Candidate 38
Date: February, 2005
Centre: Dundee
aa aa aa aa aa aa aa aa aa aa
MCQ: Usual mix of a few easy & a few weird questions.


Case 1
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.

Case 2
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 colour pins.

Case 3 
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.

Case 4 
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!!!!!!!!!!!!!!!

Case 7
Keratometry : Javal Schiotz keratometry on guy with oblique astigmatism. Asked to explain what I was doing, then principles of keratometry.

Case 8
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.

More candidate experience