|My name is Abdul Waris and I recently passed
my FRCS (Glasgow). Here is my experience.
Problem solving question:
1. A 60-year old sailor with poor vision and pale disc. How do you investigate
and manage the patient. (Answers: The usual of taking a history, medication,
nutritional history, smoking and systemic enquiry. As the patient is a
sailor, one needs to consider syphilis otherwise the rest as of other cases
of optic atrophy).
2. Post-operative trabeculectomy, the patient complained of pain. Examination
revealed shallow AC, corneal haze. How do you proceed?
(Answers: The answers should include pupillary block with incompetent
PI and malignant glaucoma.)
3. A young girl with head injury developed sixth palsy and left side
head tilt. How do you proceed with the patient?
(Answers: Answer should consists of fourth nerve palsy and raised
1. Medical viva (most candidate failed in this section)
Names of the systemic disease and drugs affecting eyes.
How myotonic dystrophica
Arrhythmias and cornea (amiodarone vortex keratopathy)
Causes of post subcapsular cataract
What are the real emergencies in ophthalmic department (Answers: CRAO and
chemical burns, GCA).
Management of status epilepticus, hypoglycaemic coma.
How do you treat anaphylaxis during FFA, the exact dose of various medications
How do you investigate carotid artery emboli (carotid duplex US, transoesophageal
2. Surgery and pathology viva
All possible complications of squint surgery. If sclera perforated in squint
surgery and vitreous comes out how to handle.
Suprachoroidal hemorrhage and its mgt.
Lasek,epilasek,epikeratomes,new techniques for flap like intralase and
To draw diagram of RD and holes as of Lincoff's rule.
How to diagnose angle closure with B-scan ultrasound,setting of laser PI,
how to manage plateau iris(iridoplasty with PI). Asked in details with
Shown a photo of trachoma and asked what lid surgeries will you do. Asked
to draw how to operate upper lid entropion.
Some candidates were asked about silicon oil injection in vitreoretinal
3. Ophthalmology viva
Shown a FFA picture of cystoid macular oedema. Asked about its management,
action of steroids and NSAIDs(asked to draw the arachidoinic acid pathway).
Then went on about topical, systemic, subtenon, intravitreal drugs(routes
and dose), insert implant.
Asked new modalities for diagnosis mainly OCT.
FFAs of proliferative diabetic retinopathy and non-proliferative diabetic
retinopathy. PRP settings, all major studies in diabetes. Why was argon
green not blue green laser used. Questions but not in details on subthreshold
micropulse concept, role of intravitreal triamcelone and macugen in endstage
high PDR with many PRP's.
Shown a picture of Eales' disease with secondary BRVO.
All examiners were kind and helping
1. Old retinal detachment with proliferative vitreoretinopathy (PVR)
grade C2-3 with a blind exotropic eye. Asked about the pathology of PVR,
management and how to manage the exotropic eye cosmetically.
2. Pathologic myopia with left esotropia. Questions on management of
the refractive problems including phakic IOL. How to manage lattice and
holes(also had to give the exact lase and cryo settings).
3. Corneal macular dystrophy with penetrating keratoplasty in the other
eye. Asked about the management, endothelial dystrophies, PKP and deep
4. Right complete 3rd nerve palsy with pupil involvement. I forgot to
perform the action of the levator.
5. Old lady with cataract,pterygium and CRVO. How would you manage the
patient and also study done on CRVO.
6. Left carotid-cavernous fistula with unilateral proptosis. pusatile
and bruit on auscultation.
I like to thank the webeditors of this website which is a great help
in my success. If you have any questions about the examination, please
email me firstname.lastname@example.org.