology

AMD (drusen subtypes, GA, CNV type 1/2/3, PED), DME and DRIL, CSCR, CME (Irvine-Gass), RVO, CRAO, vitreoretinal interface (VMT, ERM, FTMH, lamellar hole), uveitis, drug toxicity

~15%

Optic Nerve and Glaucoma OCT

Peripapillary RNFL (ISNT rule, 3.46 mm circle), macular GCL+IPL (GCC), BMO-MRW, glaucoma progression, papilledema, disc drusen, optic neuritis, MS neurodegeneration

~10%

OCT Angiography (OCTA)

Decorrelation flow detection, SCP and DCP segmentation, FAZ measurement, CNV dye-free detection, DR non-perfusion and microaneurysms, choriocapillaris flow voids, projection artifacts

~5%

Anterior Segment OCT

Corneal pachymetry, anterior chamber angle (TIA, AOD, TISA), ICL vault, meibomian gland imaging in dry eye

~5%

Artifacts, Quality, and Clinical Workflow

Segmentation errors, motion artifacts, banding, projection artifacts, complex conjugate mirror, SSI/Q-score thresholds, normative database ethnic limitations, serial registration, patient prep, documentation, DICOM-OPT

How to Pass the OCT-C Exam

What You Need to Know

Passing score: 70 scaled score (0–100 scale)
Exam length: 100 questions
Time limit: Per OPS BOC program guide (Prometric testing center)
Exam fee: $465 (non-member, includes 1-year OPS membership); $220 retest

Keys to Passing

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

OCT-C Study Tips from Top Performers

1Master the physics of low-coherence interferometry and understand why SD-OCT at 840 nm differs from SS-OCT at 1050 nm

2Learn all 10 retinal layers from ILM to choroid, including EZ, IZ, and ELM with their anatomical correlates

3Study AMD drusen subtypes (soft, cuticular, reticular pseudodrusen) and their distinct OCT appearances

4Know CNV types 1, 2, and 3 by location relative to the RPE and their characteristic OCT patterns

5Understand how to differentiate intraretinal fluid (DME, CME) from subretinal fluid (CSCR, CNV) on B-scan

6Review the ISNT rule for normal RNFL and recognize early glaucomatous sectoral thinning patterns

7Study OCTA segmentation slabs and recognize projection artifacts and their clinical significance

8Practice identifying motion artifacts, segmentation errors, and inadequate signal strength on sample scans

9Understand normative database limitations in ethnic minority and high-myopia populations

10Review the OPS OCT-C Program Guide content outline for the most current topic weighting

Frequently Asked Questions

What is the OCT-C certification?

The OCT-C (Optical Coherence Tomography Certified) is awarded by the OPS (Ophthalmic Photographers' Society) Board of Certification to imaging professionals who demonstrate proficiency in OCT acquisition and quality assessment. It requires submitting a qualifying work portfolio plus passing a written exam at a Prometric testing center.

What are the OCT-C eligibility requirements?

Candidates must submit work examples (an OCT image portfolio) that meet OPS BOC established standards, demonstrating clinical proficiency in ophthalmic OCT imaging. OPS membership is encouraged but not required for initial certification.

What is the OCT-C passing score?

The OPS BOC uses a 0–100 scaled score model with 70 as the passing score. Raw scores are converted to this scale to account for exam form difficulty variation across administrations.

How much does the OCT-C exam cost?

The non-member exam fee is $465, which includes a one-year OPS membership. The re-examination fee for failing candidates is $220 per subsequent attempt.

How long is OCT-C certification valid?

OCT-C certification is valid for 3 years. The recertification cycle begins January 1 of the year after initial certification and requires 8 continuing education credits (CECs), with at least 4 CECs from official OPS or OPS BOC pre-approved courses and workshops.

What content is on the OCT-C exam?

The OCT-C exam covers OCT physics (coherence, SD-OCT vs SS-OCT), retinal layer anatomy and segmentation (ILM to choroid), macular pathology (AMD, DME, CSCR, vitreoretinal interface disorders), optic nerve OCT for glaucoma, OCT angiography (OCTA), anterior segment OCT, and artifact recognition and quality control.

Where is the OCT-C exam administered?

The OCT-C written exam is administered at Prometric testing centers throughout the United States and selected international locations. Candidates schedule their exam after completing the application and work-sample submission process through the OPS BOC.