Candidate 45                                                     Centre: York
MRCOphth  (passed)                                                           Date: March, 2004
Pathlogy- given clinical features or gross picture as well as histological pictures with low power and or high power 
  • Retinoblastoma  - Told diagnosis ! asked about histological features, chromosome involved, histological prognostic features.
  • Toxoplasmosis- Again given the diagnosis and asked to identify on histological picture, treatment, indications for treatment.

  • Conjunctival lymphoma-shown picture of patient with a mass in the inferior fornix, asked about histological features on ordinary PAS and special stains, asked to make a diagnosis and talk about  management of condition.

  • Delayed posroperative endophthalmitis- no pictures, asked about preoperative and intraoperative prophylaxis, organisms implicated,treatment of the condition.

  • Viva - diagnose with pictures of clinical appearance and histology of sebaceous gland carcinoma; rubeosis and neovascular glaucoma 


Station 1  glaucoma, fields 

Case 1
Pseudoproptosis- secondary to myopia, asked for diagnosis, investigations to arrive at diagnosis.

Case 2
Primary open angle glaucoma- comment on disc features, comment on fields, discuss treatment of patient and  treatment in general of OHT( reasons for starting and withholding treatment).

Station 2: Communications skills 

Take a history from a diabetic who has presented with sudden loss of vision ( had vitreous haemorrhage).Obtain informed consent for PRP 

Station 3:  Anterior segment 

Case 1
Corneal Granular dystrophy - diagnosis, pathology, treatment 

Case 2
Iris nodule - differential diagnosis, investigation, management ( presumed melanoma) 

Case 3
Lid BCC ( xeroderma pigmentosum) - diagnosis, surgery 

Station 4: Posterior Segment 

Case 1
Adult onset Bests disease- diagnosis, investigations( electrophysiology features), prognosis 
? Old BRVO, ? leaking telangiectatic vessels- patient had about 3 large areas of circinate exudates in one quadrant, with obvious collaterals but no other obvious abnormal vessels no other abnormalities.  Asked about FFA features to arrive at a diagnosis and what features would be an indication for laser treatment 

Station 5  Medicine 

Case 1
Peipheral corneal ulcer and wegeners - diagnosis obtained on history. asked about investigations to confirm diagnosis, shown MRI of sinuses and CXR and asked to comment on abnormalities and what to look for, also asked about treatment of Wegeners.

Case 2
Loss of vision and giant cell arteritis- extensive history taking. Asked about investigations and to palpate temporal arteries and comment. Detailed questioning on management of GCA( doses of steroids, IV or oral, other treatment options). 

Station 6  Strabismus and neuroophthalmology 

Case 1
Third nerve palsy with pupil involvement( young patient) - causes, investigation, management of diplopia in third nerve,asked about migraine and 3rd nerve, MS and 3rd nerve 

Case 2
Pale disc with RAPD - causes, investigation 
Both cases appear easy but questioning on this station was more in depth than on the other stations 

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