Portland Community College | Portland, Oregon

1. Effectively take a complete patient history.
2. Maintain clean, safe ophthalmic equipment in the workplace.
3. Skillfully communicate with patients to ensure proper triage.

The class will be presented by means of lecture/discussion, audio-visual presentations, handouts and demonstrations. There will be comprehensive lab work requiring demonstrated competency to receive a satisfactory grade. Guest speakers and field trips may be utilized by the instructor as a means of assisting the student in mastering course goals

At the beginning of the course, the instructor will detail the methods used to evaluate student progress and the criteria for assigning a course grade. The methods may include one or more of the following tools: examinations, quizzes, homework assignments, research papers, laboratory modules and student participation.
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OPHTHALMIC EQUIPMENT/INSTRUMENTS

• Identify and learn the proper spelling of common ophthalmic equipment.
• Explain the use of common ophthalmic equipment.
• Perform proper cleaning and routine maintenance of ophthalmic equipment.
• Demonstrate general preventative maintenance of ophthalmic equipment
• Describe what information should be recorded in an instrument maintenance log, and where the log should be kept.
• Describe how to implement proper in-office maintenance; clean, maintain, lubricate and repair.
• Safely change bulbs and fuses on ophthalmic equipment.
• List 3 methods of acceptable disinfection for ophthalmic instruments that touch the eye.
• Explain precautions taken when cleaning front surface silvered mirrors.
• Describe proper handling of rechargeable retinoscopes, ophthalmoscopes and trans-illuminators
• Describe proper handling of power supplies: standard batteries, rechargeable batteries and proper usage of charging wells.
• Identify the difference between visual acuity projectors: manual projector, auto projector, electronic visual acuity tester.

MEDICAL/OPHTHALMIC HISTORY

• Describe the basic ethics of coding and billing
• Describe patient confidentiality and its importance in healthcare
• Describe the pro’s and con’s of a paper chart, and proper documentation
• Describe the role of Electronic Medical Records in the ophthalmic practice.
• Describe the role of a scribe in the ophthalmic practice.
• List 6 items of general information to include in a patient chart.
• Describe how to provide accurate historical documentation.
• Identify pertinent ophthalmic abbreviations.
• Describe proper documentation of allergies to medications.
• Describe the difference between and allergy and a side effect.
• Compare and contrast a sign verses a symptom.
• Define "Chief Complaint" and its importance in the medical record.
• Describe information that should be contained in the Chief Complaint section.
• List items included in the history of present illness.
• Describe how to succinctly and efficiently transcribe obtained information into the patient chart.
• Identify the difference between new and established patients as they relate to documentation.
• Detail the components of a medical, ocular, family and social history.
• List additional questions asked of patients complaining of headache symptoms.
• Define asthenopia.
• Take a relevant history for a strabismus workup.
• Perform a Review of Systems to assess the patient’s general health and relationship of systemic diseases and the eye.
• List additional questions asked of patients with red eye.
• List additional questions asked of patients with double vision.
• List additional questions asked of patients with tearing or discharge.
• List questions asked of patients in past ocular history.
• List types of illnesses included in medical history.
• List types of medications, both prescription and OTC, to include in the medications list.  Which supplements and herbal remedies should be included?
• List diseases included in the family ocular history and which relatives are included.
• Describe the meaning of subjective and objective information in a medical history.
• Identify types of questions to use to help elicit the patient interview: direct, indirect,
• Describe non-verbal communication cues and how they might be used to improve a patient history.
• Describe how to communicate with children, deaf, hard of hearing and non-native speakers.

MEDICAL RECORDS MANAGEMENT/READING MEDICAL CHARTS

• State three important reasons for keeping good medical records.
• List items of personal data needed in the medical record.
• Describe the meaning of subjective and objective information in the medical record.
• Explain the basic differences between the traditional and the problem oriented medical record.
• Discuss changing an entry in the medical record (EMR/Paper chart) and the importance of following correct procedure.
• Describe the proper procedure for filing X-rays, lab reports and letters from other physicians/providers.
• Describe preparation procedure for a day in clinic, the process with Electronic Medical Records vs. traditional paper charts.

APPOINTMENT SCHEDULING/TELEPHONE TECHNIQUE/TRIAGE

• Describe proper technique when placing and receiving calls and professional telephone manners.
• Describe listening styles: passive, competitive, distracted, active.
• Describe basic guidelines in appointment scheduling.
• Describe how to schedule patients in applicable increments for a physician's office schedule to run smoothly (ie. patient flow)
• Describe how to determine when a request for an appointment is an emergency.
• State the reason for recording failed appointments on the patient’s chart, and understand office protocols.
• Discuss the handling of cancellations and delays brought about by office situations.
• Document any encounters with the patient: telephone, fax, e-mail, face to face, with pharmacy, with another provider, any exams, and diagnostic tests.
• Identify the kinds of calls that will need to be referred to the physician for response.
• Identify symptoms of a true ocular emergency where a patient needs to be seen ASAP.
• Identify symptoms of urgent problems, where a patient needs to be seen the same day.
• Identify symptoms of a priority problem, where a patient needs to be seen within days.
• Identify symptoms of routine problems, where a patient needs to be seen on the next available appointment.
• Identify what actions for the patient to take if the patient with an emergent/urgent problem is a contact lens wearer.
• Describe immediate treatment for chemical injuries.

 PRELIMINARY EXAMINATION

• List at least 7 components in the ophthalmic preliminary exam.
• List six types of patient’s physicians should see without any technician workup.
• List additional tests done while screening a cataract patient.
• List at least three tests done prior to cataract surgery.
• List at least three tests done for patients with neurological symptoms
• List tests done for patients referred for glaucoma evaluation.
• Demonstrate bundling of a baby.
• Describe how to perform the basic measurement procedures in the screening examination of a strabismic patient.
• Define stereo acuity.
• Describe various methods of assessing visual acuity and their significance in strabismus.
• Describe how to perform vision screening in preschool children using appropriate testing methods for the age.
• Describe the characteristics, presentation and natural history of pseudostrabismus, congenital esotropia, accommodative esotropia and intermittent deviations.
• Distinguish between comitant and incomitant deviations.

PATIENT SERVICES

• Demonstrate proper hand washing technique and detail when this is necessary.
• Demonstrate proper hand sanitizing technique (and sanitizer alcohol content) and when it can/cannot replace hand washing.  (cdc.gov)
• Discuss guidelines for standard precautions and when to use them.
• Demonstrate testing of visual acuity at distance and near.
• Identify different types of visual acuity charts: Snellen, Allen, HOTV, Lea, Landolt, ETDRS LogMar
• Identify methods to quantify vision in a infant/toddler: Teller Acuity Cards, fixate and follow, blink to light, Central Steady and Maintained.
• Demonstrate pinhole technique and identify when the test is rendered.
• Demonstrate testing of color vision with Ishihara color plates.
• Demonstrate testing central vision with an Amsler grid.
• Demonstrate estimation of anterior chamber depth with penlight
• Demonstrate testing of stereo acuity using the Stereo Fly.
• Demonstrate testing for Marcus-Gunn (RAPD) pupil using the swinging flashlight test.
• Demonstrate proper instillation of eye drops and ointments.
• Demonstrate application of punctual occlusion and describe when to use this technique.
• Identify forms that are available in the office and what they are used for: Assignment of benefits, Authorization for Payment, Authorization for Responsibility, Release of Information, Initial patient registration, Interval visit registration, Waivers of Liability

INFORMED CONSENT

• List seven items included in an informed consent document.
• Discuss when informed consent must be utilized.

VITAL SIGNS

• Demonstrate proper measurement of blood pressure, correct documentation and patient position.
• Identify relationship of cuff size and it’s affect on blood pressure readings.
• Demonstrate proper measurement of pulse and respirations.
• Identify factors that can alter accuracy of vital sign measurements.
• Identify the normal range of blood pressure, pulse and respirations in adults and in children.
• Define Body Mass Index, and identify normal ranges.