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Tutorial for MRCP PACES Station 5 ( Last modified: 12 January 2007)

1)Fundoscopy

        This is the easiest sub-station in MRCP PACES station 5. The reason is simple, you have 99% chance of getting these three conditions in your MRCP PACES- diabetic changes, optic atrophy and retinitis pigmentosa. Remember that in your fundoscopy examination, you must give clear instructions to your patients so that they understand what to do. Another tip to remember, open your eyes and observe any clue to come to the diagnosis such as diabetic leg ulcer, walking stick, surgical scar over the scalp ...etc.I like to follow these steps while performing a fundoscopy examination,

arrow1) Inform your patient what you are going to do. " Mr...., I am going to examine your eyes with a strong light, you may feel a bit uncomfortable but it will not hurt."

arrow2) " Mr...., just look straight ahead and fix on an object in front of you. You may blink once in a while if you feel a need to."

arrow3) Look for red reflex and zoom in to the fundus, always practise a technique where you will never miss any pathology- either examine from periphery to centre ( optic disc) or from centre (optic disc) to periphery. Look at all quandrants.

arrow4) Last but not least, ask patient to look staright to your light to visualize the macula!

arrow5) Repeat these steps on the other eye!

arrow6) Remember to thank your patient!

More topics to come!

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