The following experience are kindly provided by Ms Jyothi and friends. Candidate 1 was Ms Jyothi's experience; the rest were provided by her friends and therefore the experience may be slightly incomplete. These experience are useful in giving an insight into the standard expected of
the FRCS candidates. 
Candidate 1  Pass
Station 1
1. Fundus photograph of Best disease. Discussion on its pathology

2. Slide of pyogenic granuloma. Discussion on its etiology and management

3. Plus lens identification and discussion

4. Prism: 6 prism dioptre identification. Questions on its power and how to place to 
    correct hypertropia

5. Pinhole principle and application

6. Duochrome test principle and application. Can it be used in color blind? 
    Yes.Chromatic interval?

7. Low vision aids discussion

8. Magnification of +20 D lens? D/4=5

9. Sympathetic ophthalmia Pathophysiology

10. CSR slide-pathology, management-laser parameters. Indications for laser, PSRT

11. FFA principle and applications

12. Granular dystrophy slide-discussion and management

13. Glaucoma pathophysiology

14. Argon Laser- Gas laser, wavelength etc.

Station 2
1. Scenario 1-60 Old lady with features suggestive of carotico-cavernous 
    fistula-slide. Discussion of ccf and management.

2. Scenario 2- Child with orbital cellulitis- slide. Associated sinusitis, management in 

3. Scenario 3-Male with ophthalmic Grave's disease. Discussion on hyperthyroidism, 
    it's systemic and ocular features and management

4. Scenario 4-Pituitary tumour 

5. Clinical features of different kinds of tumours with special discussion on Cuhing's 
    disease, side effects of steroids, clinical features of brain tumours at various 

6. Scenario 5-BIH. Discussion on benign intra cranial hypertension, clinical features 
    and management.

Station 3
1. Steps of ECCE-PCIOL
    a.PC tear- how to proceed
    b.AC IOL- draw and how to identify its anterior and posterior surface
    c.Hypermature cataract on entering AC -how will you proceed
    d.Expulsive hemorrhage-pathophysiology and management

2. RD surgery steps -how to locate hole in the given diagram?

3. Trauma-corneal tear with iris prolapse- how will you manage?


60 year old man sitting at the slit lamp. Instruction: Take a look
Slit lamp screws were locked. Unlocked the instrument and began with slit lamp examination. Asked to skip preliminaries.Patient was aphakic but no surgical scar in both eyes.I suspected spontaneous dislocation of lens both eyes. There was no evidence of pseudo exfoliation. Asked what would I like to do next. I wanted to examine with direct ophthalmoscope.I remarked that patient had no features suggestive of Marfan's, Homocystinuria or Weil Marchesani's'. Patient had bilateral dislocated lens in vitreous.Regarding management I said since the eye was quite and lens capsule appeared intact I would adopt a conservative management. Contact lenses or aphakic spectacles with follow up to watch development of glaucoma or iridocyclitis.The examiners seemed satisfied
Case 2: 
50 year old lady to do direct ophthalmoscopy
Patient had myopic disc and also cupping. I asked for tension and was told 17.3mmHg. I said that I wanted to rule out any congenital anomaly of optic nerve or glaucoma. I was asked which was more likely in this case. I preferred Normal tension glaucoma. I wanted to do her fields and was given automated perimetry chart wich showed typical glaucomatous field defects. The discussion was on management.
Case3 : 
To do Indirect ophthalmoscopy on a 40 year old male
The patient had Sectoral RP involving supero nasal quadrant BE. I was asked about ERG.
Case 4: 
10 year old child to do cover test
The child had had hypotropia of RE.
On doing ocular motility patient was found to have defective elevation in adduction.A diagnosis of Rt.Brown's was made. 
Medicine and Neurology
5 year old child -to examine
The child was irritable and cried as I observed him. He had right lagophthalmos. Rt.LMN facial palsy.I offered the child a toffee and the effect was dramatic. He smiled and was at once became co- operative. Patient also had left hemiplegia. I was asked to demonstrate knee jerk. It was a UMN lesion and hence I put the lesion above Pons. Regarding etiology I thought it could be post viral or post tuberculous meningitis. The child did have Tb meningitis!

Case 2: 
To examine ocular motility in an adult male
Patient had ptosis, crutch glasses and severe limitation of ocular movements in all direction. I offered dd of CPEO, Oculo pharygeal dystrophy and Myasthenia gravis. I wanted to examine him for thymectomy scar and he did have one! Discussion was on investigations and treatment of MG.

Fields of an adult male
Bitemporal hemianopia . I was asked how to pick up early bitemporal hemianopia. I mentioned color desaturation for red.Causes of bitemporal hemianopia was discussed. Patient had no signs of acromegaly.

Case 4: 
Young obese boy- to examine 
Patient had obesity and polydactyly.7 digits in all 4 limbs. He had a vacant stare and nystagmus. I wanted to examine his fundus which showed RP sine pigmento. I was asked to comment on his  ERG which was grossly abnormal.

Candidate 2 Pass 

Station 1
1.Pin hole

2.CNV slide

3.ICG discuss

4.Retina and parsplana drawing

5.Myope with tear and lattice- slide  discuss lattice

6.Draw the tear in chart

7.Free radicals and eye

8.Spectacle lens and astigmatism, optical centre- how to mark?


10.Gonioscopy- Angle recession slide

11.Posterior embryotoxon

Station 2 

1.Retinoblastoma HP slide-  problems of enucleation

2.RD- diagram old and new features without macula involvement. Principles of 
   management, surface marking of pars plana

3.ECCE vs Phaco discussion, steps

4.Expulsive hemorrhage-management, sclerotomy site, how?

Case 1 : 
SLE of 25 year old man. Patient wore hard contact lens RE with a central corneal opacity. LE showed advanced keratoconus. Questions were on management. Keratoplasty.
Indirect ophthalmoscopy of 20 year old . Patient was a myope with lattice degeneration and small round holes.Management -observe.

40 year old man with adherent leucoma and cataract. Torch light examination.

Case 4: 
15 yr old male for SLE. BE showed trabeculectomy with iridectiomy. Patient had typical Rieger's syndrome complete with dental anomaly.

Case 5: 
8 yr old male with rt.abduction defect and typical features of Rt. Duane's retraction syndrome.Patient had face turn to avoid diplopia.

Case 6: 
25 yr old for indirect ophthalmoscopy. Patient had vitreous degeneration with typical RP. Questions were on hereditary pattern and ocular associations.

Case 1: 
60 yr old male for ocular motility. Patient had pupil sparing 3rd nerve palsy. On taking relevant history was found to be diabetic.
Case 2: 
CT scan head showed occipital lobe infarction.Discussion regarding the same.

Case 3: 
Fundus exm with direct ophthalmoscope. 45 yr old lady. Both eye showed primary optic atrophy. Examiner showed a field of bitemporal hemianopia with down ward progression and discussed the possibilities.

Case 4:
20 yr old male with Arachnodactyly. Initially thought of Marfan's , on prompting by the examiner regarding increased elasticity of skin made a diagnosis of Erhler Danlos syndrome.

Case 5: 
20 yr old woman for ocular motility. Patient had minimal exophthalmos, thyroid enlargement, lid lag, lid retraction and restriction of abduction.

Candidate 3  Pass

Station 1
1. Steps of Trab- draw

2.AC shallow post op- with low tn and high tn

3.Vitreous hemorrhage management

4.PRP- laser setting and complications

5.Phaco- superior corneal burn what do you suspect?

6.Sterilisation of tonometers and virused transmitted.

Station 2
1.Bullet injury occipital lobe-draw field defect

2.Bilateral papilloedema-discuss

3.Sudden loss of vision-discuss

Station 3
1.Pupillary pathway trace


3.CSMO- define and Rx

4.Ocular muscle and other muscles- how are they different


Middle aged woman. Take a look at this lady, next fundus examination-optic atrophy, and fields. Only superonasal quadrants preserved.CT showed pituitary tumour.
Essential blepharospasm in a middle aged lady.
Case 3: 
Case 4: 
3rd nerve palsy with pupil involvement and h/o DM-what will you do next?


Canditate 4  Fail

Station 1
1.ECCE vs small incision-discuss

2.Advantage of in the bag IOL

3.Methyl cellulose vs hyaluronate

3.What is a visco-elastic?

4.Small PC rent-proceed

5.Inferior RD- locate hole and manage

6.Trab and flat AC -What to do?

7.Corneo-scleral tear with uveal tissue prolapse and fluffy cortex- management

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