mix of a few easy & a few weird questions.
Slit-lamp: was my 1st case.
Luckily 2 very friendly examiners. Patient had a failed keratoplasty with
blood vessels invading cornea at 3 & 7 o’clock. Corneal oedema,epithelial
bullae. No sutures seen. Asked if I saw anything else, I looked & lo
& behold patient had a bandage lens on. Examiner seemed satisfied.
Asked to look at other eye & comment on cornea. I thought maybe some
dystrophy which was why k’plasty was needed in other eye. But could not
find anything. After some time I said it looked normal. Luckily I was right.
Then some routine Qs about filters, calibration of tonometer.
Visual fields: Was asked
to do confrontation fields for old lady. Had bi temporal hemianopia. Used
both white & red pin. Qs about where the lesion was, why I used both
Ocular motility: Lady with
proptosed left eye looked like down & out.Was asked specifically to
start off with cover test.( But even if not asked, please do it, for distance
& near, with & without glasses). Lady had LIMITATION of movements
LE superiorly & to L. I said restricted movements. But examiner asked
to be specific. I did not understand what he meant, until he asked how
do you know it is restricted, not paralysed. Then corrected me to limitation.
Asked probable diagnosis, I jumped at thyroid… but said proptosis in thyroid
should be axial. Examiner seemed satisfied.
Pupil: patient had an RAPD
in one eye. Typical Qs: pharmacy tests for Horners, Adies, pathways.
Case 5 and 6
Direct and indirect: I saw
the patients being asked to switch between direct & indirect stations
just before I entered. As a consequence, the lady 4 direct had widely dilated
pupils, & the guy 4 indirect, smallish pupils!! There were both 20
&30 D lenses, but I was more comfy with 20D. Luckily I managed to see
thru the small pupils!! Praise the lord. Extensive chorioretinal atrophic
patches, all Qs with pale disc, BE.After describing findings, I said choroideraemia.
Examiner not too pleased with diagnosis, asked me to move on to direct.
Again chorioretinal atrophy, this time in infero-nasally. Also saw black
floating opacity in mid vitreous. Had focused at –4 & mentioned that
patient is myopic. Again asked 4 diagnosis. Dunno where this came from,
I said hyaloid artery remanants, with choroidal coloboma. Examiners guffawing,
asked for “not so fantastic diagnosis” I joined in the laughter, but could
not provide answer. Bell rang, I walked out, & immediately realized
that it had been myopic fundus both cases!!!!!!!!!!!!!!!
Keratometry : Javal Schiotz
keratometry on guy with oblique astigmatism. Asked to explain what I was
doing, then principles of keratometry.
Focimetry. No surprises
here either. Did fcoimetry for a pair of bifocals. Was shown a pair of
trifocals, & asked what I thought the power of the intermediate segment
was assuming this was for a 85 year old person. I said +1 to+2 depending
on what he wants to use segment for.
And that was it for OSCEs,
started punctually & within the hour, I was free to go.
Again examiners were helpful.
Trying to put me at ease & get used to set, charts etc. Got a 53 year
old man with CF 2 & 3 mts. Was a high myope. Luckily he read 6/4 with
my ret value (-1.5 for working distance of course) HUGELY relieved. Then
played around with cross cyl, etc. Did NV,accepted +2.5 BE. Did Maddox
rod, did not prescribe it though. Finished with 5 min to spare.
All in all exam conducted
punctually & well. Examiners were, most of them friendly & nice.