Training

On these training pages we will be storing any relevent training articles from our current issues, plus anything else we feel can be of interest to those training in these specialty fields. We are working with equipment manufacturers and more to incorporate equipment training videos, surgical procedures and presentations. If you have anything you feel would be relevent to these pages then please contact us

Content:

Training Videos

Who's who and how did they get there?

Ophthalmology exam structure

Training related Articles

Training Videos:-

Glaucoma Surgery

Trabeculectomy with MMC

The nylon loop technique

Glaucoma Surgery

Punch trabeculectomy was done without anti metabolites in following steps: Superior nasal quadrant was selected for trabeculectomy 6mm fornix based conjunctival flap was made. Partial thickness 3 × 4mm triangular scleral flap was fashioned with the base at the limbus. A clear corneal paracentesis was done at temporal limbus with 20g MVR knife. The scleral flap dissection was extended into clear corneal lamelle and anterior chamber entered with a slit knife. 0.75mm Kelly's punch was used to create a sub scleral window. A peripheral button-hole iridectomy was done through this window. Scleral flap was sutured with 3 interrupted 10/0 nylon non releasable sutures, one at the apex and one on each side. Conjunctiva sutured with 10/0 nylon with buried knots

Trabeculectomy with MMC

Triangular flap fornix based trabeculectomy in POAG using MMC

The nylon loop technique

In This technique we use the 4/0 nylon threaded through 20G disposible needle(not sharpen at its end) to divide the nucleus into 2 to 3 pieces(when use double nylon loop), and then remove each fragment to the corneal incision.The IOL was then implanted in the bag and the wound was closed with one stitch suture.The full paper can be reached at Asian journal of Ophthalmology,vol4,no4,2006

What about our new section:- 

Who's who and how did they get there?

Who are you?

 Jonathan Park: Specialist Trainee in Ophthalmology, South West Peninsula Deanery, ST1 at the West of England Eye Unit in Exeter:

How did you get to where you are today?

I was captivated by Ophthalmology during the week that I spent as a medical student in Bristol Eye Hospital.  Since then, I have made every effort possible to increase my exposure in this field in terms of patient care, teaching, training, audit and research.  I attended extra clinics and theatre sessions, passed the Undergraduate Duke Elder Examination, and completed a number of projects relating to glaucoma, diabetic retinopathy and cataract.  I had planned my elective in Anaesthetics in Grenada, but Hurricane Ivan destroyed that possibility, as it destroyed the hospital I was supposed to be going to.  This happened a week before I was supposed to arrive, and at this time I was travelling in Australia.  Fortunately it was possible to arrange an elective in the Caribbean in Ophthalmology.  This cemented my desire to pursue Ophthalmology, and also allowed me to improve my surfing and to complete my rescue scuba diving qualification. 

News Flash...Jonathan's regular diary piece of his experience as an ST1 trainee begins in the October/ November issue of Eye News.

Thanks to Dr.A.Pradeep, an OST1 trainee at LNR Deanery, who has written a piece on the new Ophthalmology Exam Structure

Ophthalmology exam structure

From August 1^st 2007, all trainees wishing to train in ophthalmology in the UK will be using the new curriculum from the Royal College of Ophthalmologists. Assessments will be workplace based assessments and examinations. The new exam structure will comprise three examinations namely Part1 FRCOphth, Refraction certificate and Part 2 FRCOphth based upon the curriculum for ophthalmic specialist training (OST) (available at: http://curriculum.rcophth.ac.uk/). Trainees will be expected to pass these at set times during the training. The last Part 1 MRCOphth was sat in October 2006, the last Part 2 MRCOphth will be held in November 2008 and the last Part 3 MRCOphth will be held in September 2008.The new Part 1 FRCOphth commenced in October 2006. The Refraction Certificate commenced in July 2007 and the first Part 2 FRCOphth will be held in October 2008.

1. Part1FRCOphth

No previous experience in ophthalmology is necessary for candidates to sit the Part 1 FRCOphth. Candidates will be required to pass this examination before they enter the third year of ophthalmic specialist training.

The part1FRCOphth examination consists of two assessment formats:

• MCQ (single best answer multiple choice and extended matching questions)
• OSE (Objective Structured Examination).                                            

The syllabus covers basic sciences similar to the old Part 1 MRCOphth but also includes theoretical optics, instrument technology, epidemiology and evidence based medicine and pathology. Candidates are expected to understand the basic principles and interpret results of orthoptic assessments and various investigations like ultrasonography, ocular angiography, retinal and optic nerve imaging. The learning outcomes from the curriculum for the first two years of training form the basis of the exam structure.

2. Refraction Certificate

Candidates don't require any previous experience in ophthalmology to sit the Refraction Certificate. However, candidates are less likely to pass this assessment if they have not undertaken a large number of clinical refractions. Candidates in OST will be required to pass this examination before they enter into the fourth year of ophthalmic specialist training.

The assessment consists of:

• 30 minutes Practical examination in Refraction
• 5 minute OSE in Focimetry
• 5 minute OSE in Retinoscopy

Exemption - Candidates who hold a valid optometric degree are exempt from this certificate.

3. Part 2 FRCOphth

This examination will be open to candidates who have passed the Part 1 FRCOphth and the Refraction Certificate. The examination will run twice yearly from October 2008. Candidates will be required to pass this examination by the end of year seven of ophthalmic specialist training.

The part 2 FRCOphth examination consists of three assessment formats:

• Written papers (single best answer multiple choice and extended matching questions)
• Structured viva
• OSCE (Objective Structured Clinical Examination)

The structure will be based on learning outcomes from the curriculum in its entirety. The written paper consists of a two-hour MCQ paper with 60 questions and a three-hour EMQ (Extended Matching Question) paper of 40 questions. Candidates successfully completing the written component could automatically sit the practical component of the examination approximately 10 weeks later. The structured viva consists of five stations, each with two examiners, of 10 minutes duration each. Each station assesses decision-making, clinical reasoning and clinical judgement. A candidate will have to have knowledge of basic and clinical sciences as well as good communication skills.

Following the viva, the candidate would sit an OSCE consisting of 7 x 15 minute stations, each with two examiners.

 The trainee candidate will be awarded Fellowship of College with the successful completion of all the three exams (Part1 FRCOphth, Refraction Certificate and Part2 FRCOphth). This will allow the holder to apply for a Certificate of Completion of Training (CCT) after satisfactory completion of training objectives and assessments.

References: Royal College of Ophthalmologists, http://www.rcophth.ac.uk/

Training related Articles

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Late Spontaneous In-the-bag Intraocular Lens and C... There have been an increasing number of reports of spontaneo... 16/04/2008

A Rare Case of Corneal Melanoma Treated with Surge... Our report describes a rare case of corneal melanoma masquer... 15/04/2008