Download - Ospe of eye
OSPE MOCK TEST HELD ON 8 NOVEMBER 2014 AT NIO&H.
DHAKA BANGLADESH, THE FULL EXAMINATION WAS
CONDUCTED BY DR MD ANISUR RAHMAN ANJUM, ASSOCIATE
PROFESSOR. NATIONAL INSTITUTE OF OPHTHALMOLOGY.
DHAKA BANGLADESH
THERE WERE TEN STATIONS, I HAVE UP LOADED ALL THE
OSPE WITH THEIR ANSWER FOR ALL OF MY STUDENT. I
HOPE THAT THESE WILL HELP THEM TO TAKE
PREPARATION IN THEIR FINAL EXAM. IF YOU HAVE ANY
QUARRY LET ME INFORM IN THE FOLLOWING MAIL &
MOBILE.
OSPE: 1
Cornea: Refractive Surgery
Question
1) What two procedures are carried out in fig A &
fig B
2) Write 2 difference between these two procedure
3) Which procedure can correct astigmatism more?
4) Write 2 other treatment option for this condition
5) Write two common adverse effect of procedure
B. which can be corrected within 3 to 6 months
Answer
1.What two procedure are carried out in fig A & fig B
Fig A: Radial Keratotomy
Fig B:LASIK
2 Write 2 difference between these two procedure
a) In fig A, we use keratome. In fig : B we use LASER
b) In fig A central cornea is spare, incision given in peripheral cornea.
• But in LASIK we treat the central 4 to 5 mm of the cornea
Answer
Q=3)Which procedure can correct astigmatism more?
LASIK
Q=4) Write 2 other treatment option for this condition
A)Spectacle
B) Contact lens
Q=5. Write two common adverse effect of procedure B. which can be corrected within 3 to 6 months
Dry eye
Halos around the light
OSPE: 2
Scenario of a systemic disease:
Sarcoidosis
Question
It is an idiopathic multisystem disorder Characterised by non-
caseating granulomata. More common in women 20-50 yrs
More common in blacks and Asians
Answer the following question:
Q=1. What is the name of the disease?
Q=2. Name the 3 major organs it affected.
Q=3.Write 2 anterior segment finding
Q=4. Write 3 posterior segment findings
Answer
Answer: 1 SARCOIDOSIS
Answer: 2
Lung
Skin
Eye.
Answer: 3
Any two
Conjunctival granuloma
Lacrimal gland involvement/dry eye
Acute or chronic uveitis
Answer
Answer: 4
i. Periphlebitis
ii. Choroidal infiltrates
iii. Multifocal Choroiditis
iv. Retinal granuloma
v. Peripheral retinal neovascularization
vi. Optic nerve involvement.
OSPE: 3
Amniotic Membrane
Question
Supplied sample is oven dried amniotic membrane
Answer the following questions
1) From where it was collected
2) How it was collected?
3) How it was sterilized?
4) In which temperature it is preserved?
5) Mention 4 important properties?
6) Enumerate 2 important ophthalmic uses?
Answer
1. From human placenta.
2. Elective C/S
3. Gamma radiation
4. 4 to 8 degree centigrade temperature.
5.
Anti inflammatory
Anti fibroblastic
Anti angiogenesis
Acts as an scalped for epithelization
Answer
• 6) Any two
a) Chemical injury of the cornea.
b) Persistent epithelial defect
c) Symblepharon release & fornix reconstruction
d) Excision of pterygium with AMT
OSPE: 4
Procedure
Question
• Make fortified Gentamycin eye drop for bacterial
corneal ulcer with the supplied materials.
• (Gentamycin eye drop, 10 cc syringe, inj gentamycin,
Signature pen, Micropore)
• Check list:
• Wearing gloves (Done)_(Not Done)
• Draw 5 ml gentamycin and discard __(Done) (Not Done)
• Mixed the whole ing gentamycin into the vial (Done) (Not
Done)
• Leveling of the vial_________ (Done) ____ (Not Done)
Answer
Marks Distribution:
• Wearing gloves _________________________2
• Draw 5 ml gentamycin and discard ______________ 3
• Mixed the whole ing gentamycin into the vial ______3
• Leveling of the vial___________________________ 2
OSPE: 5
Optics: Contact lens
Question
An aphakic patient who wears 8.6/13.5/+10.00 soft contact lenses consulted you for a pair of back up glasses.
Q: 1) What do the numbers mean?
8.6________________________
13.5________________________
10.00 ________________________
Q: 2) What is the spectacle power required if the vertex distance is 10 mm?
Q:3) What problems can occur with aphakic spectacle? Mention 4
Answer
Q: 1)
8.6 = base curve. 13.5 = diameter . 10.00 = lens power
Q: 2) 9.09 D
Q: 3) Any 4
Ring scotoma .
Pincushion effect.
excessive magnification.
altered depth perception.
weight of the glasses
OSPE: 6
Optics: Retinoscopy
Retinoscopic finding
Question
• a) Convert them into spectacle forms with minus cylinder
notation (assuming that you performed the retinoscopy at a
working distance of 67 cm from the patient).
• b) Convert them into spectacle forms with positive cylinder
notation (assuming that your consultant had an elbow injury
and can only achieved a working distance of 50cm from the
patient)
Answer
a. The power crosses translate to spherocylindrical corrections
(with minus cylinder) of
RE +1.50 / - 4.00 X 135
LE -0.75 / -1.25 X 90
As the working distance is 2/3 meter, -1.50 D is subtracted from the above
giving
RE PL / -4.00 X 135
LE -2.25 / -1.25 X 90
Answer
b. The power crosses translate to spherocylindrical corrections
(with positive cylinder) of
RE -2.50 / +4.00 X 45
LE -2.00 / +1.25 X 180
As the working distance is now 1/2 meter, -2.00D is subtracted from the
above
RE -4.50 / +4.00 X 45
LE -4.00 / +1.25 X 180
OSPE:7
Glaucoma: Optic disc
Question
Q no 1 What are the disc findings present here? Mention 3
Q no 2 Write 3 the provisional diagnosis depend upon
findings.
Q no 3 Write the name of 4 investigations for clinical
diagnosis.
Answer
Answer no 1 Any 3
a) Increase CDR, b) Narrow Neuro Retinal Rim (NRR)
c) Peri Papillary Atrophy (PPA), d) Vascular signs
Answer no 2
Suspicious disc.
Physiological cup.
Glaucomatous cupping
Answer no 3 (any 4)
IOP.
CCT.
VF.
OCT.
HRT
OSPE: 8
History Taking
Question
• This 40 - yr male suffering from double
vision. Please take the relevant history.
1) Greetings & self introduction
2) Whether double vision is monocular or binocular.
3) Direction of double vision: whether the diplopia is
horizontal, vertical or torsional.
4) Ask the patient in which direction of gaze the diplopia is
worse→ right, left, up, down, right and up, right and down,
left and up, left and down, or distance or near.
5) Ask for diurnal variability and fatigability of diplopia
6) Detailed history about :
mode of onset,
duration of onset,
associated pain,
history of strabismus in childhood,
history of trauma,
neurological symptoms such as dysphagia or weakness,
7) Underlying systemic illness:
hypertension,
diabetes,
cerebrovascular disease,
cardiac atherosclerotic disease
multiple sclerosis.
8) History of smoking or alcohol intake should be elicited.
9) Thank’s
OSPE: 9
Counseling
Question
• Counsel this pregnant lady about the
management who has severe NPDR in her R/E
and high risk PDR in her L/E
1) Greetings Done Not Done
2) Explanation about the disease Done Not
3) Information regarding Management
3a) Strict control of blood glucose, BP, renal
function, anaemia
Done Not done
3b) Mention the modalities of Rx of DR Done Not done
3c) Limitations of anti VEGF in pregnancy Done Not done
3d) Both eye should be treated with PRP Done Not Done
3e) Mode of delivery must be elective
Caesarian section
Done Not done
3f) Inform about adverse effect and cost Done Not done
4) Feedback from the patient Done Not done
5) Thank’s Done Not done
OSPE: 10
VIDEO CLIP
Question
1) What is the name of the surgery?
2) What is the name of the step?
3) Name the instrument which has been entered into the eyeball?
4) This step can be performed by another instrument. Mention it.
5) In addition to BSS, Mention 2 liquid substances have entered
into the eye.
6) Mention one common complication during this step.
7) What is the next step (not shown in the video)
Answer
Phacoemulsification with PC IOL _ =1+1
Continuous Curvilinear Capsulorhexis
_0.5+0.5+1.0=2
Rexis forcep =1
Cystitome =1
Viscoelastic substance & bluerex 1 + 1=2
Radial tear = 1.5
Hydrodessection & Hydrodeleanation__1+0.5=1.5