Candidate 71                                                 Centre: Southampton 
Final MRCOphth                                                             Date: September, 2005

1) Picture of muscle biopsy. Diagnosed Kearns-Sayres'. What is the typical appearance? What are the other ocular associations?

2) Picture of  color Doppler. What is this investigation? What are the trials & prognosis for this patient?

3) Picture of cornea. Given history of repeated graft failure - patient with herpes. What is the cause-I could see acanthamoeba cysts + intracellular proteins. What is the immunological basis?

4) Orbital tumor: cross section, asked abt various orbital cysts

5) Cross section of the eye with an amelanotic melanoma.  Asked description of tumor
Asked prognosis

6) Histology of lymphoma cannt remember all bits

7) Histology of  retinocytoma!!

8) High magnification picture of retinal layers, point out various layers at which exudates /hemmorhage /drusens occur easiest of all.

9) section of  skin with normal epidermis .island of cells in dermis.

10) Pilomatrixoma


  • Simple and straight forward except statistic.
  • Need to know all about statistics-mode /mean/paired student t-test all those that are applicable for a research/audit.


Anterior segment station

  • Examine pt with  watery eye- patient has horizontal lid laxity/ punctual narrowing

  • asked abt various surgeries /managmement
  • Patient with epithelial dystrophy-cogans asked about clinical presentation
  • Patient with prominent corneal nerves.- went back to see corneal thickness

  • all basic questions on keratoconus
  • Luckily examiners did not bring in one more patient 

Posterior segment

  • Findings in the posterior segment with 90 /78 D. Patient with chorioretinal vasculitis + fibovascular RD+ retinal cryo+ silicone.
  • Patient with typical bone spicules RP

Ocular motility

  • Tricky case- Bilateral Duanes with multiple squint surgery.
  • Ptosis of no cause.Looked for assessment of ptosis.
  • Asked all about myasthenia.


  • Red eye /football player/back ache


  • Diabetic with charcots joints. 
  • Unilateral carotid stenosis

Visual fields/ Glaucoma

  • Simple questions on GHT.
  • Patient with endothelial dystrophy /360 degree PAS/ trabe/ moltenos. Simple questions followed.
  • Patient with iridotomy in one eye/other eye shallow ac/iridectomy/trab ? ACG.

Overall impression

Very tough histopathology. I would ask candidates not to worry about it .Everybody does badly if it is a tough paper. There  is no point in doing too much histopathology as you may never be able to get to the core of the subject. Even histopaths   themselves could have gone for a spin in this paper. Stick on to this web histopath and leave the rest to fate

EMQ simple. Very little time needs to be spent on this section while preparing for the exams.
incorporate statistics as well

Diagnose  correctly /questions that follow are those that we manage in our day  to day clinics. No complicated questions. No need to remember causes/management if you have seen enough cases that comes thru in a teaching hospital set up

Contributed by D 

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