Independently perform a patient assessment and investigations sufficient to identify, describe and interpret clinical findings to arrive at differential diagnoses.

Domain of Clinical Practice Patient Management
Level Level 1
Special Interest Area Medical Retina
Code MR1.1
Descriptors
  • Demonstrate effective consultation skills, including active listening skills. 
  • Take ophthalmic and relevant systemic clinical histories appropriate to the clinical problem and patient’s needs, eliciting the patient’s ideas, concerns and expectations. 
  • Take a family history, and draw a pedigree chart as appropriate. 
  • Establish an effective, empathetic, compassionate and respectful doctor-patient relationship.  
  • Demonstrate cultural and social awareness. 
  • Understand the risks, professional responsibilities and safeguards of remote consultations, e.g. telephone, online consultations.
  • Measure and record visual acuity for near and distance using an appropriate method and interpret the results. Understand the pros and cons of different methods of assessment for different patient groups. 
  • Be able to approximate equivalent levels of vision in Snellen, logMAR or EDTRS letter scores. 
  • Understand and interpret an optometric examination, including the assessment of vision and binocular vision. Interpret the refraction result.  
  • Assess other visual symptoms with appropriate tools e.g. Amsler chart for visual distortion, Ishihara or other appropriate test for colour vision.  
  • Assess and interpret normal and abnormal visual fields by confrontation, understand the reliability of this method and when to arrange more detailed visual field analysis. 
  • Assess the pupil for abnormalities of shape, size and reaction, including for Relative Afferent Pupillary Defect (RAPD).
  • Examine the eyelids including eversion of lids. 
  • Perform slit lamp biomicroscopy of the eye and adjacent structures.  
  • Examine the cornea, ocular surface, anterior chamber, iris and lens using appropriate techniques including assessment of the red reflex and slit lamp illumination techniques. 
  • Employ gonioscopy for examination of angle structures. 
  • Measure the intraocular pressure (IOP) accurately using a variety of applanation techniques and understand the limits of each. 
  • Examine the vitreous, the choroid and the retina, including the macula and optic nerve, using appropriate techniques including the direct ophthalmoscope, binocular indirect ophthalmoscope, and lenses for binocular fundus examination with the slit lamp. 
  • Understand how retinal examination techniques differ in magnification, orientation and field of view of the retinal image. 
  • Describe and record the ophthalmic findings according to usual convention.  
  • Perform a proficient medical examination relevant to ophthalmology, including examination of the neck, skin, nose, joints and neurological system. 
  • Understand the associations between clinical findings in different parts of the eye. 
  • Understand the associations between systemic and ophthalmic diseases.
  • Select investigations appropriate to the likely diagnosis. 
  • Understand and apply knowledge of instrument technology relevant to ophthalmic practice.
  • Create differential diagnoses including common conditions and those that are sight or life threatening, where appropriate. 
  • Be aware of risks associated with investigations (e.g. Fluorescein Angiography and Indocyanine Green Angiography tests). 
  • Understand the need to request and interpret retinal optical coherence tomography (OCT) scans. 
  • Understand retinal angiography techniques, including optical coherence tomography angiography (OCTA), and be able to identify abnormalities on retinal angiography. 
  • Demonstrate effective consultation skills, for suspected genetic eye disease. 
Method of Assessment
Other information