Differential Diagnosis 
of 
Common Physical Signs 
in 
Clinical Examination
The clinical examination in the final FRCOphth / MRCOphth / FRCS is all about performing the relevant techniques to the examiners' satisfaction and at the same time demonstrate your ability to detect physical sign(s). Once the physical sign(s) is/ are detected, the examiners are likely to ask for the differential diagnosis. This section is devoted to those physical signs which are commonly encountered and aims to provide a reasonable list for each physical sign. The lists are not meant to be exhaustive and you are advised to draw up you own if you think the one provided is inadequate. Omitted from the lists are also signs which are unlikely to appear in the clinical examination such as hypopyon or corneal perforation.

When you are faced with a physical sign always consider whether it is congenital or acquired. If congenital, is it hereditary or non-hereditary? In acquired form, is it neoplastic, inflammatory, traumatic, drug-induced, iatrogenic etc.

Differential diagnosis according to the site of lesions:

                                    abnormal head posture
                                      ocular deviation
    •     Neurology
    •     Cardiovascular conditions