I sat the
FRCOphth Part 1 exam in London in May 2010.
paper was 120 questions (Best of Four). In most questions it was easy enough
to whittle down the choice of answers to 3, or in some cases, to 2
possibilities. After that, it was tough and required quite a deep
understanding of the topics. There was the expected mix of questions on ocular
anatomy and physiology, but there were also questions on general physiology.
(CRQ) paper was as follows:
the eye developing in utero.
labelled structures (lens vesicle, hyaloid artery)
will structure x develop into? (x points to outer layer of optic cup)
- Name 3
structures derived from structure y (y points to surface ectoderm)
Humphrey visual field results for 55-year-old patient (both eyes). Right eye
normal. Left eye shows superior nasal step.
What is this test?
Are the results reliable? Explain your answer
The patient did not require near addition during the test. What does this tell
you about their refractive status.
What do the test results show?
What would you expect to find on fundal examination of the patient?
Draw the optical diagram for the compound microscope
What is the nature of the image created
Other than the slit-lamp, name 2 other instruments containing a compound
(1) B-scan showing dome-shaped posterior pole lesion and (2) A-scan showing
lesion to have low internal reflectivity
What investigations are shown above?
Describe the appearances in (1)
What is the most likely diagnosis?
a patient with high myopia given (-9D right and -7D left). Axial length around
26mm each eye. Patient has nuclear sclerosis right eye.
keratometry: K1 41. K2 43.
How much astigmatism is there in the right cornea?
What type of myopia does this patient have?
What IOL power would you use? Explain
What is the A-constant for these lenses? (given on biometry print out)
Which IOL formula would you use?
axial CT scan given. Large calcified lesion around the posterior lateral wall
of the right orbit.
What is this scan?
Describe the findings of the scan (no need to give diagnosis)
Name labelled structure (?cerebral aqueduct)
scenario outlined: increasing anxiety and tachycardia. Bloods reveal: high T4,
low TSH and positive for antibodies against thyroid peroxidise.
What is the diagnosis?
Explain the blood results
Name 3 other reasons for a patient to have a high T4 level.
Give 5 possible signs on examination of this patients eyes.
the cavernous sinus
Name 7 labelled structures (sella turcica; III; IV; Va; VI; internal carotid;
Name 3 venous sinuses in direct communication with the cavernous sinus
Label A-D (a-wave, b-wave, oscillatory potentials, latency)
What is the origin of the a-wave?
What is the origin of the b-wave?
What is the origin of the oscillatory potentials?
Give 2 methods of isolating cone function in an ERG.
Calculate the difference in prismatic effect between the eyes if he was to
read through the near segment (8mm below optical centre of main lens)
What rule are your calculations bases on?
What assumptions does this rule make?
Why might the prismatic effect you have calculated be different for this
patient? Give 3 reasons
scenario outlined. Young male with shortness of breath. Chest x-ray reveals
bilateral hilar lymphadenoapthy and diffuse lung nodules. A diagnosis of
sarcoidosis is made.
other important diagnosis must be excluded?
What are the features of sarcoidosis on histological examination?
Give 4 ocular manifestations of sarcoidosis