LOW VISION AND SPECIALITY CLINICS

SHE Level 4
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code MHB525789
Module Leader Dirk Seidel
School School of Health and Life Sciences
Subject Vision Sciences
Trimester
  • A (September start)-B (January start)

Pre-Requisite Knowledge

SCQF Level 7 Module in Foundations of Optics; SCQF Level 7 Module in Refraction & Binocular Vision 1; SCQF Level 7 Module in Ophthalmic Anatomy & Physiology A; SCQF Level 7 Module in Ophthalmic Anatomy & Physiology B; SCQF Level 7 Module in Ophthalmic Materials; SCQF Level 8 Module in Refraction & Binocular Vision 2; SCQF Level 8 Module in Introductory Ocular Disease; SCQF Level 8 Module in Diagnostic Techniques; SCQF Level 9 Module in Clinical Studies; SCQF Level 9 Module in Contact Lens Studies; SCQF Level 9 Module in Clinical Ophthalmology

Summary of Content

This module is designed to provide a sound knowledge of the theoretical and practical principles of the optometric assessment of patients with binocular vision anomalies, with specific needs, including infants and the visually impaired. In addition, the module will introduce concepts and clinical techniques not routinely used in optometric practice, including electrodiagnostics. Furthermore, it will provide students with theoretical and practical information relating to the ageing process of the human eye.

Syllabus

1. Low Vision -Visual impairment: definitions and registration procedures. -Incidence, prevalence and causes of low vision. Psychological adjustment following sight loss. -Assessment and management of residual visual function - development of an assessment routine. -Management options, training methods and strategies for maximising visual performance. -Optical principles and use of plus lens magnifiers and telescopic systems. -Optical and non-optical methods for improving peripheral field awareness. -Dealing with central field loss. -Electronic low vision aids. -Lighting and glare. -Sensory substitution, non-optical aids, guide dogs and environmental design. -Rehabilitation of the visually impaired, multiple disabilities and the role of care providers for the disabled. 2. Infant vision -Techniques for assessment of infants: near retinoscopy, modified ocular motility examination, preferential looking and acuity cards. -Optometric management of the young infant. 3. Advanced optometric science and investigative techniques -Acquired dyschromatopsias: Detection and classification of acquired colour vision defects. Methods of assessment. Colour vision deficiencies in various abnormal ocular conditions. -Principles and limitations of coloured filters to aid colour defective patients. Future developments. -Aberrometry: Wave front aberrations of the eye. Zernike expansion. Aberrometers. Optical correction of refractive error using wavefront factors. -Assessment of vision and visual perception: Evaluation and treatment of optical and neural vision loss; perceptual problems/visual processing deficits. -Emmetropisation: Failure of emmetropisation and methods of preventing or reducing the progression of refractive errors. -Artificial intelligence: Use of Machine learning and Deep learning to enhance patient outcomes in eyecare. 4.Clinics -Low vision clinic: Case evaluation. Assessment and optometric management of the visually impaired. Assessment, use and application of optical, non-optical and electronic low vision aids. Training methods and rehabilitation strategies for the visually impaired. Multi/interdisciplinary approach to rehabilitation and patient management. Students are involved in the assessment and classification of visually impaired athletes. -Infant vision and learning disability clinic: Techniques for assessment of infants and patients with a learning disability : near retinoscopy, modified ocular motility examination, preferential looking and acuity cards. Optometric management of the young infant and the patient with profound and multiple disabilities. -Binocular Vision Clinic. History & Symptoms. Assessment of binocular vision anomalies, concomitant and incomitant deviations, heterophoria, heterotropia, fixation disparity, microtropia, special forms of strabismus. Compensation, motor and sensory aspects. -Methods of treatment and management of binocular vision anomalies. These clinics provide the practical underpinning to the level 4 module 'Advanced Abnormal Binocular Vision'. -Dry Eye Clinic. Use of patient symptom questionnaires. Detection and management of tear film disorders. Diagnosis and management of Meibomian gland dysfunction. -Myopia Control Clinic. Assessment of optical and non-optical risk factors for myopia. Monitoring of myopic progression using ocular biometry. Optometric management of progressing myopia including myopia control strategies.

Learning Outcomes

On successful completion of this module the student should be able to:-1. Understand the causes of low vision 2. Conduct a full assessment of residual visual function using appropriate tests and obtain clinical data from which a patient management plan can be formulated 3. Suggest appropriate optical and non-optical correction and advise on strategies to maximise visual performance4. Numerically evaluate magnification effects of optical low vision aids5. Understand the criteria for referral and the importance of liaising with other professional groups6. Understand the difficulties associated with multiple disabilities and facilitate a multidisciplinary approach to diagnosis and management for patients with abnormal visual function7. Use a variety of clinical techniques to assess and manage infants with normal and abnormal vision8. Understand theories of emmetropisation und refractive error development and demonstrate knowledge of interventions attempting to prevent the onset and progression of myopia9.Demonstrate knowledge of a variety of advanced investigative optometric techniques for the measurement of the eye and visual function10. Categorise and measure acquired colour vision defects and describe how they relate to various ocular conditions11. Demonstrate knowledge of the principles and limitations of coloured filters to aid colour vision deficient patients

Teaching / Learning Strategy

This module will be presented as a combination of lectures, interactive tutorials, and supervised clinical practice. Practical clinics will be held for the assessment of vision in infants, patients with special needs, low vision patients and patients with binocular vision anomalies. The teaching and learning strategy will be to encourage students to synthesize and develop an advanced theoretical basis for the management of vision anomalies in such a way as to allow them to apply the knowledge in a clinical environment to a variety of patient types. Students will be encouraged to develop problem solving skills to a high level and to adopt a structured, reflective and evidence based approach in the clinical environment. Students will be encouraged to consider the patient holistically and to structure appropriate management schemes based on patient needs.

Indicative Reading

Birch, J-Diagnosis of Defective Colour Vision-Butterworth-Heinemann; 2 edition Jackson, J Wolffsohn, J - Low Vision Manual - Butterworth-Heinemann, 2007 Dickinson, C-Low Vision Principles and Practice-Butterworth-Heinemann; 4 edition Evans, B-Pickwell's Binocular Vision Anomalies-Butterworth-Heinemann; 5 edition Fishman, GA-Electrophysiologic Testing in Disorders of the Retina, Optic Nerve, and Visual Pathway-OUP USA; 2 edition Heckenlively, JR & Arden-Principles and Practice of Clinical Electrophysiology of Vision-MIT Press; 2nd Edition Leat, S-Assessing Children's Vision-Butterworth-Heinemann Macnaughton, J-Eye Essentials: Low Vision Assessment-Butterworth-Heinemann RNIB & McCulloch, D-Bridge to Vision (DVD)-RNIB Taylor, D-Paediatric Ophthalmology -Wiley-Blackwell; 2nd Revised edition edition Von Noorden GK-Atlas of Strabismus-Mosby Weale, RA-On the Senescence of Human Vision-Oxford University Press

Transferrable Skills

Advanced interpersonal and patient communication and management skills, specifically for dealing with young and preverbal infants and their parents, and people with acquired visual disabilites. Use of diagnostic and testing procedures and instrumentation for binocular vision anomalies, low vision, infant vision and electrodiagnostics. Use of high order transferable skills in diagnosis, interpretation of clinical data and decision making.

Module Structure

Activity Total Hours
Lectures (FT) 36.00
Assessment (FT) 10.00
Independent Learning (FT) 110.00
Tutorials (FT) 10.00
Practicals (FT) 34.00

Assessment Methods

Component Duration Weighting Threshold Description
Exam (Exams Office) 3.00 50.00 35% unseen written paper
Course Work 01 n/a 50.00 35% Continuous assessment (MCQ class test, OSCE-style competency assessment practical assessment)