Study Guide 4 Th Year MBBS Ophthalmology

Study Guide 4th year MBBS OphthalmologyDepartment Information:Head of Department (CMH LMC): Brig (rtd). Mansoor AwanHead of Department (CMH): Brig. Junaid AfsarFaculty: Lt Col. M. Khizar NiaziLt Col. Usman DurraniDr. Sobia Usman ShahResidents: Dr. Sana AshrafOur Mission:Our mission is to equip the average student with the minimum essential knowledge, skill and attitude tomake him able to: Identify common ophthalmological diseases, emergencies, providing primary health care,referral to an appropriate center and conducting follow-ups.Perform minor procedures safely, and enabling the student to communicate effectively with thepatient and his/her family about the disease and other relevant issues.Understanding ethics, being empathetic to the patient’s plight and maintaining patientconfidentiality.Our strategy to achieve the aforementioned goals will be:I.II.III.IV.V.VI.Interactive lecturesSmall group discussionProblem based learningClinical rotations and ward visitsTutorialsCPCs and SeminarsOutcome:By the end of the rotation in the Department of Ophthalmology, the student should be able to:I.II.III.IV.Obtain an appropriate HistoryPerform routine examinationsIdentify coon eye problemsOutline appropriate management plansContent:

OPHTHALMOLOGY - BLOCK ICODE- Y4B1Written Internal AssessmentDuration: 12 WeeksBy the end of Block-1 , the Student will be able to :S.NOTheme1.Eye Lid & adnexa2.Conjunctiva,Episclera & sclera3.OrbitLearning OutcomesContentsWeightage/%Ptosis, Blephritis, lid tumors& benign lesions, Entropion,Ectropion, diseases of lacrimalsystem, evaluation of dry eye ,KCS, Bitot's spots and Vit Adeficiency.301. Recognize conditions likePterygium, Pingecula, conjunctivitisepiscleritis and scleritis and theirsystemic association whenpresents. Identify red eye causing2. common conditions for their initialmanagement.Bacterial, Viral Allergic, andother types of conjunctivitis,Pterygium, Pingecula,Ophthalmia neonatorum,Episcleritis, Scleritis.301. Recognize proptosis and its commoncauses like thyroid eye disease,orbital inflammatory disease andorbital tumors. Advice common2. investigations required for itsevaluation. Summarize various3. medical and surgical managementoptions.Proptosis and its commoncauses, Thyroid eye disease.1. Identify conditions like ptosis,lid2. Tumors and benign lesions,Entropion, Ectropion, dry eyesetc. based on their clinicalassessment and make a referralto ophthalmologist.Misc systemic diseasesaffecting sclera, episcleraOrbital tumors, Cellulitis20

4.UveitisEnd BlockAssessment1. Identify uveitis as a cause ofdecreased vision.2. Recognize signs and symptoms ofacute and chronic uveitis for giving itsinitial treatment outline ofimmunosuppressive treatments.20Anterior and Posterior uveitis andtheir major causes. Varioussystemic associations and broadEnd Block Assessment to be taken by concerned institute itselfAssessment tools: MCQs & SAQs/SEQs

OPHTHALMOLOGY - BLOCK IICODE- Y4B2Written Internal AssessmentDuration: 10 WeeksBy the end of Block-2, the Student will be able to:S.NoTheme1.Corneal DiseasesLearning Outcomes1.2.Identify corneal ulcers for givinginitial treatment.Summarize principles of cornealdisease management.ContentsWeightage/%Bacterial, Fungal, Viral,Corneal Ulcers and use ofantibiotics/ cycloplegics20Keratoconus, dysplasiasand rgery4.Glaucoma andoculartherapeuticsIdentify different types of cataractand recognize type of visualdeterioration in each type ofcataract.2. Justify different types of surgicaloptions of cataract includingphacoemulsification3. Indicate possible complications ofcataract surgery1.Types of cataracts & theirevaluation,30Congenital, Age s of cataractsurgery. Ectopia lentis1. Identify common refractiveconditions of the eye likemyopia, hypermetropiaand2. Astigmatism3. Summarizevarious treatmentoptionsGlasses, Contact lens,excimer, LASIK, DAELEK ,PKP & other refractivesurgical options201. Differentiate betweenvarious types of Glaucoma,its clinical signs,Investigations, common VFdefects and various antiGlaucoma medication.2. Enlist other options ofGlaucoma managementincluding laser filtrationsurgery, cyclo-destructiveprocedures and implants.Types of glaucoma &Evaluation, Classification,POAG, PACG, surgery,Drugs, Lasers to treatglaucoma30

3. Identify shallow anteriorchamber for avoidingmydriatic eye drops toprevent acute congestiveglaucoma.4. Suggest emergencytreatment of acute angleclosure glaucoma.End BlockAssessmentEnd Block Assessment to be taken by concerned institute itselfAssessment tools: MCQs & SAQs/SEQs

OPHTHALMOLOGY – BLOCK- IIICODE- Y4B3Written Internal AssessmentDuration: 10 WeeksBy the end of Block-3, the Students will be able to:S.NoTopics1 Retinal vascular. diseases, retinalDetachment,Common FundusPathologies,Learning Outcomes1. Correlate symptoms with signs ofretinal vascular diseases, oculartumors and fundus pathologies2. Identify retinal disorder as a cause ofreduce vision.3. Suggest common treatment option ofretinal diseases.4. Discuss broad outline ofmanagement of RD, diabeticretinopathy & AMD and use of lasersin ophthalmologyContentsConditions affecting retinalvasculature and hy, DiabeticRetinopathy, CRVO,BRVO, CRAO, BRAO,AMD,RP,ARMD,Diabetic retinopathy.ROP,Types of retinal detachment,clinical exam, investigationsand surgical optionsVitrectomy and its indications.Use of lasers2 Strabismus.&NeuroOphthalmology3.Ocular trauma1. Differentiate between comitant andnon-comitant strabismus2. Perform cover & uncover test.3. Enlist surgical and non-surgicaltreatment of strabismus.4. Reproduce Cranial nerve pathwayand nerve supply of extra ocularmuscles5. Enlist relevant laboratoryinvestigations and imaging & surgicaland non-surgical treatment options.Types of squint and itsmanagement, Cranial nervespalsies, tumors, papilledema,visual field in various opticpathway lesions301. Differentiate between penetratingand non- penetrating ocular injuries.2. Discuss different types of chemicalsTypes of ocular injuries andtheir Evaluation30and initial

damaging eye(Acid/alkali/Alcohol/elfy) and itssymptoms and signs.3. Mange chemical injuries of the eyeand to removes conjunctival foreignbody.End BlockAssessmentManagement,Ophthalmic emergency andtheir primary eye care.End Block Assessment to be taken by concerned institute itselfAssessment tools: MCQs & SAQs/SEQs

Clinical Training / List of Competencies:Learning OutcomesBy the end of 08 weeks clinical rotation , theStudents will be able to:1. Establish rapport with the patientList of CompetenciesHow to greet and counsel Patients?2. Assess level of visionVisual Acuity (Children, Adults), color vision, AmslerGrid3. Examine visual field by confrontationVisual Fields4. Identify the type of refractive errorRefractive Errors5. Diagnose vision loss due to cataractCataract Examination6. See and differentiate normal optic disc andmacula from abnormal.7. Examine interior segmentsOphthalmoscopy (Fundoscopy)Torch/Slit lamp examination8. Prescribe common eye drops keeping in mindcontraindications of dilating drops9. Enlist common ophthalmic instruments Likecataract surgery instruments, DCR surgeryinstruments etc.10. Enumerate laser use in ophthalmologyOcular Pharmacology11. Enlist helpful investigationOcular Investigations an overview12. Classify various squintOcular movements and squint assessment13. Perform retinoscopyRetinoscopy and Prescription writing14. Examine the pupilsPupillary Reactions15. Examine the lidLid examination16. Identify retinal disease as a cause of loss ofvision17. Examine proptosisCommon retinal diseases18. Measure IOPTonometryOphthalmic InstrumentsIntroduction to LasersExamination of Proptosis

common Ophthalmic surgical procedures/Instruments19. Observe common Ophthalmic surgicalprocedures/Instruments including cataract, glaucoma,oculoplastics, retinal detachment and othercommon procedures and instruments.Ward TestAcademic Calendar - 4th Year MBBS Session 627-35Start of New Class1 Module (11 Weeks)st1 Module Exam (01 week)stTo24 Sep 201824 Sep 201806 Dec 2018EYEENTCOMMUNITY MEDICINESPECIAL PATHOLOGY2nd Module (1/11 weeks)07 Dec 201814 Dec 201807 Dec 2018 (Fri)10 Dec 2018 (Mon)12 Dec 2018 (Wed)14 Dec 2018 (Fri)15 Dec 201821 Dec 2018Winter Vacations2 Module (9/11 weeks)Co-Curricular WeekSports Day22 Dec 201830 Dec 201831 Dec 201803 March 201904 March 201910 March 201908 March 20192nd Module (1/11 weeks)2nd Module Exam (01 week)11 March 201914 March 201915 March 201922 March 201915 March 2019 (Fri)18 March 2019 (Mon)20 March 2019 (Wed)22 March 2019 (Fri)23 March 201926May 201906 May 201904 June 2019ndEYESPECIAL PATHOLOGYCOMMUNITY MEDICINEENTrd3 Module (9 weeks)Ramadan (Tentatively)

3rd Module Exam (01 week)44-4627May 2019 (Mon)EYEENT29May 2019 (Wed)31May 2019 (Fri)COMMUNITY MEDICINESummer Vacations & Eid ul FitrPre-Annual ExamEYEENTCOMMUNITY MEDICINESPECIAL PATHOLOGYPractical’s47-4903 June 2019SPECIAL PATHOLOGY3637-4327May 2019Prep Leave Annual Exam (25 days)Eid ul AzhaNUMS University Annual Exam03 June 2019 (Mon)04 June 201921 July 201922 July 201907Aug 201922 July 2019 (Mon)24 July 2019 (Wed)26 July 2019 (Fri)29 July 2019 (Mon)31 (Wed) July201902 (Fri), 05 (Mon), 07 (Wed) Aug 201908Aug 201901 Sep 201912-14 Aug 201902 Sep 2019 onwardsReading Material:Clinical Ophthalmology by Shafi M. JatoiBasic Ophthalmology by Renu JogiKanski’s Clinical Ophthalmology by Brad BowlingAnatomy of Eye Ophthalmology by Richard S. SnellParsons Eye DiseaseTABLE OF SPECIFICATIONSEYE (PRE-ANNUAL/ANNUAL IV PROFESSIONAL EXAMAMINATION: THEORY):Time Allowed 03 hrs. (Including MCQs)Marks of theory paper 90Internal assessment 10Total marks 100

Pass Marks 50TOPICNUMBER OF MCQs (30)NUMBER OF SAQs/SEQs (09)(C1 06, C2 12, C3 12) 1 mark each4x SAQs/SEQs (C1 & C2) 06 marks each 5 x SAQs/SEQs (C3) (1x08 marks and 4x07marks each)01Eye Lid & adnexa5Conjunctiva, Episclera &scleraOrbit / Uveitis301401Corneal Diseases &RefractiveSurgery/Refractive errorsLens301301Glaucoma301Retinal Vascular Diseases,RDOcular Tumors, Maculardiseases,Common Fundus PathologiesStrabismus&Neuro OphthalmologyOcular trauma3013013013009TABLE OF SPECIFICATIONS (Pre-Annual/ Annual Professional ExamPractical):

Practical 90Internal Assessment 10Total Marks 100Pass Marks 50Gen Viva OSCEInt ExaminerPracticalExt Examiner1515Long CaseGen Viva PracticalInternalEvaluationTotal9010100OSCEInt ExaminerExt Examiner151530Theory: Internal Assessment (IA) CalculationABRoll No.NameTotal MarksCAll end blocks/Pre annualExams or any other examDTotal Marks of internalassessmentOut of 10Sum of Marks obtained x15/ sum of totalmarks in all internal examsPractical: Internal Assessment CalculationARoll No.BNameTotal MarksCOSCE/TOACS throughout the year/Pre annual practicalExams or any other examSum of Marks obtained x15/ sum of totalmarks in all internal examsExamination Schedule:Pre-Annual exam: 22nd July 2019 (Monday)NUMS University Annual Exam: 2ndSeptember 2019DTotal Marks of internalassessmentOut of 10

Clinical Ophthalmology by Shafi M. Jatoi Basic Ophthalmology by Renu Jogi Kanski [s Clinical Ophthalmology by Brad Bowling Anatomy of Eye Ophthalmology by Richard S. Snell Parsons Eye Disease TABLE OF SPECIFICATIONS EYE (PRE-ANNUAL/ANNUAL IV PROFESSIONAL EXAMAMINATION: THEORY): Time Allowed 03 hrs. (In