I am Dr Jyothsna and I cleared my FRCS on Feb 2010 in the first
attempt. This was the first sitting of the new pattern of examination
and after reading past candidates' experience I thought the written
essays part 2 and part 3 clinical examinations were easier this time.
I have attached a file on the answers i wrote for part 2 and these
were my questions in part 3
VIVA - 3 tables of 2 examiners
What is sight-threatening uveitis?
Causes of uveitis and classification.
Picture of slit lamp section of cornea
showed a localised opacity--the examiner wanted keratoconus with acute
hydrops but honestly it was not easy to asess the depth of lesion on 2
D picture ..management
How can diabetes affect macula ?
Causes for sudden obscuration of vision
and investigations ..if he has headache and diplopia -- wanted GCA
Picture with madarosis..and trichiasis
.. causes and complications.. seriously i could think of 4-5 causes
apart from corneal ulceration could think of no other complication and
only... finally said radiation as a cause and examiner seemed pleased.
How to manage flat AC post trab
Immediate post op comp of trab
Lid reconst surgeries ..he gave me a
scenario and i had to name procedure ..like Cutler-Beard ,Mustarde etc
Picture of BCC and management
Patient with floaters ,inferior field
loss, then sudden loss of vision ..what do u think is happening.. PVD
superior RD involving macula ..management
Management of unconscious patient
How to do CPR ...where to place your
hands and the rate
Complications of systemic streoids and
Which is worse immunosuppresive or
steroids ..tricky !!!
Level of lesion in different field
defects and prosopagnosia.
Complication of hypertension
We had four rooms -ocular motility, anterior segment, retina and
neuoro-ophthalmology. Each room had 3 patients and 2 examiners. 5 to
10 minutes allocated for each room. We were told that we had to
examine 2 patients and if we had time then procced to the third.
Contrary to what I had read about other candidates experiences posted
on this website we were given clear instructions to just do the test
examiner told us to. No need to introduce, greet, shake hands, adjust
Slit lamp etc.
Ocular motiity room
Do alternate prism cover test. Both
loose prisms and a prism bar were kept. I said i would start with
Hirschbergs corneal reflex test and then with alternate cover test.
The patient had a left exophoria and I mentioned i would place the
prism with apex towards deviation and repeated the cover test .it was
neutralized by at 25 prims dioptres.
Frankly i was nervous as this was my first room and it did not go as
smoothly as i would have liked . during feed back session most
candidates felt that this was unfair as alternated PBCT was a sub
Check extra ocular movement. Examiner
said start with observation. I mentioned a mild ptosis of the RE .
scar on the forehead . said i would liek to look at pupils. he said no
go ahead . I did duction then versions . patient had limited adduction
and depression. Time was running out and he hustled me on. I said
partial 3 N palsy. He said can it be aberrant regeneration . And I
realized it was an obvious pseudo von Graefes sign . Mentioned it and
also added no inverse Dunaes seen more as a feeble attempt at
salvaging what I thought i had messed up big time !!!!! bell rang
Young lady at slit lamp. Asked to
examine the left eye which had a clear full thickness corneal graft 8
mm in diameter with interrupted sutures. Mild opacification at graft
host junction. no loose sutures or vascn at sutures. Superior
vascularization of the host bed at 2 clock hours but not encroaching
on donor cornea. AC quiet, pupil round regular. examiner asked causes
of graft at this age, rejection, management , types of suture .Fairly
routine predictable questions.. said examine the other eye. macular
dystrophy. smiled and asked any other possibility . said opacities
seem superficial . dould it be resi bucklers but am nor sure as ia hd
not seen too many of those. bell rang
Again hydrops and keratoconus. Same
examiner and same Qs as viva
My sub-speciality ..so it was a breeze
Young patient. Indirect ophthalmoscopy
showed PRP scars, sheathed vessles and pale disc. Discussion on
vasculitis. history,work up, Eales, Bechets etc
90 D on an elderly male. Had NVD with
CRVO and freshly lasered. Diagnosis: ischaemic CRVO versus
non-ischaemic CRVO. Clinical features and FFA. Management. Aetiology
of CRVO and investigations
DO young man bilateral temporal pallor.
causes. pituitary tumour and the file defects. some bit on toxic
90 D of glaucomatous cupping 0.8 C/D and
inferior notch . Discussion on work up and managment
Exmaine pupils of young lady. Had a LE
RAPD. Subtle but was definite. Had to do direct ophthalmoscopy of RE
showed mild blurring od superior and nasal disc margins. Asked DD of
pappiledema and disc edema. How to work up disc edema. discussion on
MRI in MS. What if she had poor color vision with centrocecal scotoma
.I said i would treat as optic neuritis . asked investigation in optic
neuritis and ONTT etc etc .
I would like to thank everyone who helped me especially Dr Muthusamy
and his faculty. My main resources were the Chua web page, Wills,
Oxford Handbook of ophthalmology and Dr Muthuswamys questions. For
clinicals no substitute to attending a tertiary care hospital and
seeing maximum cases for at least 2 months esp if you are already in a
sub specialty like me and not too much in touch with other
In India unfortunately there are no organized classes or training
programs for the clinicals unlike in the mid east or UK which is
surprising considering how many Indians take it.!!!
So till then u have to rely on the websites and discussion forums !!!!
MS DNB FRCS
Consultant Vitreo Retinal surgeon