Basics of the Eye Examination (5 cr)

Objective

Knowledge base
Students are able to

• differentiate and describe the different refractive states, related symptoms and treatment
• describe the general development of refractive errors
• describe the mechanism of accommodation and it´s effects to vision
• assess measurements of accommodation amplitude and visual acuity to normal values
• describe the definition of visual acuity and the factors affecting it
• calculate the size of the required optotype at different distances
• calculate the change in visual acuity if there is an abnormal distance
• describe optics of the retinoscopy and main parts of the phoropter

Clinical/practical
Students are able to
• take patient history
• assess refraction with retinoscopy
• use trial frames, trial lenses, and phoropter and taking into account ergonomic issues
• measure visual acuity and make the records of it
• measure accommodation amblitude

Content

Refractive status: epidemiology, patient history, symptoms, distinguishing, treatment, spectacle correction and prognosis
• emmetropia
• myopia
-empty field and night myopia, night myopia
• hyperopia
• astigmatism
• accommodation
• aphakia and pseudophakia, anisometropia (definitions)
Eye examination room and equipment:
Hygiene and cleaning
o use and maintenance of tools
Anamnesis, patient history:
o Clinical Guidelines for eye examination
o patient communication
Static retinoscopy:
o optics and use
Visual acuity:
o normal developement, emmetropization and age changes
- tests for distance and near, tests for pediatrics, size of the optotypes, different optotypes, ISO standard
o definitions of visual acuity
o MAR, minimi angle of resolution
o records (decimal, Snellen fracture, and logMAR) and measuring the acuity
o factors influence to visual acuity, as retina eccentricity, refraction error, lighting intensity, contrast
o calculating the effect of distance change
Accommodaation:
o mechanism, effects of age and diseases
o Duane curve, Hofstetter-formulas
o classification: -tonic, vergence, reflex and proximal
o accommodation amplitude and measurement, (Duane line and push-up methods)
o accommodation: field between far point and near point, comfortable zone
o accommodation, pupil reflex and convergence, (the near triad)

Location and time

Teaching is given at Myllypuro campus or via online sessions (Teams or Zoom). Spring semester 2025, 1. period as given schedule.
The practical exercises included in the course are done according to the schedule and in the order given in the training facilities of the campus. Tasks and exercises other than those related to on-the-job training cannot be done under the supervision of working life.

Materials

David B. Elliot: 2014 Clinical Procedures in Primary Eye Care: The case history, Trial frame or phoropther? and Objective refraction.
Clinical Guideline: Eye Examination
ISO 8596: Ophtalmic optics – Visual acuity testing - Standard optotype and its presentation
Borish Clinical Refraction
1. Mark Rosenfield: Refractive status of the eye
2. Karla Zadnik ja Donald O. Mutti: Incidence and
distribution of refractive anomalies.
3. David A. Goss: Development of the ametropias.
4. Ciuffreda K.J. Accommodation, the pupil, and presbyopia
7. Ian L. Bailey: Visual Acuity
WHO 2015: The impact of myopia and high myopia. https://www.who.int/blindness/causes/MyopiaReportforWeb.pdf
Cathleen Fedtke 2019: Spectacles: Progressive Addition Multifocals/Executive Bifocals/Light Diffusion Technology. Brian Holden Vision Institute.

Teaching methods

Lectures
Practicals
Case-learning

Exam schedules

Written exam 10.2.2025
Retakes:
1. retake: Exam: 3.-8.3.2025
2. retake: Exam: 17.-22.3.2025
More info about Exam: https://oma.metropolia.fi/henkilokunnalle/strategia-ja-kehityspalvelut/digitalisaatio/ohjelmistojen-ohjeet/exam/exam-opiskelijoille

Eye exam practicals ready and returned by 18.2.2025 to Lobby Services. Return practicals by the name: Tanja Lehti

Student workload

Practicals 10 x 3h, 30 hours in total
Lectures 7 x 3 , 21h in total
written case group assignment 27h
individual assignments (calculations and written tasks) 8h
written exam 2h
independent work 47h

Further information

If the student has individualized educational support arrangements, shall this student contact the teacher of the course immediately after the end of the registration period (or latest before the start of the course.)

Instructions on the use of artificial intelligence during the course are given separately. Students should familiarise themselves with Metropolia's AI guidelines and follow them in their study attainments.

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:
- 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 methods and criteria

Assignment and practicals pass/rewritten
Written examination 70%
Case-task 30%

Qualifications

Spectacle application and manufacturing and Geometrical optics