Free Part 2 FRCOphth Written Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Part 2 FRCOphth Written Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A patient with a retinal vein occlusion is returning after treatment for macular oedema. Which investigation best documents the oedema and its structural response to treatment?

   1. A.Optical coherence tomographyCorrect answer: A
   2. B.Fundus autofluorescence imaging
   3. C.Ultrasound biomicroscopy
   4. D.Corneal topographic mapping

   Explanation: The RCOphth guideline states: "OCT is recommended in the diagnosis, monitoring and assessing treatment response of macular oedema secondary to RVO." OCT measures the macular changes relevant to this follow-up; the other tests do not provide the required assessment of macular oedema.

   Reference: RCOphth Retinal Vein Occlusion guideline: executive summary — page 4, Retinal imaging in RVO

2. 2An acute angle-closure presentation is found to have a secondary retrolenticular mechanism, rather than pupil block. Which initial pupil-directed treatment is appropriate?

   1. A.Topical pilocarpine
   2. B.Topical cyclopentolateCorrect answer: B
   3. C.Topical timolol
   4. D.Topical dorzolamide

   Explanation: The College distinguishes secondary lenticular/retrolenticular mechanisms from pupil block. Cyclopentolate provides cycloplegia and mydriasis; pilocarpine can aggravate this mechanism. Timolol and dorzolamide lower pressure but do not provide the requested pupil-directed treatment. The source states: "These cases should be treated with mydriasis and not pilocarpine."

   Reference: RCOphth The Management of Angle-Closure Glaucoma — page 23, Practice point

3. 3Under the RCOphth intravitreal-injection guidance, what is the minimum distance behind the limbus within the recommended entry range for a phakic eye?

   1. A.2.5 mm
   2. B.3.0 mm
   3. C.3.5 mmCorrect answer: C
   4. D.4.0 mm

   Explanation: The phakic range starts at 3.5 mm. The question asks for its minimum, so 4.0 mm being within the range does not make it another correct minimum. The guidance states: "3.5-4.0 mm in phakic patients"

   Reference: RCOphth Intravitreal Injection Therapy — page 7, section 9

4. 4At the end of routine cataract surgery, the surgeon follows ESCRS recommendations for antibiotic prophylaxis against endophthalmitis. Which administration route is recommended?

   1. A.Subconjunctival injection
   2. B.Intracameral injectionCorrect answer: B
   3. C.Intravitreal injection
   4. D.Peribulbar injection

   Explanation: Intracameral administration is the recommended route. The other routes are real ophthalmic injection routes but do not implement this routine cataract prophylaxis recommendation. The source states: "An intracameral injection should be used (e.g. cefuroxime 1 mg in 0.1 ml.) at the end of the cataract surgery to lower the risk for postoperative endophthalmitis."

   Reference: ESCRS Recommendations for Cataract Surgery — section 4.4.4

5. 5An ophthalmologist in England advises a family about entry to routine NHS diabetic eye screening. What is the programme's minimum age for a child with diabetes?

   1. A.8 years
   2. B.10 years
   3. C.12 yearsCorrect answer: C
   4. D.16 years

   Explanation: The national programme in England starts at 12 years. This does not restrict clinically indicated eye assessment at a younger age. The source states: "Everyone with diabetes who is 12 years old or over is invited for eye screening."

   Reference: NHS England: Diabetic eye screening programme overview — Target population — applies to England

6. 6An ophthalmologist describes regular corneal astigmatism as with-the-rule. Which meridian is relatively steeper, expressed in the usual 0–180-degree convention?

   1. A.45 degrees
   2. B.90 degreesCorrect answer: B
   3. C.135 degrees
   4. D.180 degrees

   Explanation: The vertical meridian is 90 degrees. The AAO definition is "Steepening along the vertical meridian". The 180-degree meridian is horizontal, while 45 and 135 degrees are oblique.

   Reference: American Academy of Ophthalmology: How to Read Corneal Topography — With-the-Rule Astigmatism

7. 7A consultant starts a substantially different ophthalmic role in a new organisation. The employer offers a structured mentoring scheme. Which approach follows GMC advice for this transition?

   1. A.Join only after an adverse event establishes a need
   2. B.Join only when a regulator makes participation mandatory
   3. C.Be willing to participate during the change of roleCorrect answer: C
   4. D.Defer participation until the next revalidation decision

   Explanation: GMC advice applies on joining or significant role change: "you should be willing to find and take part in structured support opportunities". A mentoring scheme does not require an adverse event, a regulatory direction, or waiting for revalidation.

   Reference: General Medical Council: Good medical practice — Paragraph 12

8. 8An ophthalmologist suspects peripheral anterior synechiae in an eye with angle-closure disease. Which examination is required to assess the angle directly rather than relying on supplementary imaging?

   1. A.Keratometry
   2. B.GonioscopyCorrect answer: B
   3. C.Pachymetry
   4. D.Retinoscopy

   Explanation: The College states: "Gonioscopy remains the definitive examination for diagnosis and monitoring of angle-closure disease." Anterior-segment OCT supplements this examination but cannot replace it for detection of peripheral anterior synechiae. The other options assess corneal curvature, corneal thickness or refraction.

   Reference: RCOphth The Management of Angle-Closure Glaucoma — page 14, Practice point

9. 9A patient develops atypical bilateral angle closure with supraciliary effusions. Which medication history is particularly important to seek because it may explain this mechanism?

   1. A.Latanoprost
   2. B.Tropicamide
   3. C.TopiramateCorrect answer: C
   4. D.Dexamethasone

   Explanation: Topiramate may cause supraciliary effusions and anterior rotation of the ciliary body. The other drugs can affect ocular pressure or pupils through different mechanisms but do not best explain this presentation. The source states: "use of topiramate should be routinely sought on direct questioning in suspected cases of atypical angle-closure."

   Reference: RCOphth The Management of Angle-Closure Glaucoma — page 20, acute angle-closure crisis

10. 10During a standard intravitreal injection, where should the needle tip be directed after perpendicular scleral entry to avoid contact with the posterior lens?

    1. A.Towards the anterior chamber angle
    2. B.Towards the ciliary sulcus
    3. C.Towards the posterior lens capsule
    4. D.Towards the centre of the globeCorrect answer: D

    Explanation: The central trajectory reduces the risk of touching the lens. The other directions aim anteriorly towards structures that should not be the target of this injection. The guidance states: "the needle is inserted perpendicular through sclera with the tip aimed towards the centre of the globe"

    Reference: RCOphth Intravitreal Injection Therapy — page 8, section 9