Candidate 73
Date:  November 2007
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 This website has helped me tremendously through part 1 and 2 mrcophth ...


A bit tricky ; Elkington MUST be learnt from cover to cover . Also read the squint chapter in Kanski, and did lots of past MCQs as i find for me that's the only way it sticks ... used Bhan, did all the questions on and Chua's book ( success in mrcophth part 2 )
passed on my first attempt.


Chua's book with the tutorials was invaluable , as well as the many OSE past questions on the website.

  • CT scan showing enlarged extraocular muscles. Asked how this patient may present.

  • Humphrey Visual Field showing a small nasal step. Asked about reliability.

  • Hess Chart showing LR palsy . Asked about Herring's and Sherrington's law , and which muscles were over/underacting . Not asked diagnosis.

  • Visual Evoked Potential tracings - 3 of them.

  • Prentice rule calculation.

  • AC/A ratio calculation using gradient method.

  • Fluorescien angiogram showing what looked like branch vein occlusion ; asked principle of test and findings.

  • Ray diagram of Maddox rod.


Intimidating exam but fairly friendly examiners.

  • Visual field- Confrontation : Very good patient with Left homonymous hemianopia with macular sparing. Asked use of red pin, and where the lesion was.

  • Slit Lamp- Previous ECCE with sutures in place and superior P.I. Asked about methods and how to demonstrate them.

  • Keratometer - Javal Schiotz. Asked to take reading , and then principles.

  • Focimeter - Bifocal lens ; asked to find distance and near portion power. could NOT get near portion centred ?prism in near portion ?

  • Indirect - Positioned patient , mentioned macular hyperpigmentation but felt like the examiner wanted more.

  • Direct - Widespread CR atrophy, felt like the examiner wanted more.

  • Pupils - middle aged male with dark irides ; difficult to see with poor lighting . Looked like Adies ; asked a ton of questions of various pharmacological tests.

  • Ocular motility - elderly lady with left hypotropia seen on Hirschberg reflexes ; did not move with cover/uncover ; asked possible reason - patient was NPL in that eye. went on to test motility and stupidly did ACT (alternating cover test) at each position of gaze ; asked by examiner whether it made any sense to do that if the eye was not fixing , I agreed politely.


Had a great patient ; 50 myope whose occupational requirements were reading and using the computer. 6/60 and 6/36 VA initially which after retinoscopy corrected to 6/6. Did subjective,duochrome and +1 blur test BE ( corrected to 6/5 BE ), then found her near add , making sure arms length vision was comfortable for computer use. Finally did Maddox Rod ( no Maddox wing available ) and finished in 25 mins.

Hope this helps
Good luck to all!

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