Candidate 99                                            Centre: Bristol
Final MRCOphth                                                        Date: March, 2007



1) CMV retinitis histology.


2) RD histology-6 features.


3) Fungal Keratitis cross-section of cornea-questions on staining.


4) Granular dystrophy of cornea.


5) Chalazion.


6) Clinical governence questions on endophthalmitis.


7) Pinguecula histology slide.


8) Chronic blepheritis-cross-section of upper lid showing conjunctival epithelial hyperplasia.


9) Lymphoid hyperplasia/Lymphoma differential diagnosis.


10) ? Malignant melanoma.


11) CIN - III/Carcinoma of conjunctiva.


12) Dermoid cyst with a tooth (?) in it.


13) MRI showing demyelination plaques.


14) Dysphagia; microcytic hypochromic anaemia; deranged LFT's with proptosis

DD: GI malignancy with metastasis.


15) Cavernous hemangioma.





Reasonable paper, could answer most of them






Anterior segment:

  • Proptosis with scleral injection: Discussed the differential diagnosis such as AVM, CCF, etc.

  • Fuch's endothelial dystrophy


Posterior segment:

  • Indirect ophthalmoscopy of Inferior RD: Patient had a small pupil-difficult examination but managed to get it.

  • Macular BRVO: Asked to demonstrate Amsler grid testing, VA tests, differential diagnosis.


Glaucoma and Cataract:


  • PXF with glaucoma and advanced cupping.

  • HVF and GVF of end stage glaucoma: Discussed other causes such as RP, PRP, etc.

  • Bilateral Trab's: One functional bleb and another encysted and vascularized bleb.


Ocular motility and Neurophthalmology:

  • Myotonic dystrophy: Asked to demonstrate dystrophy on quadriceps and thenar eminence, discussion went deep into genetics etc.

  • Restictive external ophthalmoplegia secondary to childhood surgery for orbital cellulitis.

  • Optic disc coloboma.


  • AAU with spondyloarthropathy: differential diagnosis.

  • Blue sclera secondary to repeated attacks of scleritis, asked to look for signs of vasculitis in the eye, mentioned PUK-examiner was pleased, discussion was very dynamic-one of the best stations for me.


Communication skills:

  • Myopic lady with features of RD: 7 minutes of history taking and rest of the time explain, counsel and console about RD and management plan.


I thought I was average in most stations but I was sure I did not make any mistakes or miss any signs. I am glad I passed in my first attempt.