| 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
)
OSC
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
)
Refraction:
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:
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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