Candidate 46
Date:  June 2005
Centre: Brighton
 
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Here is my experience from the mrcophth part 2 exam, which was held in Brighton.

OSEs:

Station 1
Ultrasonography (A and B scan)
Qs: a)What test is this, b) principles, c) structures involved?
Answer: Choroidal tumour?

Station 2 
Visual Fields (Humphrey)
Qs: a) What test is this, b) description, c)
localization?
Answer: Incongr. homonymous hemianopia?

Station 3
FFA (series + colour photos)
Qs: a) What test is this, b) principles, c)
description?
Answer: LE BRVO

Station 4
CT scan
Qs: a) What test is this, b) description, c)
structures involved?
Answer: LE sphenoid bone mass

Station 5
Fresnel prism
Qs: a) What is this, b) principles, diagram?

Station 6 
Transposition, sph. equivalent?

Station 7 
RE hypertropia
Qs: a) what prisms should we prescribe, b) decentration?

Station 8 
Hess chart
Qs: a) What test is this, b) principles, c)description?
Answer: RE orbital floor fracture.

OSCEs:

Case 1 
Pupils:
Possible RE Adie's tonic pupil, although I didn't notice any anisocoria.
Qs in pharmacological verification of Adie's pupil.

Case 2
Ocular movements:
Restriction in elevation BE, R>L, diplopia in RE.
Elevation + abduction. Didn't have time to finish the
oc. movements after cover test. No tropia or phoria.
Didn't have time for viva.

Case 3 
Slit lamp:
Asked to examine RE, which had trab bleb, PC\IOL, PI.
Examiner insisted to tell him how that bleb was different from others I have seen??? I didn't know.
Then Qs for various examination techniques, asked to check optic disc with 90D (pale disc) and asked for
C\D ratio. Then asked to demonstrate tonometer calibration. I don't think I am forgetting something!!!

Case 4 
Visual fields:
Right homonymous hemianopia. Did all the tests, asked me why I use red pin for central vision, localization,
congruity. Tip: patient had R hemiparesis.

Case 5 
Direct ophthalmoscope:
LE BRVO. Asked me for description, filters, image in myopia.

Case 6
Indirect ophthalmoscope:
Asked for description (whitish area in inferior retina), specifically didn't ask for diagnosis, just d/d. Demonstration of scleral indentation.

Case 7 
Focimetry:
Single vision lenses, transposition, no time for viva because they asked many Qs in keratometry and didn't
have time. (see below)

Case 8 
Keratometry:
J-S keratometer. Asked me what is this, principles (especially doubling), meridians (steepest?), with or
against the rule, description.
 

Refraction:

Nice lady, 76 years old. I began to take the history: any past eye problems? Answer: Yes, RE something like occlusion!!! Ok, I have to be calm!
Unaided vision: RE CFs (oops!), LE 6/36 (ok).
Started retinoscopy, I think I did ok. Then subjective. Asked examiners what should I do with RE and they told me not to examine it further, so I did the LE, which after ret was seeing 6/6 and with an adjustment of +0.50 sph and 5 degrees of the cylinder LE was seeing 6/5. I did +1.00 blur check and duochrome, everything ok, patient very pleased.
Then I explained to the examiners that in normal conditions (BE seeing) I would do certain binocular
tests which I couldn't do at the moment. The same I told for Maddox rod, which they asked me to describe
how I was going to do it.
Then added +2.50 for near, very comfortable patient. Examiners asked what I should prescribe for RE,
answer: balance glass, not plano (for distance and near). Asked  me for BVD if I should prescribe it.

Generally I don't think it was a difficult exam, and most of the examiners were friendly and helpful. Good luck everyone!

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