TABLE OF SPECIFICATIONS

MBBS- OPHTHALMOLOGY
SR TOPIC SEQS MCQS
No.
1. Orbit: - 2
i. Orbital Cellulitis
ii. Proptosis
2. Lids 1 2
i. Blepharitis
ii. Stye
iii. Chalazion
iv. Trichiasis
v. Entropion
vi. Ectropion
vii. Ptosis
viii. Common tumors
3. Conjunctiva, Cornea, and Sclera: 1 4
i. Infective and allergic conjunctivitis
ii. Pterygium
iii. Keratitis
iv. Corneal ulcers
v. Risk factors
vi. Complications and its management
vii. Episcleritis and Scleritis
4. Pupil and Visual Pathway: - 2
i. Pupil reflexes and their common
abnormalities
ii. Introduction to visual field defects
in the lesions of Chiasma and
visual pathway
5. Lacrimal Apparatus: 1 1
i. Composition and function of tear
film
ii. Dry eye
iii. Excessive tearing (Epiphora)
iv. Dacryocystitis (Acute and Chronic)
6. Therapeutics and Vitamin A: - 1
i. Drugs used in common ophthalmic
conditions
ii. Ocular manifestations of vitamin A
deficiency and its management
7. Uveal Tract: 1 2
Uveitis and its differential diagnosis from
other causes of red eye
8. Lens: 1 4
i. Classification of cataract
ii. Congenital cataract (lamellar signs
and symptoms and management)
 iii. Rubella syndrome
iv. Acquired cataract (Senile,
Traumatic, Drug induced)
v. Cataract due to systemic diseases
(Clinical picture and management
including visual rehabilitation)
9. Glaucoma: 1 2
i. Physiology o aqueous humour
formation and its circulation
ii. Measurement of IOP
iii. Definition and classification of
Glaucoma
iv. Primary Open angle and closed
angle glaucoma
v. Secondary Glaucoma due to hyper-
mature Cataract and Uveitis
vi. Principles of Medical and Surgical
Management of Glaucoma
10. Vitreo- Retina: 1 2
i. Vitreous haemorrhage
ii. Primary Retinal Detachment
(Common presentation and
principles of Management)
iii. Diabetic retinopathy
iv. Hypertensive retinopathy
v. Retinitis pigmentosa
vi. Retinoblastoma
11. Optic Nerve: 1 1
i. Papilloedema
ii. Optic Neuritis (Papillitis and
Retrobulbar Neuritis)
iii. Optic Atrophy
12. Injuries: - 2
i. Extraocular foreign bodies
ii. Closed globe injuries
iii. Open globe injuries with or without
retained intra ocular foreign bodies
iv. Burns and Chemical Injuries
v. Sympathetic Ophthalmitis
13. Squint and Amblyopia: - 2
Definition
Classification and Principles of
Management
14. Errors of Refraction: 1 2
i. Introduction to Optical System of
Normal Eye
ii. Emetropia
iii. Myopia
iv. Hypermetropia
v. Astigmatism
 vi. Presbyopia
vii. Aphakia
viii. Pseudophakia
ix. Anisometropia
x. Amblyopia
15. Systemic Disease: 1 1
i. Diabetes
ii. Thyroid diseases
iii. Vitamin Deficiencies
iv. Hypertension
v. Leukaemia/ Lymphoma
 SURVIVING OPHTHALMOLOGY
DEALING WITH PROFESSIONAL EXAM
As ophthalmology is a clinical subject, you will only be given clinical scenarios in the exam.
You will be tested on:
➢ Making Differential diagnosis
➢ Making a provisional diagnosis
➢ Investigations
➢ Treatment
You can also be asked about the management of the condition for which you have to write
under the following headings, and don’t write paragraphs, write in points:
• History i.e. symptoms
• Examination i.e. signs
• Investigations
• Treatment
 HOW TO STUDY A TOPIC

While studying any topic, you need to focus on it clinically with following headings in your
mind:
• Definition
• Clinical Features
o Symptoms
o Signs
• Differential diagnosis
• Examination and Investigations
• Treatment
Clinical features will help you in making the differentials and a final diagnosis.
The most important part of any disease is its treatment. You will be asked about it in MCQs,
written exam (in every SEQ), and in viva.

BOOKS TO FOLLOW
• Jatoi (Recommended)
• Ophthalmology book by Dr. Ali Ayaz
This guidance is made following Jatoi.
As you can see from the table of specification, the most important topics/ chapters for written
examination which can cover all of your SEQs, are:
1. Eyelids
2. Lacrimal apparatus
3. Cornea, Conjunctiva, Sclera (A combination of 3 chapters but only 1 SEQ)
4. Uveal Tract
5. Cataract
6. Glaucoma
7. Retina
8. Optic nerve
9. Errors of refraction
10. Systemic diseases
The easiest way to prepare is to:
• Do the Eyelid and Lacrimal Topics as there is 1 SEQ from each i.e. 2 SEQS done
• Next do Lens, Glaucoma and Refraction i.e. 3 SEQS. These are usually clear and easy
scenarios plus they make up about 80% of your viva
• 1 SEQ from uveal tract (usually Ant uveitis) appears nearly every year.
• And 1 SEQ from Optic Nerve is a must. It’s also easy because most of the time there
are only 2 diagnoses so FREE marks!

That’s 7 SEQs until now i.e. 70% of the paper.

The remaining SEQS are:

• 1 from metabolic disorders. It is usually going to be thyroid eye disease, diabetic
retinopathy or CN palsy
• 1 from vitreo-retina
• 1 from conjunctiva, cornea, sclera combined

And that makes up the complete 10.

Following is the detailed guideline for each chapter:
Remember: All the following topics are also important for viva as well.

EYELIDS
For MCQs
• Anatomy and Physiology of eyelids
• Tumors of Eyelids
For Written
For each of following topics, focus on:
Aetiology, Precipitating factors (if any), Symptoms and signs, Complications, Differentials,
Investigations (if any), Treatment (Medical & Surgical)
• Chalazion (VVIMP)
• Hordeolum Externum vs Internum (VVIMP)
• Blepharitis and its types (VVIMP)
• Trichiasis (IMP)
• Entropion and its types (IMP)
• Ectropion and its types (IMP)
• Ptosis and its types (VVIMP)

LACRIMAL SYSTEM
For MCQs
• Anatomy and Physiology of lacrimal system
• Epiphora
For Written
For each of following topics, focus on:
Aetiology, Precipitating factors (if any), Symptoms and signs, Complications, Differentials,
Investigations (if any), Treatment (Medical & Surgical)
• Nasolacrimal duct obstruction (Congenital + Acquired)
• Acute Dacryocystitis
• Chronic Dacryocystitis
• Dacryoadenitis
• Keratoconjunctivitis Sicca (Dry eye)
 CONJUNCTIVA
For MCQs
• Anatomy and Physiology
For Written
• Bacterial Conjunctivitis
• Mucopurulent Conjunctivitis
• Purulent Conjunctivitis
• Membranous Conjunctivitis
• Herpes Simplex Conjunctivitis
• Chlamydial Conjunctivitis
• Trachoma (VVIMP)
• Neonatal Conjunctivitis
• Allergic Conjunctivitis
• Vernal Keratoconjunctivitis (VVIMP)
• Phlyctenular Keratoconjunctivitis
• Pterygium (VVIMP)
• Pseudoterygium (VIMP)
• Pinguecula
• Xerophthalmia (VIMP)

CORNEA
For MCQs
• Anatomy and Physiology
• Keratoplasty and its types
For Written
• Bacterial Keratitis (VVIMP)
• Fungal Keratitis (VVIMP)
• Acanthamoeba keratitis (VVIMP)
• Herpes simplex keratitis
• Herpes Zooster ophthalmicus
For each of above type, focus on
o Aetiology/ Risk factors
o Pathogenesis
o Clinical features
 o Management
o Investigations
o Treatment
o Complications
• Corneal Scarring/ Opacities (VIMP)
o Macula
o Leucoma
o Nebula
o Leucoma adherent
o Ectatic cornea
o Pseudocornea
o Anterior Staphyloma

• Keratoconus (VVIMP)

SCLERA
• Read the chapter
• Episcleritis vs Scleritis (Table)

LENS & CATARACT

Complete chapter is important.
For MCQs
• Anatomy and physiology
• Types of intraocular lens implant

For Written
• Cataract types
✓ On the basis of age
✓ On the basis of location of opacities
✓ On the basis of degree of opacity
✓ On the basis of development
• Congenital Cataract
o Clinical features
o DDs
o Lab investigations
 o Treatment
• Acquired cataract
o Types
o Aetiology
o Senile cataract and its types
o Types of Cortical cataract (VVIMP)
o Clinical features
o Complications (VVIMP)
o Management

• Types of Cataract extraction (VVIMP)

1. ECCE
o Phaco (VVIMP)
o FSL
o Manual small extraction surgery
o Conventional extracapsular cataract extraction (VVIMP)
2. Intracapsular cataract extraction (VVIMP)
Study the details of each type of cataract extraction.
• Complications of cataract surgery (VVIMP)
o Preoperative
o Intraoperative
o Post-operative (Early and late)
o
• Aphakia (VVIMP)
o Causes
o Features
o Methods of correction

• Ectopia Lentis (IMP)

o Aetiology
o Hereditary causes
o Acquired causes
o Clinical features
o Treatment
o Complications

• Types of IOL

GLAUCOMA
Complete chapter is important.
For MCQs
• Anatomy and Physiology
• Classification

For Written
• Diagnostic Procedures
Names only
o Details of Gonioscopy and Fundoscopy (VVIMP)
o Grades of angle on Gonioscopy

• Glaucomatous Visual field defects (IMP)

• Details of each type of glaucoma focussing on (VIMP):
o Risk factors/ Aetiology
o Clinical features
o Investigations
o Treatment
Surgical Procedures to treat glaucoma (IMP)
• Names (Must)
• Just read the details

UVEAL TRACT
For MCQs
• Anatomy and physiology

For Written
• SUN Classification of uveitis (VVIMP)

• Anterior Uveitis (Most Likely the only thing that is going to be asked) (VVIMP)
• Intermediate Uveitis
• Posterior uveitis
• Endophthalmitis (VVIMP)
For each of above topics, focus on:
 o Aetiology
o Clinical features
o Investigations
o Treatment
o Complications

• Endophthalmitis vs Panophthalmitis (IMP)

VITREOUS
• Vitreous Haemorrhage (IMP)
• Vitrectomy

RETINA
For MCQs
• Anatomy and Physiology
For Written
• Diabetic Retinopathy (VVIMP)
o Risk factors
o Pathogenesis
o Conventional Classification of DR
o ETDR Classification
o Diagnosis
o Treatment

• Hypertensive Retinopathy (IMP)

o Clinical features
o Classification
1) Keith- Wegner and Barker classification (1939)
2) Modified Scheie classification (1953)
o Treatment

• Central Retinal Vein occlusion (IMP)

o Aetiology
o Investigations
o Ischemic and Non- CRVO
o Clinical features
 o Treatment

• Central Retinal Artery Occlusion (VVIMP)

o Clinical Features
o Treatment

• Age Related Macular Degeneration (ARMD)

o Risk factors
o Dry ARMD & Wet ARMD
o Clinical features
o Treatment

• Retinal Detachment (VVIMP)

Types; for each type focus on:
o Aetiology
o Clinical features
o Treatment

• Retinitis Pigmentosa (IMP)

o Aetiology
o Classification
o Clinical features
o Diagnosis
o Treatment

• Retinoblastoma (VVIMP)
o Aetiology
o Inheritance
o Clinical features
o Stages of Retinoblastoma
o Diagnosis
o Investigations
o Treatment

OPTIC NERVE
For MCQs
 • Anatomy and Physiology

For Written
• Papilloedema (VVIMP)
o Aetiology
o Clinical features
o Systemic symptoms
o Ocular symptoms
o Ocular signs
o Differential diagnosis
o Assessment
o Examination
o Lab investigations
o Imaging
o Treatment

• Optic Neuritis (VVIMP)

o Aetiology
o Types
o Clinical features of each type
o Investigations
o Treatment

• Optic Neuropathy
o Classification (is enough)

• Optic Atrophy (IMP)

o Optic atrophy types table

VISUAL PATHWAY
Overview of the lesion and the defects they produce (For MCQs)

PUPIL
For MCQs
• Anatomy and Physiology
• Afferent pupillary defect
• RAPD (VVIMP)
• Argyll Robertson pupil
• Horner Syndrome
• Anisocoria

ORBIT
• Thyroid Eye Disease (VVVIMP)
o Risk factors
o Symptoms
o Ocular Signs with their
o Werner Classification
o Investigations
o Treatment

ORBITAL INJURIES
• Classification of Mechanical injuries (Birmingham Eye Trauma Terminology System)
(IMP)
o For each Injury, Focus on:
o Localization
o Removal
o Further Treatment

• Mechanism of damage by blunt trauma (IMP)

• Hyphaemia
o Grading
• Blow- Out fracture (VIMP)

ERRORS OF REFRACTION
Complete chapter is important.
• Ametropia and its types
For Myopia and Hypermetropia, focus on (VVIMP):
 o Aetiological Classification
o Clinical features
o Diagnosis
o Treatment
1. Non-surgical
2. Surgical

• Astigmatism (IMP)
o Its types
o Diagnosis
o Treatment

• Presbyopia (VVIMP)
o Aetiology
o Symptoms
o Treatment

• Anisometropia
o Types
o Treatment

• Aniseikonia
o Treatment

STRABISMUS/ SQUINT
• Anatomy and Physiology
• Binocular Single Vision
o Grades

• Amblyopia (VVIMP)
o Aetiological Types
o Clinical features
o Treatment

• Classification of Squint Types Overview

• Difference between paralytic and Non-paralytic squint (VVIMP)
 • 3rd, 4th and 6th Cranial Nerve Palsy (VVIMP)

DIFFERENTIAL DIAGNOSIS
Important ones are:
• Sudden Painless loss of vision (VIMP)
• Sudden Painful loss of vision (VIMP)
• Gradual Painless loss of vision (VIMP)
• Gradual Painful loss of vision (VIMP)
• Floaters
• Red eye (VIMP)
• Painful red eye (VIMP)
• Circumcorneal congestion
• Shallow anterior chamber (VIMP)
• Deep anterior chamber (VIMP)
• Hypopyon
• Leukocoria (VIMP)
• Miotic pupil
• Mydriatic pupil

TOPICS MUST FROM SALEEM AKHTAR

• Keratoglobus (Ch Cornea pg. 129)

• DD of leukocoria in Children and Adult (Chapter Cataract pg. 168)
• Iris Shadow Test (Chapter Cataract pg. 172)
• After Cataract (Chapter Cataract pg. 175)
• Pre-Op Evaluation esp. Biometry (Chapter Cataract pg. 177)
• Fincham Stenopaeic Test (Chapter Glaucoma pg. 205)
• Aphakia Treatment and Side Effects PAST PPR Q V.IMP (Chapter Cataract pg. 183)
• Stages of Cupping (Chapter Glaucoma (pg. 193)
• Treatment of POAG (Chapter Glaucoma pg. 197)
• Unilateral and Bilateral Disc Edema Cause (Chapter Optic Nerve pg. 278)
• Malingering (Chapter Optic Nerve pg. 277)
• Lenses (Chapter Instruments)