A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity (BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography (FFA) revealed slight ffuorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperffuorescence were observed in both eyes. Indocyanine green angiography (ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography (SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment (IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay (TPPA) and a rapid plasma reagin test (RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the ffrst sign of syphilis. Prompt treatment is highly effective in resolving vision.

A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity (BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography (FFA) revealed slight ffuorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperffuorescence were observed in both eyes. Indocyanine green angiography (ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography (SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment (IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay (TPPA) and a rapid plasma reagin test (RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the ffrst sign of syphilis. Prompt treatment is highly effective in resolving vision.

Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom (FC) and problem-based learning (PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning.

Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students’ academic performance and questionnaires were designed to evaluate their perceptions.

Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre- and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisffed with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.

Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.

Background: Ophthalmology is an important medical science subject, but it is given with insufficient attention in undergraduate medical education. Flipped classroom (FC) and problem-based learning (PBL) are well-known education methods that can be integrated into ophthalmology education to improve students' competence level and promote active learning.

Methods: We used a mixed teaching methodology that integrated a FC and PBL into a 1-week ophthalmology clerkship for 72 fourth-year medical students. The course includes two major sessions: FC session and PBL session, relying on clinical and real-patient cases. Written examinations were set up to assess students’ academic performance and questionnaires were designed to evaluate their perceptions.

Results: The post-course examination results were higher than the pre-course results, and many students gained ophthalmic knowledge and learning skills to varying levels. Comparison of pre- and post-course questionnaires indicated that interests in ophthalmology increased and more students expressed desires to be eye doctors. Most students were satisffed with the new method, while some suggested the process should be slower and the communication with their teacher needed to strengthen.

Conclusions: FC and PBL are complementary methodologies. Utilizing the mixed teaching meth of FC and PBL was successful in enhancing academic performance, student satisfactions and promoting active learning.