Elective/Clerkship Course Description
Elective Title:
Clinical Ophthalmology
Elective Description:
This elective is designed to meet the educational needs of all medical
students regardless of ultimate choice of specialty. The rotation is suitable
as an introduction to ophthalmology or as an advanced course for a student
planning a career in ophthalmology. In addition to attending daily didactic
conferences, the student will engage in clinical activities under the
supervision of ophthalmology residents. The extent of participation in patient
care is determined by the skill level, motivation and initiative of the
student. Emphasis is placed on the ability to perform a good general eye exam
in order to detect common abnormalities of the eye and visual system. Students
will develop and refine skills in the use of the penlight, ophthalmoscope and
slit lamp. Students will also have ample opportunity to observe a variety of
ophthalmic surgical and laser procedures.
Rotation Supervisor:
Felix Sabates, Jr., MD
Eye Foundation of Kansas City
2300 Holmes St.
Kansas City, MO 64108
(816) 404-1780
Institution:
Eye Foundation of Kansas City / Truman Medical Center-Hospital Hill Eye
Clinic
Availability/Length of Elective:
Every month except July. This elective is one month long. Rotations of less
than four weeks in length are not possible.
Open to:
UMKC Students: |
Year 5 or Year 6. |
Visiting Students: |
Year 4 (or second half of Year 3, pending application
approval). |
NOTE: Visiting students must submit an application for this elective at
least one month in advance. An acceptance or denial decision will be made
within two weeks.
Prerequisites:
None.
Days on Duty:
Monday - Friday.
Call:
Not required.
Housing/Meals:
Not provided.
Curriculum for the Ophthalmology Elective
Objectives
Cognitive Objectives - At the end of this elective, the student will:
- Understand the basic anatomy and physiology of the eye and visual system.
- Understand basic ophthalmic terminology and abbreviations.
- Understand the pharmacology, indications, contraindications and potential
complications of commonly used ocular medications.
- Understand what information is needed when taking a general ophthalmic
history.
- Understand the basic principles of performing a general eye exam.
- Achieve a basic understanding of the pathophysiology and clinical
manifestations of important ocular disease states, including:
- Ocular manifestations of systemic diseases:
- Diabetes
- Systemic hypertension
- Intracranial hypertension
- Embolic disease
- Migraine
- Blood dyscrasias
- Sickle cell anemia
- Metastatic carcinoma
- Connective tissue disorders
- Thyroid disorders
- Sarcoidosis
- Myasthenia gravis
- AIDS
- Glaucoma:
- Primary open angle glaucoma
- Angle closure glaucoma
- Primary congenital glaucoma
- Common forms of secondary glaucoma
- Diabetic retinopathy:
- Nonproliferative retinopathy
- Proliferative retinopathy
- The red eye and its causes:
- Stye / Chalazion
- Blepharitis
- Cellulitis
- Nasolacrimal duct obstruction / Dacryocystitis
- Conjunctivitis
- Subconjunctival hemorrhage
- Dry eyes
- Pingueculum / Pterygium
- Episcleritis / Scleritis
- Contact lens overwear
- Keratitis
- Iritis
- Acute glaucoma
- Eye trauma and emergencies:
- Chemical burns
- Ruptured globe
- Hyphema
- Orbital trauma & fractures
- Lid lacerations
- Corneal abrasions & foreign bodies
- Strabismus
- Nerve palsies (Cranial nerves 3, 4, 6 and 7)
- Understand which ocular conditions can be treated by an internist or other
primary care practitioner and which conditions require ophthalmologic
consultation or referral.
- Understand what constitutes an ocular emergency.
Skill (Performance) Objectives - At the end of this elective, the
student will:
- Demonstrate the ability to obtain an ophthalmic history:
- Elicit chief complaint.
- Obtain history of present illness.
- Perform review of systems.
- Obtain past, family and social history.
- Inquire about current medications and allergies.
- Demonstrate the ability to perform a general eye exam:
- Measure and record visual acuity, distance and near.
- Perform external exam.
- Test pupils to detect abnormal responses.
- Test for strabismus and abnormal eye movements.
- Perform confrontation visual fields.
- Examine anterior segment with penlight and slit lamp.
- Perform direct ophthalmoscopy to detect fundus abnormalities.
- Describe the steps required to evaluate a red eye.
- Describe the steps required to evaluate a traumatized eye.
- Demonstrate competence to initiate appropriate management and/or physician
referral for detected or suspected abnormalities of the eye and visual
system.
Educational Methods
Didactics -
- Departmental lectures and case presentations.
- Teaching sessions with faculty.
Clinical Experience -
- Examination of patients under the supervision of ophthalmology residents.
- Observation of ophthalmic surgical and laser procedures.
Independent Study -
- Slide-script programs.
- Videotapes.
Recommended Texts -
- General Ophthalmology by Vaughan, Asbury and Riordan-Eva. This is a
good one to purchase.
- Basic Ophthalmology for Medical Students and Primary Care Residents
by Frank Berson. This will be checked out to you.
Clinical Duties
All students are expected to be present in the TMC-HH Eye Clinic each day
during normal working hours. UMKC students will be excused for their weekly
Medicine Clinics. All other planned absences must be cleared in advance
through the rotation supervisor. The rotation supervisor must also be
notified personally of unexpected absences due to illness or other reasons.
While in clinic, students are expected to be working actively with the
residents in seeing patients. Students are permitted to observe interesting
resident surgical cases. Independent study materials may be reviewed when the
clinic is slow.
Students are expected to attend departmental conferences and lectures,
including Grand Rounds, as directed by the rotation supervisor.
Evaluation Criteria and Methods
Evaluation Criteria -
- Attitude
- Peer relations
- Reliability
- Clinical competence
- Maturity
- Patient rapport
- Ingenuity
- Conscientiousness - includes attendance in clinic and in conferences.
Evaluation Methods - The student will meet with the supervisor midway
through rotation and upon completion.
Passing Grade
- Direct observation by ophthalmology residents with feedback to rotation
supervisor. This is the primary source of your evaluation. Therefore, it
is important to work with all of the residents.
- Direct observation by rotation supervisor.
- Written test.
- Paper or oral presentation.
Honors Grade
- In conjunction with the resident, write up a case report presented at Grand Rounds (or similar conference)
which will be submitted for publication by the end
of the rotation.
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