Candidate 20  Passed                                                      Centre: Leicester
                                                                                                 Date:  Nov, 2002


Station 1
Hess chart-6th nerve palsy 

Station 2
Fluorescence angiography-classic CSR-ink blot pattern 
Again principle was asked.

Station 3
CT Scan-bilateral lesion in anterolateral part of each orbit 
What investigation is this? 
What is the abnormality?-no diagnosis was asked 
Possible clinical presentation of this patient. 

Station 4
B-scan ultrasound 
This was dodgy. Retinal or choroidal detachment?
Again principle was asked 
Which structures are involved? (no diagnosis) 

Station 5
Biometry report.
Various calculated values of IOL were given and patient's pre-op refraction was given. We were supposed to chose appropriate IOL (no calculations to be done) and give reason for choosing that power of IOL. 
Also asked if A constant was 119.5 instead of 118.5 what would b the IOL power? 

Station 6
A figure of lacrimal drainage system.
We were supposed to label the indicated arrows. 

Station 7
Humphrey fields
Right eye - superior hemidepression
Left eye - superior arcuate scotoma 
What is this investigation? 
Describe the defect. 
Which anatomical structure would b involved? 

Station 8
Hruby lens 
Draw a ray diagram!! 


Case 1
I was given a pair of bifocal and was supposed to give distant prescription and near add of both sides in 5 minutes! It was bit hectic. 
Asked about how do focimeter work? 

Case 2
Keratometry-BOSCH&LOMB type 
Few candidates were really scared as they had never used it before! but all examiners were very helpful and nice they used to ask whether you have used it before or not? They also showed how to use it to the candidates who were not aware of that! 
Asked me the principle. 

Case 3
CT & Ocular motility
I had a lady with unilateral thyroid eye disease. 
On Cover test she had right exotropia with hypotropia. 
On motility - elevation was restricted.. 
So I concluded that inferior rectus was involved-teethering 
Retrogradely when I saw there was mild lid retraction as well!! 
but there was no proptosis. 

Case 4
Visual field
I had a woman with right homonymous hemianopia. 
I was asked to do confrontation by whichever method i'm comfortable with. 
So I used red and white pins. Also asked me to draw it. 
Anatomically where is the lesion?? 
Asked to find left blind spot, which  I couldn't finish as bell rang!! 

Case 5
Direct ophthalmoscopy
Woman with bilateral high myopic fundus. 
I was asked to examine post pole of both eyes. 
Bilateral large disc with cup disc ratio of 0.7, crescent,pigmented macular scar in left eye. There was PI at 12 o'clock in right eye so probably acute glaucoma surgery was done. 
Was asked to describe disc in RE. Whether was it glaucomatous or not? I said it could b just myopia giving rise to such appearance and large cup physiologically. I said I would like to do IOP, VF and other tests before stamping it as glaucoma. 
Also asked me the magnification and about the filters. 

Case 6
BIO (Binocular indirect ophthalmoscopy)
Was asked to examine left eye of the patient who was lying down on couch. 
There was disc with inferior scar and multiple pigmented chorioretinal scars throughout periphery. Was asked to draw my findings. 
Asked about 20Dvs.28D as expected! 

Case 7
Classical right Horner syndrome. 
Why do you say it is a Horner?? 
Sympathetic pathway. 
Pharmacological tests? 
Do you actually do it?
What is significance of those test?
DON'T FORGET TO CHECK ANISOCORIA IN DARK AND BRIGHT LIGHT. Some of candidates forgot and were in trouble!! 

Case 8
Asked to examine right eye and tell positive findings. 
Young pseudophakic patient with posterior capsule opacity & continuous suture superiorly, few keratic precipitates in lower parts which I missed on first look!! 
Asked me which suture material is it?
Different methods of examination. Demonstrate specular reflection. 
Showed tonometer and asked how to calibrate it ? 

51 year old lady who was secretary in the same hospital. She was very co-operative. 
near add-+1.50.....N5 with good range. 
MADDOX ROD..orthophoria

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