Candidate 57
Date:  February 2006
Centre: Sheffield
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1) FFA. ?Branch superior retinal vein occlusion with neovascularisation 
Q: what is this investigation 
Q: what are the prinicples in this investigation 
Q: Diagnosis 

2) Humphrey Visual Field. Right eye superior temporal & Nasal Defects and inferior arcuate scotoma 
Q: What is this investigation 
Q: Is this test reliable? (The left eye wasnt as there were 8 out of 10 fixation losses) 
Q: Diagnosis 

3) Hess chart showing Right orbital floor fracture 
Q: what is this investigation 
Q: what are the prinicples involved 

4) Picture of a gonioscope lens 
Q: What is this? 
Q: Draw a ray diagram to illustrate its working 

5) A low visial aid to be used has x4 written on the reference plane at 25cm. What is the power of the lens as measured by the lensometer? 

6) Dont remember correctly, but it was like a patient has R +300/-1.25 axis 90 and L +2.00/-1.00 axis 180 and on seeing near add was visualising 0.8cm.?what is the induced prismatic effect? 

7) MRI Scan brain with brightness at the occipital and parietal lobe (left side) 
Q: What is this investigation? 
Q: how would the patient present? 
Q: How would the visual field be affected? 

8) USS B scan. 2 pictures of the same eye (left) picture one showed low refelction and had GAIN 43.00 and picture 2 had better reflection and had GAIN 62.00 
Q: What is this investigation 
Q: The scan is of the same eye, how do they differ? 
Q: What are your findings? Diagnosis not essential 


1) Pupil exam.
Patient had a gross left fully dilated pupil. I checked for anisocoria and concluded that the dilated pupil was the abnormal one. However, the lighting in the room wasnt very good and the examiners tried to help out. light reflex and swinging light test. Questions on the pharmacology of cocaine, hydroxyamphetmine, and pilocarpine and how would I make 0.125% in clinic(would I make it or ask pharmacy). Very good examiners 

2) Ocular movemments.
Old nice lady. Left eye grossly?revealed exo. eye movements showed good eye movt in Right eye, left eye failed to adduct and on left abduction, right eye had nystagmus. Probably INO. Good examiners, giving cues and stuff 

3) Focimeter:
easy bifocal glasses. had to do one lens only. questions on priniciples of focimeter and why do you put the glasses other way round when you test the near segment. 

4) Keratometer: 
one eye only. Questions on wollaston prism, readings and why cant the slit lamp be used for keratometry. Good examiiner 

5) Slit lamp exam.
Patient had pigment dispersion syndrome. staining of endothelium, iris transillumination and looked something like PEX as well. questions on different knobs and switches of the?machine, demonstrate different examination techniques. examiner had no reaction to anything. 

6) Visual fields. 
Didn't have much time on this for some reason. could only do one eye. patient had a complete superior and inferior-temporal field defect and macula sparing. Diagnosis: ?advanced glaucoma. good examiner 

7) Direct ophthalmoscopy. patient had high minus lens. was hard to see his fundus but saw his disc which had a 0.8-0.9 cupping and was pale. questions on magnification of emmetrope and magnification on this particular patient 

8) Indirect. 
Patient was a young female, not very cooperative, kept moving and blinking. whenever I started looking, 2 examiers would start looking at the teaching mirror. very nerve wrecking. patient had ?RP ?CHRPE. 

After every patient I washed hands with alcohol, which all the examiner loved!! 


Amazing examiners. patient was 36 yr old male. usually wears glasses, didnt bring it here (ofcourse). VA unaided HM both eyes. Retinscopy was R -7.75/-0.50 x90 L -7.50/-0.75 x90. got him 6/5 uniocularly and 6/4 binocularly. Duochorme slight red. Maddox showed slight exo, corrected with 5PD. was asked if i would prescribe it, said no as pt didnt complain of diplopia. Measured BVD which they liked. ended on a good note. 

overall ok exam, OSE was a bit iffy, so lets see, fingers crossed.

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