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 07 — Interpretation of Common Ophthalmic Investigations

Rapid Revision • Practical Skills • Viva

🎯 Candidate Task

You are shown a series of common ophthalmic investigation outputs. Identify each investigation, describe the important information or abnormality shown, and state its principal clinical use or interpretation.

⚡ Model Station Answer

  • OCT: provides cross-sectional imaging of retinal layers and can assess macular structure and retinal nerve-fibre layer thickness.
  • Visual field: I would identify the pattern of field loss, such as a nasal step/arcuate defect, bitemporal loss or a homonymous defect, and relate it to the likely site of disease.
  • Ocular biometry: measures ocular parameters, especially axial length and corneal power, used principally for intraocular-lens power calculation.
  • B-scan ultrasonography: demonstrates posterior-segment structures when direct visualization is limited and may show abnormalities such as retinal detachment or vitreous echoes.
  • FFA and corneal topography: FFA evaluates retinal vascular filling, leakage and non-perfusion; corneal topography maps corneal curvature and helps detect irregular astigmatism or keratoconus.

🔎 How to Perform / Approach

1
Identify the investigation. Recognize its characteristic display before interpreting it.
2
Check orientation and labels. Confirm the eye, scan type, field plot or displayed measurement where available.
3
Review systematically. Compare the major structures, measurements or patterns with the expected normal appearance.
4
State the important finding. Describe the visible abnormality rather than jumping directly to a diagnosis.
5
Interpret the finding. For visual fields, describe the distribution of loss; for B-scan, identify abnormal echoes or membranes.
6
Conclude clearly. Give the likely significance or principal clinical use of the investigation in one sentence.

🖼️ Visual Learning

VISUAL 1

Recognition of Common Ophthalmic Investigation Outputs

 

 

📝 Important Viva Questions

1. What information does OCT provide?

Answer: OCT provides high-resolution cross-sectional imaging of ocular tissues, particularly retinal layers, macular structure and retinal nerve-fibre layer thickness.

2. What visual-field defect is commonly associated with glaucoma?

Answer: Typical glaucomatous defects include a nasal step and arcuate scotoma corresponding to retinal nerve-fibre bundle loss.

3. What is the main clinical use of ocular biometry?

Answer: It measures ocular parameters such as axial length and corneal power and is principally used to calculate intraocular-lens power before cataract surgery.

4. When is B-scan ultrasonography particularly useful?

Answer: It is useful for assessing the posterior segment when the ocular media are opaque, for example with dense cataract or vitreous haemorrhage.

5. What is the basic difference between FFA and corneal topography?

Answer: FFA assesses retinal vascular circulation, leakage and non-perfusion, whereas corneal topography maps corneal curvature and identifies abnormalities such as irregular astigmatism or keratoconus.

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