OPT009: Glaucoma Foundation

There are four modules that cover the subject area of glaucoma - providing the opportunity for 60 credits in total. The publication of the NICE guidelines, 'Glaucoma - Diagnosis and management of chronic open angle glaucoma and ocular hypertension' in 2009 has altered the way in which optometrists in primary care manage and refer cases of ocular hypertension or suspect glaucoma. These modules have been specifically designed to complement the levels of activity and responsibility that optometrists could undertake in community and hospital practice. The content is aligned wherever possible with national pathways for enhanced services and professional accreditation schemes - as such, they are subject to change.

This module is designed with the aim of providing postgraduate optometrists with the background knowledge and understanding about the pathogenesis and detection of glaucoma at an advanced level. As well as teaching the practical skills needed to provide a consistent approach glaucoma detection in primary care at a basic level. This module is particularly suitable for those who wish to update their knowledge in this area before providing enhanced services.

Start DateDurationCreditsPrerequisitesModule TutorsModule Code
September 201722 contact hours over one academic term10 credits

CET points available
NoneNik Sheen (Leader)OPT009

Additional information: This module is aligned with WOPEC/LOCSU training pathways for glaucoma. It complements OPT010, OPT011, OPT012 and OPT016.

Learning objectives

To acquire knowledge and understanding at an advanced level about:

  • The link between intra-ocular pressure (IOP) and glaucoma, and revise the extraneous and measurement errors which affect measurement of IOP
  • The underlying anatomy and physiology which dictate where and why visual field loss occurs in chronic open angle glaucoma (COAG)
  • Choosing the most appropriate field examination for investigation of suspect COAG.
  • Epidemiology and risk factors of the various types of glaucoma, particularly concentrating on COAG and ocular hypertension (OHT)
  • Difference between open and narrow anterior chamber angle and primary and secondary glaucoma, and how to form a basic classification based on these differences.
  • NICE guidelines for monitoring of previously diagnosed and untreated OHT and suspect glaucoma
  • NICE guidelines for referral of OHT and COAG from primary to secondary care.
  • The link between IOP and glaucoma, and revise the extraneous and measurement errors which affect measurement of IOP
  • The specific signs of glaucomatous optic disc changes
  • The principles of Van Herick's technique and the variations in the angle.

To apply this knowledge to given clinical situations and demonstrate how you would:

  • Interpret the visual field plot of a Humphrey Visual Field Analyser with particular reference to COAG
  • Look for signs of glaucomatous optic disc changes using a VOLK lens
  • Assess the anterior chamber angle using Van Herick's technique
  • Calibrate and use the Goldmann Applanation Tonometer (GAT).

How the module will be delivered

This module is taught via 5 lectures (Powerpoint with audio), delivered via Learning Central, the University's e-learning system, with supporting resources and references supplied. There are also 4 online learning sessions centred around cases for discussion.

How the module will be assessed

Online examination (50%)

There is a Multiple Choice Question (MCQ) test that will assess comprehension and application across the entire syllabus which students take at the end of the lecture series for final assessment. Visual Recognition and Interpretation of Clinical Signs (VRICS) tests will be included in these tests. VRICS are similar to MCQs but each question is linked to image slides of relevant cases.

Written coursework (30%)

Students will be required to submit two pieces of written coursework.

Practical assessment (20%)

The practical assessment is an Objective Structured Clinical Examination (OSCE). This is a type of examination used in medicine test skills such as communication, clinical examination and interpretation of results. The assessment consists of 4 stations, each lasting five minutes, including GAT measurement and calibration, Van Herick grading of the anterior chamber angle and Volk lens assessment of the central fundus using a model eye.

Syllabus content

  • NICE Guidelines.
  • Epidemiology and risk factors for glaucoma.
  • Signs and symptoms of glaucoma.
  • Optic disc assessment in glaucoma.
  • Assessment of the anterior angle.
  • Assessment of visual fields.
  • Introduction to referral refinement.
  • Goldmann tonometry.
  • Epidemiology and Risk factors for glaucoma.
  • Signs and symptoms of glaucoma.

Skills that will be practised and developed

Academic skills

  • Understanding evidence-based medicine.
  • Collate information from a number of resources to improve learning.

Subject-specific skills

  • The enhancement of clinical examination techniques.
  • Patient management.
  • Appropriate referral pathways.

Generic skills

  • Time management.
  • Working independently.
  • Problem solving.
  • Communication skills.

Websites

Glaucoma: Diagnosis and management of chronic open angle glaucoma and ocular hypertension (NICE guidelines)