Ophthalmic Education:

International Curriculum Guidelines on Medical Student Education in Ophthalmology: 7. Eyelid, Lacrimal and Orbit

On this page:

• i) Eyelid*
  
  
• ii) Lacrimal
  
  
• iii) Orbit
  
  
• Competencies
  
  
• Educational Priorities

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

Draft, September 16, 2003

I. Eyelid*

1. Examination and Technique
   
   1. Assess the position of the upper eyelid by measuring the distance between the lid margin and the corneal light reflex
      
   2. Visual inspection of eyelids and periocular area
2. Anatomy**
   
   1. Anterior and posterior lamellae***
      
   2. Lid margin**
      
   3. Orbital septum relationship to eyelid/orbit**
      
   4. Eyebrow**
      
   5. Levator aponeurosis**
      
   6. Blood supply ? internal and external carotid circulation***
      
   7. Sensory supply ? V1 and V2*
      
   8. Motor supply ? CN III, CN VII, and sympathetics*
3. Eyelid Diseases
   
   1. Malpositions
      a. Blepharoptosis**
      b. Dermatochalasis**
      c. Entropion*
      d. Ectropion*
      e. Retraction*
      f. Lagophthalmos*
   2. Inflammations
      a. Chalazion*
      b. Blepharitis*
      c. Meibomitis**
   3. Infections
      a. Hordeolum*
      b. Preseptal cellulitis**
   4. Tumors
      
      1. Benign
         1. Cysts***
         2. Nevi**
         3. Papillomas**
         4. Xanthelasma*
      2. Malignant**
         1. Basal cell carcinoma**
         2. Squamous cell carcinoma**
   5. Eyelid trauma**

II. Lacrimal

1. Examination Technique
   
   1. Visual inspection of medial canthal area*
2. Anatomy
   
   1. Upper lacrimal system ? puncta, canaliculi and lac sac*
      
   2. Lower lacrimal system ? bony and mucosal nasolacrimal duct***
3. Lacrimal Diseases
   
   1. Congenital nasolacrimal duct obstruction**
      
   2. Acquired nasolacrimal duct obstruction**
      
   3. Dacryocystitis**
      
   4. Lacrimal Trauma**

III. Orbit

1. Examination technique
   
   1. Use visual techniques to identify axial and non-axial proptosis*
      
   2. Be familiar with exophthalmometer***
2. Anatomy
   
   1. Seven bones comprise 4 walls ? floor, medial and lateral walls and roof***
      
   2. Orbital septum relationship to orbit**
      
   3. Contents of orbit ? extraocular muscles, lacrimal system, ophthalmic artery, nerves (CN II, IV, V, VI, sympathetics, and parasympathetics)*
      
   4. Relationship of orbit to surrounding structures ? sinuses, cranial cavity*
3. Orbital Diseases
   
   1. Orbital cellulitis*
      
   2. Graves? ophthalmolopathy*
      
   3. Orbital inflammatory disease**
      
   4. Orbital tumors ? vascular, nerve sheath, metastatic and lacrimal tumors***
      
   5. Orbital trauma**

Competencies

• Student should
  • Understand basic structure and function of eyelids, and common malpositions, and acquired disorders.*
    
  • Understand tear production and drainage.**
    
  • Understand orbital structure and common abnormalities.**

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: 8. Refractive Surgery***

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