Weekly outline

  • Overview of Ophthalmology 251 for AY 2022-23

    Welcome to Ophtha 251. This is a 2-week course, split into 1 week per semester. Your course coordinators are Drs. Trina Ranche and Franz Cruz. Your resident monitors are Drs. Kenjee Dee, Ricky Fontanilla, Ino Villacastin, Tara Mendoza, Zad Velasquez, and Koji Lim.

    At the end of your two weeks, you should be able to:

    1. evaluate a patient with an eye problem
    2. perform a basic ophthalmologic evaluation
    3. diagnose common out-patient and emergency eye conditions
    4. formulate management plans for patients with eye conditions
    5. demonstrate proper attitudes towards patients and their families
    6. appreciate the team approach in the management of cases
    7. apply the principles of evidence-based medicine in your approach to cases
    8. demonstrate noteworthy attitudes, ethics and professionalism

    Kindly refer to the INSTRUCTIONAL DESIGN file for more details on what we hope to accomplish.

    Your activities have been adjusted for face-to-face learning combined with asynchronous and synchronous distance learning. You will have posts at the SOJR Out-patient Department, Ward, ER, and Operating Room. Here in the VLE, there are lectures, videos, and short formative (non-graded) quizzes for your review. You may do all of these at your chosen time.You also have a project that will focus on community-oriented medical education, which will be due in Phase 2. There are required synchronous small group discussions, 1 per week. At the end of the academic year, you will have a final exam. Please read the SYLLABUS for more information about the course activities and evaluation scheme.

    Your main reference for this course is the textbook SELF-INSTRUCTIONAL MATERIALS IN OPHTHALMOLOGY (3rd edition by Valbuena & Castillo).  Other useful links will be provided in the VLE.

    If there are other concerns, you may bring them up individually or as a group.  You may book consultation times with Dr. Ranche directly via Viber/Whatsapp/Telegram (+63917 856 1274) or email (ftranche@up.edu.ph), or course them through your resident monitors. To safeguard a healthy balance between our work and personal time, please understand that your course coordinators and resident monitors cannot be available 24/7, but we will try to address your concerns as quickly as possible.

    After every teaching-learning encounter, please evaluate your teachers using the Student Evaluation for Teaching Effectiveness (SET). At the end of Phase 2, please evaluate the course using the Course Evaluation by Students (CEBS). 

  • Review Materials

    Your required review materials are

    1. History-Taking in Ophthalmology
    2. The 5-point Eye Exam
    3. Out-patient Cases
    4. Emergency Cases
    5. Ocular Pharmacology
    6. How to Use the ETDRS Chart

    These are meant to supplement what you have learned during LU5, and what you have read in the SIM.  Additional resources are also provided as optional review materials.

    Please evaluate your remote teachers using the SET.

    • The Five-Point Eye Exam File 16MB Video file (MP4)
    • The Five-Point Eye Exam (slides only) File 494.6KB Powerpoint 2007 presentation
    • Out-Patient Cases File 2.5MB PDF document
    • Emergency Cases File 62.9MB Video file (MP4)
    • Emergency Cases (slides only) File 74.1MB Powerpoint 2007 presentation
    • Ocular Pharmacology File 2.8MB Powerpoint 2007 presentation
    • Crash Course: VISION URL

      Optional resource on anatomy and physiology

      Minor correction -- The lacrimal apparatus is not only involved in tear production.  The lacrimal system consists of a secretory arm (the lacrimal glands) and a drainage pathway (from the puncta to the nasolacrimal ducts).

    • Guide to the Bedside Eye Exam URL

      Optional resource on the eye exam

      Notes:

      1. The basic or 5-point eye exam includes visual acuity testing, gross examination including pupil evaluation, motility testing, evaluation of intraocular pressure, and examination of the fundus.

      2. For estimating intraocular pressure through palpation, we don't ask patients to CLOSE their eyes.  This will trigger a reflex upgaze known as Bell's phenomenon; the corneas will then be positioned superiorly under the eyelids, where our fingers are supposed to palpate.  We ask the patients to LOOK DOWN so that we can safely press on the sclerae beneath the lids.

      3. RAPD can also be present when patients have extensive retinal pathology.

      4. During gross evaluation of ocular alignment, the corneal light reflex should be at the center of the pupil.

      5. During direct funduscopy, it is easier to start at 0 instead of +10.  Parts of the ophthalmoscope and their uses are discussed in the BASIC EYE EXAM lecture.

    • Evidence-Based Medicine Tools URL

      Optional resource for critical appraisal.

      This will help you choose literature that is pertinent to your cases.

  • Department Conferences

    You are required to attend our department conferences every Tuesday and Thursday. Please join us at the Romeo B. Espiritu Auditorium (SOJR 5th floor), 8am to 9am.

    You must sign the attendance during the conference. Attendance sheets will be placed outside the auditorium.    

    For students in quarantine or isolation, please attend the conferences via Zoom. Attendance links will be posted in the chat.

    If the conference speaker is a consultant, please evaluate him/her using the SET.

  • Subspecialty Clinics

    You must attend at least 2 subspecialty clinics during Phase 2. 

    Ask the resident to deck you a patient. Chart the patient, then present the case to the clinic consultant. You are expected to elicit a complete history and physical examination, and distill the pertinent data for oral endorsements. You may do direct funduscopy on patients with dilated pupils, as long as both of you are wearing masks and you limit the examination to 10 minutes. If the pupils are undilated, please ask the residents to give you the fundus findings. For the discussion, you are also expected to provide differential diagnoses, then narrow them down to your primary impression. Study the pathophysiology and management for the discussion of the case.

    After presenting, ask the consultant to fill up your grading sheet. The grading sheet must be returned to you. The LO will please collect all grading sheets and submit them to the resident monitors at the end of Phase 2 (deadline on succeeding Monday 5pm). Clinic grades will comprise 40% of your final grade.

    Chart and dispose other patients together with residents/fellows/consultants. You may leave the clinic once all patients are done, or at 5pm, whichever is earlier.

    For students in quarantine or isolation, a list of virtual rounds will be posted in the Telegram group of liaison officers. You must attend at least two, and submit 1 written report each. The written report must contain a short review of what was discussed during the rounds, and a journal report on the topic. Submit the written reports by 5pm on the Sunday you are shifting out, via the link provided here. Written reports will comprise 40% of your final grade. Please sign the attendance form during virtual rounds.

    Please evaluate your remote and face-to-face teachers using the SET.

  • Cataract Small Group Discussion (Phase 1)

    This exercise will focus on the management of cataracts, a leading cause of avoidable/reversible blindness in our country.

    You will have a scheduled synchronous small group discussion with a preceptor. Prior to your SGD, you must accomplish the following:

    1. Watch the cataract surgery videos.
    2. Submit the CATARACT ASSIGNMENT by Tuesday, 5pm via the submission link below. The Cataract Assignment is an INDIVIDUAL REQUIREMENT.

    This activity will be 10% of your final grade. Please refer to the grading criteria below:

      • Assignment Q1: identified 5 parts of the eye involved in cataract surgery, discussed their functions, and the surgical steps they are involved in = 15 points
      • AQ2: identified 3 correct preoperative measures and their rationale = 10 points
      • AQ3: identified 5 correct intraoperative measures and their rationale = 15 points
      • AQ4: identified 3 correct postoperative measures and their rationale = 10 points
      • AQ5: identified 3 reasons for the cataract burden in the Philippines, and discussed their impact on patients = 20 points
      • Participation in synchronous activity: gave sound input and raised informed questions during the discussion = 30 points

    Please evaluate your SGD facilitator using the SET.

    • Cataract Patient Experience URL

      Optional resource

      This will help you understand the symptoms and the surgical experience from the patient's point of view.  It will also demonstrate how we can properly advise our patients and ease their apprehensions.

    • Cataract Assignment Submission

      Please answer the following questions:

      1. What parts of the eye are involved in the surgery? Discuss 5.
      2. What measures can be taken preoperatively in order to avoid surgical site infection? Discuss 3.
      3. What measures can be taken intraoperatively in order to avoid surgical site infection? Discuss 5.
      4. What measures can be taken postoperatively in order to avoid surgical site infection? Discuss 3.
      5. Why is cataract blindness common in the Philippines?  What factors hinder patients from receiving proper treatment? Discuss 3.

      Save your answers in a PDF or Word file, A4 size, Calibri font size 12, single-spaced, maximum of 2 pages.

      Please save the file as BLOCK_Surname+First&MiddleInitials_Cat. For example, 10A_RancheFT_Cat. 

  • Ward Case SGD (Phase 2)

    This exercise will focus on the management of admitted or preoperative cases.

    You will have a scheduled synchronous small group discussion with a preceptor. Prior to your SGD, you must accomplish the following:

    1. Interview and examine a ward patient.
    2. Prepare a case presentation and discussion.

    This activity will be 10% of your final grade. Please refer to the grading sheet for the expectations and breakdown of your score. You will have individual and group marks for this activity.

    Please evaluate your SGD facilitator using the SET.

  • Formative Quizzes & Activities

    These activities are optional. This section will be updated regularly throughout the academic year.

  • COME / Public Health Project

    The purpose of this activity is to emphasize that our UPCM education is geared towards uplifting our community. Although much of ophthalmology may seem hospital- or clinic-based, there are many ways to promote and deliver eye care at the community level.

    Please identify an aspect of eye care that can be addressed with a public health lecture. This can be a common misconception about eye health, or a common disease that will benefit from early recognition, or even a rare disease that needs to be explained more in layman's terms.

    Please make a 15-minute public health lecture to be presented during Phase 2. THIS IS A GROUP ACTIVITY.

    The PHL may be scheduled from Tuesday to Friday, depending on the availability of your preceptor. Pls fill up the SET and Peer Evaluation forms after the activity.

    This activity will be 10% of your final grade. Please refer to the grading criteria below:

      • Output is easily comprehensible, with a clear message that is not prone to misinterpretation = 10 points
      • Information presented is accurate = 10 points
      • Creativity and originality = 15 points
      • Audience paid attention and showed interest = 15 points
      • Average of peer evaluation = 50%

  • Duty

    Please deck 1 clerk per duty shift. Day shift: 8am to 4pm. Night shift: 8pm to 4am. 

    At the ward, carry out the orders in the charts of the admitted patients.

    You will be informed if there is an ER patient at the SOJR. Please join the intern and resident in charting and disposing the patient.

    You are required to present 1 ward/ER case during phase 2. Choose one ward or ER patient to present as a case endorsement and discussion. You are expected to elicit a complete history and physical examination, and distill the pertinent data for oral endorsements. You are also expected to provide differential diagnoses, then narrow them down to your primary impression. Study the pathophysiology and management for the discussion of the case. For daytime duty, please present to the Team Captain at the General Clinic before 4pm. For nighttime duty, please present to the senior resident on duty before 4am. Have them fill up your grading sheet and give you feedback.

    Ward/ER grades will comprise 10% of your final grade.

    For students in quarantine or isolation, ask your block for the list of admitted cases. Choose 1, and make a written report on the pertinent history, physical exam, diagnosis, and management of said case. You need 1 ward written report for each week of your rotation. Submit it via the link provided below. Ward grades will comprise 10% of your final grade.

    If you were taught by faculty during your post, please evaluate them using the SET.

  • DOVS Teaching Videos

    Here are additional resources for self-study. These will be regularly updated throughout the academic year.

  • Links to Additional Resources