CRQS MRCOphth PART 3 GLASGOW
1. Histopathological section of Bullous
Keratopathy/ Fuchs dystrophy.
Histology of basement membrane
Changes in epithelium and BM
Clinical features of Bullous keratopathy
Stains for stromal dystrophy ( Macular,
2. Histopathological section of Cornea
Name given for appearance with congo
red stain Apple green birefringence
Other dystrophy associated with this
Mechanism of recurrence of Lattice dystrophy.
3. Patient listed for cataract surgery
complains of burning micturition and has high temperature.
How do you manage this patient?
MC cause for UTI
Antibiotic of choice
If confirmed UTI how will you further
4. Patient with Giant cell arteritis,
on ACE inhibitor, Statins and diuretics for CCF. Bloods FBC, Hb,
MCHC, CRP, ESR, U&E, Creatinine levels given.
Rasons for abnormalities in the blood
What is the positivity rate for biopsy
in GCA? And why
If systemic steroids are already started,
why do u still need to biopsy?
5. 65 yr old patient has had radiotherapy
for upperlid lymphoma 10 yrs ago.He develops a lump in the upperlid and
conjunctiva.Histpathology picture given.
Describe the histology slide?
What is the diagnosis and the usual
site for this lesion?
Predisposing lesions for it
How do you treat it?
6. 40 yr old lady with conjunctival
nodule histology slide shown.
What kind of inflammation does it show?
Blood tests for sarcoidosis
Investigations to confirm tuberculosis
in a tissue biopsy specien.
What is the histological picture of
How do you send the specimen of conjunctival
biopsy in conjunctival scarring?
7. 80 yr old female with Alzheimers
disease ,ectropion and epiphora.
Which of the corneal protective mechanisms
Protective factors absent from tears
Organisms that can cause corneal infection
Stains used for fungus
8. Slide showing corneal ulcer and microscopy
What is the morphology of the fungus?
Fungal infections in cornea
9. Female with a medial canthal basal
cell carcinoma excised has dacryocystitis.
What is the evidence for usefulness
of frozen section biopsy?
Procedure for frozen section.
Predisposing factors for wound infection
Which is the most common organism involved?
Which antibiotic is it sensitive to?
10. 75yr old male with past history
of enucleation for malignant melanoma presents with a history of purulent
discharge from right orbit and implant exposure. Picture of antiobiotic
sensitivity and culture shown.
Reasons for orbital implant exposure?
Which family does proteus belong to?
Which antibiotic is it sensitive to?(
based on the photo)
How do you mange this patient further?
What does INR stand for? What does it
Normal range of INR.
INR values when anticoagulated ?
What should INR be if cataract surgery
is planned with needle to be used for anaesthetic injection?
How will you achieve optimum INR levels?
12. 3yr old child with conjunctival
chemosis and proptosis (clinical picture, macroscopic & histology slide).
Describe the clinical features.
Macroscopic features of the exenterated
Treatment options other than exenteration?
13. Fundus picture of BRVO.
Clinical features describe.
Systemic diseases associated.
Long term complications and why?
14. Histological sections of Iris and
Retina/Vitreous interface in PDR.
Iris abnormality Ectropion Uveae
Name given to the type of vacuolation
seen in iris pigment epithelium and material deposited
Abnormality in retina vitreous interface-
15. Picture /histology slide of herpetic
Histological features in slide
Investigations to confirm herpes infections
Clinical features of primary herpes
Station 1: Anterior segments
Case1. Male with phthisis bulbi in RE and
corneal scarring with iris tissue loss and PCIOL
Reasons for this
Causes of phthis bulbi
Causes for microphthalmos
Management of Corneal laceration.
Complications in secondary cataract
Irvine gass syndrome FFA appearance.
Case 2 . Elderly lady with? Fuchs dystrophy
and PK with PCIOL other eye.
Reasons for interrupted and continuous
Causes for wound leak.
How will you detect it.
Why do you use 2% fluorescein for it.
Other complications of PK.
Station 2: Ocular motility and neuro-ophthalmology
Case 1 .
Young lady with AHP and right 4th nerve
Asked to explain every step in OM examination.
Parks 3 step test .reasons and findings
in each step.
Reasons for diagnosis
Hess chart interpretation.
Causes for bilateral palsy and clinical
Elderly gentleman examine pupils ,had
right amaurotic pupil ,total APD.
Asked if RAPD or APD
Clinical features for AION NA and
Asked to do direct ophthalmoscopy.
Case 3: Ophthalmology and medicine
Elderly gentleman Slit lamp had miosed
pupil with iris neovascularization and nuclear sclerosis
Causes for ocular ischemia
Pathogenesis of NVI in ischemia
Other risk factors in DR
Management of HTN and hypercholesterolemia
Indirect Ophthalmoscopy Chorioretinal
scarring more along arcades did not look like typical PRP scars
Causes for perivascular chorioretinal
scarring /why not PRP scars
Investigations for posterior uveitis
Station 4: Posterior segments
Elderly lady 78D examination Right
dry AMD with Left macular scar.
Causes for blot haemorrhages
Not many questions
Indirect ophthalmoscopy ,history night
blindness, VA 3/60 since childhood
Describe lesions disc pallor , atteneuated
vessels and hypopigmented patches in mid periphery no areas of hyper pigmentation.
DD- Retinitis pigmentosa sine pigmento
What other DD?
White dot syndromes
Was actually Bird shot chorioretinopathy
couldnt catch the clue abt HLA A29.
Station 5: Glaucoma and cataract
Case1 : Elderly lady with POAG (L>R) ,
notched inferiorly , R exotropia and macular scar
Management if IOPs 16.
Reasons for R exo.
Assessment of Humphreys visual
field various parameters
Case 2 : Elderly lady with R post subcapsular
cataract and Left pseudophakia
SL examn , findings
Take history and assess if the patient
needs right eye surgery.
Station 6: Counselling
You are an SHO in the preassessment clinic
for cataract surgery.The patient is a myope with prescription of -8.00
D and -14.00D and has been listed for a left cataract surgery
with a post op refraction aim of -3.00D. Counsel the patients about the
risks and benefits of the cataract surgery and the need to leave her a
bit short sighted , need for a second cararact surgery soon.