OPT042: Medical Retina 2

This course enables optometrists or allied health care professionals to further enhance their knowledge and clinical skills in medical retina.

The aim of the course is to provide community and hospital-based clinicians with enhanced knowledge of medical retina conditions.

This course is for clinicians who are working or wish to work in a consultant ophthalmologist-led medical retina service. It aims to enable practitioners to work more effectively under supervision in a multi-disciplinary medical retina team. Work settings and responsibilities may include medical retina new patient triage clinics, anti-VEGF treatment clinics and diabetic retinopathy/maculopathy assessment and monitoring.

This course is pending accreditation by the College of Optometrists to provide the Professional Higher Certificate in Medical Retina. In order to obtain this award, students must pass the module with a mark of ≥70% in the Case Scenario and Diabetic Retinopathy Grading Test and meet all requirements of the clinical placement.

* Students wishing to receive the College’s Professional Higher Certificate in Medical Retina must have gained the College’s Professional Certificate in Medical Retina and have a confirmed approved clinical placement before beginning this module.

Non-medical ophthalmic practitioners must also have a current registration with a regulatory body. Evidence of the pre-cursor qualifications, and clinical placement must be provided as part of the application process.

Learning objectives

On completion of the module, you should be able to:

• demonstrate an ability to obtain a clinical history
• demonstrate an ability to undertake a detailed slit lamp examination including Volk lens indirect ophthalmoscopy
• demonstrate an ability to use and interpret OCT imaging and fundus photography to review data and make accurate diagnoses
• demonstrate an understanding of the principles of fluorescein/ICG angiography and autofluorescence in the differential diagnosis of macular disorders
• demonstrate an ability to differentially diagnose retinal and macular conditions and manage or refer as appropriate
• demonstrate an ability to diagnose wet AMD with a provisional recommendation for treatment
• demonstrate an ability to diagnose retinal vein occlusions and refer to or manage them as appropriate
• demonstrate an ability to make re-treat decisions for wet AMD according to local protocols in a consultant ophthalmologist-led pathway, including the ability to determine when further investigations are required in the event of atypical or sub-optimal responses to treatment
• demonstrate an ability to detect the features needed to accurately grade diabetic retinopathy according to modified ETDRS criteria in addition to National Screening Protocols
• demonstrate an ability to communicate with patients about their diagnosis and potential management options
• demonstrate an awareness of NICE guidelines and local protocols for AMD, diabetic macular oedema (DMO) and retinal vein occlusions

How the module will be delivered

This module is taught via online lectures, webinars and supporting resources delivered using the University’s e-learning system. Discussion boards accessed via Learning Central will provide a platform for students to discuss any questions or queries that come up throughout the term with both the course tutors and their peers.

Summative assessment will take place at Cardiff University School of Optometry and Vision Sciences where attendance for the invigilated online examination and a practical assessment involving a clinical station examination is mandatory.

Attendance at the contact practical training day is mandatory so please contact PGOptom@cardiff.ac.uk for more information about course dates if you will need advanced notice to schedule your attendance.

How the module will be assessed

This module contains formative and summative assessments. Teaching and formative assessment is carried out online. Summative assessment (both written and practical examinations) takes place on-site at the School of Optometry and Vision Sciences, Cardiff University.

Formative assessments

There will be online key feature scenarios/management case scenarios/VRICS/short answer questions to be completed throughout the semester.

Summative assessment

This occurs at the end of the semester and comprises:

• Multiple-choice and Short answer question test (40%): This is an online test that students take at the end of the semester. There is a mixture of multiple-choice and short-answer questions that will assess comprehension and application across the entire syllabus.
• Case Scenario and Diabetic Retinopathy Grading Test (50%): This is an online multiple-choice style test that will assess comprehension and application of the clinical management knowledge gained throughout the course.
• Practical Assessment (10%): Students will sit a clinical station exam at the end of the semester.   In order to pass the module at least half of the stations must be passed.

The pass mark for each component is 50% and students must pass each individual weighted component to pass the module overall. To become accredited with the College of Optometrist’s Higher Certificate in Medical Retina students must also achieve a minimum of 70% in the Case Scenario and Diabetic Grading Test and successfully complete the clinical placement requirements.

Clinical Placement

Alongside studying this module, to be awarded the College of Optometrists’ Higher Certificate in Medical Retina, students are also required to organise a placement in a medical retina clinic. This must be supervised by a mentor who is a Consultant Ophthalmologist specialising in medical retina.

Students must record their active involvement and experience of at least 200 cases encompassing a range of medical retina conditions. In addition, a portfolio of 10 case reports will also need to be written and submitted, prior to a clinical reasoning viva. The logbook, case reports and viva are zero weighted but successful completion of all are mandatory to achieve the College of Optometrists’ Higher Certificate in Medical Retina.

During the placement, there will be regular online meetings with a medical retina specialist optometrist tutor to monitor and support overall progress. The logbook will be periodically reviewed to ensure a wide range of clinical scenarios have been included as well as mandatory cases, with documentation being signed off by the mentor.

The placement duration must be a minimum period of 3 months, although typically it may take about 9-12 months. The placement can commence one month after starting the module. A confirmed placement must be in place when applying for the module for all students intending to complete the College of Optometrists’ Higher Certificate in Medical Retina. Students must finish their clinical placement within 24 months of completing the University’s Medical Retina 2 module. On successful completion of this module and the clinical placement, the candidate will be awarded the College of Optometrists’ Higher Certificate in Medical Retina.

The placement is not a mandatory part of this module. Students are able to study this module without the clinical placement and portfolio and would achieve 20 postgraduate Master’s level 7 credits, but they would not be awarded the College of Optometrists’ Higher Certificate in Medical Retina.

Skills that will be practised and developed

In addition to subject-specific skills associated with medical retina, you will also develop the following skillset:

Academic skills

• Advance own knowledge and understanding
• Collate and synthesise information from several resources to improve learning
• Interpret data

Generic skills

• Manage projects and time
• Work independently
• Use a range of IT software packages and online resources
• Problem solving