CCOG for OMT 206 archive revision 201403
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- Effective Term:
- Summer 2014 through Summer 2015
- Course Number:
- OMT 206
- Course Title:
- Diagnostic Procedures I
- Credit Hours:
- Lecture Hours:
- Lecture/Lab Hours:
- Lab Hours:
Intended Outcomes for the course
Upon successful completion students should be able to:
1. Skillfully complete patient workup in a clinical setting.
2. Accurately perform and document the biomicroscopy and visual field examination, retinoscopy and refractometry in the clinical setting.
3. Efficiently and accurately perform applanation tonometry under supervision in a clinical setting.
Outcome Assessment Strategies
At the beginning of the course, the instructor will detail the methods used to evaluate student progress and the criteria for assigning a course grade. The methods may include one or more of the following tools: examinations, quizzes, homework assignments, research papers, laboratory modules, student participation and demonstration of competency.
Course Content (Themes, Concepts, Issues and Skills)
- Demonstrate the lacoation of the optical center of the lens.
- Demonstrate measurement and proper recording of single vision and multifocal spectacles.
- Demonstrate two methods of measurement of spectacles with prism.
- Discuss the significance of vertex distance.
- Demonstrate usage and measure base and power curves of spectacle lens using the Geneva lens clock.
- Convert Geneva lens clock measurements into a plus cylinder spectacle prescription.
INTERMEDIATE VISUAL FIELDS
- Review and demonstrate Amsler grid, confrontational, tangent screen and automated visual field testing.
- List and describe manual techniques for testing the visual field including tangent screen, and Goldmann perimetry.
- Demonstrate calibration of the Goldmann perimeter, including both stimulus and background.
- List automated methods for testing the visual field.
- Describe when corrective lenses are required and for which portion of the Goldmann perimetry procedure.
- Distinguish the difference between static and kinetic field testing.
- Differentiate testing strategies for glaucoma and neurological examinations.
- Define minimum criteria for testing for Armaly-Drance glaucoma screening examination, including blind spot screening methods.
- Describe the procedure for confirming respect for the horizontal or vertical meridian.
- Describe screening of possible malingering patient with tangent screen and expected results.
SLIT LAMP BIOMICROSCOPY
- Describe two major styles of slit lamps.
- Define “coaxial” as it relates to the slit lamp.
- Differentiate “magnification” vs. “illumination” in isolating pathology with the slit lamp.
- Describe the procedure for properly setting each eyepiece of the slit lamp microscope.
- List 6 “direct” and 6 “indirect” forms of illumination with the slit lamp.
- Describe the use and technique for each of the following forms of illumination: diffuse, parallel piped, optical sectioning, tangential, conical beam, specular reflection, proximal illumination, sclerotic scatter, direct retro-illumination from the iris, indirect retro-illumination from the iris, retro-illumination from the fundus and iris tranillumination.
- List the different filters available on the slit lamp and their usage.
- Describe the vital dyes and their usage when used with the slit lamp including: Fluorescein, rose Bengal and lissamine green.
- Describe when the Seidel test is used and how it is performed.
- Describe accessory lenses available to use with the slit lamp microscope; why and how they should be used.
- Differentiate between direct and indirect gonioscopic lenses.
- Utilize biomicroscopy to perform and anterior segment and ocular adnexa examination.
- Describe the differences in tonometers.
- Outline the advantages and disadvantages of each kind of tonometer.
- Explain how to use each tonometer.
- Decide which instrument to use to accomplish the measurement with greatest accuracy, efficiency, and least amount of discomfort to the patient.
- Discuss proper methods of cleaning and list 3 acceptable methods for disinfecting tonometers.
- Discuss technique for each method of tonometry: non-contact, TonoPen, Schiotz, pneumotonometer, hand-held tonometers, MacKay-Marg and Goldmann applanation.
- Describe the proper end point image in Goldmann applanation tonometry.
- Describe interpretation of the measuring dial of a Goldmann applanation tonometer in recording intra-ocular pressure.
- Describe and give the proper abbreviation of the units measured in tonometry.
- Describe the intra-ocular changes during the systole and diastole of the heartbeat.
- Describe the proper rotation of the tonometer prism head for patients with corneal cylinder of more than 3 diopters.
- Demonstrate the process of checking calibration of a Goldmann applanation tonometer in all three measurement ranges.
- Demonstrate checking calibration of TonoPen and proper measurement technique including replacement of OcuFilm tip covers.
- Demonstrate disinfecting each instrument.
- Perform and document applanation, non-contact, and indentation tonometry.
- Describe how central corneal thickness relates to measurement of intra-ocular pressure readings.
- Describe how intra-ocular pressure readings are converted for thick or thin corneas.
- List 3 types of patients contraindicated for tonometry.
- State and explain the principles of and indications for retinoscopy.
- Describe the mechanism and functioning of the streak retinoscope.
- Describe the various types of behavior of the retinoscopic streak.
- Explain the recording of retinoscopic results and transpose those results into sphero-cylinderical form.
- Perform retinoscopy on the schematic eye.
- Perform retinoscopy on the human eye.
- Demonstrate appropriate maintenance of various retinoscopes.
- List at least 3 types of patients for whom retinoscopy is critical because refractometry cannot be performed.
- Describe the proper setup, with both phoropter and trial frames, for performing retinoscopy.
- Describe the reasons for both “fogging” the fellow eye and having the fellow eye unoccluded during retinoscopy.
- Describe proper sleeve position for both the Copeland type and Welch Allyn types of retinoscopes.
- Describe the purpose of using a “working lens” or subtracting “working distance” from the patients retinoscopic findings.
- List the steps performed when retinoscoping in plus cylinder.
- Explain the use of the “double sphere” method in retinoscopy.
- List the types of motion observed in patients with emmetropia, myopia, hyperopia and astigmatism.
- List the types of lenses used to neutralize motion in myopes, hyperopes and astigmats.
- Describe a method of confirming that neutrality has been achieved in retinoscopy.
- Give estimated spherical refractive errors for patients with visual acuities of: 20/80, 20/200, 20/400, and worse than 20/400.
- Explain how keratometry findings can help in finding proper correction of axis in retinoscopy.
- Describe a retinoscopic reflex in patients with high refractive error.
- Differentiate between refraction and refractometry.
- Define emmetropia, ametropia, hyperopia, myopia and astigmatism.
- Describe symptoms of myopes, hyperopes and astigmats.
- Identify all knobs, dials and parts of the phoropter.
- List the five main steps in refractometry.
- List at least 5 “rules” to use during refractometry.
- Describe the proper use of the Jackson Cross Cylinder in testing both cylinder axis and power (in plus cylinder).
- Describe the “4-Step Test” for looking for cylinder power when spheres alone do not correct vision adequately.
- Describe the astigmatic clock and its usage.
- Describe the duochrome test and it’s usage in preventing over-minusing.
- Describe the principle of binocular balancing and how it is performed.
- Define “aphakia” and “pseudophakia”.
- Describe techniques to use with aphakic patients.
- Describe trial frames and loose lenses – distinguish how refractometry with these is different than that with a phoropter.
- Define vertex distance and explain when/how it is measured in performing refractometry.
- Define “Halberg Clips” and explain when/how they are used when “over-refracting”.
- Define presbyopia and list common symptoms.
- List estimated “adds for each age” for each group of presbyopes.
- List the process for checking the patients “near range” with “adds” in place.
- List three methods of measuring amplitude of accommodation.
- Describe subjective and objective methods of measuring refractive error.
- Explain the refinement technique using a cross cylinder lens.
- Demonstrate motility screening tests including cover/uncover, alternate cover tests.
- Demonstrate phoria and tropia.
- Demonstrate Krimsky and Hirschberg estimation.
- Demonstrate the use of the Maddox rod, Worth 4-Dot, red glass, duction and version testing.
- Demonstrate near point of convergence/accommodation.
- Demonstrate vergence amplitudes.
- Demonstrate use of the Risley rotary prism.
- Demonstrate extending the range of keratometry