I'm afraid I can't remember anything in enough useful detail from the written parts, but here is a summary of the clinical:

Medical

Case 1

Caucasian lady with signs of old anterior segment inflammation on the right and signs of previous disc swelling bilaterally. A discussion of the possible diagnoses led to sarcoidosis which was correct. The spoke about various investigations such as bloods for sACE, Chest X-ray for bilateral hilar lymphadenopathy and then brain imaging - spoke about MRI vs CT.

Case 2

Asked to check ocular motility on a lady - looks like she has an elevation deficit on the left, but no other obvious stigmata of any predisposing conditions - discuss the possibilities and go straight for thyroid eye disease: correct. She had had a thyroidectomy and discussion turns to hypothyroidism - what single clinical test might you do? Suggest pulse, which seems normal, but examiner is holding a tendon hammer so tendon reflexes? Yes, but which one? Didn't know so he says ankle reflex and asks for a demonstration. Have a go, not remembering very much about those, but he seems happy and we talk about hypERthyroidism (safe ground) and list all the main systemic signs such as atrial fibrillation, nails, skin etc.

Neuro/Motility

Case 1

Asked to take a relevant history and then check motility on a man with very short hair. Looks like a right 4th. Go through the Park's 3 step / Biewotsit tilt test, no problems. Transpires he had had surgery for a brain tumour, but no need for further discussion.

Case 2

Presented with an older man with a history of diplopia + ptosis. Take relevant history and check motility - seems to have a non-"classical " combination of motility defects. Discussion of medical history that included a CVA - suggest a central lesion causing the defects.

Glaucoma

Case 1

Check patient's discs - both severely cupped. Which was more so? Standard discussion on these.

Case 2

Examine anterior segment: patient has ICE - relevant discussion about IOP + management. Signs of drainage surgery? No - turns out he had a trab! (But had a flat bleb and was dilated so couldn't see the PI so examiner didn't care - as long as you looked...)

Case 3

Discussion over a couple of sets of field tests - went through all the error percentages, blink bar, MSD/PSD, GHT

Posterior segment

Case 1

Patient with a recent history of flashes floaters etc: examine with indirect and then slit lamp: he has a peripheral U-shaped tear with signs of a recent retinopexy (they wanted to know it was argon) - relevant discussion.

Case 2

Patient with mild drusen at both maculae - her sister has more severe ARMD. General discussion about risk factors + management including Ocuvite (and B-carotene/smoking associations)

Case 3

Patient with bilateral PRP discussion on risk factors for DR - pretty general.

Anterior Segment

Case 1

Patient with a right corneal graft + aphakia, left ACIOL + traby + scleral buckle (or similar!) - discussion of the possible causative scenarios. I think he had a bullous keratopathy and a secondary glaucoma. As long as you spoke sensibly about each scenario they seemed happy. Keen to know that he had a PI in the AIOL eye to prevent pupil block.

Case 2

Patient with mild non-specific corneal opacities - again a discussion of the various possibilities, so toured the corneal dystrophies, infective causes, lid / tear film abnormalities. Sensible discussion goes down well.

Communication Skills

Handed a sheet asking to take a history of the visual symptoms from an elderly patient who had previously lost most of the vision in 1 eye and now had distortions in the right.

A (good) actress plays the patient and take the history making sure to ask about the visual symptoms for a range of possible causes (although it is pretty much barn door ARMD) - but it does no harm to ask about flashes/floaters, darkening / greying, location of any scotomas etc.

I am then told she had an FFA that demonstrated untreatable occult CNVM and to then explain this to the patient and discuss further management. So I explain the differences between wet/dry ARMD and mention the treatments (PDT etc) that she is likely to have read in the paper and how these are not applicable in her case. We then move on to measures such as stopping smoking, vitamin supplements, LVAs, partial sight registration etc. Treat her like a real patient, so say stuff like "I know this must be a lot to take in" / "How will you be able to cope around the house" - loads of that kind of thing, ask her if she has any further questions at the end. Covered anything before the bell, very little intervention from the examiners, just stay focussed on the patient and all will be well!

Passed first time.