Advanced Certificate in Glaucoma 2024 (ACO-ACG)

Advanced Certificate in Glaucoma 2024 (ACO-ACG)

Date: 18/03/2024 (AEDT)

Venue: Online + Clinical Placement

Provider: Australian College of Optometry

Contact: Shazia Tahseen, [E] cpd@aco.org.au, [P] 03 9349 7546

Activity Outline

The online component will involve approximately 20 hours of education, made up of recorded lectures and online assessment tasks. Recommended reading is not included in this calculation but is encouraged to be undertaken.

The practical component of the course involves 15 hours of clinical placement experience under the guidance of an experienced mentor.

Learning Objectives

• Lecture 1b: Basic Concepts in Glaucoma 1. Review the anatomy of the anterior segment and of the optic disc, the mechanism of aqueous formation and the physiology of flow within the anterior chamber 2. Review the pathophysiology of glaucoma, including an overview of the epidemiology of glaucoma and hereditary basis of the condition 3. Review diagnostic methodologies and differential diagnoses
• Lecture 1c: Risk factors for the development of glaucoma 1. Recall the risk factors for developing glaucoma and explain their relative significance 2. Summarise the outcomes of the major clinical trials on the treatment of glaucoma and relate this to your patients on an individualised basis 3. Use the common glaucoma risk calculators to help plan a course of management for patients
• Lecture 1d: Clinical assessment of factors which predict the development of glaucoma 1. Identify the assumptions made and the limitations of relying heavily on an intraocular pressure reading as a sole criterion in the diagnosis of glaucoma 2. Discuss the range of diagnostic procedures (binocular indirect ophthalmoscopy, visual fields, tonometry, optical coherence tomography, pachymetry, gonioscopy, stereoscopic photography, 90-dioptre lens assessment) that are employed to assess glaucoma
• Lecture 1d: Clinical assessment of factors which predict the development of glaucoma 3. Explain the importance of diagnostic imagery as a useful adjunct to – but not a substitute for – detailed clinical evaluation of the optic disc
• Lecture 2a: Primary open angle glaucoma (POAG): Diagnosis and Differential Diagnosis 1. Revision of the diagnosis of primary open angle glaucoma, including pre-perimetric glaucoma 2. Review the important considerations for the differential diagnosis of glaucoma, including other optic neuropathies and when medical imaging (CT or MRI) might be required 3. Update on the use of Goldman versus Icare tonometry in glaucoma patients
• Lecture 2b: Primary open angle glaucoma (POAG): Understanding Glaucoma Progression 1. Detecting progression in POAG using visual field, OCT, disc observations, IOP measurements, and IOP target as a guide 2. Discuss the long-term risk of glaucoma in patients receiving ongoing treatment with anti-VEGF injections 3. Discuss newer glaucoma medications: ROCK inhibitors and NO-based medications
• Lecture 2c: The role of Ocular Coherence Tomography (OCT) in the diagnosis and management of glaucoma 1. Discuss anatomical and measurement concepts in OCT scanning 2. Recognise the limitations that can arise in interpretation of OCT data 3. Applying the OCT as an aide to detect progression, and integrating OCT with other clinical data to detect progression 4. Applying OCT data as an aide in the differential diagnosis of glaucoma from other causes of optic neuropathy
• Lecture 2d: Secondary open angle glaucoma (Secondary OAG) – overview 1. Discuss the classification and prevalence of secondary OAG 2. Explain the aetiology of secondary OAG and identify the risk factors that are associated with the condition 3. Assess the risk of developing secondary OAG
• Lecture 2e: Secondary open angle glaucoma - subtypes 1. List the main categories of secondary OAG 2. Evaluate the pathophysiological processes that result in secondary OAG 3. Discuss the clinical considerations that are relevant when managing secondary OAG
• Lecture 2f: Normal tension glaucoma (NTG) 1. Understand the differing pathophysiology and epidemiology of NTG compared to primary open angle and other types of glaucoma 2. Revision of the differential diagnosis of glaucoma, emphasising cases where the IOP is considered to be low 3. Discussion of the association between myopia and glaucoma, and how this applies to the diagnosis, differential diagnosis and management of patients with both glaucoma and myopia
• Lecture 2f: Normal tension glaucoma (NTG) 4. Understand the management of normal tension glaucoma and how to detect and manage progression in this unique glaucoma population
  
• Lecture 2g: Open angle glaucoma management – medical treatment 1. Discuss the overarching principles of the medical management of glaucoma 2. Explain the criteria that should be considered when deciding to commence treatment for glaucoma 3. Review the concept of target intraocular pressure (IOP) and customized treatment 4. List the options for treatment for glaucoma 5. Identify important challenges in management
• Lecture 2h: Laser treatment: open and closed angle glaucoma Glaucoma management - diagnosis, monitoring and treatment: laser 1. Review the indications & limitations of laser treatment for glaucoma 2. Understand the mechanism of action of glaucoma laser therapies 3. Understand fundamentals of performing laser treatment for glaucoma: selective laser trabeculoplasty (SLT), argon laser trabeculoplasty (ALT), micropulse laser trabeculoplasty (MLT), laser peripheral iridotomy (LPI), laser iridoplasty
• Lecture 2h: Laser treatment: open and closed angle glaucoma Glaucoma management - diagnosis, monitoring and treatment: laser 4. Understand the complications of glaucoma laser therapies
• Lecture 3a: Primary Angle Closure 1. Understanding of the definition, epidemiology and pathophysiology of angle closure 2. Identify the various stages of angle closure glaucoma when compared to the clinical classification 3. Recognise the importance of performing gonioscopy routinely to exclude angle closure
• Lecture 3b: Secondary angle closure 1. List the main mechanisms of secondary angle closure 2. Explain the risk factors and causes of secondary angle closure 3. Clinical considerations and management in secondary angle closure glaucoma
• Lecture 4a: Glaucoma Surgery Indications Part 1 1. The role of glaucoma surgery in glaucoma management 2. Target pressures and the indications for glaucoma surgery including progression of glaucoma 3. Understanding the risks and benefits of glaucoma surgery, and how this judgement is applied clinically
• Lecture 4b: Glaucoma Surgery Indications Part 2 1. Identify the normal postoperative events that are associated with glaucoma surgery 2. Demonstrate an understanding of the signs for which a clinician should be alert during the six months that follow surgery, particularly those that may indicate problems 3. Explain the common signs that warrant interventions in the early postoperative period 4. Assessing the success of glaucoma surgery
• Lecture 5a: Special Clinical Considerations in Glaucoma 1. Demonstrate an understanding of the role of topical, systemic and intravitreal steroids in exacerbating primary open angle glaucoma (POAG); 2. Discuss the risk factors, subtypes, clinical features, and management of congenital glaucoma; 3. List the systemic conditions that are associated with infantile glaucoma; 4. Recognise the important challenges that are associated with managing glaucoma in the paediatric population
• Lecture 5a: Special Clinical Considerations in Glaucoma 5. Describe the clinical considerations that are associated with the management of glaucoma in a pregnant woman
• Lecture 5b: Artificial Intelligence and the future of glaucoma assessment 1. Understand the broad concepts of Artificial Intelligence, Machine Learning, Deep Learning and Artificial Neural Networks 2. Understand the strengths and limitations of these technologies 3. Understand the applications of these technologies to healthcare and glaucoma management 4. Understand how this technology might fit into the future of clinical care in glaucoma
• Lecture 5c: Prescribing standards and regulations relevant to glaucoma management in AUSTRALIA 1. Discuss the collaborative care guidelines that regulate the management of health care provision by two or more health practitioners 2. Demonstrate a detailed understanding of the guidelines for care of patients who have developed or who are at high risk of developing chronic glaucoma
• Lecture 5c: Prescribing standards and regulations relevant to glaucoma management in AUSTRALIA 3. Discuss the legal responsibilities that are assumed by an optometrist who decides to undertake responsibility for the management of glaucoma
• Lecture 5c: Legal aspects of prescribing for glaucoma in NEW ZEALAND 1. Understand the Optometrists and Dispensing Opticians Board requirements to become a glaucoma prescriber 2. Understand the practicing and ongoing requirements to be able to prescribe for glaucoma

Max CPD hours awarded: 35

Session Information