International Council of Ophthalmology

Ophthalmic Education:

Principles and Guidelines of a Curriculum for Ophthalmic Education of Medical Students: Chapter XII: Refraction and Contact Lens

Educational Goal:

Students should understand that the human eye is an optical system and understand the principles of common refractive errors, such as myopia, hyperopia, astigmatism, and presbyopia. Students are expected to know how to measure visual acuity with a near card and near correction.

A. Refraction States (as it affects direct ophthalmoscopy).*

1. Emmetropia.* (REF. 7 Fig. 3-9 and Fig. 4-18)

2. Myopia.* (REF. 7 Fig. 3-10, p.118, and Fig. IV-18) (REF. 22 Fig. G30, G31, G34)

3. Hyperopia.* (REF. 7 Fig. 3-11, p.119) (REF. 22 Fig. G25, G26, G29)

4. Astigmatism.* (REF. 12 Fig 15, 16) (REF. 22 Fig. G21, G22) (REF. 7 Fig. 3-12)

5. Presbyopia and accommodation.* (REF. 7 Table IV-2, Average Accommodative Amplitudes for different ages, p.151)

B. Spectacle correction.***

1. Spherical lenses.***

2. Bifocals, trifocals, multi-focal lenses (progressive lenses).***

C. Special lens material.***

1. Plastic.***

2. Impact resistant high index plastic.***

3. Polycarbonate lens.***

D. Contact lenses.***

Clinically important features of contact lens:

1. Optics.***

2. Field of vision.***

3. Image size.***

4. Hard contact lens.***

5. Flexible contact lens.***

6. Therapeutic contact lens.***

E. Intraocular lens.**

Concept of correcting the refractive error caused by cataract removal.**

F. Refractive surgery.***

Concept of correcting myopia and hyperopia.***

G. Patients with low vision.***

(REF. 2B Slide 78, 79) (REF. 16 Table 3-3a, 3-3b) (REF. 22 Fig. D02, D03, D04, D05, D06, D07, D08, D09)

1. Understand that patients may benefit from low vision aids.***

2. Understand that patients may need special rehabilitation with low vision optical devices.***

Clinical Competencies

Students should:

Understand emmetropia, myopia, hyperopia, astigmatism, and presbyopia.**
Measure near central acuity in adults with near card and understand measurement of acuity in children with Allen cards or tumbling E card test.*
Understand optical principles of contact lens, intraocular lens, and refractive surgery.**
Understand the need for low vision rehabilitation.*

* Basic Level: Necessary in the education of medical students worldwide.

** Standard Level: A higher level of ophthalmic understanding than the basic curriculum of most international medical students.

*** Advanced Level: Advanced cognitive and clinical skills more appropriate for students who seek further training in ophthalmology, which may be covered in an ophthalmology elective in medical school.

(Also see: More on Educational Priorities)

Next: XIII. Refractive Surgery

Also see: