with 66 D .Young patient ( ?early 40s) with very poor vision (white stick
) with bilateral macular scars which were heavily pigmented and suggestive
of choroidal neovascular scar tissue. Also noted subtle disc drusen and
mild angioid streaks. Asked for most likely diagnosis. I suggested pseudoxanthoma
elasticum. Examiners asked for several differentials and let me ramble
on a bit…. They then smiled and said I was right the first time and quizzed
me on systemic complications
with 20D. Young patient (30 ish) with bilateral PRP scars and epiretinal
membrane in one eye. Asked for differentials. Asked about complications
of PRP as you would describe them to a patient. Loads of questions on indications
for PRP, Macular grid etc. Fairly predictable stuff.
to comment on a FFA of patient with ischaemic maculopathy & NVD.
to comment on an FFA picture of patient with a classic SRNVM.
this patient’s right optic disc. Very cupped (0.8), with central baring
of pores of lamina cribrosa, rim disobeying the ISNT rule. Inferior notch
with adjacent haemorrhage. Lots of questions on normal tension glaucoma.
this lady’s left eye. Large cystic overhanging bleb. PI. PXF, pseudophakia,
cupped disc 0.9. Many questions on bleb morphology, microcysts etc . Dynamic
discussion on the management of PXF glaucoma, including pros and cons of
combined phaco-trab vs staged surgery. Discussed anterior chamber fluid
dynamics via the trabeculoectomy.
to discuss HFT reliability indices in general
an HFT of a superior homonymous quadrantanopia which was incongruous. Describe
the defect. Where is the lesion and why? What other clinical features of
pariental lobe lesions do you know?
Asked to discuss grading scales for cataracts.
patient (actress), had been seen by a junior colleague who had apparently
diagnosed iritis with secondary raised pressure and had started topical
beta-blockers,cyclo and intensive steroid drops. Patient has now returned
to clinic with a massive painful dendritic ulcer, and has exacerbated asthma.
She is very upset and angry :wants to sue the hospital, and have the previous
doctor sacked for incompetence. She has been using the drops in both eyes
which are now sore and blurred, doesn’t want any more drops and demands
to see the consultant.
patient with congenital glaucoma( Trabeculectomy, Large corneal diameters-
asked to measure these with SL!, Haab’s striae, goniotomy scars)
. How does goniotomy help? General management of congential glaucoma.
LE has a PKP . Asked why-- I mentioned descemet’s rupture and corneal oedema.
Why has only one eye been grafted? Other indications for grafts.
What types of grafts do you know? Lots of questions on poor prognostic
factors in graft surgery.
elderly gentleman with with LE aphakia and PI. Looked like he has
had pars plana vitrectomy from the conj and scleral scars Asked causes
of aphakia. Complications of aphakia. Management of aphakia in children
motility and neuro-ophthalmology
to describe my findings in a patient with thyroid ophthalmopathy. Cover
test, Ocular motility , and optic nerve function tests. Investigations
and management including that of euthyroid patients.
to assess a ptosis including pupils. A fairly standard post-cataract aponeurotic
ptosis. I had also had noticed a brow scar and some brow ptosis-
looked like trauma. The examiner said no initially. Then the patient said
that yes she had been in an RTA previously with consequent brow trauma!
The examiner said sorry and well spotted !
of photos of lid things including rhabdomyoscarcoma-was asked about conclusive
investigations and management
Please examine this lady’s fundus using the 90D lens!! She had optic nerve
head drusen and large angioid streaks. Asked for differential. Asked to
examine her systemically to reach a diagnosis – pseudoxanthoma elasticum
: Examine this gentleman’s fundi with the indirect . He had a treated melanoma
in the RE and a non-suspicious naevus in the LE. Long discussion on treatment
modalities and survival.
:.Pathology was tricky. EMQs were reasonable OSCE Questions were fair and
unambiguous. Very pleasant examiners.