Ophthalmic Education:

Principles and Guidelines of a Curriculum for Education of the Ophthalmic Specialist: Chapter 2. Optics

On this page:

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

General Educational Objectives:

Understand the principles, concepts, instruments, and methods of optics outlined below and be able to apply them in clinical practice.

Basic Level Goals: PGY-2

A. Physical optics

1. Properties of light
   1. Electromagnetic spectrum
   2. Wave theory
   3. Photon-particle theory
      
      
2. Diffraction
   
   
3. Interference and coherence
   
   
4. Resolution
   
   
5. Polarization
   
   
6. Scattering
   
   
7. Transmission and absorption
   
   
8. Photometry
   
   
9. Lasers
   
   
10. Illumination
    
    
11. Image quality
    
    
12. Brightness and radiance
    
    
13. Light propagation –optical media and refractive index

B. Geometric optics

1. Reflection (mirrors)
   1. Laws of reflection
   2. Reflection at a plane surface (image and field of a plane mirror)
   3. Reflection at curved surfaces (focal point and focal length of a spherical mirror)
   4. Images and objects as light sources
   5. Refractive index
   6. Multiple lens system
      
      
2. Refraction
   1. Laws of refraction (Snell’s law)
      1. passage of light from one medium to another
      2. absolute index of refraction
      3. total internal reflection
   2. Refraction at a plane surface
   3. Refraction at curved surfaces
   4. Critical angle and total internal reflection
   5. Image jump and displacement
      
      
3. Prisms
   1. Definition
   2. Notation of prisms (e.g., prism diopters)
   3. Uses in ophthalmology (diagnostic and therapeutic)
   4. Types of prisms (plane, parallel, plate)
   5. Prentice's rule
   6. Fresnel prism
   7. Refraction of light through a prism
   8. Thin prisms
   9. Prismatic effect of lenses
      
      
4. Spherical lenses
   1. Cardinal points
   2. Thin lens formula
   3. Thick lens formula
   4. Formation of the image
   5. Vergence of light (diopter, convergence, divergence, vergence formula)
   6. Concave and convex
   7. Magnification (linear, angular, relative size, electronic)
   8. Spherical decentration and prism power
   9. Lens form
   10. Binocular balancing
   11. Refracting the basic low vision patient
       
       
5. Astigmatic lenses
   1. Cylindrical lenses
      1. sphero-cylinder lenses and surfaces
      2. cross cylinders (e.g., Jackson cross cylinder)
   2. Maddox rod
   3. Toric lenses
   4. Conoid of Sturm
      
      
6. Notation of lenses
   1. Spectacle prescribing
   2. Simple transposition
   3. Toric transposition
      
      
7. Identification of unknown lenses
   1. Neutralization
   2. Focimeter
   3. Geneva lens measure
      
      
8. Aberrations of lenses
   1. Correction of aberrations relevant to the eye (spherical, coma, astigmatism, distortion, pantoscopic tilt)
   2. Duochrome test 
      
      
9. Lens materials

C. Clinical optics

1. Optics of the eye
   
   
2. Transmittance of light by the optic media
   
   
3. Schematic and reduced eye
   
   
4. Pupillary response and its effect on the resolution of the optical system (Styles- Crawford effect)
   
   
5. Visual acuity
   1. Distance and near acuity measurement
   2. Minimal (visible, perceptible, separable, legible)
   3. Vernier acuity
      
      
6. Contrast sensitivity
   
   
7. Catoptric images
   
   
8. Emmetropia
   
   
9. Accommodation
   
   
10. Purkinje shift
    
    
11. Pinhole
    
    
12. Ametropia
    1. Myopia
    2. Hypermetropia (hyperopia)
    3. Astigmatism
    4. Anisometropia
    5. Aniseikonia (Knapp’s rule)
    6. Aphakia
    7. Optical parameters affecting retinal image size
       
       
13. Accommodative problems
    1. Insufficiency
    2. Excess
    3. AC/A ratio
       
       
14. Refractive errors
    1. Prevalence
    2. Inheritance
    3. Changes with age
    4. Surgically induced
       
       
15. Correction of ametropia
    1. Spectacle lenses
    2. Contact lenses
    3. Intraocular lenses
    4. Principles of refractive surgery
       
       
16. Problems of spectacles in aphakia
    
    
17. Effect of spectacles and contact lens correction on accommodation and convergence (amplitude, near point, far point)
    
    
18. Effective power of lenses
    
    
19. Back vertex distance
    
    
20. Spectacle magnification
    
    
21. Calculation of intraocular lens power
    
    
22. Presbyopia (measuring for near adds)
    
    
23. Low vision aids
    1. High reading addition
    2. Magnifying lenses
    3. Telescopic aids –Galilean telescope, Keplerian telescope 

D. Clinical refraction

1. Retinoscopy
   
   
2. Subjective refraction
   
   
3. Measurement of back vertex distance (BVD)
   
   
4. Muscle balance tests
   
   
5. Accommodative power
   
   
6. Measurement of interpupillary distance (IPD)
   
   
7. Decentration of lenses and prismatic effect
   
   
8. Best form lens
   
   
9. Prescribing multifocal lenses
   
   
10. Prescribing for children
    
    
11. Cycloplegic refraction

E. Instruments and tests

1. Direct ophthalmoscope
   
   
2. Indirect ophthalmoscope
   
   
3. Retinoscope
   
   
4. Focimeter
   
   
5. Simple magnifying glass (loupe)
   
   
6. Lensmeter
   
   
7. Glare and contrast testing
   
   
8. Potential acuity meter
   
   
9. Automated refractor
   
   
10. Slit lamp biomicroscope (including methods of examination)
    
    
11. Stereo tests
    
    
12. Corneal topographic measurements (placido disc, keratometer, automated corneal topography)
    
    
13. Applanation tonometer
    
    
14. Specular microscope
    
    
15. Operating microscope
    
    
16. Zoom lens principle
    
    
17. Corneal pachymeter
    
    
18. Lens screen/Hess chart
    
    
19. Synophtophore
    
    
20. Lenses used for fundus biomicroscopy (panfunduscope, Goldmann lens, Hruby lens, 90 diopter lens, etc.)
    
    
21. Fundus camera
    
    
22. Gonioscope
    
    
23. Tonometers
    
    
24. Color vision  tests (Ishihara color plates; Hardy-Rand-Rittler plates, Farnsworth-Munsell testing)

Standard Level Goals: PGY-3

Improve proficiency in Basic Level skills.

Advanced Level Goals: PGY-4

Apply, at the highest level of understanding, the relevant optics information (above) in the following situations:

1. Refraction and prescribing of spectacles and contact lenses
   
   
2. Intraocular lens calculation
   
   
3. Cataract surgery
   
   
4. Use of prisms for diplopia
   
   
5. Low vision aid prescribing

Next: Chapter 3. Retinoscopy and Refraction

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