OPT010: Glaucoma 1

This module builds on from the OPT009 – Glaucoma Foundation to help facilitate knowledge, understanding and training in corneal pachymetry plus further experience in visual field and disc evaluation (from our University library of images).

It aims to provide the practical skills training and knowledge for optometrists to participate in monitoring those suspected of having glaucoma or ocular hypertension (OHT), who have been diagnosed in secondary care but who are not receiving treatment. The follow-on module, OPT031 – Glaucoma Level 2, aims to develop these topics further.

Start DateDurationCreditsPrerequisitesModule TutorsModule Code
March 2017

September 2017
26 contact hours over one academic term10 credits

CET points available
OPT009

or

Exemption via LOCSU Glaucoma/Wales Glaucoma Referral Refinement Scheme
Alexander Paulus (Leader)

Nik Sheen
OPT010

Additional information: This module complements OPT011, OPT012 and OPT016.

Learning Objectives

To acquire knowledge and understanding at an advanced level about:

  • Structure and biomechanics of the optic nerve head
  • The risk factors for conversion to glaucoma and the NICE guidelines
  • The time-frames for follow-up of patients with OHT or suspect glaucoma, taking into account the risk of progression with and without medication
  • The use of perimetric techniques to monitor and assess the visual field
  • Corneal pachymetry, particularly with respect to glaucoma assessment.

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

  • Take a comprehensive, relevant, ophthalmic history in a patient with OHT or suspect glaucoma
  • Have effective communication skills to be able to inform patients of the rationale for monitoring their condition
  • Use and interpret perimetric techniques used to assess the visual field
  • Interpret optic disc appearance

To critically evaluate a clinical situation and suggest appropriate management of a patient with respect to:

  • The appearance of the anterior chamber angle using Van Herick's technique
  • Use of the Goldmann Applanation Tonometer (GAT) and corneal pachymetry

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

  • Inform patients of the rationale for monitoring their condition and explain the risk of developing glaucoma

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 is an online learning session about optic disc assessment to accompany lecture 3, and also 3 tutorials accompanied by a practical element.

How the module will be assessed

Online Examination (40%): There is a 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.

Online Coursework (20%): There are four case-based presentations to work through – these are key features scenarios, where the learner must work through the case by answering sets of questions. The advanced level case histories will also rely on re-call of the Foundation Level Module (OPT009).

Practical assessment (40%): Students will be marked on their clinical performance against a set of transparent criteria. These will be in the form of direct observation of procedures (called DOPs) for techniques such as:

  • Goldmann Applanation Tonometry
  • Angle assessment using Van Herick's
  • Disc evaluation.

Syllabus Content

  • Structure and biomechanics of the optic nerve head.
  • Corneal thickness - attribute, measurement, relevance to glaucoma.
  • The risk factors for conversion to glaucoma and the NICE guidelines.
  • Taking a structured ophthalmic history from patients at risk of glaucoma.
  • Ocular hypertension (OHT) Definition.
  • Risk factors for conversion to COAG.
  • Primary open angle glaucomas - high pressure and normal pressure disease.
  • Secondary open angle glaucomas including, pigmentary, exfoliative, corticosteroid-induced.
  • Evidence-based management of OHT and COAG.
  • Time frames to follow up.
  • The use of perimetric techniques to monitor and assess the visual field.

Skills that will be practised and developed

Academic Skills:

  • Collate information from a number of resources to improve learning.
  • The interpretation of data.

Subject-Specific Skills:

  • Advancing own knowledge and understanding to higher level.
  • The enhancement of clinical examination of disc and corneal thickness.
  • To develop practical skills to assess and manage OHT and suspect glaucoma cases.

Generic Skills:

  • Time management.
  • Working independently.
  • Improve problem solving skills.
  • Communication skills.

Websites

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