June 30, 2010

A Guide For Clinical Year USM [Ophthalmology posting]

Peace be upon all of you,

In USM, this is a minor posting which takes 3 week duration including exam week. Therefore, it is actually very compact.

Bear in mind that ophthalmology is a sub specialty program. Therefore, you only need to know about basic thing and principles of management

This is what you should prepare for this posting

a) Guide book in ophthalmology by Ophthalmology dept.

This book will be given on first day you are registered as 4th year med student. It will guide you on what topic to be stress on, nice to know topic and what should you study during this course.

b) Ophthalmoscope

You are required to observe minimum requirement 20 fundus. It is better for you to have your own fundoscopy but it is expensive. If I’m not mistaken, RM600 per item. Your alternative is to rent it from Ophthalmology clinic (8-10 ophthalmoscope only) and also rent it from Persatuan sains Perubatan. You may also ask senior who bought it and borrow from them.

c) Colour pencil

This is to draw your fundus finding. Every color has their own meaning. Please confirm it with any MO since I also forget. As far as I remember

i. Red= blood vessel or hemorrhage

ii. Blue= fibrosis

iii. Yellow= exudated

d) Pen torch at least 2 for external eye examination and reflexes

e) Examination tool like cotton wool, snellen chart. There will be seniors who will sell this to you later. It’s not very expensive

f) Reference book

i. Lecture note on ophthalmology (this is very2 simple)

ii. Clinical Ophthalmology by Kansky (Very thick one and expensive too. If you are rich, then can buy it.

iii. ABC of ophthalmology (I used soft copy only)

iv. Bashak ophthalmology (this is not being recommended by lecturer but I used this book. For me, it’s better than lecture note on ophthalmology. I suggest this book to you.

v. Others; General ophthalmology, Ophtalmology;An illustrated colour text.

Posting Requirement

1. Tutorials (attendance is compulsory)

Please make sure you get the tutorial question from posting coordinator and refer to tutor on how they want to conduct the class. Make sure that you answer all the question before coming to tutorial session to gain more benefit. What can I say, it’s a very pack and sometimes you get more than 2 tutorial per day.

2. Fundus examination (as what been mentioned before, minimum 20)

3. Case presentation (minimum 10), can be either formal long case, short case or summary of the case in clinic depending on MO’s avaibility.

4. Clinic session

i. Clinic is open from Monday to Wednesday. Please divide yourself accordingly.

ii. Please have empathy on patient. From my observation, we as medical student tend to examine patient repeatedly until they are not uncomfortable. Have some mercy on them.

iii. Other than fundus examination, other procedure can be seeing here like what is being stated in your guideline book.

5. OT Session

Minimum requirement is 3 OT. But, the more you go, the better experience you will gain. As what I mention earlier, this is very sub specialize field. Therefore, you wont have any chance anymore to observe this OT after this posting end unless you are specializing in ophthalmology later.

6. Wards

i. Please come before 8 a.m because Mo’s and specialist will examine their patient around this time. It’s a great opportunity to learn from them

ii. If there is no patient or you have cover all the patient, do not waste your time in the ward. Go to OT Room or clinic as it will be more beneficial to you.

7. On Call session

Please adjust it with registrar on call. Usually they will do a teaching session. On call is different from other department and you don’t have to stay until mid night. Some MO will bring the On call session earlier.


You will have two session in HRPZ which are

i. Clinic

ii. Wards

Depends on your luck, during my time, we have lot of interesting cases in HRPZ. Some group might not lucky.

9. Community eye services

I heard that they already cancel this session.

10. Exam

You will have three part exam which are

i. Short case with your supervisor

ii. Interpretation data

iii. MCQ.


  1. Assalamualaikum..
    Dr Na'im, regarding opthalmology department, may I ask you something?

    In case of diabetic patient who is having diabetic retinopathy; visual acuity worsen but not yet develop blindness, what is the treatment for them? Any medication?

    I googled and found that one of the treatments is laser..Is there any
    criteria in patient selection to undergo this procedure?

    I'm asking because my auntie 65y/o already develop few late complications of DM but it seems like no active treatment is given.

    Your attention is highly appreciated..thanks Dr.

  2. I suggest that your mother should be evaluated by the eye specialist as there are many reason causing the reduce vision in diabetic patient. The assessment shouldbe yearly or more frequent if having pathology. Laser treatment is for the proliferative diabetic retinopathy. If it is non proliferative then tight glucose control is mandatory. Cataract may also the cause of reduce vision in elderly esp with diabetes. It require some lens operation

  3. Thanks a lot Dr Na'im for such a quick respond..it helps..InsyaAllah..

    good luck in your career..u'll make a great emergency & trauma specialist iAllah.


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