JOB SPECIFICATION · ocular surgery and local anaesthesia under supervision of Ophthalmologist. 3. Carry out activities related to patient care in In Patient Department (IPD). 4

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JOB SPECIFICATION

1 JOB TITLE : OPHTHALMIC ASSISTANT LEVEL : 3

2 JOB DESCRIPTION Assist Ophthalmologists in tertiary and secondary eye care, render primary eye care, organise out-reach eye care, impart eye health education.

3 LIST OF TASKS: 1. Perform preliminary activities in Out Patents Department (OPD) 2. Perform assisting activities in operation theatre (OT) and perform specified extra-

ocular surgery and local anaesthesia under supervision of Ophthalmologist. 3. Carry out activities related to patient care in In Patient Department (IPD). 4. Plan organise and implement out-reach and community eye health activities. 5. Select appropriate educational material and impart eye health education. 6. Identify health needs in the community. 7. Carry out managerial activities in primary and secondary eye care. 8. Perform maintenance of commonly used ophthalmic equipment and instrument.

4 QUALIFYING NOTES (entry requirement etc.)

- Normal Health

- SLC or equivalent level passed

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TASK SPECIFICATION

5 TASK NO: 1 Perform preliminary activities in Out Patents Department (OPD)

6 Task Elements 1. In order to be able to perform preliminary activities in OPD the OAT should be able to: 1.1 Take History of the patient. 1.2 Examine the eye with a torch, slit lamp and ophthalmoscopes. Recognise abnormal eye conditions, injuries and

common diseases of the eye. Initiate the appropriate treatment of ocular disorders when required. 1.3 Know and apply the appropriate drugs to treat common eye problem and the conditions under which treatment

must be given. 1.4 Recognise and refer patients with suppurative Keratitis,uveitis,operable cataract, Glaucoma, sudden loss of vision,

posterior segment abnormalities.

1.5 Perform visual acuity and pinhole examinations. 1.6 Identify and carry out clinical and functional assessment of low vision cases and prescribe appropriate optical and

non optical devices. 1.7 Administer sub-conjunctival, sub-tenon and peri-ocular injections. 1.8 Remove superficial ocular foreign bodies. 1.9 Carry out investigations and procedures involved in diagnosing eye disorder such as Tonometry (Schioetz,

applanation and non contact Tonometry), Biometry, Visual filed examinations (Confrontation, Bjerrrums screen, Lister, Friedman, Goldman, Humphrey), Schirmer test, shiedle, colour vision (Ishihara and Fansworth)

1.10 Perform mechanical and electric epilation

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1.11 Carry out irrigation of the eye. 1.12 Carry out Lachrymal sac irrigation and probing. 1.13 Receiving assisting and counselling of an eye patient. 1.14 Perform subjective, objective and auto refraction with the help of essential equipments: Retinoscopy, Lensmeter,

Keratometer, Trial frame, Cross cylinder, Astigmatic fan, Placido disc, Duchrome Test etc.

1.15 Fitting of glasses in the spectacle frame appropriately. 1.16 Carryout clinical assessment and advice appropriate device to low vision patient

7 TASK PERFORMANCE REQUIREMENTS Patient, Various Ophthalmic diagnostic equipment, Ophthalmic instruments

8 TASK PERFORMANCE STANDARDS

- Standard format, patient history completed all items entered correctly.

- Patients Visual acuity accurately determined and recorded with standard format.

- Examination of eye, provisional diagnosis and initial treatment made correctly.

- All ophthalmic investigation procedure such as refraction visual field, colour vision etc. are perform correctly within

desirable time frame.

- Prepare and perform S/C and Sub Tenon Injections with appropriate dosages and instruments within given time frame.

- Perform sac syringing and probing as per instruction within given time frame.

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9 10 TASK TRAINING DATA

TASK NO:

T. E. No.

TECHNICAL KNOWLEDGE APPLIED CALCULATIONS GRAPHIC INFORMATION

SAFETY & HYGENE

1 1 2 3 4

-Importance of case history. - Conversant with step of history taking - Knowledge on systemic diseases and important symptoms, systemic medication, family history related to eye diseases.

- Knowledge on ocular anatomy and physiology.

- Knowledge on use and caring ophthalmic equipment

- Knowledge on normal and abnormal function of eye and part of the eye

- Knowledge on common ocular disorder, their cause, sign and symptom and their appropriate treatment

- Knowledge on pharmacokinetics and pharmaco-dynamics of medicine commonly used in eye.

- Know appropriate dose, and side effects of ocular medicine

- Knowledge on indication for

Differential diagnosis of similar sign and symptoms Knowledge on harmful medicine, and complications of medicine due to wrong prescription and toxic dose etc.

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5 6 7

surgery of surgical patients - Knowledge to monitor the

condition and nature of ocular pathology.

- Knowledge on when to refer and where to refer the patient with eye problem.

- Knowledge on importance on

visual acuity test in relation to ocular diagnosis

- Knowledge on principle of

visual acuity test and complete range of visual acuity for distance and near

- Knowledge on use and availability of optical and non optical device used in low vision assessment.

- Knowledge monitoring the visual condition of patients after using low vision devices.

- Knowledge on appropriate sit

for injections

- Knowledge on complication of s/c, sub tennons and peribulbar injections

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8. 9 10

- Knowledge on complication of metallic and organic FB if it remains in eye.

- Knowledge on complication of FB according to its location

- Knowledge on use and caring

various ophthalmic investigating equipments

- Knowledge on specificity and

sensitivity and predictive value of each test

- Knowledge and principle of

refraction

- Knowledge on use and caring refractive equipment

- Knowledge on interpreting the

glass prescription

- Knowledge on checking the glass according to prescription.

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TASK PERFORMANCE TEST (SKILL ASSESSMENT)

11 TASK TITLE : OPHTHALMIC ASSISTANT L – 3 TASK NO : 1

LOCATION OF TEST : CANDIDATE'S NAME : EVALUATORS NAMES:

12 TEST FACTORS AND ITEMS STANDARD MET / (%) STANDARD NOT MET /(%)

DID THE CANDIDATE? 1.1 Determined visual acuity test correctly with standard

method 1.2 Diagnosed and give standard advice/treatment to

common ocular disorder. 1.3 Perform ocular procedure such as visual field testing,

tonometry, sac syringing, FB removal as per standard method within specified time frame

1.4 Perform Refraction and generate the prescription of

patient within specified time frame. 1.5 Perform Low vision clinical assessment and advice

appropriate advice 1.6 Use with care the equipment and instrument required

to perform the task

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TASK SPECIFICATION

5 TASK NO: 2 Perform assisting activities in operation theatre (OT) and perform specified extra-ocular surgery and local anaesthesia under supervision of Ophthalmologist.

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Task Elements

2. In order to perform assisting activities and perform extra ocular surgery and local anaesthesia the OAT at the end of

training be able to: 1. Prepare operation room on operation day.

2. Prepare patients for surgery and monitoring patient conditions.

3. Give local anaesthesia. 4. Administer pre medication for surgery according to prescribed clinical protocol. 5. Take care of instruments (cleaning, handling, checking and storage) 6. Prepare instrument trays and trolleys for different types of eye surgery. 7. Identify instruments by name. 8. Assist Ophthalmologist in major eye surgery 9. Sterilize instruments by the following methods: a) Boiling b) Autoclaving c) Chemical d) Ultra sound e) Radiation 10. Perform extra ocular surgery as specified under the supervision of Ophthalmologist.

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TASK SPECIFICATION

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TASK PERFORMANCE REQUIREMENTS Surgical Instruments, Sterilizing equipments, Medicine, Medical supplies, Patients


- Operation trolley prepared as per instructions - Monitor the vital signs of patients

- Successful facial, Retrobulbar and Peribular injections

- Sterilize instrument and other medical supplies as per protocol

- Assist Ophthalmologist in surgery handing proper instruments

- Perform specified extra ocular surgery without producing any complications

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TASK NO:

T. E. No.


SAFETY & HYGENE

2 1 2 3 4 5 6 7 8

Knowledge on aseptic cleaning and sterilization methods and procedure in operating room Knowledge on preoperative procedure in different kind of eye surgery Knowledge on different type of local/ocular anaesthesia their usual dose and the procedure Conversant with all kind of Ophthalmic Surgical procedure and their steps Knowledge on name their use and delicateness of all surgical instruments Knowledge of preparing OT linen, gauze, swabs and preparing the same before surgery Knowledge on inventory management of medicine and medical supply and monitoring the stock Knowledge in surgical step of extra ocular surgery and their possible complications

Risk of infection in operating room Complication of local anaesthesia and their management. Be aware of complication

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11 TASK TITLE : OPHTHALMIC ASSISTANT L – 3 TASK NO: 2



DID THE CANDIDATE? 2. 1 Administered local/ocular anaesthesia correctly 2.2 Prepare the OT room including linen, instrument and

required medical supply for the specified surgery 2.3 Assist the Ophthalmologist with handing all the

instrument and medical material in acceptable standard. 2.4 Perform extra ocular surgery with accepted procedure

without producing any complications

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TASK SPECIFICATION

5 TASK NO: 3 Carry out activities related to patient care in In Patient Department (IPD).

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TASK ELEMENTS:

In order to carry out activities related to patient care in IPD the OAT at the end of training must e able to:

1. Instruct patients the correct way to: a) lay in bed b) to call for help 2. Set a sterile trolley for preoperative and post operative dressing. 3. Recognise early signs of post-operative complications. 4. Manage simple post-operative infections and other complications. 5. Feed patients after operation appropriately: a) kind of food b) how to feed c) when to feed

6. Conversant with routine postoperative treatment protocol and to carry out the instructions of Ophthalmologist for caring the postoperative patients.

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TASK SPECIFICATION

7 TASK PERFORMANCE REQUIREMENTS Torch, Trolley, Dressing materials, Postoperative clinical protocol, medicine and medical supplies

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TASK PEREFORMANCE STANDARDS

- Carry out the Doctors instruction properly (medications etc) - Recognize postoperative complication and initiate the management

- Patient are instructed properly

- All patient document are properly filled at the time of admission and during the preoperative and postoperative period

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TASK NO:

T. E. No.


SAFETY & HYGENE

1 2 3 4 5

Knowledge on bed making of patient according to condition of patient Knowledge on preparing the dressing trolley according to type of patients (septic, postoperative etc) Knowledge on common postoperative condition and early sign and symptoms and seriousness of postoperative complication. Knowledge on type of form, format, and clinical protocol use in hospital. Knowledge on route of medication and their proper administration.

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- Did the candidate able to tell postoperative post-operative instruction properly?

- Did the candidate able to set postoperative trolley

satisfactorily.

- Did the candidate able to recognize postoperative complication and suggest the appropriate measures.

- Is the candidate conversant with clinical protocol and

commonly used medical form and format in the hospital.

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TASK SPECIFICATION

5 TASK NO: 4 Plan organise and implement out-reach and community eye health activities.

6 TASK ELEMENTS In order to organise and run outreach clinics/screening camp, the Ophthalmic Assistant should be able to:

1. Carry out feasibility study and appropriate site selection for out reach interventions. 2. Plan, lay out and conduct surgical camps, screening camps, School health programme.

3. Perform the screening of patient in eye camp.

7 TASK PERFORMANCE REQUIREMENTS Outreach (Surgical Camp, Screening Camps, School Health Programme) planning and implementation protocols and guidelines Basic eye examination equipment (Torch, Direct Ophthalmoscope etc)


- Candidate is thoroughly conversant with eye camp planning procedure and guidelines. - Selection of the patient with cataract and requiring other surgical interventions - correct diagnosis of VADX, Trachoma, squint refractive error and other common pathology found in School going children.

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TASK NO:

T. E. No.


SAFETY & HYGENE

1 2 3

Knowledge on conducting feasibility study for intervention programme such as population, endemic diseases and magnitude of problem in the community Knowledge on requirement to conduct surgical camp and screening camp such as physical facilities manpower, instrument, equipment, logistics, Publicity procedure and local support Knowledge of eye examination and screening of normal and abnormal eye and select the patient who require referral and surgery

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DID THE CANDIDATE?

- Did the candidate able to explain appropriately the outreach planning and conducting procedure

- Did the candidate able to make correct diagnosis of

Cataract, Trachoma, VADX, Refractive error, squint and other pathology commonly found in school going children

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TASK SPECIFICATION

5 TASK NO: 5 Select appropriate educational material and impart eye health education.

6 TASK ELEMENTS

In order to provide education on primary eye care including health promotion and prevention of preventable eye diseases selecting appropriate health education material, the OAT should at the end of the training be able to: 1. Educate the community on endemic diseases eg. Trachoma, Xerophthalmia. 2. Educate the community on communicable diseases of the eye. 3. Train village health workers Traditional Birth attendants, Traditional Healers on preventive measures of

eye diseases. 4. Plan a training programme for a primary eye care personnel using the training manual. 5. Teach the special teacher of blind school to identify and carryout functional assessment of low vision

patient.

6. Supervise and monitor the activities of primary eye care worker after the training.

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7 TASK PERFORMANCE REQUIREMENTS

Health Education Material, Teaching aids, Primary eye care training curriculum


- Explain to community regarding the prevention of disease and health promotion (Communication skills) - Conversant with purpose and objective of primary eye care training

- Explain Training content, lesson plan, duration and assessment of primary eye care training to different people (Health

worker and community)

- Conversant with monitoring and supervising procedure and its importance


TASK NO:

T. E. No.


SAFETY & HYGENE

- Communication and teaching skills

- Knowledge on training content of primary eye care curriculum

- Knowledge on communicable eye diseases and mode of its transmission

- Knowledge in endemic diseases

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and their prevention - Knowledge on environment as

health determinants - Knowledge on reporting

monitoring and supervising procedure of health personnel

- Knowledge n health education

material and their appropriate use





1 2 3

DID THE CANDIDATE? Did the candidate correctly teaches on prevention of endemic diseases such as Trachoma, Xerophthalmia Did the candidate correctly explain the mode of transmission of ocular diseases Did the candidate correctly instruct clinical and functional assessment to low vision people

TASK SPECIFICATION

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5 TASK NO: 6 Identify health needs in the community.

6 TASK ELEMENTS

1. Assist and carry out Health intervention and survey. 2. Able to calculate utilisation, coverage, and effectiveness of health interventions.

3. Identify the community with public health problem such as Trachoma, Xerophthalmia and other emerging

causes of blinding diseases.

7 TASK PERFORMANCE REQUIREMENTS Survey methodology,

8 TASK PERFORMANCE STANDARDS The candidate able to explain the basic survey methodology in eye care such as sampling procedure, methodology and validity of survey.

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TASK NO:

T. E. No.


SAFETY & HYGENE

1 2 3 4

Knowledge on type of survey Knowledge on prevalence and incidence of diseases and measuring health outcome in the community Knowledge on public significance of endemic diseases Knowledge on emerging eye diseases in the country and worldwide

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DID THE CANDIDATE?

- Understands well the principal and objective of Epidemiology.

- Able to calculate prevalence, incidence, and coverage

in given data

- Able to identify public health problem of the community in the given data

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TASK SPECIFICATION

5 TASK NO: 7 Carry out managerial activities in primary and secondary eye care.

6 TASK ELEMENTS

In order to manage an eye clinic and depart of the hospital including record keeping and maintaining stocks, the OAT should at the end of the training be able to:

1. Prepare the list of eye medicine require for the clinic.

2. Maintain adequate stock of essential medicine and generate the requisition of required medicine and place an order.

3. Keep medical records in prescribed format and generate periodical reports. 4. Communicate with concern health and other related organization to promote hospital and Primary Eye Care Centre. 5. Perform finance related activities primary eye care centre and hospital department including preparing budget,

payment, and record income and generate periodical financial reports.

7 TASK PERFORMANCE REQUIREMENTS List of medicine, Stock book, Medicine Medical supplies requisition and order form, Letter Head, Computer

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- Candidate able to generate medicine requisition, order and stock balance form properly - Candidate able to fill and maintain medicine and medical stock book properly

- Candidate able to communicate in official later head as per prescribed format and procedure

- Candidate has basic skill to use computer for typing and running inventory programme

- Candidate able to generate payment, income voucher and periodical financial report as per prescribe format


TASK NO:

T. E. No.


SAFETY & HYGENE

1 2 3 4.

Knowledge on all range of available medicine and medical supplies in eye care Knowledge on type of form and format use for administering medicine and medical supplies Knowledge on principal and purpose of budget and periodical administrative and financial report Knowledge on basic computer operating skill and official letter writing

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DID THE CANDIDATE?

- The candidate able to prepare list of essential medicine and medical supplies for primary eye care centre and certain department of the hospital.

- The candidate able to make proper entry of medicine

and medical supplies and prepare periodical stock balance.

- The candidate able to write standard official letter

and operate computer.

- Prepare annual budget, payment and receive voucher and periodical financial report

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TASK SPECIFICATION

5 TASK NO: 8 Perform maintenance of commonly used ophthalmic equipment and instrument.

6 TASK ELEMENTS

In order to carry out proper maintenance of ophthalmic equipment and instrument the OAT at the end of training must be able to:

1. Follow and carry out the proper user's instruction of all type of ophthalmic (electric, electronic and optical)

equipment. 2. Carry out preventive maintenance of all ophthalmic equipment instrument 3. Able to identify minor fault in commonly use equipment.

4. Conversant with delicateness of used equipment and instrument.

7 TASK PERFORMANCE REQUIREMENTS Ophthalmic Equipment Instrument and their accessories


- Carry out proper use of instruction as per manufacturer instructions - Able to tell basic preventive measure for longevity of life of equipment instrument

- Instrument store and packed correctly

- Sharp instrument are cleaned and kept according to instructions

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TASK NO:

T. E. No.


SAFETY & HYGENE

- Knowledge on using and caring equipment and instrument properly

- Knowledge on connecting

electrical and electronic equipment with correct power source and earthing etc

- Basic knowledge on detecting

and repairing minor fault of commonly used equipment instrument

Hazard on no proper storing and handling Know about hazard of faulty connections

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DID THE CANDIDATE?

- able to explain the reason and hazard of not following users manual while operating instrument and equipment

- able to explain purpose of preventive maintenance

- able to explain caring procedure of some delicate

ophthalmic equipment instrument

Documents

JOB SPECIFICATION · ocular surgery and local anaesthesia under supervision of Ophthalmologist. 3. Carry out activities related to patient care in In Patient Department (IPD). 4