Glaucoma / cataract:
Primary open angle glaucoma. I was asked to comment on the disc and the
visual field and asked if the two correlate.
Previous acute angle closure glaucoma. The patient had bilateral peripheral
iridotomies, glaucoflecken and shallow anterior chamber.
Aphakia. Asked about complications and treatment.
Floppy eyelid syndrome. Patient complains of sore, gritty eyes. I was asked
to examine the patient and give possible diagnosis. I mentioned I liked
to evert the eyelid and the examiner asked me to go ahead. I got to the
diagnosis eventually with some prompting.
Bilateral corneal grafts for keratoconus. One had had previous rejection
episode. Asked about the management of rejection.
Lattice dystrophy. Asked about the inheritance and presenting symptoms.
28 year old professional footballer with low back pain and red painful
eye. Asked to take a history and discuss management. Had to take his sexual
Patient with rheumatoid arthritis. Asked to examine the hands. Had shows
and socks off too and asked to comment on the feet (synovial swelling and
subluxation of the joint). The patient was wearing neck collar and I was
asked about atlanto-axial subluxation during operation.
Young man with resolving anterior uveitis. He was HLA B 27 positive with
a diagnosis of ankylosing spondylitis. Discuss the management and diagnosis.
Neuro-ophthalmology and ocular motility:
Patient with myotonic dystrophy. Asked to examine the upper limb function
and demonstrate the slow relaxation of the muscles after shaking.
Carotico-cavernous fistula. Asked to examine the patient by inspection
initially. Comment on arterialization of scleral vessels. Also asked to
listen for bruit.
Patient with bilateral sixth nerve palsy and poor facial expression. Possibly
Examine with an indirect ophthalmoscope. Retinitis pigmentosa with pale
disc, attenuated vessels then further examination on the slit-lamp. The
patient has bilateral posterior subcapsular opacities. Asked about management
of the cataract and risk of cystoid macular oedema.
Angioid streaks in a patient with pseudoxanthoma elasticum. The patient
has choroidal neovascularization. Discuss the management of the new vessels.
Laser, PDT and surgery.