Duke Elder Neuro-ophthalmology & Paediatrics

The afferent side comes first: the visual pathway from retina to cortex, and the field defect each lesion along it produces. Get that mapping solid, because it converts directly into marks. Then the pupil, covering the light and near reflexes, the relative afferent pupillary defect, Horner syndrome and a third nerve palsy with a fixed dilated pupil. Then the optic nerve, with optic neuritis, papilloedema, idiopathic intracranial hypertension and giant cell arteritis. Then the efferent side, meaning the third, fourth and sixth nerve palsies and what each one looks like, plus a basic grasp of nystagmus.

Cover visual development and amblyopia, and why the timing of treatment matters. Then strabismus, meaning the difference between a latent and a manifest squint, the cover test, and the broad division into concomitant and incomitant deviations. Then the childhood conditions that appear repeatedly: leukocoria and the retinoblastoma it must not be, congenital cataract, retinopathy of prematurity and why premature babies are screened, and congenital nasolacrimal duct obstruction as the common benign cause of a watering infant eye.

For neuro-ophthalmology, draw the visual pathway from memory and mark the defect at each level, then test yourself with localisation questions until the pattern arrives before you have finished reading the stem. For paediatrics, learn the conditions by presenting sign, because that is how the questions frame them, and leukocoria in particular. Both topics respond well to short repeated sessions rather than one long push, since they are pattern recognition more than they are content.