MADHYA PRADESH PARAMEDICAL COUNCIL
6th Floor, Satpura Bhawan, Bhopal
Syllabus & Guidelines
Schedule Serial No. 29
Subject:-Diploma in Paramedical Ophthalmic Assistant.
Teaching faculty with minimum qualification & experience
qualification & experience
Laboratory with Equipment
2 year (24 months) Diploma
1. Professor of Ophthalmology1.
2. Associate Professor
Ophthalmology 1. 3. Assistant Professor Ophthalmology 1.
Full established Ophthalmology
deptt. With laboratory-2 as per of MCI norms
Lecture Hall2500 sqft. Demonstration room 3 1250 sqft each.
25 room double seated 15 x 20 with kitchen dinning rooms, toilets
Qualification and experience of teaching staff as per M.C.I. norms.
1. Eyelids: General description, Location, Histology, Function. (Page 611)
2. Medical and lateral palperbral ligaments, Orbital septum, Glands of the lids, Palpebral and neighboring muscles.
4. Conjunctive: Histology and Gross anatomy, Glands, Blood and Nerve supply, Car uncle, Plica Semilunaris.
5. Lacrimal apparatus.
6. The Extrinsic muscles and related structures, origin insertion, nerve and blood supply, levator, Tenens capsule, check ligaments.
5. ACADEMIC PHASE I
(The details of the course curriculum):
5.1 Anatomy & Physiology:
5.1.1 Human Anatomy with special reference to special senses.
(i) Parts of the body.
(ii) Organs of special senses.
5.1.2 Pany Orbit and ocular adnexa (lids & lacrimal system).
5.1.3 Ocular muscles & cranial nerves.
5.1.4 Gross anatomy of coats of eye ball (Cornea, Sclera Uvea, retina, lens & Vitreous).
5.2 Physiology of the Eye Ball:
5.2.1 Physiology of vision including colour vision.
5.2.2 Ocular movements & Binocular Vision.
5.2.3 Accommodation & convergence.
5.2.4 Formation & circulation of aqueous & lacrimal fluids.
5.3 Physics & Optics:
5.3.1 Law of refraction & reflection spherical & cylindrical surfaces.
5.3.2 Optical aberrations of ophthalmic glasses.
5.4.1 Introduction to the various organisms responsible for ocular diseases (Bacteria, virus & fungi).
5.4.2 Technique of conjunctival smears, cultures, scropings & staining (Grams & KOH).
5.4.3 Infections & its prevention-routes, cross infection antisepsis & asepsis.
5.5 Clinical Pathology:
5.5.1 Examination of urine Gross albumin & sugar.
5.5.2 Preparation & staining of blood slides for DLC and malarial parasite.
5.6.1 various methods of Administration of drugs in ophthalmic diseases.
5.6.2 Preparation and dispensing of various ophthalmic drugs including fluorescence, Mercurochrome, sodium sulphacetamide, homatropine, atropine pilocarpine & antibiotic drops.
5.6.3 various side reaction of common ophthalmic drugs & drug abses.
5.6.4 Anaesthetics & Antibiotics and acetazolamide.
5.6.5 Miotics & Mydriatics.
5.6.6 Examination (Assessment) I.
5.7 Vision Testing:
5.7.1 various components of vision, principles of testing for visual acuity.
5.7.2 Lecture demonstration of distant vision, near vision & colour vision (Ishihara).
5.8 Geometrical & Physiological Optics:
5.8.1 Optics of human eye and refractive errors.
5.8.2 Myopia, hypermatropia & its correction.
5.8.3 Aphakia its correction.
5.8.4 Astigmatism, Prebyopia & its correction.
5.8.5 Lecture demonstration on measurement of IPD, fitting and adjustments of spectacles (types of lenses, centering).
5.8.6 Lecture demonstration on measurement of accommdation & convergence. 5.8.7 Ophthalmic Lenses.
5.8.8 Decentering, befocasls, segment heights & transposition of lenses.
5.8.9 Contact Lenser-uses and abuses.
5.8.10 Checking of spectacles. 5.8.11 Protective glasses & L.V.A.
5.9 Retinosopy & Subjective Testing:
5.9.1 Estimating optical refractive errors including presorition of glasses-2 lectures & 10 demonstrations.
5.10 Visual Fields:
5.10.1 Lecture and 5 demonstrations
5.10.2 Examination (Assessment) II.
5.11 Common Eye Diseases:
5.11.1 Types of conjunctivitis including trachoma.
5.11.2 Corneal ulcers & opacities.
5.11.3 Iritis & cataract.
5.11.4 Lids & lacrimal sac. And eye emergencies.
5.11.5 Chemical & radiotional injuries including prevention, first aid & treatment.
5.11.6 Mechanical injuries, prevention first & treatment.
5.14.1 Diabetes & hypertension.
5.15 Nursing care of Ophthalmic Patients:
5.15.1 Pre-operative preparation, cutting or lashes, preparation eye and ocular bandaging.
5.15.2 Bed making and laying trolley for dressing.
5.16 Ophthalmic Instruments:
5.16.1 Name, uses & maintenance of surgical instruments.
5.16.2 Laying of trolley for surgery (Cataract, glaucoma, Sae, ptorygium chalazion, entropion & squint).
5.16.3 Maintenance of surgical instruments.
5.17 Ocular Surgery, Fundamentals of Asepsis Technique:
5.17.1 Asepsis, fumigation, and sterilization of instruments.
5.17.2 Making of swabs sticks, pads & packing of drums and autoclaving.
5.18 Ophthalmic Dianosis Equipment (Maintenance):
5.18.1 Trail set, slit lamp, focimeter.
5.18.2 Synoptophore, keratometer, rorinoscope & Ophthalmoscope.
5.18.3 Examination (Assessment) II.
5.18.4 Use of Lensometer & neutrailization of lenses.
5.18.5 Transposition of Lenses.
5.18.6 Fitting & Check up of spectracles.
5.18.7 Maintenance of tonometer.
5.19 Minor Surgical Procedures:
5.19.1 Installation of eye drops & Subconjunctival injection etc.
5.19.6 Seeting up of I/v. drips, Ryles tube & enema.
5.20 Emergency Resuscitation: General & Ophthalmic.
5.21 Medical Records: Diseases index, alphabetic index, and numerical index major & minor surgical records.
5.22 Health Education:
5.22.1 National Plan for Control of Blindness.
5.22.2 Screening of School children for eye problems.
5.22.3 Survey methodology.
5.22.4 Functioning of Eye bank (Collection, preservation, transportation & Publicity)
5.22.5 Rehabilitation of blind & vocational training for blind.
5.22.6 Role of Ophthalmic Assistants in eye camps.
5.22.7 Examination (Final assessment).
5.23 Demonstration during Institutional Training:
5.23.1 50 on refraction, lenses focimeter etc.
5.23.2 10 on common eye lesions.
5.23.3 5 on squint.
5.23.4 Tonometry-1 demonstration.
5.23.5 Nursing Care (II) 2.
5.23.6 Laying of trolley for surgery, O.T. Techniques.
5.23.7 Minor surgical procedures-5
5.23.8 Demonstration on Pharmacy-5
5.23.9 Pathology & Microbiology-3 5.23.10 Eye Sank-1
5.23.11 Medical Records-3
5.23.12 Health education & publicity-5.
5.23.13 Rehabilitation of blinds-5.
(Annexure II to Appendix II).
6. ACADEMIC PHASE II
6.1 Training at Mobile Ophthalmic Unit (30 hrs.)
One Lecture each on:
6.6.2 Eye health education in industrial workers.
6.7 Ophthalmic Instruments and O.T.:
There should be 4 lectures covering.
6.7.1 Care and sterilization of the instruments.
6.9.1 6 Lecture- cum- Demonstration on practical problems in refraction- 6 Hours.
6.10 Patients and Nursing Care of eye problem:
6.10.1 6 demonstration/practical, on actual patient and nursing care of eye patients- 6 hours
6.11 Training at P.H.C.- 10 Hours
6.11.1 Health education The group recommends 4 Lectures to cover this subject. One Hour lecture on each of the following: -
6.11.1 National Health Programme.
6.11.2 Health setup in P.H.C.
6.11.3 Family welfare orientation.
6.11.4 Interaction with other health workers.
6.12 Hygiene The group recommends 3 lectures to cover this subject.
6.13.3 Referrals to Distt. Hospitals- 1 Hrs.
1. To develop manpower as Para Medical Ophthalmic Assistance Force who can assist in early detection of visual impairment and hence in control of blindness, under National Programme for control of Blindness & Visual Impairment.
Function and Duties-
1. Taking case history of patient.
2. Taking visual acuity and dealing with errors of refraction.
9. Sterilizing, caring for instruments and trays.
10. Performing tonometery, syringing.
11. First aid treatment of emergency primary basic vision threatening diseases.
22. Keeping & maintenance of Medical records.
COURSE AND CURRICULUM:
The course will be divided in four semester/phase
I. Training of Teaching Institutions
Phase/Semester I Phase/Semester II 1 year teaching institution and mobile ophth unit.
II. Field Training-
Phase/semester II/ District Hospital 6 Months Phase/Semester IV/ at Primary Health Centers 6 Months
Academic Phase I (At Teaching Institutions) Anatomy & Physiology
1. Human anatomy with special reference to special senses.
(i) Parts of the body
(ii) Organs of special senses.
2. Bony orbit and ocular adnexa (lids & lacrimal system.)
3. Ocular muscles & cranial nerves.
4. Gross Anatomy of coats of eye ball (Cornea, sclera, urea, retina, lens& vitreous).
PHYSIOLOGY OF THE BALL:
1. Physiology of vision including colour vision.
1. Laws of refraction & reflection- Spherical & cylindrical surfaces.
2. Optical aberrations of ophthalmic glasses.
1. Introduction to the various organisms responsible for ocular diseases (Bacteria, virus & fungi).
1. Examination of urine- Gross albumin & sugar.
2. Preparation & staining of blood slides for DLC and material parasite.
1. Various methods of administration of drugs in ophthalmic diseases.
2. Preparation and dispensing of various ophthalmic drugs including fluorescing, Mercurochrome, sodium sulphacetamide, homatropine, atropines, pilocxarpine & antibiotic drops.
3. Various side reaction of common ophthalmic drugs & drug abuses.
4. Anesthetics & antibiotics and acetazolamide.
5. Miotics & mydriatics. 6. Ophthalmic topics.
1. Various components of vision, principal of testing for visual acuity.
2. Lecture demonstration of distant vision, near vision & colour vision (Ishihara).
GEOMETRICAL & PHYSIOLOGICAL OPTICS:
1. Optics of Human eye and refraction errors.
2. Myopia, hypermetropia & its correction.
3. Aphakia & its correction.
4. Astigmatism, Presbyopia & its correction.
5. Lecture demonstration on measurement of IPD, fitting and adjustment of spectacles (types of lenses,centering).
6. Lecture demonstration on measurement of accommodation & convergence.
7. Ophthalmic lenses.
8. Decentering, bifocals, segment heights & transportation of lenses.
9. Contact of spectacles.
10. checking of spectacles.
11. Protective glasses & L.V.A.
RETINOSCOPY & SUBJECTIVE TESTING:
1. Estimating optical refraction errors including prescription of glasses-
2 lectures & 10 demonstrations.
1. Lecture and 5 demonstrations.
COMMON EYE DISEASES:
1. Types of conjunctivitis including trachoma.
2. Corneal ulcers & opacities.
3. Iritis & cataract.
4. Lids & lacrimal sac. And eye emergencies.
5. Chemical & radiational including prevention, first aid & treatment.
6. Mechanical injuries, prevention, first aid & treatment.
1. Recognition & diagnosis.
2. Tonometry Methodology & precautions.
3. Role of Ophthalmic Assistant in early detection and follow up of glaucoma cases.
1. Nomenclature, classification & measurement.
2. Cover test, Maddox rod, Maddox wing & diplopia charting.
3. Uses of synoptophore & exercises.
4. Amblyopic with emphasis on prevention.
5. Assessment of binoculsr vision.
2. Diabetes & hypertension.
NURSING CARE OF OPTHALMIC PATIENTS:
1. Pre-operative preparation cutting of lashes, preparation of eye and cular bandaging.
2. Bed making and laying trolley for dressing.
1. Name, uses & maintenance of surgical instruments.
2. Laying of trolley for surgery (Cataract, glaucoma, sac, pterygium, chalazion, entropion & squint.)
3. Maintenance of surgical instruments.
OCULAR SURGERY, FUNDAMENTALS OF ASEPSIC TECHNIQUE:
1. Asepsis, fumigation, sterilization of instruments.
2. Making of swab sticks, pads & packing of drums and autoclaving.
OPHTHALMIC DIAGNOSTIC EQUIPMENT (MAINTENANCE):
1. Trail set, silt lamp, focimeter.
2. Synoptophore, Keratometer, Retioscopy & Ophthalmoscope.
3. Examination (Assessment) III.
4. Use of Lensometer & neutralization of lenses.
5. Transposition of lenses.
6. Fitting & check up of spectacles.
7. Maintenance of tonometer.
MINOR SURGICAL PROCEDURES:
1. Instillation of eye drops & Subconjunctival injections etc.
6. Setting up of I/v drops Ryles tube & enema.
General & Ophthalmic MEDICAL RECORDS:
Disease index, alphabetic index, numerical index, major & minor surgical records.
1. National Plan for control of Blindness.
2. Screening of school for eye problems.
3. Survey methodology.
4. Functioning of Eye Bank (collection, preservation, transportation & publicity).
5. Rehabilitation of blind & vocational training for blind.
6. Role of ophthalmic assistants in eye camps.
7. Examination (Final assessment).
DEMONSTRATION DURING INSTITUTIONAL TRAINING:
1. 50 on refraction,lenses, focimeter etc.
2. 10 on common eye lesions.
3. 5 on squint.
4. Tonometry 1 demonstration.
5. Nursing care (11) 2.
6. Laying of trolleys for surgery O.T. Techniques 5.
7. Minor surgical procedures 5.
8. Demonstration on pharmacy 5.
9. Pathology & Microbiology 3.
10. Eye Bank 1.
11. Medical Records 3.
12. Health education & Publishing 5.
13. Rehabilitation of Blinds 5.
ACADEMIC PHASE II:
1. Training at Mobile Ophthalmic Unit.
2. Mobile Ophthalmic Unit set up.
3. Organization of Eye camps.
4. Publicity technique.
5. Arrangement of OPD at camps.
6. Arrangements of refradition of camps.
7. Arrangements operation theatre at camps.
8. Arrangements of wards at camps.
9. Arrangements of sanitation and illumination at camp.
10. Arrangements of catering at camps.
11. Arrangements of exhibition at camp.
12. Public relation with voluntary organization.
13. Interaction with volunteer.
14. Winding up of camp.
15. Health education General.
16. Health Education Ophthalmic.
17. Surveys in Schools & Sub-health Centros.
PATIENT CARE IN WARD AND O.T.:
1. Pre-operative preparation of patient in camp.
2. Anesthesia & Akinesia.
3. Dispensing & Preparation of drops.
4. Eye dressing & bandaging including preparation of dressing trolley.
5. Role of Ophthalmic Assistant in O.T.
6. Sterilization, carbonization & Fumigation.
7. Follow up instructions to patients & follow up visit.
8. Eye Health education.
1 Analysis of camp data.
2. Screening programme.
3. Referral to district hospital Medical College.
4. Examination (Assessment).
1. Diagnostic techniques & O.T. assistance.
2. Health education (Methodology).
3. Cases Records & Statistics.
4. Publicity Lectures to Panchayats & School Children.
TRAINING AT DISTT. HOSPITAL FIELD (30 hrs.):
1 Health Set-up 6 hrs. :
1.1. One lecture on the existing health set up in the district and the available health services in the district.
1.2. One lecture on various National Health Programmes with special emphasis on National programme for prevention of Visual Impairment & Control of Blindness.
1.3. One lecture on community care with emphasis on common causes of blindness and their prevention. Dos and Donts regarding the ophthalmic care should be highlighted.
1.4. One lecture on the role or voluntary organization. (Page 631)
1.5. Two lectures on health exhibition.
(a) Incidence of eye diseases in various countries and in India.
(b) Trachoma and infective conjunctivitis with stress on environment sanitation and personal hygiene.
(c) Cataract Caution from Coachers.
(d) Glaucoma Types, early detection.
(e) Injuries Crackers, eclipse, blindness.
(f) Eye Bank Donation of eye.
(g) Malnutrition articles of good their food value.
(h) Reading habits, visual hygiene (Posture light).
(i) Squint Amblyopia.
EYE HEALTH EDUCATION (4):
One Lecture each on:
1. Screening Programme for school children.
2. Eye health education in industrial workers.
3. Referral system emphasis on referring cases well in time and at proper place.
OPHTHALMIC INSTRUMENTS AND O.T.:
There should be 4 lectures covering.
1. Care and sterilization of the instruments.
2. Laying of Instruments & preparing trolleys.
3. Asepsis in O.T.
4. Sterilization of Linen.
1.The group felt that there should be two lectures and
2 demonstrations covering this subject, Emphasis should be laid on common ocular emergencies like.
(a) Injuries of the eye including F.B.s.
(b) Acute glaucoma.
(c) Causes of sudden blindness.
(d) Preventive measure should be highlighted.
1. Lecture- cum- Demonstration on practical problems in refraction- 6 Hours.
PATIENTS AND NURSING CARE OF EYE PROBLEM:
1. Demonstration/practical, on actual patient and nursing care of eye patients- 6 hours.
TRAINING AT P.H.C.- 10 Hours:
1. HEALTH EDUCATION 4 Lectures to cover this subject. One Hour lecture on each of the following: -
1.1. National Health Programme.
1.2. Health setup in P.H.C.
1.3. Family welfare orientation.
1.4. Interaction with other health workers.
HYGIENE: 3 lectures to cover this subject.
1.1. Environmental sanitation and personal hygiene. Lecture- 2 hours.
1.2. Common Medical disorders in the community. Lecture- 2 hours.
EYE HEALTH EDUCATION:
1. Eye Health care talks to Panchayats, schoolteacher and village social workers- 1 hours.
2. Data collection school surveys- 1 Hrs.
3. Referrals to Distt. Hospitals- 1 Hrs.
1. Since the course lays stress on the practical skills, as far as possible in the institutions, a minimum number of cases be specified for the common skills which the trainee is likely to use most often later on. They shall be recorded in the daily diary and added on to the practical note book to be initiated periodically (at least once a month) in the faculty members.
2. PRACTICAL TRAINING PROGRAMME: The details of the course curriculum are already mentioned.
3. PRACTICAL TRAINING AT MOBILE OPHTHALMIC UNIT: The details of course curriculum ars shown in Annexure IV.
RECORD: I II III IV V VI
10 10 10 10 10 10
Sr.No. Place of posting
1. OPD Visual acuity. Colour vision. Field peripheral. Central. Tonometry. Sac syringing. Minor surgical procedures nature.
2. Refraction & Orthoptics.
3. O.T. & Wards Pre-operative,
(b) Care of instruments sterilization techniques, preparing of trolleys.
(c) To be signed if student has understood or has practically demonstrated.
4. Survey work Cases screened, cases referred having ocular problems. Lecture on eye health education in schools. Month assessment by Ophthalmologist I II III IV V VI.
*The candidate will be supposed to maintain a diary of daily activities. From this diary this evaluation report will be prepared monthwise.
EVALUATION OF TRAINEES:
The committee felt that the objectives spelt out may be achieved by: Part-I Assessment at the end of 6 months. Institutional training. Internal assessment 250 marks. External assessment 250 marks.
(a) Theory 100 marks.
(b) Practicals 150 marks.
1. EVALUATION AT THE MEDICAL COLLEGE:
Theory Max. Marks: 50
Paper I Part (a) Basic Sciences (including human Anatomy, Physiology,
Pharmacy, Microbiology) in relation to clinical ophthalmology 25 marks.
Part (b) Ophthalmic Techniques & Ophthalmic equipment 25 marks
Paper II Part (a) Optics & Refraction 25.
Part (b)Health education & Common eye disorders and muscle imbalance - 25.
2. Practicals of 75 marks each.
3. INTERNAL ASSESSMENT:
4. Record of 4 periodicals assessment (theory) 100.
5. Record of 4 periodicals assessment (practicals) 100.
6. Day to day assessment from the individual daily diary record 50.
7. The main (internal & external) pass percentage shall be 50% (separate for theory & practicals). Those trainees securing less than 50% marks may be allowed 2 more chances One at the end of their posting in Mobile unit & second at the end of their posting in Distt. Hospital. If he clears at the end of these 2 attempts he can take the final examination (Part II) at the completion of the 2 years of starting the course. In case he does not clear in these three attempts he shall be dropped from the course.
8. The external assessment shall be conducted by two external and two internal examiners. The practical assessment shall be last for one day. One of the internal examiners shall be the head of the department who is the coordinator of the course. The other internal examiner by rotation shall be a faculty member with a teaching experience of 5 years. The external examiner should from an identified medical college running such a course. At least one such external examiner shall be from outside the state. Part two of the assessment shall be at the end of 2years. It shall be conducted at the Medical College by a team of examiners consisting of two external and two internal examiners. One of the internal examiners will be the head of the Deptt. who is the coordinate of the course & the internal examiner by rotation shall be a faculty member with a teaching experience of 5 years. Out of the 2 external examiners should be from outside the state. Both the external examiners shall be from identified medical college, running such courses.
Marks:Internal assessment -500 marks
External assessment -500 marks
The qualifying marks shall be 50% for theory and practical.
Mobile Ophthalmic Unit - 200 marks
Distt. Hospitals - 200 marks
PHC - 100 marks
Mobile Ophthalmic Unit
(a) 2 theory assessments of 40 marks each 80 marks
(b) 2 Practicals assessment of 40 marks each 80 marks
Total 200 marks
(a) 2 theory assessments of 40 marks each 80 marks
(b) 2 Practicals assessment of 40 marks each 80 marks
Internal Assessment at PHC (100) 50 marks
Theory shall consist of 3 papers of 100 marks each.
(a) Health education.
(b) Community Ophthalmic techniques.
Practicals 150 marks
(a) Ophthalmic instruments & equipment (maintenance & sterilization).
(b) Assistance in O.T.
(b) Ophthalmic Technique.
Qualifying marks 50% (combined for internal & external assessment separately for theory & practical). They shall be awarded a certificate at the end of completion of their programme.
PRACTICAL TRAINING PROGRAMME AT TEACHING INSTITUTIONS:
1. Visual acuity 500 cases.
2. Near vision 500 cases.
3. Colour vision (Ishihara) 200 cases.
4. Visual Fields 40 cases.
5. Central 20 cases.
6. Peripheral 20 cases.
7. Identification of lenses including spherical, cylindrical and prisms & neutralization.
8. Retinoscopy 200 cases at least 20% are to be counter checked.
9. Subjective verification (PMT) 200.
(c) Presbyopia 50.
10. Measurement/verification of IPD 150 cases.
11. Common Eye diseases. Prevention & recognition.
12. Squint 100 cases.
(g) Occlusion therapy for amblyopia 10 cases.
13. Tonometry (Schiotz) 100 cases.
14. Nursing care
(c) Occular bandaging Uniocular & binocular 50 cases.
15. Laying of trolley for dressing and surgery 10 cases.
(d) Squint 5 cases 5 each.