ORTH 4994
Topics: Ocular Motility I
4 credits
Mondays 3:15 – 5:00 pm
Tuesdays 3:25 – 5:00 pm
Clinic: one half day per week, beginning
October
Old Main, 1st floor, Room 103
HENRIETTA SCHMOLL
School of Health
Orthoptics
Course Syllabus
Instructor Information
Name: Lisa P. Rovick, MHSc, CO, COMT
Office location: Minneapolis Campus. Old Main #401
Phone: 651-690-7778
E-mail
Cell: 612-716-4418
lprovick@stkate.edu
Office Hours: Mondays 1:00 – 2:30; by appointment
Course Goals
The overall goal for this course is to provide a knowledge and skill base upon which all of
the additional courses in the orthoptic major are built. A majority of the basic skills and
concepts used by orthoptists are presented in this course for the first time, providing a
framework for the clinical experience which begins in the next semester.
Course Objectives
Upon successful completion of this course, students will be able to
-identify and describe the major structures of the brain, eye and orbit, including extraocular
muscles, cranial nerves and the visual pathway
-in the anatomy lab, successfully identify the major structures of the brain: the lobes, the
major fissures, the ventricles, and the major blood vessels
-in the anatomy lab, successfully trace and identify the structures involved in the visual
pathway from optic nerve through the visual cortex.
-in the anatomy lab, successfully identify and trace the path of cranial nerves II, III, IV, V and
VI from the brain stem to the point of exit from the brain, where they enter the orbit.
deduce the meaning of a medical term through the understanding of the structure of medical
terminology
discuss the development of vision, the concepts of binocular vision, and amblyopia
demonstrate proper techniques used in assessment of visual acuity, binocular vision and eye
alignment
list the elements of a full sensorimotor examination and comprehensive eye exam
describe the different subspecialties within the field of ophthalmology and the patient
populations served by each
Page 1
Course Assignments
Criteria for Quality Work:
This is a BRIEF overview of required assignments. Criteria for quality work and specific
requirements needed to complete each assignment will be given in a timely manner. Specific
questions pertaining to every assignment are addressed when it is assigned. As appropriate to the
assignment, project, or activity, students who fail to meet the quality work criteria may revise work
to meet these descriptors. All revised assignments must be returned to the instructors no later
than the next class session to receive credit. Late revised assignments are not accepted, unless in
excused-absence situations as agreed upon with the instructors.
1. Attendance/Preparation/Participation (max. 30 pts. /week)
Evidenced in on-going assessment (e.g. class discussions, group projects during class) 5
pts./session
Weekly content quiz (based on material presented and discussed during that week) 10 pts./quiz
Weekly medical terminology quiz (based on material in assigned chapter) 10 pts/quiz
2. Weekly medical terminology quiz (10 pts./quiz)
This quiz will be administered at the beginning of class each Monday and will cover the assigned
chapters in the Medical Terminology textbook. Unless there are questions, no class time will be
spent on the Medial Terminology portion of this course.
3. Weekly content quiz (10 pts/quiz)
This quiz will cover the material covered in the discussion and readings from the previous week’s
material. The purpose of the quiz is to make sure that everyone is understanding the material
covered.
3. Clinical Rotation (100 pts)
Students are expected to report to their assigned clinic for a 4 hour shift once each week.
Exact schedules will be determined individually with clinical preceptors. Evaluation of clinical skills
will be performed by the preceptors at the end of the semester.
4. Clinical Case Reports/Portfolio: (15 pts/paper)
Students will prepare and present a description of a patient observed during the clinical rotation
each week. Included in the written document will be a self-assessment of skills and progress on
these skills. Each case report will include at least one primary source from which information on
the patient’s disorder was drawn. The grading rubric will be distributed before the first day of
clinic.
5. Eye Model Project: (100 pts)
Working individually or in groups, construct a working model of a globe, it’s extraocular muscles,
the ligaments and the nerves that innervate the muscles.
Include: limbus, so that the muscle insertions may be attached appropriately
rectus and oblique muscles and their respective cranial nerves
The structures in the orbit that involve extraocular muscle rotation (trochlea, orbit, Whitnall’s
ligament)
Color code the cranial nerves to match the muscles that they innervate and include a color key.
The muscles, when pulled, should move the globe in the correct direction.
Page 2
Grading Scale
The final grade will represent student performance on weekly quizzes in medical terminology,
completion of homework assignments, quality of “ophthalmic practice” descriptive papers, quizzes,
midterm and final examinations. Student attendance and class participation will be included in the
final assessment.
The grading policy followsAverage of all weekly content and Medical Terminology quizzes………………......…A
(the lowest scoring quiz in each section will be dropped)
Average % of all Clinical case reports ………………………………………………………………………..B
Average % of Clinical Rotation evaluation scores……………………………………………………..C
Average of A + B + C ..................................................................................................................... D
Midterm examination score ……………………………………………………………..……..…..E
Final examination score ……………………………………………………………………..………….F
Eye model score………………………………………………………………………………………………..G
Average of E + F + G...........................................................................................................................H
Average of D + H…….....................................................................I
Class attendance/participation points…………………………………………………………………………………………………………….J
Final weighting for course … I = 90%, J = 10%
Final Score ____
Final course grade will be determined by converting the final point score to a letter according to
the following scheme:
Final Percentage
Final course grade
90 – 100
A
80 – 89
B
70 – 79
C
60 – 69
D
< 60
F
A final percentage of 70 or greater (C or better) in this course is required for continued
enrollment in the orthoptic major. Exceptions to this rule may be made at the discretion of the
program director.
INCOMPLETES: “A grade of incomplete is given only when unusual circumstances deem it
appropriate. Ordinarily, such circumstances would involve matters that are not wholly within a
student’s control, such as illness. Students who wish to receive an incomplete must complete a
Petition for Incomplete Grade form (available online
http://minerva.stkate.edu/RecOffFrms.nsf/Incomp4?OpenForm ) no later than the last day of the
term in which course requirements are due. The student must be making satisfactory progress in
the course at the time the petition is approved by the instructor. Incompletes are awarded at the
instructor’s discretion” (Petition for an Incomplete Grade, from Registrar’s Section St. Catherine
University Website).
Page 3
The “Legal” Section
ATTENDANCE
• “Regular class attendance is expected of all students. Students are responsible for class
assignments whether present or not. Absences for any reason will be taken into account in the
evaluation of the student’s work.
• Absences will affect your grade because ongoing and interactive assessments are done during
classes. Attendance and thoughtful participation are crucial to your learning and provide evidence
of it. Class participation points for excused absences can be made up; they cannot be made up for
unexcused absences.
• If you cannot get to class (e.g. illness, car won’t start, relative dies), contact me before
class begins. Instructors need to be informed about any absence before class or it will be
unexcused.
• If you are going to miss your clinic day, please contact me AND the clinical preceptor.
• Students who miss class are responsible for asking classmates and/or instructors for notes and
picking up handouts/materials.
ASSIGNMENTS
• All students are expected to turn in assignments by the DUE dates. Every assignment
for this class must be completed in order to receive a final grade for the course.
• It is your responsibility to contact the course instructor in advance of the due date, if you are
struggling with an assignment. I am happy to work with you, but you are responsible to ask for
help.
EQUAL OPPORTUNITY
• “AT ST. CATHERINE’S WOMEN NOT ONLY HAVE EQUAL OPPORTUNITY, BUT EVERY
OPPORTUNITY. Everything we do here – both inside and outside of the classroom – is designed to
provide the opportunities to build the skills and values that not only help students succeed in
college, but inspire them to excel in their personal and professional lives” (2000-2007
Undergraduate Academic Catalog, p. 5).
• As instructor, I shall make every attempt to deal with all students equally. I encourage you to
talk with me about your concerns of equal opportunity in the classroom.
• If you have a documented disability that requires an accommodation, please provide me with
the accommodation plan no later than the second class session.
• “The O'Neill Center for Academic Development addresses the diverse academic needs and
interests of students. The professional and student staff offer programs, services and facilities
designed to promote academic achievement through the Writing/Reading Center, the Math Center
and the Resources for Disabilities Center. The O'Neill Center is located on the ground level of the
Coeur de Catherine on the St. Paul Campus. The phone number is 651.690.6563.” This information
was taken from the center’s home page at http://minerva.stkate.edu/offices/academic/oneill.nsf.
RESPONSIBILITIES
• It is our responsibility to facilitate your learning. However …
• Since no teacher can learn anything for you, learning is, in the final analysis, your
responsibility. Make the most of this opportunity.
• To ensure a productive learning environment be respectful of ALL, please turn off
electronic devices such as cell phones, pagers, and personal stereos. Children, friends
or relatives of enrolled students may not attend class sessions unless prior consent of
the instructor is given.
Page 4
ACADEMIC INTEGRITY POLICY
• The mission of St. Catherine University provides for excellence in education through the search for
truth and justice. In accordance with the mission, the college expects all students and faculty to uphold
the highest standards of academic integrity, and acts of academic dishonesty will not be tolerated.
Academic dishonesty includes, but is not limited to, the following examples of conduct:
 violating the academic rights of another student;
 cheating on assignments or exams, including the use of crib notes or other unauthorized
materials;
 submitting papers or assignments written by another person (student, commercial agency,
etc);
 copying from another student’s paper;
 stealing copies of exams or answer sheets;
 conveying test items to other students;
 plagiarizing on papers and other assignments;
 consenting to have one’s work used by another student as her/his own;
 falsely reporting information or misrepresenting actions in clinical or classroom laboratories;
 depriving other students of necessary course materials by stealing books, periodicals or other
materials from the library, media center, labs, etc.;
 submitting the same paper, or substantially similar papers, to meet the requirements of more
than one course without approval of the appropriate instructors;
 interfering in a harmful way with another student’s work, such as sabotaging another
student’s laboratory experiment, or entering or deleting data in another student’s computer
account, or
 unlawfully duplicating copyrighted materials.
Texts / Materials
REQUIRED:
Medical Terminology… A Programmed Systems Approach 9 th edition revised (there is a new edition
out this year….we’ll use 9th edition…less expensive) Authors are Dennerll, Jean Tannis & Davis,
Phyllis E. ISBN: 1-4180-2021-4
JCAHPO/ATPO Pocket Guide order this from the JCAHPO web site.
http://www.jcahpo.org/pdfs/Pock_Guide_Order_Form.pdf
Handbook of Pediatric Strabismus and Amblyopia Wright, K., Spiegel, P, & Thompson, L. ed
Springer 2006. ISBN: 0-387-27924-5
Fundamentals for Ophthalmic Technical Personnel. Cassin, B. W. B Saunders, 1995.
Binocular Vision And Ocular Motility. vonNoorden, Gunter Available online (you may print your own
copy, if you prefer to read on paper) through Cybersight:
http://www.cybersight.org/bins/content_page.asp?cid=1-2193
Purchase from instructor on first day of class: Orthoptic Syllabus $100.00
PURCHASE LATER in the semester: Basic Clinical & Science Course. Neuro-ophthalmology and
Pediatric Ophthalmology sections. Published by the American Academy of Ophthalmology. (I will
get a discount when I order them at a meeting in October.)
OPTIONAL:
Management of Strabismus and Amblyopia A Practical Guide second edition. Pratt Johnson, Tillson
ISBN: 0-86577-992-9 (you don’t need to purchase this one, but it’s a good one to have)
Clinical Orthoptics, 2nd ed. Rowe , Fiona. Blackwell Publishing, 2004 ISBN: 1-4051-1342-1
Page 5
Clinical Neuroanatomy Made Ridiculously Simple (3rd Edition; Book & CD-ROM) (Paperback) Stephen
Goldberg ISBN 978-0-940780-57-6
SCU Blackboard
• This is a Blackboard supported course.
• How do I access Blackboard?
You can access Blackboard directly at http://blackboard.stkate.edu/
Links are also available on the LeGuide under “Technology Resources.”
• Additional questions about using Blackboard are answered at:
http://minerva.stkate.edu/ithelpguides.nsf/dir/BlackboardFAQ
• It is your responsibility to check Blackboard for weekly messages, updates, assignment
folders, websites, and other support material for this course.
Anatomy Lab
• Students in the course will have the opportunity to have a session in the anatomy lab after
studying the structures of the brain in the classroom and in text and diagrams
• Prior to attendance in the anatomy lab, students will complete training in the required protocol
and other lab procedures
• Consent and protocol forms are to be found at the end of this document. The link to the
orientation video is
http://mediamill.cla.umn.edu/mediamill/embed/18412
Page 6
Week
Thurs.
9/8
(lab)
Mon,
9/12
topic
VA, history
(adult)
Skull, orbits,
brain, blood
supply
Tentative Class Schedule (subject to change, as needed)
Homework/readings
Cassin Chapter 15, pg. 154-161
Med
Term
Unit 1
Cassin Chapters 2-3
(Goldberg Chapter 1,2)
http://memo.cgu.edu.tw/cgmj/3303/330310.pdf
Orthoptic Syllabus p. 2-3,10-12
Tues,
9/13
Globe, muscles,
nerves, cranial
nerves
vonNoorden Chapter 3,6
(Goldberg Chapter 4)
Cassin Chapter 1, 6, 10, pg. 307-308
Wright Chapter 2: pp 24-60
Orthoptic Syllabus p. 7-9, 12-14
Thurs.
9/15
(lab)
Mon.
9/19
Confrontation
VF, versions
BCSC Neuro-Ophthalmology (Section 5) p. 98
Eyelid, tears,
conj. & cornea
Tues,
9/20
Fixation, Eye
movements,
Hering,
Sherrington
Laws,
positions of
gaze
Mon,
9/26
Tenon’s,
episclera,
Med
term
quiz
unit 1
Med
Term
Unit 2
Quiz
on
Week
1
Cassin p. 3-6, 397-399
Orthoptic Syllabus p.3-5
Cassin pg 161-163, 278-279, Chapter 21
Wright Chapter 2: pp 61-67
vonNoorden Chapter 4
Syllabus p. 24-26
Med
Term
Cassin p.6-8, 406-418
Syllabus 5-6, 17-18
Page 7
sclera, angle
structures, uvea
Tues,
9/27
Thurs,
9/29
(lab)
Mon,
10/3
Tues,
10/4
Mon,
10/10
Pupil Function,
Visual
development,
age-appropriate
vision testing
Binocular
testing, color
testing
Peds VA testing
Lens, vitreous,
retina, color
vision, optic
nerve
Tropia/phoria.
Basic types of
strabismus
(includes
Dissociated
strabismus)
Clinical
Discussion
Evening seminar
prep.
quiz
unit 2
Med
term
unit 3
Quiz
on
Week
2
Cassin pg. 157-163
Wright Chapter 1: pp 1-12, Chapter 4
vonNoorden Chapter 14
Article: Dissociation of processing of featural and spatiotemporal information in the infant cortex
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNP-50G06781&_user=1822421&_coverDate=07%2F05%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C
000054564&_version=1&_urlVersion=0&_userid=1822421&md5=4bf825352d72b0bc5171c7ba36eac689
Wright pp 1-12
Med
term
quiz
unit 3
Med
term
unit 4
Quiz
on
Week
3
Cassin Chapter 5, p.397, 424-426
Syllabus p. 6-7, 12
Med
term
quiz
unit 4
Med
term
Evening seminar prep. and practice
Cassin Chapter 20
Wright Chapter 3: pp. 84-94
Syllabus
Page 8
Tues
10/11
Mon,
10/17
Mon.
10/17
Tue,
10/18
Cover tests,
corneal reflex
tests
(Hirschberg/
Krimsky)
Recording
results
Clinical
Discussion
Visual pathway,
visual fields,
pathology
Tues,
11/1
Cassin Chapter 20
Wright Chapter 5:pp. 143-160
vonNoorden
Syllabus
Med
term
quiz
unit 5
Med
term
unit 6
(Goldberg pp. 45-47)
Cassin Chapter 7,16
Syllabus
Evening Seminar 6:30-8:00 pm
VISION SCREENING (specificity vs sensitivity, critical line testing, photoscreening, screening vs. complete eye exam, summary & clinical pearls)
Review
MIDTERM
EXAM
Mon,
10/24
Tues,
10/25
Mon,
10/31
Happy
Hallow
een!
unit 5
Quiz
on
Week
4
Quiz
on
Week
5.
Review: 3-4 pm
Midterm Exam: 4-5 pm
Two part examination: Part 1: Ocular A&P, terminology through unit 6 (30 points)
Part II: Ocular Motility topics
NO CLASS
NO CLASS (make up = Evening Seminar)
Please go to assigned clinic
NO CLASS (make up = Evening Seminar)
Please report to assigned clinic
BCSC Neuro Ophth. Pg 20, 27-37,
50-55, Chapter 11
NO CLASS
Clinical
Discussion
Neuroanatomy
intro (circle of
Willis, cranial
nerve pathways,
chiasm)
Sensory fusion,
motor fusion,
Quiz
on
Week
6
Med
Term
unit 7
NO
QUIZ
Cassin Chapter 6, 8, 10
Eye Model Project Due
CASSIN pg. 278-282
Page 9
Mon,
11/7
Tues,
11/8
Mon
11/14
Panum’s area,
monofixation,
retinal
correspondence
Clinical
Discussion
Evening
Seminar Prep.
Fusional
amplitudes,
accommodative
amplitudes,
Near reflex
Clinical
Discussion
More
Neuroanatomy:
Cerebellum
Wright Chapter 3: pp. 70-83, Chapter 6: pp 174-188
vonNoorden
Med
term
quiz
unit 7
Med
term
unit 8
Quiz
on
Week
7
Evening Seminar Prep.
Cassin pg 15, 139-145, 170, 194-195, 282-287
Wright pp. 90-100
vonNoorden
Med
term
quiz
unit 8
Med
term
unit 9
BCSC Neuro Ophth pg 48-49, 52
Cassin Chapter 8
Mon.
11/14
Evening Seminar 6:300-8:00pm
AMBLYOPIA (anatomy & physiology of amblyopia, types of amblyopia, traditional/historical treatment, treatment recommendations from ATS studies,
looking to the future; clinical pearls)
Tues,
11/15
Introduction to
paralytic and
supranuclear
disorders (neuro
ophthalmic
disorders)
Quiz
on
Week
8
Cassin Chapter 9
BCSC pp. 37-41, Chapter 7
Wright pp. 423-440
Page 10
Mon,
11/21
Clinical
Discussion:
Pons and cranial
nerve nuclei
Tues
11/22
Diplopia:
monocular,
binocular
Diplopia vs
confusion
Mon
11/28
Cadaver lab
session
Clinical
Discussion
Pupil function,
includes pupil
pathway
Tues,
11/29
Mon,
12/5
Torticollis:
ocular and nonocular
Non-organic
(Functional)
vision loss
Clinical
Discussion
Evening
Seminar Prep
Med
term
quiz
unit 9
Med
term
unit 10
Quiz
on
Week
9
Med
term
quiz
unit
10
Med
term
unit 11,
12
Quiz
on
Week
10
Cassin Chapter 10
BCSC pg. 51-62
BCSC Chapter8
Wright pp. 174-178, 188-204
Meet in St. Paul
Neuro anatomy review
Ocular and orbital anatomy dissection (guided)
Video: http://www.medicalvideos.us/play.php?vid=87
Syllabus p. 17-18
Cassin Chapter 22
BCSC Chapter 13, pg 247
Med
term
quiz
unit
11,
12
Med
term
Evening Seminar Prep
Page 11
Tues.
12/6
unit
13, 14
Quiz
on
Week
11
Mon.
12/12
Spectacle
problems
related to
strabismus,
prism correction
Pupil disorders,
testing
Mon.
12/12
Evening Seminar 6:30-8:00 pm
INFANTILE STRABISMUS (infantile ET, infantile XT, ,infantile torticollis, management of adults with a history of infantile strabismus, clinical pearls)
Med
term
quiz
13,
14
Med
term
unit 15
+
review
Cassin pp. 286-287
BCSC Neuro-Ophthalmology (Section 5) Chapter 15 starting page 169.
Watch YouTube videos on Horner’s, APD, Adies, normal pupil testing, neutral density filters for grading APD
Tues,
12/13
Exam review
Med
term
quiz
unit
15
Review
Thurs.
12/15
3:305:30
pm
Jterm
FINAL EXAM
(written)
2 parts: Ocular A&P + Terminology 1 hour
Ocular Motility 1 hour
January 3, 2012
Happy New Year!
Report to your clinic. Please contact your assigned clinic and make arrangements for the first day
Page 12
POLICIES REGARDING ANATOMY LAB USE BY STUDENTS
With regards to anatomy lab participation at St. Catherine University, students are required to
follow these policies.
1. No cell phones and/or cameras are allowed in the laboratory. Videotaping or photographing
the human anatomical material is strictly prohibited without the prior consent of St. Catherine
University’s anatomy lab director and the Anatomy Bequest Program Proposal Review
Committee at the University of Minnesota, including but not limited to any images which will
published or distributed.
2. Students shall track all loaned human anatomical material by keeping the donor’s acquisition
number tag with the donor at all times during the loan. If the tag becomes disassociated from
the donor, the course instructor should be contacted immediately, who then will notify the St.
Catherine University anatomy lab director. All tissue removed from the donor during dissection
must be retained, identified with the donor’s acquisition number, tracking during the loan and
returned at the completion of the loan.
3. Anatomical material must not be removed from the dissecting laboratory.
4. Only registered students, teaching assistants and faculty members are allowed access to
human donors and/or anatomical material. Visitors and guests are not allowed access.
5. Both conversational and written language relating to the donor and donor dissection by
human anatomy students lab be respectful and discrete. Any information about the donor
including the donor’s demographical, social or medical history is confidential and students are
not allowed to disclose this information.
6. The use of the Internet in general, and social media sites in particular, including, but not
limited to, Facebook, MySpace, Twitter, etc., by students as a venue for discussing any aspect
of the donor or donor dissection is strictly prohibited.
7. Doctor of Physical Therapy Program and Physician Assistant program students: Any student
who wishes to access the lab after standard business hours is required to have at least one
other student in the same academic program present with them at all times in the anatomy lab.
8. Non-compliance with the above policies may result in a student being immediately expelled
from the course with a failing grade, the student being referred to further disciplinary actions
such as a conduct review hearing, and/or criminal charges, if applicable.
May 2011
Page 13
St. Catherine University - Human Anatomy Lab
Orientation video from the University of Minnesota Anatomy Bequest
Program
Each St. Catherine University student utilizing the Human Anatomy Lab is required to view the
following orientation video and then print off and sign the disclosure form and return it to their
faculty member PRIOR to accessing the Human Anatomy Lab for the first time.
http://mediamill.cla.umn.edu/mediamill/embed/18412
Anatomy Bequest Program
Human Anatomy Access Orientation Disclosure Form
The opportunity to review and dissect the human body is a privilege afforded to only a limited
number of individuals. It carries with it an important responsibility for treating the person who has
given his/her own body to advance your education and research with utmost respect and dignity.
It is important that each individual appreciate the opportunity afforded and observe the policies
outlined in the Anatomy Bequest Program Human Anatomy Access Orientation. These policies have
been set up to promote respect for the donor and success for you in the laboratory. Failure to adhere
to these rules may result in your eviction from the Anatomy lab.
Please read the following statements and place a check mark in the respective boxes to signify
your compliance and comprehension of the rules.
In order to have access to the human anatomical materials provided by the Anatomy Bequest
Program, I verify that I have taken part in a Human Anatomy Access Orientation session either in
person or by video.
I understand that my access to the human anatomical materials is a privilege, and all
donations have been made by consenting individuals and/or families to better aid in anatomy
education and research.
I understand that it is my responsibility to adhere to the policies of the Anatomy Bequest
Program and additional laboratory policies outlined in the course syllabus or proposal form.
I understand that failure to comply with the established rules and policies regarding human
anatomical materials may result in my eviction from the anatomy lab.
I also verify that to the best of my knowledge I do not know any Anatomy Bequest Program
whole body donors who have died within the last two years.
If a donor is known, please leave this box unchecked, and fill in the donor’s name:
_____________________________________________
This disclosure form is to be signed, dated, and returned
to the course/lab instructor for filing.
Print Name
Date
Sign Name
Page 14