SHARED CARE AND OCULAR THERAPEUTICS

SHE Level 4
SCQF Credit Points 30.00
ECTS Credit Points 15.00
Module Code MHB526552
Module Leader Laura Sweeney
School School of Health and Life Sciences
Subject Vision Sciences
Trimester
  • A (September start)-B (January start)

Pre-Requisite Knowledge

SCQF Level 8 Module in General and Systemic Pathology, Physiology & Microbiology; SCQF Level 8 Module in Introductory Ocular Disease; SCQF Level 8 Module in Diagnostic Techniques ; SCQF Level 9 Module in Clinical Ophthalmology

Summary of Content

The module will cover common ocular disorders and how they can be managed by Optometrists, either independently or as part of shared care and co-management schemes. The module will help to consolidate and expand the knowledge introduced in levels 2 and 3 on conditions affecting both the anterior and posterior eye and adnexae, their symptoms and signs, differential diagnosis and management. Management options include non-pharmacological and pharmacological treatment by Optometrists, referral and strategies for emergencies, first aid and co-management. Students will also be introduced to management of anterior and posterior eye conditions as undertaken in a hospital eye clinic or other secondary or tertiary referral centres. The module covers advanced diagnostic techniques for the assessment of ocular disease including gonioscopy, fluorescein angiography, fundus imaging and advanced visual field assessment. Students will expand their ability to make clinical decisions based on evidence based practice, considering the College of Optometrists' Clinical Management Guidelines (CMGs) and be exposed to examples of local management protocols. Practical sessions include cycloplegic refracion and Glaucoma assessment.

Syllabus

-359 College of Optometrists Clinical Management Guidelines / local guidelines b7 Shared care schemes, co-management and independent optometric management of ocular disease affecting structures such as the eyelids, cornea, and conjunctiva, lens, optic nerve, retina, and choroid b7 Development of a clinical management plan and reflective practice b7 Differential diagnosis, initiating treatment and monitoring compliance and response to treatment b7 Knowledge of natural progress of conditions being treated b7 Identifying and reporting adverse drug reactions b7 Knowledge of own limitations and criteria for referral in the context of applicable guidelines b7 Drug legislation and drug licensing b7 Prescription writing -359b7 Sources of drug information b7 Record keeping b7 Clinical Governance in relation to prescribing b7 Prescribing safely and professionally b7 Evidence based practice Topics in pharmacology: -359b7 Topical drug delivery b7 Systemic drug delivery relevant to treatment of the eye b7 Ophthalmic pharmaceuticals including product availability, product characteristics, selection and use b7 Use of diagnostic drugs in the detection and monitoring of external and internal eye disease b7 Non-pharmacological and pharmacological management of ocular disease such as conditions affecting the lacrimal system, eyelids, conjunctiva, cornea, episclera, sclera, uvea, aqueous, vitreous humour and retina b7 Non-pharmacological and pharmacological management of inflammation and infection of the eye b7 Optometric and ophthalmological management of glaucoma Specialist diagnostic techniques: -359b7 Gonioscopy, pachymetry and optic nerve head assessment in the context of Glaucoma management CyclCycloplegic refraction b7 Fluorescein angiography b7 Imaging techniques

Learning Outcomes

On successful completion of this module the student should be able to:-1. Describe and recognise key aspects relating to ocular and systemic disorders, e.g. aetiology, manifestation, and management 2. Develop a clinical hypothesis based on available clinical information and apply problem solving approaches to evaluate the validity of the hypothesis, using evidence-based practice3. Understand and apply the structure, form and urgency of referrals to the appropriate health care professional4. Understand, explain and apply appropriate management strategies (non-pharmacological and pharmacological) based on legal requirements and clinical guidelines relating to optometric practice 5. Critically assess optometric, medical and therapeutic strategies to meet the needs of patients and a view to enhancing patient health 6. Recognise and manage adverse ocular, systemic and visual reactions to pharmacological treatment

Teaching / Learning Strategy

-260 The teaching format will include lecture, interactive case discussion, practical and tutorial formats supported by independent reading and private study. The teaching and learning strategy will be to encourage students to synthesise and develop the theoretical basis for the management and medical treatment of abnormal ocular conditions. By using sample clinical cases, students will be taught to contextualise history, clinical information, and applicable clinical management guidelines. The students will be encouraged to develop their own problem-solving strategies and techniques to a level that will allow them to adopt a structured and reflective approach to the clinical presentation of abnormal ocular conditions and their management. Throughout, students will be encouraged to consider patients holistically. External experts may be invited to provide relevant first-hand information on their experiences relating to the management of ocular disease in community and hospital settings. Practical sessions will be used to introduce students to cycloplegic refraction and specific aspects of Glaucoma assessment.

Indicative Reading

-359 Bowling B (2016) Kanski's Clinical ophthalmology 8th ed. Butterworth-Heinemann (or previous edition such as 6th or 7th ed.) The College of Optometrists. Clinical Management Guidelines. http://www.college-optometrists.org/ Additional Reading List -359 British National Formulary BNF.nice.org.uk College of Optometrists Formulary https://www.college-optometrists.org/resourceLibrary/optometrists-formulary.html Elliot David B. (2014) Clinical procedures in primary care: a practical manual, 3rd ed. Butterworth-Heinemann Hopkins, G. & Pearson, R. (2007), Ophthalmic Drugs, Diagnostic & Therapeutic Uses, 5th ed. Butterworth-Heinemann Millidot M. Dictionary of optometry and visual sciences 5th ed. Butterworth-Heinemann 2000 or newer edition (optometryonline.net) European Glaucoma Society. Terminology and guidelines for glaucoma 4th ed. -360

Transferrable Skills

-358 Critical interpretation of clinical significance in diagnosis and management Development of interpersonal and patient management skills b7 Formulation and testing of clinical hypotheses b7 Effective interaction with other health care providers (e.g. information transfer, liaison, debate, analysis, education and clinical decision making) b7 A reflective attitude to all aspects of patent-practitioner interaction Ability to critically appraise scientific literature

Module Structure

Activity Total Hours
Tutorials (FT) 4.00
Practicals (FT) 6.00
Independent Learning (FT) 234.00
Lectures (FT) 50.00
Assessment (FT) 6.00

Assessment Methods

Component Duration Weighting Threshold Description
Course Work 01 n/a 30.00 35% Class Test
Exam 01 3.00 70.00 35% Unseen written paper