|My name is Ashraf Mohammad Mobarak From
Mansoura, Egypt I have attended FRCS. (Glasgow. In New Delhi September
2005 and thanks GOD I have passed then thanks my parents for unlimited
encourages and prayers .
Here are what I went through.
Essay questions (2 hours)
1. An 85-year-old man has had advanced primary open angle glaucoma for
30 years. He had a trabeculectomy performed on the left eye many years
ago but the vision has been poor in this eye ever since the operation.
Visual acuity are 6/12 right eye and hand movement left eye despite being
on maximum medications. His IOPs are 28mmHg right eye and 10mmHg left eye.
Lt. His visual fields are grossly restricted in both eyes and he is on
warfarin tablets for atrial fibrillation. Discuss this patient management
and explain the risks to his vision.
2. A 30- years- old general surgical colleague presented to your clinic
complaining of redness and blurring in his right eye for one week. He had
had bilateral laser refractive surgery
4 weeks back and and although his vision had initially been good it
is now reduced to 6/36 right eye & 6/6 left eye unaided. He is busy
and just wants you to give him some drops.
Describe how you will deal with this situation and what possible investigations
and treatment would you recommend.
3. A 10-year old boy is found by his optician to have reduced vision
in his right eye. On examination the vision is 6/36 in this eye. There
is a right relative afferent pupillary defect and fundoscopy shows disc
pallor. Discuss the possible diagnosis & explain how you would manage
MCQ. 300qs. study MCQs of this website and general medicine from American
Academy of Ophthalmology Series.
Station 1: General medicine and Neurology
2 Indian examiners.
First examiner asked the following questions:
2nd examiner asked the following:
Starting with showing me fundus photos with haemorrhages and opacification
of retina saying that this belongs to an AIDS patient. (Differential diagnosis:
CMV retinitis, HIV retinopathy, PORN).
FFA showing vascular staining (Differential diagnosis retinal vein occlusion,
Photograph of a 15-years-old with hearing aid and cataract with esotropia
(Differential diagnosis: congenital rubella, congenital syphilis, Refsum's
CT of orbit and brain showing opacity of ethmoidal sinus.
MRI of the brain with hyperintense lesions in the paraventricular regions.
Questions on multiple sclerosis, treatment and criteria for the diagnosis
Patient with bilateral ptosis and ophthalmoplegia (Differential diagnosis:
myasthenia gravis and chronic progressive external ophthalmoplegia). How
to differentiate between the two conditions from history and investigations
(family history, muscle biopsy, antibody tests etc). Treatment of myasthenia.
Fundus photo of a patient with polymyalgia rheumatica showing pale disc.
Diagnosed giant cell arteritis. Investigations, temporal artery biopsy.
complications of steroids.
Medical management of a patient who has epileptic fit in operating room.
(ABC, position, shout for help, diazepam, air way)
Station 2: Ophthalmic surgery and pathology
One English and one Indian examiner
Lacrimal gland swellings: what are the possible diagnosis. Investigations.
Should biopsy be done?.
Management of acute angle closure glaucoma.
Blow-out fracture and blow-in fracture. Investigations and management.
How to detect and mange zonulysis during cataract operation. If the dialysis
is 2 clock hours and if it is 270 0 . Use of capsular tension
ring and how to choose its diameter.
Retinoblastoma in children. Possible differential diagnosis and management.
Station 3: Medical ophthalmology
I passed the above and got into the clinical session.
60-year-old patient with NIDDM for 20 years with decrease vision. How to
manage the CMO. Definitions of significant macular oedema and high risk
new vessels and how do you manage the patients. PRP: argon setting and
How to manage a patient with IOP of 26 right eye and 27mm. with normal
field and normal cup/disc ratio. Advantages of treatment versus no treatment.
New technique for detecting nerve fibre layer loss. The importance of corneal
thickness on IOP.
40-year- old female with sudden loss of vision. Give a DD and then
move on to multiple sclerosis.
Types of blepharitis. How to manage marginal keratitis.
Clinical examination: in total 7 cases were examined
1. Non-proliferative diabetic retinopathy with macular oedema using
the indirect. Discussion about macular oedema and indications for treatment.
2. Fundal examination using 90D, the patients had C/D ratio of 0.8 right
eye and 0.9 left eye. Patients already on maximum medications. Questions
on treatment options. Important of target pressure.
3. Fundal examination of a patient with macular drusens and dry age-related
4. Slit-lamp examination of a patient with bilateral pseudophakia. One
eye was operated on with phacoemulsification and the other with ECCE.
5. Slit-lamp examination of an eye with shallow anterior chamber. The
eye had peripheral iridotomy and posterior synechiae.
6. A case of bilateral upper lid retraction. Asked to examine the ocular
7, A case of exotropia. Asked to perform cover test for near and distant.
I am more than happy to help other candidates. My e-mail is amobarak1@