FRCOphth Part 2 Written Urgent Eye Care & Trauma

Work through the acute presentations rather than the diseases. Sudden painless visual loss brings in retinal arterial and venous occlusion, giant cell arteritis, retinal detachment and vitreous haemorrhage. Sudden painful loss brings in acute angle closure, endophthalmitis and optic neuritis. The red eye needs a triage approach rather than a list. For trauma, cover chemical injury and its grading, open globe injury and intraocular foreign body, orbital compartment syndrome, traumatic hyphaema and the risk of rebleeding, commotio retinae, traumatic optic neuropathy, orbital fractures including the white-eyed blowout in children, and sympathetic ophthalmia. Postoperative and post-injection endophthalmitis belongs here as well as in the subspecialty domains.

Most stems in this domain are sequencing questions in disguise. They are asking what you do first, not what the diagnosis is, and the diagnosis is often stated in the stem. Chemical injury, orbital compartment syndrome and giant cell arteritis all recur precisely because the correct first action comes before confirmation rather than after it. Reading these questions as diagnostic puzzles is the single most common way to lose marks here.

Build fixed sequences and then drill them until they survive time pressure. For each time-critical presentation, know the first action, and know it separately from the full workup. Work mixed sets rather than sets by topic, because the exam gives you an undifferentiated presentation and the sorting is part of the question. Use the referenced explanations to confirm the ordering rather than just the endpoint, and revisit anything where you knew the right answer but arrived at it slowly. Slow is a fail in this domain.