scholarly journals THE UNDERGRADUATE MEDICAL STUDENTS’ PITFALLS IN EYE EXAMINATION STATION OF OBJECTIVE STRUCTURED CLINICAL EXAMINATION

2019 ◽  
Vol 8 (3) ◽  
pp. 144
Author(s):  
Widyandana Doni ◽  
Angela Nurini Agni ◽  
Agus Supartoto
Keyword(s):  
Visual Acuity ◽  
Medical Students ◽  
Visual Field ◽  
Clinical Examination ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Objective Structured Clinical Examination ◽  
Undergraduate Medical Students ◽  
Skill Laboratory ◽  
Eye Examination

Background: High prevalence of eye disorders in Indonesia requires medical doctors to be skillful and well trained in ophthalmologic examination. Undergraduate medical students usually start their clinical simulation practice and ophthalmology assessment in a safe learning environment. Skill laboratory as the learning facility should be evaluated and improved regularly. This study aimed to evaluate student’s pitfalls in the eyes OSCE station. Methods: Descriptive analytic study involving Objective Structured Clinical Examination (OSCE) eye examination station score from 1st - 4th year undergraduate medical students batch 2010 in Faculty of Medicine, Universitas Gadjah Mada, Indonesia (n=516). All checklists’ scores were analyzed based on particular sub-scales in every examination topic to explore the most pitfalls made by students in eye examination station during OSCE. Results: The order average value of each subscale in OSCE are: Doctor patient interaction (88.42), History taking skills (82.44), Professionalism (76.43), Physical Examination (74.62), Diagnosis (60.68), Management of Pharmacotherapy (54.70). The percentage of failed-students (scores <70) in 1st-4th year OSCE based on topics skills were Year 1: Visual field (5.08%), Visual acuity (14.21%), Anterior Segment (2.54%). 2nd year: IOP by palpation (24.38%), Visual acuity (9.38%), Anterior Segment (29.38%). Year 3:  visual field (4.94%), IOP by palpation (2.47%), Visual acuity (12.35%), Anterior Segment (7.41%), Posterior Segment (22.22%). Year 4: Comprehensive eye exam (17.95%). Conclusions: Students mostly challenged in the skills of diagnosis establishment and pharmacological management. The highest number of failed students in each year OSCE vary from each year. 1st year failed most at visual acuity examination, 2nd year was anterior segment examination and 3rd year was posterior segment examination. Those three skills need to be enhanced systematically. Keywords: OSCE, pitfall pattern, eye examination, undergraduate students, skill laboratory 

Cerulean Cataract in a Person with Down s Syndrome

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Madbouhi K ◽  
◽  
Cherkaoui O ◽  
Keyword(s):  
Visual Acuity ◽  
Clinical Examination ◽  
Down's Syndrome ◽  
Anterior Segment ◽  
Down’S Syndrome ◽  
Congenital Form ◽  
The Right ◽  
Radial Arrangement ◽  
Loss Of Visual Acuity

We report the case of an 18-year-old patient who consults for a loss of visual acuity in the right eye for 1 year. On clinical examination, visual acuity is 20/100. Eye tone is 12 mmhg. Examination of the anterior segment shows the existence of a cataract made up of whitish opacities corresponding to a congenital cerulean cataract (Figure 1). The treatment consisted of a cataract cure by phacoemulsification with good progress. Cerulean cataract is a rare congenital form of bluish tint, made up of whitish opacities in concentric layers with a radial arrangement at their center. Visual acuity is fairly good in childhood but may deteriorate later. In the literature, the incidence of cataracts in Down’s children ranges from 5% to 50%. In previous studies of congenital or infantile cataract, 3-5 % of cases were associated with Down’s syndrome [1].

Comparative Study of the Usefulness of the Binocular Spot Vision Screener Autorefractor in the Detection of Childhood Visual Disorders

2018 ◽  
Vol 235 (04) ◽  
pp. 416-419 ◽  
Author(s):  
Nathalie Voide ◽  
Nicole Hoeckele ◽  
Pierre-François Kaeser
Keyword(s):  
Visual Acuity ◽  
Clinical Examination ◽  
Screening Tool ◽  
Ocular Motility ◽  
Primary Position ◽  
Visual Potential ◽  
Visual Acuity Loss ◽  
Eye Examination ◽  
Visual Screening ◽  
Vision Screener

Abstract Background The Spot Vision Screener (SVS) is designed to detect significant ametropia, anisometropia, and strabismus in non-dilated eyes. This study evaluates the efficacy of the SVS in paediatric visual screening. Patients and Methods All children screened during the paediatric visual screening day in Lausanne in 2016 were evaluated with the SVS, conventional monocular autorefractors, and clinical orthoptic examination. Recommendations for a further eye examination of the SVS were compared with those issued from traditional clinical screenings (monocular refraction and orthoptic examination). Results One hundred and sixty-eight consecutive children were included. The median age was 3.9 years. The SVS median spherical equivalent (SE) was + 0.25 D OU and it detected seven cases of (4.2%) anisometropia (SE difference ≥ 1 D). The conventional monocular autorefractor median SE was − 0.13 D OU and 20 cases of anisometropia (11.9%) were detected. Refraction could not be measured in 1.2% of patients with SVS versus 17.2% with monocular refractors. The SVS screened two manifest strabismus cases against five manifest and > 100 latent strabismus with orthoptic examination. As expected, the SVS was unable to assess reactions to monocular occlusion, visual acuity, and stereovision as well as to detect ocular motility disorders without strabismus in the primary position, and missed two cases of abnormal Brückner reflexes. Overall, the SVS identified 66 suspect patients (39.3%) against 102 (60.7%) after complete clinical examination. Conclusions The SVS can be a useful objective screening tool for non-ophthalmologists. However, because it fails to detect ocular motility troubles, organic visual acuity loss, or to assess the visual potential, it should only be used in association with a clinical examination, even in routine screening procedures.

Investigations and their interpretation

2018 ◽  
pp. 51-108
Keyword(s):  
Blood Flow ◽  
Visual Field ◽  
Adaptive Optics ◽  
Anterior Segment ◽  
Field Testing ◽  
Posterior Segment ◽  
Flow Quantification ◽  
Blood Flow Quantification ◽  
Clinical Strategies ◽  
Goldmann Perimetry

‘Investigations and their interpretation’ introduces the reader to both standard and emerging technologies that enable assessment of the structure or function of the eye and visual system. Starting with visual field testing, the chapter covers automated and Goldmann perimetry, novel protocols and progression analysis. Anterior segment imaging covers keratometry, topography and OCT. Posterior segment imaging includes angiographic techniques, novel blood flow quantification methods, OCT, and adaptive optics. Electrodiagnostic tests are introduced including multifocal techniques. Finally ophthalmic ultrasonography and radiology are supported by clinical strategies and examples to support the practice and interpretation of these techniques.

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