Electrophysiology in Disorders of the Visual System

Details

Title

Electrophysiology in Disorders of the Visual System

Type

Stage One

Module code

HPS227

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST, in respect to visual electrophysiology, will be able to perform, analyse, interpret and provide comprehensive diagnostic reports on electrophysiological recordings. They will be able to use electroretinography (ERG), pattern electroretinography (PERG) and multifocal electroretinography (mfERG) to assess the function of different retinal cell types and layers; to distinguish between generalised retinal dysfunction and localised macular dysfunction; to separate the function of the retinal rod system and the cone system; to distinguish between disease affecting the photoreceptor layer and inner retinal disease. They will be able to use the electro-oculogram (EOG) to assess the generalised function of the retinal pigment epithelium. They will be able to interpret visual evoked potentials (VEP) and be aware of the need to take confounding factors, such as nystagmus, media opacity, etc., into account. They will be able, using PERG and/or mfERG in conjunction with the VEP, to distinguish between post-retinal dysfunction and more anterior disturbances of vision. The Clinical Scientist in HSST will also be able to formulate an appropriate plan for investigation and management, in conjunction with medical colleagues, being aware of the need to expedite investigation in suspected serious disease.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, interpret and report, using their expert knowledge with respect to the:

• the physiological origins of the International Society for Clinical Electrophysiology of Vision (ISCEV) Standard ERGs;
• the separation of rod and cone system function with ERG;
• recognition of normal and abnormal electrophysiological waveforms;
• identification of the causes of abnormal electrophysiological results;
• the limitations of the ISCEV Standard ERGs;
• formulation of the differential diagnosis of the causes of abnormal electrophysiological results;
• appropriate disease pathophysiology.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical and communication skills and will:

• take a thorough, relevant and focused history;
• plan appropriate visual electrophysiological investigations using specified protocols;
• interpret visual electrophysiology and relate normal and abnormal results to the symptoms, signs, family history, medical history, inheritance pattern, etc.;
• integrate the electrophysiological results with relevant imaging and/or psychophysical studies;
• advise and communicate effectively with patients, relevant clinicians, patients and the public, and other healthcare professionals.