2-week Internship Rotation at the Department of Ophthalmology and Eye Center
Course Objectives:
1. To conduct a series of lectures identified as core ophthalmic knowledge for all graduating
medical students.
2. To discuss presentations to support interactive cases for medical students.
At the end of the rotation, the student should be able to:
1. Describe the anatomy of the eye and the visual system.
a. List the important structures of the eye.
i. External Eye and Adnexa
ii. Conjunctiva
iii. Sclera
iv. Cornea
v. Anterior Chamber
vi. Ciliary Body and aqueous drainage system
vii. Iris
viii. Lens
ix. Optic nerve
x. Retina
xi. Extraocular muscles
b. Describe the location and functions of these structures.
2. Perform a basic eye exam.
a. Describe how to measure and record visual acuity
b. Describe how to examine pupillary responses
c. Describe how to examine ocular motility
d. Describe how to assess visual fields by confrontation testing.
e. Describe how to assess for severely increased intraocular pressure by palpation, when
indicated
f. Describe how to examine the important structures of the anterior segment of the eye with a
penlight in a systematic way
g. Describe how to examine the fundus with direct ophthalmoscope and identify the most
important structures.
3. Describe how to evaluate a patient with acute painless vision loss.
a. List and describe the pathophysiology of the important causes of acute vision loss including:
i. Retinal detachment
ii. Retinal Vascular Events such as retinal artery occlusion, retinal vein occlusion,
amaurosis fugax, and optic nerve pathologies (giant cell arteritis, non-arteritic ischemic
optic neuropathy, compressive optic neuropathy, and optic neuritis)
b. Describe the initial management and urgency of referral for these diagnoses.
4. Describe how to evaluate a patient with chronic vision loss.
a. List and describe the pathophysiology of the common causes of chronic vision loss including:
i. Refractive error - myopia, hyperopia, astigmatism, presbyopia
ii. Cataract
iii. Glaucoma
iv. Macular Degeneration
v. Diabetic Retinopathy
b. Describe the presenting signs and symptoms of these diagnoses and narrow a differential
diagnosis based on the elicited history and exam.
c. Describe the management for these diagnoses by an ophthalmologist.
5. Describe how to evaluate a patient with a red or painful eye.
a. List and describe the pathophysiology of the common and important to not miss causes of a
painful or red eye including:
i. Blepharitis and Dry Eye
ii. Preseptal cellulitis and Orbital Infection
iii. Conjunctivitis (bacterial, viral, allergic) iv. Subconjunctival hemorrhage
v. Scleritis
vi. Corneal Abrasion
vii. Corneal ulcer (infectious - herpetic, bacterial, contact lens related)
viii. Angle closure glaucoma
ix. Uveitis
x. Intraocular infection / endophthalmitis
b. Describe the initial management and urgency of referral for these diagnoses.
6. Describe how to evaluate a patient with eye trauma.
a. List and describe the common manifestations of eye trauma including:
i. Corneal abrasion
ii. Corneal foreign body
iii. Corneal laceration
iv. Chemical injury
v. Hyphema
vi. Ruptured globe
vii. Vitreous hemorrhage
b. Describe the initial management and urgency of referral for these diagnoses.
c. Describe the importance of ruling out globe rupture before manipulating the eye.
7. List and describe the pathophysiology of the most important ophthalmic problems in children.
a. Refractive Error
b. Amblyopia and Strabismus
c. Congenital Cataract
d. Congenital Glaucoma
e. Retinoblastoma
f. Retinopathy of Prematurity
8. Describe the ocular manifestations of systemic conditions.
a. Describe the ocular manifestations of systemic conditions including:
i. Diabetes
ii. Hypertension
iii. Human Immunodeficiency Virus/ Immunocompromised patients
iv. Thyroid eye Disease
v. Pregnancy
9. List the most important ocular side effects of systemic drugs.
a. Corticosteroids (oral, topical, injected, inhaled)
b. Hydroxychloroquine
c. Sympathomimetic & anticholinergic medications
10. List the common ocular medications that can have systemic side effects
a. Topical beta blockers
b. Topical alpha-2 adrenergic agonists
c. Topical anticholinergics
11. Describe when it is necessary to urgently refer a patient to ophthalmology.
a. Eye pain
b. Acute Diplopia
c. Flashes/Floaters/Curtains
d. Sudden Vision loss
e. Concern for ruptured globe
Learning Strategies:
1. Lectures
2. Reading of Book Chapter Topics and watching Lecture Videos for Self-directed Learning
3. Case Discussions and Reporting
4. Surgical and Demonstration Videos
5. Teleconference
Week 1
Monday Basic Eye Eye Anatomy video
Anatomy (Dr. [Link]
Abigail Montes)
External eye and adnexa videos
[Link]
[Link]/resources/[Link]/BASIC20
16/basicinteractive/interactive/1/[Link] Ophthalmic Medical
Assisting ([Link])
[Link]
[Link]/resources/[Link]/OMA201
7/OMAinteractive/interactive/3/[Link] [Link]
[Link]/resources/[Link]/BASIC20
16/basicinteractive/interactive/4/[Link]
[Link]
[Link]/resources/[Link]/OMA201
7/OMAinteractive/interactive/5/[Link]
Cornea
[Link]
[Link]/resources/[Link]/
OMA2017/OMAinteractive/interactive/6/[Link]
Anterior Chamber
[Link]
[Link]/resources/[Link]/BASIC20
16/basicinteractive/interactive/9/[Link]
Retina
[Link]
[Link]/resources/[Link]/BASIC20
16/basicinteractive/interactive/12/[Link] [Link]
[Link]/resources/[Link]/OMA201
7/OMAinteractive/interactive/8/[Link]
Extraocular muscles
[Link]
[Link]/resources/[Link]/
OMA2017/OMAinteractive/interactive/11/[Link]
[Link]
[Link]/resources/[Link]/
BASIC2016/basicinteractive/interactive/1/[Link]
Tuesday 8 am Zoom teleconference
Department
Conference Book Reading: Chapter 1: The Eye Examination, AAO Basic
Ophthalmology
5 pm 5-point How to perform basic exam videos
Ophtha Exam (Dr. [Link]
Jaloy Duque) [Link]
Common Afferent Pupillary Defect
Ophthalmology [Link]
Emergencies (Dr. [Link]/resources/[Link]/BASIC20
Jaloy Duque) 16/basicinteractive/interactive/3/[Link] [Link]
[Link]/resources/[Link]/BASIC20
16/basicinteractive/interactive/7/[Link]
Visual Fields
[Link]
[Link]/resources/[Link]/
BASIC2016/basicinteractive/interactive/5/[Link]
[Link]
[Link]/resources/[Link]/
OMA2017/OMAinteractive/interactive/9/[Link]
Wednesd 5 pm Acute Book Reading: Chapter 2: Acute Vision Loss, AAO Basic
ay painless vision loss Ophthalmology
(Dr. Sharlene
Noguera) Management of acute vision loss
[Link]
Retinal Cause of vision loss
[Link]
Central Causes of vision loss
[Link]
Optic Neuropathies
[Link]
Thursda 5 pm Book Reading: Chapter 3: Chronic Vision Loss, AAO Basic
y Ophthalmology
Chronic Vision
Loss Vision Loss and Refractive Error
(Group 1 Report) [Link]
Video Vision Loss and Cataract
presentation of [Link]
cataract surgery
ECCE, Phaco Vision Loss and Glaucoma
(Dr. Sharlene [Link]
Noguera)
Vision Loss and Macular Degeneration
[Link]
The Eye and Diabetes Mellitus
[Link]
Friday 5 pm Book Reading: Chapter 4: The Red Eye, AAO Basic
Ophthalmology
Red and Painful
Eye (Group 2 How to Distinguish between Vision-Threatening and non-vision
Report) threatening causes of Red Eye
[Link]
Video
presentation Why Does the Eye get red?
Pterygium [Link]
Surgery (Dr.
Sharlene Noguera) External Causes of Red Eye
[Link]
Scleral and Conjunctival Causes of Red Eye
[Link]
Anterior Chamber Causes of Red Eye
[Link]
Saturday 6 pm
Case presentations
Monday 5 pm Book Reading: Chapter 5: Ocular and Orbital Injuries, AAO Basic
Ophthalmology
Patient with
Eye Trauma Assessing Eye Trauma
(Ocular and [Link]
Orbital
Injuries) Trauma of the Anterior Segment Part
(Group 3 1:[Link] Part
Report) 2:[Link]
Trauma of the Posterior Segment
[Link]
Trauma of the Periocular Structures
[Link]
Tuesday 8-9 am: Zoom teleconference
Department
Conference Book Reading: Chapter 6: Amblyopia and Strabismus, AAO Basic
Ophthalmology
5 pm
Ophthalmic Leukocoria [Link]
problems in
Children Amblyopia [Link]
(Group 4 Pediatric Cataract [Link]
Report)
Retinoblastoma [Link]
Retinopathy of Prematurity
[Link]
Wednesda 5 pm Book Reading: Chapter 9: Ocular Manifestations of Systemic Disease,
y AAO Basic Ophthalmology
Ocular
Manifestation The Eye and Diabetes Mellitus
s of Systemic [Link]
Conditions
(Group 5 Hypertension and the Eye
Report) [Link]
The Effects of HIV in the Eye
[Link]
Thyroid Eye Disease
[Link]
Pregnancy and the Eye
[Link]
Thursday 5 pm
Book Reading: Chapter 10: Drugs and the Eye, AAO Basic
Drugs and the Ophthalmology
Eye: Ocular
side effects of Ocular Side Effects of Corticosteroids
systemic [Link]
drugs and Ocular Side Effects of Hydroxychloroquine
common [Link]
ocular e
medications
that can have Ocular Manifestations of Autonomic Pharmacology
systemic side [Link]
effects The Eye and Diabetes Mellitus
(Group 6 [Link]
Report)
Friday 5pm
Case
presentations
Saturday Review for
Exam
Sunday 5pm End of
Rotation
Exam
Competencies and Student Evaluation:
1. Attendance – 10% (5% online attendance, 5% OPD attendance)
2. Group Report – 20%
3. Case Discussion / Presentation – 40%
4. End of Rotation Exam – 30%
Reference:
AAO Basic Ophthalmology: Essentials for Medical Students, 10 th edition, 2016.
[Link]
