Candidate 42                                         Centre: York
MRCOphth (Passed)                                          Date: March, 2004
Clinical Examination

Anterior segment 
Case 1: Thyroid eye disease asked to test everything you feel necessary for example eye 
             movements, pupil, optic nerve 
Case 2: Heterochromia & aphakia - causes of the two together. (Chronic uveitis in 
             juvenile rheumatoid arthritis; Fuch's heterochromic cyclitis; trauma)

Ophthalmology and medicine
Case 1: Flashing lights&visual loss for a day in both eyes&headache(differential diagnosis, 
            arteriorvenous malformation features),fields examination 
Case 2: Episcleritis & SLE (patient has butterfly rash on the face).

Posterior segment
Case 1: Retinal emboli -complications, significance for rest of body, management of acute 
             arterial occlusion. (breathing into bag to vasodilate the vessels, oral acetazolamide 
             and ocular message; paracentesis)
Case 2: Macular scar - differential, management of old macular scar, causes of choroidal 
             folds, characteristics of preproliferaive DR 

Case 1: Partial third & sixth but no fourth( able to look up ,abduct or adduct) - possible 
             location of  problem, differential diagnosis, shown MRI -cavernous haemangioma 
Case 2: Bilateral swollen discs in teenage girl-differential & management,had BIH 

Case 1: Pupil examination-RAPD causes, examine discs-causes of unilateral optic atrophy 
             examine ant seg-bilateral PIs & left trab -give likely history.examine discs of same 
             patient-cupped discs L>R.examine fields  of same patient -R superior 
             quadrantinopia which was incongrous-is it due to the discs & what could have 
             accounted for it. 

Communication skills:
Age-related macular degeneration, consent for FFA, tell patient it is not amenable to treatment.

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