Medic One Funded Projects
Foundation Course In Ophthalmology
Mr Martin Farrar
I was fortunate enough to receive funding to attend the Edinburgh Focus Course last year. This is a very popular course with a high demand for places and is run by the specialist registrars at the Princess Alexandra Eye Pavilion in Edinburgh.
Urgent eye conditions commonly present to the ED, particularly out-of-hours. These conditions can seem a mystery to many and coupled with the prospect of handling specialist ophthalmic equipment, are often approached with some trepidation.
In applying for the course I hoped to gain an insight into the management of common eye problems presenting to ED and also to gain additional competence in some of the diagnostic techniques and equipment that is used.
The Focus Course is mainly aimed at doctors commencing a career in ophthalmology but nurse practitioners, ED doctors and GP trainees are also made to feel very welcome. The course provided an ideal opportunity for me to interact closely with the ophthalmic specialists and others on the course and gain an understanding of how to approach common emergency presentations.
The great feature of this course is that it is a very much a hands-on practical course. There were lectures interspersed with a variety of practical sessions. This allowed consolidation of the information taught in each lecture. Skill stations were conducted in small groups of four delegates and plenty of time is allowed to practice on the equipment.
The Lectures covered a wide variety of subjects including, ophthalmic history taking, visual acuity testing, visual fields, and an introduction to slit lamp examination. Common problems such as lid abnormalities, blurred vision, and the red eye were also covered. Thereafter case based scenarios in small discussion groups were used to underline this teaching.
There course organisers also facilitated sessions in the ophthalmology clinic where selected ‘volunteer patients’ with specific pathologies attended for delegates to examine. I found this a particularly good way to highlight earlier teaching.
The course provided me with a great opportunity to develop my skills with some of the equipment that is used. This particularly applies to the Algerbrush tool, utilised for the removal of metallic foreign bodies and rust rings. The use of the Tonopen, an intraocular pressure measuring instrument, is another valuable asset to have when assessing a patient with suspected glaucoma. Additionally, I was able to gain a more detailed insight into the use of the slit lamp. These skills will enable me to improve the care I provide for patients and I am looking forward to sharing this knowledge with fellow nurse practitioners and other clinical staff.
The myriad of ophthalmic diagnoses and some of the acronyms used can sometimes be quite confusing and the use of diagnostic algorithms or decision trees can be helpful. Following the course I made some notes on some of the most commonly encountered clinical presentations and likely symptoms, for example, suspected iritis, retinal detachment, glaucoma etc. I intend to write these out more clearly as guide to help colleagues recognise and manage these problems.
The Focus Course was well organised and delivered in a friendly and relaxed atmosphere. The ophthalmologists demonstrated enthusiasm for their subject and successfully accommodated those with different learning needs offering additional practical training when required.
I would like thank both the staff at the Eye Pavilion for facilitating the course and the Medic One Trust, whose support enabled me to attend.