Scenario 1: (Appearing in Sept, 2003)
A 60 year-old woman with bilateral myopia of -8.00D and cataract. Explain to her how you will carry out the operation ie. local or general anaesthesia and the choice of implant for the operation. (Suggestion:
Scenario 2: (Appearing in Sept, 2003) You are given a referral letter from a GP about a 23 year-old footballer with an unilateral red eye. The patient has been treated with chloramphenicol eyedrop without improvment. You are asked to ask the patients some questions and decide on the appropriate treatment. (The patient turned out to have Reiter's syndrome. The candidate did not ask about the sexual history and systemic enquiry regarding backache etc as expected by the examiner. In addition, the examiner expected the candidate to inform the patient the effect of mydriatic on his football career.) Scenario 3: A 50 year-old man with bilateral advanced glaucoma has just failed his Estermann visual field and you have to tell him that he should not be driving. (Suggestion:
Scenario 4: A 40 year-old woman with a choroidal mass returns for her investigation. The chest X-ray suggests the presence of metastatic carcinoma. (Suggestion:
Scenario 5: A 50 year-old man with a painful right blind eye. Advise regarding the various options for treating his painful eye including enucleation or evisceration. (Suggestion:
Scenario 6: A 63 year-old man returns 4 weeks later for a follow up cataract visit. Refraction shows that a wrong lens has been inserted resulting in a hypermetropic shift. The patient is unhappy that he could neither read or see distance without glasses. Explain to him what has happened and the various options open to him including lens exchange and contact lenses. (Suggestion:
Scenario 7: A 35 year-old has had two failed corneal graft for heretic corneal disease. The cornea is heavily vascularized. He likes to have another corneal graft but you know there is little of a successful outcome. Explain to him why you think a re-graft is not appropriate. (Suggestion:
Scenario 8: A 69 year-old woman is referred by her GP for possible cataract operation because of very poor vision in both eyes. After examining the patients, you discover that she has minimal cataract and the poor vision is caused by bilateral disciform macular degeneration. Explain to the patient why you think that cataract is inappropriate. (Suggestion:
Scenario 9: A woman has a 2 year old child with bilateral retinoblastoma. She is planning a second pregnancy and likes to know the risk of a having another child with retinoblastoma. (Suggestion:
Scenario 10: You are the only doctor in the minor operating room and the eye unit. A woman is referred directly to you by her GP for a cyst removal from the right upper lid. However, the lesion appears to be a large basal cell carcinoma. You have no experience of excisional biopsy in this area. Explain to the patient why you are not going to carry out the operation on that day. (Suggestion:
Scenario 11: A 60 year-old man was diagnosed with glaucoma 3 months ago. He was given a beta-blocker to be applied topically twice a day. However, the intraocular pressures remains high and there is deterioration of the visual field. His wife says he is not taking the medication regularly. Find out if he has been taking the medications regularly and explain to him the importance of taking the glaucoma medication. (Suggestion:
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