Opinto-opas

Objective

Students are able to explain the principles of binocular vision and anatomical foundations for it, its significance to vision and development in childhood. They are able to distinguish binocular vision disorders and describe the factors causing them. Students are able to asses near vision, ocular muscle balance and binocularity. They are able to calculate the required prism correction and adjust spherical correction to control accommodative convergence.
After work placement (5 credits) students are able to plan and conduct the objective and subjective refraction. They can produce appropriate customer records. They are able to suggest and justify various options for vision correction and discuss the vision, visual problems and eye care with the customer.
Students are able to use optometry-related resources in English. They are able to present their optometric knowledge in English, both verbally and in writing. They are able to guide the customer in vision-related issues in English. Their verbal and written communication skills correspond to the skill level B2 of the Common European Framework of Reference for Languages.

Content

Anatomical and physiological foundation and development of binocular vision in childhood. Classification of strabismus. Synergy between accommodation and convergence. Accommodation and vergence disorders, prism corrections and utilising high ACA values by spherical power corrections. Near vision corrections, fixation disparity. Measuring and assessing heterophoria, heterotropia and fusional convergence. Assessment of near vision and function of accommodation. Dynamic retinoscopy, spectacle prescription, customer records. English skills in customer service and communications.

Materials

Lecture notes, articles
Literature among lecture notes:
Primary Care Optometry: Anomalies of Binocular Vision, sivut 75-85, Dynaaminen retinoskopia 197-199, Akkommodaatiotestit 231-234, Akkommodaatiohäiriöt 267-268
Borish´s Clinical Refraction: Fusion and Binocularity, pages 121-156, Accommodation, the pupil, and presbyopia, sivut 93-138
AOA: Care of the patient with Presbyopia
Stidwill and Fletcher 2014: Normal Binocular Vision: Theory, Investigation and Practical Aspects; The Development of Binocular vision p 15-28.
Scheimann, M & Wick, B., Clinical Management of Binocular Vision - Heterophoric, Accommodative, and Eye Movement Disorders 3rd Ed., Lippincott Williams & Wilkins (2008) Chapter 1-2, 12.
English material will be found in the OMA platform.

Teaching methods

Interactive lectures,
Guided practices and assignments (work placement and practices in University)
Guided problem based group assignment (PBL)
Workplacement
Moodle -web course

Exam schedules

Exam 16.10.2019, 1.retake xx and 2.retake xx
PBL -assignment final presentation xx

Student workload

Work placement (weeks 34-36)
Lectures 32h
PBL work: consists of one binocular vision problem case. Group size is five students. The PBL tutorial process has:
• a starting session clarifying terms, defining problem(s), brainstorming, structuring and hypothesis
• independent study
• two workshops identifying what they already know, what they need to know
• final session (synthesis)
Practicals: Students examine fellow students.
o 15 sessions x 4h =60h, Practicals: verbal and written instructions are given at the start of the session
o There are 15 four-hour practical sessions with one or two supervisors.
o After 15 practical sessions the student has examined 15 fellow students.

Further information

Previous courses in eye examination (sx00bp25) shall be passed before (by 9th January 2019) participating in this course
• Presbyopia: Epidemiology and symptoms, Mechanisms of presbyopia, Effects of ageing on the ciliary muscle and accommodation, Anomalies of Presbyopia, Treatment: Add ja deth of field (far point / near point)
- Examination: dynamic cross cylinder test, Prince rule, trial lenses
• Accommodation: Diagnosis of disorders, Etiology, Symptoms, Examination (PRA/NRA, dynamic retinoscopy; MEM and NOTT, facility flipper test), Treatment
• Normal binocular vision: Normal binocular vision development in the infant and child. Purpose and roles for vision. Basic requirements for binocular vision. Summation. .
-Corresponding retinal points. Binocular localisation. The Horopter. Panums area. Physiological diplopia. Monocular clues and binocular aspect of perception of depth.
- Ocular dominance and examination (Four dot test, fogging dominance test, hole-test)
• Heterophorias / tropias (horisontal, vertical): Classification, Etiology, Symptoms, Examination (Graeffe, Maddox cylinder, Schober cross, Hirsberg and Krimsky), supression. Treatment (prism and spherical power corrections) and prognosis, criteria of Sheard´s and Percival criterions. Assessment of positive, negative and vertical fusional vergence (PRC, NRC, supra, infra with phoropter and prism bars)
• Accommodation and vergence relationship: ACA and CAC, calculated and gradient
• Heterotropias: Definitions, Classification, Etiology, Symptoms, Examination
• Fixation disparity: Definition, Etiology, Symptoms, Examination (Mallet, Wesson card), Treatment
• Patient records: ICD 10 refractive status, accommodation and vergence disorders
• Preliminary tests, refraction, accommodation and binocular vision measurements: analyze, treatment and prescription
Work placement: Course starts with a 3 week (15 days) work placement. Students have to do 3 retinoscopy and 5 eye examinations that consist of preliminary tests, retinoscopy and refraction. They have Moodle web-based learning assignment on one of these cases.

Evaluation scale

0-5

Assessment criteria, satisfactory (1)

The student is able to:
- display learning in professional knowledge and core content in the field
- search information from a variety of sources
- work in various duties in a variety of operating environments
- show that he has achieved the targets for core competence
- display learning in the key safety practices in the field
- act according to ethical principles
- to contribute his learning for the benefit of a group or project

Assessment criteria, good (3)

The student is able to:
- use concepts and knowledge in his field systematically
- find information and assess and use information sources with a critical eye
- apply professional information in professional assignments
- apply professional expertise in various work assignments
- act independently and responsibly in professional contexts
- plan operations with safety in mind
- act according to professional ethics
- act purposefully in working groups and projects

Assessment criteria, excellent (5)

The student is able to:
- use concepts and knowledge in his field professionally
- argue the use of his sources - argue a course of action on the basis of research information or findings
- operate in a range of duties and work situations, also in international contexts
- to act in a way that is customeroriented and displays entrepreneurial spirit
- to act responsibly, taking safety issues into consideration
- argue his choices on the basis of professional ethics
- organise and manage the operation of a group and project

Assessment criteria, approved/failed

The student is able to:
- The student does not know or appreciate knowledge in the field sufficiently
- The student does not know or cannot use concepts in his field properly
- The student's professional level is insufficient
- The student is not acting in accordance with his training and guidance
- The student is not trying to develop himself or his actions
- The student is unconcerned about professional safety or ethical principles
- The student is not motivated by or participating in group or development work

Assessment methods and criteria

Maintainence in lectures and eyeexaminationpractise
Written examination represets 60% of the final mark
PBL -assignment including reflection 40% of the final mark
Practical guided assignments done and evaluated (oraly)
Work placement evaluation:passed
English for optometrists: To get a passing grade (3 credits) for English, students are required to
*attend and actively participate in contact sessions
*do the required homework assignments for each class
*give an oral presentation in class
*submit a final written assignment in due time .

Qualifications

Function of the Eye and Refraction