DEPT OF OPHTHALMOLOGY
AIIMS NAGPUR
SYLLABUS FOR UNDER GRADUATE TEACHING
GOAL
The broad goal of the teaching of students in ophthalmology is to provide such knowledge
and skills to the student that shall enable him/her to practice as a clinical and as a primary
eye care physician and also to function effectively as a community health leader to assist in
the implementation of National Programme for the prevention of blindness and
rehabilitation of the visually impaired.
OBJECTIVES
(a) KNOWLEDGE
At the end of the Ophthalmology posting, the student shall be able to:
At the end of the course, student shall have the knowledge of
1.Common problems affecting the eye,
2. Principles of management of major ophthalmic emergencies, main systemic diseases
affecting the eye;
4. Effects of local and systemic diseases on patient’s vision and the necessary action
required to minimize the sequelae of such diseases;
5. Adverse drug reactions with special reference to ophthalmic manifestations; 6,
Magnitude of blindness in India and its main causes;
7. National programme for control of blindness and its implementation at various levels.
8. Eye care education for prevention of eye problems
9. Role of primary health center in organization of eye camps;
10.organization of primary health care and the functioning of the ophthalmic assistant;
11. Integration of the national programme for control of blindness with the other national
health Programmes.
12. Eye bank organization
(b) SKILLS
At the end of the course, the student shall be able to:
1. Elicit a history pertinent to general health and ocular status;
2. Assist in diagnostic procedures such as
i. Visual acuity testing,
ii. Examination of eye,
iii. Schiotz tonometry,
iv. Staining of corneal pathology,
v. Confrontation perimetry,
vi. Subjective refraction including correction of presbyopia and aphakia,
vii. Direct ophthalmoscopy
viii. Conjunctival smear examination and
ix. Cover test;
3. Diagnose and treat common problems affecting the eye;
4. Interpret ophthalmic signs in relation to common systemic disorders,
5. Assist/observe therapeutic procedures such as
i. Subconjunctival injection,
ii. Corneal conjunctival foreign body removal,
iii. Carbolic cautery for corneal ulcers,
iv. Nasolacrimal duct syringing and
v. Tarsorrhaphy
6. Provide first aid in major ophthalmic emergencies;
7. Assist to organize community surveys for visual check-up;
8. Assist to organize primary eye care service through primary health centres.
9. Use effective means of communication with the public and individual to motivate for
surgery in cataract and for eye donation.
10. Establish rapport with his seniors, colleagues and paramedical workers, so as to
effectively function as a member of the eye care team.
CLINICAL TRAINING :
The students would be posted in the Ophthalmology department ( OPD and Ward ) for a total period
of 2 months on rotation basis. Here they would learn the basic Ophthalmic examination, become
familiarised with diagnosing the common eye diseases and learning the elementary management,
including communication skills.
The clinical training would consist of
1) Two classes on introduction to the clinical aspects of vision testing methods, physiology of vision,
various normal finding in eye
2) Bed side teaching and case discussion on common Eye conditions like refractive error, cataract,
Red eye, epiphora, squint assessment, retinal examination techniques, glaucoma examination.
3) Orientation to commonly used Ophthalmology like vision drum, autorefractometer, tonometer,
slit lamp
4) Exposure to commonly done OPD procedures like refraction ( dry, wet) syringing & probing, FB
removal, epilation of trachiatic eye lashes,
5) Exposure to selective operative procedures like cataract surgery like SICS, Phacoemulsification,
DCR, Lid surgery, laser procedure in eye.
Syllabus( COURSE CONTENT- MCI wise)
1) COMMON DISEASE OF EYE.
A) Conjunctiva.
Symptomatic conditions: Hyperaemia, Sub conjunctival Haemorrhage.
Diseases : -
Classification of Conjunctivitis
Mucopurulent Conjunctivitis
Membranous Conjunctivitis Spring Catarrh.
Degenerations Pinguecula and Pterygium
B) Cornea: -
Corneal Ulcers: Bacterial,
Fungal, Viral, Hypopyon.
Interstitial Keratitis.
Keratoconus.
Pannus
Corneal Opacities.
Keratoplasty.
C) Sclera :
Episcleritis.
Scleritis.
Staphyloma.
D) Uvea
Classification of Uveitis
Gen. Aetiology, Investigation
and Principles Management
of
Uveitis.
Acute & Chronic Iridocyclitis.
Panophthalmitis.
End Ophthalmitis.
Choroiditis.
E) Lens :
Cataract – Classification &
surgical management of
cataract.
Including Preoperative
Investigation.
Anaesthesia.
Aphakia.
IOL Implant
F) Glaucoma :
Aqueous Humor Dynamics.
Tonometry.
Factors controlling Normal
I.O.P.
Provocative Tests.
Classifications of Glaucoma.
Congenital Glaucoma.
Angle closure Glaucoma.
Open Angle Glaucoma.
Secondary Glaucoma
G) Vitreous :
Vitreous Opacities.
Vitreous Haemorrhage.
H) Intraocular Tumours:
Retinoblastoma.
Malignant Melanoma
I) Retina :
Retinopathies : Diabetic, Hypertensive Toxaemia of
Pregnancy.
Retinal Detachment.
Retinitis Pigmentosa, Retinoblastoma
J) Optic nerve :
Optic Neuritis.
Papilloedema.
Optic Atrophy.
K) Optics :
Principles : V.A. testing Retinoscopy, Ophthalmoscopy.
Ref. Errors.
Refractive Keratoplasty.
Contact lens, Spectacles
L) Orbit :
Proptosis – Aetiology, Clinical Evaluation, Investigations &
Principles of Management
Endocrinal Exophthalmos.
Orbital Haemorrhage.
M) Lids :
Inflammations of Glands.
Blepharitis.
Trichiasis, Entropion.
Ectropion.
Symblepharon.
Ptosis.
N) Lacrimal System
Wet Eye.
Dry Eye
Naso Lacrimal Duct
Obstruction
Dacryocystitis
O) Ocular Mobility
Extrinsic Muscles.
Movements of Eye Ball.
Squint : Gen. Aetiology,
Diagnosis and principles of
Management.
Paralytic and Non Paralytic
Squint.
Heterophoria.
Diplopia.
P) Miscellaneous
Colour Blindness.
Lasers in Ophthalmology – Principles.
Q) Ocular Trauma : -
Blunt Trauma.
Perforating Trauma
Chemical Burns
Sympathetic Ophthalmitis
2) Principles of Management of Major Ophthalmic Emergencies :
Acute Congestive Glaucoma.
C. Ulcer.
Intraocular Trauma.
Chemical Burns.
Sudden Loss of vision
Acute Iridocyclitis.
Secondary Glaucoma
3) Main Systemic Diseases Affecting the Eye :
Tuberculosis.
Syphilis.
Leprosy.
Aids.
Diabetes.
Hypertension
4) Drugs :
Antibiotics/ anti-microbials
Steroids.
Glaucoma Drugs.
Mydriatics.
Viscoelastics.
Fluorescein.
5) Community Ophthalmology :
Blindness : Definition Causes
& Magnitude
N.P.C.B. – Integration of
N.P.C.B. with other health
Preventable Blindness.
Eye care.
Role of PHC‟s in Eye Camps.
Eye Banking.
6) Nutritional
Vit. A. Deficiency
Clinical Ophthalmology cases To Be Covered
History taking & Eye examination
Assessment of visual function.
Conjunctiva
Pterigium.
Pinguecula
Conjunctivitis.
Sub Conj. Haemorrhage.
Cornea
Corneal Opacity .
Corneal Ulcer.
Corneal Abscess.
Corneal Transplant
Sclera
Scleritis, Epi Scleritis.
Staphyloma.
Uvea Iridocyclitis.
Lens
Cataract.
Aphakia
IOLs
Complications
Glaucoma – Types, Signs, Symptoms & Management
Squint
Lids
Entropion
Ectropion
Ptosis.
TUTORIALS
SURGICAL TECHNIQUES
Cataract
a) ECCE
b) ICCE
c) IOL Implantation
d) Phaco-emulsification.
- Pterigium
- Chalazion
- Glaucoma
- Foreign Body Removal
- Enucleation
- Keratoplasty
- Basic of squint
INSTRUMENTS
i. OPD
ii. Operative
iii. Basic Examination and Diagnostic instruments
iv. Tonometer, Sac Syringing, Slip Lamp.
OPTICS
i. Lenses – Spheres, Cylinders, Prisms, Pinhole, Slit, Maddox Rod & Maddox wing,
ii. Red & Green Glasses.
iii. IOLs
iv. Ophthalmoscopy
v. Retinoscopy
vi. Contact Lenses
vii. Colour Vision
DRUGS
i. Miotics
ii. Antibiotics
iii. Steroids
iv. Anti-Fungal
v. NSAIDS
vi. Anti virals
vii. Antiglaucoma
viii. Mydriatics
ix. Viscoelastics
x. Pre-Op. & Post – Op
COURSE CONTENT- Competency wise
SL NO TOPIC MUST
KNOW
SHOULD
KNOW
MAY
KNOW
1. History taking in relation to common complaints encountered in Ophthalmology
2. Vision acuity assessment and errors, its
physiology
3. Anatomy, Physiology & embryology of eye
4. Physiology and neurology of vision
5. Elementary optics, elementary physiology of
optics
6. Causes of low vison and differentiate between
various causes of low vision
7. Refractive error of eye
8. Examination of Anterior segment and posterior
segment of eye
9. Red eye and its differential diagnosis
10. Pterygium and other conjunctival lesion
11. Keratitis, corneal ulcer, keratoconus, Vernal
keratoconjuctivits,
12. Immunology mediated diseases, corneal
dystrophies and degenerative changes
13. Keratoplasty
14. Scleritis, episcleritis, related immunological
diseases
15. Uveitis ,its classification, examination on slit
lamp and related diseases with treatment of
uveitis
16. Lens examination on torch light, direct
Ophthalmoscope & slit lamp
17. Diagnosis cataract and its various types,
formulate the treatment according to grade of
cataract
18. Various cataract surgeries, indication,
complication. Visual rehabilitation
19. News surgery of cataract, its indication,
complications, instruments used in cataract
surgery.
20. Glaucoma types, diagnosis, its investigation,
and treatment
21. Newer antiglaucoma medication and surgical
management of glaucoma
22. Management of acute angle closure glaucoma
23. Congenital glaucoma and juvenile open angle
glaucoma
24. Retinal disease associated with systemic
disease, vascular disorders of retina, inflmation
of retina, degeration of retina , retinal
detachment,
25. Congenital abnormalities of retina,
Phakomatosis
26. Retinal surgery instruments, various retinal
implants.
27. Changes in vitreous with age, opacities of
vitreous, vitreous haemorrhage
28. Papilledema, inflammation of optic nerve optic
atrophy, toxic and hereditary optic neuropathy
29. Tumours of optic nerve, congenital anomalies of
optic nerve
30. Tumour of uveal track , tumour of retina
31. Injuries to eye and its management
32. Assessment of ocular movement and related
disorders like squint, nystagmus etc
33. Disease of lid, lacrimal apparatus, disease of
orbit
Integration: The teaching will be aligned and integrated horizontally and vertically in order to
allow the learner to understand the structural basis of eye problems, their management and
correlation with function, rehabilitation and quality of life.
ASSESSMENT AND EXAMINATION
1) Formative : 3 internal assessments (theory) of 50 marks will be conducted once in 3 months.
Practical internal assessment of 40 marks will be conducted at the end of each clinical postings. 10
marks shall be allotted for log book. Total weightage of internal marks is 50% in the calculation of
final result.
2) Summative: A professional examination theory of 100 marks and practical of 100 marks will be
conducted at the end of the professional year. Total weightage of the professional examination will
be 50% in the calculation of final result .
Theory assessment paper would contain Long Answer Questions, Short Answers Questions and
objective type questions (Multiple Choice Questions). MCQs shall be accorded a weightage of not
more than 20% of the total theory marks.
Practical assessment would include 40% weightage for clinical case presentation, 40% for OSCE
(Observed Structured Clinical Examination) and 20 % for viva voce.
Theory: 100 marks: 1 paper: 20 marks MCQs+ 80 marks Questions
Practicals: 100 marks: 2 cases (60) Table viva (20) Optics (20)
Criteria for passing in a subject: A candidate shall obtain 50% marks in University
conducted examination separately in Theory and Practical (practical includes: practical/
clinical and viva voce) in order to be declared as passed in that subject.
SUGGESTED BOOKS
1) Parson's Diseases of the Eye: Dr. R. Sihota
2) Synopsis of Clinical Ophthalmology, International Edition: Kanski