The second level of the Paraoptometric Certificate Program consists of 15 hours of lectures in five subject areas:

• Anatomy and Physiology of the Eye 1
• Ophthalmic Dispensing 2
• Ophthalmic Lenses 2
• Introduction to Patient Care 2
• Contact Lenses 2

Students may complete all 15 hours at one location OR take only part of the hours at one location and then take additional hours at future program offerings. Following completion of the lecture series, students may sit for a test to demonstrate their competency in the subject matter. Students must pass tests in all five subject areas in order to receive a certificate from the Indiana University School of Optometry acknowledging their completion of Level 2 of the program. The sessions are noncredit courses, thus do not count toward a degree at Indiana University.

For more information, contact Sue Gilmore at the Indiana University School of Optometry.

	URL: http://www.opt.indiana.edu/ce/paraopt/level2.htm Revised: June 12, 2007
	IU Optometry home page: http://www.opt.indiana.edu/ Comments: Web Administrator Page design and coding: Terri Greene Copyright © 2007, The Trustees of Indiana University

• Part I. The Eye (1).
  The first part of an overview of the structure and function of the eye. The following will be introduced: eyelids, tear film, lacrimal drainage, cornea, sclera, limbus, conjunctiva, iris, pupil, and pupil reflexes.
• Part II. The Eye (2).
  To complete the overview of the structure and function of the eye, this segment will include: ciliary body, choroid, lens, accommodation, aqueous humor, intraocular pressure, vitreous humor, and retina.
• Part III. Visual Pathway and Extraocular Muscles.
  A brief discussion of the visual pathway, the extraocular muscles, and monocular eye movements.

• Part I. Frame Selection.
  A good frame selection depends upon blending excellence in cosmetic aspects and compatibility with lens prescription requirements. In this section we will be looking at the guidelines for selecting the best frame size, color, style and shape based on wearer facial characteristics and lifestyle needs. We will also be balancing prescription considerations and how these will affect the appearance of the final Rx.
• Part II. Facial Measurements.
  Instruction will be given in how to take the many different individualized measurements necessary once the frame has been selected. This ranges from interpupillary distances with a millimeter rule or with instrumentation to techniques for measuring bifocal, trifocal, occupational seg heights and progressive addition fitting heights.
• Part III. Repairs and Nosepad Adjustments.
  Service is still an important aspect in making optometric practices successful. And a large part of that consists of helping people who have broken or damaged eyewear. Here we will be considering repairs from simple screw repairs (unfortunately not all are simple!), on through hints, helps, and how-toÕs for many commonly occurring repairs. In addition, there will be a limited discussion on some of the more specialized nosepad adjustments such as changing the vertex distance and frame height.

Bring a millimeter rule and two frames for measuring seg heights.

• Part I. Verification and Standards for Single Vision Lenses.
  Having established what the elements of a lens prescription are in Level 1, we will go over how to tell if a lens prescription received from the laboratory is within expected standards. Standards will include sphere, cylinder and axis, PD expectations and prism tolerances. Explanation will be related to both the manual and automated lensmeter.
• Part II. Understanding Multifocals with Visible Near Segments.
  An individual's visual needs often require different lens powers for different distances. These needs must be met using lenses with more than one power area. In this section we will explore the concept of the near addition lens and how it may be varied to meet a diversity of viewing needs.
• Part III. Gaining Proficiency with Progressive Addition Lenses.
  On first glance a progressive addition lens looks like any other single vision lens; however, between their surfaces they hide an area of progressively changing power. Here we will find out how a progressive lens works, how progressive lenses differ, what the key points on a progressive lens are, why frame selection is so important.

• Part Ia. Color Vision.
  
  1. An overview of the physical and psychological variables that contribute to normal color vision:
  1. wavelength and hue
  2. purity and saturation
  3. amplitude and brightness
  2. A description of normal color vision
  3. A discussion of color vision deficiency in patients with and without ocular disease
  4. A discussion of the difference between:
  1. protanomalous and protanopia
  2. deuteranomalous and deuteranopia
  3. tritanomalous and tritanopia
  5. A brief overview of the epidemiology of color vision deficiencies
  6. A description of color vision tests
• Part Ib. Visual Pathway.
  
  1. A review of the anatomical relationship between the eye and the brain
  2. A review of the anatomy of the retina
  3. A review of the neurological wiring from the retina to the visual cortex
  4. A discussion of the relationship between the visual pathway and the visual field
  5. A discussion of how problems in the visual pathway can lead to problems in the visual field
• Part II. Visual Field Testing.
  
  1. A discussion of the role of visual field testing in the examination of the patient
  1. indications for visual field testing
  2. diagnosis of related clinical conditions
  2. A description of the components of the monocular visual field
  3. A description of the components of the binocular visual field
  4. The definition of perimetry and isopter and a description of the isopters of the normal visual field
  5. A discussion of the relationship between normal isopters and mapping the visual field of a patient
  6. A discussion of the difference between:
  1. kinetic perimetry
  2. static perimetry
  3. qualitative perimetry
  4. quantitative perimetry
  7. A discussion of the procedures for the manual evaluation of the visual field and the effect of:
  1. changing the size of the target
  2. changing the distance between the patient and the target
  8. A discussion of the procedures for the automated evaluation of the visual field
  1. units of measure
  2. stimulus notation
  3. threshold testing
  4. test patterns
Part III. Visual Field Defects.

1. A description of the types, size, and shapes of defects that can be found in the visual field:
1. contraction
2. depression
3. scotoma
4. hemianopsia
5. metamorphopsia
2. A discussion of the relationship between visual field defects detected in the visual field and location of the problem in the visual pathway
3. A discussion of how visual field tests are interpreted
1. icontour maps
2. gray scale
3. dB scale
4. A brief overview of some of the more common types of visual field defects

The appropriate sections of

• Stein HA, Slatt BJ, Stein R. The Ophthalmic Assistant, 8th edition, Mosby, 2006.
• Choplin NT, Edwards RP. Visual Fields, Slack, 1998.

• Part I. Optical Principles.
  The optical considerations of both the eye and contact lenses to achieve best visual correction will be addressed.
• Part II. Preliminary Examination, Fitting, and Follow-Up Procedures.
  Critical aspects of preliminary examination, fitting of contact lenses, and follow-up procedures for successful contact lens wear.
• Part III. Complications.
  Adverse effects of contact lens wear including contact lens solutions will be discussed as will the remedies to successful contact lens wear.