Government of Karnataka

PARA MEDICAL BOARD

Revised Syllabus
of
II & III Year Diploma in Ophthalmic
Technique
(Previously first/second year certificate course/
I year DOT/II DOT)

2017
Model Curriculum Handbook
OPTOMETRY
Who is an Allied and Healthcare Professional?
The Ministry of Health and Family Welfare, accepted in its entirety the definition of an allied and
healthcare professional based on the afore-mentioned report, though the same has evolved after multiple
consultations and the recommended definition is now as follows-
„Allied and healthcare professionals (AHPs) includes individuals involved with the delivery of health or healthcare related
services, with qualification and competence in therapeutic, diagnostic, curative, preventive and/or rehabilitative interventions. They
work in multidisciplinary health teams in varied healthcare settings including doctors (physicians and specialist), nurses and
public health officials to promote, protect, treat and/or manage a person(„s) physical, mental, social, emotional, environmental
health and holistic well-being.‟1
Since the past few years, many professional groups have been interacting and seeking guidance on all
those who would qualify under the purview of “allied and healthcare professionals”. In the healthcare
system, statutory bodies exist for clinicians, nurses, pharmacists and dental practitioners; but a regulatory
structure for around 50 professions is absent in India. Currently, the Government is considering these
professions (as listed Annex-1) under the ambit of the allied and healthcare system. However, this
number is subject to changes and modifications over time, particularly considering how quickly new
technologies and new clinical avenues are expanding globally, creating newer cadres of such
professionals.
Scope and need for allied and healthcare professionals in the Indian healthcare
system
The quality of medical care has improved tremendously in the last few decades due to the advances in
technology, thus creating fresh challenges in the field of healthcare. It is now widely recognized that
health service delivery is a team effort involving both clinicians and non-clinicians, and is not the sole
duty of physicians and nurses.1 Professionals that can competently handle sophisticated machinery and
advanced protocols are now in high demand. In fact, diagnosis is now so dependent on technology, that
allied and healthcare professionals (AHPs) are vital to successful treatment delivery.

Effective delivery of healthcare services depends largely on the nature of education, training and
appropriate orientation towards community health of all categories of health personnel, and their
capacity to function as an integrated team. For instance in the UK, more than 84,000 AHPs, with a range
of skills and expertise, play key roles within the National Health Service, working autonomously, in
multi-professional teams in various settings. All of them are first-contact practitioners and work across a
wide range of locations and sectors within acute, primary and community care. Australia‟s health system
is managed not just by their doctors and nurses, but also by the 90,000 university-trained, autonomous
AHPs vital to the system.2,3
As the Indian government aims for Universal Health Coverage, the lack of skilled human resource may
prove to be the biggest impediment in its path to achieve targeted goals. The benefits of having AHPs in
the healthcare system are still unexplored in India. Although an enormous amount of evidence suggests
that the benefits of AHPs range from improving access to healthcare services to significant reduction in
the cost of care, though the Indian healthcare system still revolves around the doctor-centric approach.
The privatization of healthcare has also led to an ever-increasing out-of-pocket expenditure by the
population. However, many examples assert the need of skilled allied and healthcare professionals in the
system, such as in the case of stroke survivors, it is the support of AHPs that significantly enhance their
rehabilitation and long term treatment ensures return to normal life. AHPs also play a significant role to
care for patients who struggle mentally and emotionally in the current challenging environment and
require mental health support; and help them return to well-being.2 Children with communication
difficulties, the elderly, cancer patients, patients with long term conditions such as diabetes people with
vision problems and amputees; the list of people and potential patients who benefit from AHPs is
indefinite.
Thus, the breadth and scope of the allied and healthcare practice varies from one end to another,
including areas of work listed below:
 Across the age span of human development from neonate to old age

With patients having complex and challenging problems resulting from systemic illnesses such as in the
case of diabetes, cardiac abnormalities/conditions and elderly care to name a few;
 Towards health promotion and disease prevention, as well as assessment, management and evaluation
of interventions and protocols for treatment;
 In a broad range of settings from a patient's home to community, primary care centers, to tertiary care
settings; and
 With an understanding of the healthcare issues associated with diverse socio-economies and cultural
norms within the society.
Learning goals and objectives for allied and healthcare professionals
The handbook has been designed with a focus on performance-based outcomes pertaining to different
levels. The learning goals and objectives of the undergraduate and graduate education program will be
based on the performance expectations. They will be articulated as learning goals (why we teach this) and
learning objectives (what the students will learn). Using the framework, students will learn to integrate
their knowledge, skills and abilities in a hands-on manner in a professional healthcare setting. These
learning goals are divided into nine key areas, though the degree of required involvement may differ
across various levels of qualification and professional cadres:

1. Clinical care
2. Communication
3. Membership of a multidisciplinary health team
4. Ethics and accountability at all levels (clinical, professional, personal and social)
5. Commitment to professional excellence
6. Leadership and mentorship
7. Social accountability and responsibility
8. Scientific attitude and scholarship (only at higher level- PhD)
9. Lifelong learning
Promoting self-directed learning of the professionals
The shift in the focus from traditional to competency-based education has made it pertinent that the
learning processes may also be revisited for suitable changes. It is a known fact that learning is no more
restricted to the boundaries of a classroom or the lessons taught by a teacher. The new tools and
technologies have widened the platform and introduced innovative modes of how students can learn and
gain skills and knowledge. One of the innovative approaches is learner-centric and follows the concept
of self-directed learning.
Self-directed learning, in its broadest meaning, describes a process in which individuals take the initiative with or without
the help of others, in diagnosing their learning needs, formulating learning goals, identifying resources for learning, choosing
and implementing learning strategies and evaluating learning outcomes (Knowles, 1975).14
In self-directed learning, learners themselves take the initiative to use resources rather than simply
reacting to transmissions from resources, which helps them learn more in a better way.15 Lifelong, self-
directed learning (SDL) has been identified as an important ability for medical graduates (Harvey, 2003)16
and so is applicable to other health professionals including AHPs. It has been proven through many
studies worldwide that the self-directed method is better than theteacher-centric method of learning.
Teacher-directed learning makes learners more dependent and the orientation to learning becomes
subject-centred. If a teacher provides the learning material, the student is usually satisfied with the
available material, whereas if a student is asked to work on the same assignment, he or she invariably has
to explore extensive resources on the subject.15
Thus the handbook promotes self-directed learning, apart from the usual classroom teaching and opens
the platform for students who wish to engage in lifelong learning.

Integrated structure of the curriculum

Vertical integration, in its truest sense, is the interweaving of teaching clinical skills and knowledge into
the basic science years and, reinforcing and continuing to teach the applications of basic science
concepts during the clinical years. (Many efforts called „vertical integration‟ include only the first half of
the process).
Horizontal integration is the identification of concepts or skills, especially those that are clinically
relevant, that cut across (for example, the basic sciences), and then putting these to use as an integrated
focus for presentations, clinical examples, and course materials. e.g. Integration of some of the basic
science courses around organ systems, e.g., human anatomy, physiology, pathology; or incorporating
ethics, legal issues, finance, political issues, humanities, culture and computer skills into different aspects
of a course like the Clinical Continuum.
The aim of an integrated curriculum is to lead students to a level of scientific fluency that is beyond mere
fact and concept acquisition, by the use of a common language of medical science, with which they can
begin to think creatively about medical problems.19
This innovative new curriculum has been structured in a way such that it facilitates horizontal and
vertical integration between disciplines; and bridges the gaps between both theory & practice, and
between hospital-based practice and community practice. The amount of time devoted to basic and
laboratory sciences (integrated with their clinical relevance) would be the maximum in the first year,
progressively decreasing in the second and third year of the training, making clinical exposure and
learning more dominant.11 However it may differ from course to course depending on the
professional group.

Learning methodologies
With a focus on self-directed learning, the curriculum will include a foundation course that focuses on
communication, basic clinical skills and professionalism; and will incorporate clinical training from the
first year itself. It is recommended that the primary care level should have sufficient clinical exposure
integrated with the learning of basic and laboratory sciences. There should also be an emphasis on the
introduction of case scenarios for classroom discussion/case-based learning.
Healthcare education and training is the backbone of an efficient healthcare system and India's education
infrastructure is yet to gain from the ongoing international technological revolution. The report „From
Paramedics to Allied Health: Landscaping the Journey and way ahead‟, indicates that teaching and learning of
clinical skills occur at the patient‟s bedside or other clinical areas such as laboratories, augmented by
didactic teaching in classrooms and lecture theatres. In addition to keeping up with the pace of
technological advancement, there has been a paradigm shift to outcome-based education with the
adoption of effective assessment patterns. However, the demand for demonstration of competence in
institutions where it is currently limited needs to be promoted. The report also mentions some of the
allied and healthcare schools in India that have instituted clinical skill centres, laboratories and high-
fidelity simulation laboratories to enhance the practice and training for allied and healthcare students and
professionals. The report reiterates the fact that simulation is the replication of part or all of a clinical
encounter through the use of mannequins, computer-assisted resources and simulated patients. The use
of simulators addresses many issues such as suboptimal use of resources and equipment, by adequately
training the manpower on newer technologies, limitations for imparting practical training in real-life
scenarios, and ineffective skills assessment methods among others.1 The table mentioned below lists
various modes of teaching and learning opportunities that harness advanced tools and technologies.

Assessment methods
Traditional assessment of students consists of the yearly system of assessments. In most institutions,
assessments consist of internal and external assessments, and a theory examination at the end of the year
or semester. This basically assesses knowledge instead of assessing skills or competencies. In
competency-based training, the evaluation of the students is based on the performance of the skills as
per their competencies. Hence, all the three attributes – knowledge, skills, and attitudes – are assessed as
required for the particular competency.
Several new methods and tools are now readily accessible, the use of which requires special training.
Some of these are given below:
 Objective Structured Clinical Examination(OSCE), Objective Structured Practical Examination
(OSPE), Objective Structured Long Examination Record(OSLER)
 Mini Case Evaluation Exercise(CEX)
 Case-based discussion(CBD)
 Direct observation of procedures(DOPs)
 Portfolio
 Multi-source feedback
 Patient satisfaction questionnaire

An objective structured clinical examination (OSCE) is used these days in a number of allied and
healthcare courses, e.g. Optometry, Physiotherapy, and Radiography. It tests the performance and
competence in communication, clinical examination, and medical procedures/prescriptions. In
physiotherapy, orthotics, and occupational therapy, it tests exercise prescription, joint
mobilization/manipulation techniques; and in radiography it tests radiographic positioning, radiographic
image evaluation, and interpretation of results. The basic essential elements consist of functional analysis
of the occupational roles, translation of these roles (“competencies”) into outcomes, and assessment of
trainees' progress in these outcomes on the basis of demonstrated performance. Progress is defined
solely by the competencies achieved and not the underlying processes or time served in formal
educational settings. Most methods use predetermined, agreed assessment criteria (such as observation
check-lists or rating scales for scoring) to emphasize on frequent assessment of learning outcomes.
Hence, it is imperative for teachers to be aware of these developments and they should suitably adopt
them in the allied and healthcare education system.

Background of the profession

Statement of Philosophy– Why this profession holds so much importance
An estimated 456 million people of India‟s population of 1.12 billion people require vision correction
(spectacles, contact lenses or refractive surgery) to be able to see and function for learning, work and life
in general. Twenty six million people are blind or vision impaired due to eye disease. A further 133
million people, including 11 million children, are blind or vision impaired simply from lack of an eye
examination and an appropriate pair of glasses (uncorrected refractive error).
Blindness and vision impairment place a significant economic burden on families, communities and
society at large – due to lost productivity, as well as the cost of education and rehabilitation22. About
85% of all vision impairment and 75% of blindness globally could be avoided23, prevented or cured if the
appropriately trained personnel and care facilities existed. The World Health Organisation (WHO) and
the International Agency for the Prevention of Blindness (IAPB) launched the global initiative VISION
2020: the Right to Sight to eliminate avoidable blindness and vision impairment.
Uncorrected refractive error is the major cause of avoidable vision impairment, and the second most
common cause of blindness24. “Without appropriate optical correction, millions of children are losing educational
opportunities and adults are excluded from productive working lives, with severe economic and social consequences.
Individuals and families are pushed into a cycle of deepening poverty because of their inability to see”25.
In 2007, an estimated 456 million people of India‟s population of 1.12 billion people required vision
correction (spectacles, contact lenses or surgery) to be able to see and function for learning, work and
general life activities26,27. This included 37 million children younger than 16 years of age28. Almost all of
these 456 million adults and children would have normal vision if they had access to an eye examination
and an appropriate pair of spectacles. However, lack of access has left 133 million of them, including 11
million children, blind or vision impaired from uncorrected refractive error.29,30,31
The burden32of avoidable blindness and vision impairment on the health care system in India is
significant, with India currently having the highest number of blind people in the world33.The direct and
indirect cost, including lost productivity, due to uncorrected refractive error in India has been estimated
at $23 billion per year (I$269 billion globally)34. As the population ages, future demand for eye care
services will increase substantially. Enhancing access to these services will require an increase in the
number of eye care professionals, as well as more efficient utilisation of existing professionals.
Optometry is recognized by the World Health Organization (WHO) as an independent profession
through its ongoing official relations with the World Council of Optometry (WCO) – the international
optometric organization which represents almost 300,000 optometrists from 87 member organizations in
47 countries.
Optometry as a profession has the primary public health responsibility for eliminating uncorrected
refractive error. To provide excellent vision care to all the people of the country, India needs 116,000
optometrists. India currently has approximately 9,000 4-year trained optometrists and an estimated
30,000 2-year trained eye care personnel.

About Optometry
Optometry means a health care profession that is autonomous and concerned especially with examining
the eye for defects and faults of refraction, with prescribing correctional lenses, eye exercises and/or
visual rehabilitation care for visually impaired, with diagnosing diseases of the eye, and with treating such
diseases or referring them for treatment.
Optometry as a profession has the primary public health responsibility for eliminating uncorrected
refractive error (the leading cause of vision impairment globally). As primary eye care practitioners,
optometrists have a vital role in detecting potentially serious eye diseases such as cataract, glaucoma and
Diabetic retinopathy, age-related maculopathy, as well as general health conditions such as hypertension
and diabetes, which means optometrists can also help alleviate the burden of other causes of blindness
through diagnosis, referral and in some cases co-management. Optometry can and should play a leading
role in eye care provision at the primary level, and can also assist at secondary and tertiary levels where
possible, working with ophthalmologists and other eye care providers towards the unified goal of
combating blindness.
Recognition of Title and qualification
The recommended title for this group of professionals stands as the ‘Optometrist’.
It is a known fact that with the career advancement, the nomenclature will also vary and will also depend
on the sector and profile of the professional. Considering the 10 NSQF levels designed by the NSDA,
the following level progression table has been proposed by the taskforce to map the nomenclature,
career pathways and progression in different sectors of professional practice for Optometrist. The
proposed progression is for further discussion and deliberation, the implementation time of the
same may vary depending on the current system and regulations in place.

Definition of Optometrist
“Optometrists are primary health care practitioners of the eye and visual system who provide comprehensive eye and vision
care, which includes refraction and dispensing, detection/diagnosis and co-management of disease in the eye and the
rehabilitation of conditions of the visual system”
Optometrist also means a person having-
i. Graduate degree in optometry obtained after the completion of a full time course of 4 years(baccalaureate) which includes
supervised clinical training from any university recognized by the University Grants Commission established under the
University Grants Commission Act 1956; or
ii. Post graduate degree in optometry after completion of a full time course of two years and /or PhD in the same.
iii. Diploma in ophthalmic techniques/ Diploma in optometry will be considered as entry level until 2020. The program
will be phased out and the diploma will be encouraged to upgrade to degree through lateral entry courses. After this period
they will not be designated as Optometrist.

Education of the Optometry

When developing any education programme it is necessary that programme planning should be
outcome-based, meeting local and national manpower requirements, personal satisfaction and career
potential for the professionals with supporting pathway in the development of the profession. One of
the major changes is the shift from a focus based on traditional theoretical knowledge and skills to
competency based education and training. Optimal education/training requires that the student is able to
integrate knowledge, skills and attitude in order to be able to perform a professional act adequately in a
given situation.
Thus, the following curriculum aims to focus on skills and competencies based approach for learning
and are designed accordingly. The curriculum is prescriptive and is designed with an aim to standardize
the content across the nation. As stated above the focus of the profession is to create qualified and skill
manpower in the field of Optometry through the following levels of higher education –
1. Bachelor of Optometry (B. Optom)
2. Master of Optometry (M. Optom)
3. PhD
Job Opportunities:
The job sectors for optometrist can be divided into the following areas:
1. Corporate sector
2. Private practice
3. Work for an optical chain or under an optical store
4. Public health
5. Industries/companies
6. Eye care hospitals & institutions
7. Education sector
8. Scientific research
The aims of the recommended curriculum are to produce Optometrist who are-
- Technically and clinically competent;
- Understand the theoretical basis for evidence based practice;
- Independently competent in vision care as defined;
- Effective members of the multidisciplinary team;
- Prepared to participate in or initiate research into practice;
- Can work according to registration requirements on the respective continents.
Introduction:
Learning Objectives: At the completion of this course, the student should -
1. Be able to develop skills to provide comprehensive eye examination
a. To acquire knowledge on ocular structures, its functions and pathological changes
b. To carryout ophthalmic investigations
c. To impart knowledge with regard to common eye diseases
d. To impart knowledge on treatment modalities from the perspective of counselling
e. To acquire knowledge about the referral guidelines for ocular and systemic conditions
2. Be able to correct refractive error and provide spectacle prescription
3. Be able to fit, evaluate, prescribe and dispense contact lenses for refractive correction and other ocular
conditions
4. Be able to assess the low vision and provide comprehensive low vision care
5. Be able to have adequate knowledge to develop skill in manufacturing of spectacle lenses, contact
lenses and low vision devices.
6. Be able to do complete binocular vision assessment, manage non-strabismic binocular vision
anomalies and refer condition which warrants surgery
7. Be able to assess the visual demands for various occupations and match it to the visual capabilities.
Also be able to advice on eye safety wear for various occupations.
8. Have knowledge and skill for early detection of various ocular conditions and pathologies –Refractive
error, Strabismus, Cataract, Diabetic retinopathy, Glaucoma etc.
9. Have knowledge regarding organizations of eye banks and preservation of ocular tissues.
10. Have knowledge on sensory substitution and other rehabilitation measures for totally visually
challenged.
11. Have knowledge of counselling on visual/ocular hygiene, nutritional and environmental
modifications

Expectation from the future graduates in the providing patient care.

1. Optometrist will work independently or in conjunction with other eye/health care professionals.
2. The optometrist will be knowledgeable, skilful and analytical in diagnosis, treatment planning,
management of visual defects & impairments and in co-managements of ocular conditions.
3. The optometrist can work in hospitals (both private and public sectors), optical outlets and/or work as
independent practitioner
4. The course will lead to a basic degree in optometry, which is considered as the minimum essential for
statutory registration of optometrists in countries where optometry has been brought under legislation.
5. Undertake public health optometry projects and vision screening eye camps in schools, colleges, urban
slums, rural areas and also practice occupational optometry in industries.
6. Public education on ocular hygiene and related nutritional and environmental counselling.

7. Offer a helping hand and or efficiently manage and successfully run any ophthalmic clinic, optometry
department in hospitals, optical shops, and offer product expertise in ophthalmic industry & trade.
Preamble

Present nomenclature- Those with SSLC qualification enter the three year’s COT
course called the first, second and third year COT respectively. Those with PUC
qualification enter the two year’s DOT course called the first year and second year
DOT respectively. Second year COT and first year DOT students are combined
and third year COT and second year DOT are combined for teaching and exams.
This nomenclature is creating confusion in the minds of teachers, students and
evaluators every time. Hence it is proposed as follows:

Single nomenclature-paramedical Ophthalmic assistant’s course-“D.O.T. –

DIPLOMA IN OPHTHALMIC TECHNIQUES”

Second Year Diploma in Ophthalmic Technique

Paper - 1
SECTION-A Q P Code: 5161
Syllabus:

1.Anatomy of the eye and orbit.

Anatomy of the eye and orbit to be taught so that they can correlate the anatomical
basis for the diseases and their treatment which will be taught subsequently.
Anatomy of the eyelids and lacrimal apparatus should also be stressed upon. The
topic need not be taught in depth like MBBS students. Structures can be
demonstrated on models, Atlas or human cadaver. Structures of the eye are best
demonstrated on human cadaver donor eyes obtained from eye banks.

2. Physiology of the eye:

Candidates must be taught the various normal functions of the different structures
of the eye and orbit in brief.The four types of visual perceptions (Light , form,
color, contrast sense). Physiology of vision,visual acuity, visual field, color vision.
The principles and use of snellens chart, near vision charts, finger confrontation
visual field testing, perimetry and Ishihara’s chart. Formation and drainage of
aqueous humor, Introcular pressure and its importance.Production and drainage of
tears in brief.Importance of normal tear film. Explanation of binocular single
vision, understanding ocular movements, accommodation and convergence

3.Physical Optics and Physiological optics.

Laws of reflection and refraction.Uses of various mirrors in
Ophthalmology.Concave , Convex and Cylindrical lenses, Prismsand their
application in Ophthalmology. Optical system of the normal eye.Defintion and
diagrams of emmetropia, myopia, hypermetropia, various types of astigmatism,
presbyopia,aphakia.

4.Practice of refraction.

Retinoscopy–(the most important method of estimating the refraction

objectively),Optics of retinoscopy( 3 stages). Various types of
retinoscopes(Reflecting, self illuminating; Spot and streak retinoscope). Practice of
retinoscopy. Cycloplegics in refraction- their indicatons and limitations. Post
cycloplegic test. Difficulties in retinoscopy.Trial frame, trial set and its
accessories.Standard notation of axis of cylinder.

Alternative methods of estimation of refraction- Refractometers( including

automated), Keratometry, A scan.

Subjective verification of refraction- Fogging technique, Duochrome test, Jacksons

cross cylinder and its uses, Astigmatic fan, Correction of near vision.

SECTION-B Q P Code: 5162

5.Assessment of visual function

a>Visual acuity – Theory and practice of testing visual acuity for distance and
near. Various charts used for testing visual acuity, testing visual acuity in all age
groups, Notations for recording visual acuity. Pin hole testing- its importance in
visual acuity testing.

b>Field of vision – Confrontation testing, Techniques of Static(Automated)

perimetry.

c>Color vision – defects of color vision and their importance, testing of color
vision especially Ishihara chart.

d>Binocular vision -Synaptophore(Amblyoscope), stereoacuity tests(TNO, Frisby

etc.)

e>Errors of refraction – Ametropia and its correction by various methods,

Anisometropia and its importance(especially unilateral Aphakia), Presbyopia and
its management , accommodation and convergence – its measurement and
anomalies.

6.Making and fitting of spectacles:

Transposition of lenses(simple and toric), Identification of lens types and

determination of its power(Neutralisation method and focimeter), IPD
measurement and its importance, Various types of spectacle frames(material,
design etc) , Various types and designs of prescription lenses (Tinted, U.V. filters,
Photochromic lenses, Antireflection coatings, high index lenses, Bifocals,
Multifocals)etc.

Low visual aids – applications.

7.Alternatives to spectacles – 1. Contact lenses: Indications, Contraindications,

advantages, disadvantages and dangers

2. Refractive surgeries: LASIK, Phakic IOL’s, etc.

Examination Pattern:
Theory Max 100 marks(Part A-50 marks & Part B-50 marks)
1. Short notes- answer any four 4*5=20marks
2. Short answers 10*3=30 marks
Total 50 marks

Practicals 100 marks

Pattern of practicals :
10 spotters 2 mark each - 20 marks ( 2 mins each)
Two special procedures to be described 30 marks each – 60 marks ( I hour)
Practical Record -10 marks
Viva voce -10 marks
 Paper - II
SECTION-A Q P Code: 5163

1. .Common eye diseases: These are covered in brief so that the students are able
to differentiate minor non vision threatening and major vision threatening/ life
threatening diseases, decide how urgently patients are to be referred to
Ophthalmologists. They must also be in a position to educate patients about
prevention of common diseases like vitamin A deficiency, ophthalmianeonatorum,
corneal ulcers,injuries,and preventing blindness due to glaucoma and diabetic
retinopathy. Conjunctivitis and its treatment, prevention of spread of conjunctivitis.
Corneal ulcers, importance of proper management of corneal abrasions and foreign
bodies,prevention, seriousness and urgency of management of corneal ulcers.
Iritis,Blepharitis, lid infections, chalazion, dacryocystitis, lacrimal syringing proper
method and interpretation,iritis,

2. Ophthalmic emergencies , first aid and indications for referral.

Injuries- chemical and mechanical- first aid management of chemical injuries,

protecting the eye, applying a shield,

Corneal ulcer,Acuteiritis and acute glaucoma

Orbital cellulitis, panophthalmitis.

Patient presenting with sudden loss of vision.

3. Cataract- definition, Magnitude of cataract blindness, types, diagnosis,

vision media disparity, conservative management with refractive correction,
indications for surgery, types of surgery,complications of hypermaturity,
importance of ruling out coexisting glaucoma and retinal or optic nerve
diseases, relevant systemic and local investigations before cataract surgery,
Biometry. Post operative care and follow up of cataract surgery patients.Post
operative spectacle correction.
 SECTION-B Q P Code: 5164

4. Glaucoma. What is glaucoma, importance of IOP( digital, schiotz, applanation,

noncontact tonometry),Visual fields, importance of understanding that disc
examination is very important during every refraction testing, long term follow up.

5. Squint: Types of squint, its importance in causing amblyopia especially in

children, cover test, assessment of BSV and stereoacuity tests.

6. Systemic diseases.

Vitamin A deficiency- prevention and prompt management to prevent morbidity

and blindness.

Diabetes and Hypertension as a cause of blindness and prevention and

management of blindness due to these diseases.

Teaching Time Schedule – as at present

Examination pattern –suggested below are two options.

Examination Pattern:
Theory Max 100 marks(Part A-50 marks & Part B-50 marks)
1. Short notes- answer any four 4*5=20marks
2. Short answers 10*3=30 marks
Total 50 marks

Practicals 100 marks Pattern of practicals :

10 spotters 2 mark each - 20 marks ( 2 mins each)
Two special procedures to be described 30 marks each – 60 marks ( I hour)
Practical Record -10 marks
Viva voce -10 marks
Question
MAX.
Paper SUBJECT SECTION paper
MARKS
Code
Section A 5161 50
Paper - I
Paper 1 Section B 5162 50
Practical 100
Section A 5163 50
Paper - II
Paper 2 Section B 5164 50
Practical 100
Log book assessment 100
 ThirdYear Diploma in Ophthalmic Technique
Paper - I
SECTION-A Q P Code: 6161

1.Nursing care of Ophthalmic patients.

PreOperative preparation for various Ophthalmic surgeries, trimming of eye lashes.

Preparation of the eye and ocular dressings.

Bed making and laying dressing trolley in the wards.

Shifting blind/ophthalmic patients from Ward to OT etc.

2. Theoretical basis for work in ophthalmic Operation Theatres.

OT Aseptic techniques,prevention of infections in ophthalmic operative

procedures, prevention of transmitting infections from patients to hospital staff like
HIV and HbSAg. Fumigation, sterilization,packing sterilization bins, applying
indicators for autoclaving, ETO Sterilization, various types of autoclaves

O.T. Cleaning and maintenance.

Surgical Instruments used in common eye surgeries like cataract, glaucoma, squint,
lid surgeries, lacrimal apparatus,chalazion, keratoplasty and retinal surgeries-
names of instruments, how to assist using these instruments, cleaning and proper
maintenance of the same.Laying the OT trolley for various eye surgeries.

Operating microscope- importance of preventing damage to microscope, especially

the optics and electrical connections, IPD setting, sterile caps for the microscope,
care of the foot switch, etc.

Phaco machine uses and how to get it ready for surgery- tubings, vitrectomy hand
piece, Phaco hand piece, Irrigation aspiration headpiece etc.

Various sutures used in ophthalmology (both intraocular and extraocular), their

sterilisation
 SECTION-B Q P Code: 6162

Anesthesia machine, gas cylinders including their color coding, Connecting cardiac
monitors, endotracheal tubes,use of suction apparatus,Drugs used in GA cases,
Role of paramedical Ophthalmic assistants in looking after a GA case.

Use of diathermy and cryomachines,

I.V. Line Principles,starting and care of I.V line, Commonly used I.V. fluids

Scrubbing techniques, gowning, gloving, etc.

Proper disposal of OT waste, segregation of OT waste, color coding of disposal

bins/ covers.

General work culture and discipline in OTs. Maintenance of OT registers and case
sheets.

3. ophthalmic diagnosticequipments names and how to use them.

Trial set, retinoscopes, keratometer, A Scan biometer, lens meter, Slit lamp
biomicroscope,direct and indirect ophthalmoscope,pachymeter, maintenance of
tonometres, BP checking, Use of a glucometer.

Maintenance of set of fuses, bulbs for the slit lamp and operating microscope,
periodic calibration of instruments like keratometer, applanation tonometer, etc.

Examination Pattern:
Theory Max 100 marks(Part A-50 marks & Part B-50 marks)
1. Short notes- answer any four 4*5=20marks
2. Short answers 10*3=30 marks
Total 50 marks

Practicals 100 marks

Pattern of practicals :
10 spotters 2 mark each - 20 marks ( 2 mins each)
Two special procedures to be described 30 marks each – 60 marks ( I hour)
Practical Record -10 marks
Viva voce -10 marks
 Paper - II
SECTION-A Q P Code: 6163

1.Emergency resuscitation- CPR

2.Records and statistics – OPD and IPD records, consent forms, ICD-10,Surgical
records- OT lists, OT registers,Medicolegal registers, maintaining various
investigation reports.

3.Community eye health- epidemiology of blindness, definition of blindness,

preventable/irreversible blindness

a>NPCB and DBCS, role of eye camps

b> School eye screening- importance of examination of each eye separately for
vision, anisometropia and squint and its importance in causing lazy eye(amblyopia)

c> Eye bank over view-eye donation forms, motivation for eye donation,
enucleation of donor eyes, storing transporting and proper utilization of donor
tissue, maintanence of records.Facts and myths of eye donation.

Rehabilitation of the blind.– Medical rehabilitation, Training and psychosocial

rehabilitation, educational rehabilitation, Vocational rehabilitation, Visual
disability certificate percentage etc.

Basic eye health education of the community – Importance of treating

Anisometropia in school children to prevent amblyopia, importance of fundoscopic
examination in patients even with good vision, danger of indiscriminate use of over
the counter medications especially steroid eye drops, role of protective eye gear at
the workplace, importance of fundoscopic examination at every spectacle change
visit.
 SECTION-B Q P Code: 6164

4. Common symptoms in ophthalmology

Dimness of Vision: sudden loss, gradual loss, painful loss, painless loss, existence
of serious disease without vision loss (glaucoma, extensive Diabetic retinopathy,
hypertensive retinopathy, Papilledema), pain in and around the eye, red eye,
watering, photophobia, white discoloration of cornea or pupil, headache, proptosis,
swelling of lids.

5. Simple clinical signs in Ophthalmology.

Congestion, Loss of corneal window reflex, identifying corneal ulcer, identifying

shallow Anterior chamber depth, Pupil size and reaction to light,dacryocystitis,
lagophthalmos etc.

6. Common drugs used in Ophthalmology:

Various methods of drug administration:-drops, ointment, Injections- sub

conjunctival, retrobulbar, intravitreal.

Topical- anti infectives, mydriatics, miotics, steroids, NSAIDS, fluorescein,- when

to use and when not to use.

Commonly used Anti glaucoma drugs, contraindications, advising patients about

proper use of antiglaucoma drugs.

Local and general anaesthesia in brief.

Oral pain killers commonly used.

Corticosteroids uses and dangers.

Among others practical knowledge of the following is mandatory

Vision recording, retinoscopy, prescription of glasses, lacrimal sac syringing,

epilation,keratometric measurements, A scan for axial length measurement,
mounting of phaco machine and adjusting the parameters of the machine surgery,
common eye diseases – prevention and recognition.
Examination Pattern:
Theory Max 100 marks(Part A-50 marks & Part B-50 marks)
1. Short notes- answer any four 4*5=20marks
2. Short answers 10*3=30 marks
Total 50 marks

Practicals 100 marks

Pattern of practicals :
10 spotters 2 mark each - 20 marks ( 2 mins each)
Two special procedures to be described 30 marks each – 60 marks ( I hour)
Practical Record -10 marks
Viva voce -10 marks

Question
MAX.
Paper SUBJECT SECTION paper
MARKS
Code
Section A 6161 50
Paper - I
Paper 1 Section B 6162 50
Practical 100
Section A 6163 50
Paper - II
Paper 2 Section B 6164 50
Practical 100
Log book assessment 100

Books:
i. Parson's Diseases of Eye by Mayo and worth
ii. Opthalmic Assistant Refraction by Duke Elder Ahmed or Khurana
(Diseases of eyes)
Reference:

i. Clinical Ophthalmology by Kanski

ii. DBCS Manuals by Govt. of India.