Ophthalmic Education:

International Curriculum Guidelines on Medical Student Education in Ophthalmology: 5. Retina Vitreous

On this page:

• i) SYMPTOMS SUGGESTIVE OF VITREORETINAL DISORDERS**
  
  
• ii) ANATOMY OF VITREOUS AND RETINA**
  
  
• iii) EXAMINATION OF THE EYE BY DIRECT OPHTHALMOSCOPY*
  
  
• iv) NORMAL FUNDUS FEATURES BY DIRECT OPHTHALMOSCOPY*
  
  
• v) ABNORMAL FUNDUS FEATURES BY DIRECT OPHTHALMOSCOPY*
  
  
• vi) WHEN TO REFER PATIENT TO AN OPHTHALMOLOGIST
  
  
• Competencies*
  
  
• Educational Priorities

The International Council of Ophthalmology Task Force on Medical Student Education in Ophthalmology

Draft, September 16, 2003

I. SYMPTOMS SUGGESTIVE OF VITREORETINAL DISORDERS**

1. Flashes
   
2. Floaters
   
3. Central blur and/or distortion and/or minification
   
4. Abrupt or progressive dimming of vision in one eye
   
5. Abrupt or progressive loss of peripheral visual field in one eye

II. ANATOMY OF VITREOUS AND RETINA**

1. Clarity of vitreous
   
2. Transparency of retina and normal retinal blood vessel walls
   
3. Location of rods and cones in retina relative to vitreous and choroid
   
4. Nature of retinal pigment epithelium
   
5. Nature of choroid

III. EXAMINATION OF THE EYE BY DIRECT OPHTHALMOSCOPY*

1. Evaluation of red reflex
   
2. Examination of optic disc
   
3. Examination of retinal blood vessels on and adjacent to optic disc
4. Examination of posterior retina and choroid

IV. NORMAL FUNDUS FEATURES BY DIRECT OPHTHALMOSCOPY*

1. Appearance of normal red reflex
   
2. Appearance of normal optic disc
   
3. Appearance of normal retinal arteries and veins
   
4. Appearance of normal posterior retina and choroid

V. ABNORMAL FUNDUS FEATURES BY DIRECT OPHTHALMOSCOPY*

1. General*
   
   1. Loss of normal red reflex
      
   2. Dark spots in red reflex
      
   3. Abnormal color of red reflex
2. Fundus features of important systemic diseases*
   
   1. Diabetes mellitus
      
      • Background diabetic retinopathy
        
      • Proliferative diabetic retinopathy
   2. Systemic hypertension*
      
      • Vasospastic (accelerated) retinopathy
        
      • Sclerotic (chronic) retinopathy
   3. Atherosclerotic carotid occlusive disease*
      
      • Central retinal artery occlusion
        
      • Central retinal vein occlusion
        
      • Embolic cardiovascular disease
   4. AIDS**
      
   5. Disseminated metastatic cancer***
3. Fundus features of important ocular diseases
   
   • Retinoblastoma*
     
   • Retinal detachment**
     
   • Age-related macular degeneration*

VI. WHEN TO REFER PATIENT TO AN OPHTHALMOLOGIST

1. Whenever examination reveals abnormal features of red reflex or fundus**
   
2. Whenever patient reports visual loss or symptoms consistent with a vitreoretinal disorder**

Competencies*

• Student should
  • Understand anatomy and function of retina*
    
  • Understand definition and function of the macula*
    
  • Recognize normal retinal vasculature*
    
  • Detect diabetic retinopathy*
    
    • background
      
    • proliferative
  • Understand definition and treatment of retinal detachment***
    
  • Understand importance of retinoblastoma and recognize leukocoria*
    
  • Understand importance of choroidal malignant melanoma ? definition and prevalence***
    
  • Understand importance of dilated fundus exam*
    
  • Recognize a change in red reflex*

Educational Priorities

In the listing above, essential ophthalmic knowledge and clinical eye care skills are marked with a single asterisk *. This material is basic for all international medical student education.

Information that reflects a greater level of understanding is marked with two asterisks**.

Areas of cognitive and clinical skills that are more appropriate for students who seek further training in ophthalmology are marked with three asterisks***.

While important to ophthalmic care, the Task Force does not regard the cognitive or skill set designated ** or *** as essential to the basic curriculum of most international medical students.

Next: 6. Lens & Cataract

Also see:

• Introduction to the "International Curriculum Guidelines on Medical Student Education in Ophthalmology"
  
  
• Table of Contents for the Curriculum
  
  
• Education of Medical Students in Ophthalmology