Candidate 107 

Final FRCS (passed)                          

Centre: Glasgow                               

Date:    November, 2007 

 CLINICAL CASE INTERPRETATION
All three questions must be answered.
Note to Candidates: Please note that an essay type examination answer is not what is wanted.

1. A 50 -year-old woman complains of arecent onset of vertical diplopia. On examination there is a small right hypertropia. What is the differential diagnoses and describe how you would investigate and manage this patient?

2.A 74-year-old man has been treated for ocular cicatrical pemphigoid for several years and had a right cataract extraction performed 6-months ago. He is sent to your clinic with pain in his right eye and you diagnose right corneal decompensation with bullous keratopathy and vision of Counting Fingers. The left eye has a vision of 6/24 with a cataract. State what treatment options are for this patient and what management plan you would recommend.

3.A 24-year-old man was assaulted one year ago and had a left malar fracture repaired by the Maxillo-Facial surgeons. He is now referred to your clinic by his optician who has found the vision in the left eye to be reduced to 6/18 and han noticed a left relative afferent pupillary defect.
What are the possible diagnoses with this patient and how would you manage him?