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This is
Dr.Srilakshmi from India . I cleared FRCS part 3 in
first attempt from Hyderabad .
I want
to thank my family for their support , your website for immense amount
of information it holds and its total utility for exam preparation .
I want
to share my experience for use of future candidates .
I
studied kanski ,yanoff , wills eye manual , oxford hand book . I
practiced clinical examination repeatedly for last month in the steps
detailed in this web site . This is very important to arrive at a
diagnosis with in 6 min in the examination . They look at the
techiniques that we follow ( they appreciated that I wanted the
patient to lie down for indirect , I did monocular examination in
ocular motility , started with observation then measurements in ptosis
etc ) and question further based on what answer you say . I'd suggest
all to write down all the questions asked in the past candidate
experience ( you will find there is quite a bit of repetition after a
while ) and answer them or find their answers . This when done
deligently will secure a pass along with practice of clinical
techniques . In viva examiners have a set of 3 questions each and they
have answers given to them . They will question with in the purview of
these questions to understand the depth of candidates knowledge . This
is why past candidate experience matters .
My
cases were
Orbit and oculoplasty
1.Thyroid ophthalmopathy- lid signs , problems with thyroid
ophthalomopathy , what to do for optic nerve involvement .
2.
simple ptosis - all questions on examination techniques and clinical
significance of each tests.
3.
Anopthalmic socket .
Anterior segment
1.
Healed corneal ulcer - management of infected corneal ulcer ,
conditions not responding to regular antibiotic treatment , organisams
causing contact lens related corneal ulcer .
2 .Sclerokeratouveities
with total cataract - had seclusiopupillend PI. Causes.
3.
Neurotrophic keratitis - tarsorraphy. , BCL and ulcer . Missed BCL
but told it is an option when questioned . I asked to look again but
time us up . I was worried a bit .
Posterior segment
1 .Postvitrectomy
for RD with emulsified silicone oil in the anterior chamber and tube
implant in the PC. There was an ERM as well . Asked about management
of ERM . Was not significant so no intervention .
2. Case
of bilateral red lesions in foveae. Did not fit into any one
particular diagnosis. Gave a DD of pattern dystrophy and atypical
Bests disease . They wanted to know if it could be photic retinopathy
?
3. Just
asked me to see the third case .
Neuro ophthalmology -
1. Sixth
nerve palsy - secondary changes in the other muscles , treatment for
diplopia , when will you consider surgery ?
2.Bilateral optic atrophy - patient also had a homonymous hemianopia
denser in the superior quadrant , localizing the lesion to the
left temporal lobe patient also had difficulty in talking , wanted to
take history of seizures time up .
Viva -
Medicine - Most fantastic table ( one I was worried Most )
History
taking in unilateral headache - duration , onset , severity , DD
. Treatment of trigeminal neuralgia -carbamazepine.
Post
exposure prophylaxis - virus transmitted via needle prick , which is
the most common ? Why ACE inhibitors in DM ? (seems to be a
pet question )
immunocompromised
patient with lymphoma with vitritis has yellowish white lesion in
the peripheral retina what are the causes? - intraocular lymphoma -
wanted to know possibilities of causes like ARN, PORN ect - Told them
features of these lesions and why they are less likely .
Papilledema - causes
Pseudotumour cerebri - causes ,
Other
complication of oral contraceptives .
Picture
of Diabetic macular edema - what are the possibilitis what do you do ,
what are the systemic implications .
Ophthalmic medicine -
A child
with 40 degree esotropia .They asked what do you do ? I started with
refractive correction but he asked me what before refractive
correction? They expected full ophthalmic examination.I Thought they
are giving me the actual diagnosis after complete evaluation. The
lesson is always start with history and evaluation they will stop you
if they don't want it .
AC/A
ratio .
Picture
of corneal infiltrate with hypopyon history of injury . What will you
do ?what is the most important complication ? what are the findings in
the B Scan ?
Picture
of keratoplasty with infiltrate at graft host junction - What are the
causes and complications .
Picture
with drusen and CNVM - Asked me to describe the picture and asked what
will you do next ? OCT what are the findings in the OCT ?
Ophthalmic surgery - Please answer what you have seen and done
first . They will ask questions on that . More likely to pass .
Petrygium - causes of pseudo pterigyum , surgeries ( bare sclera ,
with auto graft , with glue ) what will you do ?
Complications of MMC
What
cataract surgery will you do ? what will you do if there is a central
rent ? what are the complications of incomplete anterior vitrectomy ?
PK with
endon view - asked me multiple times weather it is a full thickness or
lamellar ( I insisted I cant answer with this picture , but I can see
that graft is edematous and is eccentric ). Causes of corneal edema in
a patient with PK . (rejection , graft failure , high IOP). Treatment
of graft rejection .
3 month
old with epiphora( seemed to be a favourite question ) .What are the
causes ?What will instruct mother for massage ? Massage till when ,
when probing ? When repeat probing ? What next? Precautions before DCT(
ENT clearance ) .
Drugs
used in endophthalmitis .Resaon for choice of drugs .
All the
Best . Contact me is you have any queries
srilakshmisrinivasan79@gmail.com.
Regards,
Dr.Srilakshmi
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