OSPE/OSCE for post graduate ophthalmology student (FCPS Part=2)

Dr Md Anisur Rahman Anjum

MBBS (DMC) DO (DU) FCPS (Eye)

Associate Professor

National Institute of Ophthalmology

OSPE=1OSPE=1

• A diabetic patient in his right eye NPDR with macular edema and left eye suspected PDR. Mention investigation and treatment plan.

ANS=1ANS=1

• FBS, 2 hr after breakfast, HbA1c, Lipid profile, creatinine, Hb% estimation, OCT,R/E (macular region), FFA, B/E to detect capillary non perfusion, NVD, NVE.

• Rx.Rt.Inj.avastin/lucentis to control oedema and follow up .

• Left eye if PDR

• -PRP and follow up

OSPE=2OSPE=2

• A patient came to you with the complained of impairment of vision in one eye. On fundoscopy, you find that there is a scar in the macular region. Mention investigations and treatment plan.

ANS=2ANS=2

1) ESR2) MT3) X-ray chest p/a view4) TPHA5) Antibody for toxoplasma.6) FFA,OCT

Rx.  Treatment of any infective disease relevant If the scar due to CNVM and associated with oedema inj. anti VEGF in intravitreal route.

OSPE=3OSPE=3

• A 60 yrs old patient presenting with sudden A 60 yrs old patient presenting with sudden loss of vision, headache and jaw claudication. loss of vision, headache and jaw claudication.

• 1) What is your clinical diagnosis?1) What is your clinical diagnosis?

• 2) Name 3 investigations for diagnosis.2) Name 3 investigations for diagnosis.

• 3) Mention one common treatment 3) Mention one common treatment

ANS=3ANS=3

• Superficial temporal arteritis (giant cell arteritis).

• Investigations:a. High ESRb. Raised C-Reactive  protein.c. Thrombocytosisd. Superficial temporal artery biopsy.

• Rx, Systemic steroid,1-2 yr duration.

OSPE=4OSPE=4

3 photos have been given here. These term we 3 photos have been given here. These term we use in different ophthalmic diseases. You just use in different ophthalmic diseases. You just mention one name (disease) for each mention one name (disease) for each

Photo=1. Tobacco DustPhoto=1. Tobacco Dust

Photo=2 Scrambled egg

Photo 3 =Champagne Cork

ANS

• 1) Pigmented cells in the vitreous seen in retinal detachments are often described as tobacco dust

• 2) vitelliform macular dystrophy/ Best's disease

• 3) In the late stages of papilloedema, the optic disc takes the appearance of the dome of a champagne cork