Candidate 23
Date: June, 2003
Centre: Leeds
Result: Passed
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Overall a very fair and well-run exam


Station 1
A-scan USS of two eyes. Questions on quality of the scans and how to improve the reliability.

Station 2 
A stick-on fresnel. Principles (ie ray diagram).

Station 3 
Hess-chart. Restriction of upgaze LE and slight restriction LE adduction. Early sequelae.
Questions of principles of Hess charts.

Station 4 
FFA. 2 colours and 16 FFA images - proliferative diabetic retinopathy. Questions on principles and asked what the FFA pictures show.

Station 5 
Picture of lacrimal apparatus. Asked to identify upper canaliculus and beginning of nasolacrimal duct. (? some candidates said this was a repeat of the previous exam)

Station 6
B-scan USS. Funnel-shaped RD. V. poor quality image. Asked about principles and to comment on the scan.

Station 7
Axial CT-scan w/ contrast  LE mucocoele from ethmoidal sinus.
Causing proptosis and lateral displacement. Asked to    comment on scan.

Station 8
Humphrey Visual Fields. Right incomplete inferior homonymous hemianopia - obeyed vertical midline. Questions on diagnosis and site of lesion.

Very different style of questions from previous MCQs according to many
Many questions on applied optics and clinical orthoptics. No calculations.
No formulas required.
A few ambiguous questions, but overall quite fair.


Very well organized. 2 stations per room. 2 examiners per room. We were given a minute or two
between moving from room to room. My experience:

Case 1 
Pupils:  Right RAPD. Many questions on pathways (incl. higher centres for
convergence), differentials of anisocoria,      pharmacological tests. Fair.

Case 2
Slit-lamp:  75-year old lady. Corneal scarring RE. Previous bilateral ECCE's. Now AC lens in RE. Sphincter tear RE. Areas of iris atrophy BEs. Pigment on endothelium of RE. Just asked to comment on what I saw. Not asked to demonstrate any techniques. However, tried to demonstrate most of
the techniques while going through. Fair.

Case 3
Indirect: Difficult as very poor indirect. Many reflections, lens opacity and patient moving. Asked to look at the macula of RE. Small naevus along the superior arcade. Differentials. LE: asked to look at the periphery. Superotemporal laser retinopexy. Very difficult to get a proper view. Slight air of panic. A few questions on lenses and magnification.

Case 4
Direct: Difficult as patient quite photophobic. Asked to comment on RE disc. Looked pale. Asked for C/D ratio 0.7. RE:  inferior notch, C/D ratio 0.8. Questions on magnification in a myope and about use of the red-free filter.

Case 5
Eye movement: 60 year old lady with fresnel prism fitted to her distance glasses. Asked to perform cover test. Had a LE esotropia, with poor re-fixation. Had restriction in abduction BE and in elevation. Gave differentials of  bilateral VI, or TED.

Case 6
Visual fields: RE paracentral scotoma. Not absolute. Questions on why I used a red hat-pin rather than a white one. And where the lesion might be. Didn't get a chance to examine the other eye.

Case 7
Keratometer: J-S keratometer. Straight forward. Asked about the principles
and the limitations (ie assumptions made).

Case 8
Focimeter: I hadn't seen this model before. But straightforward. Questions on principles.

77-year old lady with lens opacity.
Really thought I had failed this.
Had a really difficult time with the reflex on the RE due to a small amount of PSCLO. Had to come back after refracting the LE. Came down to 6/6 BE from CF. Finished the retinoscopy with about 5 minutes to spare. Performed the fastest subjective ever. With less than a minute to go I was still chasing
the cyl axis in the RE. Patient then asked to remove the trial frame to scratch her eye. Thought I was going to have an MI. Managed to finish the subjective with 20 seconds to spare. Guessed +3 for Near-add. Could read N5 at a reasonably comfortable distance. No time for any questions. No time for muscle balance. Very fortunate to pass this.

More candidate experience