Abstract: The goal of ophthalmology residency training is to produce competent ophthalmologists. Appropriate assessments must be employed to ensure this goal is met. Valid and reliable workplace-based assessments are designed to assess competence in the many domains required of a good ophthalmologist. These assessments increase standardization and objectivity as compared to simple observational feedback. When used appropriately, workplace based assessments not only provide measures of competence but also facilitate effective formative feedback and enhance learning.

Abstract: Cataract surgery is arguably the most commonly performed operation in ophthalmology. Surgical skills transfer from experienced surgeons to resident surgeons is complicated by the fact that the teaching surgeon primarily acts as an observer rather than directly performing the procedure. Therefore, wet lab and simulator training are utilized to reduce the learning curve of the novice surgeons, which establishes tissue awareness, dexterity and muscle memory required to perform each step of the procedure, safely. Access to a wet lab and simulator environment is accomplished by establishing a surgical training curriculum in residency programs. In the operating room, topical anesthesia is a safe alternative for teaching cataract surgery. There are three well-described approaches to teaching individual steps of cataract surgery: forward, “backwards”, and deconstructed step-by-step instruction. Simulator training can be incorporated prior to live patient experience or integrated concurrently with learner presence in the operating room. The trend towards a competency-based instruction model has necessitated appropriate evaluation tools that include Objective Assessment of Skills in Intraocular Surgery (OASIS), Global Rating Assessment of Skills in Intraocular Surgery (GRASIS), and the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR). We review the literature on trends in surgical teaching in ophthalmology, with the focus on cataract surgery instruction to the novice surgeon.

Abstract: RAF near point rule (RNPR) is a routinely used instrument in ophthalmology and optometry practice as well as for research purposes to measure the near point of convergence (NPC). The measurement of NPC is an important criterion for diagnosis and management of convergence insufficiency. The RNPR forms an important tool for ophthalmic clinicians however, only a very little is understood about it. This article tries to describe and review the designs, measurement techniques, merits and demerits of the RNPR and establish the need for its modification. It recommends that clinicians and researchers consider these findings while measuring NPC with the RNPR.

Abstract: The Handan Offspring Myopia Study (HOMS) is the first offspring eye study in a Chinese population. The study design is based on another representative study, Handan Eye Study. In this study, we found 1 diopter (D) of generational myopic shift, a weak protective effect of the outdoor activity on myopia, and a modest protective effect of the eye exercises of acupoints on myopia, among the rural children in the northern area.

Abstract: Myopia in children remains a major public health problem worldwide, especially in some Asian countries such as China, Singapore and Japan. Although many interventions have been attempted, few has been proven to be effective in controlling onset and progression of myopia in children. Environmental factors, genetic susceptibility or ethnic differences can affect the efficacy of these interventions. However, many questions remain unclear and even controversial for controlling myopia. China has the biggest population with myopia, especially for children myopia. Thus, it is of importance to present what achievements Chinese scientists have made in the field of myopia control in children. We summarize the current findings on myopia control in children from the Anyang Childhood Eye Study, including epidemiological data, clinical trials, systematic reviews and meta-analyses, and compare them with studies in other countries to find potential clues for controlling myopia in children.

Abstract: Optical coherence tomography (OCT) is an ocular imaging technique that can complement the neuro-ophthalmic assessment, and inform our understanding regarding functional consequences of neuroaxonal injury in the afferent visual pathway. Indeed, OCT has emerged as a surrogate end-point in the diagnosis and follow up of several demyelinating syndromes of the central nervous system (CNS), including optic neuritis (ON) associated with: multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies. Recent advancements in enhanced depth imaging (EDI) OCT have distinguished this technique as a new gold standard in the diagnosis of optic disc drusen (ODD). Moreover, OCT may enhance our ability to distinguish cases of papilledema from pseudopapilledema caused by ODD. In the setting of idiopathic intracranial hypertension (IIH), OCT has shown benefit in tracking responses to treatment, with respect to reduced retinal nerve fiber layer (RNFL) measures and morphological changes in the angling of Bruch’s membrane. Longitudinal follow up of OCT measured ganglion cell-inner plexiform layer thickness may be of particular value in managing IIH patients who have secondary optic atrophy. Causes of compressive optic neuropathies may be readily diagnosed with OCT, even in the absence of overt visual field defects. Furthermore, OCT values may offer some prognostic value in predicting post-operative outcomes in these patients. Finally, OCT can be indispensable in differentiating optic neuropathies from retinal diseases in patients presenting with vision loss, and an unrevealing fundus examination. In this review, our over-arching goal is to highlight the potential role of OCT, as an ancillary investigation, in the diagnosis and management of various optic nerve disorders.

Abstract: The inverted retina is a basic characteristic of the vertebrate eye. This implies that vertebrates must have a common ancestor with an inverted retina. Of the two groups of chordates, cephalochordates have an inverted retina and urochordates a direct retina. Surprisingly, recent genetics studies favor urochordates as the closest ancestor to vertebrates. The evolution of increasingly complex organs such as the eye implies not only tissular but also structural modifications at the organ level. How these configurational modifications give rise to a functional eye at any step is still subject to debate and speculation. Here we propose an orderly sequence of phylogenetic events that closely follows the sequence of developmental eye formation in extant vertebrates. The progressive structural complexity has been clearly recorded during vertebrate development at the period of organogenesis. Matching the chain of increasing eye complexity in Mollusca that leads to the bicameral eye of the octopus and the developmental sequence in vertebrates, we delineate the parallel evolution of the two-chambered eye of vertebrates starting with an early ectodermal eye. This sequence allows for some interesting predictions regarding the eyes of not preserved intermediary species. The clue to understanding the inverted retina of vertebrates and the similarity between the sequence followed by Mollusca and chordates is the notion that the eye in both cases is an ectodermal structure, in contrast to an exclusively (de novo) neuroectodermal origin in the eye of vertebrates. This analysis places cephalochordates as the closest branch to vertebrates contrary to urochordates, claimed as a closer branch by some researchers that base their proposals in a genetic analysis.