Candidate 75                                                 Centre: Southampton 
Final MRCOphth                                                             Date: September, 2005

Difficult and full of lots of marginal cases, the path portion of the website and the self assessment are invaluable. Its worth noting the number of marks derived directly from interpretation of the slide probably only constitute a third (if that) for the total of the question.

Matched response

Generally quite fair, there were the obligitory stats questions which were pretty much guesswork.


I had scored the final session on the final day. There appeared to be a bit of a drought of patients, despite this everyone saw two patients. The examiners were unfailingly nice without exception and any time they saw that you were maybe a bit stuck gave you a bit of 
a prompt. Lots and lots of questions maybe because there were not enough patients


1.CN VI palsy with aberrent regeneration. I was asked to take a brief history and examine the patient. Asked about localisation of the lesion from infomation gained in the history, differentials, questions on the clinical features of a CP angle lesion, few quick questions on treatment.

2. Sensory esotropia in a girl with congenital cataracts, straightforward examination. Then asked to carry out pupil examination on the same patient, once again routine. Lots of 
questions then about visual acuity testing and examination of the patient had she been only one year old, on treatment with regards to amblyopia, cataract extraction, muscle surgery

Ophthalmology and Medicine

1. Advanced diabetic eye disease. The patient had recently had PPV and oil. Questions on expected vision of patient (missed the fact he was carrying a white stick), use of vitrectomy in DR, medication that he may be on and the reasons behind this (DM trials, asprin, 
statins, ACEI)

2. Acromegaly. Description of clinical features, symptoms/ signs that might be expected, treatment options

Posterior Segment

1. Indirect. Have no idea what this was but described what I saw and gave a few differentials, used my 28D but after I finished was told to use the 20D as I would require more magnification. Despite the increased magnification I still had no idea what this was

2. Choroidal folds with macula oedema . asked for differentials 


1. Advanced pigment dispersion glaucoma. standard examination, then asked to look at the discs (heavily cupped)

2. Examination of a patients trabeculectomies, type II blebs, asked about expected function of the blebs. 

Lots of general questions: asked to describe HVF, how would I perform a trabeculectomy, use of antimetabolites, day one post op problems with trabs, Sidiel's test.

Communication Skills

History from a patient who has had sudden loss of vision in one eye. Given the diagnosis of temporal arteritis after my spiel. Explanation of condition and treatment to be given to patient (she was not keen to be commenced on steroids)

Anterior Segment

1. Corneal graft for FED, questions on risk factors (donor and recipient). few more questions but have forgotton these

2. Fuchs cyclitis, pseudophakic, vitreous changes, heterochromia, KPs. Questions and treatment of operative (hyphaema) and post operative complications in patients with Fuchs (CMO), treatment of the floaters, causes of iris hypo and hyperchromia

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