Siirry suoraan sisältöön

Silmän toiminta ja taittovirheen määrittäminen (15 cr)

Code: SX00BP25-3011

General information


Enrollment

02.05.2019 - 15.05.2019

Timing

21.10.2019 - 20.12.2019

Number of ECTS credits allocated

15 op

Mode of delivery

Contact teaching

Unit

Kuntoutus ja tutkiminen

Campus

Mannerheimintie 172

Teaching languages

  • Finnish

Degree programmes

  • Optometrian tutkinto-ohjelma

Teachers

  • Johanna Valtanen
  • Tanja Lehti
  • Anou Londesborough
  • Satu Autio

Teacher in charge

Johanna Valtanen

Scheduling groups

  • Avoin amk: Polku: Optometria (Koko: 0. Open UAS: 0.)

Groups

  • SXE19K1
    Optometrian tutkinto-ohjelma, päivä

Small groups

  • Avoin amk: Polku: Optometria

Objective

Students are able to describe the development of the eye, anatomy of the eye and its adjoining structures and explain the basic functions of the eye and the mechanisms regulating those functions. They are able to use biomicroscopy, topography and keratometry when evaluating the anterior parts of the structures of the eye. They are able to assess, whether accommodation, convergence, pupil reactions, fixation and eye movements are within physiological range.
Students are able to obtain an appropriate case history for an eye examination. They are able to measure visual acuity and explain the impact of the anatomical, optical and test related factors influencing visual acuity measurements. Students are able to tell the differences between the types of refractive errors and determine the refractive error of the eye objectively and subjectively. Students are able to tell the design principles of the tests and procedures used. Students are able to describe the factors influencing IOP measurements and their reliability, principles of measurements and they know the physiological range of IOP.

Content

Development of the eye, orbit, external ocular muscles and ocular movements, ocular blood circulation, neural innervation, eyelids, structure of the eye, tear secretion and structure of the tear fluid, significance of lachrymal fluid. Function of the cornea, functioning principles of the retina and its cells, metabolism of lens, accommodation and its amplitude, near point of convergence, H-test, saccades, pursuit movements, pupil reaction. Regulation mechanisms of IOP, measuring IOP. Biomicroscopy, keratometry and topography. Development of the eye’s optical components and refractive power in different age groups, prevalence and classification of refractive errors, anisometropia, amblyopia,
presbyopia, case history, development of visual acuity in infants and children, preliminary tests, tests of visual acuity, retinoscopy, autorefraction, subjective refraction.

Location and time

Autumn semester 2019, 2.period, The Faculty of Optometry

Materials

Lecture notes, articles
Literature among other things:
Primary Care Optometry: Anomalies of Refraction, sivut 3-21, Epideminology of Anetropia/ Myopia / Hyperopia 22-74, The Preliminary examination 112-123, Objective Refraction 183-197 ja 201-207, Subjektive Refraction 209-218 Management of Anomalies of refraction 251-256, Nonsurgical methods of Myopia Control or reduction 370-387
Borish´s Clinical Refraction:
AOA:
Thomson, David. VA testing in optometric practice. Part 1: The Snellen chart. Optometry Today 2005.
Thomson, David. VA testing in optometric practice. Optometry Today 2005. Part 2: Newer chart designs. Optometry Today 2005.
Kukkonen, Kuusela & Tuomaala 2016. Opas näöntutkimuksen objektiivisten testien tekemiseen, tulkintaan ja kirjaamiseen. Opinnäytetyö, Metropolia AMK. Luettavissa: https://issuu.com/kukkonenkuuselatuomaala/docs/opas_versio_18.11._pdf
Ammatillinen ohje optikon toimen harjoittamisesta. Optometrian Eettinen Neuvosto 2014.

Teaching methods

Interactive lectures,
Guided practices and assignments
Guided problembased group assignment (PBL)
Pair and self reflection (PBL)

Exam schedules

Check -point I and II (written task) , first retake: 16.12.2019 , second retake: 27.1.2020.

Guided problem-based group assignment (PBL) return; including individual reflection assignment.

Further information

Clinical exam about retinoscopy; pass/redo. Student exams fellow student´s both eyes, 15 min, supervisor evaluates one eye.
Clinical exam about non-contact tonometer; pass/redo. Student have to measure, evaluate and explain result.
Detailed content:
Anamnesis
• According to Gold Standard
• Communication with patient
Visual acuity:
• test configuration
• various acuity types
• factors influencing acuity including blur, intensity and contrast
• specification of visual acuity (decimal, Snellen fraction, logMAR)
Refractive state of the eye:
• epidemiology, history and symptoms, identification, treatment and management using spectacle and prognosis.
• emmetropia
• myopia
o empty field and night myopia
o myopiacontrol
• hyperopia
• astigmatism
Presbyopia, amblyopia, anisometropia: definition, epidemiology and symptoms
Accommodation:
• mechanisms, effects of ageing and diseases
• classification (tonic, vergence interaction, reflex, and proximal)
• Hofstetter formulas
• interrelationships between pupillary changes, accommodation, and convergence (the near reflex)
Eye movements:
• characteristics and control of the various eye movements
• reflex eye movements, including compensatory movements
• small eye movements associated with steady fixation
• fixation ability
• versional eye movements (pursuits and saccades)
• vergence eye movements (tonic, accommodative including models of accommodative/vergence interaction, fusional, and proximal)
Pupil reactions:
• factors affecting pupil size
• neurological control of pupillary reflexes and accommodation
• RAPD
• physiological anisocoria, Horner syndrome, Adie, 3. cranial nerve palsy
Clinical tests: clinical use, instrumentation, procedure, implications
• visual acuity
• standard subjective refraction including astigmatic dial technique, crossed cylinders, fogging methods and equalisation (duochrome) techniques
• binocular subjective refraction procedures, including accommodation binocular balancing methods
• keratometry, topography
• static retinoscopy
• automatic objective refraction
• slit lamp examination: illuminating- and observation systems. Apertures and filters, principles for illuminating systems.
• tonometry (NCT, I care): normal IOP
• objective test: NPC, cover test, H-test, pursuits and saccades (NSUCO), Duane and Push up-accommodation amplitudi test
• pupil measurement and reactions
Ocular anatomy and physiology
Orbit
• Location of bones and openings
• Anatomical relationships among orbital structures (extraocular muscles, nerves, blood vessels, fat compartments, fascia)
Extraocular muscles
• Names, origins, insertions
• Innervation, blood supply
Ocular blood supply
• Branches of internal and external carotid arteries related to the orbit, eyelid and upper face
• Branches of the internal and external jugular veins
• Dural sinuses
Ocular and orbital nerves
• Intracranial and extracranial course, branches and functions of cranial nerve I, III, IV, V, VI, VII
• Parasympathetic and sympathic nerves (course, branches, tissue innervated)
Eyelid
• Structures of layers, muscles and glands
Eyebrow (structure and function)
Conjunctiva
• Structure of layers, cell types, glands
• Relationship with adjacent structures
Lacrimal system
• Lacrimal gland (structure, innervation)
• Accessory lacrimal glands (location, function)
• Composition and structure of the tear film
• Drainage of tears
• Location of lacrimal fossa and nasolacrimal canal
Cornea
• Normal dimensions
• Composition and ultrastructure of epithelium, Bowman's membrane, stroma,
• Descemet's membrane and endothelium
• Innervation
• Wound healing and regeneration
Sclera
• Dimensions and colour
• Relationship to adjacent structures
• Composition of layers
• Structure of lamina cribrosa
Anterior chamber and angle
• Shape and dimensions
• Composition and ultrastructure of the trabecular meshwork, juxtacanalicular tissue, Schlemm's canal, the scleral spur and Schwalbe's ring
Iris
• Dimensions, zones and coloration
• Composition and ultrastructure of anterior border, anterior epithelium, stroma and posterior epithelium
• Composition and ultrastructure of Sphincter and dilator muscles
• Blood supply, venous drainage
• Innervation
Pupil and posterior chamber
• Locations and dimensions
Ciliary body
• Dimensions and relationship to adjacent structures
• Locations and components of pars plana and pars plicata
• Ultrastructure of the epithelium and stroma and the Ciliary muscle
• Blood supply and venous drainage
• Innervation
Lens and zonule
• Ultrastructure and composition of capsule, epithelium and cortex
• Location of nuclei and sutures
Choroid
• Extent and thickness
• Blood supply, venous drainage
Vitreous
• Composition, ultrastructure, volume and shape
• Attachments to retina and lens (ultrastructure)
• Location and origin of hyaloid canal
Retina
• Components and ultrastructure of each layer
• Relationship between retinal pigment epithelium and Bruch's Membrane and photoreceptor
• outer segments
• Synaptic connections within retina
• Location, names and function of glial cells
• Blood supply, venous drainage
• Location, size and ultrastructure of area centralis, parafovea, fovea, foveola, macula lutea, ora serrata
Optic nerve
• Location of central retinal artery and vein
• Normal surface and optic disc/cup features
Pupillary pathways
• Sympathetic and parasympathetic pathway to iris
• Functional relationships between pupillary pathways and central nervous system

Evaluation scale

0-5

Assessment criteria, satisfactory (1)

The student is able to:
- display learning in core content
- use individual professional concepts correctly
- find information for a specific situation
- distinguish between non-theoretical and theoretical information
- act in individual professional situations as instructed - display learning in his professional
field
- show that he has achieved the targets for core competence
- follow safety instructions
- display learning in the ethical principles of his professional field
- operate as a member of a student group

Assessment criteria, good (3)

The student is able to:
- display an understanding of concepts and professional knowledge in the field
- assess and limit the amount of information needed
- operate well in typical professional duties and contexts
- operate in a multicultural environment
- operate safely
- act according to professional ethics
- operate in a student group

Assessment criteria, excellent (5)

The student is able to:
- use concepts and knowledge in his field systematically
- assess and use various information sources
- apply professional information in professional assignments
- work in various duties in a variety of operating environments
- act independently and responsibly in professional contexts
- to take safety issues into consideration in his action
- argue his choices on the basis of professional ethics
- organise the activities of a group of students

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 not properly developed
- The student is not acting in accordance with his training and guidance
- The student is not familiar with instructions related to professional safety or ethical principles
- The student withdraws from cooperation with others

Assessment methods and criteria

Maintainense in lectures and eye examination practises
Group Assignment and reflection (selfevaluation) (PBL) 50%
Check -point I (written task) 25%
Check -point II (written task) 25%

Qualifications

General Anatomy and Physiology, Visual Optics and Customer Care and Dispensing in Optical Practice