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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