Candidate 120

Final MRCOphth (passed)                          

Centre: UK                             

Date:    Sept. 2008 

 

Glaucoma:
PXF - describe what you see. What is the material histologically. How does it cause glaucoma.
Visual Fields: What do the reliability indices mean. What is MD, PSD, GHT etc etc
Trabeculectomy. Why do it and what are pros/cons of fornix vs limbal based access.

Anterior Segment:

Fuchs Uveitis syndrome
Posterior Polymorphous Dystrophy: also asked about all the other dystrophies (inheritance, histological details)

Medicine:

Pseudoxanthoma Elasticum. Patient had gross atrophic AMD but no obvious streaks. Asked to examine skin. Neck changes were very apparent.


Visual field exam in a patient with junctional scotoma. Also asked to examine disc with direct (undilated). Asked about Pituitary pathology and eventually apoplexy
 


Posterior Segement:

AMD: describe clinical features, basics of FFA (and "interpret this angiogram"). New Lucentis guidelines

Indirect on patient with raised posterior polar lesion. Differentials. Discussion on Melanoma features, treatment and referral.
 


Communication Skills:

Lady with flash/floaters. Discussed PVD. Then told she had a RD and needed surgery. Discussed surgery. Concerns re: father went blind from "tumour" which I felt was what I needed to elicit and reassure about. Also discussion on flying and RD surgery. Finished in 8 mins. Sat outside for 7 mins thinking of things i could have said more and not knowing if finishing early was a good thing (but passed station easily so just shows don't be too analytical)

Passed. My tips are:

  • Buy Wong: read from cover to cover

  • Buy Chua's clinical exam book (15 BMJ bookshop online)

  • Path wasn't as hard as expected: just learn corneal dystrophies, giant cell arteritis, retinoblastoma, melanoma and granulomatous inflammation.