CURRICULUM

FOR

2 YEARS DIPLOMA PROGRAMME

IN

OPHTHALMIC MEDICINE
AND
SURGERY
(DOMS)

2007

UNIVERSITY OF HEALTH SCIENCES

LAHORE, PAKISTAN
SR. CONTENTS PAGE NO

1 Foreword 1
2 Aims and Objectives of the Course 3
3 Specific Learning Outcomes 4

3 Nomenclature and Duration 5

4 Eligibility Criteria for Admission 8

5 Recognition/Equivalence Related Issues 9
6 Content Outline 10

8 Methods of Instruction/Course Conduction 18

9 Log Book 20

10 Literature Review 22

11 Examinations 23

12 Recommended Books 28
 FOREWORD
University of Health Sciences (UHS) Lahore was inaugurated by the
President of Pakistan on the 3rd of October 2002 with the vision to
explicitly address academic and research needs in the field of health
sciences and allied disciplines and to uplift their existing level to bring
them on a par with the international standards.

The mission of the University is to develop an intellectual nexus to

provide excellence and innovation in medical education and research in
order to;

• Impart knowledge and skills to health care providers to enhance

their competence in providing community oriented and multi-
disciplinary patient -centered care
• Train and produce researchers and specialists in basic and
clinical medical sciences
• Establish and maintain continuing professional development
programmes for the faculty
• Provide trained professionals and scientists/researchers for the
field of Electro Medical/Bio-Medical disciplines
• Assure quality in health education and research at all levels

A university is the zenith of knowledge that imparts quality education

and awards degrees for extensive educational attainments in various
disciplines with attendant advancement for the development of
intellectual community. Protection of traditional knowledge, making
exploration about it and obtaining deep understanding of modern
technology and research techniques are some of the responsibilities of
any university.

UHS is running a number of courses in the field of health sciences in

Punjab. The list extends from undergraduate level courses up to the
doctorate level both in basic, clinical and allied health sciences.

Since its inception, certain vital tasks were taken into serious
consideration by UHS, for instance, curricula development and their
up-gradation were among the most important tasks besides
introduction of contemporary educational programmes.

UHS has revised and finalized curricula for undergraduate Medical/

Dental Education, BSc Nursing, and Allied Health Sciences.

In keeping with its commitment for further improvement in the

standard of medical education, UHS has taken an initiative to modify
and improve one year postgraduate diploma courses to 2 years
structured training programmes.
1
I do not believe in selling an old product in a new packing with a fresh
label on it, just to do the job. Original products with actual outcomes
for the society must be guaranteed. Being the Vice Chancellor of a
public sector health university, I believe, it is my duty to remain
vigilant and committed to the cause of improvement of the
conventional medical and allied health sciences’ curricula on regular
basis. This will help produce technically sound professionals with
advanced knowledge and skills.

Presently, UHS has designed and facilitated curriculum development

committees for eleven clinical disciplines namely: DTCD, DPM, DMRT,
DOMS, DLO, Dip. Card, DCH, DCP, DGO, DMRD and DA.

This document precisely briefs the details of updated curriculum for

Diploma in Ophthalmic Medicine and Surgery (DOMS) as prepared by
the Experts’ Committee.

I am pleased to acknowledge the efforts made by Prof. I. A. Naveed,

the Department of Medical Education and the members of the
committee for DOMS consisting of: Prof. Tahsin-un-Nabi Sahi
(NMC),Prof. Mohammad Tayyab (SIMS), Prof. Ali Haider (PGMI), Prof.
Imran Akram (PGMI) and Prof. Muhammad Khalil Rana (LMDC) . The
contributions made by them will go a long way in the education and
training of doctors in this field.

I do hope, the revised course will be able to meet the needs of latest
trends in Ophthalmic Medicine and Surgery and will certainly produce
competent mid-level specialists in the field, which is the main objective
of this programme.

Prof. M. H. Mubbashar
Hilal-e-Imtiaz, Sitara-e-Imtiaz
MB, FRCP, FCPS Psych, FRC Psych, DPM
Vice Chancellor/ Chief Executive

2
 AIMS AND OBJECTIVES OF THE COURSE

AIM

The aim of 2 years diploma programme in Eye is to equip medical

graduates with relevant professional knowledge, skills and ethical
values to enable them to apply their acquired expertise at primary and
secondary health care organizations as non-academic consultants.

OBJECTIVES

At the end of training in DOMS, a trainee doctor should be able to:

1. Take a comprehensive and pertinent history of a patient presenting

with Eye related complaints
2. Perform detailed physical examination in a rational sequence that is
both technically correct as well as methodical
3. Elicit physical signs without discomfort to the patient
4. Evaluate patient s in the setting of outpatients department, hospital
wards and emergency
5. Order a set of relevant investigations considering availability,
diagnostic yield, cost-effectiveness, side effects, and implications
for management
6. Comprehend Community Indicators related to individual’s health
7. Aware of and can apply national and international guidelines for
treatment and assessment
8. Counsel patients and relatives in patient’s preferred language in
elective and emergency situations in keeping principles of good
communication skills, empathy and empowerment of patients
9. Exhibit emotional maturity and stability, integrity, ethical values
and professional approach, sense of responsibility in day-to-day
professional activities
10. Take proper informed consent for physical examination and ensure
confidentiality and appropriate environment for intimate physical
examination
11. Act as an independent specialist at community/Tehsil and District
Headquarter Hospital
12. Show initiative and become life long self-directed learners tapping
on resources including clinical material, faculty, internet and on-line
learning programmes and library

3
 SPECIFIC LEARNING OUTCOMES
Following competencies will be expected from a student completing 2
years’ course in DOMS, including clinical, surgical and preventive
practice in eye, student should be able to:

1. Discuss etiology, pathogenesis, epidemiology and management of

disorders in Eye on topics given in the list of course contents
2. Discuss principles of basic sciences as applied to Eye like
haemorrahage, blood transfusion, shock, sterilization of
instruments, infection, antibiotics, inflammation, repair & healing
and malignancy
3. Identify common eye problems in a scientific manner while keeping
in mind the logical reasoning and a clear understanding of their
impact on human mind and body
4. Formulate a working diagnosis and consider relevant differential
diagnosis
5. Decide and implement suitable treatment s considering safety, cost
factors, complications and side effects
6. Practice proper procedures in operating theatres & procedure rooms
including gowning, gloving, use of various sutures, surgical
principles, & use & working of electro medical equipment
7. Assist at major surgery and perform recommended eye related
procedures under supervision
8. Maintain follow-up of patients at appropriate intervals, recognizing
new developments and/or complications and offering sensible
management protocols

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 NOMENCLATURE AND DURATION

NOMENCLATURE OF THE PROPOSED COURSE:

The name of diploma course should be retained as DOMS. This name

has been recognized and established for the last many decades
worldwide. The duration of courses should be two years structured
training in a recognized department under an approved supervisor.

Course Title: DOMS (Diploma in Ophthalmic Medicine and

Surgery)

Training Centres: Eye Depart ments (accredited by UHS) in

affiliated institutes of the University of Health
Sciences Lahore

Course Duration and Scheme of the Course:

Total Duration 2 years structured training (6 months in Part I and

one & a half year in Part II) in a recognized depart ment under the
guidance of an approved supervisor

Part I-SIX MONTHS

Theoretical Component
• Anatomy of Orbit and its application pertaining to diseases
and surgical procedures
• Physiology of eyeball and adnexa and structures as applied to
or affected by disease process
• Pathology (Microbiology, Interpretation of Laboratory Test)
• Ocular Pharmacology
• Principles of General Surgery
• Behavioral Sciences
• Biostatistics and Research

Clinical Component
• Instrumental Skills
1. Slit Lamp Examination
2. Direct Ophthalmology
3. Indirect Examination
4. 90D Examination
5. Gonioscopy
6. Use of Microscope
7. Refraction
8. Exophthalmometry
5
9. Hess Test
10. Keratometery
11. Visual Field
12. Ultrasound

• Clinical Skills
1. Visual Acuity
2. Pupil Reactions
3. Digital Tonometery
4. Ocular Movements
5. Cover Test
6. Colour Vision
7. Lid Eversion
8. Regurgitation
• Regular duties in wards and OPD Routine history taking,
examination and investigations

Part II- YEAR & a HALF

Theoretical Component

• Neuro Ophthalmology
• Medical Ophthalmology
• Differential Diagnosis
• Lids
• Cornea
• Conjunctiva
• Uveal Tract
• Lens
• Glaucoma
• Retinal Disease
• Lachrymal Apparatus
• Occular Motility

Clinical Component
• Surgical Skills
Cataract Extraction
Glaucoma Surgery
• Common Lid Surgery
Ectropion
Entropion
Trichiasis
• Common Conj Surgery
Pterygium
Squint
• Regular duties in ward and OPD
6
 • Routine history taking examination and investigations

Radiological Tests
• X-ray
• CT
• MRI
• Ultra Sound
• A scan
• B scan

7
 ELIGIBILITY CRITERIA FOR ADMISSION

DOCUMENTS REQUIRED FOR THE ADMISSION

1. Completed DOMS application form

2. Copy of MBBS degree with mark sheets of professional
examinations and certificate of number of attempts in the
professional examinations
3. Copy of PMDC registration certificate
4. Three latest passport size photographs
5. Reference letters from two consultants, with whom the applicant
has worked
6. Certificates of completion of required experience

GENERAL REQUIREMENTS

Candidates eligible for admission should have MBBS or equivalent

qualification, registered with PMDC and can fulfill one of the following
criteria:

a. One year experience in Ophthalmology as house officer/medical

officer from a recognized institution
b. Six months experience in Ophthalmology and six months in General
Medicine or Surgery as house officer/house surgeon/medical officer

SPECIAL REQUIREMENTS

A. Obtaining pass percentage in the entry test as determined by

the UHS rules
B. Qualifying the interview successfully
C. Having up to the mark credentials as determined by the UHS
rules (no. of attempts in each professional, any gold medals or
distinctions, relevant work experience, research experience from
a recognized institution, any research article published in a
National or an International Journal)

REGISTRATION AND ENROLLMENT

• The total number of students enrolled for the course must not
exceed 8 per unit
• UHS Lahore will approve supervisors for diploma courses
• Candidates selected for the courses will be registered with relevant
supervisors and enrolled at UHS

8
 RECOGNITION/EQUIVALENCE OF THE DEGREE AND
INSTITUTION
After two years training course, candidate should be given status of
mid-level specialist equivalent to any other similar qualification.

ACCREDITATION RELATED ISSUES OF THE INSTITUTION:

1. Faculty
Properly qualified teaching staff in accordance with the
requirements of Pakistan Medical and Dental Council (PMDC)

2. Adequate Space
Including class-rooms (with audiovisual aids ), computer lab,
examination rooms and relevant instruments and machines for
eye examination for example, Ophthalmoscope direct and indirect,
retinoscope, slit lamp bio-microscope, gonioscope and three
mirror lens, tonometer, Cross cylinder, ultrasound machine,
operation theater, Operating microscope, 90, 78, and 60 D lens,
keratometer

3. Library
Departmental library should have latest editions of recommended
books for DOMS, reference books and latest journals (two National
and one International)

9
 CONTENT OUTLINE

Part I DOMS

ANATOMY
At the end of the course the candidate should be able to discuss gross
anatomy of the orbit and its application pertaining to diseases and
surgical procedures. Following topics are relevant to teach in Anatomy:

1. Applied Embryology of Eye

2. Orbit bones
3. Soft parts
4. Cranial nerves, autonomic nervous system
5. Eye ball + Adenexa
6. Pathways + Cortex
7. Extra ocular muscles
8. Eye ball with its coats
9. Cranial Nerves, 2nd, 3rd, 4th, 5th, 6th, 7th,
10. Autonomic supply of the orbit and its contents
11. Blood supply of the orbit and its contents
12. Lacrimal system
13. Visual pathway and visual cortex

PHYSIOLOGY
The candidate should be able to understand functions of the eye ball
and adnexa and structures as applied to or affected by a disease
process.

1. Transparency of Cornea
2. Aqueous humour dynamics
3. Pupil, its functions and controls
4. Accommodation
5. Functions of retinal pigment epithelial cells – retina and its
physiology
6. Rods and cones, formation of nerve signal and vitamin A
metabolism
7. Lens transparency
8. Functions of extra ocular muscles (ocular motility)
9. Binocular vision

PATHOLOGY
1. General Pathology

Cell Injury and adaptation

Cell Injury
• Reversible and Irreversible Injury
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 • Fatty change, Pigmentation, Pathologic calcification
• Necrosis and Gangrene
Cellular adaptation
• Atrophy, Hypertrophy,
• Hyperplasia, Metaplasia, Aplasia
Inflammation
• Acute inflammation --- Vascular changes, Chemotaxis,
Opsonization and Phagocytosis
• Enlist the cellular components and chemical mediators of
acute inflammation
• Differentiate between exudates and transudate
• Chronic inflammation
• Etiological factors, Granuloma
Cell repair and wound healing
• Regeneration and Repair
• Healing--- steps of wound healing by first and second
intention
• Factors affecting healing
• Enlist the complications of wound healing
Haemodynamic disorders

• Define and classify the terms Edema, Haemorrhage,

Thrombosis, Embolism, Infarction & Hyperaemia
• Define and classify Shock with causes of each.
• Describe the compensatory mechanisms involved in shock
• Describe the pathogenesis and possible consequences of
thrombosis
• Describe the difference between arterial and venous
emboli
Neoplasia
• Dysplasia and Neoplasia
• Differences between benign and malignant neoplasms
• Enlist the common etiological factors for neoplasia
• Define and discuss the different modes of metastasis
• TNM staging system and tumor grade

Immunity and Hypersensitivity

2. Special Pathology
Ocular Tumors

3. Microbiology

• History and introduction to Microbiology

• Microbiology, Physiology, Life Cycle and Classification and
parasites.
• Role of Microbes In Various Human Diseases
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 • Infection source
• A brief account of the classification of microorganisms .
• Morphology: Identification of various shapes of bacteria and
viruses under the microscope.
• Distribution, size, motility, reproduction and functions of bacteria
and viruses.
• Effects of environment upon bacteria and viruses.
• Sterilization and disinfection. Definition, use of physical and
chemical disinfectants.
• Infection and immunity pathogenicty, pathology of infection,
resistance and natural immunity, antigens and antibodies.
• Common Bacterial and viral diseases of man.
• Spores, Yeast and moulds.
• Nosocomial Infections
• Bacterial Growth and Death
• Important Viruses
• Important Parasites
• Sterilization and disinfection
• Immunization
• Use Of Investigation And Procedures In Laboratory

• Interpretation of Laboratory Tests

The student should be able to understand the relevance and

importance of:

- Swab
Collection
Transfer
Plating

- Biopsy
Collection
Transfer

- Gram Staining
TLC
ESR
Hb%

OCULAR PHARMACOLOGY

The student should be able to choose appropriate drug for a given

situation and select the proper route for the best possible delivery

Introduction to ophthalmic pharmacology

Diagnostic
12
Therapeutic
Cycloplegics & mydriatics (mechanism of action, pharmacodynamics,
pharmacokinetics )
Uses of cycloplegics & mydriatics, Adverse effects.
Antibiotics (Types, Uses, Adverse reactions and Side Effects)
Antiviral
Anti-fungals
Anti-glaucoma drugs
Adverse Reactions of other Ophthalmic Drugs
Anti-histamines
Topical anesthetics
Steroids
Anti-inflammatory drugs
Non-steroidal anti inflammatory drugs
Lubricants
Diagnostic Stains: Fluorescein, Rose Bengal

Principles of General Surgery

Behavioural Sciences

a. Bio-Psycho-Social (BPS) Model of Health Care

b.jUse of Non-medicinal Interventions in Clinical
Practice

• Communication Skills
• Counselling
• Informational Skills

c. Crisis Intervention/Disaster Management

d. Conflict Resolution
e. Breaking Bad News
f. Medical Ethics, Professionalism and Doctor-Patient
Relationship
• Hippocratic Oath
• Four Pillars of Medical Ethics (Autonomy,
Beneficence, Non-malficence and Justice)
• Informed Consent and Confidentiality
• Ethical Dilemmas in a Doctor’s Life

g. Delivery of Culturally Relevant Care and Cultural

Sensitivity
h. Psychological Aspects of Health and Disease
• Psychological Aspect of Health
• Psychological Aspect of Disease
• Stress and its Management
• Psychological Aspect of Pain
13
 • Psychological Aspect of Aging

Biostatistics and Research

a. Introduction to Bio-Statistics
b. Introduction to Bio- Medical Research
c. Why research is important?
d. What research to do?
• Selecting a Field for Research
• Drivers for Health Research
• Participation in National and International Research
• Participation in Pharmaceutical Company Research
• Where do research ideas come from
• Criteria for a good research topic

e. Ethics in Health Research

f. Writing a Scientific Paper
g. Making a Scientific Presentation
h. Searching the Literature

Part II DOMS

Neuro Ophthalmology
Disc Oedema
Optic Neuritis
Intra-cranial pathology affecting
• Eyes
• Vision
• Visual Field

Paralytic squint

Medical Ophthalmology
Autoimmume disease and eyes
Intraocular tumours
Endocranial Disease

Lids
Entropia/Ectropia
Blephritis
Tumours
- Benign
- Malignant
Ptosis

14
Cornea
Keratitis
Bacterial
Viral
Chlamydial
Fungal
Corneal Opacities
Corneal degeneration and dystrophia
Keratoconus

Conjuntiva
Inflammation
Pterygium
Tumours
- Benign
- Malignant
Symblepharon
Dry Eye

Uveal Tract
Uveitis
- Type
- Complication
- Treatment
Coloboma

Lens
- Types of Cataract
- Syndromes
- Surgery
Glaucoma
Types of Glaucoma
Treatment
- Medical
Betablockers
Prostaglandins
Others
- Surgical

Retinal Disease
Diabetic retinopathy
Retinal detachment
Central retinal vein occlusion and artery occlusion
Vitreous haemorrahage

15
Lachrymal Apparatus
Lachrymal passages obstruction and management at different ages
Dry eye

Occular Motility
Squint
- Paralytic
- Myaesthenia Gravis
Differential Diagnosis
Students should know major groups of differential diagnosis

Low Vision
- Painless gradual
- Painless sudden
- Painful sudden
- Painful gradual

Red Eye
Painful blind eye
Diplopia
Proptosis
Cause of peripheral constriction of visual field
Congenital and developmental diseases of the crystalline lens
Epiphora/watery eye
Corneal deposits/opacities
White pupil
Dry eye
Ocular surface disease
Papillae
Follicles

Physical Optics
Light
Lasers
Reflection
Laws
Plain surface
Lenses and their formy best
Curved Surface
Total internal reflection
Principals of refraction

Prisms
Clinical Optics
• IOLs
• Optics
• Calculation
16
• Principles of Refraction
• Retinoscopy
• Objective
• Subjective
• Cross cylinder
• Duochrome test
• Transposition of lenses
• Low vision aids
• Optics and ray diagrams of Instruments

17
METHODS OF INSTRUCTION/COURSE CONDUCTION
As a policy, active participation of students at all levels will be
encouraged.
Following teaching modalities will be employed:

1. Lectures
2. Seminar Presentation and Journal Club Presentations
3. Group Discussions
4. Grand Rounds
5. Clinico-pathological conferences
6. SEQ as assignments on the content area
7. Self study, assignments and use of internet
8. Bedside teaching rounds in ward
9. OPD & Follow-up clinics
10. Operation/assistance/supervised surgery
11. Long and short case presentations
12. Clinical skills training workshops

In addition to the conventional teaching methodologies following

interactive strategies will also be introduced to improve both
communication and clinical skills in the upcoming consultants:

1.1. Monthly Student Meetings

Each affiliated medical college approved to conduct training for DOMS

will provide a room for student meetings/discussions such as

a. Journal Club Meeting

b. Core Curriculum Meetings
c. Skill Development
d. Interactive Sessions

a. Journal Club Meeting

Two hours per month should be allocated to the presentation and

discussion of a recent Journal article related to Eye Diseases. The
article should be critically evaluated and its applicable results should
be highlighted, which can be incorporated in clinical practice. Record of
all such articles should be maintained in the relevant department of
each medical college. Students of different medical colleges may be
given an opportunity to share all such interesting articles with each
other.
18
 b. Core Curriculum Meetings

All the core topics of DOMS should be thoroughly discussed during

these sessions. The duration of each session should be at least two
hours once a month. It should be chaired by the Chief Student (elected
by the students of the relevant diploma). Each student should be given
an opportunity to brainstorm all topics included in the course and to
generate new ideas regarding the improvement of the course
structure.

c. Skill Development

Two hours twice a month should be assigned for learning and

practicing clinical skills.

List of skills to be learnt during these sessions is as follows:

1. Communication skills
2. Physical examination related to the Eye
3. Practical skills i.e, use of relevant clinical instruments
4. Presentation skills: Power point, lectures, small group
discussions, article presentation etc.
5. Research and scientific writing
6. Management of eye related emergencies in Primary Care
7. For acquisition of instrumental skills like slit lamp examination,
direct ophthalmoscopy, indirect examination, 90D examination,
gonioscopy, use of microscope, refraction, exophthalmometery,
Hess Test, keratometry, visual field, ultrasound etc.,
opportunities during ward postings should be availed

1.2 Annual Grand Meeting

Once a year all students enrolled for DOMS should be invited to the
annual meeting at UHS Lahore.
One full day will be allocated to this event. All the chief students will
present their annual reports. Issues and concerns related to their
relevant diploma courses will be discussed. Feedback may be collected
and also suggestions can be sought in order to involve students in
decision making. The research work and their literary work may also
be displayed.
In the evening an informal gettogether and dinner should be arranged.
This will help in creating a sense of belonging and ownership among
students and the faculty.

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 LOG BOOK
The trainees must maintain a log book and get it signed regularly by
the supervisor. A complete and duly certified log book should be part
of the requirement to sit for the DOMS examination. Log book should
include adequate number of diagnostic and therapeutic procedures,
routine and emergency management of patients, case presentations in
CPCs, journal club meetings and literature review.

Proposed Format of Log Book is as follows:

Candidate’s Name: _________________________________

Roll No. _____________

PROCEDURES:

1. Cataract Surgery
2. Glaucoma Surgery
3. Common Lid Surgery
Ectropion
Entropion
Trichiasis
4. Common Conj. Surgery
Pterygium
Squint

Procedures Performed

Sr.# Name of Patient, Diagnosis Procedure Supervisor’s

Date Age, Sex & Performed Signature
Admission No.
1
2

Emergencies Handled

Sr. Name of Patient, Procedure Supervis

# Date Age, Sex & Diagnosis /Manage or’s
Admission No. ment Signatur
e
1
2

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Case Presented

Sr.# Date Name of Patient, Case Presented Supervisor’s

Age, Sex & Signature
Admission No.
1
2

Seminar/Journal Club Presentation

Sr.# Date Topic Supervisor’s

signature
1
2

Evaluation Record
(Excellent, Good, Adequate, Inadequate, Poor)

Method of Evaluation
Sr.# Date (Oral, Practical, Theory) Rating Supervisor’s
Signature
1
2

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 LITERATURE REVIEW
Students will be assigned a clinical problem; commonly encountered in
the relevant specialty and will be specifically trained to review
literature in the pertinent field and write a ‘Review of an Article’
comprising of:

• Topic
• Introduction
• Discussion of the reviewed literature
• Conclusion
• References

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 EXAMINATIONS

Assessment

It will consist of action and professional growth oriented student-

centered integrated assessment with an additional component of
informal internal assessment, formative assessment and
measurement-based summative assessment.

Student-Centered Integrated Assessment

It views students as decision-makers in need of information about

their own performance. Integrated Assessment is meant to gi ve
students responsibility for deciding what to evaluate, as well as how to
evaluate it, encourages students to ‘own’ the evaluation and to use it
as a basis for self-improvement. Therefore, it tends to be growth-
oriented, student-controlled, collaborative, dynamic, contextualized,
informal, flexible and action-oriented.

In the proposed curriculum, it will be based on:

• Self Assessment by the student

• Peer Assessment
• Informal Internal Assessment by the Faculty

Self Assessment by the Student

Each student will be provided with a pre-designed self-assessment

form to evaluate his/her level of comfort and competency in dealing
with different relevant clinical situations. It will be the responsibility of
the student to correctly identify his/her areas of weakness and to take
appropriate measures to address those weaknesses.

Peer Assessment

The students will also be expected to evaluate their peers after the
monthly small group meeting. These should be followed by a
constructive feedback according to the prescribed guidelines and
should be non-judgmental in nature. This will enable students to
become good mentors in future.

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Informal Internal Assessment by the Faculty

There will be no formal allocation of marks for the component of

Internal Assessment so that students are willing to confront their
weaknesses rather than hiding them from their instructors.

It will include:

a. Punctuality
b. Ward work
c. Monthly assessment (written tests to indicate particular
areas of weaknesses)
d. Participation in interactive sessions

Formative Assessment

Will help to improve the existing instructional methods and the

curriculum in use

Feedback to the faculty by the students:

After every three months students will be providing a written feedback

regarding their course components and teaching methods. This will
help to identify strengths and weaknesses of the relevant course,
faculty members and to ascertain areas for further improvement.

Summative Assessment

It will be carried out at the end of the programme to empirically

evaluate cognitive, psychomotor and affective domains in order to
award diplomas for successful completion of courses.

Eligibility to Appear in Final Examination

- Only those candidates will be eligible to take final examination,

who have passed Part 1 examination (after 6 months of
education) and have completed two years of
structured/supervised training programme.
- Students who have completed their log books and hold
certificates of 75% attendance may be allowed to sit for the
exam
- The application for the final examination will be forwarded with
recommendation of the supervisor
- Only those candidates who qualify in theory will be called for
clinical examination

24
DOMS Examination

Part I DOMS

Topics included in paper 1

1. Anatomy of Orbit and its application pertaining to diseases and

surgical procedures (15 MCQ)
2. Physiology of eyeball and adnexa and structures as applied to or
affected by disease process (15 MCQ)
3. Pathology (20 MCQ)
General/Special Pathology (10 MCQ)
Microbiology, Interpretation of Laboratory Test (10 MCQ)
4. Ocular Pharmacology (15 MCQ)
5. Principles of General Surgery (20 MCQ)
6. Behavioural Sciences (10 MCQ)
7. Biostatistics and Research Methods (05 MCQ)

Components of the Part 1 examination

MCQ Paper 100 One Best Type

Total Marks 100 Marks

Part II DOMS

Topics included in paper I

1. Neuro Ophthalmology
2. Medical Ophthalmology

Topics included in paper II

1. Differential Diagnosis
2. Cornea
3. Lids
4. Conjunctiva
5. Lens
6. Glaucoma
7. Uveal Tract
8. Retinal Disease
9. Lachrymal Apparatus
10. Occular Motility
Part II Examination

Theory
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Paper I 100 Marks 3 Hours
10 SEQs (No Choice) 50 Marks
50 MCQs 50 Marks

Paper II 100 Marks 3 Hours

10 SEQs (No Choice) 50 Marks
50 MCQs 50 Marks

The candidates who pass in theory papers, will be eligible to appear in

the clinical & viva voce.

OSCE 90 Marks

10 stations each carrying 9 marks of 10 minutes duration; each

evaluating performance based assessment with five of them
interactive

Clinical 90 Marks

Four short cases each carrying 15 marks and one long case of 30
marks.

Components of the Part 2 examination

Theory paper 1 100 marks

Theory paper 2 100 marks

Clinical/Oral 180 marks

Internal Assessment/Log Book 20 marks

Total Marks 400

A panel of four examiners from affiliated Eye departments (Two

internal and two external) will be appointed for practical examination.

Each component of practical examination will be assessed by two

examiners awarding marks simultaneously and independently. The
final score awarded will be an average score, as agreed by both
examiners.

Pass Percentage and Other Regulations Regarding Examination

• Criterion referenced assessment principles will be used

26
• 20 marks for the log book will be included in the OSCE
component
• 60% marks will be a pass score in each component
• Candidates failing in any one component will have to re-sit the
entire examination
• A maximum of 5 attempts to sit for the examination will be
allowed, to be availed within 3 calendar years of the first
attempt
• Re-admission in DOMS course is not permissible under any
circumstances
• The results will be announced according to rules and regulations
set by the Examination Branch of University of Health Sciences
Lahore

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 RECOMMENDED BOOKS

Anatomy

1. Snell R. S., Lemp M. A. Clinical Anatomy of Eye.

2. Wolf’s Anatomy of the Eye
3. Newell F. W. Ophthalmology Principles and Concepts.

Optics and Refraction

1. Elkington A. R., Frank H. J., Greaney M. J. Clinical Optics.

2. Duke-Elder. Practice of Refraction.

Physiology
1. Guyton. Textbook of Medical Physiology.
2. Newell F. Ophthalmology Principles and Concepts.
3. Adler’s Physiology of the Eye. (For reference)

Pathology

1. Apple D. J., Rabb M. F.Ocular Pathology.

2. Gree. Ocular Pathology.

Kanski J. J. Clinical Ophthalmology.

Ophthalmic Surgery

Newill F. W. Ophthalmology Principles and Concepts

Ophthalmic Surgery

Willshaw H. Practical Ophthalmic Surgery.

Bailey and Love. Short Practice of Surgery.

Rana M. H., Ali S. Mustafa M. A Handbook of Behavioural

Sciences for Medical and Dental Students. Lahore: University of
Health Science; 2007.
Fathalla M. F. and Fathalla M. M. F. A Practical Guide for Health
Researcher. Cairo: World Health Organization;
2004.
Journals
1. Archives of Ophthalmology (AMA USA)
2. British Journal Of Ophthalmology (UK)
3. Journal Of Oculoplastics and Reconstructive Surgery (USA)
4. Retina (USA)
5. Eye RC Ophth (UK)

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