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CLINICAL OPTOMETRY

Optometry Clinical Training Suite

13 modules · 52 items · ~325 min · v1.0.0

OD year 3–4 students, recent graduates, international optometry program enrollees

COMPETENCY FRAMEWORK ALIGNMENT
ACOE / NBEO
Mapped to NBEO content domains and ACOE program standards
Accreditation Council on Optometric Education (ACOE)
Clinical Optics & Refraction
Binocular Vision & Pediatrics
Anterior Segment Disease
Posterior Segment Disease
Ocular Pharmacology & Therapeutics
Contact Lens Practice
Glaucoma & Neuro-optometry
Clinical Synthesis & Patient Management
ASSESSMENT METHOD Fixed-form assessment; located-facts reporting; version-frozen for future calibration study. Adaptive item selection is roadmapped pending pilot data.
Start Module 1 → ~20 min
Module 14 items
NEXT

Refractive Error & Optical Correction

Physics-accurate simulation of the human eye as an optical system. Adjust refractive error parameters (sphere, cylinder, axis) and corrective lens powers to visualize retinal image quality with real-time blur rendering. Covers vertex distance effectivity, transposition, and spectacle vs. contact lens equivalence.

Clinical Optics & Refraction
Interpret sphere, cylinder, and axis notation in standard optometric formCalculate vertex distance effectivity for high-power prescriptionsPredict uncorrected visual acuity from refractive error magnitudeCompare spectacle and contact lens correction for the same eye
~20 min
Module 24 items

Retinoscopy & Objective Refraction

Simulated retinoscope with realistic reflex dynamics. Sweep the beam across the pupil, observe with/against/neutral motion in each principal meridian, select neutralizing lenses from a virtual trial lens set, and compensate for working distance. Covers streak and spot retinoscopy techniques across 10 clinical cases including high myopia, astigmatism, and media opacities.

Clinical Optics & Refraction
Identify with-motion, against-motion, and neutral reflex in each meridianSelect neutralizing lenses and apply working distance compensationDetermine objective refraction in eyes with irregular corneasRecognize retinoscopy artifacts from media opacities and poor fixation
~25 min
Module 34 items

Subjective Refraction

The complete "best vision sphere → duochrome → JCC cylinder → axis → binocular balance" protocol. Refine sphere power using the duochrome (red-green) test, determine cylinder power and axis with Jackson cross-cylinder, and verify binocular balance with prism dissociation and polarized targets. Includes 8 cases from simple myopia to compound hyperopic astigmatism.

Clinical Optics & Refraction
Perform duochrome (red-green) sphere refinement to maximum plus acceptanceApply Jackson cross-cylinder to refine cylinder power and axis independentlyExecute binocular balance to equalize accommodative demandIdentify over-minused and under-plussed end-points in challenging cases
~30 min
Module 44 items

Binocular Vision & Vergence Assessment

Full binocular vision evaluation including cover/uncover test, alternate cover test with prism neutralization, near point of convergence measurement, stereopsis testing (Randot/TNO), and ±2.00D accommodative facility. Eight clinical cases span intermittent exotropia, convergence insufficiency, accommodative esotropia, and superior oblique palsy.

Binocular Vision & Pediatrics
Perform cover/uncover and alternate cover tests with prism neutralizationDistinguish tropias from phorias and classify strabismus type and magnitudeMeasure near point of convergence and identify convergence insufficiencyAssess stereopsis and accommodative facility in appropriate clinical context
~20 min
Module 54 items

Slit Lamp & Anterior Segment Examination

Adjustable slit lamp simulator with all beam configurations: diffuse illumination, direct focal, indirect, specular reflection, and sclerotic scatter. Identify anterior segment findings across cornea, anterior chamber, iris, and crystalline lens in 12 pre-loaded clinical cases including corneal ulcer, acute angle closure, cataract grading, and traumatic hyphema.

Anterior Segment Disease
Configure slit lamp beam width, angle, height, and magnification appropriatelyGrade corneal pathology using standardized scales (Oxford, NEI)Assess anterior chamber depth and grade the Van Herick angleClassify lens opacities by type, density, and location (LOCS III)
~25 min
Module 64 items

Fundoscopy & Posterior Segment Evaluation

Direct and indirect ophthalmoscopy simulation with SVG-rendered, clinically accurate fundus views. Examine optic disc, macula, and retinal vasculature across 12 clinical cases: NPDR, PPDR, PDR, glaucomatous cupping, AMD (dry and wet), retinal detachment, CRVO, BRVO, hypertensive retinopathy, and normal fundus variants.

Posterior Segment DiseaseGlaucoma & Neuro-optometry
Identify normal fundus anatomy and common anatomic variantsRecognize and grade glaucomatous optic disc changes (C/D ratio, NRR thinning, RNFL defects)Stage diabetic retinopathy severity per ETDRS classificationDetect retinal detachment, macular pathology, and vascular occlusive disease
~30 min
Module 74 items

Advanced Anterior Segment Pathology

Extended slit lamp examination covering 8 advanced pathological entities: keratoconus (Munson's sign, Vogt's striae, Fleischer ring), Fuchs' endothelial dystrophy, dry eye disease (TBUT, staining patterns), gonioscopy for angle assessment, iris melanoma, anterior uveitis (flare, cells, KPs), band keratopathy, and map-dot-fingerprint dystrophy.

Anterior Segment Disease
Identify keratoconus biomicroscopic signs and differentiate from pellucid marginal degenerationPerform and interpret Van Herick angle estimation and gonioscopic findingsGrade tear film break-up time and conjunctival/corneal staining patternsRecognize sight-threatening anterior segment pathology requiring urgent referral
~25 min
Module 84 items

Contact Lens Fitting & Evaluation

Fluorescein pattern interpretation for soft spherical, toric, multifocal, and rigid gas-permeable lenses. Identify flat, steep, and optimal fits and modify parameters (base curve, diameter, power) to achieve the target fit. Includes LARS rule for toric misalignment, RGP troubleshooting, and extended wear complication identification across 8 fitting cases.

Contact Lens Practice
Interpret fluorescein patterns to classify lens fit quality (flat/steep/optimal)Apply the LARS rule to correct toric soft lens misalignmentModify RGP base curve and diameter based on fluorescein pattern findingsIdentify extended wear complications including microcystic edema and GPC
~20 min
Module 94 items

Pediatric Vision Assessment

Age-stratified vision assessment techniques: Teller acuity cards (preferential looking) for pre-verbal infants, Bruckner test and red reflex screening, cover test for accommodative esotropia detection, cycloplegic refraction interpretation, and formal amblyopia risk screening. Eight cases span ages 6 months to 8 years.

Binocular Vision & Pediatrics
Apply preferential looking (Teller cards/Lea gratings) for pre-verbal visual acuityInterpret Bruckner reflex asymmetry as a screening tool for strabismus and anisometropiaIdentify significant refractive error thresholds for amblyopia risk (AAO pediatric guidelines)Differentiate accommodative from non-accommodative esotropia and determine management pathway
~25 min
Module 104 items

Ocular Pharmacology & Therapeutics

Clinical scenario-based drug selection covering all major therapeutic categories: mydriatics, cycloplegics, prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors, alpha-2 agonists, miotics, mast cell stabilizers/antihistamines, fluoroquinolones, aminoglycosides, fortified antibiotics, antivirals, and topical NSAIDs. Eight clinical cases with mechanism-of-action diagrams.

Ocular Pharmacology & Therapeutics
Select appropriate mydriatic and cycloplegic agents by onset, duration, and indicationConstruct a pharmacological management plan for acute angle-closure glaucomaChoose evidence-based first-line and adjunctive glaucoma therapy based on patient profileIdentify clinically significant drug contraindications and interactions in optometric practice
~25 min
Module 114 items

Humphrey Visual Field Interpretation

Ten pre-loaded 24-2 and 30-2 Humphrey visual field printouts spanning the full spectrum of glaucomatous, neurological, and retinal field loss. Interpret total/pattern deviation plots, reliability indices (fixation loss, false positive/negative rates), mean deviation, pattern standard deviation, and GHT classification. Includes localization of lesions from retina to visual cortex.

Glaucoma & Neuro-optometry
Classify glaucomatous visual field defect patterns (arcuate, nasal step, temporal wedge)Recognize neurological field loss respecting the vertical or horizontal meridianLocalize lesions to the retina, optic nerve, chiasm, optic tract, radiations, or cortexAssess reliability indices and determine test validity for clinical use
~25 min
Module 124 items

Tonometry & IOP Assessment

Goldmann applanation tonometer simulator with realistic fluorescein mire alignment, requiring correct semicircle contact and endpoint recognition. Applies pachymetry-based correction (Ehlers formula) for central corneal thickness and interprets IOP in clinical context across 8 cases including ocular hypertension, low-pressure glaucoma, and post-LASIK thin corneas.

Glaucoma & Neuro-optometry
Align Goldmann mires to the correct endpoint (inner edge touching at split-lamp axis)Apply CCT-based IOP correction for pachymetry values outside 520–540 µmInterpret IOP within the full clinical context including disc appearance and VF statusRecognize sources of IOP measurement error (excessive fluorescein, corneal irregularity)
~20 min
Module 134 items

Case Integration Capstone

Six complete clinical workups requiring synthesis of refraction, anterior segment, fundoscopy, tonometry, and visual field data into a full diagnosis and evidence-based management plan. Cases: progressive myopia management, primary open-angle glaucoma with VF change, diabetic eye disease requiring urgent referral, pediatric accommodative esotropia, contact lens-related microbial keratitis, and superior temporal retinal detachment with macula-on status.

Clinical Synthesis & Patient Management
Integrate multi-modal examination findings into a coherent clinical pictureFormulate ranked differential diagnoses with supporting and refuting evidenceConstruct evidence-based management plans including treatment, monitoring, and referral thresholdsCommunicate urgency level and apply appropriate clinical prioritization
~35 min