Candidate 40
Date:  2005
Centre: Edinburgh (Passed)
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Day 1: 

MCQs---quite a tough paper compared with MRCOPhth part 2 and especially with the negative marking system things are worse. There were topics like 

A) Audit 
B) Epidemiology? What is meant by incidence, prevalence cohort study etc 
C) Regression analysis 
D) Parametric analysis 

In general the questions were not out of the syllabus, but quite tricky with hidden catches in some of them. I marked around 245 out of 300 mcq? 

Day 2 ( morning ) 


In general the pattern of the exam is quite well conducted and we had to rotate in between cubicles were questions were stuck on to the desk 

Station 1: 

Picture of child with left ptosis 
  • What is this condition called?
  • What does it mean if there is no lid crease?
  • How you will test the levator function in this child?
  • What is the most dreaded complication?

    Station 2: 
    Hess chart with L superior oblique weakness 
  • What is this investigation.  
  • How do u dissociate the eyes? 
  • Describe your findings and the long term muscle sequlae 
  • Don't remember. 

  • Station 3: 

      Applanation tonometer: 
    • What is this instrument? 
    • What is the exact diameter used and the reason for this. 
    • What is the reason for the red mark? 

    Station 4: 

    Fundus photograph of posterior pole BE with FFA of late venous phase BE showing CMO LE 
  • Which phase is it in? 
  • Name two clinical scenario associated with this condition.
  • How would u treat this? 

  • Station 5: 

    USG B scan and A scan showing choroidal mass with a arrow mark pointing the choroidal layer 
  • What does this show? 
  • Which layer the arrow points and what is the normal thickness? 
  • When do you get T sign? 
  • Don't remember.
  • Station 6: 
    X ray orbit showing a opaque body ( probable pellet ) at the L infraorbital margin 
  • What does this show? 
  • Name 2 other investigation will u do to diagnose this. 
  • Name 2 foreign bodies which can lead to devastating eye problems 
  • What complications can you expect in this patient.

  • Station 7: 

    Photograph of child with leucocoria. 
  • What is this condition known as? 
  • Name 3 scuh conditions which can give rise to a similar appearance. 
  • If the USG B scan revealed calcification what would have been your diagnosis? 

  • Station 8: 

    Goldmann Visual field showing extremely constricted field. 
  • What is this investigation and what does it show? 
  • Name two conditions which can give rise to a similar field. 
  • What is the most sensitive setting used in this particular test . 

  • Day 2 (afternoon ) 


  • I believe the refraction part of MRCS is much more scary than the London exam. For the first 15 minutes u are left alone in the room with the patient and the examiners expect u to take a history, record both near and distant visual acuity , do the retinoscopy and much of the refraction within this time. The next 15 minutes the examiners are there with u and they are a bit more than being a fly on the wall. 
  • Most candidates complained that the room settings were explained but quite hurriedly and the candidates were not given time to settle down in the room and get to know the settings themselves. However, the light settings and the view box at Princess Alexandra Hospital was not too complicated and although there was a lot of frustration at not being able to refract within 15 minutes. In general the examiners were nice and very helpful. None of the candidates got complicated patients like cataracts, scissors reflex, amblyopia etc. Pretty straight forward, but there were very few candidates who were satisfied at the end of the refraction. 

  • Day 3 (Morning ) 

    Oral table with 2 examiners 10 minutes each 

    Topics I was asked:

  • Advantages of Indirect and direct ophthalmoscopy and their mutual disadvantages 
  • Use of USG, Principle 
  • Amblyopia 
  • Various types of scotomas, and to classify them and clinical conditions thereof 
  • Colour vision testing of various types 
  • Shown an orthoptic report with L microtropia and L suppression scotoma as evident on Bagolini? 
  • Shown specular microscopy picture showing corneal megatheism. Asked about normal endothelium cell count and at what critical level corneal clouding tends to occur 
  • Shown Fresnel prism and uses 
  • Given power cross and asked to take off working distance and write prescription in negative cylinder 
  • Fresnel prism with myopic correction? This looked quite weird and I have never seen such a Fresnel before. It looks like a Fresnel with circular markings. However the examiners were helpful, relaxed and I did not get pressurized at all. 
  • Asked about histological features in temporal arteritis and atherosclerosis 
  • Causes of altitudinal field defects 
  • There are quite a few other topics which I don? remember?? 

  • OSCE:

    One large room with 6 patients and 2 examiners 

    1st patient: 

    • Direct ophthalmoscopy on a patient of CRVO with collateral vessels 
    2nd patient: 
    • Indirect ophthalmoscopy of a patient with \PRP done with large cupping ...was asked to look at the other eye as well which had normal fundus without any collaterals or cupping 
    3rd patient: 
    • Esotropic patient with some intraocular surgery in the esotropic eye and was asked to check pupils. this gentleman had dark iris and a esotropia with >45 degrees of strabismus. it was extremely difficult to appreciate the pathology. However , I could only find out from consensual reflex that he had a RAPD in the esotropic eye 
    3rd patient: 
    • L homonymous hemianopia 
    4th patient: 
    • Ocular motility with Duanne's retraction syndrome in an old lady of 55 years 
    5th patient: 
    • Macular hole slit lamp evaluation 
    6th patient: 
    • Narrow angle glaucoma with PI done and some endothelial changes.. 
    • Was asked about sterilization of tonometers, one mirror, Jakob-Creufeldt disease and calibration of tonometer. 


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