The Fellowship of the Royal College of Physicians and Surgeons of Glasgow (FRCS Glasgow) in Ophthalmology is one of the most internationally recognised postgraduate qualifications for ophthalmologists. Among its most challenging components is the Part 3 Oral (Viva/OSCE) Examination, which evaluates real-world clinical judgement, diagnostic decision-making, and the ability to manage ophthalmic conditions safely and logically.
For many candidates—especially international ophthalmologists working outside the UK—understanding the structure, expectations, and high-yield topics of the FRCS Glasgow Oral is essential for effective preparation.
This guide provides a comprehensive breakdown of the viva format, marking criteria, examiner expectations, and the most frequently tested clinical areas.
For the latest examination regulations and updates, visit the official Royal College of Physicians and Surgeons of Glasgow website.
The FRCS Ophthalmology examination consists of multiple parts, culminating in the Part 3 Viva/Objective Structured Clinical Examination (OSCE).
The Viva focuses on:
• Clinical judgement
• Safe decision-making
• Interpretation of investigation findings
• Application of ophthalmic knowledge to real clinical scenarios
• Communication clarity and professionalism
The oral exam is designed to reflect practical, everyday situations encountered by ophthalmologists, rather than obscure details or rare diseases.
The FRCS Glasgow Part 3 comprises two sections and candidates sit both sections of the examination at each attempt: (i) the structured oral exam and (ii) the OSCE.
The structured oral consists of 3 x 20-minute stations (2 examiners per station) on the following subjects:
• Lids, Oculoplastics and Anterior Segment
• Posterior Segment
• Neurology, Motility and General Medicine
The OSCE consists of 4 x 12-minute stations on four main themes (each theme in 1 room with typically 2-3 patients):
• Anterior Segment Disorders
• Posterior Segment Disorders
• Neuro-ophthalmic and Ocular Motility Disorders
• Oculoplastic and Lid Disorders
Examiners use structured criteria:
• Clinical reasoning and decision-making
• Diagnostic accuracy
• Prioritisation and safety considerations
• Evidence-based management
• Communication clarity
• Professional attitude
Marks are awarded across categories such as:
• Clear Pass
• Pass
• Borderline
• Fail
• Clear Fail
Candidates who demonstrate safe clinical practice, systematic approach, and logical decision-making consistently pass.
While the viva can cover the entire scope of ophthalmology, certain topics appear very frequently.
Below is a curated guide to the most tested conditions and discussion points.
Commonly Asked Conditions:
• Keratoconus
• Dry eye disease
• Infective keratitis (bacterial, viral, fungal)
• Corneal ulcer vs abrasion
• Pterygium
• Chemical injuries
High-Yield Competencies:
• Recognizing red flags
• Emergency management pathways
• Indications for corneal cross-linking
• Interpreting corneal topography
Frequently Examined Areas:
• Cataract classification & surgical indications
• IOL calculation principles
• Complications (PCR, CME, endophthalmitis)
• Paediatric cataract red flags
• Premium IOL considerations
Key Knowledge Points:
• Pre-operative assessment
• Consent and risk communication
• Post-operative complication management
High-Yield Topics:
• Open-angle vs angle-closure
• Gonioscopy interpretation
• Optic disc assessment
• Visual field interpretation
• Medication classes & side-effects
• Laser procedures (SLT, iridotomy)
Candidates must demonstrate risk stratification and long-term monitoring strategies.
Most Tested Conditions:
• Diabetic retinopathy
• Age-related macular degeneration
• Retinal vein occlusion
• Retinal detachment warning signs
• Hypertensive retinopathy
Core Skills:
• OCT interpretation
• Anti-VEGF treatment decisions
• Urgency categorisation
A challenging but frequently examined domain.
High-Yield Cases:
• Optic neuritis
• Papilloedema
• Cranial nerve palsies
• Visual field defects
• Pupillary abnormalities
Candidates must confidently integrate systemic neurological perspectives.
Often included to test safe management of vulnerable populations.
Common Topics:
• Amblyopia
• Strabismus assessment
• Pediatric cataract
• Retinoblastoma red flags
• Congenital glaucoma
Emphasis is on early identification and urgent referral when needed.
One of the most important areas due to safety implications.
High-Yield Scenarios:
• Open-globe injury
• Chemical burns
• Orbital cellulitis
• Blowout fractures
• Hyphema
• Sudden vision loss
Candidates must show:
• Correct triage
• Immediate stabilization measures
• Clear referral pathways
Follow a clinically safe approach:
History → Examination → Investigations → Management → Red Flags → Follow-up
Examiners appreciate clarity and structure.
The viva is heavily image-based. Use reputable sources such as:
• American Academy of Ophthalmology – EyeWiki
• Royal College educational resources
• Clinical atlases & standard textbooks
Always articulate:
• What must be ruled out urgently
• When you would refer
• What action is needed immediately
Safety scores are heavily weighted.
Mock viva practice enhances:
• Confidence
• Speed
• Clarity
• Ability to articulate structured responses
Using clinical scenarios is more effective than rote theory memorisation.
Here are widely used references for FRCS (Glasgow) Ophthalmology:
• Kanski’s Clinical Ophthalmology
• Ophthalmology: Expert Consult by Yanoff & Duker
• Clinical Ophthalmology: A Systematic Approach
• Oxford Handbook of Ophthalmology
• Practical Ophthalmology by American Academy of Ophthalmology
• EyeWiki
• Royal College of Physicians and Surgeons of Glasgow
• NICE Clinical Guidelines
There is a limit on attempts; candidates should confirm the latest rules through the RCPSG website, as regulations may change.
The difficulty varies by candidate, but the viva is more unpredictable because it relies on examiner questioning, images, and real-time reasoning.
Most candidates complete all parts within 1–2 years, depending on scheduling availability and preparation pace.
No. Many international candidates pass the viva successfully without UK training, provided they prepare systematically.
Yes. Examiners frequently test OCT images, optic nerve analysis, and field defects.
A significant portion of the viva is based on clinical images.
Yes, although structured mock viva practice significantly improves performance and confidence.
Royal College of Physicians and Surgeons of Glasgow (FRCS Exams)
https://rcpsg.ac.uk/exams/exams/ophthalmology
EyeWiki – American Academy of Ophthalmology (Clinical Images & Reviews)
https://eyewiki.org
AAO – Image Library
https://www.aao.org/image-library
NICE Clinical Guidelines – Ophthalmology
https://www.nice.org.uk/guidance/conditions-and-diseases/eye-conditions
Neuro-Ophthalmology (EyeWiki Category)
https://eyewiki.org/Neuro-Ophthalmology
Retina (EyeWiki Category)
https://eyewiki.org/Category:Retina
Ocular Trauma – Clinical Reference
https://eyewiki.org/Ocular_Trauma
Cataract Surgery – EyeWiki
https://eyewiki.org/Cataract_Surgery
Glaucoma – EyeWiki Overview
https://eyewiki.org/Glaucoma
