Welcome to your Ophthalmology clerkship! Our goal is to prepare you, as graduates of the University of Wisconsin School of Medicine and Public Health, with the knowledge and examination skills required by a general medical practitioner to recognize what eye disorders can be treated without referral to an ophthalmologist, and how soon the other disorders should be referred to specialists.
You will also learn to appreciate how extensively the visual system reveals the function of the central nervous system, with half the cranial nerves, representation of the visual sensation by the parietal, temporal and occipital lobes, and control of eye movements by the frontal lobes, midbrain, pons and three cranial nerves.
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This 2-week course will include an introductory review of the eye examination and experience in different clinics seeing patients with residents and faculty. An opportunity to observe ophthalmic surgery is possible for students who desire this experience and communicate to us that interest.
It is very important to become comfortable with the fundoscopic examination. It is expected that each medical student will be able to perform an eye examination including visualization of the fundus by the end of the rotation. This will require the student to use the direct ophthalmoscope and find at least 20 optic nerves. Asking faculty for assistance is encouraged if needed.
On either the Friday before the ophthalmology week or at the latest on the Monday afternoon of the first day of the clerkship, each student should pick up a packet from the Department of Ophthalmology office located at 2828 Marshall Court, Suite 200 that will include your week’s schedule, a basic ophthalmology textbook and a description of a Patient Problem that you are to discuss at the Friday afternoon examination exercise. The material can be obtained on Friday between 8:30 am and 3:30 pm, or on Monday after 7:30 am.
On the first day of your Ophthalmology rotation, please report to the University Station Eye Clinic at 8:30 am (unless a different time is indicated by the clerkship coordinator) for the review of how to do the eye examination. If you have an ophthalmoscope, you should bring it to the session fully charged; however, it is not required that you have your own ophthalmoscope. You will be expected to attend the Ophthalmology Grand Rounds at 7:00 am, held every Friday.
At the end of the experience, students should be able to:
- Know and perform the seven elements of the basic eye examination
- Visual acuity
- External appearance
- Ocular motility
- Visual fields
- Slit lamp/pen-light examination
- Recognize the causes of acute and chronic visual loss, know the systemic associations (especially giant cell or temporal arteritis), and initiate an appropriate treatment plan
- Know the various causes of a red eye and their treatments, and the consequences of topical anesthetic, antibiotic, antiviral, and corticosteroid therapies
- Understand the concept of glaucoma and its ophthalmoscopic appearance, and recognize the difference between open-angle and narrow-angle glaucoma
- Detect the presence of a relative afferent papillary defect (RAPD), and understand its significance
- Understand the basic visual field defects and their related terminology
- Detect the presence of strabismus and understand its significance. The student should be able to define amblyopia
- Know the different signs of ocular trauma and be able to distinguish between mild and serious ocular injuries
- Understand the significance of papilledema and its varied manifestations
Assessment of your performance is based upon:
- Case problem presentation and small group participation
- Faculty evaluations of clinical participation
- The score on a multiple choice quiz based on photographs of various ophthalmic disorders
The 2-3 hour Friday afternoon evaluation session is intended to provide valuable learning for the students at least as much as to evaluate your existing knowledge.
Case 1: A 74-year-old Green Bay Packers Cheerleader
Case 2: A 83-year-old with loss of vision in one eye
Case 3: A 28-year-old with eye pain
Case 4: a 64-year-old with nausea and decreased vision
Case 5: A 27-year-old medical student with a red eye
Case 6: A 27-year-old with a headache
Reference Ophthalmology Links
The following resources may prove useful as reference materials or to help satisfy your curiosity about ophthalmology as a career. They are listed in no particular order.
- Ophthobook – This is a free online textbook and video website created and maintained by Dr. Tim Root.
- Root Atlas – This is a free web repository of ophthalmology videos created and maintained by Dr. Tim Root.
- Medrounds.org – A great source of information for medical students, residents, and attendings.
- Ebling Library– Easiest way to access UpToDate and PubMed. Also has several bona fide ophthalmology textbooks in the e-book section.
- University of Wisconsin Department of Ophthalmology– Departmental website. Learn about your professors and their research interests. Also you can learn more about our residency and fellowship programs in Ophthalmology.
Clerkship Director: Dr. Dan Knoch
Design: Dr. Ravindra Ganesh
Cases and Videos: Sumit Kar
Gallery: Aos Karim
ATTN: Ophthalmology Clerkship
Department of Ophthalmology and Visual Sciences
2828 Marshall Court, Suite 200
Madison, WI 53705