Candidate four Centre: Newscastle-upon-tyneDate: Sept. 1998Ophthalmology
I was asked to examine the ocular motility of a young man. There was limited elevation of the left eye on adduction. I made a diagnosis of right Brown's syndrome. The examiner then prompted me to the presence of a scar just above the left eye. He had a traumatic Brown's syndrome.
This was a slit-lamp examination with a 90D lens. The patient had bilateral disc drusen with retinal vessels anomalies but otherwise no other ocular signs.
This was examination of the anterior segment with slit-lamp. The patient had bilateral ocular cicatricial pemphigoid and Fuch's dystrophy with corneal thickening and guttata.
Another case of slit-lamp examination with a 90D lens. The patient had bilateral high myopia with macular degeneration and bilateral aphakia.
Slit-lamp examination of the posterior segment with a 90D lens. There was right disc collaterals and I am asked to give a differential diagnosis.
Ptosis examination. The patient appeared to have a right ptosis but he also had a left proptosis. I mentioned to the examiner that I liked to examine the left fundus. This revealed a left myopic disc. I made a diagnosis of right pseudoptosis due to contralateral proptosis caused by high myopia.
Medical ophthalmology and neurology
Ocular motility examination of a 50 year-old man beginning with cover/uncover tests. The patient had a right esotropia which was larger on distant than near fixation. Ocular movement showed reduced right abduction. I made a diagnosis of right sixth nerve palsy.
Orbital examination of a middle-aged woman. The right eye had an axial proptosis and she had a thyroidectomy scar.
Ptosis examination of a middle-aged man. The diagnosis was made when I shook his hands. He had problem in relaxing his grip. He had bilateral proptosis and wore a wig.
Ocular examination of a man in his 20s. He had a left pendular nystagmus. The visual acuity was reduced in this eye but there were no obvious anterior or posterior segment to account for the nystagmus or the poor vision.
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