Background: Covid-19 pandemic negatively impacted traditional education systems. Aim of the work: Evaluation of undergraduate ophthalmology medical students' assessment methods in absence of face to face oral exams (OE) and live on-patient practical exams (PE) in Al-Azhar Faculty of Medicine of Boys during COVID-19 pandemic (Cairo,2021).. Participants and methods: 230 students responded to online survey.Objective evaluation was also done by analyzing the total marks achieved by each student. Results: Formative exams (FE) helped students for better achievement in summative written exams and Objective structured clinical exam (OSCE). As regards OSCE; data-show questions covered the assessment of most studied ophthalmology signs with high quality images. Variation of questions in written exam including MCQ, short answer questions (SAQ), structured limited essay questions (EQ) and case scenario (CS) based questions allowed assessment of most course topics precisely and simply, and could replace OE, and that was safer than face to face OE during Covid-19 pandemic. 97.8 % of students succeeded to pass ophthalmology module exams with 44.2% of them achieved A+ grade. Conclusion: It is recommended to apply FE frequently after each chapter. The use of variable forms of examinations and questions can replace face to face OE and live on-patient PE for undergraduate ophthalmology students. Students should practice answering scenario based questions.