DEPT OF OPHTHALMOLOGY

AIIMS NAGPUR

SYLLABUS FOR UNDER GRADUATE TEACHING

GOAL

The broad goal of the teaching of students in ophthalmology is to provide such knowledge

and skills to the student that shall enable him/her to practice as a clinical and as a primary

eye care physician and also to function effectively as a community health leader to assist in

the implementation of National Programme for the prevention of blindness and

rehabilitation of the visually impaired.

OBJECTIVES

(a) KNOWLEDGE

At the end of the Ophthalmology posting, the student shall be able to:

At the end of the course, student shall have the knowledge of

1.Common problems affecting the eye,

2. Principles of management of major ophthalmic emergencies, main systemic diseases

affecting the eye;

4. Effects of local and systemic diseases on patient’s vision and the necessary action

required to minimize the sequelae of such diseases;

5. Adverse drug reactions with special reference to ophthalmic manifestations; 6,

Magnitude of blindness in India and its main causes;

7. National programme for control of blindness and its implementation at various levels.

8. Eye care education for prevention of eye problems

9. Role of primary health center in organization of eye camps;

10.organization of primary health care and the functioning of the ophthalmic assistant;

11. Integration of the national programme for control of blindness with the other national

health Programmes.

12. Eye bank organization

(b) SKILLS

At the end of the course, the student shall be able to:

1. Elicit a history pertinent to general health and ocular status;

2. Assist in diagnostic procedures such as

i. Visual acuity testing,

ii. Examination of eye,

iii. Schiotz tonometry,

iv. Staining of corneal pathology,

v. Confrontation perimetry,

vi. Subjective refraction including correction of presbyopia and aphakia,

vii. Direct ophthalmoscopy

viii. Conjunctival smear examination and

ix. Cover test;

3. Diagnose and treat common problems affecting the eye;

4. Interpret ophthalmic signs in relation to common systemic disorders,

5. Assist/observe therapeutic procedures such as

i. Subconjunctival injection,

ii. Corneal conjunctival foreign body removal,

iii. Carbolic cautery for corneal ulcers,

iv. Nasolacrimal duct syringing and

v. Tarsorrhaphy

6. Provide first aid in major ophthalmic emergencies;

7. Assist to organize community surveys for visual check-up;

8. Assist to organize primary eye care service through primary health centres.

9. Use effective means of communication with the public and individual to motivate for

surgery in cataract and for eye donation.

10. Establish rapport with his seniors, colleagues and paramedical workers, so as to

effectively function as a member of the eye care team.

CLINICAL TRAINING :

The students would be posted in the Ophthalmology department ( OPD and Ward ) for a total period

of 2 months on rotation basis. Here they would learn the basic Ophthalmic examination, become

familiarised with diagnosing the common eye diseases and learning the elementary management,

including communication skills.

The clinical training would consist of

1) Two classes on introduction to the clinical aspects of vision testing methods, physiology of vision,

various normal finding in eye

2) Bed side teaching and case discussion on common Eye conditions like refractive error, cataract,

Red eye, epiphora, squint assessment, retinal examination techniques, glaucoma examination.

3) Orientation to commonly used Ophthalmology like vision drum, autorefractometer, tonometer,

slit lamp

4) Exposure to commonly done OPD procedures like refraction ( dry, wet) syringing & probing, FB

removal, epilation of trachiatic eye lashes,

5) Exposure to selective operative procedures like cataract surgery like SICS, Phacoemulsification,

DCR, Lid surgery, laser procedure in eye.

Syllabus( COURSE CONTENT- MCI wise)

1) COMMON DISEASE OF EYE.

A) Conjunctiva.

Symptomatic conditions: Hyperaemia, Sub conjunctival Haemorrhage.

Diseases : -

Classification of Conjunctivitis

Mucopurulent Conjunctivitis

Membranous Conjunctivitis Spring Catarrh.

Degenerations Pinguecula and Pterygium

B) Cornea: -

Corneal Ulcers: Bacterial,

Fungal, Viral, Hypopyon.

Interstitial Keratitis.

Keratoconus.

Pannus

Corneal Opacities.

Keratoplasty.

C) Sclera :

Episcleritis.

Scleritis.

Staphyloma.

D) Uvea

Classification of Uveitis

Gen. Aetiology, Investigation

and Principles Management

of

Uveitis.

Acute & Chronic Iridocyclitis.

Panophthalmitis.

End Ophthalmitis.

Choroiditis.

E) Lens :

Cataract – Classification &

surgical management of

cataract.

Including Preoperative

Investigation.

Anaesthesia.

Aphakia.

IOL Implant

F) Glaucoma :

Aqueous Humor Dynamics.

Tonometry.

Factors controlling Normal

I.O.P.

Provocative Tests.

Classifications of Glaucoma.

Congenital Glaucoma.

Angle closure Glaucoma.

Open Angle Glaucoma.

Secondary Glaucoma

G) Vitreous :

Vitreous Opacities.

Vitreous Haemorrhage.

H) Intraocular Tumours:

Retinoblastoma.

Malignant Melanoma

I) Retina :

Retinopathies : Diabetic, Hypertensive Toxaemia of

Pregnancy.

Retinal Detachment.

Retinitis Pigmentosa, Retinoblastoma

J) Optic nerve :

Optic Neuritis.

Papilloedema.

Optic Atrophy.

K) Optics :

Principles : V.A. testing Retinoscopy, Ophthalmoscopy.

Ref. Errors.

Refractive Keratoplasty.

Contact lens, Spectacles

L) Orbit :

Proptosis – Aetiology, Clinical Evaluation, Investigations &

Principles of Management

Endocrinal Exophthalmos.

Orbital Haemorrhage.

M) Lids :

Inflammations of Glands.

Blepharitis.

Trichiasis, Entropion.

Ectropion.

Symblepharon.

Ptosis.

N) Lacrimal System

Wet Eye.

Dry Eye

Naso Lacrimal Duct

Obstruction

Dacryocystitis

O) Ocular Mobility

Extrinsic Muscles.

Movements of Eye Ball.

Squint : Gen. Aetiology,

Diagnosis and principles of

Management.

Paralytic and Non Paralytic

Squint.

Heterophoria.

Diplopia.

P) Miscellaneous

Colour Blindness.

Lasers in Ophthalmology – Principles.

Q) Ocular Trauma : -

Blunt Trauma.

Perforating Trauma

Chemical Burns

Sympathetic Ophthalmitis

2) Principles of Management of Major Ophthalmic Emergencies :

Acute Congestive Glaucoma.

C. Ulcer.

Intraocular Trauma.

Chemical Burns.

Sudden Loss of vision

Acute Iridocyclitis.

Secondary Glaucoma

3) Main Systemic Diseases Affecting the Eye :

Tuberculosis.

Syphilis.

Leprosy.

Aids.

Diabetes.

Hypertension

4) Drugs :

Antibiotics/ anti-microbials

Steroids.

Glaucoma Drugs.

Mydriatics.

Viscoelastics.

Fluorescein.

5) Community Ophthalmology :

Blindness : Definition Causes

& Magnitude

N.P.C.B. – Integration of

N.P.C.B. with other health

Preventable Blindness.

Eye care.

Role of PHC‟s in Eye Camps.

Eye Banking.

6) Nutritional

Vit. A. Deficiency

Clinical Ophthalmology cases To Be Covered

History taking & Eye examination

Assessment of visual function.

Conjunctiva

Pterigium.

Pinguecula

Conjunctivitis.

Sub Conj. Haemorrhage.

Cornea

Corneal Opacity .

Corneal Ulcer.

Corneal Abscess.

Corneal Transplant

Sclera

Scleritis, Epi Scleritis.

Staphyloma.

Uvea Iridocyclitis.

Lens

Cataract.

Aphakia

IOLs

Complications

Glaucoma – Types, Signs, Symptoms & Management

Squint

Lids

Entropion

Ectropion

Ptosis.

TUTORIALS

SURGICAL TECHNIQUES

Cataract

a) ECCE

b) ICCE

c) IOL Implantation

d) Phaco-emulsification.

- Pterigium

- Chalazion

- Glaucoma

- Foreign Body Removal

- Enucleation

- Keratoplasty

- Basic of squint

INSTRUMENTS

i. OPD

ii. Operative

iii. Basic Examination and Diagnostic instruments

iv. Tonometer, Sac Syringing, Slip Lamp.

OPTICS

i. Lenses – Spheres, Cylinders, Prisms, Pinhole, Slit, Maddox Rod & Maddox wing,

ii. Red & Green Glasses.

iii. IOLs

iv. Ophthalmoscopy

v. Retinoscopy

vi. Contact Lenses

vii. Colour Vision

DRUGS

i. Miotics

ii. Antibiotics

iii. Steroids

iv. Anti-Fungal

v. NSAIDS

vi. Anti virals

vii. Antiglaucoma

viii. Mydriatics

ix. Viscoelastics

x. Pre-Op. & Post – Op

COURSE CONTENT- Competency wise

SL NO TOPIC MUST

KNOW

SHOULD

KNOW

MAY

KNOW

1. History taking in relation to common complaints encountered in Ophthalmology

2. Vision acuity assessment and errors, its

physiology

3. Anatomy, Physiology & embryology of eye

4. Physiology and neurology of vision

5. Elementary optics, elementary physiology of

optics

6. Causes of low vison and differentiate between

various causes of low vision

7. Refractive error of eye

8. Examination of Anterior segment and posterior

segment of eye

9. Red eye and its differential diagnosis

10. Pterygium and other conjunctival lesion

11. Keratitis, corneal ulcer, keratoconus, Vernal

keratoconjuctivits,

12. Immunology mediated diseases, corneal

dystrophies and degenerative changes

13. Keratoplasty

14. Scleritis, episcleritis, related immunological

diseases

15. Uveitis ,its classification, examination on slit

lamp and related diseases with treatment of

uveitis

16. Lens examination on torch light, direct

Ophthalmoscope & slit lamp

17. Diagnosis cataract and its various types,

formulate the treatment according to grade of

cataract

18. Various cataract surgeries, indication,

complication. Visual rehabilitation

19. News surgery of cataract, its indication,

complications, instruments used in cataract

surgery.

20. Glaucoma types, diagnosis, its investigation,

and treatment

21. Newer antiglaucoma medication and surgical

management of glaucoma

22. Management of acute angle closure glaucoma

23. Congenital glaucoma and juvenile open angle

glaucoma

24. Retinal disease associated with systemic

disease, vascular disorders of retina, inflmation

of retina, degeration of retina , retinal

detachment,

25. Congenital abnormalities of retina,

Phakomatosis

26. Retinal surgery instruments, various retinal

implants.

27. Changes in vitreous with age, opacities of

vitreous, vitreous haemorrhage

28. Papilledema, inflammation of optic nerve optic

atrophy, toxic and hereditary optic neuropathy

29. Tumours of optic nerve, congenital anomalies of

optic nerve

30. Tumour of uveal track , tumour of retina

31. Injuries to eye and its management

32. Assessment of ocular movement and related

disorders like squint, nystagmus etc

33. Disease of lid, lacrimal apparatus, disease of

orbit

Integration: The teaching will be aligned and integrated horizontally and vertically in order to

allow the learner to understand the structural basis of eye problems, their management and

correlation with function, rehabilitation and quality of life.

ASSESSMENT AND EXAMINATION

1) Formative : 3 internal assessments (theory) of 50 marks will be conducted once in 3 months.

Practical internal assessment of 40 marks will be conducted at the end of each clinical postings. 10

marks shall be allotted for log book. Total weightage of internal marks is 50% in the calculation of

final result.

2) Summative: A professional examination theory of 100 marks and practical of 100 marks will be

conducted at the end of the professional year. Total weightage of the professional examination will

be 50% in the calculation of final result .

Theory assessment paper would contain Long Answer Questions, Short Answers Questions and

objective type questions (Multiple Choice Questions). MCQs shall be accorded a weightage of not

more than 20% of the total theory marks.

Practical assessment would include 40% weightage for clinical case presentation, 40% for OSCE

(Observed Structured Clinical Examination) and 20 % for viva voce.

Theory: 100 marks: 1 paper: 20 marks MCQs+ 80 marks Questions

Practicals: 100 marks: 2 cases (60) Table viva (20) Optics (20)

Criteria for passing in a subject: A candidate shall obtain 50% marks in University

conducted examination separately in Theory and Practical (practical includes: practical/

clinical and viva voce) in order to be declared as passed in that subject.

SUGGESTED BOOKS

1) Parson's Diseases of the Eye: Dr. R. Sihota

2) Synopsis of Clinical Ophthalmology, International Edition: Kanski