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| An undergraduate prize examination will be sponsored
again this year on a national basis by The Royal College of Ophthalmologists.
This examination is intended for medical students who have completed their
ophthalmology undergraduate teaching, but it is open to all medical undergraduates
provided they have not graduated at the time of the examination.
Students may sit the examination on more than one occasion provided they
have not yet graduated and have not previously won the prize. There
will be a cash prize of £400 for the candidate gaining the highest
mark. If there is more than one candidate gaining the highest mark
this amount will be split respectively. There is no second prize.
The examination consists of an extended matching question paper of 10 questions with 3 stems to each question. Candidates will have to pick their answer from a list of options. Marking is on the basis of +1 for a correct answer and -0.5 for an incorrect answer, and 0 marks for no answer or "don't know”. The standard is high and candidates should anticipate a stiffer examination than encountered in the undergraduate class. Questions are mostly based on clinical ophthalmology but other areas covered include ocular physiology, anatomy and pathology as well as genetics of eye conditions and socioeconomic medicine relevant to ophthalmology e.g. blind registration or world blindness. In the clinical questions all the sub-speciality areas within ophthalmology are covered including:
1. A theme
Example Questions 1. Options Theme/ Topic A. Acute angle closure glaucoma
Lead in: For each patient with loss of vision select the most likely diagnosis. Stems: 1. An 80- year old Caucasian woman complains of recent
problems with reading vision, specifically words appearing distorted and
blank patches being present.
2. A 32- year old female patient experiencing weakness
and numbness in her left arm gives a three day history of increasing loss
of vision in her right eye and pain on moving the eye.
3. A 54-year-old man complains of headaches that are
made worse by coughing. They appear to be increasing in frequency. He admits
to occasionally losing vision but only for a few seconds at a time. His
visual acuities are normal.
2. Options A. Bitemporal hemainopia
Lead in: Select the most appropriate option that would fit with the clinical scenario. Stems: 1. A 68-year-old hypertensive man with poorly controlled
diabetes (Type 2) presents with sudden onset horizontal diplopia.
2. A fit 48-year-old woman complains of a very severe
headache and droopy left upper lid she gets double vision when she lifts
up her eyelid.
3. An 82-year-old hypertensive woman collapses at home.
In casualty she is found to have a right hemiparesis, an up-going planter
reflex and is dysphasic.
3. Options A. Aciclovir ointment
Lead in: Select the most appropriate therapy for the clinical scenario. Stems: 1. A 55-year-old man has intra-ocular pressures of
32mmHg in each eye. His optic discs are pathologically cupped. He is using
a salbutamol inhaler for his asthma.
2. A 73-year-old woman develops a painful rash on the
right side of her forehead. Her right eye is closed because of associated
lid oedema. She feels generally unwell.
3. A 32-year-old gardener develops a red eye with a
purulent discharge. After two days it spreads to the other eye. His young
daughter has a similar problem.
4. Options A. Amblyopia
Lead in: What is the most likely cause of the poor vision? Stems: 1. A six-week-old baby is noted to have wobbly eyes
and poor vision. On examination neither eye has a red reflex. There is
a family history of eye disease.
2. A ten-year-old boy with past history of squint surgery
is found to have poor vision in his left eye that cannot be improved with
glasses.
3. A three-year-old girl is found to have reduced vision
in both eyes. Her vision improves with glasses with convex lenses.
5. Options A. Anterior ischaemic optic neuropathy
Lead in: Select the most appropriate option that would fit with the clinical scenario. Stems: 1. A 46-year-old diabetic (Type 1) of 25 years duration
and incipient renal failure presents with red, painful, blind right eye.
2. A 42-year-old diabetic (Type 1) male complains of
a sudden onset of floaters in his right eye. They gradually settle after
one month.
3. A 46-year-old woman with Type 1 Diabetes has noticed
gradually deteriorating vision in both eyes for 12 months. She is also
troubled by glare, when driving her car at night.
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