Date: November, 2004
Calculate new power of lens when +10D lens moved from 12mm BVD to 10mm
Calculate AC/A ratio (gradient method, for near: 15D eso, 5D eso with +3D, ie AC/C = 3.3)
Ultrasound - Pt with swollen discs and two scans of RE with disc drusen (one with gain turned down). Principles of US. Describe scans and most likely diagnosis.
FFA (full series including colours) - asked to name investigation and descibe principals. Then asked to describe the findings - I thought this was a classic choroidal neovascular membrane but plenty of students thought it was a PED.
CT - Axial soft tissue window post contrast. Left extraconal lesion. Asked to describe and state what signs pt may have. No diagnosis asked for. ? lacrimal gland tumour
20D lens - Asked what it was and to draw ray diagram illustrating principals
Humphrey's field of one one eye (SITA fast). Inferior altitudinal. Reliable though oddly postioned blind spot. Few non-specific superior loss. Not sure I definitely knew what was going on since this was a very reliable field. Anyway, asked which parameter led me to decision re reliablity and to describe defect.
Hess Chart - Asked re prinicples. Asked to describe (restriction of downgaze LE - definite mechanical picture). No diagnosis asked for (?TED, MG)
Some hard questions, many straight forward, a considerable number of poorly written and ambiguous ones.
B&L keratometry on one eye only. Easy. Obvious Qs on optics of keratometry including Javel Shiotz
Focimetry on single vision glasses. RE -3.50DS, LE -3.50/-0.50x90. Straight forward Qs on optics.
Slit lamp. Got as far as band keratopathy then went straight to showing all different methods of illumination
Fields. Gross bilateral inferior altitudinal defects. Asked for differential diagnosis.
Pupils. Anisocoria worst in bright illumination. Asked for differential diagnosis, what I'd look for on slit lamp and pharmacological tests.
EOMs. Asked to do cover test first and explain what I was doing. Then EOMs - had DV looking to left and I thought abduction nystagmus in the left eye. So I went for R INO, but they didn't seem impressed! No time for saccades but I said I would do.
Direct. Not sure what I was looking at. Thought right disc was pale with peripapillary atrophy and left disc was indistinct with unusual vessels. Thinking back, was this disc drusen? Examiner did not seem impressed. Asked about different mags and filters.
Indirect. Cooperative and well dilated patient, but I wasn't sure what was going on. ?retinoschisis. Asked to draw my findings on a RD chart. No questions.
Overall went OK, but not sure if they will fail me on indirect station?
Straight forward 68yr old myope. Finished just in time including muscle balance. Ret took me to 6/4 in both eyes, but I think most candidates agree that the charts can't have been 6m away!!!