Final FRCS /MRCS

Centre:   Amman

   Date:    June 2010

I am Dr M. Khizar Niazi and I have ALHAMDULILLAH cleared Final FRCS Glasgow  held in Amman in June 2010. I dedicate my success to my family for their support and prayers without which it would not have been possible. I would like to thank everyone who helped me. My main resources were the Chua web page, Kanski, Oxford hand book of ophthalmology and Prof Muthusamys online course along with the exam materials and discussions of FCRS and FRCOphth yahoo groups. i went thru pics and short comments in the will eye atlas of ophthalmology before orals. Here is a brief Part-3 overview.

ORALS

We were told that each examiner would ask atleast two questions in his allocated 9 min with specific stems in each questions and answers were graded from 1-6 (A response of 1-3 was considered fail in that question).The good thing was that all questions carried equal marks and you could compensate a suboptimal performance in one question with a good performance in the other.   

Ophth Medicine

1^st examiner

• CHRPE  DD what if multiple How assess systemically, siblings, counselling of patient

• VF 24-2 humphrey showing nasal defect, d/d of such a defect, assess, exam findings

• Watery eye history, exam, results of probing DCG treatment of canalicular block

• Antiglaucoma drugs, which to prefer, complications of beta blockers, miotics uses

2^nd examiner

• Slit lamp photo cornea with diffuse KPs, d/d  Fuchs Management

• Cornea photo with central ring abscess in CL wearer Acanthamoeba, stains, culture, drugs

• Other infections in CL pseudomonas TX ,systemic, I/v or oral, perforation then what

Ophth surgery and Pathology

1^st examiner

• Trauma young man with beer bottle, assess before surgery, iris coming out abscision / excision steps of surgery, sutures

• Trab 2yrs back with IOP of 3 and hx of MMC, causes: RD he said no, choroidal detachment no not after 2yrs, infection, thinning.

2^nd  examiner

• 48 yrs old lady with inferior field loss for 6 days and now complete loss assess, examination how to manage this what factors for external approach , steps, what is missing in steps cryo how does that acts freezing 

• Lid photo of papilloma, complications, causes, treatment

Gen Medicine and Neurology

1^st examiner

• Child with choking after eating peanuts assess how check airway auscultate, Hemlicks manoeuver, what to say to mother later

• Photo of slit lamp with Necrotizing scleritis causes, treatment, systemic causes other than RA

• Photo of New vessels at iris with posterior synechae treatment, laser, antivegf what more what about other eye, close monitoring or laser

2^nd examiner

• 60 yrs male with Amaurosis fugax, history,  general exam pulse AF how to check for carotids, warfarin

• 40 yrs male headache and ptosis how to start from history, CT for aneurysm med vs surg lesion differentiate, if he develops 4^th n palsy how to check

• 38 yrs female with MR palsy then LR palsy d/d MG, Thyroid. If MG pt develops chough  what will u advise.

CLINICALS

Each room had 3 patients and 2 examiners .10 mins in each room. were told that  we had to examine  atleast 2 patients in each room and if time allowed then examiners would let you examine the third. We were told that the patients were already given instructions about exam and it was understood that you have exchanged greetings and asked their permission and we had to proceed directly to the command given by the examiners.

Neurolophthalmology and Motility

·         Accommodative esotropia partially corrected with glasses…….tx  options

·         INO Rt and  V pattern exotropia Lt …. Cause

Oculoplastics and lids

·         Congenital severe ptosis Rt …..causes of amblyopia

·         OCP……Features…Treatment what other body part will you examine

·         Essential Myokymia Lt half of face…..Etiology and Treatment

Anterior Segment

·         Pseudophakia with IOL Subluxation…causes, treatment options refract, miotics, surgery depending upon zonular integrity   

·         PKP Rt with KPs, causes of early rejection, why early rejection here, see other eye, I  said there could be possibility of 2^nd transplant in this eye and that could result in early rejection, he agreed

Posterior Segment

·         90 D with prp marks and burnt out DR, see other eye, hyphema with rubeosis and sclerostomy ports indicating PPV, and limbal section he asked reason, I said probably to drain hyphema in past.

·         I/O pale discs, causes of sudden loss of vision.