Universitat Internacional de Catalunya
Ophthalmology
Other languages of instruction: Catalan, English
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Dr Alfonso Anton: aanton@uic.es
Dr Marcos Roberto Muñoz: mrmunoz@uic.es
Dr Alfonso Anton: aanton@uic.es
Dr Rafael Ignacio Barraquer: ribarraquer@uic.es
Dr José Lamarca: jlamarca@uic.es
Dra Nuria Ibáñez Flores: nibanez@uic.es
Dr Ignasi Jürgens: ijurgens@uic.es
Introduction
Dear students,
I am Alfonso Antón, Professor in charge of Ophthalmology at the UIC. I welcome you all to one of the most appealing and interesting specialties of medicine. Ophthalmology is also a very rapidly evolving specialty which has considerably changed during the last decades thanks to the progress in research and technology.
Ophthalmology is small in pathology, volume and hours compared to internal medicine or general surgery. Nevertheless, you should be aware that most information that enters the brain does so through the eyes. Some of the most frequent diseases affect the visual system and there are 161 million people with visual impairment and 37 million people (WHO 2004) in the world. With this figures in mind it is clear that general practitioners, optometrists and ophthalmologists have a lot of work to do.
Finally, and probably most important for our patients, a good vision is very important to enjoy a good quality of life.
As Professor in charge of Ophthalmology I hope you find this course interesting and useful. Please remember that to enjoy and obtain best profit of all educational activities it is very important, even crucial, that you actively participate in all of them.
Welcome to Ophthalmology, I hope that you will not only acquire a broad knowledge about physiopathology, diagnosis and treatment of ophthalmic diseases, but you will also convince yourself that ophthalmology is appealing, interesting and important.
Sincerely,
Alfonso Antón MD PhD
Pre-course requirements
Prior knowledge:
It is very convenient for students to review the knowledge acquired previously, during the first cycle, on the following eye tema:
- embriologia: stages of development of the visual system
- Eye anatomy and eye looked nervous.
- Histology of the layers of the globe and annexes.
- Ocular Physiology
Objectives
Overall goal:
Convey to students intellectual knowledge, skills and attitudes that enable it to establish the pathogenesis, diagnosis and treatment of ophthalmologic diseases more common, knowing the clinical evolution and treatment of patients with these diseases, as well as knowing the usual surgical techniques to treat be diseases.
Specific goals
The student must learn or possess the necessary knowledge about:
- eye diseases to be diagnosed as early as possible, starting with not diseases themselves but from the signs and symptoms that produce.
- the diseases that cause decreased visual acuity
- visuallas alterations that produce ocular redness
- repercussion in the eye of ocular and facial trauma
- eye diseases in children
- eye diseases without visual symptoms visuales.
- Barin and visual pathway diseases
- The impact of systemic diseases on the ocular system.
- To make an effective preventive ophthalmology.
Competences/Learning outcomes of the degree programme
- 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
- 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
- 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
- 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
- 12 - Understanding the foundations for action, the indications and efficacy of therapeutic interventions, based on available scientific evidence.
- 14 - Perform a physical examination and a mental assessment.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
- 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
- 19 - Propose preventive measures appropriate to each clinical situation.
- 21 - Listen carefully, obtain and synthesize relevant information about the problems affecting the patient and understand the contents of this information.
Learning outcomes of the subject
At the end of the course the student will know the normal functioning of the visual system and the fundamental diseases that can affect it throughout life. In addition, he/she will be able to identify the symptoms and signs of ocular pathology and will have developed the necessary skills to obtain the necessary additional information through examinations and test that should be performed in each case. Finally, you will have the knowledge and deductive ability to make differential diagnosis of the most frequent pathology, establish a diagnosis and choose the most appropriate therapeutic measures.
Syllabus
Theme
Bases of vision
Foundations of vision. Development and maturation of the visual system. Histology of different tunics of the eye. Function of each of the layers of balloon. Structures of the orbit. Operation of the ocular adnexa and its relation with the vision.
The anamnesis and exploration of the visual system
Clinical history oriented ocular pathology. Signs and symptoms in the eye. Difference between central and peripheral vision and ways to explore each type of vision. Different types of signs and alterations of central vision: metamorfopsia, micropsia, alteration of the colors, vision of halos. Different types of signs and alterations of the peripheral vision: scotomas, floaters and phosphenes. Causes of the signs and symptoms of vision in the affected eye layer. Techniques and instruments necessary for the eye scan.
Ametropia (disorders of refraction)
Concept of the eye such as optical media. Types of lenses, meniscus and prisms. Definition of diopter. Hyperopia: signs and symptoms. Correction of hyperopia. Myopia: signs and symptoms. Causes of myopia. Correction of myopia. Astigmatism: types, signs, and symptoms. Correction of astigmatism.
Pathology of the ocular surface.
Concept of ocular surface - anatomo-physiological souvenir: tear film, eyelids, conjunctiva and corneal surface. Exploration and general semiology. Differential diagnosis of red eye. Dysfunction lacrimal and Sd from dry eye. Blepharitis and other eyelid inflammations. Infectious conjunctivitis. Takes samples of the ocular surface. Differential diagnosis of the acute and chronic follicular conjunctivitis. Non-infectious conjunctivitis: types of ocular allergy and autoimmune diseases in the ocular surface. Degenerative pathology and tumors of the conjunctiva. Keratopathy surface: types and differential diagnosis. Medical treatments in diseases of the ocular surface. Of the conjunctiva and ocular surface surgery.
Corneal pathology I
Anatomo-physiological memory: optico-refractiva, structural and defensive functions of the cornea; implications in the pathophysiology. Keratitis and corneal ulcers: general types. Infectious keratitis: bacteria, viruses, fungi and protozoa. Takes samples of the cornea. Treatment of bacterial, fungal keratitis and amebianas. Herpes virus infection: clinical forms and treatment. Post-Infectious Pathology: corneal perforation and corneal trophic ulcer: prevention and treatment.
Corneal pathology II
Non-infectious keratitis: types. Participation of the cornea in autoimmune diseases. Corneal degenerations and Dystrophies: main entities that affect the surface layers and the stroma. Manifestations of systemic diseases corneal. Pathophysiology of corneal edema. Endothelial degenerations and Dystrophies. Keratoconus and other corneal ectasicas alterations. Medical treatments in non-infectious corneal pathology. Surgery of the cornea: keratectomy, keratoplasty and keratoprosthesis.
Pathology of the crystalline lens.
Anatomo-physiological souvenir: the Crystal and the accommodation. Presbyopia and other disorders of accommodation. Cataracts: types and causes. Age-related cataracts: physiopathology and clinic. Cataract congenital and infantile. Subluxation and dislocation of the lens. Cataract and lens subluxado surgery. Correction of presbyopia.
Uveitis and other inflammatory diseases of the anterior segment.
Role of the sclera and the uvea in visual function. Episcleritis and scleritis: nodular and diffuse types, semiology, clinic and differential diagnosis. Necrotizing Scleritis. Anterior uveitis, iritis, iridocyclitis: definition, causes, semiology and clinical, differential diagnosis. Treatment in acute phase and treatment of maintenance.
Ophthalmologic emergencies of the anterior segment. Anterior segment trauma.
Grades and main reasons of ophthalmological emergency. Differential diagnosis of red eye. Bruised the anterior segment trauma: possible consequences. Semiology of perforation or eye popping. Superficial foreign bodies. Injuries subsections: non piercing and piercing: types, materials, possible consequences. Urgent treatment. Intraocular foreign leathers. Burns physical and chemical; classification, treatment of urgency and evolution.
Aqueous humor and intraocular pressure, glaucoma pathogenesis. Exploration in glaucoma.
Aqueous humor: function and circulation within the balloon. The mesh trabecular and its function. Concept of intraocular pressure. Functional and structural examination of the optic nerve and irido-corneal-endothelial angle.
Primary open angle glaucoma.
Primary open angle glaucoma. Pathogenesis, epidemilogia and importance of early detection. Signs and symptoms in open angle glaucoma. Medical treatment. Traneculoplastia types of surgery and laser.
Primary angle closure glaucoma.
Types of angle closure glaucoma. Closed angle glaucoma: forms of appearance. Primary and secondary causes. Acute glaucoma as urgency. Symptoms and signs of this type of glaucoma. Types of medical treatment and laser. The importance of early treatment and prevention in the contralateral eye. Acute elevation of ocular pressure: differential diagnosis.
Types and classification of the glaucomas. Secondary glaucomas. Congenital glaucoma.
Classification of the glaucomas clinic, type of angle, cause, and age. Description of the as, pigmentary, neovascular glaucoma, and others. Peculiarities of their diagnosis and treatment. Diagnosis and treatment of congenital glaucoma.
Diseases of the optic pathway. Paralysis oculo-motor.
Concept and scope of the normal visual field. Alterations (scotomas) campimetricas. Anatomy of the optic pathway and its relationship to alterations of the visual field. Decusacion of the nerve fibers in the optic CHIASM. Clinical correlation between alterations in the different levels of the optical path and defects in the visual field. Main diseases of the optic pathway.
The optical neuritis and oculomotor palsy
Causes of optic neuritis in children, young people and the elderly. Ischemic optic neuropathy. Temporal arteritis. Papilledema. Traumatic neuropathy. The blur of papilla differential diagnosis. Intrinsic ocular motility. Reflex fotomotor direct and consensual. Alteration of pupillary reflexes. Sincinesia miosis-acomodacion - convergence. Marcus-Gunn pupil, pupil of Adie, Argill-Robertson pupil. Horner's syndrome. Extrinsic ocular motility. Paralysis of the pairs creaneales III, IVy VI.
Palpebral pathology I
Anatomy and function of the eyelids. Alteration of the position of the eyelids: ptosis, entropion, ectropion, palpebral retraction. Disorders of eyelashes: trichiasis and distriquiasis (differential diagnosis with entropion or distriquiasis...). Other eyelid disorders: blefarocalasia, hypermobility,... Diagnosis and management of facial paralysis. Basic surgical principles for the correction of these pathologies. eyelashes (trichiasis and distiquiasis). Nodules and cysts eyelid benign (styes, chalacion, Zeiss cysts). Medical treatment of inflammations and infections
Palpebral pathology II
Eyelid tumors benign (cysts, junctional nevus, papillomas,
(styes...). Medical treatment of inflammations and infections. Palpebral malignant tumours (basal cell, squamous, melanoma). Differential diagnosis.Basic surgical principles for your treatment
Orbital pathology. Lacrimal pathway.
ANATOMY AND FUNCTION OF THE ORBIT. Differential diagnosis of Sd orbital syndrome. Diagnosis and treatment of orbital inflammations and infections (cellulitis, OAT..): must know diagnose and manage a cellulite and know that there is the thyroid Orbitopathy. Management of orbital trauma: examination, diagnosis and treatment. Imaging for orbital pathology tests. Via lacrimal excretory and secretory: Anatomy and physiology. Obstruction of lacrimal drainage: types of obstruction, diagnosis and treatment. Infection of the lacrimal pathway: diagnosis and treatment. Differential diagnosis of epiphora. Causes of the hiperlagrimeo in children.Congenital obstruction of lacrimal pathway.
Ophthalmology pedriatrica.
External ocular motility (ducciones and versions). Definition and prevention of amblyopia. Concept of strabismus. Main types of Strabismus (endotropias and exotropias). Treatment of Strabismus (optical correction and principles of)
surgery). Particularities of cellulitis in children and the congenital ptosis.
I remember Anatomy and physiology of the Retina. Vitreous and retinal-vireo interphase pathology. The posterior segment trauma.
Anatomy and physiology of the retina. Posterior vitreous detachment. Vitreous hemorrhage. Macular hole. Membrane epiretiniana. Vitrectomy. Edema in Berlin. Bleeding and tears. Neovascularization ruptures Neuropathies traumatic. Intraocular foreign body.
Retinal detachment.
Types of retinal detachment. Rhegmatogenous, Stevens-Johnson Syndrome and tractional. Pathophysiology of retinal detachment. Surgical treatment. Prophylaxis of predisposing lesions.
The retinal degenerations.
Inherited-degenerative diseases; retinitis pigmentosa and Stargard disease. Acquired diseases. The age macular degeneration. Types of AMD. Causes. Diagnosis and treatment.
Vascular disease of the retina
Retinal artery occlusions. Branch and central artery occlusion. Local and systemic causes. Diagnosis and treatment. Retinal vein occlusions. Branch and central vein occlusion. Local and systemic causes. Diagnosis and treatment. Retinal pathology associated with systemic diseases. Esclerohipertensiva retinopathy. Diabetic retinopathy. Pathophysiology of diabetic retinopathy types. Diagnosis and treatment.
Tumoral pathology of the retina. Retinal pathology in childhood.
Benign and malignant intraocular tumors. Uveal melanoma. Diagnosis and treatment. Forecast. Differential diagnosis. Retinopathy of prematurity. Diagnosis differs from the leukocoria
Posterior Uveitis. Endophthalmitis.
Infectious Corioretinitis by viruses, bacteria and parasites. Non-infectious Corioretinitis. Pathology associated with AIDS. Intermediate Uveitis or pars planitis.Endophthalmitis. Oftalmiasimpatica.
Teaching and learning activities
In person
Different teaching methodologies will be implemented:
- Master class (CM)
- The case method (MC)
- (ABP) problem-based learning
- Laboratory skills (LH)
Evaluation systems and criteria
In person
The course is assessed through following evaluation systems:
1. Final test: 60-100 questions on format type test, multiple choice, with 4 possible answers and one correct. Criteria of correction:
- · Question answered correctly: + 1 point
- · Question answered incorrectly: - 0.33 points
- · unanswered question: 0 points
Value on the final score: 70%. Essential to overcome this test to pass the course
2. Partial exams: 20% of the total grade. Obligatory. Passing the exam does not prevent from taking the final exam
-It will include refraction, glaucoma, anterior segment, oculoplastics, neuro-ophthalmology and pediatric ophthamology
3. Attendance, participation, work performed in class (ABP, MC) and outside of the classroom, and professionalism.
Value on the final score: 10%
IMPORTANT NOTES:
Final exman will only be passed if the resut is 5 or over. IF the puntuation is under 5, the student will have to repit the exam in the next call.
If the student fails the course, he/she must repit the final exam independently of the grades obtained in the partial exams. At the second call of the final exam, the final score will be calculated applying the same formula (final 70%, parcials 20%, professionalism 10%).
If the final-global score is less than 0.25 points (up to 0.24) under the passing, notable or outstanding minimum score, the student may choose to improve the grade on the day of the final exam review by correctly answering several oral questions asked by the teacher.
Bibliography and resources
- Guiones de oftalmología. Universidad de Valladolid
- Oftalmología clínica. Autor : Kanski
- Atlas de Oftalmología. Autor: Kanski
- Curso de ciencias básicas y clínicas de la Academia Americana de Oftalmología