Portland Community College | Portland, Oregon

Students are assigned to one ophthalmic office for the entire term.  Each weekly rotation consists of two (2) to three (3) eight-hour days in an office selected by the course instructor.  Exact hours during the clinical rotation are determined by the office schedule. 
Students are required to wear attire conforming  to the requirements of the Ophthalmic Medical Technology program.  Apparel shall consist of navy blue solid scrubs with PCC ID badge or business casual per clinical with PCC ID badge at all times.  These items are purchased by the student in accordance with the guidelines provided by the course instructor. 

Upon completion of the course students should be able to:

1. Use knowledge and apply skill as an ophthalmic technician in a clinical setting.
2. Perform ophthalmic diagnostic tests.
3. Participate as a team member in the ophthalmic practice.
4. Perform patient work-ups and provide patient education in a clinical setting.
5. Meet learning outcomes specific to this practicum as mutually agreed upon by the student and instructor in advance through a written learning contract, and as appropriate to the credit awarded for this course. 

Grades and competency will be determined according to student's ability to demonstrate theoretical understanding, technical performance, and professional growth. The student must progress by assisting the ophthalmic technician or ophthalmologist in basic procedures. The student will be directly supervised at all times. Student will demonstrate acceptable patient care, and the ability to follow directions. These traits must be demonstrated satisfactorily to progress to the next level.

Assessment will be based on verbal and written progress reports at the clinical setting and in the campus laboratory. Evaluation criteria is based on daily performance, professional development, attitude, communication skills, attendance and interpersonal skills demonstrated with patients and office personnel. Students will receive an evaluation of their technical skills as well as their overall performance by the site supervisor after each practicum experience.
The grading system for the course is "Pass" or "No Pass" .  In order to receive a "Pass" grade, the student must:
    1. Satisfactorily complete the clinical rotation.
    2.  Receive a satisfactory evaluation (both clinical and interpersonal skills) from each of the work supervisors.
    3.  Complete all of the time assigned (150 to 288 hours, depending on the term).

The student will demonstrate understanding of the following themes, issues, concepts, and development of the following skills:
Themes, Concepts, Issues

• Front Office/Medical Records Management
• Medical Ophthalmic History
• Visual Acuity
• Visual Fields/Tangent Screen/Amsler Grid
• Tonometry/Biomicroscopy
• Exophthalmometry, Color Vision, Tear Function
• Retinoscopy, Refractometry

COMPETENCIES AND SKILLS
 

• Front Office/Medical Records Management
• Demonstrate proper method of greeting and interviewing patients.
• Demonstrate ability to handle patient telephone calls appropriately, including triage and appointment scheduling.
• Perform routine front office duties such as insurance billing, reception, maintenance, and cashier.
• Prepare and demonstrate ability to properly handle medical records, i.e.initiation, filing, charting, content and purging.

Medical/Ophthalmic History

• Take an appropriate and complete medical and ophthalmic history.
• Demonstrate ability to perform adequate historical documentation.
• Transcribe obtained information into the chart succinctly and efficiently.

Visual Acuity

• Identify methods of measuring visual acuity in adults and children.
• Demonstrate accurate recording of acuity measurements in the medical record.
• Demonstrate ability to accurately measure near vision.
• Define common abbreviations used in recording visual acuity.
• Operate the lensometer accurately and efficiently.

Visual Fields/Tangent Screen/Amsler Grid

• Demonstrate static and kinetic perimetry.
• Demonstrate performance of manual and automated perimetry.
• Define isopter, scotoma, depression, contraction, central threshold target, and suprathreshold perimetry.
• Demonstrate methods for exploring defects with manual perimetry.
• Relate visual field loss to specific ocular dysfunction/pathology.
• Demonstrate the performance and properly record a confrontational field test.
• Explain quantification of scotomas and depressions.
• State four advantage of automated perimetry.
• Identify which size stimulus on a Goldman perimeter is equivalent to the usual test stimulus on a Humphrey Field Analyzer.
• Perform a Goldmann visual field examination with emphasis on correct procedure for plotting isopters, finding scotoma and investigating visual field loss.
• Perform Tangent screen if available.
• Properly calibrate Goldmann.
• Demonstrate, instruct and perform Amsler Grid.

Tonometry/Biomicroscopy

• Perform non-contact tonometry, if available.
   
• Perform applanation tonometry with Tonopen.
• Estimate anterior chamber depth with flashlight.
• Evaluate pupillary reaction.
• Perform biomicroscopy of anterior segment and ocular adnexa.

EXOPHTHALMOMETRY, COLOR VISION, TEAR FUNCTION

• Perform measurement of proptosis using a Hertel exophthalmometer.
• Demonstrate color vision testing using Ishihara test plates.
• Name alternate methods of color testing.
• Take a history relevant to identifying a possible dry eye patient.
• Perform Schirmer Tear Test I and II.
• Define and demonstrate a tear breakup time test.

RETINOSCOPY AND REFRACTOMETRY

• State and explain the principles of and indications for retinoscopy and refractometry.
• Describe the mechanism and functioning of the streak retinoscope.
• Describe the various types of behavior of the retinoscopic streak.
• Explain the recording of retinoscopic results and transpose those results into sphero-cylinderical form.
• Perform retinoscopy on the schematic eye.
• Perform retinoscopy on the human eye.
• Demonstrate appropriate maintenance of various phoropters and retinoscopes.
• Differentiate between refraction and refractometry.
• Describe subjective and objective methods of measuring refractive error.