Optics & Refraction Course

First Year

Goals: 

• This intensive two week course takes place in early July for new residents to the Department. This course will provide the new resident with knowledge of basic optical principles as well as the skills needed to accurately perform retinoscopy and refraction. These techniques are taught both didactically and via hands-on demonstrations. Trial frame refraction techniques are further refined during the first year of training, during the resident’s rotates in the Vision Rehabilitation Service. Residents will be provided with materials from the resource list noted below, prior to arriving in July, so they can acquire didactic knowledge about optics and refraction before beginning their hands-on training

Patient care

• Refraction technique to ensure accurate results for all age groups.
• Retinoscopy skills including advanced techniques.

Medical knowledge

• Elementary refraction techniques.
• The use of the retinoscope.
• The use of a phoropter.
• The use of a trial frame and trial lens set.
• The use of a keratometer.
• Types of refractive errors.
• Objective and subjective refraction techniques.
• Basic ophthalmic optics.

Practice-based learning and improvement

• Follow up will occur in the comprehensive, pediatric and vision rehabilitation services to ensure appropriate technique is being utilized and accurate results are being achieved.

Interpersonal and communication skills

• Conduct a thorough functional history to determine the patient’s refractive complaints.
• Develop patient communication techniques to facilitate greater efficiency when performing retinoscopy and refraction.

Professionalism & Professional Communicaltion

• Know how to properly fill out a spectacle prescription:
  1. Single vision
  2. Multifocal
  3. Progressive addition lenses
  4. Lenses with vertical, horizontal or slab off prism

Systems-based practice

• Work effectively as a member of the medical care team.
• Understand the various visual symptoms/complaints individuals with refractive error problems may encounter.
• Understand how to prescribe appropriate spectacle corrections to ameliorate the patient’s visual complaints.

Assessment

• Each resident will be observed doing keratometry on a fellow resident and a patient.
• Each resident will be observed during retinoscopy on a fellow resident and a patient.
• Each resident will be observed doing a subjective refraction on a fellow resident and a patient.
• Each resident will be observed doing a trial frame refraction on a fellow resident and a patient.
• Summative evaluation (see e-value form) at conclusion of rotations in the Comprehensive, Pediatric and Vision Rehabilitation Services.

Resources

1. Optics, Refraction, and Contacts Lenses, Basic and Clinical Science Course, Section 3, American Academy of Ophthalmology.
2. Wilkinson ME. Essential Optics Review for the Boards. Coralville, IA: MedRounds Publications, 2006. [Available from: http://www.medrounds.org/optics-review/]
3. Zarwell T. Retinoscopy tutorial [CD-ROM or online at http://www.medrounds.org/refract/menu.htm]: MedRounds Publications, 2007.