SCA practice case · Telephone consultation
“My newborn’s eye is gunky — it’s just a blocked tear duct, isn’t it?”
Telephone consultation
Child patient
Someone else speaking
Typical
Children & young peopleUrgent & unscheduled careGender, reproductive & sexual health
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Kai (mother on the phone) · 12 days · male
Setting
Telephone — mother of a newborn with a sticky eye.
Past history
- Newborn — nothing recorded yet
- Newborn check not yet on the GP record
Medication
- None
Allergies
NKDA
Recent notes
⚠ Reception note: “Mum says baby’s eye is gunky and a bit swollen — grandma says blocked tear duct. Wants advice.” Telephone slot.
Reason for contact
Telephone advice about a sticky eye. “I don’t want to overreact.”
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
A sticky eye in a newborn is usually a benign blocked nasolacrimal duct / mild sticky eye (managed with cleaning and lacrimal-sac massage, resolving by ~12 months) — but the key task is to TRIAGE for OPHTHALMIA NEONATORUM (conjunctivitis in the first ~28 days). COPIOUS PURULENT discharge with marked LID SWELLING/redness (as here) is NOT a simple blocked duct and needs urgent assessment, swabs and treatment. GONOCOCCAL ophthalmia (the hyperacute picture; onset timing alone does not identify it) is hyperacute and SIGHT-THREATENING — a same-day emergency needing ophthalmology/paediatric assessment and systemic treatment; CHLAMYDIAL (now the commonest cause; onset timing alone does not identify it) is usually less acute but needs systemic treatment and signals a maternal STI. Take conjunctival swabs (including gonococcus/chlamydia), and handle the maternal-infection implication sensitively, confidentially and without blame (maternal/partner sexual-health follow-up). The examinable hidden agenda is family-reassurance minimisation ("just a blocked duct, don’t want to overreact") and possible STI-related shame; validate the family wisdom for the common case but act on the red flags here, arrange urgent assessment, and support an anxious new mother without blame or panic.
The guidance behind it
Similar SCA cases
gpreasoning.uk is not affiliated with or endorsed by the RCGP. Our cases are original teaching material written for practice; none is an exam recall. For anything official about the SCA, check the RCGP SCA pages.