Cyber-Sight www.cybersight.org Cyber-Sight is a web-based telemedicine initiative of ORBIS International aimed at establishing extended presence of our volunteer faculty with partners worldwide, fighting blindness through online clinical support and education. Cyber-Sight has three distinctive program components: E-Resources is an electronic “library” of educational material available free and geared to any ophthalmologist or eye healthcare provider worldwide. E-Consultation links partners with expert mentors for the purpose of patient consultation with emphasis on teaching partners in the most effective methods of diagnosis and management. E-Learning allows enrolled eye healthcare professionals to have access to online course material covering basic and advanced concepts in ophthalmology and related eye care topics. Those who successfully complete the course material can earn an electronic certificate, including Continuing Medical Education (CME) credit.
Cyber-Sight Homepage
E-Resources Anyone interested in learning about eye health care can access materials online. Full-text books including: Strabismus: A Decision Making Approach By: Eugene Helveston, MD and Gunter K. von Noorden
Stereo Atlas of Fluoroscein and Indocyanine Green Angiography By: Rosalind A. Stephens, MD
Neuro-ophthalmology: Clinical Signs and Symptoms By: Thomas J. Walsh, MD
The Retinoscopy Book By: John M. Corboy, MD
Cyber-Sight Manuals: Assessing and Treating Glaucoma in Children of the Developing World
Vision and Refraction Manual
Manual Small Incision Cataract Surgery
Cataracts in Childhood
Video Library: 55 surgical videos demonstrating many common ophthalmic procedures are available online and are organized by ophthalmic sub-specialty.
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http://telemedicine.orbis.org//bins/volume_page.asp?cid=1-178...
E-Resources Question of the Week
Every Tuesday an interactive question relating to ophthalmology is posted. Choose your best answer and come back the following week to find out the correct answer, complete with an > E-Resources Home > QUESTION OF THE WEEK Home > 2011 Series Home > February 15, 2011 explanation from the author. Hundreds of archived questions are also available to look at Print this Page ch this site online. | General Information | E-Resources | E-Consultation | E-Learning | Site Map | ORBIS | Feedback
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2011 Series -
Lecture 10 of 16 NEXT»
February 15, 2011
To see views enlarged, click on the individual pictures...
STION OF THE WEEK
O LIBRARY
THALMOLOGY BOOKS & UALS
ing Education
cal Challenges
This four-year-old boy presents as shown in the picture. In a preliminary work up done at the time of this visit his unaided visual acuity was found to be OD 20/20 and OS 20/100.
Ophthalmology Minute
Eye Care Equipment te
uently Asked Questions
1.
This patient has:
ONLINE JOURNALS
a.
amblyopia
THALMOLOGY LINKS
b.
encapsulated hemangioma
c.
astigmatism
d.
anisometropia
e.
all of the above
ve a Question
2.
3.
The refraction would most likely be: a.
OD +0.50 sph, OS +0.50 sph
b.
OD -1.00 sph, OS +1.00
c.
OD plano, OS plano +1.50 X 135
d.
OD plano, OS -0.75 +2.00 X 45
e.
none of the above
This boy should initially be treated with the following: a.
refractive surgery
b.
glasses to correct a refractive error
c.
nothing now
d.
orthoptic exercises
e.
atropine to the left eye
For answers to the above, click here on or after February 22, 2011.
4/21/11 2:39 PM
E-Learning E-Learning consists of structured course material prepared by expert health care professionals providing eye care information that is most relevant to clinical practice.
How to sign up? Eye health care providers can enroll in E-Learning using the online form to create a personal login. Simply go to www.cyber-sight.org and click on E-Learning. Click Fill out form using online wizard
Once a student has a username and password, he or she can sign in and enroll in courses. Alternatively, students can email
[email protected] to have courses pre-loaded to their account to save time. Upon completing all of the courses in a certificate, students will receive an electronic certificate of completion from ORBIS International.
E-Learning Pediatric Ophthalmology Course Catalog*
PO-01.00: Overview of Pediatric Ophthalmology This first course in pediatric ophthalmology begins with a lecture describing the unique clinical challenges presented by the pediatric patient, especially as encountered in the developing world. The next three courses contain information from the manual “Planning Eye Care for Children”.
PO-02.00 Children’s Eye Health in the Developing World This certificate contains two lectures which cover an overview of childhood blindness in developing countries and also an overview of many common eye diseases. In addition, material is presented from the manual “Planning Eye Care for Children”.
PO-03.00 Anatomy and Physiology of the Developing Eye First, a course describes unique features of the developing anatomy and function of the eye. The second course describes delayed visual maturation, which confronts the ophthalmologist when parents present a child who appears to have poor vision when an infant should be demonstrating visual awareness.
PO-04.00 Eye Examination Techniques for the Infant and Child The first course describes a variety of techniques used for examination of the child's eyes. It emphasizes instruments and procedures that are readily available in most clinics. The second course describes more advance techniques for examining a child's eyes, which include electrodiagnosis, ultrasound, and imaging.
PO-05.00 Eye Health Screening, Refraction, and Correction This certificate, which is comprised of seven courses, covers refraction including techniques for vision and eye health screening vision loss in the world from uncorrected refractive error, basic principles of retinoscopy, other useful tips for refraction and dispensing, and more.
PO-06.00 Genetics and Hereditary Diseases Material in the first course provides an overview of genetics as it relates to ophthalmology, and the second course provides an overview of metabolic diseases. A third course presents clinical questions relating to both genetics and metabolic diseases.
PO-07.00 Cataracts in Childhood This certificate contains three lectures which cover the evaluation and management of childhood cataracts, a step-bystep guide to pediatric cataract surgery, and also technical aspects of pediatric cataract surgery.
PO-08.00 Glaucoma in Children This certificate begins with three PowerPoint lectures titled: pediatric glaucoma, surgical management of childhood glaucomas, and pediatric glaucoma and endoscopic cyclophotoablation. The next three courses contain text from the ORBIS manual describing childhood glaucoma as encountered in the developing world.
PO-09.00 Pediatric Infectious Disease This certificate contains courses which explore conjunctivitis, herpes infections, ophthalmic neonatorum, as well as an overview of many common ocular infections in children.
PO-10.00 Cornea Diseases in Children The first course, covering anterior segment and corneal diseases in children, is aimed at providing a place for students to start developing an understanding for the complex and always challenging list of conditions included in cornea diseases. The next courses cover anterior segment developmental disorders, ocular surface disease, congenital corneal opacification, and pediatric transplantation and ocular surface reconstruction.
PO-11.00 Nasolacrimal System The material in the first course is presented as a PowerPoint lecture presenting an overview of the nasolacrimal system in infancy and childhood. The second course is presented in a question-and-answer format listing the most likely issues that will be faced in the clinic.
PO-12.00 Retinoblastoma This certificate describes the clinical characteristics, diagnosis, treatment, and outcome of the most common malignant neoplasm seen in the child’s eye.
PO-13.00 Retinopathy of Prematurity
This certificate contains nine courses, which describe the diagnosis and classification of ROP, screening, treatment, ROP outcomes, advanced ROP, and more.
PO-14.00 Pediatric Retina Retinal diseases and optic disc anomalies in children are covered in the first two courses, which are presented as lectures. Then, a clinical questions course is presented from the “Question of the Week (QOW)”.
PO-15.00 Periocular Disease This first course contains a lecture which provides an overview and is intended to give the ophthalmologist a start in the process of recognizing, diagnosing, and dealing with tumors and other lesions or diseases in the periocular region. The second course contains several clinical questions from the “Question of the Week”.
PO-16.00 Phakomatosis / Hemangioma This certificate begins with lectures providing an overview of phakomatoses and capillary hemangioma. The lectures that follow provide an overview of the treatment options for capillary hemangioma including surgical treatments. The last course presents clinical questions covering hemangioma that are taken from the Question of the Week.
PO-17.00 Ptosis in Childhood Ptosis in childhood is presented in three lectures covering the important issues unique to ptosis in childhood, the work-up and clinical evaluation, and treatment of a child with ptosis. Also included are several clinical questions.
PO-18.00 Childhood Eye Trauma A wide variety of ocular trauma can present in children; this certificate aims to provide an overview of trauma through a lecture and clinical questions from the “Question of the Week” feature in E-Resources.
PO-19.00 Childhood Uveitis This certificate describes new perspectives on childhood uveitis, which accounts for over 25% of blindness in developing countries.
PO-20.00 The Blind Child—Low Vision In spite of all of our efforts, some children become blind. These courses describe strategies for helping those children meet the challenges of life.
PO-21.00 Anesthesia for Children’s Surgery This certificate contains a lecture that describes the conduct of anesthesia provided for a child in an ideal environment and stresses basic considerations unique to pediatrics including: anatomy, physiology, and reaction to the process.
* Course material contains approximately 3,000 computer screens.
Strabismus Course Catalog* ST-01.00: Anatomy of the Extraocular Muscles This course contains one lecture with an overview of anatomy. The lecture is supplemented with five lessons of book material**. Lastly, a lesson titled “Clinical Pearls” contains sections from “The Strabismus Minute”.
ST-02.00: Motor Physiology of the Extraocular Muscles The first course is a lecture on motor physiology from a clinical standpoint. Next, four book material** courses describe how the extraocular muscles work, how to test for weakness and restriction, and review the unique physiology of the extraocular muscles. Lastly, clinical pearls are presented from “The Strabismus Minute”.
ST-03.00 Sensory Physiology A lecture begins this certificate on sensory physiology. Next, several examples of sensory evaluation and sensory behavior of the eyes are discussed from material Surgical Management of Strabismus and from "The Strabismus Minute". Lastly, experts in Binocular Vision and Ocular Motility offer a comprehensive presentation of sensory physiology.
ST-04.00 Approaching the Patient with Strabismus The first lecture describes how to deal with the strabismus patient in the clinical setting. The next four lessons come from expert text**, including an algorithmic scheme for diagnosis of strabismus. Lastly, clinical pearls are presented.
ST-05.00 Amblyopia Three lectures start off this certificate, describing the impact of amblyopia and the treatment of all forms of amblyopia including occlusion and penalization. An additional lesson contains book material**. Lastly, clinical pearls are presented.
ST-06.00 Congenital Esotropia An overview of congenital esotropia is presented first in a lecture. Next, essential infantile esotropia and congenital esotropia are taught using book material. Then, the diagnosis and treatment of congenital esotropia is described in an algorithmic approach. Lastly, cases of patients with congenital esotropia are presented followed by analysis of experts.
ST-07.00 Accomodative Esotropia Accommodative esotropia is discussed first in a lecture. The next three courses consist of book material**. Lastly, a collection of important things to is presented as “Clinical Pearls”. These are offered from "The Strabismus Minute".
ST-08.00 Exodeviations The certificate contains a total of ten courses. The first lecture provides an overview of the spectrum of exodeviations, and the second provides an overview of intermittent exotropia as it occurs in the Asian population. The next three courses are comprised of book material**. The last four courses contain “Clinical Pearls”, “FAQs”, and clinical cases from the QOW.
ST-09.00 ‘A’ and ‘V’ Pattern The first two courses are lectures—one provides an overview of ‘A’ and ‘V’ pattern strabismus, and the other describes the anatomical and physiologic significance of the extraocular muscle pulleys. The next three courses are comprised of book material**. Important things to remember about ‘A’ and ‘V’ pattern strabismus are presented as “Clinical Pearls” in the sixth course. The last two courses have answers to clinical cases of patients with ‘A’ and ‘V’ pattern strabismus.
ST-10.00 Third Nerve Palsy A lecture over viewing the diagnosis and treatment of third nerve palsy is presented in the first course. Next, a further description of the diagnosis and treatment of cranial nerve three paralysis is provided in book material**. Then, in the third course, several patients with third nerve palsy are discussed in detail.
ST-11.00 Superior Oblique To begin the certificate, the student will study two lectures: one provides a comprehensive review of diagnosis and treatment, and the second takes a closer look at the anatomic structure that plays a role in strabismus. The next three courses contain book material**. The sixth course contains “Clinical Pearls”. Lastly, cases are presented from the “QOW". ** Book material is taken from the following sources: Surgical Management of Strabismus, Binocular Vision and Ocular Motility, and Strabismus: A Decision Making Approach.
ST-12.00 Sixth Nerve Palsy This certificate contains six courses including the certificate test. The first is presented in a lecture and provides an overview of the diagnosis and treatment of sixth nerve palsy. The next three courses contain book material**. Lastly, several patients with sixth nerve palsy are presented from the Cyber-Sight "Question of the Week".
ST-13.00 Duane Syndrome The certificate begins with two lectures, the first describes Duane syndrome using E-Consultation material, and the second covers diagnostic and treatment strategies. Next are three courses of book material**. Next, several patients are presented from the Cyber-Sight “QOW”. Lastly, a course provides “the Expert’s Opinion” on several cases of Duane Syndrome.
ST-14.00 Brown Syndrome The first course is a lecture describing Brown Syndrome. The next three courses contain book material**. Lastly, several cases of Brown syndrome are presented using cases from the Cyber-Sight “Question of the Week”.
ST-15.00 Dissociated Strabismus Beginning this certificate is a course which describes dissociated strabismus by presenting a variety of patients with dissociated vertical and horizontal deviations. The next three courses contain book material**. The fifth course contains a short lecture from “The Strabismus Minute”. Lastly, four cases are presented from the QOW.
ST-16.00 Nystagmus Nystagmus begins with two lectures, one providing an overview of nystagmus, and the other covering surgical treatment of nystagmus. The next two courses contain book material**. Lastly, brief descriptions of nystagmus and clinical pearls are presented in three short lectures found in “The Strabismus Minute”.
ST-17.00 Special Forms of Strabismus First is a lecture explaining strabismus occurring from a variety of causes, along with a scheme for evaluation and some suggestions for treatment of these patients. Next, thyroid eye disease is explained as it relates to strabismus, and finally, the diagnosis and treatment of post-traumatic strabismus is explored. The last three courses contain book material**.
ST-18.00 Principles of Surgery, Part 1 The first lecture describes the principles of surgical management of strabismus, covering the importance of an adequate work up, anesthesia, and techniques for the conjunctival incision and placement of sutures. The next two lectures discuss the surgical steps in recessing and resecting a rectus muscle. The last two courses contain important book material**.
ST-19.00 Principles of Surgery, Part II The first two lectures discuss surgery of the superior oblique and the extraocular muscles. Next, book text** is presented. Lastly, details to know about surgery on the oblique muscles and adjustable sutures are presented as “Clinical Pearls”.
ST-20.00 Complications of Surgery The first course is a lecture providing an overview of the complications of surgery. Next, a further description of complications is discussed in book material from Surgical Management of Strabismus.
ST-21.00 Nonsurgical Treatment of Strabismus The first two courses in this certificate are presented as lectures and provide an overview on nonsurgical treatments of strabismus. Next, the principles of non-surgical treatment of strabismus surgery is discussed in book material**.
ST-22.00 Psycho-Social Aspect of Strabismus This short certificate contains just one course, but it is in a long overlooked aspect of strabismus and includes the psychological and social implications of misalignment of the eyes.
* Course material contains approximately 3,000 computer screens
E-Consultation This program connects volunteer faculty with partner doctors who seek personalized guidance with difficult cases. E-Consultation is like practicing ophthalmology with experts at your side. How to sign up? Ophthalmologists in countries where ORBIS works can apply for assistance with patient cases. Apply by sending the application form (available from link on home page) to:
[email protected]. How E-Consultation Works: Partner doctors are assigned to a team of experts representing the subspecialty areas of ophthalmology. Once a partner doctor is accepted and has been given a username and password, he or she can log in to E-Consultation and send patient cases for consultation and discussion. Patient information, including clinical photos and questions, are uploaded through the secure website and the case is sent to the expert mentor assigned to the subspecialty area that the partner has selected. The ORBIS Volunteer Faculty mentor responds and a dialogue is established, often resulting in multiple back and forth communications regarding diagnosis and case management. “Becoming an ORBIS partner involves far more than simply consulting on a case with a mentor. It means helping the patient and creating an opportunity for the physician in charge of the patient to share that experience in treating countless thousands of needlessly blind fellow citizens.” – Dr. Addisu Worku, Ethiopia
The Essence of ORBIS Telemedicine
1.) The process is initiated by the partner.
2.) The case is studied and a reply is sent by the mentor.
