Objective Structured Clinical Examination (OSCE) STATIONS 2006

1. Name the tests. Name the purpose of each test in 1 or 2 sentences.

2. ANSWERS
1- Maddox Rod: (cylindrical lens drawing) Used to measure ocular muscle balance and detect
strabismus. It converts a point of light into a line to assess phoria and tropia.
2- Amsler Grid: (grid pattern) Tests central visual field to detect scotomas and
metamorphopsia. Particularly useful for monitoring macular degeneration.
3- Snellen Chart: (letter chart) Measures visual acuity at distance. Standard test for
determining refractive errors and vision correction needs.
4- Stereo Butterfly Depth Perception Stereopsis Test: Tests stereopsis/depth perception.
Helps assess binocular vision by requiring both eyes to work together to see hidden 3D
images.
5- Ishihara Color Test: (circles with colored number patterns) Tests for color vision deficiency.
Identifies red-green color blindness through camouflaged numbers in colored dot patterns.
6- Farnsworth–Munsell 100-hue test: is a sensitive test for both congenital and acquired color
defects
7- Retinometer: (doctor examining patient's eye) determining a patient’s potential visual
acuity after cataract surgery.

3. Name the orthoptic tests and instruments. Name the purpose of each test in 1 or 2
sentences

4. ANSWERS
1. Stereo Fly Test: Tests stereopsis/depth perception using random dot patterns. Used to
assess binocular vision and detect strabismus.
2. Prism Bar Test/Cover Test: Measures the angle of strabismus and assesses ocular
alignment. Helps quantify the degree of eye deviation.
3. Synoptophore/Major Amblyoscope: Tests binocular vision, fusion, and measures angle of
squint. Used for diagnosis and treatment of strabismus.
4. Cover-Uncover Test: Detects the presence and type of strabismus (phoria or tropia). Basic
screening test for ocular alignment.
5. Tangent Screen/Bjerrum Screen: Maps the visual field to detect scotomas and field defects.
Used to assess peripheral vision and monitor conditions like glaucoma.
6. Letter Chart/Near Visual Acuity Test: Tests near vision acuity. Used to assess reading vision
and need for reading glasses.
7. Kay Pictures Test: Visual acuity test for young children using simple picture optotypes.
Particularly useful for pre-literate children.
8. Cardiff Cards/Picture Cards: Another visual acuity test for infants and young children using
preferential looking technique. Uses simple outline drawings to assess vision in very young
patients.

5. Match the Hess charts (1-6) with the appropriate clinical conditions (A-F).
Describe each chart and the main clinical features of the matching condition
ANSWERS

6. 1. Hess Chart 1 matches with Image 9 (Superior Rectus Palsy)
 Chart shows under-action of the superior rectus in the affected eye
 Clinical image shows hypotropia (downward deviation) of the affected eye
 Characteristic limitation of elevation
2. Hess Chart 2 matches with Image 10 (Inferior Rectus Palsy)
 Chart demonstrates under-action of the inferior rectus muscle
 Clinical image shows hypertropia (upward deviation)
 Difficulty in downward gaze
3. Hess Chart 3 matches with Image 11 (Superior Oblique Palsy)
 Chart shows characteristic pattern of superior oblique under-action
 Clinical image shows upward deviation of affected eye
 Often presents with compensatory head tilt
4. Hess Chart 4 matches with Image 12 (Inferior Oblique Palsy)
 Chart demonstrates under-action of inferior oblique muscle
 Clinical image shows limitation of elevation in adduction
 Typically presents with hypotropia in contralateral gaze
5. Hess Chart 5 matches with Image 7 (Lateral Rectus Palsy)
 Chart shows significant limitation of abduction
 Clinical image shows esotropia (inward deviation)
 Clear limitation of outward movement
6. Hess Chart 6 matches with Image 8 (Medial Rectus Palsy)
 Chart shows limitation of adduction
 Clinical image shows exotropia (outward deviation)
 Characteristic impairment of inward movement
Match the visual field charts (1-5) with the appropriate clinical conditions (A-E). Give a likely
diagnosis for each match

8. ANSWERS
1. Visual filed 1 matches with Image 1 (Bitemporal hemianopia). MRI showing
hemorrhage within pituitary adenoma compressing the chiasm
2. Visual filed 2 matches with Image 2 (Glaucoma optic neuropathy). Visual field
showing severe constriction in the left eye from advanced glaucoma.
3. Visual filed 3 matches with Image 5 (Left homonymous hemianopia). MRI showing
infarction in the right optic radiations
4. Visual filed 4 matches with Image 3 (non-arteritic ischemic optic neuropathy). Visual
field showing lower altitudinal hemianopia
5. Visual filed 5 matches with Image 4 (Papilledema). Visual field showing enlarged
blind spots in both eye
Name the investigations and printouts

9. ANSWERS
1. A manual lensometer, is used measure the precise powers of the sphere, cylinder, axis, add,
and prism of a lens
2. An auto-refractor, used to measure refractive errors objectively
3. Humphrey field analyzer (HFA) is used to measure visual field
4. A color-coded corneal map showing anterior curvature details of the right (OD) and left (OS)
eyes.
5. B-scan of Vitreous Hemorrhage
Match the clinical conditions with appropriate CT-Scan

11. ANSWERS
1. Clinical condition 1 matches CT scan 1. Thyroid eye disease with asymmetric
proptosis on left. CT of orbits with thickening of recti muscles on left.
2. Clinical condition 2 matches CT scan 2. Right orbital cellulitis with ophthalmoplegia.
CT showing both pre-septal and orbital opacification.
3. Clinical condition 3 matches CT scan 3. Orbital floor blow-out fracture. CT showing
herniation of orbital fat in the maxillary sinus.
4. Clinical condition 4 matches CT scan 4. Orbital superficial cyst right eye. CT image
showing a well-circumscribed heterogeneous superficial syst.