The Equivalency of the Binocular Indirect Ophthalmoscope Simulator to Peer Practice: A Pilot Study.

SIGNIFICANCE: Optometric educators are constantly looking for learning and teaching approaches to improve clinical skills training. In addition, the COVID-19 pandemic has made educators scrutinize the time allocated to face-to-face teaching and practice. Simulation learning is an option, but its use must first be evaluated against traditional learning methods. PURPOSE: The purpose of this study was to compare the training of binocular indirect ophthalmoscopy skills achieved by students and optometrists through deliberate practice on the Eyesi Indirect Ophthalmoscope simulator with deliberate practice using a peer. METHODS: Students and optometrists were randomly allocated to practice on either the simulator or a peer. Binocular indirect ophthalmoscopy performance was assessed using a peer and the simulator as the patients at different time points. Knowledge and confidence were examined before and following all practice sessions using a quiz and survey. RESULTS: Significant improvements in binocular indirect ophthalmoscopy performance using either a peer or the simulator as the patient for assessment were seen after 8 hours of student practice (P < .001) and after a half-hour practice time for optometrists (P < .001). There was no significant difference in performance overall between those practicing on a simulator and those practicing on a peer (P > .05). Confidence in ability to perform the technique was lower for students who had practiced on the simulator. CONCLUSIONS: The simulator has similar efficacy to peer practice for teaching binocular indirect ophthalmoscopy to students and maintenance of this clinical skill for optometrists. Simulation does not replace the need for peer practice but may be a useful adjunct reducing the face-to-face hours required. These findings present a need for further research regarding diverse applications of the Eyesi Indirect Ophthalmoscope simulator in the curriculum for training optometry students and as a continuing professional development offering for optometrists, given the short exposure duration required to observe a significant improvement in skill.

Altered visual sensitivity in axial high myopia: a local postreceptoral phenomenon?

PURPOSE: The present study investigated retinal integrity in high myopia using spatial psychophysical tasks. METHODS: Ten axial high myopes (-8.5 to -11.5 D) and 10 age-matched control subjects (+/-1.0 D) were recruited. All participants underwent clinical examination and ocular biometry and demonstrated no visible macular disease with visual acuities better than 6/12. Foveal summation thresholds were determined for white and S-cone-isolating spots of various diameters up to 5.4 degrees and spatial contrast sensitivity to luminance sine wave gratings (0.5-9.7 cyc/deg). Data were analyzed after correction for the magnification induced by eye size and correcting lens power. RESULTS: Spatial summation for both white and S-cone-isolating spots showed a generalized loss of sensitivity at all spot sizes in myopes relative to control subjects (P = 0.01). Critical areas at maximum summation were significantly larger in myopes, for S-cone isolating spots only, after image size correction (P = 0.048). Sensitivity at maximum summation correlated negatively with vitreous chamber depth for both targets (P = 0.005). Sensitivities for S-cone and luminance spots also correlated (P < 0.001), indicating widespread dysfunction. Myopes displayed contrast sensitivity losses at high spatial frequencies (P

Ocular ischaemic syndrome.

Ocular ischaemic syndrome is a rare condition. It often results in blindness and is linked to serious systemic morbidity. Its presentation is usually subtle and it can be misdiagnosed due to its diverse signs and symptoms. A case of ocular ischaemic syndrome is presented and current diagnostic procedures and treatment described. Recognition by the clinician is important because of the severe ocular and potential systemic sequelae.