DEAR COLLEAGUES

MY NAME IS DR RITESH NANDKOOMAR.

I AM FROM SOUTH AFRICA AND PASSED FRCS OPHTHALMOLOGY IN NEW DELHI IN SEPTEMBER 2013

BEFORE I DESCRIBE MY EXPERIENCE, I WOULD LIKE TO DEDICATE MY SUCCESS TO MY WIFE ( DR KAAJAL HARIPARSAD) AND MY DARLING CHILDREN (ADISHESHA AND SONIA).TO MY WIFE I WOULD LIKE TO SAY A BIG THANK YOU FOR ALL THE LOVE, SUPPORT,CARING,UNDERSTANDING AND MOST IMPORTANTLY FOR  ALL THE SACRIFICES YOU HAVE MADE IN HELPING ME ACHIEVE THIS MILESTONE. I AM FOREVER INDEBTED TO YOU.

A BIG THANK YOU IS ALSO DUE TO PROF.MUTHU FOR HIS ONLINE UNIVERSITY AND PROF CHUA FOR THIS AMAZING WEBSITE WHICH IS A GREAT RESOURCE FOR ANYONE ATTEMPTING THESE EXAMS.

EXAM PREPARATION :

I RECOMMEND GIVING YOURSELF ADEQUATE PREPARATION TIME OF AT LEAST 9 MONTHS TO A YEAR.THE VOLUME OF WORK TO BE COVERED IS VAST AND INTENSE AND YOU WANT TO BE ABLE TO COVER IT THOUROUGHLY AND STRESS FREE.

I USED THE 6^TH EDITION OF CLINICAL OPHTHALMOLOGY BY KANSKI AS MY CORE KNOWLEDGE.YOU MUST READ IT THOUROUGHLY FROM COVER TO COVER.THE CHAPTER ON SYSTEMIC DISEASES IS A MUST.

FOR THE MEDICAL EMERGENCIES OXFORD HAND BOOK OF CLINICAL MEDICINE’S CHAPTER ON MEDICAL EMERGENCIES SHOULD SUFFICE.

I ALSO USED OPHTHALMOLOGY EXAMINATIONS REVIEW BY TIEN WONG AS A REVISION AID A WEEK BEFORE THE EXAMS.

IF TIME PERMITS, I FOUND GOING THROUGH AS MANY  OF THE DIAGNOSTIC AND TEST YOURSELF ATLASES BY KANSKI VERY HELPFUL, ESPECIALLY TO FAMILIARISE YOURSELF WITH PATHOLOGY THAT YOU MAY NOT REGULARLY SEE IN YOUR EVERYDAY PRACTICE.( I WENT THROUGH 5 OF THEM)

ALSO, DON’T FORGET TO FAMILIARISE YOURSELF WITH THE LATEST AND IMPORTANT LANDMARK TRIALS (PROF CHUA’S WEBSITE IS AN EXCELLLENT GUIDE IN THIS REGARD)

I HIGHLY RECOMMEND ENROLLING FOR PROF MUTHU’S ONLINE COURSE FOR THE PART 3 EXAM.IT HELPS PREPARE YOU ON HOW TO ANSWER THE QUESTIONS IN THE CORRECT MANNER

JOINING THE FRCOPHTHAL GROUP ON YAHOO GROUPS IS ALSO HELPFUL.

I WILL NOW DESCRIBE MY EXPERIENCE OF THE EXAMS :

THE EXAM TOOK PLACE FROM 23-26 SEPTEMBER.

47 CANDIDATES APPEARED FOR THE EXAM

THE VIVA’S WERE ON THE 23 AND 24 SEPTEMBER AT SIR GANGA RAM HOSPITAL.

THE OSCE’S WERE ON 25 AND 26 SEPTEMBER AT MOHAN EYE INSTITUTE

THE EXAMINERS WHERE FROM THE UK,INDIA AND MIDDLE EAST.

ALL WERE VERY FRIENDLY AND HELPFUL AND VERY OBJECTIVE IN THEIR ASSESSMENT OF YOUR PERFORMANCE

DAY 1 : VIVA

TABLE 1 : GENERAL MEDICINE AND NEUROLOGY

EXAMINER 1 : PHYSICIAN:

QUESTION  1 : YOUR  1^ST PATIENT ON THE OPERATION SLATE HAS BEEN CANCELLED BY THE ANAESTHETIST BECAUSE OF ATRIAL FIBRILLATION. HOW DO YOU DIAGNOSE ATRIAL FIBRILLATION AND WHAT IS YOUR MANAGEMENT?

ANSWER : TAKE DETAILED HISTORY FROM PATIENT.EXAMINE THE PULSE OF THE PATIENT.BLOODS FOR FBC,U&E,THYROID FUNCTION,CARDIAC ENZYMES,DRUG LEVELS,ARTERIAL BLOOD GASES.CHEST X-RAY,ECG,ECHO.STABILISE PATIENT.MANAGE ANY ELECTROLYTE ABNORMALITIES.REFER TO PHYSICIAN/CARDIOLOGIST FOR FURTHER ASSESSMENT AND MANAGEMENT EG CARDIOVERSION EITHER D.C CARDIOVERSION OR USE OF DRUGS LIKE DIGOXIN,VERAPAMIL ETC

QUESTION 2: 60 YEAR OLD MALE PATIENT ADMITTED IN YOUR WARD FOR CATARACT SURGERY COMPLAINS OF COUGH AND DIFFICULTY IN BREATHING.YOU DO A CHEST X-RAY WHICH REVEALS  CAVITATORY LUNG DISEASE. WHAT IS YOUR DIFFERENTIAL DIAGNOSIS AND HOW WOULD YOU MANAGE FURTHER?

ANSWER : 2 MOST IMPORTANT  CONDITIONS ARE TUBERCULOSIS AND BRONCHIAL CARCINOMA.

FOR TB WORK UP ONE NEEDS TO TAKE SPUTUM SAMPLES FOR AFB AND MCS. IF POSITIVE ,ONE NEEDS TO START TREATMENT WITH 4 DRUGS FOR 2 MONTHS (RIFAMPICIN,ISONIAZID,ETHAMBUTOL AND PYRIZINAMIDE) THEN 2 DRUGS FOR  4 MONTHS (RIFAMPACIN AND ETHAMBUTOL). CHECK RESPONSE TO TREATMENT ON CHEST X RAY.

FOR BRONCHIAL CARCINOMA : BRONCHOD=SCOPY,BIOPSY, REFERRAL  TO CARDIOTHORACIC SURGEON

QUESTION 3 :65 YEAR OLD PATIENT COMPLAINS OF SUDDEN BLACKOUT OF VISION WHICH RECOVERS.WHAT IS THIS CALLED? AND WHAT MAY BE THE UNDERLYING PATHOLOGY?

ANSWER : AMAUROSIS FUGAX / TIA.

CAROTID ARTERY DISEASE,ARTHEROSCLEROSIS,CALCIFIC OR CHOLESTEROL EMBOLI,EMBOLI FROM PROSTHETIC HEART VALVES,

EXAMINER 2 : OPHTHALMOLOGIST

QUESTION 1 : IDENTIFY A PICTURE OF PERIPHERAL CORNEAL ULCER.WHAT IS THE DIFFERENTIAL DIAGNOSIS? IF THE PATIENT REPORTS NOSE BLEEDS AS WELL, WHAT IS YOUR DIAGNOSIS?

ANSWER : PERIPHERAL ULCERATIVE KERATITIS,CONNECTIVE DISEASE,MOORENS ULCER

WEGENERS GRANULOMATOSIS

QUESTION 2: IDENTIFY A PICTURE OF A FUNDUS WITH MULTIPLE BRUSH-FIRE HAEMORRHAGES AND COTTAGE CHEESE EXUDATES.WHAT IS THE DIAGNOSIS? WHAT IS THE UNDERLYING SYSTEMIC DISEASE? HOW WOULD YOU MANAGE THE EYE PROBLEM? HOW WOULD YOU MANAGE THE UNDERLYING MEDICAL PROBLEM? WHAT IS YOUR CONCERN ONCE TREATMENT IS INITIATED AND RESPONSE TO TREATMENT IS NOTED?

ANSWER : CMV RETINITIS

UNDERLYING DISEASE : HIV & AIDS

CONCERN : IMMUNE RECONSTITUTION SYNDROME AND REACTIVATION OF INFECTION

TABLE  2 : OPHTHALMIC MEDICINE

EXAMINER 1 :

QUESTION 1 : PICTURE OF PURULENT CONJUNCTIVAL  DISCHARGE. WHAT IS YOUR DIAGNOSIS AND MANAGEMENT?

ANSWER : BACTERIAL CONJUNCTIVITIS EG CHLAMYDIA OR NEISSERIA.

TAKE HISTORY INCLUDING HISTORY OF STI/STD

TOPICAL AND SYSTEMIC ANTIBIOTICS

REFER TO GENITO URINARY CLINIC IF STI SUSPECTED

 QUESTION 2 : PICTURE OF WHITE DANDRUFF LIKE MATERIAL AT PUPILLARY ZONE. WHAT IS THE DIAGNOSIS? WHAT IS YOUR MANAGEMENT ?WHAT PRECAUTIONS WOULD YOU TAKE PRIOR TO CATARACT SURGERY?

ANSWER : PSEUDOEXFOLIATION SYNDROME.CHECK IOP.IF PEX GLAUCOMA PRESENT, THEN START THERAPY FOR GLAUCOMA EG TOPICAL B –BLOCKERS OR PROSTAGLANDIN ANALOUGES.IN CATARACT SURGERY ONE NEEDS TO MAKE SURE PUPIL IS ADEQUATELY DILATED AND ALSO BE WARY OF ZONULAR WEAKNESS AND ITS ASSOCIATED COMPLICATIONS

QUESTION 3 : IDENTIFY A PICTURE OF COBBLESTONE PAPPILAE  IN UPPER LID IN A YOUNG PATIENT COMPLAINING OF ITCHY EYES.WHAT IS YOUR DIAGNOSIS AND MANAGEMENT ?

ANSWER : VERNAL KERATOCONJUNCTIVITIS.PREVENT EXCESSIVE UV EXPOSURE.USE OF SUNGLASSES AND WIDE BRIMMED HATS. TOPICAL SYMPTOMATIC TREATMENT EG ANTIHISTAMINES,MAST CELL STABILISERS,WEAK STEROIDS ETC

EXAMINER 2 :

QUESTION 1 : IDENTIFY A FUNDUS PHOTO OF MULTIPLE HAEMORRHAGES,EXUDATES AND DISC OEDEMA.WHAT IS YOUR DIAGNOSIS? HOW DO YOU CLASSIFY THIS AND ON WHAT BASIS? HOW DO YOU MANAGE THIS PATIENT? WHAT IS THE PROGNOSIS?

ANSWER : CENTRAL RETINAL VEIN OCCLUSION

ISCHAEMIC VS NON ISCHAEMIC ON FUNDUS FLUORESCEIN ANGIOGRAPHY-LOOK FOR AREAS OF CAPILLARY NON PERFUSION.

FOLLOW UP EVERY 4 WEEKS.LOOK FOR NEOVASCULARISATION AS HIGHEST RISK OF DEVELOPING NEOVASCULAR GLAUCOMA AT 100 DAYS.

IF INITIAL VA >6/60 AND NO ISCHAEMIA PRESENT HTEN PROGNOSIS IS GOOD.IF PRSENTING VA < 6/60 AND ISCHAEMIA PRESENT THEN PROGNOSIS GUARDED

QUESTION 2 : FORTY YEAR OLD LADY COMES IN COMPLAING OF SEVERE FOREIGN BODY SENSATION AND TEARING IN BOTH EYES.WHAT  DO YOU THINK IS WRONG? HOW DO YOU DIAGNOSE THIS CONDITION? HOW DO YOU MANAGE?

DRY EYE SYNDROME.SCHIRMER’S TEST,TEAR BREAK - UP TIME, STAIN WITH ROSE BENGAL.EXAMINER THEN HAD A DISCUSSION OF ALL THE DYES WE USE IN OPHTHALMOLOGY.

MX : STEP WISE APPROACH -  HUMDIDFY ENVIRONMENT.MOISTURE CHAMBER GOGGLES.ARTIFICIAL TEARS.PUNCTAL OCCLUSION AS A FINAL RESORT.TRY TEMPORARY PUNCTAL PLUGS FIRST TO GAUGE IMPROVEMENT.HAD A DISCUSSION ON HOW TO UTILISE PUNTAL OCCLUSION.ALSO MENTIONED TO RULE OUT CONNECTIVE TISSUE DISESAE AS A CAUSE.ALS DISCUSSED VALUE OF N-ACETYL CYSTEINE

QUESTION 3 : PICTURE OF FUNDUS PHOTO.ASKED FOR SPOT DIAGNOSIS AND WHAT SYMPTOM MAY PATIENT PRESENT WITH IF CHOROIDAL NEOVASCULARISATION IS PRESENT?

ANSWER : ANGIOID STREAKS. METAMORPHOPSIA

TABLE 3 : OPHTHALMIC SURGERY

EXAMINER 1:

QUESTION 1 : 60 YEAR OLD WHITE MALE PATIENT WITH HISTORY OF CHRONIC SUN EXPOSURE PRESENTS WITH  THIS LESION ON HIS LOWER LID (SHOWN PHOTO OF LESION).WHAT IS THIS LESION AND THE DIAGNOSIS?HOW WOULD YOU MANAGE

ANSWER : RODENT ULCER. BASAL CELL CARCINOMA.EXCISION BIOPSY AND PRIMARY CLOSURE.IF LARGER LESION, NEED TO COMPLETE EXCISION AND LID RECONSTRUCTION.THEN DISCUSSED FROZEN SECTION AND MOH’S MICROGRAPHIC SURGERY.ALSO DISCUSSED USE OF ADJUNCTIVE RADIOTHERAPY AND CHEMOTHERAPY

QUESTION 2 :50 YEAR OLD FEMALE PATIENT PREESENTS TO YOU 1 MONTH AFTER CATARACT SURGERY AND COMPLAINS OF DECREASED VISION.WHAT IS THE MOST LIKELY DIAGNOSIS AND HOW WOULD YOU CONFIRM IT?

CYSTOID  MACULAR OEDEMA. Fluorescein angiogram and oct

QUESTION 3 : THE SAME PATIENT NOW PRESENTS A YEAR LATER COMPLAINING OF SEEING FLASHES OF LIGHT FOLLOWED BY LOSS OF VISION IN A CURTAIN LIKE MANNER INVOLVING CENTRAL VISION.WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU CONFIRM? WHAT ARE THE MANAGEMENT OPTIONS?

ANSWER :RETINAL DETACHMENT WITH MACULA OFF. WILL DO DILATED FUNDUS EXAM WITH INDIRECT OPHTHALMOSCOPY.ALSO DISCUSSED LINCOFF’S RULES AND USE OF ULTRASOUND.

MX : DISCUSSED SCLERAL BUCKLING , PPV WITH ENDOLASER/CRYO AND PNEUMATIC RETINOPEXY. HAD IN DEPTH QUESTIONING ON EACH TECHNIQUE AND WAS ASKED TO HIGHLIGHT THE ADVANTAGES AND DISADVANTAGES OF EACH.

QUESTION 4 : IDENTIFY THIS LENS ?

ANSWER : GOLDMANN 3 MIRROR LENS

QUESTION  5 : WHAT IS THE DOME SHAPED LENS USED FOR ?

ANSWER : GONIOSCOPY

QUESTION 6 : HOW DO YOU GRADE THE ANGLE ON GONIOSCOPY ?

ANSWER : DISCUSSED SHAEFFER AND SPAETH GRADING SYSTEMS

EXAMINER 2 :

QUESTION 1 : 3 YEAR OLD CHILD BROUGHT TO YOU BY PARENT COMPLAINING OF EYES BEING TURNED IN TOWARDS NOSE .SOMETIMES RIGHT EYE STRAIGHT AND OTHER TIMES LEFT EYE IS STRAIGHT.HOW DO YOU APPROACH AND MANAGE THIS CASE?

ANSWER :DISCUSSED APPROACH TO ALTERNATING ESOTROPIA, INCLUDING CYCLOPLEGIC REFRACTION, USE OF BOTOX AND SURGERY

QUESTION 2 : WHAT ARE THE SURGICAL  OPTIONS AVAILABLE TO TREAT SQUINT IN THIS CASE?

ANSWER : BILATERAL MEDIAL RECTUS RECESSION , IPSILATERAL MEDIAL RECTUS RECESSION AND LATERAL RECTUS RESECTION, BILATERAL RECTUS RESECTION.ALSO DISCUSSED HOW MANY MILLIMETRES OF RESECTION/RECESSION CORRECTS HOW MANY DEGREES/PRISM DIOPTRES OF SQUINT

QUESTION 3 : WHAT NON-SURGICAL TREATMENT MIGHT YOU CONSIDER?

ANSWER : REFRACTION IF ACCOMMODATIVE ESOTROPIA. BOTOX CAN BE TRIED.

QUESTION 4: WHAT ARE THE  COMPLICATIONS OF SQUINT SURGERY?

ANSWER : DIVIDED IT INTO PRE – OPERATIVE, INTRA-OPERATIVE, EARLY POST-OPERATIVE AND LATE POSTOPERATIVE.IMPORTANT POINTS OF DISCUSSION  WERE OCULO-CARDIAC REFLEX,SCLERAL PERFORATION,SLIPPED MUSCLE , OVER/UNDER CORRECTION AND ENDOPHTHALMITIS

QUESTION 5: WHAT IS THIS ? (SHOWN A PICTURE OF A FIBROVASCULAR GROWTH ARISING FROM CONJUNCTIVA AND ENCROACHING ONTO CORNEA)

ANSWER : PTERYGIUM

QUESTION 6 : HOW DO YOU GRADE THIS CONDITION ?

ANSWER : GRADE 1-3. GRADE 1-GROWTH EXTENDS TO LIMBUS.GRADE 2-EXTEND BEYOND LIMBUS ONTO CORNEA. GRADE 3 –INVOLVES VISUAL AXIS

QUESTION 7 : WHAT IS YOUR MANAGEMENT  OF THIS CONDITION ?

ANSWER : GRADE 1 : CONSERVATIVE – SUNGLASSES,UV PROTECTION,WIDE BRIM HATS.ARTIFICIAL TEARS,WEAK TOPICAL STEROIDS ETC. GRADE 2 AND 3 : CONSIDER SURGERY AUGMENTED WITH MITOMYCIN C, CONJUNCTIVAL AUTOGRAFT, AMNIOTIC MEMBRANE ETC

DAY 2 : DAY OFF

DAY 3 : OSCE

STATION 1 : POSTERIOR SEGMENT

EXAMINER 1

1^ST  CASE : DO INDIRECT FUNDUS EXAM ON SLIT LAMP OF 65 YR OLD FEMALE PATIENT.WHAT IS YOUR FINDINGS AND DIAGNOSIS ? HOW DO YOU MANAGE?

ANSWER : I USED MY  VOLK DIGITAL HI-MAG LENS TO EXAMINE FUNDUS (THIS IS AN EXCELLENT LENS AS IT COMBINES THE FIELD OF VIEW OF A 90D AND MAGNIFICATION OF 78D INTO 1 LENS).PATIENT  HAD BILATERAL PROLIFERATIVE DIABETIC RETINOPATHY WITH SIGNIFICANT NEOVASCULARIZATION AT DISC.DISCUSSED ROLE OF ARGON LASER PAN-RETINAL PHOTO-COAGULATION AS WELL ASA ANTI-VEG FAGENTS.

2^NDCASE : EXAMINE , USING SLIT LAMP, THE  RIGHT FUNDUS OF 52 YR OLD MAN WHO UNDERWENT  RECENT SURGERY AND NOW COMPLAINS OF POOR VISION. WHAT IS YOUR DIAGNOSIS AND MANAGEMENT

ANSWER :I AGAIN USED MY HI MAG LENS. ON QUICK ANT SEGMENT EXAM I MENTIONED PATIENT HAD CATARACT SURGERY AND IOL IMPLANT.FUNDUS EXAM REVEALED CYSTOID MACULA OEDEMA.DISCUSSION THEN CENTRED ON MANAGEMENT OF MACULAR OEDEMA

EXAMINER 2:

3^RDCASE :USING SLIT LAMP, EXAMINE THE  LEFT FUNDUS OF THIS PATIENT,DESCRIBING WHAT YOU SEE AT MACULA.WHAT IS YOUR DIAGNOSIS ? HOW WOULD YOU CONFIRM IT? HOW DO YOU MANAGE?

ANSWER : LOSS OF NORMAL ARCHITECTURE AND TORTUOSITY OF VESSELS.SAID IT WAS EPIRETINAL MEMBRANE.CONFIRM WITH OCT AND FLUORESCEIN ANGIOGRAM.WAS SHOWN RESULTS OF BOTH THESE INVESTIGATIONS WHICH CONFIRMED DIAGNOSIS OF EPIRETINAL MEMBRANE.SAID I WOULD PROCEED WITH PPV AND MEMBRANE PEEL.ASKED IF THERE WAS ANYTHING I WOULD DO AT TIME OF SURGERY PRIOR TO MEMBRANE PEEL? I SAID YES,WOULD LIKE TO STAIN MEMBRANE WITH TRIAMCINOLONE OR LISSAMINE GREEN. EXAMINER WAS PLEASED

4^THCASE  :  USE INDIRECT OPHTHALMOSCOPE AND 20D LENS TO EXAMINE RIGTH FUNDUS OF THIS PATIENT.DESCRIBE WHAT YOU SEE AS YOU EXAMINE.WHAT IS YOUR DIAGNOSIS?

ANSWER : PATIENT HAD NUMEROUS DOT-BLOT AND FLAMED SHAPED HAEMORRHAGES AND EXUDATES IN SUPERIOR TEMPORAL QUADRANT.DIAGNOSED AS BRANCH RETINAL VEIN OCCLUSION.

STATION 2 : NEURO OPHTALMOLOGY AND OCULAR MOTILITY

EXAMINER 1:

1^ST CASE: EXAMINE THIS 7 YR OLD CHILD’S OCULAR MOTILITY,DESCRIBING WHAT YOU FIND AS YOU CONDUCT EXAM.WHAT IS YOUR DIAGNOSIS?

ANSWER : PT HAD LIMITED ABDUCTION,NORMAL ADDUCTION, NARROWING OF PALPEBRAL FISSURE AND GLOBE RETRACTION. MADE DIAGNOSIS OF DUANE’S SYNDROME TYPE 1.EXAMINER WAS HAPPY.

EXAMINER 2 :

2^NDCASE :EXAMINE THIS TEENAGER USING DIRECT OPHTHALMOSCOPE.DESCRIBE YOUR FINDINGS.

ANSWER : PATIENT HAD HORIZONTAL PENDULAR NYSTAGMUS, KERATOCONUS (HAD THINNING OF CORNEA, MUNSON’S SIGN, RIZZUTI’S SIGN AND OIL DROP RED REFLEX) AND RETINITIS PIGMENTOSA ( HAD TYPICAL BONE SPICULE PIGMENTATION OF FUNDUS).DISCUSSION THEN FOCUSED ON DIAGNOSIS,CLASSIFICATION AND MANAGEMENT OF KERATOCONUS AND ROLE OF COLLAGEN CROSS-LINKING IN PARTICULAR

STATION 3 : OCULOPLASTICS AND ORBIT

EXAMINER 1 :

1^STCASE :OBSERVE THIS ELDERLY GENTLEMAN.WHAT DO YOU SEE ? HOW DO YOU CLASSIFY THIS CONDITION ?  WHAT WOULD YOU LIKE TO TEST ? WHAT ARE YOUR MANGEMENT OPTIONS?

ANSWER : ENTROPION OF LOWER LIDS. CLASSIFY AS INVOLUTIONAL,SPASTIC,CICATRICIAL AND MECHANICAL ENTROPION.HORIZONTAL LID LAXITY AND VERTICAL LID STABILITY.DISCUSSED CONSERVATIVE AND SURGICAL MANAGEMENT OPTIONS.

EXAMINER 2 :

2^NDCASE :EXAMINE THIS 20 YEAR OLD PATIENT.WHAT IS ON THE CONJUNCTIVA ? WHAT DO YOU FIND ON HIS UPPER LID? WHAT IS THE UNDERLYING DEFICIENCY AND THE NAME OF THIS CONDITION.WHAT IS THE NAME OF THE AETIOLOGICAL AGENT?

ANSWER : BITOT’S SPOT-SCARRING-ARLT’S  LINE.CONJUNCTIVAL XEROSIS DUE TO VITAMIN A DEFICIENCY FOLLOWING TRACHOMA.CAUSED BY CHLAMYDIA TRACHOMATIS SEROVARS A-D.THEN DISCUSSED TREATMENT OF TRACHOMA AS WELL AS DIFFERENT WAYS OF SUPPLEMENTING VITAMIN  A

STATION 4 : ANTERIOR SEGMENT

EXAMINER 1 :

1^STCASE :EXAMINE THIS YOUNG PATIENT’S ANT SEGMENT. WHAT IS YOUR DIAGNOSIS?

ANSWER: PATIENT HAS MARFAN’S SYNDROME WITH SUBLUXED LENS

2ND CASE :EXAMINE THE RIGHT EYE OF THIS PATIENT USING TORCH. WHAT DO YOU SEE? WHAT IS DIAGNOSIS?

ANSWER : PATIENT HAD A FILTERING BLEB AND PERIPHERAL IRIDECTOMY DONE FOR GLAUCOMA. DISCUSSION THEN FOCUSSED ON MANAGEMENT OF POAG

EXAMINER 2 :

1^STCASE :PATIENT WITH FIBROVASCULAR GROWTH IN LEFT EYE EXTENDING ONTO CORNEA. DIAGNOSE AND DISCUSS

ANSWER : PTERYGIUM.THEN DISCUSSED GRADING AND MANAGEMENT.

GOOD LUCK !!! TO ALL CANDIDATES

I HOPE THIS IS OF SOME HELP TO YOU. I AM HAPPY TO ASSIST ANYONE WHO ATTEMPTS TO TAKE THIS EXAM IN ANY WAY I CAN. YOU CAN EMAIL ME :rnandkoomar@yahoo.co.uk

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