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Outlines of course content in Certificate of Advance Study in Advanced Contact Lenses and
Understanding of Corneal and other anterior segment Mechanisms in Disease and Surgical
Management.
Module 1
Course 1
Details of
Module
Certificate of Advance Study in Advanced Contact Lenses and Understanding of
Corneal and other anterior segment Mechanisms in Disease and Surgical
Management.
Course Title: Advanced Contact Lens with in-depth understanding of
Rigid Gas Permeable Lenses
Instructor:
Mr. Michael Bärtschi
Mr. Michael Wyss
Dr. Nina Mueller
Approximate hours of lecture:
~ 20 hours
Approximate hours of workshop: ~ 10.5 hours
To provide an understanding and working knowledge of complex and
specialty contact lens designs for normal and irregular eyes. Also, to
provide an understanding of complications arising from contact lens wear
and their clinical management
1. Rigid Gas Permeable Contact Lenses
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Rigid Lens Materials, Manufacturing and Rigid Lens Design
Corneal Topography, Techniques and interpretation
Rigid Lens Fit Characteristics
Rigid Lens Fluorescein Patterns
Rigid Lens Parameter Changes
Optics and Aberrations
2. Contact lens care systems
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Basics
Silicon Hydrogel lenses
Scleral lenses
Hybrid contact lenses
3. Contact Lenses for Astigmatism
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Stabilization systems for soft contact lenses
Engraving and markings
Fitting procedures
Understanding stabilization of Front Surface Toric Rigid Lenses
Understanding of stabilization of Back Surface Toric Rigid Lenses
Understanding of stabilization and working mechanism of Bitoric Rigid
Lenses
Understanding of over refraction measurement and how to determine the
final power
4. Contact Lenses for Presbyopia
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Demography and Economy
Features of a presbyopic eye
Monovision and modified monovision
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Aplante systems
Diffractive systems
5. Fitting the Irregular Cornea
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Corneal irregularity
Regular versus irregular astigmatism
Keratoconus and fitting
Irregular astigmatism and fitting
Corneal transplants: keratoplasty
Contact lens for aphakic eyes
Post-Refractive surgery contact lenses
Contact lenses for therapeutic purposes with cases
Contact lenses for prosthetic reasons
6. Orthokeratology and Myopia Control
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Modern Orthokeratology lens design and history of Orthokeratology
Orthokeratology theory and research, Myopia control
Patient selection and fitting
Results, complications and complication management in Orthokeratology
6.
Contact lenses for Infant and Children
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Aphakia with contact lens and bifocal glasses
RGP and myopia progression
7. CL complications, gradings and management
 Soft lenses
 RGP lenses
 Extended and constant wear
 Final Discussion
Workshops
 Fluorescein interpretation
 Topography and Pentacam interpretation
 RGP fitting
 Workshop on astigmatism
 Workshop on Presbyopia
 Symergeyes
 Scleral lenses
 RGP for Keratoconus and keratoplasty
Module 2
Details of
Module
Certificate of Advance Study in Advanced Contact Lenses and Understanding of
Corneal and other anterior segment Mechanisms in Disease and Surgical
Management.
Course Title: Therapeutic Pharmaceutical application to anterior
segment diseases
Instructor:
Dr. Anthony Cavallerano
Lecture hours : ~ 12 hours
1. Ocular Microbiology/Cytology
 A review techniques and interpretation of ocular surface stains, smears,
cultures, and sensitivities will be presented.
 The role of laboratory testing in treating anterior segment infectious
disease and detail
2. Infectious and Non -Infectious Eyelid Disease and Adnexa
 Treatment of various forms of blepharitis, differentiating between anterior
and posterior lid inflammation
 Complications of blepharitis, specifically exposure keratitis and corneal
non - infectious ulcers and infiltration.
 Meibomitis and the relationship of lid gland inflammation and infection,
pre-septal and orbital cellulitis, masquerade syndrome, pyogenic
granulomas, and acne rosacea
 Parasitic infestation of the lids and lashes as well as viral lid lesions
 The emphasis is on the therapeutic treatment for each of the above
disorders. Understand the role of topical/systemic medications and
surgical procedures for lid disorders.
3. Conjunctivitis
 Why conjunctivitis manifests.
 differential diagnosis of the red eye and the clinical presentation of the
various forms of conjunctivitis in order to choose the appropriate therapy
-bacterial
-viral
-allergic
 Classifications of conjunctivitis based upon clinical signs and symptoms
 Epidemiological profiles of certain organisms
 The clinical role of cultures, stains and sensitivities
 The manifestation of viral conjunctivitis and treatment options available
 The role of steroids in treating conjunctiva disorders
 The stepwise treatment protocol for treating allergic conjunctivitis.
 A knowledge of the organisms precipitating conjunctiva infection and the
application of appropriate pharmacological agents
 The role of systemic agents in treating conjunctiva infections.
4. Keratitis
 Keratitits and affect on other tissues structures
 Mild to severe epitheliopathy
 Corneal Ulcers infectious vs non infections
- etiology
- role of contact lenses
- other conditions predisposing to ulcers
- clinical presentations
-treatment regiment
 Infiltrative keratitis
- etiology
- role of contact lenses
- clinical presentations
- treatment regiment
 Herpes Simplex
- epithelial
- stromal
- clinical manifestations of metaherpetic diseases and complications
 Herpes Zoster
 Adenovirus
 Treatment options with use of keratitis and ulcers
-topical anti - inflammatory agents
-antibiotics
-fortified antibiotics.
 Distinction between herpes simplex and herpes Zoster
-treatments specific to each
-short term and long term complications
-topical antiviral agents and their side
effects, oral anti-virals
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Evidence based medicine for treatment of infections
Ocular emergencies
Details of
Module
Course Title: Ocular Physiology Principles related to Anterior Segment
of the Eye
Instructor:
Dr. Jim Mertz
Approximate hours of lecture: 12.0 hrs
To teach students all the required cell physiology, biochemistry
and molecular biology necessary to understand its usefulness in the
diagnosis and treatment of anterior segment disease, and to provide the
needed background to support the use of available and future diagnostic
and therapeutic pharmaceuticals.
To interrelate the basic sciences to the clinical application of anterior
segment pathology
1.Tear physiology/hypersensitivity/immunology
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2.
Lids And Conjunctiva
Ocular Anaphylaxis, Hay Fever
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3.
Function
Fluid dynamics –steady state
Blinking
Composition
Secretion
Excretion forces
New research
Protection Mechanisms of the Body
Protective Mechanisms of the External Eye
How Infectious Agents Infect
Elude protective barriers (lids and lashes)
Attach to epithelial surface
Cause Injury
Protective Possibilities
Dry Eye Classification: gland, etiology, severity
Antibacterial Substances in Tears
Contact Lens Coatings
s IgA
Elements of the Immune Response - a review
Changing Definitions of Anaphylaxis - the historical perspective
Ways to release Mast Cell Contents - mimics of allergy
Mast Cell Anatomy - the fast and slow responses
The Mediators - rational drug design
Ocular Anaphylaxis: Where-MC location, Timing-MC anat
Diagnosis: a review
Treatment: now and future
Cornea and its Response to Injury
 Function, morphology and innovation
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Metabolism, function and transparency,
Drug permeability, injury and response
4. Lens physiology
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IntroductionBasic Properties
General Anatomy Relative To Glaucoma And Cataract
Variables Affecting Transparency (Cataract)
Deformability Considerations (Presbyopia)
Refraction Considerations (Age, Cataract, Diabetes)
Protection: ARMD
Lens: Unique Proteins and Lens Metabolism needed for Optical Clarity and
Protection from Oxidative Stress
 Statement Of Problem: With so much protein in the lens (i.e., more than skin)
why is it transparent, and how is the transparency maintained?
 Protein Concentration (chaperones)
 The Pump Leak System (Sorbitol and Aldol Reductase inhibitors
 Oxidative Stress
 Major Lens Proteins:
a. The Crystallins and Albuminoid
b. The chaperones, alpha crystallin
c. The gap junction protein – connexions and the
aqueous pores, aqueporin (MIP)
d. The pumps: Na, K, ATPase
e. The enzymes of metabolism (ATP and NADPH
production)
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Some pathways to Cataract
a. Sunlight - do vitamins and trace metals protect?
b. Posterior inflammations - PMN's and the
respiratory burst
c. Diabetes - the use of aldol reductase inhibitors.
d. Diabetes - Advanced Glycation End Products
(AGE's) - aspirin?
Lens -- Lecture #3 Ageing, Disruptions, Cataract
 Ageing
 Disruptions
 Consequences of Pump Interference
 Factors Interfering with Pumps
 Osmotic Interferences (gradients)
 Leak Interferences
o Cataract
 Clinical Classification
 Time Sequence
 Nuclear Brunescence vs. posterior
yellowing)
Module 3
Details of
Module
Certificate of Advance Study in Advanced Contact Lenses and
Understanding of Corneal and other anterior segment Mechanisms in Disease and
Surgical Management.
Course Title: Anterior segment problems related to dry eye and contact
Lenses.
Instructor:
Dr. Caroline Blackie
Approximate hours of lecture:
~ 10 hours
Approximate Hours of workshop: ~ 2 hours
1. Tear Film Disorders and Dry Eye for non contact lens and contact lens
wearers
 Review of anatomy of structures, physiology of tear film production,
dynamics of tear film surfacing and eliminations
 Emphasis is placed on the commonly occurring anomalies and abnormalities.
 The tests used to determine tear film sufficiency and stability are discussed as
well as the relative merits and practical application of each.
 Management strategy for each type of tear film deficiency
 Future of dry eye treatments
 Meibomian gland dysfunction and its related affect
 Affect of tear film disorders and dry eye on contact lens wearers
 Affects of lids and dry eye disorders
2. Use of corneal topography in decision making
3. Ocular surface evaluation workshop
Details of
Module
Course Title: Refractive Surgery and other corneal surgical techniques
Instructor:
Dr. J. Edeling: South Africa
Approximate hours of lecture: ~ 6 hours
Refractive surgery
1. Understanding of wavefront technology and optics of laser
2. Patient choices for refractive surgery: Different techniques, pros and cons
3. Pre –operative management for patients
4. Post operative management post refractive surgery treatment
5. Complications of refractive surgery and management/treatment options
6. Successes of refractive surgery
7. Future development in refractive surgery
Corneal surgical techniques including pre and post surgical care
1. Corneal transplants
2. Pterygium removals and grafting
3. Future in corneal repair
Lens and cataract:
1.Update on cataract surgery and techniques
2. Implants (contact lens) above crystalline lens
Details of
Module
Course Title: Overview of relevant general and ocular Pharmacology and
therapeutic drugs available on South African Market
Instructor:
Dr. George Muntingh ( South Africa)
Approximate hours of lecture: ~ 6 hrs
No info for Muntingh!!!!!! Not on Bina’s schedule
Module 4
Details of
Module
Certificate of Advance Study in Advanced Contact Lenses and Understanding of
Corneal and other anterior segment Mechanisms in Disease and Surgical
Management.
Course Title: Advanced Anterior Segment Disease with emphasis in
Cornea.
Instructor:
Dr. William Sleight
Approximate hours of lecture: ~ 20.0 hrs
LONG DISTANCE LEARNING MODULE
Time for completion: 90 days maximum
The Ocular Disease Diagnostic Tutor (ODTT)is a software tutorial program that
is designed to train clinicians to recognize and correctly describe various tissue
changes related to ocular disease. The program is unique in its clinical
pathologic approach to applying the correct terminology to common and
uncommon ocular diseases. The ODDT trains clinicians to recognize and use
terminology correctly. The correct understanding and application of clinicalpathologic terminology is the foundation of differential diagnosis and
understanding the underlying pathologic changes reflected by the clinical
presentation. The ODDT exposes clinician to common and uncommon
conditions and requires mastery of both content and cognitive interactive
exercises. It compliments the teaching of conditions already covered in the
curriculum by its unique emphasis in recognizing and properly applying critical
clinical observations to these diseases. Furthermore, it adds to the curriculum
by covering in detail rarer conditions which are not handled in detail typically in
an existing curriculum.
Limbal thinning
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Nomenclature exercises
Furrow degeneration, Dellen, Pellucid Marginal
Degeneration, Rheumatoid furrow, Systemic Lupus Furrow
Degeneration, Terrien’s Marginal Degeneration
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Diagnostic cases
Terrien’s Marginal Degeneration, Pellucid Marginal
Degeneration, Dellin, Peripheral Ulcerative Keratitis,
Systemic Lupus Erythematosus
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Reasoning cases
Blebitis, PUK
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Topic file support and interactive quizzes
Furrow degeneration, Dellen, Pellucid Marginal
Degeneration, Rheumatoid furrow, Systemic Lupus Furrow
Degeneration, Terrien’s Marginal Degeneration
Limbal Inflammation
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Nomenclature exercises
Atopic keratoconjunctivitis, Vernal Keratoconjunctivitis,
Superior Limbic Keratoconjunctivitis, Phlyctenulosis,
Mooren’s Ulcer, Terrien’s Marginal Inflammation, Sterile
Marginal Infiltrates, Roseacea keratitis, Peripheral
Ulcerative Keratitis (RA, PAN, WG, SLE)
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Diagnostic cases
CL-SLK, VKC, Rosacea, Sterile Marginal Infiltrates,
Phlyctenulosis, Pingueculitis
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Reasoning cases
SLK, Blepharo-kerato-conjunctivitis
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Topic file support and interactive quizzes
Atopic keratoconjunctivitis, Vernal Keratoconjunctivitis,
Superior Limbic Keratoconjunctivitis, Phlyctenulosis,
Mooren’s Ulcer, Terrien’s Marginal Inflammation, Sterile
Marginal Infiltrates, Roseacea keratitis, Peripheral
Ulcerative Keratitis (RA, PAN, WG, SLE)