To describe the neuro-anatomy of the visual pathways.
To describe the neuro-anatomy of the cranial nerves.
To describe the pupillary and accommodative neuro-anatomy.
To describe ocular motility and related neuronal pathways.
To describe the typical features, evaluation, and management of the most common optic neuropathies (e.g., demyelinating optic neuritis, ischemic optic neuropathy [arteritic and nonarteritic], toxic or nutritional optic neuropathy, Leber’s hereditary optic neuropathy, ethambutol toxicity, neuroretinitis, and compressive, inflammatory, infiltrative, and traumatic optic neuropathies).
To describe the typical features, evaluation, and management of the most common ocular motor neuropathies (e.g., third, fourth, sixth nerve palsy).
To describe the typical features of cavernous sinus and superior orbital fissure syndromes (e.g., infectious, vascular, neoplastic, inflammatory etiologies).
To describe the typical features, evaluation, and management of the most common causes of nystagmus (e.g., congenital motor and sensory, downbeat, upbeat, gaze-evoked, drug-induced).
To describe the typical features, evaluation, and management of the most common pupillary abnormalities (e.g., relative afferent pupillary defect, anisocoria, Horner syndrome, third nerve palsy, Adie’s tonic pupil).
To describe the typical features, evaluation, and management of the most common visual field defects (e.g., optic nerve, optic chiasm, optic radiation, occipital cortex).
To describe the epidemiology, clinical features, evaluation, and management of ocular myasthenia gravis.
To describe the epidemiology, clinical features, evaluation, and management of carotid-cavernous fistula.
To describe the epidemiology, differential diagnosis, evaluation and management of congenital optic nerve abnormalities (e.g., optic pit, disc coloboma, papillo-renal syndrome, morning glory syndrome, tilted disc, optic nerve hypoplasia, myelinated nerve fiber layer, melanocytoma, disc drusen, Bergmeister’s papilla).
Patient Care
To perform a basic pupillary examination
To describe indications for and perform basic pharmacologic pupillary testing for Horner syndrome, pharmacologic dilation, and Adie’s tonic pupil.
To list the differential diagnosis of anisocoria (e.g., sympathetic or parasympathetic lesion “physiologic”).
To describe, detect, and quantitate a relative afferent pupillary defect.
To list the causes for light-near dissociation (e.g., Argyll-Robertson pupils, diabetic neuropathy, tonic pupil).
To perform a basic ocular motility examination
To assess ocular alignment using simple techniques (e.g.. Hirschberg, Krimsky).
To describe and perform basic cover/uncover testing for tropia.
To describe and perform alternate cover testing for phoria.
To perform simultaneous prism and cover testing.
To perform measurement of deviations with prisms.
To describe the indications for and apply Fresnel and grind-in prisms.
To describe the indications for and to perform forced duction and forced generation testing.
To perform an assessment of saccade accuracy and pursuit and optokinetic testing.
To perform a measurement of eyelid function (e.g., levator function, lid position).
To describe the indications for visual field testing and to perform and interpret perimetry studies
To perform confrontational field testing (static and kinetic, central and peripheral, red and white targets).
To perform and interpret a tangent screen test.
To describe the indications for and perform basic Goldmann perimetry, and interpret results.
To describe the indications for and perform basic automated perimetry, and interpret results.
To perform basic direct, indirect, and magnified ophthalmoscopic examination of the optic disc (e.g., recognize optic disc swelling, optic atrophy, neuroretinitis).
To describe the anatomy and indications for, order appropriately, and interpret basic radiology studies of the brain and orbits, demonstrating the ability to communicate with radiologists in order to maximize both choice of proper diagnostic test and accuracy of interpretation.
To describe the indications for and interpret basic echography of orbits.
Professionalism
To treat patients with respect and compassion at all times
To treat clinical and administrative staff with respect
To treat medical students with respect and strive to create an atmosphere conducive to education
To arrive on-time for clinical experiences
To prepare in advance for surgical experiences
To work to become part of the clinical team
To work with the faculty, staff, fellow and other residents on the service to determine your responsibilities
To remain flexible and offer to help out with the responsibilities of others when you can
To remain visible and available to participate in clinical care throughout the clinical session. If you leave the clinical care area make sure that other members of the service know where you are and why
answer your pager within 10 minutes of being paged.
Interpersonal and communication skills
To communicate your name and role on the service to patients and their families.
"Hello, I'm Dr. Resident, I'm a resident working with Dr. Attending today."
To present patients to the attending in a succinct but complete way
To maintain timely and legible medical records
To talk when you should be talking, listen when you should be listening
Practice-based learning and improvement
To learn to recognize feedback from faculty, fellows, fellow residents, patients and students
To accept that feedback constructively and work to improve based on it
To accept your role as a teacher as well as a learner. Work to educate students, fellow residents, faculty, staff and patients
Systems based practice
To work for the benefit of your patients to communicate with other health care provider
To act as an advocate for your patient within the health care system
To become aware of the costs of diagnostic and therapeutic interventions. Consider these costs as you recommend and prescribe these interventions.
