OPT506 Course Overview
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Questions and Answers

Which component accounts for half of the assessments in the OPT506 course?

  • Oral presentation
  • Group project
  • Practical exam (correct)
  • Written exam (correct)

    • What is the primary focus of the OPT506 course?

  • General eye examination procedures
  • Non-vision related health practices
  • Specialist optometry skills (correct)
  • General health assessments

    • What is the maximum duration of a practical session in the OPT506 course?

  • 120 minutes
  • 50 minutes (correct)
  • 60 minutes
  • 30 minutes

    • Which of the following is NOT a topic covered in the OPT506 lectures?

    <p>Pediatric vision (C)</p> Signup and view all the answers

    Which item is essential for attendance in the practical sessions?

    <p>Optometry kit (A)</p> Signup and view all the answers

    How often are lectures scheduled in the OPT506 course?

    <p>Once a week (B)</p> Signup and view all the answers

    Which of the following is a requirement for practical session attire?

    <p>Smart attire and name tag (C)</p> Signup and view all the answers

    What is the purpose of using narrow slit illumination in the examination process?

    <p>To specifically highlight foreign bodies present in the cornea (A), To enhance the visibility of scars within the cornea (C)</p> Signup and view all the answers

    Which phenomenon is mentioned as being similar to the principles of the conical beam technique?

    <p>Tyndall’s phenomenon involving airborne dust (D)</p> Signup and view all the answers

    What tool is advised to be turned off after use during practical sessions?

    <p>Keratometer (C)</p> Signup and view all the answers

    In the retro-illumination technique, what is primarily observed?

    <p>The dark zone between the cornea and anterior lens (A)</p> Signup and view all the answers

    What angle is recommended for the conical beam technique during examination?

    <p>45 - 60° (A)</p> Signup and view all the answers

    What does the slit's height for the conical beam technique typically range between?

    <p>1 – 2mm (A)</p> Signup and view all the answers

    What is the primary advantage of using a slit lamp for assessing the anterior segment of the eye?

    <p>It offers excellent image quality and flexible illumination. (A)</p> Signup and view all the answers

    Which structures can be examined with high magnification (20-25x) using a slit lamp?

    <p>Epithelium, stroma, and endothelium (D)</p> Signup and view all the answers

    What aspect of a slit lamp's observation system is crucial for achieving the desired magnification?

    <p>Eyepiece and objective lens combination (C)</p> Signup and view all the answers

    Which of the following correctly identifies the components of the slit lamp that support patient positioning?

    <p>Chin rest and forehead rest (C)</p> Signup and view all the answers

    In slit lamp bio-microscopy, what feature of the illumination system is specifically controlled to enhance evaluation?

    <p>Height of the slit beam (B)</p> Signup and view all the answers

    What is the primary function of the diffuser filter in a slit lamp?

    <p>To scatter light for general viewing (B)</p> Signup and view all the answers

    Which filter is specifically used to enhance the contrast of fluorescein during examination?

    <p>Wratten 12 filter (B)</p> Signup and view all the answers

    Which procedure is NOT typically associated with the use of a slit lamp?

    <p>Electroretinography (B)</p> Signup and view all the answers

    What is one of the main purposes of assessing contact lenses during a slit lamp examination?

    <p>To establish patient suitability for contact lens wear (D)</p> Signup and view all the answers

    What is an essential practice to ensure safety and hygiene before using a slit lamp?

    <p>Wipe down the slit lamp (D)</p> Signup and view all the answers

    What percentage of the overall assessment is dedicated to the practical exam in the OPT506 module?

    <p>50% (A)</p> Signup and view all the answers

    Which of the following skills is NOT part of the competencies expected by the General Optical Council regarding visual impairment?

    <p>Ability to perform surgical procedures on visual impairments (C)</p> Signup and view all the answers

    Which technique is specifically assessed in Station 1 of the practical exam?

    <p>Slit lamp techniques (C)</p> Signup and view all the answers

    Which intended learning outcome involves selecting optical or non-optical aids for patients?

    <p>Evaluate and select appropriate aids for visual impairment (B)</p> Signup and view all the answers

    What type of assessment occurs during the ISCE portion of the practical exam?

    <p>SCL Aftercare routine (D)</p> Signup and view all the answers

    Which of the following is NOT a component of evaluating and selecting contact lenses?

    <p>Conducting surgical laser treatments (B)</p> Signup and view all the answers

    Which outcome relates specifically to the use of slit lamp and its accessory equipment?

    <p>Demonstrate competent use of the slit lamp (D)</p> Signup and view all the answers

    Which of the following assessments is included in the practical exam for the previous year?

    <p>Slit lamp technique evaluation (B)</p> Signup and view all the answers

    What is the primary method for examining all corneal layers, excluding the endothelium?

    <p>Parallelepiped (D)</p> Signup and view all the answers

    Which illumination technique is specifically recommended for assessing corneal oedema and pathological changes?

    <p>Retro-illumination (C)</p> Signup and view all the answers

    When performing direct retro illumination, which initial magnification is suggested?

    <p>16x (B)</p> Signup and view all the answers

    Which of the following objects would most likely be examined using indirect retro illumination?

    <p>Corneal vessels (D)</p> Signup and view all the answers

    What observation technique is used for examining keratic precipitates and other debris on the corneal endothelium?

    <p>Direct retro illumination (B)</p> Signup and view all the answers

    What is the angle setting recommended for indirect retro illumination?

    <p>0 - 10° (D)</p> Signup and view all the answers

    What is the purpose of using the Van Herick’s technique?

    <p>To evaluate the anterior chamber angle (B)</p> Signup and view all the answers

    Which condition is NOT likely to be observed using direct retro illumination?

    <p>Corneal vascularization (B)</p> Signup and view all the answers

    Study Notes

    Recording Information

    • The lecture will be recorded and available via Panopto on the module DLE pages.
    • Questions asked during the lecture may appear on the recording.
    • Students can ask the lecturer to pause the recording if they do not wish their question to be recorded.

    Module Information

    • The module is OPT506 Specialist Optometry Skills.
    • The module focuses on introducing Slit lamp biomicroscopy.
    • The module is a full-year course (terms 1 and 2).
    • The module includes 20 credits (200 hours of work).
    • Lectures: 30 hours
    • Practical sessions: 48 hours
    • Independent study: 122 hours

    Assessments

    • 50% Written exam on May 13, 2025.
      • The exam includes 50 multiple-choice questions.
    • 50% Practical exam on December 3, 2024.
      • The exam consists of 3 OSCE stations and 1 ISCE station.
      • Station 1: Slit lamp techniques
      • Station 2: Keratometry and baseline measurements
      • Station 3: RGP fit assessment(passive)
      • ISCE (May 27-28, 2025): SCL Aftercare routine

    Ground Rules

    • Be respectful.
    • Be ready.
    • Be safe.

    Specialist Optometry Skills Breakdown

    • Optometry is a general skill.
    • Specialist skills include:
    • Binocular vision
    • Pediatric vision
    • Contact Lens
    • Low Vision

    Lecture Structure

    • 1 lecture per week (2 hours each)
    • Lecture outlines are uploaded 48 hours before lecture.
    • Lecture slides are uploaded after the lecture.
    • Lecture content:
      • L1 - L5: Initial CL assessment
      • L6 - L9: Rigid Gas Permeable Lenses (RGP)
      • L10 - L11: Optics and CL material
      • L12 - L16: Soft Contact Lens (SCL)
      • L17 - L18: Low Vision
      • L19 - L20: CL care and complications

    Practical Sessions

    • 1 practical session per week (2 hours each).
    • Briefing/Demo/Q&A duration: 50 minutes.
    • Group 1: 11:05-11:15am; 11:15am – 12:05pm
    • Group 2: 9:00-9:10am ; 9:10 - 10:00am; 10:00am - 10:50am
    • Students should arrive 10 minutes early.
    • Set up the bay if you are first in your pair- don't wait.

    Practical Session Guidelines

    • All sessions have demo videos
    • Hand hygiene is critical!
    • Dress code is smart casual, with a name tag.
    • No long nails or nail varnish.
    • Clinical workbook and pen are required.
    • Optometry equipment and stationery are to be placed in locker code 2244.
    • No cell phones in the practical sessions.
    • Turn off equipment after use (such as keratometer, SL, bay lights).
    • Log out of PC before leaving the session.
    • Leave the session bay tidy.

    Intended Learning Outcomes

    • Use a variety of instruments and techniques to assess the anterior eye.
    • Understand the manufacturing process of contact lenses.
    • Evaluate and select suitable contact lenses for various refractive issues.
    • Perform appropriate contact lens aftercare.
    • Understand magnification and alternative methods for managing visual impairment.
    • Assess and select appropriate optical and non-optical aids.
    • Develop a management plan for contact lens wearers.

    Slit Lamp Biomicroscopy 1

    • Slit lamp biomicroscopy is a critical skill.
    • Understanding the anatomy of the anterior eye is key.
    • The slit lamp is a crucial tool for assessing the anterior segment of the eye.
    • It delivers excellent image quality and provides a stereoscopic view.
    • Flexible illumination and magnification enhance its versatility.

    Slit Lamp Components

    • Patient support (chin rest and forehead rest)
    • Illumination system
    • Observation system

    Observation System Components

    • Eyepiece
    • Magnification control

    Magnification Levels

    • Levels of magnification are critical in ophthalmology procedures:
      • Low (6x): overview of the eye (lids, conjunctiva, cornea, limbus)
      • Medium (10-16x): detailed examination of the anterior structures.
      • High (20-25x): deeper examination of corneal layers (epithelium, stroma, endothelium)
      • Very High (30-40x): detailed examination, identifying vacuoles, microcysts and dystrophies.

    Slit Beam Height Setting

    • The height of the slit beam can be adjusted using a dial on the illumination arm.
    • A mm gauge display can be used for setting the correct height.

    Diffuser Filters

    • The diffuser filter is essential to prevent a focused beam from damaging the eye.
    • Ground glass filters are often implemented to achieve diffuse illumination.

    Slit Lamp Filters

    • Heat reduction filter
    • Neutral density filter
    • Cobalt blue + Wratten filter
    • Red free filter

    Wratten 12 Filter

    • A yellow filter used in conjunction with the observation system to enhance fluorescein's contrast.
    • Commonly hand-held, though some slit lamps have inbuilt options.

    Slit Lamp Uses

    • Pachymetry
    • Gonioscopy
    • Fundoscopy
    • Laser photocoagulation
    • Contact tonometry
    • Anterior eye assessment

    Contact Lens Fitting Routine

    • History & symptoms
    • Baseline measurements: key step to determine the initial status.
    • Keratometry: Measurement of corneal curvature. Vital for contact lens selection.
    • Anterior eye assessment
    • Selection of lens: based on the initial data.
    • Insertion of lens: placing the lens onto the eye.
    • Fit assessment: evaluating if the lens fits well to the eye. Crucial to ensuring a comfortable wearing experience.
    • Over refraction: further adjustment of the spectacle or contact lens prescription.
    • Prescribe/refit: finalising the contact lens prescription.

    Slit Lamp and Contact Lens Fitting Procedures

    • Patient suitability assessment
    • Recording baseline measurements
    • Monitoring the contact lens fitting process, including scheduled and unscheduled visits.
    • Assessing the contact lens' condition, including surface properties and wetting.
    • Assessing ocular integrity.

    Things to Remember

    • Wipe down the slit lamp.
    • Maintain effective hand hygiene.
    • The focusing of fully corrected emmetropic individuals should be within +/-0.50D.

    Slit Lamp Examination Techniques Overview (Techniques and Purpose)

    • Direct illumination: Basic overview, fit assessment
    • Diffuse illumination: General overview
    • Parallelepiped: Detailed corneal observation, no endothelium assessment needed
    • Optic section: Detailed corneal observation
    • Indirect illumination: Detailed endothelium assessment, tear film, lens surface -Specular reflection: Endothelium, tear film, crystalline lens surface -Sclerotic scatter: Corneal surface -Conical beam: Anterior chamber -Retro-illumination: Corneal oedema and pathological changes. -Van Herick's technique: Anterior chamber angle assessment

    Diffuse Illumination Setup

    • Angle: 30-45° between the microscope and illumination.
    • Slit Width: Widest setting.
    • Filter: Diffusing filter.
    • Magnification: Low to medium.
    • Illumination: Medium to high.

    Diffuse Illumination Observation

    • Good overall view of the eye (lids, lashes, conjunctiva, sclera, redness, iris, pupil, gross pathology, and media opacities).
    • No fine details.
    • Useful for a general survey.

    Parallelepiped Setup

    • Angle: 40-60° from the straight ahead position.
    • Slit: Narrow, 1-2mm width.
    • Filter: No filter initially.
    • Magnification: 16x.
    • Illumination: Medium.
    • Microscope directly in front of the cornea.

    Parallelepiped Observation

    • Detect and examine corneal structures or defects.
    • Wider beam illumination is necessary to evaluate the depth and extent of corneal scarring or foreign bodies.
    • Corneal nerve features, appearing as fine white threads.

    Optic Section Setup

    • Angle: 45-60°
    • Slit: Narrowest possible (careful to avoid turning the illumination off).
    • Magnification: Medium to Maximum.
    • Illumination: Maximum.

    Optic Section Observation

    • Localize: Nerve fibers, blood vessels, infiltrates, cataracts.
    • Assess: Corneal thickness, thinning, foreign bodies, opacities (percentage of thickness).
    • Visualize: Wide slices of the stroma.

    Decoupling - Indirect Observation

    • Separate rotation points for the illumination and observation systems.

    Illumination Techniques

    • Sclerotic scatter: -Beam focused on the limbus. -Angle(45-60°). -Slit: Narrow slit of 0.5 mm. -Filter: No filter -Magnification: 10-16x. -Illumination: Highest setting.
    • Conical beam: -Angle(45-60°) -Slit: Parallelepiped, 1-2mm height. -Filter: No filter initially. -Magnification: Medium(10x) to maximum. -Illumination: Maximum -Focusing beam between the cornea and anterior lens surface and dark zone between cornea and anterior lens observed. -Useful for assessing anterior chamber transparency, floating cells and flare in anterior uveitis

    Retro Illumination Overview

    • Techniques specifically used for corneal edema and pathological changes.
    • Used to assess vessels and neovascularizations.

    Direct Retro Illumination Setup

    • Angle: 30-50° for iris/lens; 0 - 10° for retina.
    • Slit: Parallelepiped max height; parallelepiped, pupil size.
    • Magnification: 16x initially, and increase
    • Illumination: Medium-high; Low-medium setting

    Direct Retro Illumination Observation

    • Assess objects close to the cornea.
    • Identify infiltrations, small scars, corneal vessels, microcysts, and vacuoles.

    Indirect Retro Illumination Observation

    • Infiltrations, small scars, corneal vessels, micro cysts, and vacuoles.
    • Corneal features seen against a dark background.

    Anterior Chamber Angle Assessment

    • Assessment of ACA
    • Assessment of ACD
    • Van Herrick's grading system for assessing the anterior chamber angle (ACA).
    • Grades 0 -4 based on the relative width of the anterior chamber and visible corneal structures (with the relationship between cornea and iris)

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