Pathology viva:
Microbiology for corneal scrapes- the details re gram stain and plates.
Chlamydia tests e.g. Giema, PCR, ELISA and the details of how to perform
each one! Retinoblastoma- prognostic factors for life (they rubbished the
Reese-Ellsworth classification), genetics. Corneal pathology ?granular
dystrophy
Medicine & Neurology
Case 1:
Take a history from patient who had unilateral gradual non specific
visual loss. Asked to examine the patient as if I was in clinic: positive
RAPD, centrocaecal scotoma, pale optic disc (direct ophthalmoscope, undilated
pupil). Differential diagnosis. Investigation and management of meningioma.
Case 2.
Young man: asked to examine his gait and proceed. Ataxic gait, positive
Rombergs. No cerebellar signs, intact reflexes, upgoing planters, normal
power, diminished proprioception, mild bilateral facial weakness. Most
signs difficult to elicit since patient had jeans on (I did ask to have
them removed without success) Asked to put everything together. I couldn’t.
The examiner said they couldn’t either -?mitochondrial disease
Case 3:
Middle age man with one side of glasses frosted. Asked to take a history-
strange history of intermittent malaise, generalised small joint pain and
swelling, complete heart block, nasal discharge, painful eye. I offered
Wegeners and SLE as differential diagnosis. Exam of eye showed scleromalacia
perforans. Asked to explain his general symptoms and asked about eye manifestations
of Wegeners, including exudative RD and optic nerve involvement. Discussed
treatment, including side effects of cyclophosphamide.
Ophthalmology:
Case 1:
Congenital glaucoma, pendular nystagmus, bilateral aphakia, one side
hazy corneal. Discussed causes, long term complications, and possibility
of secondary lens implant etc.
Case 2:
Bilateral high myope, unilateral pseudophakia and YAG. Right previous
RD surgery. Left prophylactic cryo. Talked about considerations when doing
his other cataract.
Case 3:
Young man gives history of progressive night blindness and constricted
visual fields. asked for differential diagnosis. Exam showed bilateral
aphakia, RP changes, glaucomatous optic discs, unilateral epiretinal membrane.
Asked to long term management.
Case 4:
Middle aged woman came into the room on crutches. Asked to exam eye
movements. Abnormal head posture, L exotropia on cover test. small palpebral
fissure on L. Limited abduction more than adduction. A pattern exo. No
INO,RAPD. Asked for differential diagnosis. Offered aberrant regeneration
of 3rd, MG, demyelination and Duanes. Turned out to be MS.
Case 5:
Middle aged woman with unilateral lipid keratopathy and neovascularisation.
Asked for differential diagnosis. Offered HSV as most likely cause.
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