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Dear friends,
I am sharing my experience of feb FRCS exam held at Hyderabad .kindly
excuse me for writing in late.
Whole stress on right preparation my by all mentors helped me to excel
in my first attempt.
It my first day of examination with VIVA on jan 29 at hotel Taj
Krishna , Hyderabad.
It started late by 45 min from the proposed schedule but I must
acknowledge it to be organized by the people from college.All stations
had an Indian and a foreign examiner both in viva and clinical exams.
TABLE 1—ophthalmic surgery and ocular pathology( 20min)
1)I was shown a pic with lower lid mass –a papilloma
Asked me to describe it and tell my management.i answered it to be a
lowerlid papilloma which requires excisional biopsy. Asked if I were
to do full thickness or just anterior lamellar excision.
I said just the skin with lesion and send it for HPE followed by skin
closure.
2)showed a pic of cataract with pigment deposits on anterior lens
capsule
Asked wat are the conditions presenting like that. And wat is my mgt.
Said needs complete evaluation and cataract surgery.discussion
continued with phacosurgery steps and complications anticipated in
high myope.
3) case was told a old lady having undergone cataract surgy now
presents with burring vision and flashes occ.wat is your mgt.
I started of telling from case history taking but examiner wanted only
retinal detachment suspect..bell rang and shifted to another table.
TABLE 2—emergency medicine and neuro ophthalmology(20min)
1)showed a pic of RE disc edema … asked for DD. Asked to define
papilledema.
discussion on AION, GCA and ONTT trial was there
2) med prof started with case of an old man smelling a fruity odour,
semiconscious..
Asked wat is my diagnosis and management.
3)gave a case history again that while doing angio, suddenly patient
collapses.. wat r u going to do??
Expected anaphylaxis managemt to b told.
Asked the dosage of adrenaline per kg BW for kids.
Asked if u have to repeat the procedure, would you like to do or wat
precautions to b taken.
4)Asked about anisocoria. Discussuion was for Adie’s pupil.
TABLE 3—ophthalmic medicine (20min)
1)showed a pic of lady with prominent eyes and
puffiness of lids, lower scleral show
Asked wat is diagnosis and demonstrate the visible signs on photo.
2) showed a pic of lowerlid swelling and eczema
Asked about allergy
3) showed a pic of cataract with pseudo exfoliation
Asked abt diagnosis and other findings expected in eye
Discussion on glaucoma
Asked about intra op complication withPXF..
Asked about small pupil management ..
4) showed a pic of old man with left eye proptosis of
sudden onset and skin excoriation—this was a case of cavernous sinus
thrombosis..
Bell rang so the end of my viva session..
Day 3 Feb 1 for practicals..
No proper guide as to examination centre ..finally to peripheral
centre of LVPEI ..
Again delay by an hour..
STATION 1 – neuro ophthal and squint..
1) A young girl with left eso..
Started examining ..asked me to do cover and uncover test. And EOM.
Asked if I want to check convergence..
I gave my DD as left LR palsy and DRS ..
2) Young boy with right head tilt and ptosis.
Asked me to check EOM, elevation was limited in both eyes and no other
abnormality was detected.
Asked I want to know if he has diplopia..they said no..
Limited elevation and ptosis—I gave my diagnosis of bil Double elevatr
palsy.. I could not explain head tilt..
Bell rang.. I was out of room felt miserable .but thought that I
should not carry forward this to next station..
STATION 2—orbit & oculoplastic
1) Case of young boy with right sided ptosis
Asked me to do all measurements.
Asked me to recheck LPS function as I had not blocked frontalis in my
first examination.. I realized it and corrected it the sec time.
It was a case of u/l R ptosis mild degree with good LPS function.
So asked wat is my plan for surgery I said levator resection..
The examiner asked if I want frontalis sling..
I said no since it is mild n u/l ..he asked if exposure is a problem
in him.. I said no as he is having good bell’s phenomenon..
2) An old lady with prominent eyes with stary look and puffiness of
lids
Asked me to demonstrate proptosis evaluation with
Hertel’sexophthalmometer..askedwat is it and to show measurements with
it.
Asked to demonstrate all eye signs- she had bil LR limitation..asked
which muscles are affected..
Asked about further mgt—I said medical mgt control systemic n hen
local..
The examiner seemed convinced..bell rang
STATION 3 –anterior segment
1) Left eye s/p corneal tear repaired with inferior 4
clckiridodialysis and early cataract
Asked me to do slit lamp examination with techniques and describe the
findings..
Asked if this pt has come for second opinion to you how would you move
on
I said I would check vision , fundus examination and check if there is
an intra ocular FB with B scan.. I also said to do gonio..asked when..
I said after 1 month to rule out angle recession n also check IOP..
2) Examiner handed an IDO light to examine next patient pupil
reaction.
Asked the room light to be dimmed and started examining.. It was a
case of left eye APD..asked anatomy of pupil pathway.. causes of APD..
I fumbled bit. Told optic nerve disorders. in that tension I could not
tell individual causes..
Gave me DO ..to check his fundus—it was a case of Total glaucomatous
optic atrophy..
I described my findings ..bell rang
STATION 4—posterior segment
1)asked me to do 78D examination on a patient
It was a case of left eye vitreous hemorrhage with sup temp vein
occlusion with NVE with superotemporal TRD..
I described findings asked my management..he was a young person so
said all possible workup v routinely do—seemed convinced..
Asked I would do laser.. I said wait till vitreous hemorrhage settles
and then decide..
2)Gave me IDO and asked to check an old man’s fundus
It was a case of retinitis pigmentosa with total gla optic atrophy.
Described it..askedwat are other association of RP..
3) Asked me to check fundus of other patient with 78D
It was a case of diabetic macular edema
Described it..askedwat is my further mgt..
I said I wuld like to do OCT and FFA..
Asked if I want to do laser..I said I vl try with IVAV..hedin say
anthing
Bell rang ..time flew without realizing that I had completed all 4
stations in 40 min..
I finally thank the Almighty , parents and grand parents and all my
well wishers for guiding me through my preparation.
The stage is set high and vl try my level best to keep abreast with
new n latest in the field to deliver best possible and evidence based
treatment to my patients..
I thank Dr. Ghada and the other moderators of the group who have given
enough guidance in this platform of sharing experiences and knowledge.
I also thank Dr. Muthusamy for constantly encouraging and guiding in
learning process.I must appreciate and acknowledge the amount of work
delivered by his team members.. I am very happy to be a part of this
team.
I also thank Dr. Chua and his website for providing so much study
material at one place .
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