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STATE OF LIBYA

MINISTRY OF HIGHER EDUCATION

UNIVERSITY OF BENGHAZI

FACULTY OF MEDICINE

Department of Ophthalmology

Course specifications: Ophthalmology

M.B.B.Ch., fourth year, 2016-2017

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Basic information

Course title: Ophthalmology.

Course code: OPH.

Course duration: 4 weeks.

Department offering the course: Ophthalmology department.

Program on which this course is given: M.B.B.Ch.

Academic year/ Level: 4th

year of M.B.B.Ch. program

Academic year in which the course is given: 2016-2017.

Date of specifications /revision: 2017.

Date of approval by departmental/faculty council: / /2017

Teaching language: English

Contact teaching hours: 96 hrs.

Theoretical: 26 hrs.

Practical & tutorials: = 70 hrs. (30 sessions)

Head of department & course director: Prof. Abdelsalam A. Geilani

Authors: Dr. Samar A. Bukhatwa and Dr. Naeima M. Elzlitni

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Over all aims of the course

• The ability to properly deal with the patient’s eye.

• The ability to diagnose and manage common ophthalmic diseases.

• The ability of first aid management of ocular emergencies.

• Provide ability of preventive measures to common ophthalmic

diseases.

• Ability of self-learning, interpretation of diseases of common

ophthalmological problem.

Intended learning outcomes (ILOs)

a) Knowledge and Understanding

a1 Describe the structure and the function of each part of the eye.

a2 List kinds and describe steps of clinical examination of the eye.

a3 Describe clinical features, differential diagnosis and complications

of common eye diseases.

a4 Explain the principles of management of the common eye diseases.

a5 Identify of the main ageing eye changes.

a6 Describe basic principles of primary health services regarding

prevention, screening, early detection and control of common ocular

problems.

b) Intellectual Skills

b1 Application of clinical skills including: History taking, physical

examination, diagnosis and differential diagnosis of common eye

diseases.

b2 Relate ocular manifestations to their specific systemic diseases.

b3 Competence to investigate a patient with common ocular diseases,

emergency and vision threatening conditions.

b4 Use problem solving skills in a variety of ophthalmic diseases.

b5 Competence in health promotion and ophthalmological diseases

prevention.

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c) Practical and professional skills.

c1 Measure visual acuity.

c2 Test visual field.

c3 Test ocular motility.

c4 Perform examination of adenexa of the eye.

c5 Examine pupillary light reflex.

c6 Examine anterior segment of the eye.

c7 Competence in skills of communication with patients, patients

relative and other members in the health care team.

c8 Practice basics of health and patient’s safety in all procedures during

practical and clinical years.

c9 Simulate first aid measure for ocular emergencies and trauma.

d) General and transferable skills

d1 Understanding the basics and clinical aspects of ophthalmology.

d2 Present medical information in written, oral and electronic forms.

d3 Manage time effectively.

d4 Work cooperatively and effectively with the colleagues.

d5 Respect the seniority of all members of healthcare professionals.

d6 Aptitude for personal development and appropriate transferable

skills during the course.

d7 Use of critical thinking, problem solving, clinical reasoning and

judgment regarding ophthalmological problems.

e) Attitude:

e1 Respect patient’s wrights and involve them or their caretakers in

management decisions.

e2 Clearly communicate with patient regardless of their social, cultural

and ethnics back ground.

e3 Dealing with situations including breaking bad news.

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Course contents

Subjects (jewel threads )

Lectures

(1 hour)

Bedside teaching no. Overall

hours

(96 hrs.) Fourth year:

Slide

session

(2 hours)

Tutorial

(2 hours)

Clinics

(3 hours)

Ophthalmology 26 10 10 10 56 setting

1. Introduction (Embryology,

Anatomy, Physiology, eye exam.)

2 _ _ 1/2

2. Eyelids 1 1 _ 1/2

3. Lacrimal Apparatus 1 1 _ 1/2

4. Conjunctiva 2 1 _ 1/2

5. Corneo sclera 2 1 _ 1/2

6. Cataract 2 1 _ 1/2

7. Uveitis 2 1 _ 1/2

8. Glaucoma 2 1 _ 1/2

9. Squint 2 1 _ 1/2

10. Refraction/refractive surgeries 1 _ 1 1/2

11. Orbit 1 1 _ 1/2

12. Vitreous & Retina 1 1 _ 1/2

13. Retinopathies 1 _ 1 1/2

14. Trauma 1 _ 1 1/2

15. Red Eye _ _ 1 1/2

16. Ocular Tumors 1 _ 1 -

17. Neuro ophthalmology 2 _ 1 1/2

18. Pediatric Problems _ _ 1 1/2

19. Ocular pharmacology 1 _ 1 1/2

20. Loss of vision 1 _ 1 1/2

21. Eye in systemic disease _ _ 1 1/2

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Time table for student’s assessment

Types time Method Allocated Mark Weight %

Assessment exam. Written exam

(MCQs)

Clinical (slides)

5

5

10%

Final exam (end of year ) Written exam

(MCQs)

Clinical (slides)

Clinical (cases)

Oral exam

40

20

20

10

90 %

Total 100 marks 100%

• Passing grades are:

Grade Percentage

Excellent ≥ 85%

Very good 75 - 85%

Good 65 - 75%

Pass 60 - 65%.

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OPTHALMOLOGY CLINICAL TRAINING

All students are expected to spend time equivalent to one month in

Ophthalmology department for clinical training that includes :

1. Slide sessions.

2. Small group teaching (Tutorials).

3. Clinical Teaching (Case Discussion)

4. Special ocular Diagnostic procedures.

5. To observe ocular surgeries in the major or minor operation

theater.

1. Slide sessions.

These include photo sessions on different topics that were given in

lectures.

a. Around 30 sessions are conducted.

b. Each session starts with photos on a specific topic and students are

asked to describe pathology seen and then to discuss etiology and

way of treatment.

c. Special Emphasis is usually given on the following topics:

• Anterior segment diseases common in Libya specially

Trachoma.

• Cataract management.

• Uveitis presentation and treatment.

• Treatment of Squint and prevention of Amblyopia.

• Retinal pathologies.

2. Tutorials:

a. Various topics in ophthalmology in clinical point of view are

discussed in small groups.

b. Feedback from students in the form of taking part in the clinical

discussion is obligatory to prepare the students for logical analysis

and scientific argument.

c. Around 30 tutorials are conducted.

d. The opening of clinical training starts with history taking and

clinical examination of the eye.

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e. Special Emphasis is usually given on the following topics:

• Refractive errors

• Effects of systemic diseases on the eye.

• Differential diagnosis of red eye.

• Ocular tumors.

• Ocular injuries.

• Neuro-ophthalmology.

f. Case demonstration may be included in the tutorials to enforce the

discussion.

3. Clinical Teaching (Case demonstration):

a. Every student is obliged to examine the case by himself / herself.

b. This usually includes: history taking, clinical examination and case

presentation by the student and discussion on differential diagnosis

and management.

c. Cases are seen in hospital ward and in outpatient department.

d. Anterior segment examination by the torch.

e. Posterior segment training includes teaching the use of Direct

Ophthalmoscope.

4. Special Ocular Diagnostic Procedures:

These procedures include:

a. Sac syringing.

b. Tonometry.

c. Field testing.

d. Synoptophore uses.

e. Color vision test.

f. Exophthalmometry.

g. Biometry.

Usually the procedures are demonstrated by the tutors, but students

may undertake the procedure by themselves under direct

supervision of the tutor.

5. Ocular surgeries:

• All the students are required to view the operations carried in

both major and minor operation Theaters.

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Course-Intended learning outcomes Matrix

Assessment tools

Tool Purpose ILOS

Written Examination To assess ILOS from ( a1-6) and ( b1-5)

Oral Examination To assess ILOS from (a1-6) , (b1-5), (d1-9) and ( e1-3)

Clinical ( slides) To assess ILOS from ( b1-5), ( c1-9) and ( d1-9)

Clinical ( cases) To assess ILOS from ( b1-5), ( c1-9), ( d1-9) and (e1-3)

Subject Knowledge

and

understanding

Intellectual

skills

Professional

skills

General and

transferable

skills

Attitude

1 Introduction (Embryology,

Anatomy, Physiology, eye

exam.)

a1,2 b1,2 c1-6, c8 - e1-3

2 Eyelids a1-6 b1-5 c4,c7-9 d1-7 e1-3

3 Lacrimal Apparatus a1-6 b1-5 c4,c7-9 d1-7 e1-3

4 Conjunctiva a1-6 b1-5 c4,c6-9 d1-7 e1-3

5 Corneo sclera a1-6 b1-5 c4,c6-9 d1-7 e1-3

6 Cataract a1-6 b1-5 c1-9 d1-7 e1-3

7 Uveitis a1-6 b1-5 c3-9 d1-7 e1-3

8 Glaucoma a1-6 b1-5 c1-9 d1-7 e1-3

9 Squint a1-6 b1-5 c1-9 d1-7 e1-3

10 Refraction/refractive

surgeries

a1-6 b1-5 c1-9 d1-7 e1-3

11 Orbit a1-6 b1-5 c1-9 d1-7 e1-3

12 Vitreous & Retina a1-6 b1-5 c1-9 d1-7 e1-3

13 Retinopathies a1-6 b1-5 c1-9 d1-7 e1-3

14 Trauma a1-6 b1-5 c1-9 d1-7 e1-3

15 Red Eye a1-6 b1-5 c1-9 d1-7 e1-3

16 Ocular Tumors a1-6 b1-5 c1-9 d1-7 e1-3

17 Neuro-ophthalmology a1-6 b1-5 c1-9 d1-7 e1-3

18 Pediatric Problems a1-6 b1-5 c1-9 d1-7 e1-3

19 Ocular pharmacology a4 b5 c5,c8 d4-6 e1-3

20 Loss of vision a1-6 b1-5 c1-9 d1-7 e1-3

21 Eye in systemic disease a1-6 b1-5 c1-9 d1-7 e1-3

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List of books and references

• General Ophthalmology

Daniel G. Vaughan, Taylor Asbury, Paul Riordan_Eva

• Clinical Ophthalmology (Jack J.Kanski).

• Course notes by department’s staff.

• Ophthalmology A Pocket textbook Atlas (G. Lang).

All the text books are available at hospital Library.

Web Sites:

• http://www.emedicine.com/oph/contents.htm

• http://www.cis.rit.edu/people/faculty/montag/vandplite/pages/ch

ap_8/ch8p3.html

• http://cim.ucdavis.edu/eyes/eyesim.htm

• http://www.djo.harvard.edu/index.php

Facilities required for teaching and learning.

• Lecture halls: at hospital and faculty.

• Rooms for tutorials and slide sessions.

• Black and white boards.

• Audiovisual aid (data shows).

• Faculty library.

• Electronic library.

• Outpatient clinics.

• Inpatients units.

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OPHTHALMOLOGY SYLLABUS

4TH

YEAR

CONTENTS

Theory Program-(OPH) 1. Embryology of Eye-OPH.A1.

2. Ocular Anatomy-OPH.A2.

3. Ocular Physiology-OPH.A3.

4. Clinical Examination of Eye-OPH.A4.

5. Refraction and Refractive Errors-OPH.B.

6. Diseases of Eye Lids-OPH.C.

7. Lacrimal System and its anomalies-OPH.D.

8. Conjunctival Disorders-OPH.E.

9. Diseases of Cornea and Sclera-OPH.F.

10. Diseases of Uveal tract-OPH.G.

11. Lens and its anomalies-OPH.H.

12. Glaucoma-OPH.I.

13. Diseases of Retina –OPH.J.

14. Orbit and its disorders-OPH.K.

15. Strabismus-OPH.L

16. Neuro-ophthalmology-OPH.M

17. Ocular trauma-OPH.N

18. Ocular Pharmacology-OPH.O

19. Laser application in ophthalmology-OPH.P

20. Eye in systemic disease-OPH.Q.

21. Ocular Tumors-OPH.R

22. Loss of vision-OPH.S.

23. Red eye -OPH.T

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OPH.A.1.Development of Eye

OPH.A.1.1. The Primary Optic Vesicle

OPH.A.1.2. The Secondary Optic Vesicle(two Embryonic layers of

Retina)

OPH.A.1.3. The Lens Vesicle

OPH.A.1.4 Structures Deriving from Different Embryonic layers

OPH.A.1.5. Ectoderm

OPH.A.1.6. Mesoderm

OPH.A.1.7. Neural Ectoderm

OPH.A.1.8. Eye at Birth-Different Ocular Parameters of a new born

child.

OPH.A2. Ocular Anatomy

OPH.A2.1. External Appearance of Eye

OPH.A2.2. General Outlook of Bony Orbit

OPH.A2.3. General Outlook of Eye Ball

OPH.A2.4. Muscles & Adnexa

OPH.A2.5. Detailed Anatomy of individual structures (To be described

under corresponding chapters)

OPH.A3. Ocular Physiology

OPH.A3.1. Aqueous Humor Dynamics

OPH.A3.2. Intra Ocular Pressure

OPH.A3.3. General idea of ocular physiology.

OPH.A4.Clinical Examination of Eye

OPH.B. Refraction and Refractive Errors

OPH.B.1. Eye as a refractive media.

OPH.B.2. Factors affecting the refraction.

OPH.B.3. Geometric eye.

OPH.B.4. Clinical Evaluation

B.4.1. Refractive Errors-Definition, Causes, Optics, Diagnosis and

Modalities of Treatment

B.4.2. Visual Acuity test with out and with Pin hole

B.4.3. Retinoscopy

B.4.4. Cycloplegic Refraction

B.4.5. Autorefractometry

B.4.6. Myopia

B.4.7. Hypermetropia

B.4.8 Astigmatism

B.4.9. Presbyopia

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B.4.10. Anisometropia

B.4.11. Aphakia

OPH.B.5. Modalities of Treatment of Refractive Errors

B.5.1. Glass Correction

B.5.2. Correction by Contact Lenses

B.5.3. Correction by Intra Ocular Lenses

B.5.4. Refractive Surgeries

OPH.C.Lids

OPH.C.1. Relevant Anatomy of Lids

OPH.C.2. Congenital Disorders

C.2.1. Coloboma-Definition,Treatment

C.2.2. Distichiasis-Definition, Clinical features, Treatment

C.2.3. Epicanthus-Definition

OPH.C.3. acquired Disorders

C.3.1. Entropion-Definition, Types, Clinical features, Treatment

C.3.2. Ectropion-Definition, Types, Clinical features, Treatment

C.3.3. Ptosis-Definition, Types, Causes, Clinical presentation,

Clinical Evaluation and Treatment

C.3.4. Inflammation and Infections

C.3.4.1. External Hordeolum-Definition, Causes, Clinical

presentation, Management

C.3.4.2. Internal Hordeolum-Definition, Causes, Clinical

presentation, management

C.3.4.3. Chalazion-Definition, pathogenesis, causes, clinical

presentation, management

C.3.4.4. Blepharitis-Definition, Types, Causes, clinical features,

management

C.3.4.5. Viral Infections-Herpes Simplex, Herpes Zoster, Viral

Warts.

OPH.C.4. Eye lashes disorders (Trachiasis, Madarosis, Poliosis)

OPH.C.5. Miscellaneous

C.5.1. Blepharospasm-Definition,Treatment

C.5.2. Lid Retraction-Definition

C.5.3. Lid Edema-Definition, Causes, Treatment

C.5.4. Xanthelasma-Definition,Treatment

OPH.C.6. Eye Lid Tumors

C.6.1. Benign

C.6.1.1. Viral Warts-Definition, treatment

C.6.1.2. Simple Naevus-Definition, treatment

OPH.C.6.2. Malignant

C.6.2.1. Basal Cell Carcinoma-Definiton,clinical presentation,

management

C.6.2.2. Squamos Cell carcinoma-Definition, clinical findings,

treatment

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C.6.2.3. Sebaceous gland Carcinoma-Definition, treatment

C.6.2.4. Melanoma-Definiton,treatment

C.6.2.5. Kaposi’s Sarcoma-Definition, types, treatment

OPH.D. Lacrimal Apparatus

OPH.D.1. Relevant Anatomy –Lacrimal Gland, Lacrimal Drainage

System

OPH.D.2. Physiology of Tear Drainage

OPH.D.3. Pre-corneal Tear Film-Anatomy and Functions of all layers

OPH.D.4. Dry Eyes-Causes and Systemic associations,

symptomatology, clinical assessment, management

OPH.D.5. Epiphora-Definition, Causes, Clinical assessment,

Investigative techniques(Jones Test, Syringing of lacrimal

sac, Dacryocystography),Management

OPH.D.6. Dacryocystitis

D.6.1. Infantile nasolacrimal duct obstruction ,Congenital

Dacryocystitis-Definition, Causes, Clinical presentation,

management

D.6.2. Acute Dacryocystitis-Definition, Causes, Clinical

presentation, Differential Diagnosis, Management

D.6.3. Chronic dacryocystitis-Definition, Causes, Pathogenesis,

clinical features, investigations, management

OPH.D.7. Lacrimal Gland Tumors-Definition, clinical types, clinical

presentation, management

OPH.E. The Conjunctiva

OPH.E.1. Relevant Anatomy

OPH.E.2. Clinical Presentation of Conjunctival cases in general-

Symptoms, Signs (Discharge, Congestion, Follicles, Papillae,

Scarring, Edema)

OPH.E.3. Conjunctivitis -Classifications of Conjunctivitis(Etiological

and Clinical [ Acute, subacute & chronic]

OPH E.3.1. Bacterial Conjunctivitis-Types, Clinical Features of each

type, treatment

E.3.2. Ophthalmia neonatorum

OPH.E.3.3. Chlamydial(TRACHOMA)

E.3.3.1. Definition

E.3.3.2. Etiology

E.3.3.3. Prevalence

E.3.3.4. Clinical Profile

E.3.3.5. Trachoma Staging with Clinical Signs(W.H.O)

E.3.3.6. Séquelle

E.3.3.7. Complications

E.3.3.8. Lab. Diagnosis

E.3.3.9. Treatment and Prophylaxis

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OPH.E.3.4. Viral Conjunctivitis-Definition, clinical presentation and

management

OPH.E.4. Allergic Conjunctivitis-Types

E.4.1. Vernal Conjunctivitis-Definition, Pathogenesis, Clinical

presentations, Conjunctival signs, Management

E.4.2. Acute Rhino keratoconjunctivitis-Definition, clinical

presentation, management

E.4.3. Phlyctenular Conjunctivitis-Definition, pathology, clinical

presentation, conjunctival signs, investigations, management

E.4.4. Giant Papillary Conjunctivitis-Definition, causes,

management

OPH.E.5. Degenerative Conditions of Conjunctiva

E.5.1. Pinguecula-Definition

E.5.2. Pterygium-Definition,Causes,Types,clinical presentations,

management

OPH.E.6. Conjunctival Tumors-(To be described with ocular tumors)

OPH.F. Cornea and Sclera

OPH.F.1. Relevant Anatomy and Physiology

OPH.F.2. Corneal Infections-Etiological and Morphological

Classification

F.2.1. Bacterial Corneal Infection-Definition, Causative

Organisms,pathology,stages,clinical

features,complications,investigations and treatment of

disease and its

F.2.2. Viral (Herpes simplex, herpes zoster)-Definition,

Types,Clinical presentation of each types, investigations,

treatment

F.2.3. Fungal-Definition, causative organisms, clinical

presentation, corneal signs, investigations, management

F.2.4. Protozoal-Definition,clinical signs, treatment

F.2.5. Disciform Keratitis-Definition, clinical sign, treatment

OPH.F.3. Ectatic Conditions of Cornea

F.3.1. Keratoconus-Definition, types, clinical presentations, clinical

signs, special investigations, management

F.3.2. Keratoglobus-Definition

OPH.F.4. Corneal Degenerations

F.4.1. Arcus Senilis-Definition

F.4.2. Band Shaped Keratopathy-Definition, treatment

OPH.F.5. Corneal Deposits-Copper and Iron-Clinical signs

OPH.F.6. Exposure Keratopathy-Definition,causes,clinical signs,

management

OPH.F.7. Neurotrophic Keratopathy-Definition, causes, clinical signs

and management

OPH.F.8. Nutritional Keratopathy-Causes, clinical features,

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management

OPH.F.9. Sclera.

F.9.1. Episcleritis-Definition, causes, types, clinical presentation,

investigations, management

F.9.2. Scleritis-Definition, causes, types, clinical presentations,

complications, Investigations, management

F.9.3. Styphylomas-Defintion,types,management

OPH. G. Uveal Tract

OPH.G.1. Relevant Anatomy

OPH.G.2. Clinical Symptoms and signs in general

OPH.G.3. Uveitis ,Classification (Anatomical, Clinical, Pathological,

Etiological)

G.3.1. Anterior uveitis (Acute & Chronic Iridocyclitis)

G.3.1.1. Defintion and causes

G.3.1.2. Pathology

G.3.1.3. Clinical Features(symptoms and signs)

G.3.1.4. Complications

G.3.1.5. Differential Diagnosis

G.3.1.6. Investigations

G.3.1.7. Treatment

G.3.2. Intermediate uveitis (Pars Planitis)

Definition, causes, clinical signs, treatment.

G.3.3. Posterior uveitis: Definition, Causes.

OPH.G.4. Toxoplasmosis: Aethiology, Clinical features, Treatment.

OPH.G.5. Harada syndrome: Clinical features.

OPH.G.6. AIDS and posterior uveitis.

OPH.G.7. Special Form of Uveitis

G.7.1. Juvenile rheumatoid arthritis.

G.7.2. Ankylosing spondylitis

G.7.3. Fuch’s Heterochromic Cyclitis-Definition,clinical findings,

management

G.7.4. Behçet disease: Clinical features.

G.7.5. Sympathetic Ophthalmitis-

Definition, causes, pathology, clinical presentations,

management

OPH.G.8. Endophthalmitis-Definition, causes, clinical features,

investigations, management

OPH.G.9. Panophthalmitis-Definition, causes, management

OPH.G.10. Uveal Melanomas--(To be described with ocular tumors)

OPH.H. The Crystalline Lens

OPH.H.1. Applied Anatomy

OPH.H.2. Cataract-Definition and Classifications

H.2.1. Congenitial Cataracts

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Definition, Etiological Factors, Types of Congenital

Cataracts, Clinical evaluation and decision making,

modalities of treatment-Medical, surgical, correction of

Pediatric aphakia and treatment of amblyopia

OPH.H.2.2. Acquired Cataracts-Senile, Complicated, Toxic, Traumatic,

After Cataract, Radiation Cataract, Cataract associated

with different syndromes

H.2.2.1. Senile Cataract

Definition, etiological factors, stages of cataract

formation,clinical features-symptoms and signs, clinical

evaluation of a case of senile cataract, complications,

Treatment Modalities and Complications

H.2.2.2. Complicated Cataract-Definition, Causes, Clinical signs,

management

H.2.2.3. Toxic Cataracts-Definition, causes, clinical signs,

management

H.2.2.4. Traumatic Cataract-Definition, clinical types, management

H.2.2.5. After Cataract-Definition, types, clinical signs, management

OPH.H.3. Ectopia lentis: Lens dislocation, Lens subluxation: Causes,

Symptoms, Signs, Management.

OPH.I.GLAUCOMA

OPH.I.1. Applied Anatomy of Ciliary body, Trabecular meshwork,

Schlemm’s canal, and Angle structures.

OPH.I.2. Applied physiology of aqueous dynamics

OPH.I.3. Clinical Evaluation of a case of Glaucoma-

I.3.1. Visual Acuity

I.3.2. Intra Ocular Pressure

I.3.3. Anterior Segment Examination in Slit lamp

I.3.4. Gonioscopy(Visualizing Angle of Anterior Chamber)

I.3.5. Fundoscopy

I.3.6. Visual Field changes

OPH.I.4. Classification of Glaucoma-Congenital, Primary, Secondary

OPH.I.4.1 Congenital Glaucoma-Definition, Causes, clinical

presentation, clinical signs, management

OPH.I.4.2. Primary Angle Closure Glaucoma

I.4.2.1. Definition

I.4.2.2. Incidence

I.4.2.3. Risk Factors

I.4.2.4. Stages

I.4.2.5. Clinical presentation and Diagnosis in each stages

I.4.2.6. Management in each stage

OPH.I.4.3. Primary Open Angle Glaucoma

I.4.3.1. Definition and Prevalence

I.4.3.2. Pathogenesis

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I.4.3.3. Criteria

I.4.3.4. Clinical presentations

I.4.3.5. Clinical Evaluation

I.4.3.6. Management

OPH.I.4.4. Secondary Glaucoma-Definitions and management

I.4.4.1. Pretrabecular-Neo vascular

I.4.4.2. Trabecular causes-Blood, Macrophages, Pigment,

Neoplastic cells, Inflammation, etc.

I.4.4.3. Post Trabecular-Carotid cavernous fistula, Sturge Weber

Syndrome

I.4.4.4. Tramatic Angle Recession

OPH.I.4.5. Lens Induced Glaucoma

I.4.5.1. Phacomorphic

I.4.5.2. Phacolytic

I.4.5.3. Phacoanaphylactic

OPH.J. VITREOUS & RETINA

OPH.J.1. Relevant Anatomy, Physiology, Normal Fundus &

Fundoscope.

OPH.J.2. Vitreous degeneration.

OPH.J.3. Vitreous hemorrhage: Causes, Complications &

management.

OPH.J.4. Retinal Detachment.

J.4.1. Definition of Retinal Detachment

J.4.2. Predisposing Factors for Retinal Detachment

J.4.3. Types of Retinal Detachment-Rhegmatogenous, Exudative,

Tractional

OPH.J.5. Rhegmatogenous Retinal Detachment

J.5.1. Definition

J.5.2. Typical history

J.5.3. Clinical Evaluation

J.5.4. Complication

J.5.5. Treatment modalities

OPH.J.6. Tractional Retinal Detachments-Definition, Causes,

treatment.

OPH.J.7. Exudative Retinal Detachment-Definition, Causes,

treatment

OPH.J.8. Vascular Retinopathies

J.8.1. Diabetic Retinopathy-Definition, Pathogenesis, Staging,

Fundus findings, Modalities of treatment

J. 8.2. Hypertensive Retinopathy-Definition, Classifications

(essential & accelerated ),Fundus pictures, treatment

J. 8.3. Retinal Vein Occlusion-Causes, types, Fundus pictures,

treatment

J. 8.4. Retinal Artery Occlusion-Causes, Fundus pictures,

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treatment

OPH.J.9. Macular Disorders-Clinical Evaluation

OPH.J.10. Hereditary Disorders of Retina & choroid , Definition,

Clinical Evaluation, Special Investigative Techniques

J.10.1. Retinitis Pigmentosa-Definition, Etiological factors,

pathogenesis, clinical presentation, clinical types,

complication and sequele,treatment modalities

OPH J.11. Neuro-retinal tumors. (To be described with ocular tumors)

OPH.K. Orbit

OPH.K.1. Relevant Anatomy

OPH.K.2. Evaluating Cases of Orbital Disorders

K.2.1 Symptomatology

K.2.2. Clinical Signs

K.2.3. Special investigations:

K.2.3.1. Diplopia Charting

K.2.3.2. Exophthalmometry

K.2.3.3. Radiographs

K.2.3.4. Ultrasonography

K.2.3.5. CT & MRI

K.2.3.6. Angiography

OPH.K.3. Orbital Disorders & Proptosis

OPH.K.3.1. Dysthyroid Ophthalmopathy-Grave’s Disease, Thyroid

Ophthalmopathy

K.3.1.1. Pathogenesis-Hypertrophy of Extra Ocular muscles, Cell

infiltration, proliferation of Orbital fats

K.3.1.2. Classification & Clinical signs-Soft tissue changes, Eye lid

changes,Proptosis,Optic neuropathy, Restrictive myopathy

K.3.1.3. Management

OPH.K.3.2. Orbital Cellulitis-Definition, Types, Clinical presentations,

Investigations, Management

OPH.K.3.3. Vascular Diseases of Orbit-Orbital Venous

anomalies,Carotido Cavernous Fistula

OPH.K.3.4. Cystic Lesions of Orbit-Definition, management

K.3.4.1. Dermoid Cysts

K.3.4.2. Mucocele

K.3.4.3. Encephalocele

OPH.K.4. Orbital Tumours-Definition, types, clinical presentations,

evaluation, special investigations and treatment modalities

OPH.L. Strabismus

OPH.L.1. Anatomy of Extra Ocular muscles

OPH.L.2. Ocular Movements

L.2.1. Ductions

L.2.2. Versions-Cardinal Positions of Gaze, Diagnostic positions of

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gaze, Laws of Ocular motility

L.2.3. Vergences

OPH.L.3. STRABISMUS : Definition, Classification ( False & True,

Paralytic, Non-paralytic( Latent & manifest) , effects,

compensatory mechanisms

OPH.L.4. Clinical Approach to a squint Case

L.4.1. Amount of Deviation-In angle and prism Diopter

L.4.2. Light Corneal Reflex, Cover Test, Uncover test, Alternate

Cover tests.

L.4.3. Visual Acuity & Refraction.

L.4.4. Fundus Examination-Macular Fixation

L.4.5. Diplopia testing

L.4.6. Test for Binocular Vision

OPH.L.5. Non-paralytic:

OPH.L.5.1. Esodeviation

OPH.L.5.2. Exodeviations

OPH.L.6. Paralytic Squint-Definition, Causes, Clinical features,

management

OPH.L.7. Suppression & Amblyopia-Definition, types, management

OPH.M. Neuro Ophthalmology

OPH.M.1. Anatomy of Visual Pathway

OPH.M.2. Anatomy of Cranial Nerves-II,III,IV,VI

OPH.M.3. Pupillary Pathways-Sympathetic and Parasympathetic

OPH.M.4. Pupillary reflex and their abnormalities.

OPH. M.5. Miosis & Mydriasis

OPH.M.6. Clinical Approach to Neuro- Ophthalmic cases

OPH.M.7. Optic Nerve Diseases

M.7.1. Optic Neuritis-Definition, types, clinical presentations,

Fundus Findings, Differential Diagnosis, Special

Investigations, Management

M.7.2. Papilloedema-Definition, Causes, Fundus findings,

management

M.7.3. Optic Atrophy-Definition, types, Fundus Findings

M.7.4. Optic Nerve Tumors-Types

OPH.M.8. Lesions in Visual Pathway and Visual Field Defects

OPH.M.9. Cranial nerve Palsies-III,IV and VI

OPH.M.10. Myasthenia Gravis-Definition, Clinical features, treatment

OPH.M.11. Headaches and Migraine-Causes, treatment

OPH.M.12. Nystagmus-Definition, types, management

OPH.N. Ocular Trauma

OPH.N.1. Types of Trauma

OPH.N.2. Blunt Trauma to the orbit & the eye ball.

OPH.N.3. Penetrating Eye Injuries-Features and management

21

OPH.N.4. Intra Ocular Foreign Body-Detection, management

OPH.N.5. Chemical Injuries to Eye-Types, clinical features,

management.

OPH. N.6. Radiation injuries

OPH.O. Ocular Pharmacology

OPH.O.1. Routes of Administering Drugs

OPH.O.2. Blood ocular barrier

OPH.O.3. Types of Ocular Drugs-Strength, indications,

contraindications, mode of action, toxicities

O.3.1. Cholinergic drugs

O.3.2. Anti-cholinergic drugs

O.3.3. Adrenergic drugs

O.3.4. Adrenergic blocking agents

O.3.5. Antiglaucoma drugs

O.3.6. Anti-infective drugs-Antibiotics,Antivirals,Anti fungals,Anti

chlamydial

O.3.7. Local anesthetics

O.3.8. Dyes

O.3.9. Steroids

OPH.P. Laser Application in ophthalmology

OPH.P.1. Types of lasers.

OPH.P.1.1 .Mode of actions

P.1.2. Laser Iridotomy & Capsulotomy

P.1.3. Retinal photocoagulation

OPH.P.2. Photorefractive surgeries.

OPH Q. EYE IN SYSTEMIC DISEASE

OPH Q. 1. Infection:

Q.1.1 Septicemia.

Q.1.2. Chronic infections (Tb, Syphilis, AIDS)

OPH.Q.2. Endocrine

Q.2.1. Eye in diabetic patient.

Q.2.2. Thyrotoxicosis.

Q.2.3. Hyperparathyroidism.

OPH.Q.3. Autoimmune.

Q.3.1. Rheumatoid arthritis

Q.3.2. Seronegative arthritis

OPH.Q.4. Cardiovascular

Q.4.1. Hypertension.

Q.4.2. Endocarditis.

OPH.Q.5. C.N.S:

Q.5.1. M.S.

Q.5.2. Neurofibromatosis

22

OPH.Q.6. Hematological Disorders

OPH.Q.7. Metastatic tumors.

OPH.R. Ocular tumors

OPH.R.1. Conjunctival tumors ( Naevus, melanoma, Kaposi sarcoma)

OPH.R.2 Iris (Naevus, melanoma)

OPH.R.3 Tumors of the choroid-(choroidal melanoma, metastatic

tumors).

OPH.R.4. Neural retinal tumors- Retinoblastoma-Definition,

prevalence, etiology and genetics, clinical staging, presenting

signs, special investigations, differential diagnosis,

histological findings, prognostic evaluation and treatment

modalities

OPH.R.5 Optic nerve tumors- glioma, meningioma.

OPH.R.6 Embryonal sarcoma( Rhabdomyosarcoma-presentation,

signs and symptoms, investigations, treatment)

OPH.S. Loss of vision & visual field

OPH.S.1. Sudden (Painful, Painless)

OPH.S.2 Gradual (Painful, Painless)

OPH.S.3 Visual field:

S.3.1. Definition

S.3.2. Methodology.

S.3.3. Normal & Abnormal range

OPH.S.4. Amaurosis fugax.

OPH.T.Red eye.

OPH.T.1. History and examination.

OPH.T.2 Etiology (non-traumatic causes), differential diagnosis.

OPH.T.3. Conjunctivitis, episcleritis, Scleritis, uveitis, keratitis, angle

closure glaucoma.( presentations, management)