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Curriculum
NBEMS Diploma
Ophthalmology
Objectives of The Programme
Teaching and Learning Activities
Syllabus
Subject Specific Competencies
Procedures
Log Book
Recommended Text Books & Journals

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Curriculum for NBEMS Diploma in Ophthalmology PAGE 2 OF 30

INDEX
S. No Contents Page No.
I Objectives of The Programme 5
II Teaching and Learning Activities 9
III Syllabus 12
IV Subject Specific Competencies 15
V Procedures 21
VI Log Book 24
VII Recommended Text Books & Journals 26

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I. OBJECTIVES OF THE PROGRAMME
1. Programme Goal
i. To produce competent specialist who shall recognize the health needs of the
community, and carry out professional obligations ethically and in keeping
with the objectives of the national health policy.
ii. The purpose of this postgraduate training program is to impart appropriate
expertise to create competent ophthalmic specialist having adequate current
knowledge of the subject with sufficient diagnostic and surgical skills that are
required to be practiced at the secondary levels of the health care delivery
system.
iii. The competency-based training programme for Diploma in Ophthalmology
aims to produce specialist in ophthalmology who having undergone the
required training should be competent to handle all common ophthalmic
problems and should be able to deal effectively with the eye care needs of the
community.
iv. Ability to contribute in reducing blindness from our country by helping in
implementation of National Programme for Control of Blindness and Visual
Impairment.
2. Programme Specific Learning Objectives

A candidate upon successfully qualifying in the Diploma (Ophthalmology)
examination should be able to:
i. Offer to the community, the current quality of ‘standard of care’ in ophthalmic

diagnosis as well as therapeutics, medical or surgical, in most of the common
situations encountered at the level of health services.
ii. Effectively communicate with patients or relatives so as to educate them
sufficiently and give them the full benefit of informed consent to treatment and
ensure compliance.
iii. Be aware of his/her own limitations to the application of the specialty in
situations, which warrant referral to more qualified centers or individuals.
iv. Contribute as an individual/group towards the fulfillment of national objectives
with regard to prevention of blindness.
v. Periodically self-assess his or her performance and keep abreast with ongoing
advances in the field and apply the same in his/her practice.
vi. Acquire the basic skills of teaching nursing and paramedical professionals.

3. Competencies
Ophthalmic specialists are expected to have followed competencies which are
advocated by Accreditation Council for Graduate Medical Education (ACGME):
i. Patient Care
a) Have adequate theoretical Knowledge of the subject to be able to give
desirable standard of patient care
b) Provide patient care that is compassionate, appropriate, and effective for
the treatment of health problems and the promotion of health
c) Communicate effectively and demonstrate caring and respectful
behaviors when interacting with patients and their families;
d) Gather essential and accurate information about patients;
e) Make informed decisions about diagnostic and therapeutic interventions,
based on patient information and preferences, up-to-date scientific
evidence, and clinical judgment;
f) Develop and carry out patient management plans;
g) Counsel and educate patients and their families;
h) Use information technology to support patient-care decisions and patient
education;
i) Competently perform the medical and invasive procedures for treating
eye diseases
j) Provide health care services aimed at preventing health problems or
maintaining health.
k) Work with health care professionals, including those from other
disciplines, to provide patient- focused care.
l) Be aware of his/her own limitations to the application of the speciality in
situations which warrant referral to more qualified persons
ii. Medical Knowledge

a) Demonstrate knowledge about ophthalmic sciences and the apply this
knowledge to patient care;
b) Demonstrate an investigatory and analytic thinking approach to clinical
situations;
c) Know and apply the basic and clinically supportive sciences, which are
appropriate to ophthalmology.
iii. Practice-based Learning and Improvement

a) Investigate and evaluate patient care practices; appraise and assimilate
scientific evidence; and improve patient care practices;

b) Analyse practice experience and perform practice-based improvement
activities using a systematic methodology;
c) Locate, appraise, and assimilate evidence from scientific studies related to
patients ‘health problems; and
d) Use information technology to manage information, access on-line
medical information, support ongoing personal professional
development.
iv. Communications Skills

a) Demonstrate communication skills that result in effective information
exchange and teaming with patients, patients' families, and professional
associates;
b) Create and sustain a therapeutic and ethically sound relationship with
patients; Use effective listening skills and elicit and provide information
using effective nonverbal, explanatory, questioning, and writing skills;
and
c) Work effectively with others as a member or leader of a health care team
or other professional group.
v. Professionalism
a) Demonstrate a commitment to carrying out professional responsibilities,
adherence to ethical principles, and sensitivity to a diverse patient
population;
b) Demonstrate respect, compassion, and integrity;
c) Demonstrate a responsiveness to the needs of patients and society that
supersedes self-interest; accountability to patients, society, and the
profession; and a commitment to excellence and on-going professional
development;
d) Demonstrate a commitment to ethical principles pertaining to provision or
withholding of clinical care, confidentiality of patient information,
informed consent,
e) Demonstrate sensitivity and responsiveness to patients' culture, age,
gender, and disabilities.
vi. Systems-based Practice

a) Demonstrate an awareness of and responsiveness to the larger context and
system of health care and effectively call on system resources to provide
care that is of optimal value;
b) Advocate for high quality patient care and assist patients in dealing with
systemic complexities;

c) Contribute as an individual/group towards the prevention of blindness.
d) Know how to partner with health care managers and health care providers
to assess, coordinate, and improve health care and know how these
activities can affect system performance.
e) Professional attitudes and conduct require that ophthalmic specialists
must also have developed a style of care, which is:
• Humane (compassion in providing bad news, management of the
visually impaired,
• and recognition of the impact of visual impairment on the patient
and society);
• Reflective (recognition of the limits of knowledge, skills and
understanding);
• Ethical;
• Integrative (involvement in an interdisciplinary team for the eye
care of children, the handicapped, the systemically ill, and the
elderly)
Using all these competencies the resident at the end of two years of training
should fulfil overall objectives of the training programme.
4. Overall Objectives
The clinical Postgraduate Diploma training program is intended to impart
essential and clinical information (cognitive, affective and psychomotor) that are
necessary for specialist in ophthalmology. A postgraduate should possess the
following qualities, knowledge and skills:
i. Basic Sciences: Resident should possess basic knowledge of the structure,

function and development of the human body as related to ophthalmology, and
of the factors which may disturb these, the mechanisms of such disturbances,
and the disorders of structure and function which may result.
ii. Clinical Knowledge: Resident should be able to practice and handle most day-
to-day ophthalmic problems independently, should recognize the limitations of
his clinical knowledge and know when to seek further help.
iii. Environment and Health: Resident should understand the effect of environment
on health and be familiar with the epidemiology and common diseases in the
field of ophthalmology. He/she should be able to integrate the preventive and
promotive methods with the curative and rehabilitative measures in the
comprehensive management of the disease.
iv. Community Ophthalmology: Resident should be familiar with common eye
problems occurring in communities, especially in rural areas and be able to deal
with them effectively. He /She should also be aware of National Program for

Control of Blindness and Visual Impairment and its working and components.
The student should be able to organize and conduct survey in rural, urban and
industrial communities and special group population.
v. Communication Skills: Residents must be able to demonstrate interpersonal and
communication skills that result in effective information exchange and teaming
with patients, patients’ families, and professional associates. Residents are
expected to: Create and sustain a therapeutic and ethically sound relationship
with patients, use effective listening skills and elicit and provide information
using effective nonverbal, explanatory, questioning, and writing skillsandWork
effectively with others as a member or leader of a health‑care team or other
professional groups.
vi. Professionalism: Residents must demonstrate a commitment to carrying out
professional responsibilities, adherence to ethical principles, and sensitivity to a
diverse patient population as laid down under professionalism in the preamble.
vii. Recent Advances: Resident should be familiar with the current developments in
Ophthalmic Sciences.
viii. Teaching: Resident should be able to plan educational programs in
ophthalmology in association with senior colleagues, and be familiar with
modern methods of teaching.
ix. Medico-legal aspects: Resident should have basic knowledge of medico legal
aspects of medicine. He/she should be familiar with patient counselling and
proper consent taking.
II. TEACHING AND LEARNING ACTIVITIES
Acquisition of practical competencies being the keystone of postgraduate

medical education, postgraduate training is skill oriented. Learning in
postgraduate program should essentially be self-directed and primarily
emanating from clinical and academic work. The formal sessions should merely
be meant to supplement this. The departments may select a mix of the following
sessions and award grade for each activity performed by resident.
1. Methods for Theoretical learning and teaching: Formal Teaching and

Learning Activities:
i. Basic science course
ii. Seminars
iii. Tutorials / Group discussion
iv. Guest speakers on core specialty topics

2. Methods for Clinical Training: The residents can be imparted clinical training
in several ways including
i. Work-Based Learning (WBL), such as:
a) Daily round-based learning
b) Clinic-based learning
c) Emergency / On-call-based learning
ii. Practice-Based Learning, such as:
a) Case presentation
b) Grand round
c) Inter departmental case or seminar
d) Surgical Skills in Operation Theatre: Observe/Assist / Perform
• Recent Advances
• Participation in CMEs and Workshops
3. Theoretical teaching:
The theoretical knowledge is imparted to the candidate through distinct courses
of lecture demonstrations, seminars and inter- and intra- departmental meetings.
The students are exposed to recent advances through participation in CMEs.
Teaching and learning are designed for delivery through various methods by
mixing formal didactic lectures and self-learning processes through a structured
and programmatic core education program. Knowledge in applied, basic and
para-clinical and clinical sciences may be imparted by the members of the staff
in respective disciplines or by clinicians themselves by conducting didactic
courses (lectures and demonstrations).
4. Seminar:
Seminars should be conducted at least once weekly so as to cover as wide a range
of topics as possible. The duration should be at least one hour. The relevant topics
should be repeated every year. Seminars could be individual presentations or a
continuum (large topic) with many residents participating.
5. Tutorials / Group Discussion:

The junior residents may present some topics to their senior postgraduates and
amongst themselves where it is fully discussed before finally being discussed
with senior eye specialists. A free and fair discussion is encouraged. These
discussions enable the residents to enhance learning.

6. Clinical Training:
Relevance of beds and admissions in Ophthalmology has really gone down at
present, as most of the surgical and special investigative procedures are being
performed on out-patient basis. Most of the teaching has to be imparted in out-
patient’s department and Operation theatre using Work-Based Learning (WBL)
and Practice-Based Learning.
7. Case discussion:
i. Bedside discussion on the rounds and outpatient teaching takes their toll with
patient management. Therefore, in addition to these, clinical case discussions
should form part of training schedule at a fixed time every week. This could
range from 1-2 hours and could be held at least once or twice a week. The choice
and manner of presentation and discussion varies widely and is left to the
discretion of the department. Every effort should be made to include as wide a
variety of cases as possible over two years with multiple repetitions. Problem
oriented approach is better as it aids in decision making skills. In addition to
bedside teaching rounds, at least 2 hour of formal teaching per week are
necessary.
ii. Case discussions on the patient’s records written by the student is to be
encouraged as it helps exercise the student’s diagnostic and decision-making
skills. It also helps the consultant in critical evaluation of the student’s progress
academically.
iii. Case presentation at other in-hospital multidisciplinary forums. Consultant case
presentation is another approach which should be encouraged as it aids in
solving complex problems and also is forum for discussion of interesting cases.
8. Out-Patients / Clinics:
For the first six months of the training programme residents may be attached to
a faculty member to be able to pick up methods of history taking and ocular
examination in ophthalmic practice. During this period the resident may also be
oriented to the common ophthalmic problems. After 6 months, the clinical
resident may work independently, where he receives new and old cases
including refractions and prescribes for them. The residents are attached to a
senior resident and faculty member whom they can consult in case of difficulty.
9. Wards / Indoor:
Each resident may be allotted beds in the in-patient section depending upon the
total bed capacity and the number of the postgraduates. The whole concept is to
provide the resident increasing opportunity to work with increasing

responsibility according to seniority. A detailed history and case record is to be
maintained by the resident.
10. Surgical Training in Operation Theatre: To provide surgical training, a

phased program with graded responsibility may be undertaken.
i. In the first phase the student is given training in wet lab. He is also exposed to
regional anesthetic block, preparations of cases for operation, and
premedication.
ii. In the second phase, the student shall assist the operating surgeon during the
operation.
iii. In the third phase, the student operates independently assisted by senior
surgeon.
11. Professional Development and Record Keeping:

i. Participation in accredited scientific meetings (CME, Symposia, and
Conferences).: Trainee should have attended two conferences/CMEs/Workshops
during his /her tenure.
ii. Maintenance of log book: Log books shall be maintained and must be submitted
periodically, checked and assessed periodically for continuous monitoring by
the specialist mentor.
III. SYLLABUS
1. Basic medical science:

i. Orbital and ocular anatomy – Gross, Histology, Embryology
ii. Ocular Physiology
iii. Ocular Biochemistry-Biochemistry applicable to ocular function
iv. Ocular Microbiology-Specific microbiology applicable to the eye
v. Ocular Pathology
vi. Ocular Pharmacology
a) Attain understanding of the structure and function of the eye and its parts
in health and disease including Anatomy, Physiology, Biochemistry,
Pathology, Microbiology, Pharmacology etc. and its relevance to
ophthalmology.
b) Attain understanding and application of knowledge of CNS and other
systems of body which influence or control the structure and function of
the eye.
c) Attain understanding of, and develop competence in, executing common
general laboratory procedures employed in diagnosis of ocular disorders.

2. Optics & Refraction:
i. Basic physics of optics
ii. Applied ophthalmic optics
iii. Applied optics including optical devices
iv. Disorders of Refraction
v. Acquire competence in assessment of refractive errors and prescription of glasses
for all types of refraction problems.
vi. Acquire basic knowledge of manufacture and fitting of glasses and competence
in judging the accuracy and defects of the dispensed glasses.
3. Clinical Ophthalmology
The student will be given adequate opportunity to work, on the basis of graded
responsibilities, in outpatients, in patient, and operation theatre (on a rotational
basis). Thus, from the day of entry to the completion of the training program, the
student shall be able to:
i. Acquire scientific and rational approach to the diagnosis of ophthalmic cases.

ii. Acquire understanding of, and develop inquisitiveness to investigate, cause and
effect of diseases.
iii. To understand the principles, perform observe all routine ophthalmic
investigations for example, Slit lamp examination Gonioscopy, Tonometry,
Perimetry, Dark room procedures – Direct & Indirect Ophthalmoscopy,
Keratometry, A-scan Biometry etc.
iv. Manage and treat all types of ophthalmic cases resulting from
a) Disorders of the Orbit
b) Disorders of the lids
c) Disorders of the lacrimal system
d) Disorders of the Conjunctiva
e) Disorders of the Sclera
f) Disorders of the Cornea
g) Disorders of the Uveal Tract
h) Disorders of the Lens
i) Disorders of the Retina & Vitreous
j) Disorders of the Optic Nerve & Visual Pathway
k) Glaucoma
l) Strabismus & Amblyopia
m) Intraocular Tumours
n) Neuro ophthalmology
o) Pediatric ophthalmology

p) Ocular involvement in Trauma
q) Ocular involvement in systemic disease
v. Ophthalmic pathological/microbiological/biochemical sciences: The student
should be able to interpret the relevant pathological / microbiological /
biochemical data, and correlate with clinical data.
vi. Imaging Techniques in Ophthalmology: The student should be able to interpret
the relevant X-Rays, Ocular USG A-Scan & B-Scan, CT scan etc.
Note: The desired scope of various aspects in the course content has been outlined in
Annexure-1 (including basic and standard level goals) as recommended on National
Curriculum for ophthalmology residency training).
4. Medical and Surgical Management of Ophthalmic Disorders:

i. To demonstrate the knowledge of the pharmacology (including toxic) aspects of
drugs used in ophthalmic practice and of drugs commonly used in general
diseases affecting the eyes.
ii. To exhibit competence in medical management of ophthalmic cases.
iii. To competently handle and execute safely common surgical procedures on Lens,
lid, sac, adnexa and ocular surface including conjunctiva, cornea, sclera etc.
iv. Be familiar with micro-surgery and special surgical techniques
v. To competently handle all ophthalmic medical and surgical emergencies.
5. Community Ophthalmology:
i. National Program for Control of Blindness and Visual Impairment
ii. Eye Donation and Eye Banking
iii. Ethical and Medico legal aspects relevant to the discipline
iv. Postgraduate students may be able to assist or carry out eye camps; community
and school surveys.
6. Teaching Methodology: To acquire the basic skills of teaching Nursing and

Paramedical professionals.

IV. SUBJECT SPECIFIC COMPETENCIES
At the end of the course the student should be able to acquire the following
competencies under the three domains:
1. Cognitive domain (Knowledge domain)

No limit can be fixed and no fixed number of topics can be prescribed as course
contents. The student is expected to know his subject in depth; however,
emphasis should be on the diseases/health problems most prevalent in that area.
Knowledge of recent advances and basic sciences as applicable to his/her
specialty should get high priority.
2. Psychomotor domain (Practice Based or Practical Competencies)

The following practical skills shall be acquired:
i. Essential diagnostic skills: Examination techniques along with interpretation

a) Slit lamp Examination
b) Diffuse examination
c) Focal examination
d) Retroillumination – direct and indirect
e) Sclerotic scatter
f) Specular reflection
g) Staining modalities and interpretation
h) Corneal Diagram with color coding
ii. Fundus evaluation

a) Direct/Indirect ophthalmoscopy
b) Fundus drawing
c) 3-mirror examination of the fundus
d) 78-D/90-D/60-D examination
e) Amsler’s charting
3. Basic investigations along with their interpretation

i. Tonometry -Applanation /Indentation /Non-contact
ii. Gonioscopy- Grading of the anterior chamber angle
iii. Tear/ Lacrimal function tests Staining- fluorescein and Rose Bengal Schirmer
test/tear film break up time Syringing Dacrocystography
iv. Corneal
a) Corneal scraping and cauterization
b) Smear preparation and interpretation (Gram’s stain /KOH)

c) Media inoculation
d) Keratometry - performance and interpretation
e) Pachymetry
f) Corneal topography - if available
v. Colour Vision evaluation
a) Ishihara pseudoisochromatic plates
b) Eldridge Green Lantern, if available
vi. Refraction
a) Retinoscopy- Streak/ Priestley Smith
b) Use of Jackson’s cross-cylinder
c) Subjective and objective refraction
d) Prescription of glasses
vii. Diagnosis and assessment of Squint
a) Ocular position and motility examination
b) Lees screen usage
c) Diplopia charting
d) Assessment of strabismus - cover tests/prisms bars
e) Amblyopia diagnosis and treatment
f) Assessment of convergence, accommodation, stereopsis, suppression
g) Synoptophore usage if available
viii. Exophthalmometry: Usage of Hertel’s exophthalmometer - proptosis
measurement
ix. Contact lenses
a) Fitting and assessment of RGP and soft lenses
b) Subjective verification of over refraction
c) Complications arising of contact lens use
d) Educating the patient regarding CL usage and imparting relevant
knowledge of the complications arising thereon
x. Low Vision Aids
a) Knowledge of basic optical devices available and relative advantages and
disadvantages of each.
b) The basics of fitting with knowledge of availability & cost
4. Special Investigations: The resident must be well versed with the following
special investigations modalities although he may or may not perform it
himself but should be able to interpret the following tests:
i. Fundus photography
ii. Fluorescein angiography (FFA)
iii. Ophthalmic ultrasound USG A-scan/B scan
iv. Automated perimetry for glaucoma and neurological lesions

v. Radiological tests - X rays, Antero posterior, Lateral view, Water’s view, Optic
canal view, Localisation of intra-ocular and intra orbital FBs, Interpretations of
- CT/ MRI Scans
vi. Optical Coherence Tomography (OCT) and UBM
vii. Corneal Topography
5. Surgical Skills:
The resident shall be provided with an opportunity to perform operations, both
extra-ocular and intra-ocular, with the assistance of the and / or under the direct
supervision of a Senior Surgeon. Resident shall be provided with an
opportunity to learn special and complicated operations by assisting the Senior
Surgeon, in these operations. Resident shall be responsible for the postoperative
care of these cases. It is desirable that the student be able to perform
independently/under guidance various surgeries; the thrust areas include
cataract, lacrimal sac, entropion and enucleation / evisceration. The resident
surgery should be evaluated by available tools like OSCAR, CEX to provide
surgical training, a phased program with graded responsibility may be
undertaken:
i. In the first phase the student is given training in wet lab. He is also exposed to
regional anesthetic block, preparations of cases for operation, and
premedication.
ii. In the second phase, the student shall assist the operating surgeon during the
operation.
iii. In the third phase, the student operates independently assisted by senior
surgeon.
5.1 The student must know and be able to perform independently:
i. Minor surgical procedures:

a) Conjunctival and corneal foreign body removal on the slit lamp
b) Suture removal- skin / conjunctival/ corneal / corneoscleral
c) Epilation, electroepilation
d) Syringing and probing
e) Subconjunctival injection
f) Chalazion incision and curettage
g) Tarsorrhaphy
h) Biopsy of small lid tumors
i) Artificial eye fitting
j) Acute management of acid and alkali burns.

ii. Ocular Anesthesia: The student must know and be able to perform independently
Ocular Anesthesia
a) Peribulbar / Retrobulbar / Subtenon / Topical /Intra-cameral use of Anesthetics
b) Facial nerve blocks- O’Brien / Atkinson/ Van lint & modifications
c) Frontal nerve blocks
d) Infra orbital nerve blocks
e) Blocks for sac surgery
5.2 The student must be able to perform independently / under supervision / assist and
deal with complications arising from the following Ocular surgeries:
i. Lid Surgery
a) Ectropion & entropion (simple procedures)
b) Lid repair following trauma – including lid margin tears
ii. Destructive procedures

a) Evisceration with or without implant
b) Enucleation with or without implant
c) Enucleation for eye donation
d) Cyclocryotherapy
iii. Sac surgery

a) Dacryocystectomy / Dacryocystorhinostomy
b) Probing for congenital obstruction of nasolacrimal duct Strabismus surgery
iv. Ocular surface procedures

a) Pterygium excision with modifications
b) Conjunctival cyst excision
c) Conjunctival flap/peritomy
d) Repair of corneal / corneo – scleral perforations
5.3 The student shall be well conversant with use of Operating microscope and must be
able to perform the following surgeries competently using the microscope:
i. Cataract surgery
a) Standard ECCE with IOL implantation
b) Small incision Cataract surgery with IOL implantation

ii. Vitreous Surgery
a) Intra-vitreal and intra-cameral (anterior chamber) injection techniques and
dosages, particularly for endophthalmitis management.
b) The student should know the basis of anterior vitrectomy in the management
of cataract surgery complications.
5.4 The student should have preferably assisted in the following microscopic Surgeries
i. Cataract surgery: Phacoemulsification

ii. Glaucoma surgery: Trabeculectomy
iii. Keratoplasty
a) Therapeutic and optical
b) Application of glue and bandage CL
iv. Desirable to have assisted/ have knowledge of the following Laser procedures:
a) YagCapsulotomy
b) Laser iridotomy
c) Focal and panretinal photocoagulation
d) Kerato-refractive procedure
It is essential that by the completion of the training resident should have independently
performed / performed with assistance at least 25 Cataract surgeries with IOL Implantation
and 15 Extra ocular surgeries including
• Eyelid surgeries (Entropion / Ectropion / Eyelid repair),

• Lacrimal sac surgeries (DCT / DCR / Syringing & Probing)
• Eye retrieval procedures (Enucleation)
• Ocular surface procedures (Pterygium, Repair of corneo scleral perforations,
Conjunctival flap/peritomy, Corneal suture, FB removal, Glue and bandage
CL)
5.5 Affective domain (Attitudes including Communication and Professionalism) Basic

Sciences: Instruct patients about eye diseases using model of an eye **
i. Optics, Refraction and Contact Lens

a) Instruct patients regarding uses, advantages, and care of spectacles**
b) Instruct patients regarding safe CL insertion and removal, CL wearing
schedule, lens care regimens, CL disinfection care, indications
contraindications**
c) Instruct patients regarding costs, types, advantages and disadvantages of
IOLs**

ii. Cataract and Lens - General Educational Objectives
a) Develop and exercise clinical and ethical decision making in cataract
patients**
b) Develop good patient communication techniques regarding cataract surgery**
c) Work effectively as a member of the medical care team**
d) Develop teaching skills about cataract for instructing junior trainees and
students**
e) Instruct patients about post-operative care after cataract surgery. **
iii. Cornea and External Diseases

a) Counselling for eye donation and donor cornea harvesting**
b) Good patient communication techniques regarding penetrating keratoplasty
*
iv. Neuro-Ophthalmology: Breaking bad news (Intracranial tumors) **
v. Glaucoma
a) Counsel patient and relatives regarding glaucoma screening and medication
b) Consent for Trabeculectomy **
vi. Ophthalmic Pathology: Good patient communication techniques regarding

diagnostic procedures
vii. Vitreoretinal Diseases

a) Communicate about blindness due to specific retinal diseases
b) Provide patient with all relevant information about proposed investigative

procedures for Retinal disease like FFA, OCT including risks and
complications
viii. Uveitis and Ocular Inflammation

a) Provide patient with all relevant information about proposed ancillary
testing procedures for uveitis, including risks and complications.
b) Counsel about side effects of immunosuppressive therapy.
c) Provide patient with relevant information about possible side effects of
medications and proper monitoring of medications.

ix. Ocular Oncology
a) Discuss prognosis and various management options with patients and their
families in a detailed, ethical, and compassionate manner**
b) Genetic counseling of parents of a child with retinoblastoma**
c) Use information technology and other aids to cope with lack of expert
knowledge**
d) Assist patients with selecting the most appropriate management in
collaboration, if necessary, with a subspecialist in ocular oncology.
x. Low Vision
a) Demonstrate low vision devices and educate low vision patients on the uses
and limitations of these devices**
b) Educate patients on use of low vision equipment**
xi. Ethics and Professionalism in Ophthalmology

a) Confidentiality of health information
b) Professional competence and maintenance of competence
c) Informed consent
xii. Refractive Surgery: Counsel a patient for refractive surgery
xiii. Community Ophthalmology: Develop an activities plan for a one-year

operational plan for a blindness prevention program for health district
Note: ** denotes the must know skills and has been adapted from the International
Council of Ophthalmology Curriculum for Residents
V. PROCEDURES
Under Under
Can Perform Cannot
PROCEDU supervisio supervisio
SURGERIES Independent Perfor
RE n with n without
ly m
assistance assistance
Conjunctival and
Minor
corneal foreign body
surgical 
removal on the slit
procedures
lamp

Pterygium excision
with recent 
techniques
Suture removal- skin

/ conjunctival/

corneal /
corneoscleral
Subconjunctival

injection
Posterior Sub-

Tenon’s injections
Repair of corneal /
corneo – scleral 
perforations
Chalazion incision

and curettage
Biopsy of small lid 

tumors
Peribulbar /
Retrobulbar 
anesthesia
Facial nerve blocks-

O’Brien / Atkinson/

Van lint &
modifications
Frontal nerve blocks 

Ocular
Anesthesia Infra orbital nerve

blocks
Blocks for sac


surgery
Ocular Anesthesia 
Peribulbar /
Retrobulbar 
anesthesia

Tarsorrhaphy 
Ectropion&entropion

(simple procedures)
Lid Lid repair following

trauma – including 
lid margin tears
Epilation,

Electroepilation
Dacryocystectomy 
Dacryocystorhinosto

my
Lacrimal
Apparatus Probing for
congenital

obstruction of
nasolacrimal duct
Cataract surgery
Standard ECCE with


IOL implantation
Small incision
Cataract surgery
Lens 
with IOL
implantation
Secondary AC or PC

IOL implantation
Phacoemulsification 
Trabeculectomy 
Pharmacological
Glaucoma modulation of 
Trabeculectomy
Iridectomy 
Therapeutic
Cornea 
Keratoplasty

Optical Keratoplasty 
Kerato-refractive

procedures
Intra-vitreal and
intra-cameral
(anterior chamber)
injection techniques
Retina 
and dosages,
particularly for
endophthalmitis
management.
Evisceration with or

without implant
Destructive Enucleation with or


procedures without implant
Enucleation for eye


donation
Cyclocryotherapy 
Recession and
Strabismus resection procedures

surgery on the horizontal
recti
YagCapsulotomy 
Laser Laser Iridotomy 

Procedures
Focal and Panretinal

Photocoagulation
VI. LOG BOOK

The candidate will maintain the record of all academic activities undertaken by
him/her in log book. The log book should show date wise evidence that the
before mentioned subjects were covered. Apart from personal profile of the
candidate, educational qualification/Professional data logbook should contain
• Record of case histories

• Procedures learnt

• Record of case Demonstration/Presentations
• Record of operations (assisted / performed) during the training period,
certified by the concerned senior consultant / Head of the department.
• Record of participation/ attendance in CME. Workshop and Conference
The performance of the Postgraduate student during the training period should
be monitored throughout the course and duly recorded in the log books as
evidence of the ability and daily work of the student.
1. Personal attributes
i. Behavior and Emotional Stability: Dependable, disciplined, dedicated, stable in
emergency situation shows positive approach.
ii. Motivation and Initiative: Takes on responsibility, innovative enterprising, does
not shirk duties or leave any work pending.
iii. Honesty and Integrity: Truthful, admits mistakes, does not cook up information,
has ethical conduct, exhibits good moral values, loyal to the institution.
iv. Interpersonal Skills and Leadership Quality: Has compassionate attitude
towards patients and attendants, gets on well with colleagues and paramedical
staff, is respectful to seniors, has good communication skills.
2. Clinical Work:
i. Availability: Punctual, available continuously on duty, responds promptly on
calls and take proper permission for leave.
ii. Diligence: Dedicated, hardworking, does not shirk duties, leaves no work
pending, and does not sit idle, competent in clinical case work up and
management.
iii. Academic ability: Intelligent, shows sound knowledge and skills, participates
adequately in academic activities, and performs well in oral presentation and
departmental tests.
3. Clinical Performance:
i. Preparing documents of the case history/examination and progress notes in the
file (daily notes, round discussion, investigations and management)
ii. Skill of performing bed side procedures and handling emergencies.
4. Academic Activity:
i. Performance during presentation at Seminar and other academic sessions.
ii. Proficiency in clinical presentations and discussion during rounds and OPD
work up
iii. Proficiency in skills as mentioned in job responsibilities.

Marks for personal attributes and clinical work should be given annually by all
the consultants under whom the resident was posted during the year. Average
of the two years should be put as the final marks out of 25. Marks for clinical
Performance academic activity should be given by the all consultants who have
attended the session presented by the student. The Internal assessment should
be recorded in Log book.
Every candidate, at the time of practical examination, will be required to produce

performance record (log book) containing details of the work done by him/her
during the entire period of training as per requirements of the log book. It should
be duly certified by the supervisor as work done by the candidate and
countersigned by the administrative Head of the Institution.
This log book shall be made available to the board of examiners for their perusal
at the time of the final examination. In the absence of production of log book, the
result will not be declared.
VII. RECOMMENDED TEXT BOOKS & JOURNALS
TEXT BOOKS
i. Albert DM. Ophthalmic Surgery: Principles and Techniques. Blackwell
Science.
ii. Albert DM, Jakobiec. Principles and Practice of Ophthalmology. W B Saunders
iii. Principles & Practice of Ophthalmology Gholam a Paymen
iv. The Current American Academy of Ophthalmology Basic and Clinical Science
Course (13volumes) supplemented by reading selected references ostensibly
covers the curriculum, including the basic sciences.
v. Abrams D. Duke Elder’s Practice of Refraction. Churchill Livingstone.
vi. Text book of Ophthalmology Yanoff and Duker
vii. Stephen J Ryan: Retina
viii. Sandra Byrne and Ronald Green: Ophthalmic Ultrasound
ix. Krachmer JH, Mannis MJ, Holland EJ. Cornea: Fundamentals, Diagnosis, and
Management 3 ed. Mosby Elsevier, 2011.
x. Yanoff N, Duker JS. Ophthalmology 3 ed. Mosby Elsevier, 2009
xi. Friedman NJ, Kaiser PK, Trattler WB. Review of Ophthalmology. Elseview
Saunders 2005, Philadelphia.
xii. Vajpayee RB. Corneal Transplantation 2nd edition. Jaypee Brothers Medical
Publishers India (P) Ltd, New Delhi.

xiii. Coster D. Cornea (Fundamentals of Clinical Ophthalmology Series). Blackwell
i. Publishing Limited.
xiv. Gasson A, Morris A J. The Contact Lens Manual. A practical guide to fitting.
4th ed. i. Butterworth Heinemann Elsevier, 2010.
xv. Steinert’s cataract surgery 2nd Ed
xvi. Shields Text book of glaucoma
xvii. Smith and Nozik: Uvea
xviii. Rootman’s diseases of the orbit
xix. Shields JA, Shields CL. Eyelid, conjunctival and orbital tumors. An atlas and
textbook.
xx. Second ed. Philadelphia: Lippincott Williams & Wilkins; 2008.
xxi. Shields JA, Shields CL. Intraocular tumors. An atlas and textbook. Second
Edition ed.
xxii. Taylor and Hoyt: Pediatric Ophthalmology. Saunders Ltd. 2004.
xxiii. Pratt-Johnson and Tilson: Management of Strabismus and Amblyopia. Thieme
Verlag.
xxiv. Wright, Spiegel and Thompson: Handbook of Pediatric Eye and Systemic
disease.
xxv. Von Noorden GK. BinocularVision and Ocular Motility. Theory and
Management of Strabismus. Mosby.
xxvi. Helveston: Surgical Management of Strabismus.
xxvii. Von Noorden and Helveston: Strabismus: A Decision Making Approach.
xxviii. Char DR. Thyroid Eye Diseas., Williams and Wilkins, Baltimore, 1985
xxix. Collin JRO (ed). A Manual of Systematic Eyelid Surgery. Churchill
Livingstone, Edinburgh, 1983
xxx. Agarwal A, Agarwal A, Jacob Soosan. Refractive Surgery 2nd edition. Jaypee,
2009.
xxxi. Gimbel HV, Penno EEA. LASIK Complications, Prevention and management
2nd edition. Slack Inc., 2001.
xxxii. Alio JL, Azar DT. Management of Complications of Refractive Surgery.
Springer, Holladay JT. Quality of Vision: Essential Optics for the Cataract and
Refractive Surgeon. Slack Inc., 2006.
xxxiii. Ocular Pharmacology: Havener
xxxiv. Anatomy: Wolff 's Anatomy of the Eye and Orbit
xxxv. Physiology: Adler’s Physiology of the Eye
xxxvi. Easty DL, Sparrow JM.Oxford Textbook of Ophthalmology (2 volumes)
Oxford Medical Publications.
xxxvii.Forrester JV, Dick AD, McMenamin PG, Lee WR. The Eye. Basic Sciences in
Practice. W B Saunders.

xxxviii. Gass JDM. A Stereoscopic Atlas of Macular Diseases: Diagnosis and
Treatment
xxxix. Glaser JS. Neuroophthalmology. LipincottWilliams & Wilkins.
xl. Harry J, Misson G. Clinical Ophthalmic Pathology. Butterworth/Heinemann.
xli. Jimenez Sierra JM, Ogden TE, Van Boemel GB. Inherited Retinal Diseases. A
Diagnostic Guide. Mosby.
xlii. Colquhoun, M. C., Evans, T. R., Handley, A. J. (2003) ABC of Resuscitation.
Published by BMJ Publishing Group.
xliii. 43. Miller NR, Newman NJ. Walsh and Hoyt’s Clinical Neuroophthalmology
(5volumes) Williams and Wilkins. This is the principle reference text for
neuro-ophthalmology.
xliv. Oyster CW The human eye Sinauer Associates. Sunderland. Massachusetts
xlv. Taylor D. Paediatric Ophthalmology. Blackwell Science.
xlvi. Van Heuven WAJ, Zwann J. Decision Making in Ophthalmology. Mosby.
Provides useful guidance concerning how a wide range of conditions should
be managed.
xlvii. Wills Eye Manual
xlviii. Kanski’s Clinical Ophthalmology – A systematic Approach 9th edition
Butterworth / Heinemann.
xlix. Parsons' Diseases of the eye Sihota and Tandon 23rd Edition International
Council of Ophthalmology Residency Curriculum available at
http://www.icoph.org/
JOURNALS
i. Indian Journal of Ophthalmology
ii. American Journal of Ophthalmology
iii. Ophthalmology
iv. Survey of Ophthalmology
v. International Ophthalmology Clinics
vi. British Journal of Ophthalmology
vii. Cornea
viii. Journal of Cataract and Refractive Surgery
ETHICS AND PROFESSIONALISM IN OPHTHALMOLOGY MEDICAL

ETHICS DOCUMENTS
i. The Hippocratic Oath

http://www.nlm.nih.gov/hmd/greek/greek_oath.html

ii. WMA Declaration of Geneva
http://www.wma.net/en/30publications/10policies/g1/
iii. Ethical Code, International Council of Ophthalmology
http://www.icoph.org/pdf/icoethicalcode.pdf
iv. Code of Ethics, American Academy of Ophthalmology
http://www.aao.org/about/ethics/code_ethics.cfm
v. Nuremburg Code
http://ohsr.od.nih.gov/guidelines/nuremberg.html
vi. WMA Declaration of Helsinki
http://www.wma.net/en/30publications/10policies/b3/
vii. Belmont Report
http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html

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NATIONAL BOARD OF EXAMINATIONS IN MEDICAL SCIENCES
Ministry of Health & Family Welfare, Govt. of India
Medical Enclave, Ansari Nagar, New Delhi- 110029

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Curriculum

Teaching and Learning Activities

Subject Specific Competencies

Recommended Text Books & Journals

Curriculum for NBEMS Diploma in Ophthalmology PAGE 2 OF 30

I Objectives of The Programme 5

II Teaching and Learning Activities 9

IV Subject Specific Competencies 15

VII Recommended Text Books & Journals 26

Curriculum for NBEMS Diploma in Ophthalmology PAGE 3 OF 30

Curriculum for NBEMS Diploma in Ophthalmology PAGE 4 OF 30

2. Programme Specific Learning Objectives

i. Offer to the community, the current quality of ‘standard of care’ in ophthalmic

Curriculum for NBEMS Diploma in Ophthalmology PAGE 5 OF 30

ii. Medical Knowledge

iii. Practice-based Learning and Improvement

Curriculum for NBEMS Diploma in Ophthalmology PAGE 6 OF 30

iv. Communications Skills

vi. Systems-based Practice

Curriculum for NBEMS Diploma in Ophthalmology PAGE 7 OF 30

i. Basic Sciences: Resident should possess basic knowledge of the structure,

Curriculum for NBEMS Diploma in Ophthalmology PAGE 8 OF 30

II. TEACHING AND LEARNING ACTIVITIES

Acquisition of practical competencies being the keystone of postgraduate

1. Methods for Theoretical learning and teaching: Formal Teaching and

Curriculum for NBEMS Diploma in Ophthalmology PAGE 9 OF 30

5. Tutorials / Group Discussion:

Curriculum for NBEMS Diploma in Ophthalmology PAGE 10 OF 30

Curriculum for NBEMS Diploma in Ophthalmology PAGE 11 OF 30

10. Surgical Training in Operation Theatre: To provide surgical training, a

11. Professional Development and Record Keeping:

1. Basic medical science:

Curriculum for NBEMS Diploma in Ophthalmology PAGE 12 OF 30

i. Acquire scientific and rational approach to the diagnosis of ophthalmic cases.

Curriculum for NBEMS Diploma in Ophthalmology PAGE 13 OF 30

4. Medical and Surgical Management of Ophthalmic Disorders:

6. Teaching Methodology: To acquire the basic skills of teaching Nursing and

Curriculum for NBEMS Diploma in Ophthalmology PAGE 14 OF 30

1. Cognitive domain (Knowledge domain)

2. Psychomotor domain (Practice Based or Practical Competencies)

i. Essential diagnostic skills: Examination techniques along with interpretation

ii. Fundus evaluation

3. Basic investigations along with their interpretation

Curriculum for NBEMS Diploma in Ophthalmology PAGE 15 OF 30

Curriculum for NBEMS Diploma in Ophthalmology PAGE 16 OF 30

5.1 The student must know and be able to perform independently:

i. Minor surgical procedures:

Curriculum for NBEMS Diploma in Ophthalmology PAGE 17 OF 30

ii. Destructive procedures

iii. Sac surgery

iv. Ocular surface procedures

Curriculum for NBEMS Diploma in Ophthalmology PAGE 18 OF 30

i. Cataract surgery: Phacoemulsification

• Eyelid surgeries (Entropion / Ectropion / Eyelid repair),

5.5 Affective domain (Attitudes including Communication and Professionalism) Basic

i. Optics, Refraction and Contact Lens

Curriculum for NBEMS Diploma in Ophthalmology PAGE 19 OF 30

iii. Cornea and External Diseases

iv. Neuro-Ophthalmology: Breaking bad news (Intracranial tumors) **