OPT 4633: Ocular Disease and Therapeutics II - Glaucoma and Diseases of the Vitreous, Retina and Posterior Segment

Joseph Sowka, OD, FAAO, Diplomate

Professor

Course Instructor

Office Hours: Academic Office #1472

262-1472

Office hours can be reserved by advance appointment. Please email with desired times for meeting and I will respond via email.

Lecture Hours:Wednesday 9:00 am – 10:00 am; Thursday 9:00 am – 10:00 am; Friday 11:00 am – 12:00 pm.

Course Description:

This course examines the diagnosis and management of diseases of the posterior segment, including glaucoma and diseases of the retina, vitreous, and posterior uvea. Emphasis is placed upon the advanced optometric management of these diseases. The role of the optometrist in the therapeutic management of these diseases is maximized to the fullest extent of optometric training. In some instances, education beyond current optometric practice is introduced in an effort to lay the foundation for future amplification of optometric licensure and prepare the student and graduate practitioner to function in the ever-changing profession.

Learning Objectives:

At the conclusion of the course, the student will be able to:

  1. Accurately diagnose disorders of the posterior segment and institute appropriate management.
  2. Understand the pathophysiology of primary glaucoma.
  3. Understand the pathophysiology and mechanisms behind secondary glaucomas.
  4. Understand the indications, contraindications, and side effects of medications used in glaucoma treatment.
  5. Visually recognize retinal vascular disease, understand the involved pathophysiology, and initiate appropriate management.
  6. Visually recognize peripheral retinal disease, understand the involved pathophysiology, and initiate appropriate management.
  7. Visually recognize retinal inflammatory disease and understand the involved pathophysiology, and initiate appropriate management.
  8. Visually recognize acquired and hereditary maculopathies, understand the involved pathophysiology, and initiate appropriate management.
  9. Understand the relationship between systemic disease and retinal disease and identify characteristic fundus findings of commonly encountered systemic diseases.
  10. Understand advanced diagnostic testing modalities of automated visual fields testing, fluorescein angiography, and diagnostic imaging for glaucoma and retinal disease.
  11. Understand the principles behind therapeutic laser use for glaucoma and retinal disease.

Lecture Notes:

Lecture notes are invaluable and lectures will closely follow the notes. Lecture notes are in handout form to assist the student in following the lecture, but are not intended as a replacement for lecture. It is encouraged that the student takes supplemental notes in lecture to assist in understanding the material. Lecture notes and slide graphics are considered copyright material and may not be reproduced for publication or any other unauthorized use without advance permission.

Images are provided to accompany many of the lectures. These images are copyright material and may not be used for publication or reproduced or distributed in any way. Please be aware that these images are not an ultimate resource and are not meant to be the end-all resource for these conditions, but merely a representative image to assist understanding during lecture. Many more examples will be given in class. Images from class will not be available outside of class. Please be aware that many fine examples of the conditions that we discuss exist in books and on the Internet. It is your responsibility to search out pictures and graphics to enhance your learning and understanding these conditions.

Audio Taping and Video Taping

Audio taping of the lectures is allowed as long as it is not disruptive. Video taping of lectures is strictly prohibited and will not be allowed.

Attendance Policy:

The attendance policy of this course is in keeping with the previously published attendance policy of the HPD. It is extremely disruptive for students to enter the lecture hall after the session has begun. In other words, be on time, or don’t come at all.

Communications:

Each student must maintain a computer account with the University. Although you may have your E-mail forwarded to a private account, this may reduce the reliability of this line of communication. Many aspects of the course, including grade notices, may be delivered to your E-mail account exclusively.

I will not answer any email questions regarding class material. If you have questions, you must ask me personally or, preferably, in class so that all students will hear the question and answer.

Examinations

Examinationsare intended to measure your grasp of material as it was presented in this course. When a curriculum is designed to deliver skills and knowledge that lie at the cutting edge of a discipline, it often happens that different authorities will have different opinions about what is right, or there may simply be more than one correct answer, procedure or treatment.

If you encounter apparent contradictions between the material aspresented in this class and some other source, whether written or verbal, it is your obligation to raise the issue during class so that the issue can be resolved prior to its appearance on an examination. The answers to examination items are based exclusively upon what is presented in this course. Challenges based upon other sources simply will not be entertained; such issues must be clarified in class prior to examinations.

Scheduled examinations will have a blank front page. If you encounter a test item that you believe is defective in some manner, you must briefly identify, on this blank page, why you have this opinion. Challenges to items that you generate after the test has been graded will begin with whatever you wroteabout the item on this front page. You are very unlikely to prevail on a challengeunless you have commented about it while you are taking the test.

There are four equally weighted examinations, each accounting for 25% of the course grade and comprised of 35 questions each. The second and fourth exams will be comprehensive. The fourth exam will be comprehensive from the second half of course, and not the entire course. Testing will include multiple choice questions and images. There will be no essay or fill- in- the- blank questions. There are no “extra credit” assignments. You will be asked 140 test questions throughout the semester. If you answer 98 of them correctly, you will pass the course. If you do not answer 98 correctly, you will not pass the course. There is no such thing as failing this course “by one test question”. It is failing the course by forty-three test questions. There is no curving of grades in this course. Additionally, there is no “rounding up” of final grades. A grade of 69.9 is not a passing grade. After each test, you will have a maximum of two weeks in which to review your test in my office. After that, you will not be allowed to review past exams. Please be aware that there may be no office hours or instructor availability during the week of an examination.

You are expected to take examinations when they are scheduled. If you anticipate a conflict that will compel you to miss an examination, advance permission must be obtained to take it at another time. This will occur only under extremely special circumstances and must be coordinated through the Associate Dean of Student Affairs. No examination will be given prior to the time that it is scheduled for the rest of the class. If an unanticipated emergency causes you to miss an examination, the instructor must be notified at once. The instructor will decide if your reason for missing an examination is legitimate and may arrange for you to complete another comparable exam at a later time. An unexcused absence from an examination will result in a grade of zero for that exam. There is no extra credit or means to gain points other than through the examinations.

Grade Disputes:

If you want to dispute a grade in an examination you must give written notice to the instructor within five working days from the date it was posted, and you must follow all other procedures as outlined in the current issue of the Student Guide.

Tentative Lecture Schedule

Date / Topic
Wednesday 1/7/09 / Primary Open Angle Glaucoma
Thursday 1/8/09 / Primary Open Angle Glaucoma
Friday 1/9/09 / Primary Open Angle Glaucoma
Wednesday 1/14/09 / The Gonioscopic Evaluation for Glaucoma
Thursday 1/15/09 / The Optic Nerve Evaluation for Glaucoma
Friday 1/16/08 / The Optic Nerve Evaluation for Glaucoma
Wednesday 1/21/09 / Medical Therapy of Glaucoma
Thursday 1/22/09 / Medical Therapy of Glaucoma
Friday 1/23/09 / Medical Therapy of Glaucoma
Wednesday 1/28/09 / Automated Visual Field Analysis
Thursday 1/29/09 / Automated Visual Field Analysis
Friday 1/30/09 / Diagnostic Imaging for Glaucoma
Monday 2/2/09* / Exam 7:45 am – 8:45 am
Wednesday 2/4/09 / Diagnostic Imaging for Glaucoma
Thursday 2/5/09 / Normal Tension Glaucoma
Friday 2/6/09 / Angle Closure Glaucoma
Wednesday 2/11/09 / Angle Closure Glaucoma
Thursday 2/12/09 / Secondary Glaucomas
Friday 2/13/09 / Secondary Glaucomas
Wednesday 2/18/09 / Secondary Glaucomas
Thursday 2/19/08 / Congenital and Developmental Glaucomas; Laser and Surgical Therapy
Friday 2/20/09 / Glaucoma Case Analysis
Monday 2/23/09* / Exam 7:45 am – 8:45 am
Wednesday 2/25/09 / Posterior Segment Fundamentals
Thursday 2/26/09 / Posterior Segment Anomalies
Friday 2/27/09 / Fluorescein angiography
Wednesday 3/4/09 / Diabetic Retinopathy
Thursday 3/5/09 / Diabetic Retinopathy
Friday 3/6/09 / Hypertensive Retinopathy; Retinal Vascular Occlusions (11:00 am – 1:00 pm- No Community Outreach II)
Wednesday 3/11/09 / Retinal Vascular Occlusions
Thursday 3/12/09 / Retinal Vascular Occlusions
Friday 3/13/09 / Retinal Breaks and Detachments (11:00 am – 1:00 pm- No Community Outreach II)
Wednesday 3/18/09 / Acquired Maculopathies
Thursday 3/19/09 / Proficiencies
Friday 3/20/09 / Proficiencies
Wednesday 3/25/09 / Acquired Maculopathies
Thursday 3/26/09 / Acquired Maculopathies
Friday 3/27/09 / Acquired Maculopathies; Ocular Oncology (Dr. Alan Kabat) (11:00 am – 1:00 pm- No Community Outreach II)
Monday 3/30/09* / Exam 7:45 am – 8:45 am
Wednesday 4/1/09 / Hereditary Maculopathies (Dr. Lori Vollmer)
Thursday 4/2/09 / New Retinal Technologies
Friday 4/3/09 / Retinal Potpourri (11:00 am – 1:00 pm- No Community Outreach II)
4/6/09-4/10/09 / Spring break
Wednesday 4/15/09 / Posterior Uveitis
Thursday 4/16/09 / Posterior Uveitis
Friday 4/17/09 / No class; 11:00 am – 1:00 pm Community Outreach II instead
4/20/09 / Exam

* Exam dates tentative

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