Candidate 25
Date: October, 2003
Centre: Madurai, India
Result: Passed
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Station 1:: 
Question: What is this instrument? Draw a ray diagram to explain its principle?
Answer: Maddox wing. Ray diagram.

Station 2:
Question: What is this investigation? What does it show? What is the probable site of lesion?
Answer: HFA. Congruous Left Superior quadrantanopia. Right temporal lobe

Station 3:
Question: What is this investigation? What are the principles related with this diagnostic technique? What does it show? 
Answer: Hess charting. Haploscopic principle, foveal correspondence, Herring’s law, Sherington’s law. RIGHT EYE superior oblique palsy.

Station 4: 
Question: Transpose into minus cylinder form ? What is its spherical equivalent?
Answer: ??? donut remember the exact figures.

Station 5: 
Question: What is this investigation? What does it show? Which part of the eye is involved?
Answer: USG A-scan and USG B-scan. Membrane like (high reflectivity) lesion with underlying mass (low reflectivity) like lesion, and no sound attenuation. ?? Retina and Choroid involved (?? Retinal detachment with underlying subretinal haemorrhage or choroidal melanoma with retinal detachment).

Station 6:
Question: What is this investigation? What does it show? What is the probable diagnosis?
Answer: sequential Fundus Fluorescein Angiography scans. Irregular areas of hyperfluoresence and hyperfluoresence increasing with time located in the centre of macula (1disc area). CNVM/ARMD

Station 7: 
Question: What is this investigation? What does it show? Which part of the eye is involved?
Answer: CT Scan Orbits. ?? Contrast enhancing, well-defined mass lesion with areas of bony shadows behind the globe and in area of Lacrimal gland producing proptosis and medial deviation of globe. ??? Lacrimal gland (tumour) or vascular (haemangioma) involvement

Station 8:
Question: patient has exotropia of 10 prism dioptres in and his refractive correction is +5D. What is the type of prisms is used in management. What will be the amount of optical decentration of lens in front of right eye to maintain alignment?
Answer: BI prisms. 2cm nasal deviation of lens.


Station 1: 
 ?? Diagnosis: Bitemporal hemianopia. Detected on static confrontation field test. 
 Questions: Demonstrate? What is the field defect? Where is the site of lesion? Describe the optical pathway at the chiasma that explain the field defect. Asked to find/ demonstrate the extent of lesion (with finger). What are the various coloured targets used for? Asked to demonstrate the use of coloured targets.

Station 2: 
 ?? Diagnosis: Total right eye third nerve palsy
 Questions: Asked to observe the patient and tell findings (Ptosis, dilated pupils, right eye out and down)? Performed cover test (sec dev = primary dev)? EOM showed restriction of MR, SR, IR, IO. Asked and demonstrated how to look for SO in cases of 3rd CNP. Asked me about probable site of lesion and probable cause of lesion.

Station 3: 
KERATOMETRY of right eye of young male
Questions: Principle of keratometer? Type of keratomer? Principle of image doubling? Principle of variable object/image size? Difference between different types of keratometers? 

Station 4: 
FOCIMETER of patients distance vision glasses
 Questions: what adjustments I made before starting the examination and why? What all I can calculate with the help of focimeter? How will I find out that prism is present in the lens? How will I mark the optical centre of the lens? What is the principle behind the working of this machine?

Station 5: 
DIRECT OPHTHALMOLOGY of left eye of young girl
 ?? diagnosis: macular scar and medulated nerve fibre at disc
Questions: demonstrate and describe findings? What is the possible cause of this lesion? What is the magnification of this instrument? What is the effect of patients refractive error on magnification? what are  green filter used for in examine the patient? Examine the right eye of another gentlemen sitting next to the lady and tell the findings? (??? Vitreous haziness, disc details obscured due to haemorrages). Bell rings while I was in middle of examination

Station 6: 
INDIRECT OPHTHLMOLOGY of left eye of middle aged male with poor vision in left eye
 ?? diagnosis: old CRVO with Old Pan Retinal Laser Photocoagulation and macular gliosis and plucker
Questions: demonstrate and describe left eye findings? Look and Describe right eye which has good vision? (?? Normal posterior pole) What is the magnification of 20D lens? What is the difference between 20 and 28D lens?

Station 7: 
 ?? diagnosis: right eye Total 3rd nerve palsy with pulsatile bony defect sec to surgery on the right forehead
Questions: demonstrate and describe? Why do u think it is 3rd nerve palsy? Where is the possible site of lesion? What is the possible cause of lesion? What is Relative Afferent Pupillary Defect? What does Relative Afferent Pupillary Defect signify?

Station 8: 
SLIT LAMP EXAMINATION of both eyes of a girl child
 ?? diagnosis: B/L Keratoconus with Left eye acute hydrops
Questions: demonstrate and describe findings? Why u used blue filter? What various illumination u used for examination (diffuse, direct focal, optical slit, indirect focal)? What other examination techniques u know of in slitlamp examination (retroillumination, specular reflection, sclerotic scatter)? Demonstrate how will u perform specular microscopy and describe while doing?


65year old male patient
Diagnosis: Bilateral aphakia.

RIGHT EYE +9.50/+2.25*180 6/6 & LEFT EYE +10.0/+2.00*180 6/6
NV add +2.50 N6 
JCC, Duchrome test, binocular balancing for near and distance, BSV test, Maddox rod test, BVD, IPD measurements done. Asked in last one minute about old glasses and explained to examiners about the need for comparison with the new prescription

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