Download MGR (The Tamil Nadu Dr. M.G.R. Medical University) MBBS (Bachelor of Medicine and Bachelor of Surgery) 3rd Year Ophthalmology Syllabus
I. Goal
The goal of teaching of students in ophthalmology is to provide such
knowledge and skill to the students that will enable them to
1. Diagnose and manage common ophthalmic diseases, ocular
manifestations of systemic diseases and emergencies.
2. Knowledge of using common drugs keeping in mind their
adverse reaction.
3. Knowledge of common ophthalmic investigations and interpretation
of results.
II. Objectives
A. Knowledge
1. Aetiology, Clinical features and treatment of conjunctival
infections, allergies, pterygium, xerosis and trachoma.
2. Aetiology, Clinical features, complications and treatment of
coreneal ulcers, keratomalacia and other inflammations of sclera
and cornea.
3. Basic principles of corneal blindness eye donation and corneal
transplant (keratoplasty).
4. Aetiopathogenesis and complications of ectropion, entropion,
ptosis, lagophthalmos, symblepharon and lid inflammations.
5. Aetiology, clinical features and treatment of lacrimal sac infections
and causes of epiphora.
6. Classification, clinical features,diagnosis and treatment of various
forms of congenital and senile cataract.
7. Classification, clinical features, diagnosis and treatment of various
forms of glaucoma.
8. Classification, etiology, clinical features, complications and
management of various diseases of uveal tract.
9. Classification, aetiology, clinical features and treatment of various
refractive errors and presbyopia.
10. Types of blindness causes and their management .
11. Objectives of National Program for Control of Blindness,
Trachoma control Program and vision 2020.
12. Aetiology, Clinical features and treatment of common retinal
disorders including retinopathies vascular occlusions,
degenerations, inflammation and detachment.
13. Types of ocular trauma,clinical features, complications and
management including sympathetic ophthalmia.
14. Aetiology, Clinical features and management of optic nerve
disorders including optic atrophy, differentiation of papilloedema
and optic neuritis.
15. Aetiology, clinical features and management of orbital diseases
common causes of proptosis.
16. Ocular manifestation of systemic diseases including diabetes,
hypertension, tuberculosis, leprosy, anemia, AIDS and pregnancy
induced hypertension.
17. Ocular side effects of systemic drugs.
18. Aetiology, Clinical features and principles of treatment of vitreous
diseases e.g., haemorrhage, degeneration, endophthalmitis.
19. Recent advances in ophthalmology-lasers, intraocular lens
implantation.
B SKILLS
1. Determine visual acuity
2. Test Colour vision
3. Anterior segment examination using torch light and slit lamp
biomicroscope
4. Use of direct ophthalmoscope.
5. Determine field of vision by confrontation method
6. Removal of extra ocular foreign body
7. Perform epilation of eyelashes.
8. Incise and drain lid abscess
9. First aid for chemical injuries.
C. INTEGRATION
The Under graduate training in ophthalmology will provide an integrated
approach towards other disciplines like Neuro-Sciences, Dermatology,Dental,
ENT, Obstetrics & Gynaecology, Pediatrics, General Surgery and General
Medicine.
II TEACHING HOURS - 100
1. Lectures ? 64hours,
2. Theory TESTS-3x2=06 hrs
3. Integrated Lectures ? 20 hours
4. Demonstration - 4 hours
5. seminars --6 hours
III TEACHING METHODOLOGY
Didactic lectures,
Seminars,
Short lectures,
Case presentations,
DEMONSTRATION,
Theatre live surgical demonstration,
Attending ward round,
Minor theatre- foreign body removal, syringing nasolacrimal duct,
Visual acuity testing.
IV THEORY SYLLABUS
1. Anatomy of orbit, eye ball & adnexa.
2. Anatomy of visual pathway, pupillary pathway
3. Physiology of eye.
4. Bio-chemistry of ocular tissues.
5. Lid swellings, blepharitis
6. Ptosis, Lagopththalmos, ectropion, entropion, symblepheron
7. Anatomy of lacrimal drainage system, dacryocystitis and management
8. DD of limbal nodule,
9. Scleral, Episcleral affections
10. Pterygium, pseudo pterygium and its management
11. Etiology, Clinical features and management of Allergic conjunctivitis,
ophthalmia neonatorum, and other conjunctivitis.
12. Etiopathogenesis and clinical features, complications and management of
Bacterial, fungal, viral and protozoal corneal ulcer,
13. Etiology and types of cataract, preoperative evaluation, different types of
cataract surgery and post operative complications
14. Classification, etiopathogenesis, clinical features and management of various
glaucomas.
15. Various types of refractive errors and management. Retinoscopy and
pinhole, & Colour vision test
16. Differential Diagnosis of Red eye.
17. Clinical features, Management and complications of uveal tract diseases.
18. Causes and types of blindness. National Program for Control of
Blindness(NPCB)District Blindness Control Society(DBCS) VISION 2020,
Eye Bank, Hospital corneal Retrieval Program (HCRP) ? objectives and
functions
19. Aetiology, Clincial features and management of optic neuritis, optic atrophy
and papilloedema
20. Diabetic retinopathy, Hypertensive retinopathy, retinal detachment, Retinitis
pigmentosa, retinopathy of prematurity, retinal vascular occlusion
21. Signs of thyroid opthalmopathy.
22. Ocular manifestations of systemic disease.
23. Ocular motor nerve palsies
24. Types of ocular injuries, clinical features and management of chemical, blunt
injuries, sympathetic ophthalmia
25. Causes of proptosis, clinical features, complications and management of
orbital cellulitis
26. White reflex in pupillary area.
27. Watch incision and curettage for chalazion, incision and drainage for lid and
lacrimal abscess, removal of corneal foreign body, epilation, enucleation and
evisceration
28. Lasers in ophthalmology
29. Ocular anaesthesia.
30. Types of strabismus, cover uncover test, Hirschberg's test
31. Types of amblyopia and management
32. Dry eyes & thyroid ophthalmopathy.
33. Ocular manifestations of rheumatological diseases.
34. Clinical presentation and discussion of ophthalmic cases
35. Medical ethics- Bioethics
-Benefits & harm,
-human dignity & human rights
V PRACTICAL SYLLABUS
LIDS;
Ptosis, lagophthalmos,entropion, ectropion.
Blepharitis, Chalazion, hordeolum internum, hordeolum externum,
Pterygium, limbal nodule, bitot's spot, subconjunctival hemorrhage
Chronic dacryocystitis
LENS:
Cataract
Lens induced glaucoma
GLAUCOMA
Primary glaucoma
Secondary glaucoma
UVEITIS
CORNEA
Corneal opacities, corneal ulcers (purulent & non purulent)
Anterior staphyloma
SURGICAL INSTRUMENTS, slides,(microbiology, pathology
Specimens, Drugs used in ophthalmology
INVESTIGATIVE tools (Fluorescein strips, ophthalmoscope etc)
Visual Field charts, imaging,(CT, MRI, USG)
Refraction set, pinhole, maddox rod,
slit lamp examination
Tonometry
Colour vision
VI - REFERENCE LEARNING BOOKS
Parson's Diseases of the eye
Kanski's Text Book of ophthalmology
Kanski's Atlas in ophthalmology
VII Theory Examination :
1 . Essay
1 x 10 marks
= 10 marks
1. Brief Answeres 5 x 4 Marks
= 20 marks
2. Short Answers 5 x 2 Marks
= 10 marks
--------------
Total
40 Marks
VIII Practical Examination & sOSCE examinations
LONG CASE : 1 x 15 30 minutes 15 marks
Presentation-5 marks
Diagnosis & management-5 marks
Discussion-5 marks
SHORT CASES: 2 x 5 30 minutes 10 marks
Presentation -5 marks
Discussion -5 marks
OSCE/SPOTTERS 5 X 1 (10 minutes) 5 marks
Display for OSCE
Investigative tools & microbiology, pathology slides , Clinical Scenario
--------------
Total
30 marks
---------------
Viva
:
10 marks
I.A.
:
` 20 marks ( Theory 10, Practical
10)
SUGGESTED LONG CASES:
- Cataract, Aphakia,Pseudophakia, Lens induced glaucoma
SUGGESTED SHORT CASES;
- Corneal opacity, Corneal ulcers, iritis, Pterygium, Bitots spots, Hordeolum
Internum & externum, Subconjunctival hemorrhage, blepharitis,ectropion,
entropion, trichiasis.
IX --VIVA
VIVA
=
10 marks ( 4 x2.5 )
Refraction
2.5 marks
Community ophthalmology
2.5 marks
Systemic ophthalmology (includes Basic)
2.5 marks
Instruments & Pharmacology
2.5 marks
X INTERNAL
ASSESMENT =
20 Marks
Theory (average of minimum 3 tests)
10 marks
Practical
( Practical 5 marks + Log Book 5 marks
10 marks
Log Book to be approved by HOD
FORMATIVE ASSESSMENT-WHEN TO SUBMIT ?
-Formative assessment is an ongoing assessment wherein students in groups are allotted
to be with a specific tutor/ consultant in the hospital during OPDs, theatre ? everyday for
about an hour.
-At the end of the each (3) posting, the tutor/consultant does a formative assessment of
the students who are posted with him/her.
Schedule for Formative assessment
PERIOD
POSTING DURATION
TESTS
4th Semester
4 Weeks
One theory test
6th Semester
4 Weeks
Two theory tests and
two clinical test
9th Semester
2 Weeks
One theory and one clinical test
Subjects wise Tests: (To be held according to clinical postings)
Test 1- Anatomy,physiology, biochemistry,pharmacology & pathology
Test 2-Cataract,glaucoma, cornea
Test 3-Uvea, Retina, Refraction, Neuro ophthalmology, systemic & community ophthalmology
Test 4-Model examination (Complete Syllabus including recent advances).
INTERNAL ASSESSMENT TEST-UNIT WISE ? submitted as below
X INTERNAL
ASSESMENT =
20 Marks
III.
Theory (average of minimum 3 tests)
10 marks
IV.
Practical
10 marks
V. For practicals ? the following can be added- Practical assessment is done by
end of posting practical exam and OSCEs similar to the university
exams. .
MEDICAL ETHICS-RESPECT OF CADAVER needs to be covered during their
induction into MBBS before anatomy dissection and classes.
MEDICAL ETHICS needs to be covered when students are introduced to clinics.
Separate medical ethics lecture or classers not required separately in ophthalmology.
INTEGRATED TEACHING ? needs to be addressed at a higher pan departmental
meeting involving the overall UG curriculum in- charge and all the departments. Not
possible by one department alone to decide on integrated teaching.
RECORD / LOG BOOK ? submitted- log book approved by the HOD has to be
submitted at the time of university practical examination. The formatted log book has
already been made and available with the academic officer.
CRRI Orientation programme based on the clinical subjects- once again has to be done
by the overall UG curriculum ? in ? charge during overall orientation sessions.
Separate session needed for ophthalmology.
Foreign body removal
Syringing of nasolacrimal duct
Observing IOP recording, perimetry recording,
Other investigative procedures
THEORY SYLLABUS
MUST KNOW:
1. Anatomy of eye and various structures(parts)
2. Anatomy of visual pathway, pupillary pathway
3. Anatomy of lid - lid swellings, blepharitis, ptosis, lagophthalmos, ectropion,
entropion, symblepheron
4. Anatomy of lacrimal drainage system - dacryocystitis and management
5. VITAMIN A -Clinical features and WHO classification and management of Vit A
deficiency
6. DD of LIMBAL NODULE
-vernal,phlycten,episcleritis,scleritis,pterygium,pseudopterygium and its
management
7. CONJUNCTIVITIS -Etiology, clinical features and management of Allergic
conjunctivitis, ophthalmia neonatorum, and other conjunctivitis.
8. CORNEAL ULCER -Etiopathogenesis and clinical features of Bacterial,fungal,viral
and protozoal corneal ulcer and its complications and management
9. CATARACT -Etiology and types of cataract, preoperative evaluation, different types
of cataract surgery and post operative complications
10. GLAUCOMA -Classsification, etiopathogenesis, clinical features and management
of various glaucomas
11. REFRACTIVE ERRORS -Various types of refractive errors and management.
Retinoscopy and pinhole test
12. RED EYE -Differential Diagnosis of Red eye. Clinical features, management.
13. UVEITIS ?Iridocyclitis, clinical features and management
14. Causes and types of BLINDNESS. National Programme for Control of
Blindness(NPCB), District Blindness Control Society(DBCS),VISION 2020,EYE
BANK, Hospital Corneal Retrieval Programme(HCRP) - Objectives and Functions
15. Differentiation of optic neuritis, optic atrophy and papilloedema
16. Layers of retina. Diabetic retinopathy, hypertensive retinopathy, retinal detachment,
retinitis pigmentosa, retinopathy of prematurity, central retinal vein
occlusion(CRVO) and branch retinal retinal vein occlusion(BRVO)
17. Tests for visual acuity, colour vision, recording IOP, direct ophthalmoscopy
18. FIELD TESTING Confrontation method and Bjerrum screen
19. Medical ethics.
DESIRABLE TO KNOW:
1. Types of ocular injuries. Clinical features and management of chemical injuries,
blunt injuries, sympathetic ophthalmia.
2. Causes of Proptosis. Clinical features, complications and management of Orbital
cellulitis
3. Ocular manifestations of Tuberculosis, Leprosy, AIDS, Eclampsia, Anemia
4. Antibiotics, antifungal, antiviral, steroids, mydriatrics and cycloplegics.
Antiglaucoma drugs- dose, mode of action and side effects
5. Incision and curettage for chalazion. Incision and Drainage for lid and lacrimal
abscess. Removal of corneal Foreign body, epilation
6. LASERS in ophthalmology
NICE TO KNOW:
1. Origin, insertion, nerve supply and actions of Extra ocular muscles
2. Types of strabismus, cover uncover test, Hirschberg's test
3. Types of amblyopia and management
Practical syllabus
Must know;
1. Basic examination of the eyes
2. Visual acuity recording- presence of refractive error or other ocular pathology
3. Detection of conjunctivitis, presence of extra ocular foreign body, cataract, iritis
4. First aid for ocular trauma-in particular chemical injuries
5. Management of conjunctivitis
6. Referring patients requiring ophthalmic opinion to the eye specialists.
7. Counseling for the patients with diabetes mellitus, hypertension, thyroid disorders,
pregnancy induced hypertension for a thorough ophthalmic check by the competent
ophthalmologists
Desirable to know;
1. To check for presence of glaucoma
2. Neurological disorders requiring ophthal opinion- papilloedema-raised intra
cranial pressure
3. Presence of diplopia ? ocular motor nerve palsies= to R/O DM, HT, SOL
4. To give a thorough irrigation of eyes with clean water in the presence of chemical
injuries
5. To detect corneal pathology & refer the patients to an ophthalmologist.
Nice to know;
1. The presence of intra ocular infections
2. The presence of retinopathies
3. To detect papilloedema
4. To remove conjunctival foreign body ( not corneal foreign body)
5. Refer patients with any suspected ophthalmic diseases to the competent ophthalmologist.
This post was last modified on 02 July 2021