Candidate 9   Pass                                       Centre: Liverpool
                                                                    Date:    June, 2001

OSCE

Case 1.
Focimetry: only one of the glasses of a pair of bifocals was to be measured. questions were asked on principles, optics etc.

Case 2.
Keratometry: only one eye of a patient was to be measured. the instrument had different axis dials for the 2 eyes which i got wrong and examiner asked me to have another look which i subsequently corrected. questions on principle.

Case 3.
Pupils: middle aged woman with LE ptosis and enophthalmos (pseudoptosis-a red herring) but no anisocoria but a very slight (grade 1) RAPD on the right. questions on pharmacological testing of pupil.

Case 4. 
Slit lamp examination: asked to demonstrate all techniques (retroillumination, sclerotic scatter and specular etc.) the eye in question  had dry eye with surface epithelial changes with a superficial corneal opacity. no further questions were asked on the DD.

Case 5. 
Visual fields: bitemporal hemianopia with extension to inferonasal quadrant in one eye. (pt also had see-saw nystagmus). questions on the site of lesion were asked.

Case 6. 
Ocular motility: old  man with LE esotropia and phoria (sometimes alternating) with horizontal diplopia in primary position and persisting in extremes of  gaze. no defect on ocular motility. i said looks like squint rather than neurological.

Case 7.
Direct ophthalmoscopy: of only one eye was asked. oblong and round pigment spicules( but not bone corpuscle like) in inferior fundus with macular stippling and mild disc pallor. i was asked DD. said sectorial RP and old BRVO. questions on management and filters.

Case 8. 
Indirect ophthalmoscopy: multiple white dots in temporal fundus. I could not locate another lesion which the examiner wanted me to look for. questions on lenses, magnification etc.
 
 

OSE

Case 1. 
x-ray: intraorbital FB.

Case 2. 
ERG: extinguished b- wave.

Case 3. 
B-scan with lateral views as well. i thought it was a funnel RD. other thought choroidal detachment.

Case 4. 
Hess: 4th nerve.

Case 5.
Flourescein: principles and preproliferative DR to describe the features.

Case 6. 
Fresnel prism: identification and ray diagram.

Case 7. 
Orthoptic report: 4 yr old with 6/60 and 6/6 vision and right suppression on worth 4 dot and anisometropic hypermetropia questions on cause for amblyopia and type of fixation in RE.

Case 8. 
I can't remember.
 
 

Refraction

52 yr old with moderate myopia with high 3-4 D astigmatism in BE. could improve only to 6/9 with rushing up in the end. very difficult retinoscopy in one eye. i thought i have failed it but may be as i did all the things in the right way saved me in the end.
 

MCQs

MCQs: lot of emphasis on clinical examination and much less optics. almost no formulae calculations were required. i did 254.
 
 

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