Ophthalmology For Medical Students 2017-2018 Professor Clement THAM Chairman Department of Ophthalmology & Visual Sciences Faculty of Medicine The Chinese University of Hong Kong Prince of Wales Hospital (PWH) Address : 1/F, Eye Centre, Shatin, New Territories, Hong Kong Telephone : (852) 3505 2879 Hong Kong Eye Hospital (HKEH) CUHK Eye Centre (CUHKEC) Address : c/o Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong Telephone : (852) 3943 5855 Page 1 of 8
Ophthalmology for Medicine Year 6 Objectives for Glaucoma 1. Understand the definition of glaucoma as a type of optic neuropathy, and misconceptions of the past 2. Learn the important types of glaucoma 3. Learn the presentation, diagnosis, and management of acute and chronic types of angle closure glaucoma 4. Learn the presentation, diagnosis, and management of primary open angle glaucoma 5. Understand the principles of glaucoma drug treatment and the possible side effects 6. Understand the principles of laser treatment in glaucoma 7. Understand the principles of surgery in glaucoma Objectives for Ocular surface disease/external eye 1. Understand the causes and treatment for dry eyes. 2. Understand the causes and treatment for red eyes 3. Understand the causes and treatment for pterygium 4. Understand the indications and possible complications for penetrating keratoplasty 5. Understand the signs/symptoms and treatment for corneal ulcer Objectives for Medical Retina diseases and in relation to systemic problem 1. To acquire knowledge about ophthalmic manifestations of systemic disease 2. Working knowledge of ophthalmic manifestations of diabetes mellitus and hypertension 3. Ability to recognize ophthalmic manifestations of diabetes 4. To acquire basic knowledge on treatment of ophthalmic manifestations of systemic disease 5. Understand the classification and treatment of age-related macular degeneration Objectives for Surgical Retina 1. To understand the pathophysiology of diseases of the retina and vitreous, including a. Rhegmatogenous retinal detachment b. Proliferative diabetic retinopathy including tractional retinal detachment c. Retinopathy of prematurity 2. To understand the principles behind the various types of vitreoretinal surgery including: a. Scleral buckle b. Pars plana vitrectomy c. Pneumatic retinopexy 3. To understand the etiologic agents responsible for causing post-operative / post-traumatic endophthalmitis and to understand the timing and mode of surgical treatments 4. To understand the rationale behind and the timing of the screening of retinopathy of prematurity Objectives for Paediatric Ophthalmology 1. Know how to perform ocular examination such as pupil examination, fundi examination, extraocular movement and so on 2. Learn the presentation, diagnosis, and management of common eye diseases such as cataract, glaucoma, diabetic, retinopathy, amblyopia strabismus and so on 3. Understand the principles in treatment of eye diseases, for example laser 4. Understand normal visual development and the importance of binocular vision Page 2 of 8
Objectives for Cataract 1. Cataract a. Understand the risk factors and the effects of cataract formation in the human lens b. Understand the principle of the optical system in human eyes c. Understand the optics of aphakia, pseudophakia d. Understand the optics of aphakic glasses, and its advantages and disadvantages 2. Cataract surgery a. Understand the types surgical procedures in cataract surgery b. Understand the different types of intraocular lens currently available c. Understand the major complications associated with cataract surgery and their treatment d. Understand the different types of anaesthesia available in cataract surgery e. Understand the principle in intraocular lens power calculation in cataract surgery Objectives for Optics, refractive surgery and contact lens 1. Optics a. Understanding the principle of reflection and refraction b. Understanding the principle of laser generation and the different forms of laser available in Ophthalmology c. Understand the cause and optics of myopia, hyperopia, astigmatism and presbyopia d. Understand the principle of spectacles and contact lens correction of the above mentioned conditions e. What is aneisometropia and what are the problems associated with it 2. Refractive surgery a. Understand the different types of refractive surgeries currently available b. Understand how refractive surgery can correct myopia, hyperopia and astigmatism c. Understand the common complications of refractive surgery 3. Contact Lens a. Understand the complications associated with contact lens use b. Understand the cleansing method used in contact lens ware Objectives for Oculoplastic and orbital surgery 1. Understand the clinical features (and causes) of common oculoplastic disorders (entropion, ectropion, ptosis, lid retraction, proptosis, enophthalmo, tearing, lid lumps) 2. Early identification and referral of the following conditions: orbital cellulites, suspected periocular malignancy, orbital trauma (fracture, lid margin involving laceration), thyroid eye disease, acute dacryocystitis, proptosis 3. Concept of periocular rejuvenation Objectives for Neuro-Ophthalmology 1. To be able to perform a basic neuro-ophthalmological examination, including visual acuity, color vision, pupils, confrontational visual fields, extraocular movement and direct ophthalmoscopy of the optic discs; and to know how to interpret the findings. 2. Basic understanding of common neuro-ophthalmological conditions, including optic neuropathies, visual field defects, abnormal pupil responses, extraocular movement disorders and abnormal optic disc appearance. Page 3 of 8
Texts The required text for the rotation is: Basic Ophthalmology for Medical Students and Primary Care Residents. Bradford C.A. 8th edition, 2004, by the American Academy of Ophthalmology. (Available at the CUHK bookstore) Other recommended textbooks are available at the Li Ping Medical Library: 1. Clinical Ophthalmology: a systematic approach. Kanski J. J., Edinburgh, Churchhill Livingstone, 2007 (6 th Edition) 2. The Physician s Guide to Eye Care. Trobe J. D., San Francisco: American Academy of Ophthalmology, c2001 (2 nd Edition) 3. Vaughan and Asbury s General Ophthalmology. Riordan-Eva P. and Whitcher J. P., New York: Lange Medical Books/McGraw Hill, Medical Pub. Division, c2004 (16 th Edition). Instruments You should have with you at all times during this rotation the following: a direct ophthalmoscope a penlight proper attire, white coat with your CUHK name-badge You should seize every opportunity to use these instruments to examine eyes. Practice, practice and more practice is the only way to acquire clinical skill that you will find useful for the rest of your medical career regardless of what specialty you choose to become. Activity Schedule You are a part of the Department of Ophthalmology & Visual Sciences during your attachment and you are expected to devote your time to the activities of our department. Our faculty staff will supervise you & medical officers designated by the department will be your teachers and you will participate in carrying out clinical duties. Your clinical performance is assessed upon the following criteria: 1. attendance and participation 2. attitude and bed-side manners 3. sense of duty and responsibility 4. knowledge 5. clinical judgement Page 4 of 8
Evaluation You are required to pass Ophthalmology before you can sit for the final Surgery paper. If you fail Ophthalmology, you are required to repeat the entire two-week ophthalmology rotation at the end of the year. If you fail both Ophthalmology and ENT, you are deemed to have failed Surgery. You are marked according to the following: 1 Out-patient Participation 20% 2 Operative Session Participation 15% 3 Clinical Skills Tutorial 15% 4 Case Tutorial 20% 5 MCQ (60 questions) 30% Grand Total 100% Remember, an environment is created and provided for you to learn Ophthalmology and this clinical attachment is meant to be an educational experience to help you to become better equipped and more accomplished as a medical practitioner. WELCOME ABOARD! Page 5 of 8
Department of Ophthalmology & Visual Sciences Name: Date of rotation: from to Outpatient Participation 20% Operative participation 15% Clinical Skills Tutorial 15% Case Tutorial 20% MCQ (60 questions) 30% Grand Total 100% Page 6 of 8
Log sheet for Senior Clerkship for Medical Year 5 Students 2017/2018 Hong Kong Eye Hospital (period from to ) Notes to students 1. Please kindly ask your tutor to sign on the log sheet before the end of your training ; 2. You should stay in your assigned training unless you are informed by the training program coordinator of any changes; 3. Please be reminded that there will be no date-back signature from tutors unless special approval is sought. 4. Please return the log sheet to the training program coordinator upon completion of your training period 5. You must return the log sheet to the secretary on the last day of your attachment. Notes to training tutors: 1. Please kindly sign ONLY in the box of your designated training ; 2. Date-back signature is not encouraged unless special reason is given Student Name: (# ) Date: (Monday) 09:00-End of Session Date: (Tuesday) 08:45- End of Session Date: (Wednesday) 08:45-End of Session Date: (Thursday) 09:00-End of Session Date: (Friday) 09:30-End of MCQ Test Page 7 of 8
Senior Surgical Clerkship 2017/2018 Department of Ophthalmology and Visual Sciences Year 6 is the year that medical students have the most extensive exposure to Ophthalmology. In this year, students will have 10 s (5 full days / 10 s) of ophthalmology attachments in one week. To facilitate students to gather the useful information, basic information will be provided in multimedia format. There will be a video on basic examination and slit-lamp examination uploaded on website for pre-tutorial learning, followed by a clinical skills tutorial in the first. Clear learning objectives will be provided. Students will understand the areas that they are expected to know. The knowledge mentioned above will provide good basic knowledge in Ophthalmology. Assessment in this part will be based on 60 MCQ questions in which a pass mark of 60% is required. Only pass/fail will be given and if a student failed the exam, he/she can take the exam unlimited times until he/she pass this MCQ. The following is a timetable for the Year 6 student attachment in the Prince of Wales Hospital or the Hong Kong Eye Hospital: AM PM Mon Tue Wed Thu Fri 9:00 9:30 8:45 End of 8:45 End of 9:00 End of Briefing Session Session Session 9:30 End of OT / Laser OT / Laser / Case Tutorial Session /Triage clinic Triage clinic Clinical Skills Tutorial 9:30 End of Session MCQ test* *If the MCQ test day falls onto a public holiday, the MCQ test will move to Wednesday PM. Page 8 of 8