Candidate 61
Date:  June 2006
Centre: Norwich
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1. CT SCAN: old stroke. Questions about the expected visual field defect. 

2. HESS: 6th nerve palsy / restriction of abduction. Asked to describe the principles of the Hess chart and explain how the test is done. Asked to describe the findings of the chart. 

3. US BIOMICROSCOPY: picture of a closed angle. Asked to identify the test and describe the diagram. 

4. RAY DIAGRAM: retinoscope. Asked to draw the ray diagram for the retinoscope and describe how it works. 

5. FFA: classic CNVM + peripheral drusen. Questions about principles of FFA. 

6. Humphrey VF: Homonymous hemianopia. Questions about reliability indices and where the lesion was. 

7. AC/A ratio: Asked to calculate the AC/A ratio. Just given degree of vergence with and without correction for distance and near. 

8. Prism decentration: Given the prescription of two toric lenses and asked to calculate the prism induced by decentration. 


1. Javal Shiotz Keratometer. Q: Principles. 

2. Focimeter. Q: Principles. 

3. Ant. Segment: not sure about the diagnosis. Q: Demonstrate various illumination techniques. 

4. Visual Fields: Glaucomatous VF defects. Q: Where is the lesion? 

5. Pupils: RAPD. Q: Where is the lesion? Describe the light reflex pathway. What are the pharmacological tests for Horners? 

6. EOM: Duane's Type 1. Q: Tell me about Duane's? Would you treat this patient? 

7. Direct: Myelinated nerve fibres. Q: Tell me about the graticules on the direct. Tell me about the magnificaiton and field of view in myopes. 

8. Indirect: small white lesion next to a blood vessel. Lesion was inferonasal to the optic nerve head. Q: Magnification with the 20D and 30D. What happens with myopia? 


Very good patient - reliable - well behaved. 78 year old lady. She did a lot of knitting. She did not drive. She normally wore glasses to read and when she was out and about. No POH. I knew from the start that she would either be slightly hypermetropic or slightly myopic because she was 6/12 and N10 unaided. IPD was 64. No tropia for distance. Slight phoria for near. Retinoscopy was straightforward as I already had an idea of her prescription. Subjective was also straightforward. I left her just on red on the duochrome and she could read 6/6. She had a slight myopic presctiption. The reason she was N10 in spite of being a slight myope was that she had no accommodation (because of her age). She had no vertical phoria but had a 0.5 Dioptre esophoria with the maddox rod. I put on +2.5D reading add bilaterally and she found that comfortable. She read N5 at her normal reading distance and her near point was about 10cm. BVD was 10mm. Q: I was asked when BVD was essential. A: Px 5D or more. I finished within the 30 minutes. The trick is to write straight onto the answersheet and not on scrap paper. This saves time. Also, write your findings as you go along. Otherwise you might forget. 

Just read Elkington. It's all there. 

I passed. Hurrah.


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