FICO (International Council of Ophthalmology) Exams Made Simple

fico frcs ico ophthalmology Aug 18, 2026

ICO EXAMINATIONS

International Council of Ophthalmology

Overview

International written examinations with a staged route toward FICO.

Standard Examinations: Visual Sciences; Optics, Refraction and Instruments; Clinical Ophthalmology.
Advanced ICO is taken after the Standard Examinations.
FICO requires passing the Advanced Examination plus a local face-to-face ophthalmology examination.
The ICO route is also relevant to the FRCS Glasgow pathway because ICO passes may create exemptions/eligibility.

Steps and Certification Pathway

Step 1: Visual Sciences.
Step 2: Optics, Refraction and Instruments. This can sometimes be taken on the same day as Visual Sciences if the centre can accommodate it.
Step 3: Clinical Ophthalmology after passing Visual Sciences and Optics/Refraction/Instruments.
Step 4: Advanced ICO after passing all Standard Examinations.
Step 5: FICO postnominal requires Advanced ICO plus a local face-to-face ophthalmology examination.

Eligibility

Visual Sciences: typically taken early in residency/training; no local practical exam component described on the ICO page.
Optics, Refraction and Instruments: frequently taken early in residency/training.
Clinical Ophthalmology: offered to ophthalmologists who have passed both Visual Sciences and Optics/Refraction/Instruments.
Advanced ICO: designed for candidates who have passed Visual Sciences, Optics/Refraction/Instruments and Clinical Ophthalmology.
Final eligibility should always be checked in the ICO registration system and local exam-centre instructions.

Exam Breakdown

Exam	Format	Duration	Key focus
Visual Sciences	120 MCQs/SBAs, four options	3 hours	Basic science, ocular anatomy, physiology, pathology, epidemiology/statistics
Optics, Refraction & Instruments	60 SBAs, four options	1.5 hours	Optics, refraction theory, ophthalmic instruments
Clinical Ophthalmology	200 MCQs/SBAs, four options	4 hours	Breadth and depth of clinical ophthalmology knowledge
Advanced ICO	Advanced written assessment	Check current ICO handbook	Integrated higher clinical reasoning

Published Date, Place / Online Status and Fees

Item	Current information
Next Standard Examinations	19 October 2026
Next Advanced Examination	19 October 2026
Place / format	Through ICO examination centres / local coordinators; not simply a home exam
Fees	Handled via ICO online registration/local processes; local charges may apply; candidates may need to contact ICO Examinations Office
Results	Typically mailed around six weeks after the exam for the older paper-based structure

Pros

Cons

Mainly written/theoretical; does not replace a practical clinical exam or local specialist registration.
FICO requires additional local face-to-face ophthalmology examination after Advanced ICO.
Recognition and value vary between countries and employers.
Fees/locations may depend on local coordinators and registration system.
Not a shortcut to FRCOphth; RCOphth does not grant exemptions for ICO examinations.

Study Strategy

Visual Sciences: build basic science systematically: anatomy, physiology, cell biology, pathology, microbiology, pharmacology, optics foundations and statistics.
Optics: master lenses, prisms, retinoscopy theory, BVD, magnification, instruments and refraction principles.
Clinical Ophthalmology: revise common diseases by pattern recognition, investigations, management and complications.
Advanced ICO: move from recall to integrated clinical judgement; practise timed mixed-topic papers.
Use a cycle: syllabus map -> topic notes -> SBA practice -> error log -> weak-topic repair.

Cross-Pathways

ICO Visual Sciences + ICO Optics/Refraction/Instruments may exempt from FRCS Glasgow Part 1.
ICO Clinical Ophthalmology may exempt from FRCS Glasgow Part 2.
All three ICO Standard Examinations can therefore potentially allow progression to FRCS Glasgow Part 3, subject to experience and documentation.
ICO Advanced 180 has been used for RCSEd written-component exemption under the current Edinburgh pathway, but candidates must confirm applicability with RCSEd because the pathway is changing.
ICO examinations do not exempt candidates from FRCOphth components.

The ICO Standard Examination is not a single examination; it consists of three components. The commonly quoted fees are:

ICO examination	Indicative fee
Visual Sciences — Part A	CHF 460
Optics, Refraction and Instruments — Part B	CHF 380
Parts A and B taken together	CHF 610
Clinical Ophthalmology — Part C	CHF 760
Advanced Examination — Advanced 115Q	CHF 610

Indicative total pathway cost

However, these are indicative rather than fixed 2026 fees. The ICO officially states that fees vary according to:

The candidate’s country and its World Bank income category
Whether the candidate belongs to an ophthalmological society that is an ICO member
The applicable local examination-centre arrangements

The exact amount appears in the online application after the candidate enters their country and membership details.