Course Content
👁️ Station 1 — Ophthalmic History Taking
• Take a structured history from a patient presenting with an ocular complaint. • Identify the chief ocular complaint and its duration. • Explore relevant associated ocular symptoms. • Obtain relevant previous ocular, medical and treatment history. • Present the important findings of the ocular history in a concise clinical format.
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🔤 Station 2 — Visual Acuity Examination
• Correctly position the patient and visual-acuity chart. • Assess distance visual acuity in each eye separately. • Record visual acuity correctly. • Use pinhole assessment where appropriate. • Interpret an abnormal visual-acuity result.
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🔦 Station 3 — Pupillary Examination
• Inspect pupil size, shape and symmetry. • Assess direct pupillary light reflex. • Assess consensual pupillary light reflex. • Assess the pupillary response systematically. • Recognize an abnormal pupillary response.
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👀 Station 4 — Visual Field Examination by Confrontation
• Position the patient correctly for confrontation testing. • Examine each eye separately. • Assess the major visual-field quadrants systematically. • Compare the patient's visual field with the examiner's field. • Identify the presence of a gross visual-field defect.
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🔬 Station 5 — Slit-Lamp and Anterior Segment Examination
Integrated KMU activities: 5. Slit-Lamp Examination 6. Anterior Segment Examination Learning Objectives The student should be able to: • Identify the major parts/components of a slit lamp. • Explain the basic purpose of slit-lamp examination. • Position the patient appropriately. • Examine the anterior segment systematically using the slit lamp. • Identify important anterior-segment structures during examination.
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🩺 Station 6 — Direct Ophthalmoscopy and Fundus Examination
• Demonstrate correct handling of the direct ophthalmoscope. • Position themselves and the patient appropriately. • Perform direct ophthalmoscopy systematically. • Visualize the optic disc and retinal background. • Describe important fundus findings seen during examination.
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📊 Station 7 — Interpretation of Common Ophthalmic Investigations
The student should be able to: • Identify a presented ophthalmic investigation. • Describe the basic information provided by OCT. • Interpret common visual-field findings. • Recognize the role/output of ocular biometry. • Interpret basic B-scan findings. • Recognize FFA and corneal-topography images and state their clinical use.
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👁️ Station 8 — Ptosis Examination
• Inspect a patient with suspected ptosis. • Compare eyelid position between both eyes. • Perform a systematic clinical assessment of ptosis. • Identify important abnormal findings. • Record and communicate the findings appropriately.
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👓 Station 9 — Examination of Common Lid Abnormalities
• Examine the eyelids systematically. • Recognize ectropion. • Recognize entropion. • Identify chalazion. • Identify stye. • Differentiate common lid abnormalities from one another on clinical examination or photographs.
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👁️ Station 10 — Proptosis Examination
• Recognize the presence of proptosis. • Compare both eyes for symmetry. • Perform a structured ocular examination in a patient with proptosis. • Assess relevant associated ocular findings. • Present the examination findings systematically.
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💧 Station 11 — Topical Anaesthesia, Fluorescein Staining and Corneal Assessment
• Demonstrate appropriate use of topical ocular anaesthesia. • Demonstrate fluorescein staining of the ocular surface. • Examine the stained cornea appropriately. • Identify a superficial corneal abnormality/foreign body when presented. • Explain the purpose of corneal scraping in suspected corneal infection.
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💦 Station 12 — Lacrimal Regurgitation Test
• Explain the purpose of the lacrimal regurgitation test. • Position the patient appropriately. • Perform the test correctly. • Observe for reflux from the lacrimal puncta. • Interpret a positive or negative result.
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🚨 Station 13 — Ocular Trauma and Chemical Eye Injury First Aid
• Perform an initial assessment of an ocular-trauma patient. • Identify the need for urgent eye first aid. • Demonstrate immediate management of chemical eye injury. • Perform appropriate eye irrigation/eye wash. • Explain essential precautions during initial ocular-trauma management.
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🔍 Station 14 — Optic Disc Examination: Normal, Glaucomatous and Swollen Disc
• Identify and describe a normal optic disc. • Examine or interpret the optic disc systematically. • Recognize features of a glaucomatous disc. • Recognize a swollen optic disc. • Differentiate a normal disc from major abnormal disc appearances.
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🩸 Station 15 — Retinal Lesions and Retinal Vascular Disease
• Inspect a retinal photograph/fundus image systematically. • Detect common retinal abnormalities. • Recognize common retinal vascular abnormalities. • Differentiate common retinal vascular conditions from one another. • Describe the important visual findings presented.
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⚠️ Station 16 — Recognition of Retinal Detachment
• Recognize retinal detachment in a clinical image. • Describe the abnormal retinal appearance. • Distinguish detached retina from a normal retinal appearance. • Identify retinal detachment as a significant cause of visual loss. • Communicate the finding clearly in an OSCE setting.
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📈 Station 17 — Tonometry and Glaucoma Assessment
• Identify the Goldmann applanation tonometer. • Explain the purpose of tonometry. • Describe the basic method of Goldmann tonometry. • Interpret an intraocular-pressure reading in the clinical context. • Relate tonometry to assessment of glaucoma.
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🌫️ Station 18 — Cataract Examination and Recognition
• Perform a basic ocular assessment for cataract. • Recognize the presence of cataract on ocular examination. • Describe the abnormal lens appearance. • Differentiate a clear lens from a cataractous lens. • Recognize adult and congenital cataract when presented clinically or visually.
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↔️ Station 19 — Extraocular Movements and Ocular Motor Examination
• Inspect ocular alignment. • Examine extraocular movements systematically. • Test the major directions of gaze. • Identify limitation of ocular movement. • Recognize an abnormal ocular-motility pattern during examination.
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🔁 Station 20 — Squint Examination: Cover Tests and Squint Pattern
• Assess ocular alignment. • Perform the cover test. • Perform the uncover test. • Perform the alternate-cover test. • Identify the presence of manifest or latent deviation from the examination. • Differentiate an esotropia pattern from an exotropia pattern.
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AIM OSPE/OSCE Lab — Ophthalmology Module | 4th Year MBBS

AIM OSCE / OSPE • MBBS • 4th Year • Eye

Station 16 — Retinal Detachment Recognition

Rapid Revision • Practical Skills • Viva

🎯 Candidate Task

Examine the provided fundus image. Describe the important abnormal retinal findings, identify the most likely diagnosis, and communicate its clinical significance to the examiner.

⚡ Model Station Answer

  • The retina appears elevated and detached rather than flat.
  • There is a grey-white, corrugated or folded retinal appearance with loss of the normal underlying fundus detail.
  • Retinal vessels course over the elevated retina and may appear undulating or out of focus.
  • These findings are consistent with retinal detachment.
  • This is a sight-threatening cause of visual loss requiring urgent ophthalmic assessment.

🔎 How to Perform / Approach

  1. Identify the image: Recognize it as a fundus/retinal photograph.
  2. Assess retinal position: Decide whether the retina appears normally flat or abnormally elevated.
  3. Look for surface changes: Identify grey-white elevation, folds or corrugations.
  4. Assess vessels and background: Note vessels passing over the elevated retina and reduced visibility of normal choroidal detail.
  5. Compare with normal: A normal retina is flat, orange-red and has clearly focused retinal vessels without folds.
  6. State the conclusion: Clearly identify retinal detachment and mention its importance as a cause of visual loss.

🖼️ Visual Learning

VISUAL 1

Normal Retina vs Retinal Detachment

📝 Important Viva Questions

1. What is the main funduscopic feature of retinal detachment?

Answer: An elevated grey-white retina with folds or corrugations, rather than a normally flat retinal surface.

2. How do retinal vessels appear over a detached retina?

Answer: They course over the elevated retina and may appear undulating, displaced or less sharply focused.

3. How does a normal retina differ from a detached retina?

Answer: A normal retina is flat and orange-red with sharply focused vessels; a detached retina is elevated, pale-grey and folded.

4. Why is retinal detachment clinically important?

Answer: It is a sight-threatening condition that can cause significant or permanent visual loss if not assessed and treated promptly.

5. What symptoms commonly raise suspicion of retinal detachment?

Answer: Sudden flashes, new floaters and a curtain or shadow progressing across the visual field are typical warning symptoms.

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