am Dr Khaleel Ahmed .By the Grace of God I managed to clear my FRCS exams
in the first attempt at Delhi (Sept 2006). Dr Prof. Muthusamy’s coaching
for the problem solving questions was very useful.His website is
www.mvupgo.com. Other than Kanski ,Wong was quite useful.Though not too
accurate it gives a good orientation to the exam type of questions &
Clinical solving questions
1. A patient with history of dry eye &
joint pains presents with a perforated corneal ulcer & flat AC.Investigation
I wrote about rheumatoid arthritis,..
2. Three year old boy with recurrent attacks
of acute dacryocystitis right side. Has underwent two probings. Left side
symptoms subsided , right side probe passed “easily” both times.Parents
are angry & want a second opinion. How will you manage this situation.Write
a letter to the family physician explaining the problem.
Must be false passage.I mentioned DCG
3. An 56 year old artist with retinoschisis
recently noticed distortion of his central vision RE & also his colour
vision.The referring optometrist feels that his Schisis has extended to
his macula.How will you manage him.
I wrote about AMD & mentioned CSR.Schisis
unlikely to extend to macula.
Surgery & Pathology Station
1. Picture of hyphaema on laptop:
Features of blunt trauma of the globe?
Features & management of rupture globe?
IOP low, AC depth altered, ?? B-Scan.
2.He gave me Bowman’s lacrimal probe.
Asked it’s uses?
3.Glaucomatous cupping, field changes
but IOP 14 mm Hg .What will you do? History of medications. He said
–no medications . Ans: Congenital disc abnormality, methanol poisoning.
What else? May be he wanted pachymetry.
4.Post trab- IOP 32 mm Hg ,no bleb- management?
Gonio to check blocked ostium, Argon laser
Procedure of argon laser suturolysis?
1.Which cataract procedure do you perform
SICS & Phaco.
Asked about PCR management & vitrectomy
2.Drew RD on paper .Asked where could
be the primary break.
Management? Principle of buckling &
encirclage? To relieve traction.
Medical Ophthal station
1.HFA print out : Grey scale showed tubular
vision.Pattern deviation plot showed only early glaucomatous change.
False negatives : N/A . Asked what is
If pupil small ,patient on pilocarpine
what you will do? Ans:Stop pilo for about 2 weeks?.Replace with another
2.Refraction .Power cross OD: plano, OS:
high cyl.,transposition, If in child what possibility. Ans: Amblyopia.
1.Fundus photograph of diabetic retinopathy
Signs of macular ischemia ?
FA picture of same patient showed leakage.
Neurology & Medicine
1.Photograph of young lady with anisocoria.
Anisocoria increasing in dim light.
Horner’s pharmacological tests & it’s
2.Fundus Photo of HT retinopathy.BP 200/120
HT drugs. Gradual reduction of BP.
Causes of secondary HT?
Signs of hyperthyroidism?
GCA management? Complications of steroids
What will you prescribe with steroids?
Observer Medical student faints in theatre
. Que on syncope.
How will you perform CPR?
During FA Patient breathless ,management?
1. Slit lamp examination: Superficial stromal
paracentral coneal opacity. I said healed corneal ulcer.What other exam
? IDO ,gonio for foreign body .What else? Lid eversion to look for scarring
,FB. What else? May be he wanted giant pappilae.
2.RE esotropia with nystagmus on extreme
adduction.Asked to perform motility & cover test. I also did hirschberg
3.IDO (indirect ophthalmoscopy) :
Young girl semi dilated pupil. Managed to see pale optic disc.I said I
suspected optic nerve glioma & will request CT Scan.
4. IDO of coloboma choroids involving disc.
5. SLE of disorganized globe with iridodialysis
.I said post traumatic endophthalmitis.
6. Young man with subluxated lens. Asked
about other ocular features of marfans.
7. Band keratopathy treated with epithelial
Questions to other candidates:
- Gram staining
- Procedure of wearing gloves
- Proptosis management
- Herpes simplex management
- Angiod streaks- ocular & systemic
- Young man with unilateral dilated pupil
& headache- management?
- Sutures & needles
- Lid reconstruction
- Patient with fever – management ?
- DCR –procedure & method of block,
bones removed during osteotomy? Must start with nasal packing.
They can just ask anything!
All the best.