Portland Community College | Portland, Oregon

Upon successful completion of the course students should be able to:

1. Identify and describe the structures and functions of the visual system, eye, and adnexal structures.

2. Describe the physiology of the visual system.  

The material in this course will be presented in lecture format. Other educationally sound methods may be employed such as discussion, recitation, research papers and small group work. Guest speakers and field trips may be utilized by the instructor as a means of assisting the student in mastering competency.

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, website videos, PCC course website downloads.

COMPETENCIES AND SKILLS

VISUAL SYSTEM

• Define the anatomical directions/planes of the body

• Name three coats of the eye

• List the three chambers of the eye

• List the structures found within each chamber

• Locate and describe the iris, ciliary body and choroid

• Detail the diameter of the eye between anterior and posterior poles in inches and millimeters

• Locate and describe the function of the optic nerve

• Contrast visual axis to geometric axis

CORNEA AND SCLERA

• Describe dimension of normal cornea

• Describe with the rule, against the rule and oblique corneal astigmatism

• Corneal thickness both central and peripheral

• Name layers of the cornea and its regenerative properties, & importance of the basement membrane

• Types of cells in the epithelium

• Source of oxygen and nutrition of endothelium, and function of the endothelium

• Normal corneal sensitivity

• Vascular state of normal cornea

• Sources of oxygen and oxygen requirements

• Average front surface power of cornea in diopters and millimeters of radius

• State refractive index of cornea

• Limbus and limbal blood supply

• Average width of corneal scleral limbus

• Function of sclera and lamina cribrosa

• Episcleral vessels

• Understand corneal topography and keratometry

• Understand the terms associated with these structures

UVEA

• Locate and describe the iris, ciliary body and choroid

• Describe the ciliary process and formation of aqueous humor

• Describe the major components of the ciliary body

• Describe the location and action of dilator and sphincter muscles, suspensory ligaments and layers of the crystalline lens

• Describe direct and consensual light reflex

• Describe two major functions of the choroid

• Understand the functions of the choriocapillaris and Bruch’s membrane

• Define cells and flare

• Understand the terms associated with these structures

• Define types of synechia

RETINA & OPTIC NERVE

• Locate retina and describe its general function

• Locate and describe the optic nerve, macula lutea, fovea centralis, and central retinal artery and ora serrata, and posterior pole, and cilioretinal artery

• Describe visual pathway from retina to occipital cortex

• Locate and describe function of the chiasm

• List the ten main layers of the retina

• Locate and describe general function of pigment epithelium

• Locate and describe the functions of rods and cones and importance of Vitamin A, rhodopsin and iodopsin

• Describe photopic and scotopic vision and which photoreceptors are responsible for each

• Define and locate visual axis of the globe

• Understand blood supply to retina, and specifically the macular area

• Understand the types of color blindness

• Define where retinal detachments occur

• Understand the terms associated with these structures

• Understand ultraviolet radiation effects on structures of eye

• Understand OCT and the retina

LENS

• Define amplitude of accommodation and how it changes with age

• Locate and describe ciliary muscles, suspensory ligaments and layers of crystalline lens

• Describe sequence of events that enable accommodation of the lens

• Describe the lens nucleus, cortex, zonules and capsule, and when they developed.

• Define cataract and be able to understand the difference in types of cataracts

• Understand the mechanics of accommodation and structural changes that occur with it.

• Understand the terms associated with these structures

• Understand aphakia and pseudophakia, ectopic lenses

AQUEOUS AND VITREOUS

• Aqueous humor dynamics

• Describe aqueous humor drainage system

• Locate and describe aqueous drainage system including: "angle", trabecular meshwork, Schlemm's canal

• Describe normal intraocular pressure, variables affecting intraocular pressure

• Define tonometry

• Describe normal vitreous attachments

• List functions of the vitreous

• Define Cloquet’s canal, persistent pupillary membrane, and persistent hyperplastic vitreous

• Define Bergmeister’s papilla and Mittendorf dot and their derivation

• Define coloboma

• Describe the hyaloid arterial system and its purpose during development of the eye

• Define syneresis and vitreous separation, floaters and photopsia

• Define hypopyon, hyphema, hyperemia

• Understand the terms associated with these structures

• Understand open angles vs narrow or closed angles

SKULL & ORBIT

• Locate & describe the shape and function of the orbit

• Identify the seven bones of the orbit

• Identify the bones of the orbital rim

• Name the weakest orbital bones

• Identify the three openings into the orbit from the cranial vault

• List the types of important tissues that pass through each of these openings from the cranial

• List and locate the four sets of paranasal sinuses that surround the orbit

• Locate and describe Tenon’s Capsule, orbital septum, annulus of Zinn, trochlea

• Define proptosis, exophthalmos, osteopathy, endophthalmitis

• List the cranial nerves involved with eye and adnexa

• Understand the terms associated with these structures

OCULAR ADNEXA/LACRIMAL SYSTEM

• Locate and describe geographical landmarks as related to upper and lower eyelids including canthus and palpebral fissures

• Describe general function of eyelids

• List muscles of the eyelids and their function

• Define palpebral fissure

• List the precorneal tear films

• Locate lacrimal glands, Meibomian glands, Goblet cells and describe the purpose of fluids secreted by each

• Locate and describe the collection system for tear film including puncta, canaliculi and lacrimal sac

• Define and explain role of enzyme lysozyme

• Name and locate bulbar and palpebral conjunctiva and fornix, and tenon’s capsule

• Describe conjunctival tissues

• Locate and describe the function of the cilia and brows

• Describe normal pH of tear chemistry

• List the layers, makeup and function of the tear film

• Understand the terms associated with these structures

EXTRAOCULAR MUSCLES

• Locate origination of ocular muscles in orbit

• Name and locate the six muscles responsible for ocular movements

• Locate the origination and insertion points of ocular muscles to the globe

• Locate and describe trochlea

• Describe Adduction and abduction, elevation and depression, intorsion and extorsion

• Discuss the significance of primary and secondary deviations

• Describe the diagnostic positions of gaze. Discuss nystagmus and its consequences.

• Define amblyopia

• Explain the acronym SIN-RAD

• List names and describe the function of various tests for strabismus

• Understand the terms associated with these structures

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BLOOD SUPPLY AND NERVE INNERVATION

• Describe the location of the central retinal artery and central retinal vein, and their function

• Describe the location of vortex veins

• List the cranial nerves which innervate the eye, extraocular muscles or eyelids.

• Define efferent vs. afferent

• Compare and contrast the central retinal artery and the choriocapillaris blood supply

• Understand the sympathetic and parasympathetic nervous system

• Understand the neurotransmitters and cell receptors

• Understand the terms associated with these structures

• Define the cranial nerves that involve ocular structures

THE VISUAL PATHWAY

• Describe visual pathway from retina to occipital cortex

• Locate and describe the function of the chiasm

• Describe how the location of lesions within the retina affects the image in the visual field

• Describe three characteristic defects of the visual field caused by damage in the visual pathway

• Understand the terms associated with these structures

• Understand visual fields and their relation to lesions in the eye, optic nerve, chiasm, optic tract, and cerebral cortex

• Understand homonymous, bitemporal, congruous, incongruous, macular sparing, scotoma, arcuate defect, central and cecco-central defects

• Understand the pupillomotor system, both afferent and efferent arms, function and anatomy

• Understand structures within the ciliary ganglion

• Define types of visual aberrations

CONGENITAL ANOMALIES

• Define congenital cataracts, staphyloma, medullated nerve fibers, colobomas, aniridia, buphthalmia

• Define persistent pupillary membrane, Bergmeister’s papilla, Mittendorf dot, Chloquet’s canal, and where they are formed from

• Define the hyaloid blood supply

• Understand visual acuity of newborn

• Define which major structures and not fully developed at birth

THE IMMUNE SYSTEM

• Define the immune system

• Define Lymphatic drainage and the lymphatic system

• Understand lymphocytes, monocytes, T-cells

• Understand the inflammatory mediators – histamine, kinin’s, complement, and prostaglandins

• Define inflammation and its bodily response