Ophthalmic Education:

Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist: Chapter 14. Ocular Oncology

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• Basic Level Goals: PGY-2
  
  
• Standard Level Goals: PGY-3
  
  
• Advanced Level Goals: PGY-4

Basic Level Goals: PGY-2

A. Cognitive Skills

1. Describe the basic categorization of common extraocular and intraocular tumors.
   
   
2. Describe the differential diagnosis, epidemiology, evaluation, and management of leukocoria (e.g., inflammatory, infectious, neoplastic, congenital, persistent fetal vasculature, cataract, Coats' disease, vitreous hemorrhage, retinal detachment).
   
   
3. Describe major diagnostic features of major intraocular tumor types (e.g. retinoblastoma, choroidal melanoma, metastatic lesions) and describe the differentiating features of similar lesions.

B. Technical/Surgical Skills

1. Perform slit lamp, ophthalmoscopic and ocular transillumination examination of patients with intraocular tumors (e.g., choroidal melanoma).
   
   
2. Recognize an ocular tumor and refer appropriately.

Standard Level Goals: PGY-3

A. Cognitive Skills

1. Describe management options for different intraocular tumors.
   
   
2. Describe the findings of the Collaborative Ocular Melanoma Study (COMS).
   
   
3. Describe the classification of retinoblastoma and its treatment.
   
   
4. Describe basic histopathology of intraocular tumors.
   
   
5. List the differential diagnoses for tumors of the iris, ciliary body, choroid, retina and optic disc (e.g, melanoma, retinoblastoma, hemangioma, melanocytoma).
   
   
6. Describe diagnostic techniques for common intraocular tumors (e.g., physical examination, imaging, laboratory, oncology referral).
   
   
7. Describe the prognostic significance of different types of ocular tumors and be able to guide evaluation for systemic involvement.

B. Technical/Surgical Skills

1. Perform indirect ophthalmoscopy in the diagnosis and localization of intraocular tumors.
   
   
2. Perform transillumination for intraocular tumor.
   
   
3. Describe indications for an examination under anesthesia for pediatric intraocular tumors.
   
   
4. Describe indications for A-scan and B-scan echography of intraocular mass lesions.
   
   
5. Describe indications for fluorescein angiography of intraocular tumors
   
   
6. Describe indications for destruction or excision of conjunctival, corneal and intraocular tumors.
   
   
7. Describe indications for laser photocoagulation for intraocular tumors.
   
   
8. Describe indications for and techniques of transpupillary thermal therapy for intraocular tumors.
   
   
9. Recognize major histopathologic appearance of common intraocular tumors.
   
   
10. Describe the indications for surgical or other therapeutic procedures and their complications, and for referral, if necessary, for:
    
    
    1. Plaque or other radiotherapy
       
       
    2. Iridectomy and iridocyclectomy
       
       
    3. Resection of conjunctival tumors
       
       
11. Perform an enucleation.
    
    
12. Describe indications for and techniques and complications of radiation therapy for ocular tumors (e.g., radioactive plaque localization, external beam radiation, radiation retinopathy).
    
    
13. Discuss various treatment options with patients and their families in a detailed, ethical, and compassionate manner.

Advanced Level Goals: PGY-4

A. Cognitive Skills

1. Describe management options for unusual intraocular tumors (e.g. choroidal metastasis, choroidal osteoma).
   
   
2. Apply the findings of the Collaborative Ocular Melanoma Study (COMS).
   
   
3. Recognize, evaluate, and treat most forms of extraocular and intraocular tumors.

B. Technical/Surgical Skills

1. Perform indirect ophthalmoscopy for the diagnosis and localization of intraocular tumors prior to treatment.
   
   
2. Describe indications for and to perform an examination under anesthesia for pediatric intraocular tumors (e.g., retinoblastoma).
   
   
3. Describe indications for and to interpret A-scan and B-scan echography of intraocular mass lesions.
   
   
4. Describe indications for and to interpret fluorescein angiography of intraocular tumors.
   
   
5. Describe indications for and perform excision or other treatment of conjunctival, corneal, and intraocular tumors.
   
   
6. Describe indications for and to perform laser photocoagulation for intraocular tumors.
   
   
7. Recognize major histopathologic appearance of common and less common intraocular tumors.
   
   
8. Describe indications for surgical procedures and their complications and be able to perform or to refer for:
   
   
   1. Plaque radiotherapy
      
      
   2. External beam radiotherapy
      
      
   3. Iridectomy and iridocyclectomy
      
      
   4. Resection or cryotherapy of conjunctival tumors, or use of antimetabolite eyedrops
      
      
   5. Transpupillary thermal therapy
      
      
9. Perform a complicated enucleation (e.g., complicated by hemorrhaging, small orbit, scar tissue) or exenteration.

Next: Chapter 15. Low Vision Rehabilitation

Also see: Table of Contents of the Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist