Eye Prof Bank 2014

All students went to floor 3 but respective professors conducted viva acc to schedule. Long case first. 2 students on 1 pt. Mostly catract. Few glaucoma. Few Trauma,aphakia.

Short... 3 or 4 pts. Ull b told to examine one. They change pts aftr sumtym. ONLY TEL FINDINGS eg red eye. Watering. Corneal lens opacity. Droopin o lid.

Imp in every unit:

Long case:
cataract
glaucoma
ptosis
proptosis
lid margin nodule ( D/D)
pterygium
limbal nodule D/D
eye trauma
blunt trauma esp. and its effects
lid malignancy

Short case:

pterygium again, ectropion,entropion. synechiae. symblepharon.... ye is liye ke pata ho ke kyun hote aurin ki pics aik bar google kar lo takey identify kar sako:)

optic nerve, refractive errors, squint, aur conjunctivitis aur ucer n lacrimal system n

conjuctive aur cornea

yar ulcers, errors, conjuctiva and squint and cover uncover b kratay hain short case me tou poch b skty hai hain aur lacrimal system b kiok regurgitation test b buhat cmmonly kraya jata hai...

Eye drugs: wo to bs ek do hain..pilocarpine,timilol,latanoprost.atropine. Phenylephrine.cyclopentolate.tropicamide,alcain, tobramycin,ciprofloxacin in sb ka pta hona chaiye n dexamethasone

Drugs of Glaucma,  miotc, mydriatc.

Red ones are mydriatic

Green miotics
White ones are either antiobiotics r anaesthetics
Moa and ci r indicatns b 

Causes of red eye and back pain:
Venereal disease..Most common cause
Ankylosing spondylitis is uncommon
RARE causes:
Congo hemorrhagic fever
Ebola
Juvenille rheumatoid arthritis
Reiter syndrome
Relapsing polychondritis
Yellow fever 

 foldable phaco me dalta hai mostly
Hard ecce me.. nai?
Rigid PMMA
Aur flexible silicon, acrylic.
Hard and soft iol 
Iol soft age se 
Foldable 
And rollable 

Yag laser ka moa "blast effect" hota hai.. After cataract me mainly ye use hota
Excimer laser ka moa - breaking of inter-carbon bonds... corneal ablation me main use iski 

YAG LASER:
*For after cataract..yag laser capsulotomy
*For narrow angle glaucoma,laucoma...laser iridotomy
*thermokeratoplasty...hypermetropia

ARGON LASER:
*in open angle glaucoma..argon laser trabeculoplasty
ARGON/DIODE/KRYPTON LASER:
*Diabetic retinopathy
*PRP
*direct photocoagulation
*focal burns
*grid pattern
EXCIMER LASER
*photorefractive keratectomy (PRK).. In myopia

Unit 1 

Unit sir imran sahaf k class lectures zaror prh k jaain particularly long case cataract n glucoma k. N methods k accurate method. Direct n indirect ophthalmoscope k advantages n disadvantages. 

long case -cataract(external)
listens to history and positive findings..
finding in pseudophakiahow will u know its a pseudophakic eyewht type of surgery preferred in senile cataract and why light perceptionoblique illumination
loupe
power calculation

short case - sir imran
pt. had bilateral corneal opacities.congestion.lacrimation.redness.entropion
sir asked entropion type and why
showed slides
chalazion.corneal ulcers.stye.iridodialysis.white pupil.causes.retinoblastoma.enucleation.kahan kahan enucleation hoti.stye chalazion diff.
chalaziom scoop.utrata forcep.tropicamide.

Short case: he ask abt major findings.of.case u r alloted.. there were2 cases .. mine was corneal opacity...he asked me wat is specifc abt this opacity.. ?? 
Drug was tropicamide.. he asked abt his use 
Instrumenrmt vanna n squint hook..asked their uses 
Laptop pictures easy to identify.. wats evisceration n when it is.done.. baki lectures wale then .. occlusion tst wale b ..

Y is ant chamber deep in pseudophakia

How wud u tel by looking that the patient has iol
How many fibers cros in optic chiasm
Which is strong direct or consensual light reflex? both have equal fibers i.e 50% so both are equal.
Sir sahaf took minor viva today
Cases were of cataract and corneal opacity
Pseudophakia and pterygium
He asks general case related questions and shows some pictures on his laptop jo k unki slides wali hoti hayn...tau slides zaroor zaroor parh k jana
Bak8 book say cataract glausoma errors of refraction karnay hayn mainly
Baki ka pochtay b nae
Long case cataract ka tha...
Dark room tests zaroor zaroor karnay hayn
External asked about retinoscope and its mirror ...uses... concave lens kis may ise kartay hayn aur indirect opthalmoscopy ka uses..
Visual acuity and meaning of 6/36
Cataract k sawal...history kia li

Those who are going to appear in UNIT1 for viva

-Dark room tests especially self made retinoscope and corneal loupe
-sir sahaf's slide
Zaroor zaroor kar k jana.

LONG CASE: Beds were alloted sharp at 9... per bed two students... we had 1hr 15 min almost to take history and do examination...  PGs n HOs were great help..at 10:15 Dr Imran came... with me he started with history "what exactly

you asked your patient?" ( u have to tell exactly what u asked the patient don't try to quote patient's answer ).. why did u ask about asthma? smoking? etc... then he asked me to perform regurgitation test.... from my fellow student he performed same test then asked about findings... ant chamber examination (throw light from the side and examine at front), there was synechie he asked what is that? how it will affect the ant camber etc...from

other students he was asking about direct and indirect ophthalmoscopy, perform nai kerwa rahay theiy just identification n use.... (atleast jab tk mere samnay viva le rahay theiy) her tarah k tests kerwa rahay theiy ocular movements, field of vision, etc aur kisi

b test pe khush nai ho rahay theiy... other questions that i know he asked:

what do u see on direct light reflex ( alternate constriction n dilation )

consensual light reflex srtrong hota ya direct? both r equa;

kitnay % optic fibres chiasma mein cross kertey hain?

SHORT CASE

external is quite good... there were 3 patients n 3 students at a time... he gave almost 2 min to examine left or right eye whichever he says... my patient had surgery for cataract so he was pseudophakic... other patients were of cataract and DCR post-op.

what are your findings?

how did u know he's pseudophakic?

what are signs of aphakia?

what are purkinje image?

what possible surgery is done on this patient? its complications? advantages disadvantages?

Extrnal was bit tough.. he was asking abt dark room tsts alot..do them vry well if he takes the long case.. asked abt history..regurgitation tst krwaya.. Distant direct oph n retinoscopy sune.. wats nodal point ?? N did u perform distant dirct ur patient 

Instruments se related kuch b nai hua... and no laptop images either.... depends on Dr

Imran's mood... :)LONG CASE: EXTERNAL-depends on ur case-diagnosis 

-dark rum tst bohat sun ray hain-corneal loop n converging lens ki power n focal length-pin hole test-surgry of cataract ki complicationz-diff bw aphakia n pseudophakia -methods me mostly movemnts of eyeball,reurgitation tst n squints k tsts-cataract me kon c ophthalmoscopy krty hain 

SHORT CASE: SIR IMRAN sir has an endless collection of slides but mostly easily identifiable including -squint-iridodylasis -basal cell CA-enucleation-exentration-ptosis -white pupil (retinoblastoma)-amblyopia-corneal ulcer..kaisy pta chla (flourisciene staining) kis me dekhty hain (cobalt blue lite in slit lamp) -chalazion-stye-abcess ka treatmnt drugs me jst uses n mechanism of action 

It is used in keratoconjuctivitis we apply any ointment in the eye n cover it wd celluphane tape n that chamber is Sahafs wet chamber .
Sahaf's gold weight implant..  used in Bells palsy ..
What sir told about sequestered lens protein? Kya hoga unky exposure p ? N body me aur kahan hoti?
type 1 hypersenstivity hu g
Han sympathetic ophthalmia wali proteins bta do. Histidine something I guess
Sequestered proteins thyroid
Lens 
Sperms

uveal tissue
Type 4 hypersenstvty
Mecha of rapd.

Diff in glaucoma n cataract clin...which is treated first ?
Direct indirect opthalmo advantages. 

15-12-14

LONG CASE (DR.Imran)

Case was cataract,sir asked kya pucho gay iski history mein,aapko btana h k u'll take the history on basis of exclusion method,catarct ki jitni causes hoti hayn unkay baray mein puchna h aur unko apnay case k sath associate krna h.Ask for AGE- senile cataract, Ocuupation-whether he has any occupational hazard which may lead to cataract,Radiational exposure- UV,IR rays can cause cataract, Endocrine-ask for diabetes,sir kehtay hayn k diabetes ka kesay pucha to usmein woi k polyphagia,polydipsi,polyuria h k nae h.Neck surgery-to rule out thyroid/parathyroid association.Ask for hakeem medication,steroids,antiepileptics.Trauma-to rule out traumatic cataract.Similarly go on asking other causes of cataract.Phir sir kehtay hayn k causes k elawa history ko kesay filter kro gay k cataract h,to btana h k I'll look for the symptoms of the cataract i-e u have to as for halos,polyopia etc,as my patient has these complaints.

Anterior chmaber inspection mein u have to throw light from the side of eye and look from side.Sir did like that today.

Direct Ophtahlmoscope ka PRIMARY use-to see RETINA,then tell other uses.Advantage of indirect ophthalmoscopy-Binocular vision,stereopsis,enables u to accurately perceive things at their exact location,its not possible vd uniocular direct ophthalmoscopy,iskay baad baqi advantages btani hayn jo bhi parhi hui hayn.

SHORT CASE

examine the subject(my subject had cataract),external asked whats ur diagnosis,use of wire vectus,identify Bard Parker knife.

hmara long case was of cataract...sir sahaf asked k ap pt.

say kya questions krain gy? like tarteeb sy full detail and cataract k causes uski treatment phaco ka procedure? ophthalmoscope thi un k pas sath jo k DDO k liay b use krtay or sath mai Indirect ophthalmoscope b thi..sir nay dono k ek faiday nuqsan pochay , tests mai covrr uncovrr or pupillary reactions krwaey. baqi ext. wala viva mera simple tha case was of pseudophakia,asked about purkinje images,acute congestv glaucoma,pilocarpine,chalazion.scoop

he also had corneal loop n retinoscope palne mirror .wo

poch rae the .. for dark room tests notes of red book r enough .. wohe sunte han n perform krwaya kuch se.

Corneal opacity k grades and treatment . Ans: Nebula, macula, leukoma,  adhesive leucoma ... (leucoma plus anterior synchie ). treatment optical iridectomy.. nebula me

opacity only involves epithelium in macula half of stroma is involved also and In leukoma full thickness of stroma is involved. .

If lens is dislocated into vitreous what is its treatment ? 
If capsule is intact thn no treatment is reqiured if it isnt thn pars plana vitrectomy ...

 dr.imran was in good mood .. u r alloted a case out of 2 or 3 mine was corneal opacity .. he asked about findings n wats specific abt the opacity .. drug was tropicamide asked its use .. intruments squint hook n vanna scissor.. laptop pictures were also easy to identify mostly of his lectures .. may ask 2 or 3 questions related to them .. mine were when is evisceration them n wat is it ? occlusion therapy ?

Sir sahaf implants bhei hain aik round nd pear shape probably. ..  

Gold implant; sir said k gold inert sub his bells palsy ppt k eye lid main daltye hain aik thin si plate, gold k weight ki waja sai ppt is able to close his eyes aur exposure keratopathy sai bach jata hai. ...(levator fun normal hota hai so there is no prob in opening the eye)
Complications of excimer :

Dry eyes, slight fibrosis leading to haze, epithelialization of flap, keratitis, corneal hydrops.
yaar ant. chamber kyun deep ho ga psudo phakia aur apkhakia mein? and ink diff.? dno me.
Pseudophakia and aphakia dono me iris ka support lost hu jata hai for this reason iris peche chala jata ha and ant chamber deep
Pseudophakia is eye with iol . Aphakia absence of lens.. secondly pseudo me 3 purkinje images bante ha aphakia me 3 n 4 lost.inki movements ka b koi difference hota hai which i dont knw
cataract and glaucoma ana chahaiy
And diffentials anay chahaiy
Methods aj nahe kraye but they were asking about dark room tests
Unit 2

Major viva 
Dr moeen (external)
Diabetic retinopatgy, effects of diabetes on lens?
types of diplopia n there tests ?
Muscles of the orbit n the action in diplopia
Myopia? Hypermetropia?
Phoria? Tropia?
examine of extraoccular muscles ?dark room tests?
Hemianopia?
Catract surgery ? Advantages of ECCE
Phaco mai post capsule hai hai tou kon sa lens dalo gai n kaisay..
Ward card pay jo fill kiya hoa hai us k mutaliq poochtay hain .

. He thoroughly reads your history and even ward card and points out mistakes of all kinds. Questions mostly case related except ofcourse you mention something out of context. So be strictly to the point.  ek koi method kara lete hain, kaafi tang kartay hain us pe b. Or madam amtul ne apnay paas 3 patients rakhay thay for short case. Corneal opacity cataract or ek kuch or. Pgs and HOs help A LOT her cheez me. bata detay hain kya kya ha. Or slides dikhati hain 1,2 madam. Plus a couple of instruments and drugs. Today she had chopper, needle holder, macpherson's forceps (not sure about spellings) 

external long case: mine was cataract .. history suni

thi..floaters, flashes,halos kia disease me hote .. diagnosis? districhiasis, photorefractive keratectomy? meningioma? major symptom that is proptosis .. ICCE me konsa lens use krte? anterior chamber lens .. phir pucha is ki complications? direct ophthalmoscoy me magnification kitni hoti r image kaisa bnta?

MAM AMTUL: images dikhae laptop p r diagnosis pucha sath me patient ki diagnosis r 1 drug r 1 instrument

EYE UNIT 3 

Dr.Asad 's fav Qs:

Types of Iop
Reason of sutures in phaco, Small incision so sutures not required mostly
CCC
Cataract surgeries
Indications
Steps of phaco
Errors
Cataract
External

long case: He asked me to read the history. He said dont repeat anything, time zaya na kren, lakeer k faqeer na bnen. Books say bahir nikal k bhi perha kren.knowledge nahi hota KE walon k pas. KE aur Mayo ka standard gir gya hai. He asked aap ney history mae Hepititis ka kyun nahi pucha, puchna chahiye tha. 

He has got a Retinoscope and Ophthalmoscope. He asked me to perform Distant Direct Ophthalmoscopy. the moment you hold the instrument, he says 'lagta hai pehli dafa aap ney pakra hai isay'. 

He asked causes of color blindness, Eye findings in Ebola infection, How to tell the type of lens by looking at the glasses, name of computerized procedure used to check eyesight, advantages of slit lamp bimicroscopy.

RAPD

Hepatitis k case me hw wd u sterlize instruments.
Opthalmoscope pkrai k on kro.
Retinoscope kia hti?
patient ki ankh se related questions.
IOP measure krne k tarikay.Bacho me kese measure krtay

dark room tsts bht achi trha anay chahye,,, external

internal dono ko pasand,, notes books jahan se milay sb prh len,, sir asad long len to wo mirror,lens aur corneal loop le atay h,, external le to wo ophthalmoscope aur retinoscope hi mangwa leta h aur hr aik se perform krwata,, and usay pta lg jata h bae k pehle kbi pkri h ya ni .

and external ka mind clinical type h, snerios tk deta,, he wants k bchun ne books k elawa b clinical prha hua ho ward main,, aik adh ajeeb ques sb se krta like ebola se eye pr effect type,, hakeem ki medicine khati h patient to kya hoga?? us main steroids hotay so cataract.

and agr sir asad long len to wo cataract bht suntay hain so wo must,,, sir ki slides hain blog pr,, complications and procedures achi trha krnay,, alternate hota roz,, aj external ne long lia, mon ko sir asad len gay most probably.

sir asad k to woi fav questions hain,, cataract ki complications,surgery procedures,phaco k faiday,corneal ulcer thora sa aur glaucoma and cataract ka diff etc,,
agr external le long to wo aik bchay se history sunta h dosray se examination, aur retinoscope and ophthalmoscope zror krwata hai,, baqi bs kch normal ques kch bs zra ajeeb.

Sir Asad's frequently asked questions today were:

complications of iridocyclitis, of dacrocystitis, of entopion (recurrent corneal ulcers). correction of aphakia (4 names from jatoi) demerits of specs,treatment of cataract, types of cataract extraction procedures. advantages of phaco, Atropine. 

he asked +ve findings for short case, started from that topic. whatever finding u get. instruments clamps thay, chalazion aur entropion wala. bone nibbler tha aaj..

if external takes long case, he comments on history.

 Long case by external, focussed more on general + clinical kowledge today. ek achay doctor ko jo jo poochna chahiye in history + common sense related to medicine/latest batein (history me viral inf ki history he said today,k leni chahiye. and g.k me Age related eye disease study (AREDS) suggest which vitamin for eye health latest??A shaid. chaye me konsa chemical hota hai for eye health lol) but these were just to assess how much u know outta book. freq asked today wer spectacles dekh kr kesay pta chlaega +ve lens ki hai or -ve (asked from students with specs only), adv of slit lamp. one student history. the other one findings. a dark room test from both.

computerized eyesight AUTOREF say check kerty hain. auto

refractometer it is... dark room tsts jo notes k hain un sbki modern forms ka pta hona chahye. 

Sir Nasir told in revision class: 
modern form of retinoscope is "streak retinoscope" aur aaj kal us ki bhi zrurat nahe parti because "autorefractometers" use ho rhay hein.

 Wo pair jise patient allot hta h ,us k

frst roll no se history so just cram the history of patient and frm the othr one he asks clinical exam,, positive findings btani haen phle..

Dr asad had corneal loop n plane mirror with him. Only asked use. Dd gradual

blindnes.cataract surgry. Phaco y betr. Dilation o pupil causes. Treatmnt diabetic retino. Hw wil u diff btw catarct n glaucoma. Wich treat first. Tonometry kraya. Regurg.

Sir asad shrt case...squint and its typs..squint in childrn...atropin k uses.uvdeitis ki compl.simcos cannula..and white puppil k causes..extrrnl..only histry
Sir asad short case:
Pilocarpine k use.
Whch drug incrz uveo scleral outflow

Complications of cataract
Ectropian causes
Most comon cause of cicatrical ectropian (acid burns)
Aphakia k signs
Causes of jetblack pupik

Sir asad gve importnce to concepts

Catract
Glaucoma
Errors of refraction
mechanisms of phakomorphic,phakolytic glaucoma
Direct indirect Ophthalmoscopy
Glaucoma and catrct ko kese diferntiate krte
From unit 3.

V didn't get drugs.
Retinoscope n corneal loupe tha bus
Easy hai.  Cataract glaucoma.
Dark room tests. Concept only
Cataract.  Diff in pseudo n aphakia.  Corneal opacity
Dark rm instruments me ye btana tha k kia hai.n kis leya use hota..r modifed form kia h iski
like Modified form of corneal loupe is slit lamp

Sirs Qs : late complications of cataract surgery,their treatments, causes of gradual painless loss of vision. Treatments of myopia. Aap ne abhi tk excimer kyun nae kraya? Stages and treatments of diabetic retinopathy, classif of glaucoma, what happens if u dont treat cataract, mech of glauc in phacolytic and phacomorphic.
Sir Asad Aslam is incredibly sweet. PGs saaray long cases bta dete hn. They are either cataract or glaucoma. Sir Asad even says k agr kisi ka koi Q drop ho tou its PGs fault.
light perception, regurg, digital tonometry
Instruments : corneal loupe, plain mirror with hole.

Light perception se kya check kartay hein

Ext : tell findings of pt. ,diff b/t aphakia and pseudophakia., what are errors of refrac? Define . Define astigmatism. Types of astigmatism. Treatments. 

Types of keratoplasty are:
Lamellar
Tectonic
Penetrating
Pilocarpine ka congenital glucoma me kya use h? Sir ny batya tha kch,i think it was to support da lens n prevent its ant dislocation.....eyeball enlarge honay ligaments stretch hote n den lens subluxation k chances xiada ho jate hain
Pilocarpine also betters the vision in congestive glaucoma.
Its prevents pupilary block.
How contact lens cause ulcer?
Decreased oxygen to cornea? Irritation? Anyother cause?
Dryng effect
And bacterial proliferation
Under d contact lens

Dust b. Behind lens
Tear film cant reach cornea behind d lens
So it gets dried And damaged
Due to acumulation of dust and bacteriaetc
What is neovascular glucoma? Wat is its TREATMENT? PHOTOCOAGULATION?
Treatments of neovasc glaucoma : beta blockers, carbonic anhydrase inhib, treat the cause , I/V avastin (VEGF Inhib), laser to retina, Sahaf's modified anterior trabeculectomy.in modified trab we remove a piece of corneal stroma as wel 

Dr asad. Short cases. Findings. White reflex. +v regurge test. Cause of white reflex?

Cataract. Regurge? Dacrocystitis. Comolicatiin of dacrocystitis. Drug...atropine di...wat are its uses. Complications of iridocyclitis. 
Long case. Cataract. External ne history suni. Systemic n drug history kiu imp hoti hai. Is se agay pta ni kaha ponch gae thay...ophthalmo ya retinoscope de k on krwatay hai....phr direct ya DDO b krne ka kehte hain. Wat r their uses.
Aj unho ne ophthalmoscopes n retinoscopes rakhe hue thay.
Long case cataract, external asked advantages of slit lamp, adv of phaco
Sir asad took short case. Findings? Complications of iritis, correction of aphakia. Complctn of entropion.atropine thi. Entropion clamp. Chalaxion clamp.

When we are showing light into one eye,it can go into other eye and by that patient can tell the direction..so we put a hand so it doesn't go into other eye. We check retina through light perception