Introduction to Ophthalmic and Vision Science

Module details

Title

Introduction to Ophthalmic and Vision Science

Type

Rotation

Module code

SPS203

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with knowledge, understanding and awareness of the diversity of patients attending ophthalmic and vision science services. Trainees will observe a range of investigations and care pathways used in the management of a wide range of patients experiencing ophthalmic or vision difficulties.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,2,3,4,5	Competency Control infection risks in accordance with departmental protocols.	Action View
# 2	Learning outcome 1,2,3,4,5	Competency Minimise risks and hazards in compliance with health and safety policies.	Action View
# 3	Learning outcome 1,2,3,4,5	Competency Plan investigations for various ophthalmic/vision referrals with supervisor.	Action View
# 4	Learning outcome 1,2,3,4,5	Competency Prepare the environment and lighting level and select the  needed for ophthalmic examination or measurement of: visual acuity Ishihara colour vision ocular or retinal imaging automated static perimetry or confrontational visual field.	Action View
# 5	Learning outcome 1,2	Competency Obtain a full patient history from an adult patient (under supervision).	Action View
# 6	Learning outcome 1,2,3	Competency Explain to an volunteer adult subject the procedure for: visual acuity measurement Ishihara colour vision assessment automated static perimetry or confrontational visual field.	Action View
# 7	Learning outcome 1,2,3,4	Competency Gain informed consent from a volunteer adult subject to: Perform LogMAR visual acuity Perform Ishihara colour vision assessment take and store an ocular image visual field or a confrontational field.	Action View
# 8	Learning outcome 1,2,3,4,5	Competency Perform on a volunteer adult LogMAR visual acuity with and without spectacles Ishihara colour vision test an automated static visual field or a confrontational field. Examine: normal ocular and retinal images normal ERG traces.	Action View
# 9	Learning outcome 1	Competency Write acuity measures using correct notation. Compare with UK car driving standard.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Perform a visual acuity and colour assessment	DOPS
Guide and assist patients with vision impairment	DOPS
Obtain a detailed patient history and suggest an initial management strategy	OCE

Learning outcomes

1. Measure visual acuity using a LogMAR chart for adult subjects.
2. Perform an Ishihara colour vision assessment on an adult subject.
3. Perform an automated static perimetry or confrontation visual field on an adult subject.
4. Label the main peaks of a normal electroretinogram (ERG).
5. Identify the landmarks of the eye and fundus in different imaging modalities.

Learning outcomes

1. Describe, compare and contrast a range of methods and ophthalmic equipment used for the routine psychophysical assessment of patients’ vision.
2. Describe the principles and equipment used for imaging and measurement of eye and ocular adnexae.
3. Assess the principles and methods used for the electrophysiological assessment of patients’ vision.
4. Discuss and evaluate patient special needs and circumstances as applied to ophthalmic and vision services, such as people with learning difficulties, cognitive and sensory impairment, physical disabilities, older people, paediatrics and intensive care.
5. Describes the ways that non-NHS or external statutory, voluntary, charitable agency services in the community can assist with patient care in ophthalmic and vision services, i.e. social services.

Indicative content

• Routine test procedures and equipment used in the ophthalmic clinic for assessment of visual acuity, colour vision, visual field and refractive error
• Clinical presentation, assessment, routine examination and management of common ophthalmic disorders
• Clinical indications for and common methods of imaging and measurement of the eye and ocular adnexae with light, laser and ultrasound
• Basic methods for assessment of refractive error of the eye Basic methods for assessment of binocular function
• Modifications of assessment strategies and techniques according to patient age and any disabilities
• Clinical indications for and methods used to assess electrophysiology of vision
• The diversity of ophthalmic and vision services; special needs; people with learning difficulties, cognitive and sensory impairment, physical disabilities, older people, paediatrics, intensive care
• Statutory, voluntary, charitable agencies or services, e.g. social services

Activities

• Observe the work of those offering support to patients with visual This may be in the community, with non-NHS or external statutory, voluntary, charitable agencies, or in an NHS low visual aid and rehabilitation clinic, or with counsellor or liaison workers. The trainee will reflect on their role in the management of patients who experience visual impairment. Or, with permission, they will spend a day with a person with visual impairment to observe some methods for vision rehabilitation and discuss the advantages and disadvantages of optical and electronic aids, mobility training and daily living skills with them.
• Observe history taking and clinical examinations in patients with signs and symptoms of ophthalmic/vision disorders and diseases. Consider with your training officer the application of different clinical approaches and strategies that depend on clinical reasoning, innovative approaches to complex situations and the differing priorities of a given situation.
• Attend paediatric outpatient clinics and observe the processes of ophthalmic history taking in children and reflect on the differences in history taking between adults and children.
• Attend paediatric clinics and observe the assessment of visual acuity in preverbal and pre-literate children and the methods used to assess disorders of binocular vision. Reflect on the experience and consider the differences between adults and children.
• Observe a range of ocular imaging and measurement modalities used to assess ophthalmic diseases. These include retinal photography, optical coherence tomography (OCT) imaging and autofluorescence, biometry (low coherence interferometry), ultrasound, perimetry and visual electrophysiology, including electroretinography and visual evoked potentials. Critically evaluate how these investigations contribute to the diagnosis, management and care of patients. Reflect on how they are adapted to meet the needs of people with disabilities within a typical care pathway.
• Observe fundus fluorescein angiography (and indocyanin green angiography if available), and discuss with your training officer the indications, procedure, blood flow through the eye and how the procedure can aid the diagnosis of ocular disease.