OSE:
 

STATION 1: HESS CHART
Hess chart showed a restriction of movement of the right lateral rectus muscle.
It was a case of right 6th nerve palsy, but quite a number of candidates also thought it might be Duane’s. Again the diagnosis was not asked, only to interpret the chart.

STATION 2: ULTRASOUND
The ultrasound had both A and B scan pictures. Diagnosis was not asked for and we were asked to comment on the picture. Question was asked about what structure is involved, it was a choroidal melanoma.

 
STATION 3: HUMPHREY FIELD
The Humphrey had the fields of both the eyes and there was a bitemporal superior quadrantinopia. (At least that’s what I thought)
Question was asked about the possible location of the lesion.

STATION 4: FFA
The FFA had a full set of pictures, about 32 I think, the first one was a colored photo and the rest were flourescein. 
No diagnosis was asked, one eye was normal the other had a central pathology, i.e. leakage of dye in the macular area.
It was a case of CSR.

STATION 5: CT SCAN
CT scan showed both the orbits with thickening of all the extra ocular muscles, no diagnosis was asked but it was a case of thyroid ophthalmopathy

STATION 6: EOG
Question was asked about what this investigation is and to comment on the 2 highlighted values with yellow, which were Arden index and LP.

STATION 7: TONOMETER HEAD
Tonometer head was to be identified and asked to draw its working principle.

STATION 8: VISUAL ACUITY IN CHILDREN
5 tests were written and we were asked to tell which test applies to which age group in children.
The tests were:
1. Preferential looking
2. Kay single picture test
3. Sheridan Gardiner test
4. Sonksen Silver test
5. Log MAR chart

All this is given in strabismus chapter pg 528 JJ Kanski.

OSCE:

STATION 1: 
Direct Ophthalmoscope: the patient was a girl in her 20’s who had peripheral bone spicules all over the fundus with pale disc. I was asked to examine only her right eye.
Questions were asked about all the filters of the direct ophthalmoscope including Slit, red free and blue. I was specifically asked about how many cm would a lesion be if it were focused with a plus-6 lens of direct. (3 diopters represents a 1 cm lesion).

STATION 2:
Indirect ophthalmoscope:  I was asked to do the indirect and comment as I go along. This was an old guy who had and IOL in his left eye (the eye I was asked to examine).
He had laser burns all over his periphery and a small lesion on the supero temporal vessel. I was asked to draw the lesion on the retina chart.

STATION 3:
Pupil examination: I was asked to do all the tests of pupil examination; the case had a right RAPD. Questions were asked about the pathway of light reflex with possible lesion sites. Also whether cataract and vitreous haemorrhage lead to an RAPD.

STATION 4:
Slit lamp:  I was asked to perform all the slit lamp techniques. Patient had a cataract in his left eye and AC IOL in his right eye.

STATION 5:
Focimeter:  principal of focimeter was asked. There were bifocal glasses, I had to find the prescription for distance and the near add of one side only.

STATION 6:
J-S Keratometer:  again the working principle was asked. I was asked to do the K reading of one of the staff nurses.

STATION 7:
Goldman perimeter: I was asked to identify the instrument, it working, calibration and positioning of patient and what instructions would I give the subject. One chart of Goldman was shown to me and asked about the diagnosis.

STATION 8:
Extra ocular movements: I found this a bit difficult and confusing as the patient had a left head turn and left head tilt. His right eye had very poor vision but full extra ocular movements while the left eye had a 6/6 vision with restricted abduction and elevation. I wonder why he had a head tilt and turn when he could not have had diplopia with only one good eye.

REFRACTION:
 

I think the hospital was quite short of patients since many of the subjects chosen for refraction were hospital staff.

I had a 23 yr old female (hospital staff) with  vision of  OD: 6/60, 6/18 PH. OS: 6/60, 6/24 PH.

Her final prescription was OD: -5.5 DS/ -2.25 DC axis 180.  6/4
                                           OS: -5.75 DS/ -1.75 Dc axis 180   6/4

Red on duochrome
Slight exophoria with Maddox rod.
+ 1 blur.