REFRACTION AND BINOCULAR VISION 1

SHE Level 1
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code M1B525790
Module Leader Peter Rafferty
School School of Health and Life Sciences
Subject Vision Sciences
Trimester
  • B (January start)

Summary of Content

This module will allow students to develop a knowledge and understanding of the aetiology and management of refractive errors, and of the principal sensory and motor mechanisms that underpin binocular vision. Students will be introduced to a range of common clinical techniques for assessing the visual, refractive and binocular status of a patient. The module is intended to act as a precursor to more advanced study of these concepts in "Refraction and Binocular Vision 2" in Level 2.

Syllabus

-284 Lectures b7 Visual acuity notations: Snellen, logMAR, decimal b7 Test types: legibility, British and international standards b7 Test charts: Snellen, Bailey-Lovie and other logMAR designs, illiterate E, Landolt C, Sheridan Gardner, Cambridge cards, Kay Pictures, Ffooks' symbols, Keeler logMAR crowded test, computerised test charts b7 Near acuity notations and charts b7 Factors affecting visual acuity: stimulus factors, optical factors, age b7 Prescription writing and transposition of prescriptions b7 Measurement of interpupillary distance b7 Use of trial frame and lenses b7 Static retinoscopy b7 Methods of monocular subjective refraction: best vision sphere, crossed-cylinder, fan and block, bichromatic tests, pinhole, +1.00 blur test, Scheiner disc, stenopaeic slit b7 Distribution of refractive errors b7 Aetiology, classification, signs, symptoms and correction of myopia, hypermetropia, and astigmatism (including spectacle, contact lens and surgical options for correction) b7 The vergence system b7 The accommodation system b7 Components of oculomotor responses b7 Spatial localisation: binocular localisation, cyclopean theory, corresponding points, horopter, physiological diplopia/suppression b7 Panum's areas: physiological basis, stereoscopic vision, methods of measuring the horopter b7 Heterophoria: definition, classification and clinical measurement b7 Heterotropia: definition, classification and clinical measurement b7 Ocular motility: kinematics of eye movements b7 Clinical assessment of ocular motility Labs/tutorials b7 Measuring PD, trial frame fitting, measuring vision/visual acuity b7 Retinoscopy: model eyes b7 Subjective refraction: best vision sphere/+1.00 blur test b7 Subjective refraction: best vision sphere/cross-cylinder b7 Subjective refraction: best vision sphere/fan and block b7 Clinical assessment of motor status of binocular vision: heterophoria and heterotropia b7 Clinical assessment of ocular motility -284

Learning Outcomes

On completion of this module, students should be able to:1. Assess and record the vision/visual acuity of a patient using a variety of common charts and notations and demonstrate a knowledge and understanding of the factors affecting visual acuity2. Demonstrate a knowledge and understanding of the distribution, aetiology, classification, signs, symptoms, and management of refractive errors3. Demonstrate an understanding of how static retinoscopy and common methods of monocular subjective refraction may be used to assess the refractive status of a patient4. Demonstrate a basic knowledge of the sensory and motor characteristics of binocular vision5. Perform the necessary clinical tests to assess binocular motor function and ocular motility, as part of the standard clinical refraction routine

Teaching / Learning Strategy

This module comprises a programme of lectures, tutorials and practical laboratory sessions. Tutorials will provide students with the opportunity to consolidate the theoretical knowledge gained in lectures, while practical sessions will enable students to develop a range of clinical skills for the assessment of a patient's refractive and binocular status.

Indicative Reading

-171b7 Abrams, D. (1993). Duke-Elder's Practice of Refraction (10th ed.). Churchill-Livingstone. b7 Benjamin, W.J. (2006). Borish's Clinical Refraction (2nd ed.). Butterworth Heinemann. b7 Duke-Elder, S. & Wybar, K. (1973). System of Ophthalmology Volume VI: Ocular Motility and Strabismus . Kimpton. b7 Elliott, D.B. (2014). Clinical Procedures in Primary Eye Care (4th ed.). Elsevier. b7 Eskridge, J.B., Amos, J.F. & Bartlett, J.D. (1991). Clinical Procedures in Optometry . J.B. Lippincott. b7 Evans, B.J.W. (2007). Pickwell's Binocular Vision Anomalies (5th ed.). Butterworth Heinemann. b7 Henson, D.B. (1996). Optometric Instrumentation (2nd ed.). Butterworth. b7 Julesz, B. (1971). Foundations of Cyclopean Perception . University of Chicago Press. b7 Keirl, A. & Christie, C. (2007). Clinical Optics and Refraction . Butterworth Heinemann. b7 Lyle, T.K. & Wybar, K.C. (1967). Lyle and Jackson's Practical Orthoptics in the Treatment of Squint (5th ed.). H.K. Lewis. b7 Michaels, D.D. (1985). Visual Optics and Refraction (3rd ed.). Mosby. b7 Rabbetts, R.B. (2007). Bennett and Rabbetts' Clinical Visual Optics (4th ed.). Butterworth Heinemann. b7 Reading, R.W. (1983). Binocular Vision: Foundations and Applications . Butterworths. b7 Rosenfield, M., & Logan, N. (2009). Optometry: Science, Techniques and Clinical Management (2nd Ed.). Elsevier. b7 Rowe, F. (2012). Clinical Orthoptics (3rd ed.) . Wiley-Blackwell. b7 Scheiman, M. & Wick, B. (1994). Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders . J.B. Lippincott. b7 Schor, C.M. & Ciuffreda, K.J. (1983). Vergence Eye Movements: Basic and Clinical Aspects . Butterworths. b7 Solomons, H. (1978). Binocular Vision: A Programmed Text . Heinemann. b7 Tunnacliffe, A.H. (1993). Introduction to Visual Optics (4th ed.). ABDO. b7 Von Noorden, G.K. & Campos, E.C. (2002). Binocular Vision and Ocular Motility (6th ed.). Mosby. b7 Zadnik, K. (1997). The Ocular Examination . W.B. Saunders.

Transferrable Skills

Use of diagnostic instrumentation, manual dexterity, interpretation of clinical data, verbal and non-verbal communication skills

Module Structure

Activity Total Hours
Assessment (FT) 6.00
Independent Learning (FT) 146.00
Lectures (FT) 24.00
Practicals (FT) 18.00
Tutorials (FT) 6.00

Assessment Methods

Component Duration Weighting Threshold Description
Exam (Exams Office) 2.00 60.00 35% unseen written examination paper
Coursework 1 n/a 20.00 35% 2 practical assessments (Retinoscopy, Subjective refraction)
Coursework 2 n/a 20.00 35% 2 practical assessments (cover test, motility)