BLDE University Courses

M.S. (Ophthalmology)

COURSE SYLLABUS

Essential Theoretical Knowledge

These are only broad guidelines and are illustrative, there may be overlap  between sections.

The Basic sciences:

• Orbital and ocular anatomy
  • Gross anatomy
  • Histology
• Ocular Physiology
• Pathology
  • General pathology
  • Ocular pathology: Gross pathology, Histopathology.
• Biochemistry: General biochemistry, biochemistry applicable to ocular function.
• Microbiology
  • General Microbiology
  • Specific microbiology applicable to the eye
  • Immunology with particular reference to ocular immunology
• Geometric and ophthalmic optics
  • Basic physical optics
  • Ophthalmic optics
  • Applied optics including optical devices

Clinical ophthalmology

• Disorders of refraction
• Disorders of the Lids
• Disorders of the Lacrimal system
• Disorders of the conjunctiva
• Disorders of the sclera
• Disorders of the cornea
• Disorders of the uveal Tract
• Disorders of the lens
• Disorders of the Retina
• Disorders of the Optic Nerve & Visual pathway
• Disorders of the orbit
• Glaucoma
• Neuro ophthalmology
• Pediatric Ophthalmology
• Systemic Ophthalmology ( ocular involvement in systemic disease )
• Immune ocular disorders
• Strabismus & Amblyopia

Essential diagnostic skills – instrumentation

Tonometry

• Applanation
• Indentation (Commonly Schiotz)

Assessment of epiphora

• Jone’s dye test
• Syringing – Performance & interpretation

Dry eye evaluation

• Schirmer test
• Rose Bengal staining
• Tear film breaking up time
• Tear meniscus evaluation

Corneal ulceration.

• Taking a corneal scraping
• Inoculation into media
• Evluation if Gram’s stain
• Evluation of KOH Preparation
• Corneal wedge biopsy

Direct ophthalmoscopy

• Distant direct
• Media assessment
• Use of filters provided

Indirect Ophthalmoscopy

• Scleral depression
• Fundus drawing capability
• Use of filters provided

Slit lamp examination

• Diffuse examination
• Focal examination
• Retro illumination – direct & indirect
• Sclerotic scatter
• Specular reflection
• Staining modalities and interpretation

Slit lamp Accessories:

• Applanation tonometry
  • Goldman’s applanation
• Gonioscopy
  • Single mirror gonioscope
  • Gonioprism
  • Grading of the angle
  • Testing for Occludability
  • Indentation gonioscopy
• 3 – mirror examination of the fundus
• 78-D/90-D/60-D examination
• Hruby lens examination
• Opticsal pachymetry
• Slit lamp photography

Colour vision evluation

• Ishira pseudoisochromatic plates
• Other tests including
  • Farnsworth – Munsell 100- hue or 15- hue tests
  • Holmgrens wools
  • Edridge – Green lantern

Use of Amsler’s charting

• Instructing in the use of and interpreting the chart.
  • Corneal topography and corneal mapping
    • Interpretation of corneal topography mapping
  • Specular microscopy of the corneal endothelium

Keratometry

• Performance & interpretation of keratometry
• Diagnosis of situations such as keratinous
• Keratoscopy
• Fundus photography & fundus fluoresce in angiography ( FFA,FAG)
  • Doing and evaluating stereoscopic fundus photographs
  • Performance of and interpretation of FFA

Refraction

• Retinoscopy
• Streak retinoscopy
• Use of trial set
• Use of Jackson’s cross - cylinder
• Subjective and objective refraction

Autorefractometry

• Use of and interpretation of autorefractometer

Diagnosis & assessment of Squint

• Ocular position and motility examination
• Versions,ductions and vergences
• Convergence facility estimation
• Cover/Uncover / Altertnate cover test
• Use of prism bars or free prisms in assessment of squint
• Use of synaptophore / major amblyoscope
• Use of Bagolini’s striated glasses / red filters / Maddox rod
• Use of worth’s four dot test
• Use of monor amblyoscope
• Use 7 interpretation of the Hess chart / Lees’ screen
• Performance & interpretation of diplopia charting
• Diagnosis of amblyopia

Exophthalmometry

• Use of Hertel’s exophthalmometer
• Use of Luedde’s exophthalmometer
• Use of other exophthalmometers
• Measurement of proptosis or exophthalmose

Use and evaluation of Ophthalmic ultrasound

• A- Scan ultrasound with biometry
• B- Scan ultrasound : performance & interpretation
  • Interpretation of perimetry
• Tangent screening
• Goldman perimeter & interpretation
• Static computerized perimetry
• Interpretation of commonly managed problems

Radiology

Interpretation of plain skull films

• PA- 20 ( Caldwell’s view )
• PNS ( Water’s view )
• Lateral
• Submentovertical
• Optic canal views
• Localisation of intra ocular and intra orbital FBs

Interpretations of contrast studies

• Performance & interpretation of dacryocystograms
• performance and interpretsation of orbital venograms
• Interpretation of carotid angiograms

Interpretation of CT – Scans & MRI Scans

• Orbital CT interpretation & Orbital MRI evaluation
• Brain CT interpretation.

Thesis / Dissertation:-

• Aims : To instill spirit of scientific enquiry
• Objectives
  • To teach the basic concept of research,methodology & epidemiology, to train the student to critical analyze relevant published research paper.
• 3. General Guidelines:
  • The thesis / dissertation is compulsory for candidates registered for M.S
  • The subject of thesis along with a synopsis ( about 200 words) countersigned by the post Graduate teacher,head of the department and the head of the Institution should be submitted to the University within 6 months of registration as post Graduate student. A penalty of Rs. 50/- every day will be levied after the due date.
  • The subject and plan of work of the thesis should not be same as that of a thesis, which has been accepted by the University in the past three years.
  • If a work required for the thesis entails collaboration with other department or specialties, the collaborative portion of work will be supervised by a co-guide designated by the Head of the institution. A co-guide should normally be a post – Graduate teacher in his own specialty. In cases where there is guide and a coguide for thesis, the certificate required for submission of the thesis should be signed both by the guide and co-guide.
  • The thesis will be examined for acceptance by two external evaluators.
  • If a students has submitted his examination form as also his thesis previously, he will be permitted to take examination within a period of 4 years any time in future provided the thesis has been accepted. The terms satisfactorily ke pt by him/her are valid in future, only for a period of 4 years subsequent to submission of his / her thesis after which he / she will have to appearing for the theory, clinical and practical examination.
  • If the progress of a candidate’s work including thesis work is not satisfactory, the University on recommendation of Head of the department, Head of the Institution and the Dean of faculty of Medicine may not grant that particular term and the period of training will be extended by the number of terms not granted.
  • Procedure for defaulters : Every department should have a committee to review such situations. The defaulting candidate is counseled by the guide and head of the department. In extreme cases of default the departmental committee may recommended that defaulting candidate be withheld from appearing the examination, if she /he fails to fulfill the requirements in spite of being given adequate chances to set himself or herself right
• The dissertation should be written under the following headings:
  • Introduction
  • Aims or Objectives of study
  • Review of Literature
  • Material & Methods
  • Results
  • Discussion
  • Conclusion
  • Summary
  • References
  • Tables
  • Annexure
  • The written text of dissertation shall be not less than 50 pages and shall not exceed 150 pages excluding references, tables, questionnaires and other checklists. It should be neatly typed in double line spacing on one side of paper and bound properly. Spiral binding should be avoided.The dissertation shall be certified by the guide, head of the department and head of the Institution.
  • Four copies of dissertation thus prepared shall be submitted to the University, six months before final examination on before the dates notified by the University.
  • The dissertation shall be valued by the evaluators appointed by the University . Approval of dissertation work is an essential precondition for a Candidate to appear in the University examination.
  • Guide : the academic qualification and teaching experience required for recognition by this University as a guide for dissertation work shall be as per medical council of India Minimum qualification for Teachers in Medical Institutions regulations,1998. Teachers in Medical College/institution having a total of eight years teaching experience out of which at least five years teaching experience as Lecturer or Assistant Professor gained after obtaining postgraduate degree,shall be recognized as postgraduate teachers A Co – Guide may be included provided the work requires substantial contribution from a sister department or from another medical institution recognized for teaching/training by the University/Medical council of India. The co-guide shall be a recognized postgraduate teacher.
  • Change of Guide: In the event of registered guide leaving the College for any reason or in the event of death of guide mey be changed with prior permission from the university.

Essential Research Skills.

• Basic stastical knowledge
  • Ability to undertake clinical & basic research
  • Descriptive and Inferential stastics
  • Ability to publish results of one’s work
• Ability to constructively criticize publications in the field and without.
• This could be achieved during the course by attending workshops on Research Methodology, basic statistics classes and regularly having journal clubs etc.Where selcted articles could be taken and evaluated for content quality and presentation.

Other skills required

• Contact Lenses
  • Assessment
  • GP fitting
  • Soft lens fitting
  • Troubleshooting
• Subjective correction of refraction
  • Techniques of subjective correction
  • Knowledge of basic optical devices available and relative advantages and disadvantages of each.
• Low vision aids
  • The basics of fitting with knowledge of availability & cost
• 4. Community Ophthalmology
  • Ability to organize peripheral eye screening
  • Ability to organize peripheral eye screening camps
  • Knowledge and ability to execute guidelines of National programme for Prevention of Blindness
• Presentation
  • Ability to present One”s work effectively at various scientific for a particularly free papers in scientific conferences within allotted framework of time.
• Organisation
  • Ability to organize meetings, seminars and symposia
  • Ability to get along with colleagues and work as a team with the other members of the department.
  • Ability to interact with and work as a team with other disciplines that may exist in the same hospital.
• Communication skills
  • With patients
  • With colleagues
• Record keeping
  • The ability to maintain records as scientifically as possible
  • Knowledge of computer software is helpful
• Teaching
  • the ability to pass on skills acquired to one’s juniors, theoretical, procedural and surgical