Vitreoretinal surgery

2016 ◽  
Author(s):  
Sidath E. Liyanage ◽  
Fred K. Chen ◽  
James W. Bainbridge
Keyword(s):  
Clinical Skills ◽  
Vitreoretinal Surgery ◽  
Optical Power ◽  
Detailed Examination ◽  
Posterior Segment ◽  
Real Image ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Submacular Surgery ◽  
Retinal Photocoagulation

This chapter explores vitreoretinal surgery. It starts off with a detailed examination of retinal anatomy, including a discussion of retinal embryology, and then discusses the physiology of the retina. Next, it outlines the clinical skills of posterior segment history taking and examination. It then discusses the use of diagnostic lenses, which enable visualization of the fundus by neutralizing the optical power of the eye (direct lenses) or increasing the refractive power of the eye to create an inverted real image of the fundus anterior to the eye (indirect lenses). It then continues with a discussion of the practical skills of optical coherence tomography, ultrasonography, and retinal photocoagulation. The chapter also outlines clinical knowledge areas of vitreous disorders, retinal detachment, peripheral retinal abnormalities, macular surgery, submacular surgery, retinal tumours, choroidal tumours, vitreoretinopathies, and posterior segment trauma.

Vitreoretinal surgery

2012 ◽  
Author(s):  
Fred K. Chen ◽  
Simon D.M. Chen
Keyword(s):  
Retinal Detachment ◽  
Vitreoretinal Surgery ◽  
Posterior Segment ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
History Taking ◽  
Anatomy And Physiology ◽  
Submacular Surgery ◽  
Case Based ◽  
Retinal Photocoagulation

This chapter begins by looking at retinal anatomy and physiology, before covering key clinical and practical skills, namely posterior segment history taking and examination, diagnostic lenses, optical coherence tomography, ultrasonography, and retinal photocoagulation. The following areas of clinical knowledge are then discussed: vitreous disorders, retinal detachment, peripheral retinal abnormalities, macular surgery, submacular surgery, retinal tumours, choroidal tumours, vitreoretinopathies, retinopathy of prematurity, and posterior segment trauma. The chapter concludes with two case-based discussions, on retinal detachment and elevated fundal mass.

Training in Ophthalmology

2016 ◽  
Keyword(s):  
Clinical Skills ◽  
Treatment Options ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Training Curriculum ◽  
Core Knowledge ◽  
Specialist Training ◽  
Basic Sciences ◽  
Relative Lack ◽  
The Core

This title addresses the Royal College of Ophthalmologists syllabus for trainee ophthalmologists and is an essential read for those studying ophthalmology, optometry, and orthoptics. With the relative lack of ophthalmology teaching at medical school and the often inconsistent formal teaching of fundamental examination and clinical techniques during initial posts, ophthalmology trainees often feel they are being ‘thrown in at the deep end’ early on in their career. In addition, trainees are now expected to clearly demonstrate evidence of having acquired the expected knowledge, clinical, technical, and surgical skills at each stage of their training in order to progress. This book aims to help address these issues by mapping the stages of the Ophthalmic Specialist Training curriculum and providing trainees with the core knowledge and clinical skills they will require to succeed. As a theoretical and practical aid, it guides readers through postgraduate Ophthalmic Specialist Training. Emphasis is placed on the practical assessment and management of key ophthalmic conditions. Each chapter explores basic sciences, clinical skills, clinical knowledge, and practical skills. Conditions are discussed with general explanations of the pathophysiology and clinical evaluation, which are followed by differential diagnoses and treatment options.

scholarly journals A Case of Bilateral Permanent Subluxation of the Lateral Meniscus

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Jun Suganuma ◽  
Tadashi Sugiki ◽  
Yutaka Inoue
Keyword(s):  
Magnetic Resonance ◽  
Knee Joint ◽  
Lateral Meniscus ◽  
Detailed Examination ◽  
Magnetic Resonance Images ◽  
Posterior Segment ◽  
Anterior Dislocation ◽  
Normal Position ◽  
Straight Position ◽  
History Of

We report a case of bilateral, permanent subluxation of the lateral meniscus. To our knowledge, the present case is the first reported description of bilateral irreducible anterior dislocation of the posterior segment of the lateral meniscus. This disorder is characterized by a flipped meniscus sign of the lateral meniscus on sagittal magnetic resonance images of the knee joint, with no history of trauma or locking symptoms. A detailed examination of serial magnetic resonance images of the lateral meniscus can help differentiate this condition from malformation of the lateral meniscus, that is, a double-layered meniscus. We recommend two-stage treatment for this disorder. First, the knee joint is kept in straight position for 3 weeks after the lateral meniscus is reduced to the normal position. Second, if subluxation of the lateral meniscus recurs, meniscocapsular suture is then performed. Although subluxation of the lateral meniscus without locking symptoms is rare, it is important to be familiar with this condition to diagnose and treat it correctly.

Cross-disciplinary perspectives on the transition to remote education

2021 ◽  
pp. bmjstel-2020-000814
Author(s):  
Natasha Houghton ◽  
Will Houstoun ◽  
Sophie Yates ◽  
Bill Badley ◽  
Roger Kneebone
Keyword(s):  
Medical Education ◽  
Performing Arts ◽  
Procedural Knowledge ◽  
Clinical Skills ◽  
Technology Enhanced Learning ◽  
Practical Skills ◽  
Digital Resources ◽  
Face To Face ◽  
Direct Patient Contact ◽  
Enhanced Learning

The COVID-19 pandemic has prompted the cancellation of clinical attachments and face-to-face teaching at medical schools across the world. Experiential learning—through simulation or direct patient contact—is essential for the development of clinical skills and procedural knowledge. Adapting this type of teaching for remote delivery is a major challenge for undergraduate medical education. It is also an opportunity for innovation in technology enhanced learning and prompts educators to embrace new ways of thinking. In this article, the authors explored how educators from different disciplines (medicine, music and performing arts) are using technology to enhance practical skills-based learning remotely.The authors, five experienced educators from different fields (surgery, medicine, music and magic), jointly documented the transition to technology enhanced remote teaching through a series of five structured conversations. Drawing from literature on distance learning in medicine and professional experience in education, the authors identified seven practice-enhancing recommendations for optimising teaching of procedural knowledge and skills. These are: (1) make a virtue out of necessity; (2) actively manage your environment; (3) make expectations clear; (4) embrace purposeful communication; (5) use digital resources; (6) be prepared for things to go wrong and (7) personalise the approach. The authors argue that widening the discourse in technology enhanced learning to include cross-disciplinary perspectives adds richness and depth to discussions. This article demonstrates a cross-disciplinary approach to addressing challenges in technology-enhanced medical education.

Teaching appraisal and assessment

2017 ◽  
Keyword(s):  
Patient Safety ◽  
Clinical Skills ◽  
Shoulder Dystocia ◽  
Clinical Knowledge ◽  
Doctor Who ◽  
Forceps Delivery ◽  
Safety Communication ◽  
Active Involvement ◽  
Practical Management ◽  
Initial Reading

This task assesses the following clinical skills: … ● Patient Safety ● Communication with colleagues ● Applied clinical knowledge … You are teaching practical management of shoulder dystocia to your ST1 doctor who has just started obstetrics. He/ she has witnessed a shoulder dystocia after a forceps delivery last week and is very stressed about facing one. You have a pelvis and baby model and today you are teaching the shoulder dystocia scenario. You have 10 minutes for this task (+ 2mins initial reading time). This station assesses the candidate’s ability to teach a practical skill. This will also assess their knowledge of managing shoulder dystocia. Please observe the teaching and do not interrupt. You are a ST1 doctor who has just completed the foundation training. This is your second week on the delivery suite. You have seen one shoulder dystocia after forceps delivery recently. You found the experience stressful and are now worried about facing such a scenario. Your Registrar has kindly agreed to teach you the practical management of Shoulder dystocia using the pelvis and baby model. Please do not prompt and follow the instructions of the candidate (registrar). Patient safety … ● Avoid dangerous manoeuvres fundal pressure and excessive lateral and downward traction ● Explain advanced techniques and advice the importance of using them only if experienced— Zavanelli’s manoeuvre and symphysiotomy ● Explains the importance of documentation… Communication with colleagues … ● Explains the objectives of the station ● Allows active involvement of the team/ trainee ● Promotes team working ● Makes the trainee demonstrate while talking through the steps and allows trainee to talk through while demonstrating ● Finally gives opportunity to the trainee to independently talk through and demonstrate the whole scenario… Applied clinical knowledge … ● Has knowledge of all the manoeuvres ● Demonstrates and talks through the steps ● Recognize the problem ● Call for help ● Mc Roberts manoeuvre ● Suprapubic pressure ● Consider episiotomy ● Posterior arm delivery or internal rotatory manoeuvres ● Turn into all fours ● Emphasize subsequent management ● If unsuccessful consider repeating the manoeuvres ● If experienced, consider advanced manoeuvres ● Complete delivery.

Oculoplastics

2012 ◽  
Author(s):  
Allon Barsam ◽  
Jimmy Uddin
Keyword(s):  
Botulinum Toxin ◽  
Congenital Abnormalities ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Botulinum Toxin Injections ◽  
Case Based

This chapter begins by looking at the eyelid and nasolacrimal system anatomy, before covering the key areas of clinical knowledge, namely lash abnormality, entropion, ectropion, ptosis, benign lid lesions, premalignant and malignant lid lesions, epiphora, acquired nasolacrimal system abnormalities, and congenital abnormalities. Clinical and practical skills are then covered, including ptosis examination, evaluation of the patient with acquired epiphora, incision and curettage of chalazion, syringing and probing, and botulinum-toxin injections. The chapter concludes with three case-based discussions, on epiphora, ptosis, and lid lump.

Strabismus and oculomotility

2012 ◽  
Author(s):  
Rebecca Ford ◽  
Moneesh Patel
Keyword(s):  
Clinical Skills ◽  
Strabismus Surgery ◽  
Ocular Motility ◽  
Clinical Knowledge ◽  
Ocular Movements ◽  
Single Vision ◽  
Visual Acuity Testing ◽  
Concomitant Strabismus ◽  
Binocular Single Vision ◽  
Retinal Correspondence

The chapter begins by discussing the anatomy and actions of the extraocular muscles and central control of ocular motility, before covering the key clinical skills, namely patient assessment, assessment of ocular movements, visual acuity testing, tests of stereopsis and binocular single vision, tests of retinal correspondence and suppression, and Hess charts. It then covers the key areas of clinical knowledge, including amblyopia, binocular vision and stereopsis, concomitant strabismus, incomitant strabismus, restrictive ocular motility disorders, complex ocular motility syndromes, vertical deviations , and alphabet patterns, and the key practical skills, namely the principles of strabismus surgery and other procedures in strabismus. The chapter concludes with five case-based discussions, on myopic anisometropia, esotropia, infantile esotropia, orbital floor fracture, and consecutive exotropia.

Cataract

2012 ◽  
Author(s):  
Georgia Cleary ◽  
David Spalton
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Congenital Cataract ◽  
Intraoperative Complications ◽  
Intraocular Lenses ◽  
Posterior Capsular Opacification ◽  
Clinical Knowledge ◽  
Practical Skills ◽  
Age Related ◽  
Nd:Yag Laser Capsulotomy

The chapter begins by discussing lens anatomy and embryology, before covering the key areas of clinical knowledge, namely acquired cataract, clinical evaluation of acquired cataract, treatment for acquired cataract, intraoperative complications of cataract surgery, infectious postoperative complications of cataract surgery, non-infectious postoperative complications of cataract surgery, congenital cataract, management of congenital cataract, and lens dislocation. Practical skills are then covered, including biometry, local anaesthesia, operating microscope and phacodynamics, intraocular lenses, and Nd:YAG laser capsulotomy. The chapter concludes with three case-based discussions, on age-related cataract, postoperative endophthalmitis, and posterior capsular opacification.

Principles of clinical examination in children

2016 ◽  
Author(s):  
Sharmila Jandial ◽  
Helen Foster
Keyword(s):  
Young People ◽  
Clinical Examination ◽  
Clinical Assessment ◽  
Clinical Skills ◽  
Detailed Examination ◽  
Evidence Base ◽  
Clinical Findings ◽  
Whole Child ◽  
Children And Young People ◽  
Musculoskeletal Development

The clinical examination of children and adolescents is an essential component of assessment, facilitates appropriate interpretation of investigations and is integral to the process of making a diagnosis. The clinical assessment of children and young people differs from that of adults, requiring greater reliance on physical examination as the history may be vague and illocalized and requires knowledge of normal musculoskeletal development, normal motor milestones and different patterns of clinical presentations across the ages. The interpretation of clinical findings needs to be in the context of the whole child and the clinical presentation. The degree of expertise required in clinical skills varies with the clinical practice of the examiner and ranges from the basic screening assessment to a more detailed examination of joints, muscles and anatomical regions. The evidence base for clinical assessment in children and young people is accruing and undoubtedly, competent clinical skills requires learning to be embedded in core child health teaching and assessment starting at medical school and reinforced in postgraduate training.

Utility of digitally assisted vitreoretinal surgery systems (DAVS) for high-volume vitreoretinal surgery centre: a pilot study

2019 ◽  
Vol 104 (3) ◽  
pp. 432-436 ◽  
Author(s):  
Naresh Babu ◽  
Piyush Kohli ◽  
Soumya Jena ◽  
Kim Ramasamy
Keyword(s):  
Anterior Segment ◽  
Three Dimensional ◽  
Vitreoretinal Surgery ◽  
High Volume ◽  
Posterior Segment ◽  
Projected Image ◽  
Hand Eye Coordination ◽  
Frequent Switching ◽  
Eye Symptoms ◽  
And Performance

AimTo compare the surgical experience and preferred imaging platform, between digitally assisted vitreoretinal surgery systems (DAVS) and analogue microscope (AM), for performing various surgical manoeuvres.Material and methodsA questionnaire was used to evaluate the experience of surgeons who used DAVS for at least 6 months in the last 1 year.ResultsTwenty-three surgeons, including 12 fellows, answered the questionnaire. Eighty-two per cent of surgeons got accustomed to DAVS in <10 surgeries. The higher magnification provided by DAVS was perceived as helpful by 87.0% surgeons. Seventy-eight per cent surgeons felt that DAVS provided a bigger field of view. Colours displayed on DAVS appeared unnatural to 39.1%. Difficulty using three-dimensional glasses over spectacles, asthenopia and dry eye symptoms while using DAVS were faced by 17.4%, 17.4% and 21.7% surgeons, respectively. Difficulty in frequent switching between DAVS and AM was faced by 30.4% surgeons. Difficulty in depth perception, hand–eye coordination and performance anxiety while using DAVS was faced by 43.5%, 21.7 % and 30.4 % surgeons, respectively. Majority consultants did not have any imaging platform preference for most posterior segment procedures, while majority fellows preferred DAVS. Majority surgeons preferred AM for anterior segment procedures and complicated situations like small pupil, corneal oedema and surgical surprise(s). Once the surgeons became accustomed to DAVS, none of them had to shift back to AM during any case.ConclusionIt was easy to adapt to DAVS. DAVS was preferred for performing most posterior segment surgeries. Drawbacks like unnatural colours of the projected image and difficulty in performing anterior segment manoeuvres need to be addressed.

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