Optometry Examining Board of Canada
SAMPLE CASE Presbyopia Management (AVAILABLE AT WWW.OEBC.CA)
The following is a sample case for the OEBC OSCE that
is published on the OEBC website.
OPTOMETRY OSCE – INTERACTIVE CASE
CASE BACKGROUND
INFORMATION
Case Name
Case Type
Issue
Practice Areas
Competency(ies)
Objective(s)
Type of Encounter
Setting
Presbyopia Management
Interactive
Presbyopia requiring a prescription for progressive glasses
(primary practice area marked *; other areas are secondary)
Communication
Patient Centred Care
Diagnosis and Planning
*Patient Management
Select communication style appropriate to situation
Establish a shared decision making process with the patient
Engage in dialogue with patient to bring about understanding , acceptance
and cooperation
Formulate a management plan
1. Explain the diagnosis of presbyopia
2. Explain the treatment options
3.Recommend progressive lenses
New patient
Optometry Clinic
REFERENCES
Mo Jalie, Opthalmic Lenses and Dispensing ( 3rd Ed.) 2008 page 169 176-178
CASE SYNOPSIS & DESCRIPTION
SYNOPSIS
This 48 year old patient with successful laser refractive surgery at age 35 is now presbyopic requiring
progressive addition lenses.
DESCRIPTION OF THE CONDITION
Successful laser vision correction results in normal vision for distance for a myopic (nearsighted)
person. Presbyopia is the loss of elasticity of the intraocular lens. Symptoms start in the early 40s and
progress through the early 60s. Focusing at near becomes more delayed as age increases.
Progressive lenses correct for this error by allowing the wearer dynamic vision at all distances and
preventing fluctuation when vision is transferred from one distance to another. Progressive addition
lenses have the appearance of single vision lenses with no dividing lines on the lens.
PROPERTY OF OEBC
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Optometry Examining Board of Canada
SAMPLE CASE Presbyopia Management (AVAILABLE AT WWW.OEBC.CA)
Instructions for Candidate
You are an optometrist working in a private clinic.
You have just completed an eye examination for Alison Lee, age 48. She
is a new patient to your clinic.
Explain your diagnosis and treatment plan
You have 8 minutes to complete this task.
Equipment and Props Supplied
Summary of Patient Exam Record
PROPERTY OF OEBC
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Optometry Examining Board of Canada
SAMPLE CASE Presbyopia Management (AVAILABLE AT WWW.OEBC.CA)
Summary of Patient Exam Record
Patient Name
Gender
Age
Occupation
Hobbies
Chief Complaint
Additional History
Ocular History
Medical History
Family History
Clinical Data
Alison Lee
Female
48
Hospital emergency care nurse
More difficult seeing fine print. Eyes are tired at end of the
day. Having a hard time entering data on the computer
and focusing down the hall.
Working 12 hour shifts at the hospital.
At night, small print is worse. Likes to do crafts.
Successful refractive laser surgery at age 35 to treat
myopia. Last eye exam was 5 years ago and the
optometrist told her at some point to get magnifiers but
never got them.
None
Parents wear spectacles full time
OD none
Current Spectacles OS none
OU
OD
Unaided Visual Acuity
OS
OD +0.00/-0.50x090 Add 2.00
Subjective Refraction
OS -0.25 Add 2.00
Binocular Vision Normal
Colour Vision OD normal
Ishihara Plates OS normal
OD 12 mmHg
Tonometry
OS 10 mmHg
Pupils PERRLA
Slit Lamp Examination Unremarkable
Fundus Examination Unremarkable
Diagnosis Presbyopia
PROPERTY OF OEBC
6/
6/
6/7.5
6/7.5
6/6
6/6
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Optometry Examining Board of Canada
SAMPLE CASE Presbyopia Management (AVAILABLE AT WWW.OEBC.CA)
SP PROFILE
Standardized Patients (SPs) receive a profile that outlines
 Demographics of the patient
 Appearance, behaviour and starting position
 Details of the chief complaint (and any secondary complaints)
 Relevant ocular, medical and social history
 Signs and/or symptoms to portray
 Statements or questions to use at the beginning of the interaction, in response to the
candidate, or to prompt the candidate if necessary
SPs may use make up or other props to present features of the case. In situations where the
SP is unable to portray a specific sign or symptom a photograph may be used, or the examiner
may provide the information when specific conditions are met.
PROPS AND EQUIPMENT
On the Station
(Exam Room)
Door
Inside the
Station (Exam
Room)
1. Instructions for Candidate
2. Summary of Patient Exam Record
1.
2.
3.
4.
5.
6.
7.
8.
PROPERTY OF OEBC
Instructions for Candidate
Summary of Patient Exam Record
Chair for Examiner
Chair for Candidate
Chair for SP
Blank paper
Clipboard
Pen
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Optometry Examining Board of Canada
SAMPLE CASE Presbyopia Management (AVAILABLE AT WWW.OEBC.CA)
How a candidate is evaluated
As a candidate, you will be evaluated on:



Your communication skills in the areas of empathy, coherence, verbal expression and
non-verbal expression.
The outcome for the patient; that is, whether the examiner determines that you have
solved the patient problem (Problem Solved), marginally solved the patient problem
(Marginal Solved), possibly solved the patient problem (Uncertain), or not solved the
patient problem (Unsolved).
Your overall performance in the station with reference to the thoroughness, depth and
quality of the interaction, accuracy of information provided, and absence responses
that could place the patient at risk.
Communication Skills will be assessed in the interactive stations using a Global Rating
Scale. Four Communication domains (areas) will evaluated and will include Response to
Patient’s Feelings and Needs, Degree of Coherence and organization in the interview, Verbal
Expression which includes the appropriate level of vocabulary to ensure patient
understanding, and Non-Verbal expression which includes establishing eye contact with the
patient.
PROPERTY OF OEBC
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