Date: November 2007
1. Visual Evoked Potentials- Asked about the test, principles, etc. Three VEPs were shown and I didn't have a clue what they were.
2. FFA- Shown a series of photos, principles and diagnosis.
3. Hess chart- Asked about diagnosis and principles.
4. Maddox Rod- Asked to draw ray diagram and explain principles and uses.
5. Imaging of TED- Asked how a patient would present.
6. Calculation of a prism in spectacles using Prentice's rule.
7. Humphrey Visual Field Sensitivity/Specificity/PSD/MD.
8. Squint assessment. Calculation of AC/A ratio using the gradient method.
The odd esoteric question but generally Elkington and Rowe are the books to use for this. Detail is required, as is a solid understanding of the principles behind retinoscopy and ray diagrams. The MCQ's on this site are really useful.
Examiners gave little away. Here are my experiences :
Station 1 -
Keratometry Slightly nervous but was put at ease by friendly examiners. Asked what the machine was and to examine the patient - an Ophthalmology SpR with against the rule astigmatism. My findings which were compared by the examiners. A few questions on the principles.
Station 2 -
Focimetry Slightly different type to the one I was used to. Asked to check the distance prescription and then the near add in a pair of bifocals. Then asked about how the machine works, what does the target lens do, etc.
Station 3 -
Direct Ophthalmosocopy Patient with bilateral pale discs. Asked about direct magnification, sizes of images in emmetropia/myopiaand hypermetropia, etc.
Station 4 -
Indirect Absolute shocker ! Had difficulty tightening the headpiece and struggled with examination. I seemed to lose track of time and spent too long on the right eye. Couldn't see the lesion - although others stated it was myelinated nerve fibres . Didn't go very well at all!
Station 5 -
Ocular Motility Female in her 40's with left INO, left sided residual ptosis and aberrant regeneration, possibly an old 3rdCN palsy. Asked about possible causes. Talked my way through the findings as I performed each test.
Station 6 -
Pupil examination Teenage male with a right Adie's Tonic pupil. Dark iridies made things a little tricky - but again I talked my way through the examination and was asked differential diagnosis, pharmacological tests.
Station 7 -
Slit lamp examination Patient was an elderly male with difficulty hearing. Asked to examine the left eye where there was evidence of a trabeculectomy bleb, a surgical iridectomy and as hallow AC. Then asked to examine the right - an artificial eye (which was very convincing). Finally asked about filters, their uses and then principles of tonometry. Examiners seemed pleased.
Station 8 -
Visual Fields on an Asian male in his 50's with a left temporal field defect. NPL in the fellow eye. Asked about the pin colours, where the lesion was. Overall I learnt that time was short - only 5 minutes per station so you have to get on with your examination. Have a routine and work systematically through it - I found describing my findings as I went along helped. There is no substitute for practice -the techniques are more important than the diagnoses.
I had a 28 year old high myope with moderate against the rule astigmatism. CF both eyes unaided, improving to 6/4 both eyes after retinoscopy. 15 minutes gone. Only a +0.25 adjustment in the left eye required. Duochrome, +1 blur, Humphrey and Maddox Rod. No reading add required. Finished up without any rush at25 minutes. Final prescription around to Asked a few questions about Maddox Wing. Friendly examiners and helped with the Snellen charts. All in all, seemed to go well. I managed to get a few useful tips from a local optician and did lots of practice. It's important to look slick and be able to deal with potential problems.
Good luck !