Orthoptic / OPTO 420

 

Course Description
  
This class will introduce the student to the complexities of analysis of the visual system. This will be achieved through lecture, discussion, group activity, given clinical scenarios as well as experimental and clinical settings in which the student is required to engage in direct patient care, including sensory visual evaluation, physical ocular assessment, and biomedical application of ophthalmic instrumentation. This class will provide the student with the knowledge and practical application to be able to solve visual problems regarding the binocular single vision misalignment and abnormalities, as well as the treatment of binocular vision anomalies including those conditions which result in a reduction of visual efficiency (phorias, decreased vergence facility) and conditions which result in decreased binocular function (amblyopia and strabismus) or deficit of pursuit, saccades and eye-hand coordination.
 
Course Objectives
 
This class will provide the student with the knowledge and experience specific to abnormal binocular vision so that the student will show the following understanding and abilities:
 

1. The ability to select and administrate diagnostic tools to evaluate binocular status and identify anomalies in a patient scenario.
2. The ability to determine the appropriate sequence and application of tests for sensory visual evaluation and physical ocular assessment, based on the findings of ophthalmic examination
3. Understand the abnormality and method of treatment for strabismus, saccade, pursuit convergence, divergence and vergence range problems.
4. Understand the treatment of other visual and Oculo-motor problems such as deficit of pursuit, saccades and eye-hand coordination
5. Perform treatment of binocular problems emanating from visual and oculo-motor inefficiency
6. Think and act logically following standardized testing methods to provide the highest quality of patient care.
7. Identify testing procedures considered necessary for each orthoptic patient where the patient’s age, mental, physical and emotional capability will permit such testing

 
Teaching strategies
 
This course is broken down into weeks and each week consists of one in- depth power point lecture, often with additional readings that you will receive in advance. Typically, this is a 2 hours in-class delivery, so plan on committing that much time per week for the read- through to review. You will be provided a written copy of the lectures, also you will view the lectures on the internet (through your email) as printed-out versions could lack some detail.
 
   There is an additional assigned weekly 1-hour laboratory component in which to practice the skills taught in lectures. I would suggest you set aside at least this amount of time each week, in addition to the lectures, to practice your skills.
 
    To aid you in your practice and help you learn proper examination techniques, you will be given a skills booklet in which to record your practice under observation. For each skill, you will find a check-off list of things to remember when you are performing each task, and those are the things your proctor will be looking for as well. You will be required to have a proctor observe your performance, sign the corresponding page in the practice booklet confirming that you have been performing the task properly, and deliver it to me within the designated period (see calendar for exact weeks that these are due). Other forms of evaluation include assignments, discussion questions, and written exams. Please read on for details...
 
Learning Resources
 
By the start of the course, you would receive:

1. Weekly printed copies of lectures (Outlines of the PowerPoint lectures will be circulated prior to each lecture).
2. Accompanying readings for each lecture,
3. Course outline, calendar, etc
4. Practical Skills Booklet

  
Continuous Assessments:
 
There will be 1 continuous assessment tests (written exam) during the course of this semester. It will be in the form of multiple-choice and short answer quizzes during the lecture periods or short essays on topics already covered. Other forms of evaluation include assignments, class's discussion questions, and written exams. Please read on for details...
 
Course Evaluation:
 
1.         Assignment (10%)
2.         in class participation (5%)
3.         Practical Skills Booklet (20%)
4.         Midterm Exam (25%)
5.         Final Exam (40%)
 
Attendance Policy
 
     Attendance at all lectures and laboratories is mandatory.
 
Detailed Course Evaluation by Component:
 

1. Assignment (10%)

 
     Please find the assignment section of your course and you will see that you have (Assignment #1) due at the end of the course. This involves an APA style research paper that is sent to the entire class. It will be from this research that you will study this topic and no other lectures will be provided. Please see me for more details.
 
2- In class participation (5%)
 

1. Practical Skills Booklet (20%)

     Weekly (will be indicated in the course calendar and course summary by weeks), we will clinically practice the course assigned clinical examinations. These sections are designed to explore the practical content of the class and develop your clinical skills. You are required to participate as well as completing and returned the checklist with the Skills Objective Achievement sheet you have received earlier. All completed practical skills booklet forms must be submitted by the required due date. Your participation in the practical section as well as completing your assignments will greatly impact your clinical participation grade for the course. Please review the practical skills booklet for more detail.
 
4-Midterm Exam (25%)
 
     This will be a short answer and multiple-choice test to be completed within 2 hours under the supervision of a proctor. This exam will be sent to your proctor and they will administer it and then send it to me for grading.
 
5-Final Written Exam (40%)
 
    Similar to the midterm, but usually requires 3 hours to complete and includes all course material.
 
Please Note: Examinations must be written during allotted times and make- ups will be permitted only due to illness or other very exceptional circumstances. You must notify me before the scheduled exam if you will be absent. A physician’s medical report dated that day of the missed examination will be necessary to document legitimate illness.
 
Late assignments will be accepted with the following penalties:
1-day late10% penalty
2 days late 20% penalty
3 days late 30% penalty and so on....
 
Required Texts:

• Clinical Orthoptics, Fiona Rowe, (Published by Blackwell Science Ltd., 1999).
• Diagnosis and management of ocular motility disorders, Mein, J., & Harcourt, B.
• Handbook of Orthoptic principles 4th Edition, Cashell G.T. and Durran I.M., (Published by Churchill Livingston, 1980).

 
Essential References
 

• Atlas of Strabismus 2nd Edition, Von Noorden G.K. & Maumenee A.E., (Published by C.V. Mosby Company, 1973)
• Fundamentals for Ophthalmic Technical Personnel Ed. Cassin, B., & Latif M. H. W.B. Saunders, 1995.
• Von-Noorden, G. K. (1996). Binocular Vision and Ocular Motility: Theory and Management of Strabismus (5th ed.). St Louis: MOSBY.

Additional Reading:

• Assigned readings will be provided from various sources. You will find journal articles, etc. that aid in the delivery of certain topics about the appropriate lecture section.

 
Electronic Materials, Web Sites etc:

• http://sprojects.mmi.mcgill.ca/ophthalmology/index.htm
• http://www.mrcophth.com/chua1.html
• Duane's ophthalmology on CD-ROM, 2006 Edition( e-source): http://www.oculist.net/downaton502/prof/ebook/duanes/pages/contents.htm
• Yale School of Medicine site on cranial nerves http://info.med.yale.edu/caim/cnerves

  
 
 
 
 
 

Topics to be Covered
List of Topics	No. of weeks	Contact hours
Introduction to strabismus-Strabismus Comitant / Incomitant strabismus Vertical Strabismus / Cyclo Strabismus Pattern strabismus: A and V patterns	2	4
Micro-strabismus: Examination & Managements	1	2
Exodeviations: Examination & Managements	2	4
Med Term Exam	1	2
Esodeviation: Examination & Managements	2	4
Incomitant Strabismus / Neurogenic Disorders	1	2
Incomitant Strabismus / Mechanical and Myogenic	1	2
Incomitant Strabismus / Intranuclear and Supranuclear	1	2
Management of suppression and Amblyopia	2	4
Review	1	2

  
 

 
   

Schedule of Assessment Tasks for Students During the Semester:
 

		Assessment task (e.g. essay, test, group		Proportion of
		project, examination, speech, oral	Week Due	Total
		presentation, etc.)		Assessment
b.	Scientific Research: Supra-nuclear, Nuclear, Infra-nuculear & Visual Pathway	Week 14, 15	10%
c.	Practical Skills Booklet (Clinical Examinations)	Week 14, 15	20 %
d.	In class participation	Every week	3 %
e.	On line participation	Every week	2 %

  
 
 
 
 
 
 
 

Course rules
 
Attendance: Attending at least 75% of the lectures is mandatory otherwise students will be denied access to the final exam. Students who arrive to class 15 minutes late for two times will be considered absent for one class.
 
Special examination: NO special examination will be given for students who have missed the scheduled examination time except in cases of special circumstances accompanied with the necessary documentation. In this case, students have to take the exam during the next week from the initial scheduled examination time.
 
Participations: Positive participation with the instructor is recommended, but side talks are prohibited as well as using mobiles during the lecture

Class Leader:
 
A class leader is a student in the class who will be chosen by the majority of class students. She should fulfill the following criteria:

• GPA:  not less than 3.5 /5.00
• Good relationship with all students in the clasess
• High moral standards and effective communication skills.

Duties of the Class leader:

• Acquiring contact information from all students in the classes
• Maintaining continuous contact with the course instructor with quick interaction
• Delivering information and answering questions to the students quickly
• Delivering students concerns, information and questions to the instructor quickly

 
Advantages for the class leader:

• If the Class leader is successful in performing the above-mentioned duties, he will get the full mark in Class discussion and assignment (5 marks)
• If the group leader fails in these duties, the instructor has the right to call for choosing another Class leader

OPTO 420 Assignment
 
Supra-nuclear, Nuclear, Infra-nuculear & Visual Pathway

• Identify the Supranuclear control of eye movement
• Discuss difference in function of the supranuclear eye movement systems
• Identify and locate the cortical supranuclear pathways
• Identify and locate the subcortical supranuclear pathways
• Identify and locate the gaze centers
• Discuss eye movement syndromes that may occurs from the Supranuclear pathway disorder
• Identify the cranial nerves by name and Roman numeral
• Describe the location of the cranial nerves nucleus that sub serve the visual system
• Compare the functions of the cranial nerves that sub serve the visual system
• Describe the infra nuclear pathways of the cranial nerves that sub serve the visual System
• Discuss eye movement syndromes that may occur from damage to the nerves, its nucleus, and its vesicles
• Identify the Vestibular control mechanisms
• Explain how the vestibular system interconnects with the ocular motor system

You will be graded on the following:

1. Clear statement of purpose in the introduction
2. Logical structure of your paper
3. Rigor applied to your research
4. Ability to synthesized evaluate and recognize relevant information
5. Attention to APA formatting, spelling and grammar
6. Style and quality of your essay

SMulla, 2017