Back Module: S-OV-S2

Visual Pathway

Module information

Module details

Title
Visual Pathway
Type
Specialist
Module code
S-OV-S2
Credits
10
Phase
2
Requirement
Compulsory

Aim of this module

Trainees will be exposed to the various techniques used to assess the visual pathway and how the visual system is appropriately assessed. Trainees will become acquainted with how the eye and visual pathway works and relate this to pathological conditions. They will be involved in ensuring safe effective patient centered care is delivered.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1,5,7 Training activities

Take a full medical and ophthalmic history from  patients

 Type ETA Action View
# 2 Learning outcome 2,4,5,7 Training activities

Perform and document visual acuity test on patients

 Type ETA Action View
# 3 Learning outcome 2,4,5,7 Training activities

Perform and document the following tests on patients:

  • Colour vision
  • Contrast sensitivity
 Type DTA Action View
# 4 Learning outcome 2,4,5,7 Training activities

Perform and document visual field tests

 Type DTA Action View
# 5 Learning outcome 1,5,6,7 Training activities

Assess patients presenting with signs of nystagmus and select the appropriate investigative tests

 Type DTA Action View
# 6 Learning outcome 5,6 Training activities

Assess stereopsis in patients

 Type DTA Action View
# 7 Learning outcome 2,4,5,7 Training activities

Make up trial frame from  prescription

 Type ETA Action View
# 8 Learning outcome 3,5,7 Training activities

Take measurements of intraocular pressure in a patient

 Type DTA Action View
# 9 Learning outcome 5,7 Training activities

Evaluate the use of other psychophysical tests and how they can be applied in the department and feedback to colleagues

 Type DTA Action View
# 10 Learning outcome 1,5 Training activities

Collate and discuss a patient’s diagnostic tests results to determine site of pathology in a visual pathway with a supervisor

 Type DTA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform a visual field test on a patient.
  • Perform a stereopsis test on a patient.
  • Make up a trial frame from interpreting a patient’s prescription.
  • Perform a visual acuity test on a patient.

Observed Clinical Event Titles

  • Explain the reason for a procedure to a patient, checking for understanding.
  • Take a full history from a patient.
  • Explain to a colleague where the visual pathology lies based on diagnostic tests carried out.

Learning outcomes

# Learning outcome
1

Construct an appropriate history and symptoms from a patient to inform management decisions.
2

Apply psychophysical tests to measure visual function, including visual acuity, contrast sensitivity, visual fields and colour vision.
3

Measure intraocular pressure.
4

Simulate a prescription in a trial frame.
5

Employ effective communication with a range of individuals, including the patient and the multidisciplinary team.
6

Perform a range of binocular function tests.
7

Produce clear, concise and accurate documentation in line with local standards and legislation.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Attend an orthoptic clinic to observe how ocular motility is documented.
  2. Attend an optometry clinic.
  3. Attend a biometry clinic.
  4. Observe an ophthalmic surgery clinic e.g. strabismus or cataract.
  5. Attend a low vision/occupational therapy clinic.
  6. Attend a genetic clinic.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Design evidence-based clinical investigation plans for ophthalmic patients using knowledge of the anatomy and physiology of the eye.
  2. Critique academic literature and technical information regarding measurement techniques and pathology to formulate strategies to adopt in clinical practice.

Indicative content

The visual pathway anatomy and physiology will be used to critically reflect on each of the following ophthalmic measurement techniques, how they can be optimised and their relevance to differentially diagnosis of pathological conditions.

  1. (Visual Acuity) Different test techniques, understanding of normal range, consider patient communication/ability/vision and effects of refractive error. Paediatric testing. Common pathology that affects visual acuity.
  2. (Colour) Retina and optic nerve anatomy, physiology and pathology. Causes of colour deficiency. Understanding of normal range.
  3. (Contrast) common conditions that can affect contrast and relation to visual pathway, tests available and normal limits.
  4. (Visual Field) Visual pathway anatomy and physiology. Knowledge of common neurological pathologies and the impact they have on the visual pathway. Testing techniques and relation to common pathology. Adaptions to elderly/paediatrics/deaf etc. Static, kinetic and confrontation. Understanding of normal range.
  5. (Bionocular vision) The oculomotor triad. Tests of binocular vision including stereopsis, along with their advantages and disadvantages and normal range.
  6. (Refraction) Different types of refractive error – myopia, hypermetropia, astigmatism, presbyopia. Different types of lenses and their documentation in a prescription (sphere, cyl, axis, add). Principles of focimetry. Changes with normal ageing i.e. likely to be + in paeds emmetropisation-> presbyopia in elderly.
  7. (Px history) Different common ophthalmic and non-ophthalmic medications and the potential impact on vision. (In paediatrics) the importance and implication of a birth history and appropriate developmental milestones. Different common medical conditions and the potential impact on both the patient as a whole and their vision. Different ophthalmic conditions and the potential impact on vision.
  8. (IOP) Knowledge of the conditions that might cause high/low IOP. The anatomy and physiology behind eye pressure. Consequences on the eye of high/low IOP. Knowledge of tonometry techniques pros/cons etc. Relationship with corneal thickness. Knowledge of different ways of measuring CCT pachymetry, biometry and OCT. Factors influencing intraocular pressure such as corneal thickness.

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS2-2-22 Specialty title Ophthalmic & Vision Science [2022] Action View
Specialty code SPS2-2-23 Specialty title Ophthalmic & Vision Science [2023] Action View
Specialty code SPS2-2-24 Specialty title Ophthalmic & Vision Science [2024] Action View
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