96032 Binocular Vision and Ocular Motility 2

Warning: The information on this page is indicative. The subject outline for a particular session, location and mode of offering is the authoritative source of all information about the subject for that offering. Required texts, recommended texts and references in particular are likely to change. Students will be provided with a subject outline once they enrol in the subject.

Subject handbook information prior to 2025 is available in the Archives.

UTS: Health (GEM)
Credit points: 6 cp
Result type: Grade and marks

Requisite(s): 96028 Binocular Vision and Ocular Motility 1
There are course requisites for this subject. See access conditions.

Description

This subject extends student's knowledge of the basic principles of sensory and motor function introduced in 96028 Binocular Vision and Ocular Motility 1 and applies this knowledge to more complex sensory and motor defects. Developmental defects of binocular cortical function and ocular motility are studied through problem-based learning using clinical case studies requiring the application of clinical reasoning. The management of strabismus through orthoptic interventions and ophthalmic surgical techniques is discussed. Students are encouraged to incorporate information from scientific literature and take an evidence-based approach to the development of management strategies. More complex ocular muscle conditions, the impact of laws of ocular motor control on motor sequelae, and the effects of facial trauma and pathology on ocular motility are studied. Students learn advanced orthoptic practice-based procedures that aid in the assessment of ocular motility disorders, specifically orbital and restrictive ocular motility problems.

Subject learning objectives (SLOs)

32.1.	Apply knowledge of binocular vision and ocular motility, the anatomy and physiology underpinning complex sensory and motor defects and the impact of laws of ocular motor control on muscle sequelae to the interpretation of complex ocular motility.
32.2.	Interpret patient signs and symptoms and link these to clinical data in the context of complex conditions and disorders affecting binocularity and ocular motility, to formulate appropriate diagnoses, and plans for investigation of these conditions.
32.3.	Integrate current evidence and theoretical knowledge with sound clinical reasoning in the analysis of complex orthoptic cases and the development of effective investigation and interdisciplinary management plans including, both orthoptic and surgical management techniques.
32.4.	Demonstrate novice level clinical skills in advanced orthoptic investigative methods and accurately interpret observations and test results, relating these to the diagnosis and management of complex orthoptic conditions.
32.5.	Utilise advanced communication skills for the effective explanation of tests, clinical conditions and therapeutic and surgical management procedures in orthoptics, in terms that can be readily understood by a diverse range of patients, while demonstrating a respectful and compassionate approach to patient care.

Course intended learning outcomes (CILOs)

The learning outcomes for this subject are as follows:

Practice professional expertise and clinical reasoning to provide safe, responsible, and evidence-based orthoptic care for the benefit of the community. (01.01)
Utilise research knowledge and skills to analyse and synthesise literature, design research methodology and ethically conduct research in the field of orthoptics. (02.01)
Engage in reflective practice to support lifelong learning and professional development that enhances patient outcomes and health service delivery. (02.02)
Critically reflect on Indigenous Australian contexts and apply principles of cultural safety and ethical research practices to work effectively with and for Indigenous Australians within the orthoptic profession. (04.01)

Contribution to the development of graduate attributes

In addition, this subject contributes to the development of the following graduate attributes:

• Lifelong Learning

• Professional Capacity

• Cultural Competence

Teaching and learning strategies

Preparation for Learning: Students will be provided with the details of preparation activities each week through the subject’s Canvas site. Activities are designed to introduce topic areas and help students prepare for their learning in workshops by engaging them with videos, textbook, journal and other readings, videos, online resources, quizzes and short answer questions and group discussion. In addition, clinical practical classes have pre-practical reading and questions attached, which are expected to be completed prior to attending these classes to ensure maximal time can be spent on hands-on practice.

Active Workshops: Workshops throughout the session are opportunities for active class discussion and collaborative thinking around topic areas and clinical problem-based learning scenarios. Workshops require students to engage and participate in the analysis of case presentations, quizzes and trivia, class discussion and debate and other active and collaborative learning methods.

Case-based Learning: Case-based learning is a form of problem-based learning (PBL) and a key learning strategy used in workshops. Authentic patient clinical cases are analysed individually and in small (POD) groups. Through this students develop skill in clinical reasoning and practice the application of theoretical knowledge gained in lectures and practical classes to differentially diagnose and develop appropriate plans for the investigation and management of patients with a variety of ocular conditions.

Research-integrated Learning: Taking an evidence-based approach to the investigation and management of patient cases is essential for effective patient care and an important skill for Orthoptic students to develop. Current research is integrated into content provided in lectures and pre-work and students are provided opportunities in workshop classes and through assessment to read, discuss and utilise current research in ophthalmology and orthoptics in the context of evidence-based patient care.

Collaborative Learning: As health professionals, teamwork is an essential skill to ensure patients are managed appropriately within interdisciplinary teams of health professionals. Teamwork skills are developed through collaboration with peers in active lectures and workshops, conducted in collaborative POD classrooms, as well as, when performing clinical skills in practical classes and through group assessment.

Reflective Learning: Students are encouraged to critically reflect on their learning throughout the subject to identify areas where they may improve their performance and to assist in the development of lifelong learning skills. Specific activities where reflective learning is encouraged are; self-evaluation of clinical skill performance in practical classes against OSCE marking criteria and skill achievement checklists and through post lecture/workshop review of learning questions on Canvas.

Practice-based Learning: Clinical practical classes are conducted in small groups (max. 12 students) each week for this subject. These provide students with an opportunity to learn and develop competency in clinical skills relevant to orthoptic practice. These sessions are entirely practice-based and following a short demonstration of the skill, students are closely supervised and provided instruction and feedback, as they participate in hands-on practice of skills, including the use of specialised orthoptic and ophthalmic equipment and technology.

Authentic and Simulated Clinical Experiences: Clinical practical classes are conducted in our dedicated teaching clinic rooms and provide students with access to a simulated clinical environment including, key technology used in professional orthoptic practice. Students participate in role play and simulation of various ocular conditions using prisms and other orthoptic equipment. Students are additionally shown patient videos to demonstrate conditions and test responses in lectures, workshops and practical classes.

Self-directed Practice: Clinical practical classes provide students with supervised practice of clinical skills, however, to attain a sufficient level of competency in clinical skills, self-directed practice outside of class time is required. As a general guide, students are expected to spend approximately 1 hour of self-directed practice in the orthoptic dedicated teaching clinics per subject. This is important preparation for clinical placement and your OSCE exams.

Ongoing Feedback: In-class verbal feedback is an important teaching and learning strategy employed throughout the subject. Students are provided with immediate feedback relating to the performance of clinical skills in clinical practical classes and relating to clinical reasoning and understanding of key concepts by staff facilitating workshops. Opportunities for verbal formative feedback on assignments are given prior to final submission and detailed summative feedback following final submission. In week 14, Mock OSCE exams are held to provide students with formative feedback on clinical skills prior to the OSCE exams.

Content (topics)

Binocular Vision and Ocular Motility 2 is the second subject on binocular vision and ocular motility in the Masters of Orthoptics course. This subject builds directly on foundational concepts related to normal binocular vision and ocular motility and common disorders of these systems learnt in 96028 Binocular Vision and Ocular Motility 1 by introducing more complex conditions impacting binocularity. In addition to theoretical knowledge of these conditions, this subject prepares students for the assessment of these conditions by refining orthoptic clinical skills introduced in Binocular Vision and Ocular Motility 1 and introducing more advanced examination procedures. Learning in this subject is further built on in subsequent semesters in 96036 Neurological Disorders, 96037 Therapy, Management and Rehabilitation and 96040 Advanced Professional Practice.

Topics covered in this subject include; the impact of accommodative convergence and refraction on ocular posture, accommodative esotropia, congenital esotropia, dissociated vertical deviation, congenital nystagmus, exotropia, vertical deviations, microtropia, abnormal retinal correspondence and non-functional binocular vision, advanced anatomy of the extraocular muscles and strabismus surgery, abnormal head postures, incomitant strabismus with a focus on restrictive conditions including; Brown’s and Duane’s syndromes, myasthenia gravis, thyroid eye disease and blow out fracture. In addition, students will learn advanced binocular vision and ocular motility investigative methods and management procedures for all conditions covered.

Assessment

Assessment task 1: Case Study Assignment

Intent:	The case study assignment aims to further student’s understanding of common disorders affecting ocular motility and the way in which these conditions present clinically and are appropriately investigated and managed. Students are required to employ evidence-based practice skills in the research of these conditions and apply this knowledge to develop an accurate description of the clinical presentation of a patient with the condition. Through this, students will have an opportunity to practice and further develop their clinical reasoning and academic writing skills.
Objective(s):	This task is aligned with the following subject learning objectives: 32.1, 32.2, 32.3 and 32.5 This task is aligned with the following course learning outcomes: .05, .09, 01.01, 02.01 and 02.02
Type:	Case study
Groupwork:	Individual
Weight:	30%
Length:	Each case study should be no more than 2000 words in length.
Criteria:	You will be assessed on: Your ability to utilise clinical reasoning to analyse a patient case and develop diagnoses that are supported by your interpretation of the clinical information. Your demonstrated understanding of the patient condition and the typical clinical presentation, with a particular focus on your understanding of ocular motility and binocular vision. The appropriateness of your choice of tests according to the condition and the patient case presented and accurate/ correct recording of all patient results. Your ability to utilise evidence from the literature to clearly and strongly justify your clinical reasoning in regard to investigative choices and interpretation of examination results. Your demonstrated ability to construct an evidence-based management plan that is appropriate for the patient case you have presented and deals with all aspects of patient care including multidisciplinary care, where appropriate. Your academic writing skill including; written expression, spelling and grammar and referencing. Marking criteria will be provided on Canvas.

Assessment task 2: OSCE (must-pass component)

Intent:	This exam is an authentic form of assessment, conducted in a simulated clinical environment to most appropriately assess a student’s clinical competency for participation in a future clinical working environment, including clinical placement. An objective structured clinical exam (OSCE) enables students to demonstrate components of understanding, clinical and equipment skill, clinical reasoning and communication that are not readily assessed in a written format. These exams will allow the student to demonstrate knowledge they have gained across the subject through lectures, clinical practicals and through self-directed practice.
Objective(s):	This task is aligned with the following subject learning objectives: 32.2, 32.3, 32.4 and 32.5 This task is aligned with the following course learning outcomes: .05, .06, .09, 01.01, 02.01, 02.02 and 04.01
Type:	Examination
Groupwork:	Individual
Weight:	30%
Length:	30 minutes approximately
Criteria:	You will be assessed on: Your competency in performing clinical procedures safely and ensuring patient comfort throughout the examination. Your ability to demonstrate a clear understanding of the task and competently perform the skill, to obtain accurate results and document these as would be appropriate in a medical record. Your ability to complete set tasks in a given timeframe and demonstration that you would be able to perform efficiently in a clinical setting. Your ability to communicate appropriately with a patient including, correct targeting of instruction and ability to adapt instruction to ensure patient understanding. Demonstrated clinical reasoning skill in the context of a specific patient scenario, through the selection of appropriate test procedures, correct interpretation of results, understanding of the case and ability to verbally justify reasoning to the examiner. Demonstrated professionalism in a clinical environment. Prior to the exam students will be given the criteria for individual examinable skills and formative feedback on performance during Mock OSCEs.

Assessment task 3: Viva Examination

Intent:	The Viva examination will aid determination of whether you have met the learning objectives of this subject and will give a summative assessment of your level of knowledge and understanding of the content. This also provides you an opportunity to demonstrate your understanding and ability to clinically reason through patient cases.
Objective(s):	This task is aligned with the following subject learning objectives: 32.1, 32.2 and 32.3 This task is aligned with the following course learning outcomes: 01.01, 02.01 and 02.02
Type:	Case study
Groupwork:	Individual
Weight:	40%
Length:	30 minutes
Criteria:	You will be assessed on your level of content-based knowledge, as well as, problem-solving and clinical reasoning ability within the context of binocular vision and ocular motility, demonstrated through accurately expressed ideas and conclusions.

Minimum requirements

You are required to attend 90% of scheduled lectures. Clinical practicals will be scheduled on weeks 1-13. It is expected that you attend 100% of your scheduled clinical practicals.

Note: there is a must-pass assessment in this Subject. Please check assessment descriptions for details.

Required texts

Coursework Assessments Policy

Coursework Assessments Procedures

Graduate School of Health Policy, Guidelines and Procedures (login required)

Recommended texts

Students will be required to access journals through the UTS library and reference appropriate journal articles. Specific references may be indicated, if required via UTSOnline throughout semester by the coordinator or lecturers. In addition, the following texts may be of use:

Ansons, AM & Davis H, (2014) Diagnosis and Management of Ocular Motility Disorders 4th ed. Wiley-Blackwell

Rowe, FJ (2012) Clinical Orthoptics. John Wiley & Sons, Hoboken

Hoyt CS & Taylor D (2013) Pediatric Ophthalmology and Strabismus 4th ed. Saunders Ltd.