Candidate 19  Passed                                                      Centre: Leicester
                                                                                                    Date:  Nov, 2002

MCQs
Mainly clinical optics- and the questions repeated themselves- especially on the instruments. if you know elkinghton and frank and have been through the MCQ books i.e. Bahn, the little blue one, and the questions from this website, then they were pretty straightforward.
 
OSE

Station 1
Biometry calculations- which eye measurement most accurate i.e. lower standard deviation, which lens would you use and why, which lens if IOL constant higher i.e. add one.
 

Station 2
Hruby lens- there was a hruby lens on the table- asked what it was, and draw its ray diagram (i.e. the one from E + F)
 
Station 3
Humphrey visual fields- what is this? (!!), describe visual field defect, where is the lesion (- both showed glaucomatous changes)
 
Station 4
Diagram of nasolacrimal duct- what is this? asked to name the inferior canaliculus and valve of Hassner- odd question for the part 2!
 
Station 5
B-scan- what is this? principles of US (i.e. piezolelectric effect), and what does scan show- not sure- looked like snow storm in vitreous- i think the B-scans are usually more straightforward.
 
Station 6
CT scan- what is this? i.e. axial CT orbits, what does it show?- bilateral intermediate density lesions in area of lacrimal glands i.e. lacrimal gland enlargement, and how could the patient present.
 
Station 7
FFA- what is this? what are the principles? what does it show?- looked like CSR.
 
Station 8
Hess chart showing VI palsy- acute as overaction of contralateral medial rectus only- what is this? what are the principles? what does it show?
 
As you can see there were a lot more questions on principles and description, rather than making a diagnosis.
 

OSCE

Case 1
Focimeter of glasses, transposition, how does focimeter work.
 
Case 2
Bausch and Lomb Keratometer, take measurements, then asked how it works- this surprised everyone- i think that only a few people had seen it, let alone used it before, so i'm not sure if the just ignored the whole station .
 
Case 3
Ocular motility- asked to do cover test and extraocular movements, and parks 3-step test. they kept interupting me so never got to complete any part of the examination
 
Case 4
Visual fields to confrontation- had central scotoma on right and inferior field defect on left- asked wbout causes, what red pin is for.
 
Case 5
Direct ophthalmoscopy- asked to examine fundus only (both eyes dilated)- right are had papilloedema, left normal.  asked magnification with direct, and causes of unilateral papilloedema.
 
Case 6
Indirect ophthalmoscopy- patient already lying on couch- difficult as wasn't tolerating even low light very well- had disciform on r, drusen on l.  asked magnification with +20D lens (i.e. 3x) and with +28D (i.e.2.2x)- advantages of +28D- i.e. wider field of view so better in less cooperative patients e.g. kids.
 
Case 7 
Pupils- Unilateral Adies ( although some people had bilateral), cause of dilated pupil, pharmacological tests
 
Case 8
Slit lamp examination- prosthesis on one side, on other side band keratopathy scar (Although i couldn't remember name!), ECCE scar, bleb, broad iridectomy.  Asked to demonstrate retroillumination and sclerotic scatter.
 
Although the whole thing was pretty stressful, everyone agreed that the examiners were very nice and tried to push you in the right direction if you were struggling.
 
Refraction.
54 year old nurse- high myope R -10.75/-1.00x175, L -18.00, with poor best corrected vision on left- which examiners kindly told me during the ret- as could not really do subjective on left, or binocular balance, had plenty of time at end- during which examiners asked lots of questions.
 
 

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