Ask to use indirect followed by slit lamp. Patient had bilateral sub
foveal CNV scars. Right eye had small angioid streaks. Asked to link up
together, and systemic associations of angiod streaks
Slit lamp examination of diabetic retinopathy and PRP treament. Asked
on NVD and whether they were active or not. Mentioned that signs were unilateral
and possible causes. Mentioned ocular ischaemic syndrome and examiners
pointed to neck scar with previous surgery for carotid endartrectomy. Asked
about possible tests, mentioned CVS risk factors
and thrombosis screen.
Glaucoma and Cataract
Patient with bilateral pseudophakic. Distance between IOL and posterior
capsule in one eye very deep. Asked why. Turned out that patient had 2
IOL inserted due to refractive problems
Patient with PXF and asked about signs and glaucoma risks and risks
in cataract operation.
Asked to go through Visual Fields 24-2. Asked about field of vision
tested and false negative, false positive etc meant.
Asked to talk to patient with regards to initial diagnosis of POAG,
importance of drops, complicance, small visual field defect, risks of driving,
whether "laser by Boots" could cure POAG, and Side effects of b-blockers.
Patient with corneal scar and vascularization. Asked about possible
aetiology and mentioned herpes keratitis. Asked about disciform keratitis
and management. Asked about prophylaxis and mentioned HEDS.
Patient with heterochromia and evidence of KPs. DDx. Mentioned Fuch's
Patient with Bilateral Fuch's endothelial dystrophy. One eye with guttata
and asked to examine other eye. Other eye pseudophakic with evidence of
bullous keratopathy. Almost missed contact lens, but spotted it before
bell rang. Asked about purpose, and mentioned for comfort.
Neurophthalmology and Ocular Motility
Asked to perform visual fields. Took a while, patient had bitemporal
hemianopia, worse on Left than right, and Right Superior worse than inferior.
Asked about location of lesion. Mentioned parasellar tumours and probably
came from inferior due to worse defect superiorly. Asked about other eye
signs, but wasn't too sure what examiner wanted.
Asked to examine patient with seventh nerve palsy. Comment on facial
features, Asked about whether UMN or LMN lesion. forehead not spared thus
LMN lesion. Asked to examine relavant cranial nerves. Looked for CN 5,6,7,8.
signs. Asked about possible diagnosis, mentioned cerebellopontine angle
Medicine and Ophthalmology
2 very sound examiners : )
Asked to examine lids of patient, who had a left ptosis. Measure MRD,
IPD and levator function, which the latter was very poor. Very faint scars
noted, which suggested lid surgery. Asked which most likely, and mentioned
brow suspension. Asked for differentials of bilateral
ptosis. Mentioned myasthenia gravis, myotonic dystrophy and Kearns-Sayers.
Asked about features of first two.
Next patient young girl in 30's with NVD and PRP. Asked about diabetic
control, mentioned glucose, HBA1c and significant level. Asked
what would be good BP control. what agents to use for BP control. Mentioned
ACE inhibitors, beta blockers and diuretics. Asked about management of
patient that had gone to party for few drinks and collapsed. Mentioned
ABCs and glucose required. Asked about whether if ketoacidosis
required glucose. Wasn't sure. Examiners told me yes.
Told that final patient had signs of papillodema and headache. Asked
for differential. Mentioned had to rule out Benign Intercranial Hypertension.
Asked to describe type of headache typical of this, mentioned textbook
answer, nausea and vomiting etc. Examiners seemed satisfied. Asked if they
presented to optician first, what would they complain about. Paused to
think, and bell rang. Examiners said "that's fine...thank you"