Paediatrics in Ophthalmic and Vision Science

Details

Title

Paediatrics in Ophthalmic and Vision Science

Type

Stage One

Module code

HPS232

Requirement

Compulsory

Module objective

By the end of this module the Clinical Scientist in HSST, with respect to paediatric practice, will be able to analyse, synthesise, evaluate and apply their knowledge, perform and adjust a range of technical procedures and clinical skills and demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, synthesise, critically evaluate and apply their expert knowledge with respect to the design, application and interpretation of examinations and findings in infants and children of all ages presenting with a range of ophthalmic conditions that occur in isolation or as part of systemic conditions.

This will include expert understanding of all disciplines of OVS applied to a developing and maturing visual system, including an expert understanding of:

• normal ocular, visual pathway and CNS embryology, development and maturation;
• the vulnerability and developmental consequences of insult during specific periods of gestation;
• the sensitive periods of visual development and the development of amblyopia and abnormal binocular function;
• the impact of prenatal, birth, prematurity, perinatal events, and post-natal events, and the features and factors amenable to treatment or intervention to ameliorate harm to the visual system;
• genetic eye and visual pathway disorders: developmental control genes and specific ocular conditions and how these will manifest in early life;
• visual milestones;
• the range and test dependence of normative data for different age groups from infancy to adulthood of psychophysical, electrophysiological and imaging techniques;
• trajectory and statistical treatment of normative data;
• general developmental milestones, the interplay and dependence of vision on achieving these, and the impact of multiple sensory defects, e.g. deaf blind;
• the design of age-appropriate approaches, communication though play and demonstration to achieve optimal results;
• role of HSST in both national and local pathways to ensure the child is foremost and always protected;
• parental consent;
• clinical governance and networks of reporting if concerned about a child;
• the Health and Social Care Act 2012;
• the role of the Royal College of Ophthalmologists (RCOphth) and Royal College of Paediatrics and Child Health (RCPCH) in drafting guidelines of clinical practice, e.g. non-accidental injury (NAI) and retinopathy of prematurity (ROP);trajectory and statistical treatment of normative data;
• the Children and Young People’s Health Outcomes Forum Working Together to Safeguard Children March 2013.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST, with respect to ophthalmic and visual pathway disorders in children with ocular +/– other neurological, metabolic, genetic, or systemic condition, will be able to demonstrate a critical understanding of current research and its application to the performance and mastery of the following technical skills:

• select the appropriate test of choice;
• perform the pertinent tests (which may include electrophysiology, imaging, or psychophysics) adapted for the age of the young patient;
• modify, design and develop new tests changing the method of measurement according to task, need and clinical condition.

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 encourage and communicate effectively with young patients, relevant clinicians, patients and the public, and other healthcare professionals, and will:

• take a comprehensive history, understanding the nature of the visual complaint and expressing this in terms of reference to the development of the visual system and the differential diagnosis;
• analyse and integrate all OVS and other developmental data;
• interpret these results taking into account history and clinical examination;
• produce a clear and informative report with recommendations for further investigation and/or treatments;
• where appropriate, communicate with patient’s carers and families the implications of the findings
• within the context of a multidisciplinary team meeting (MDT) advise on the best course of management, including recommendation for stimulation-supported learning; draw attention to available research studies such as stem cell or photoreceptor replacement programmes, gene studies looking at ocular and systemic disease;
• reflect critically on the challenges of applying research to practice in relation to children in these areas of practice and suggest improvements, building on a critique of available evidence;
• take a kind, child-friendly and holistic approach in making and explaining possible and confirmed diagnoses to the child and family;
• strive to adapt current, and develop novel, tests to best describe and capture a patient’s visual impairment;
• reflect critically on the impact that these ophthalmic disorders in children have on general development, learning and the everyday quality of life for the child and family, and the strategies and agencies available to provide support and help to maximise a child’s potential.