The Curriculum Outline of Ophthalmology for Nepalese Medical Students

The Cu rri cul um O ut lin e of

Oph tha lmo log y
for Nepalese Medical Students

De par tme nt o f O ph tha lmo log y, W ei fan g M edi cal Co lle ge

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Department of Ophthalmology, Weifang Medical College(2006)

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 The Curriculum Outline of Ophthalmology for Nepalese Medical Students

The Curriculum Outline of Ophthalmology

Total period 134 Theory 54 Practice 54 Study hall 26

Contents Total period Theory Practice Study hall

General overview of ophthalmology 1 1

Fundamentals of ophthalmology 10 4 4 2

Ocular examination 9 3 4 2

Disease of the eyelid 5 2 2 1

Disease of the lacrimal system 2 1 1 0

Disease of the ocular surface 5 2 2 1

Disease of conjunctiva 5 2 2 1

Disease of cornea 11 4 4 3

Disease of sclera 2 1 1 0

Disease of the lens 10 4 4 2

Glaucoma 11 4 4 3

The uvea 10 4 4 2

Vitreous 5 2 2 1

Disease of retina 10 4 4 2

Disorder of the optic nerve and the optic 5 2 2 1

pathway
Eye optics 5 2 2 1

Strabismus and amblyopia 10 4 4 2

Orbitopathy 5 2 2 1

Ocular trauma 10 4 4 2

Ocular manifestation of systemic diseases 5 2 2 1

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 Department of Ophthalmology, Weifang Medical College(2006)

Ophthalmology is a special medical science , a branch of clinical medicine, which deals

with research for development, treatment and prevention of the disorders of visual organs
(including eyeball and its accessory apparatus, visual pathway as well as visual center).

Ophthalmology Curriculum introduces the student to the diagnosis and management of common
ophthalmological problems. Students are required to participate in a one-term course in
ophthalmology. The three principal goals of this one term clerkship are to:

1. Acquaint students with the major cause of severe vision loss in the world.
2. Acquaint students with major symptom complexes that present commonly to
ophthalmologists and to non-ophthalmic physicians.
3. Acquaint students with some of the major unsolved problems in ophthalmology and
vision science.

The goals described above are accomplished through a series of didactic lectures, reading
assignments, and observation in the eye clinics at the several affiliated hospital.

General overview of ophthalmology

Obj ecti ves and requ irem ents :
1. To be aware of the definition of ophthalmology
2. The tasks of ophthalmology
3. The main fields of ophthalmology
Con tent of pres enta tion
1. Overview of ophthalmology
2. The main tasks and fields of ophthalmology
3. How to study this curriculum

Chapter 1 Fundamentals of ophthalmology

Obj ecti ves and requ irem ents :
1. Master the names and function(s) of the major layers of the eye.
2. Know the histology of the accessory structures associated with the eye.
3. Master the definition of visual pathway
Con tent of pres enta tion
1. Classically, the eye is described as having three layers or tunics (each composed
of sublayers) with three additional refractive elements.
2. Optic nerve is composed of fibers sent out by retinal ganglion cells.It is the
segment of nerve from the disc to the anterior angle of the chiasm, about 42-47mm
long.
3. Visual pathway.Vision is generated by photoreceptors in the retina. The information
leaves the eye by way of the optic nerve, and there is a partial crossing of axons
at the optic chiasm. After the chiasm, the axons are called the optic tract. The
optic tract wraps around the midbrain to get to the lateral geniculate nucleus
(LGN), where all the axons must synapse. From there, the LGN axons fan out through
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 The Curriculum Outline of Ophthalmology for Nepalese Medical Students

the deep white matter of the brain as the optic radiations, which will ultimately
travel to primary visual cortex, at the back of the brain.
4. The accessory structures associated with the eye: eyelid, conjunctiva, lacrimal
apparatus, the extraocular muscles and orbit.
5. Normal anatomy and physiology of the extraocular muscles.
6. The conjunctiva is a thin, transparent mucous membrane lining the inner surface of
the eyelid (palpebral conjunctiva) and covering the anterior sclera (bulbar
conjunctiva).
7. The lacrimal excretory system, composed of the puncta, the canaliculi, the lacrimal
sac, and the nasolacrimal duct.
Pra ctic e:
1. Discuss the cellular organization and layers of the cornea.
2. Describe the chambers of the eye and route of fluid transport out of eye.
3. Name the layers of the retina.

Chapter 2 Ocular examination

Obj ecti ves and requ irem ents :
1. Know well history-taking and major symptoms of ocular diseases.
2. Master the examination of visual function .
3. Master the examination of globe and its accessory organs
Con tent of pres enta tion
1. History-taking. Present complaints, previous eye disorders, family eye problems,
present and past general illnesses, medications, and allergies.
2. The general order for nonemergency examination.
1) Visual acuity. Distant and near without and with glasses, if used, and with
pinhole if less than 20/30 is obtained.
2) Extraocular muscle function. Range of action in all fields of gaze, stereopsis
testing, and screening for strabismus and diplopia.
3) Color vision testing.
4) Anterior segment examination under some magnification if possible (loupe or
slitlamp), with and without fluorescein or rose bengal dyes.
5) Intraocular pressures (IOPs).
6) Ophthalmoscopy of the fundi.
7) Visual field testing.
3. Highly specialized office techniques: FFA, ERG,VEP, EOG, et al.
Pract ice:
1. The examination of near vision.
2. Describe the measurement of ocular pressure.
3. Definition: visual acuity, visual field

Chapt er 3 D iseas e o f the eye lid

Obj ecti ves and requ irem ents :
1. Master the clinical manifestations ,diagnosis and treatment of the Eyelid
inflammation and tumors.
2. Kown well eyelid anatomy and congenital eyelid anomalies.
Con tent of pres enta tion
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 Department of Ophthalmology, Weifang Medical College(2006)

1. Hordeolum is a focal acute infection arising within the meibomian glands or other
glands at the eyelid margins. Its classification, definition, etiology, diagnosis
and treatment principles.
2. Chalazion is a focal chronic inflammation of a meibomian gland. Its clinical
manifestations and principle of treatment.
3. Blepharitis is the most common inflammation of the lashes and the lid margins. Its
classification, definition, etiology, and clinical manifestations.
4. Eyelid tumors. Basal cell carcinomas, Squamous cell carcinomas and Sebaceous cell
carcinomas. Their basic character and treatment.
5. Entropion. Its definition ,classification: Cicatricia, congenital, spastic
6. Ectropion. Its definition ,classification: Cicatricia, senile, paralytic
7. Ptosis. Its definition ,classification: congenital and acquired ptosis. principle of
treatment.
Pra ctic e:
1. The defination of inner hordeolum, external hordeolum,chalazion.
2. The type of entropion and ectropion.
3. The classification, definition, etiology, and clinical manifestations of
blepharitis.

Chapter 4 Disease of the lacrimal system

Obj ecti ves and requ irem ents :
1. Master the diagnosis and treatment of the Lac rima l i nflam mati ons .
2. Kown well the tumors of lacrimal gland.
Con tent of pres enta tion
1. Lacrimal excretory anatomy and physiology.
2. The results analysis of lacrimal passage washing. The treatment of stenosis or
obstruction of lacrimal ducts.
3. Chronic dacryocystitis: etiology, clinical manifestations and principle of
treatment.
4. Acute dacryocystitis: etiology, clinical manifestations and principle of treatment.
Pra ctic e:
1. Describe the examination of stenosis or obstruction of lacrimal ducts.
2. The definition and clinical manifestations of chronic dacryocystitis.

Chapter 5 Disease of the ocular surface

Obj ecti ves and requ irem ents :
1. Master the definition of ocular surface and ocular surface diseases.
2. Master the layers of tear film.
3. Kown well the treatment principles of ocular surface diseases
4. Kown well the difinition,. clinical manifestations and treatment principles of
keratoconjunctivitis sicca.
Con tent of pres enta tion
1. The definition of ocular surface and ocular surface diseases.
2. The tear film is comprised of three layers:the superficial lipid layer,the middle
aqueous layer,the inner mucin layer.
3. The difinition,clinical manifestations and treatment principles of
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 The Curriculum Outline of Ophthalmology for Nepalese Medical Students

keratoconjunctivitis sicca.
Pra ctic e:
The tear film has many functions and responsibilities. Describe these.
Describe the Causes of Dry Eye and Ocular Surface Disease.
How do you Treat/Manage Dry Eye and Ocular Surface Disease?

Chapt er 6 D iseas e o f con junc tiva

Obj ecti ves and requ irem ents :
1. Master the clinical manifestations , diagnosis and treatment of the bacterial
conjunctivitis
2. Master the diagnostic criteria , clinical stage , and advanced stage complication of
trachoma.
3. Know well the clinical manifestations and treatment of viral conjunctivitis,
immunity conjunctivitis, and the degenerational process of conjuctiva.
Con tent of pres enta tion
1. Conjunctivitis: etiopathogenisis, categorization, clinical manifestation and
therapeutic principle
2. Bacterial conjunctivitis: diagnose and treatment; clinical manifestations of
superbac conjunctivitis, 　 subac. Or acute conjunctivitis and chronicity
conjunctivitis
3. Trachoma: clinical manifestations, diagnostic criteria, clinical stage and treatment
4. Viral conjunctivitis: etiopathogenisis , clinical manifestations and treatment
5. Vernal keratoconjunctivitis: clinical manifestations, typing and treatment
6. Pterygium: clinical manifestations and treatment
Pra ctic e
1. Describe the WHO’s diagnostic criteria of trachoma .
2. To discuss the advanced stage complication of trachoma.
3. The clinical manifestations and typing of vernal keratoconjunctivitis.

Chapter 7 Disease of cornea

Obj ecti ves and requ irem ents :
1. Master the etiopathogenisis , pathoprocess , clinical manifestations and therapeutic
principle of keratitis
2. Master the etiopathogenisis, clinical manifestations and treatment of bacterial
keratitis, mycotic keratitis and viral keratitis.
3. Know well the congenital anomaly of cornea
Con tent of pres enta tion
1. Keratitis: Its etiopathogenisis, pathogenesis and pathological changes. The
characteristic of infiltrate stage, elcosis stage, regression stage and
convalescence stage. The ventricle clinical manifestations and therapeutic principle
of keratitis.
2. Bacterial keratitis: Its etiopathogenisis , clinical manifestations and treatment
3. Mycotic keratitis: Its etiopathogenisis , clinical manifestations and treatment
4. Viral keratitis: Its etiopathogenisis , clinical manifestations and treatment
5. The clinical manifestations and treatment of acanthamoeba keratitis, exposure
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 Department of Ophthalmology, Weifang Medical College(2006)

keratitis, neuroparalytic keratitis and rodent ulcer.

6. Keratomalacia : Its etiopathogenisis , clinical manifestations and treatment
7. The clinical manifestations, diagnosis and treatment of macrocornea and microcornea
8. The advancement and progression of keratomileusis
Pra ctic e:
1. To discuss the pathogenesis and pathological change of keratitis
2. Differential diagnosis: bacterial keratitis, mycotic keratitis and viral keratitis
3. Try to discuss the therapeutic principle of keratitis

Chapter 8 Disease of sclera

Obj ecti ves and requ irem ents :
1. Know well the feature of each type of scleritis
2. Know well the conception and dissection type of scleral staphyloma
Con tent of pres enta tion
1. Episcleritis: conception , clinical manifestations and treatment
2. Scleritis: conception , clinical manifestations and treatment
3. Scleral staphyloma: conception and dissection type
Pra ctic e:
The conception of scleral staphyloma

Chapter 9 Disease of the lens

Obj ecti ves and requ irem ents :
1. Know well the history-taking and types of cataract.
2. Master the Characteristics of different cataracts .
3. Master the operative applications of the cataract and the corrected methods of
vision acuity after the examination.
4. Know well the types, the characteristics of congenital and metabolic cataract.
5. Know well the types and clinic symptoms of the lens dislocation.
Con tent of pres enta tion
1. History-taking and types of cataract.
2. The types of the age-related cataract, the progress and the symptoms of cortical
cataract ,the characteristics of the nuclear and subcapsular cataract.
3. The Characteristics and Treatment principles of different types of congenital
cataract.
4. The clinical Characteristics and Treatments of traumatic cataract, metabolic
cataract, complicated cataract, drug-induced and poison cataract, and after
cataract.
5. The examinations before the cataract operation and operative applications.
6. The operation types and its advantages or shortcomings.
7. The method of corrected visual acuity after operation and its new progress.
8. The types, clinic Characteristics, diagnosis and treatment of the lens dislocation.
Pra ctic e:
1. The classification, clinic Characteristics and treatment of age-related cataract.
2. The corrected method visual acuity of after cataract operation .
3. Explanation of Basic Phrase : cataract, after cataract, lens dislocation.
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 The Curriculum Outline of Ophthalmology for Nepalese Medical Students

Chapter 10 Glaucoma

Obj ecti ves and requ irem ents :

1. Know well normal ocular pressure and its influencing factors.
2. Know well types of glaucoma.
3. Master the classification, clinic symptoms, diagnosis and treatment principles of
acute angel-closure glaucoma.
4. Know well the clinic symptoms, diagnosis and treatment of the chronic angle-closure
glaucoma.
5. Master the clinic symptoms and diagnosis of primary open angle glaucoma.
6. Master the treatment of primary glaucoma.
7. Know well the congenital glaucoma.
Con tent of pres enta tion
1. Definition of the ocular pressure. The circulation pathway of the Aqueous Humor.
2. The range of normal ocular pressure, its influencing factors and pathological
pressure.
3. The classification of glaucoma.
4. The history-taking, clinic symptoms, types, diagnosis and differential diagnosis of
acute angel-closure glaucoma.
5. The history-taking, clinic symptoms and diagnosis of the chronic angle-closure
glaucoma.
6. The history-taking, clinic symptoms and diagnosis of the open angle glaucoma.
7. The basic treatment principals, operative applications of the glaucoma.
8. The treatment of primary and angle-closure glaucoma.
9. The characteristics the different glaucoma.
10. The clinic symptoms and treatments of congenital glaucoma.
Pra ctic e:
1. The clinic symptoms and treatment principals of different periods of acute angle-
closure glaucoma.
2. The clinic symptoms of open angle glaucoma.
3. The treatment of primary glaucoma.
4. Explanation of Basic Phrase :glaucoma, ocular hypertension , normal pressure
glaucoma.

Chapter 11 The Uvea

Obj ecti ves and requ irem ents :
1. Master the diagnosis and treatment principles of anterior uveitis.
2. Know well the classification of Uveitis.
3. Know well some specific type uveitis.
Con tent of pres enta tion
1. The etiology ,pathophysiology, classifications of Uveitis.
2. Anterior uveitis:type, clinical manifestations, complication, and treatment
principles.
3. Intermediate uveitis:conception and clinical manifestations
4. Posterior uveitis: conception and clinical manifestations
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 Department of Ophthalmology, Weifang Medical College(2006)

5. The clinical manifestations of Behcet’s disease, Vogt-Konayaki-Harata’s

disease,and sympathetic ophthalmia.
Pra ctic e:
1. Discuss the clinical manifestations, complication, and treatment principles of
Anterior uveitis .
2. Describe clinical manifestations of Behcet’s disease,Vogt-Konayaki- Harata’s
disease.
3. sympathetic ophthalmia.

Chapter 12 Vitreous
Obj ecti ves and requ irem ents :
1. Know well the configuration and composition of vitreous.
2. Know well the character of vitreous syneresis, posreior vitreous detachment and
floaters.
3. Know well the etiology , clinical manifestations and treatment principles of
vitreous hemorrhage.
4. Master the pathologic progress and classification of PVR.
Con tent of pres enta tion
1. The configuration and composition of vitreous.
2. the characters and treatment of vitreous syneresis, posreior vitreous detachment
and floaters.
3. the etiology , clinical manifestations and treatment principles of vitreous
hemorrhage.
4. the pathologic progress and classification of PVR
5. The indication of vitreous surgery.
Pra ctic e:
1. Discuss the classification of PVR.
2. vitreous hemorrhage

Chapter 13 Disease of retina

Obj ecti ves and requ irem ents :
1. Know well the major pathologic signs of retina diseases.
2. Master the clinical manifestations of central retinal vein occlusion.
3. Master the clinical manifestations of central retinal artery occlusion.
4. Know well the central serous chorioretinopathy.
5. Know well the clinical symptoms of retinitis pigmentosa.
Con tent of pres enta tion
1. The major pathologic signs of retina diseases:circulatory disturbance, .
2. Central retinal artery occlusion:the etiology , clinical manifestations and
emergency treatment.
3. Central retinal vein occlusion: the etiology , clinical manifestations and
treatment.
4. Diabetic retinopathy: clinical manifestations and international classification.
5. Central serous chorioretinopathy: clinical manifestations and treatment.
6. Age related macular degeneration:. Clinical manifestations
7. Retinal detachment: clinical manifestations and classification
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8. Retinitis pigmentosa: clinical manifestations

Pra ctic e:
1. Describe the clinical symptoms of retinitis pigmentosa.
2. Discuss the clinical manifestations and emergency treatment of central retinal
artery occlusion.
3. Describe the clinical manifestations and classification of retinal detachment.

Chapter 14 Disorder of the optic nerve and the optic pathway

Obj ecti ves and requ irem ents :
1. Master the clinical manifestations and treatment of optic neuritis.
2. Know well the etiology of optic atrophy .
Con tent of pres enta tion
1. the structure character of opitic nerve.
2. optic neuritis:the etiology , clinical manifestations and treatment.
3. Anterior ischemic opticoneuropathy: the clinical manifestations and treatment.
4. optic atrophy: the etiology ,classification,clinical manifestations and treatment.
5. Papilloedema: the etiology ,classification,clinical manifestations.
Pra ctic e:
1. Describe the clinical classification of papilloedema.
2. Discuss the etiology and clinical manifestations of optic neuritis.

Chapter 15 Eye optics

Obj ecti ves and requ irem ents :
1. Understand accommodation and convergence.
2. Master the classification and clinical manifestations of myopia and
hyperopia.
3. Understand the definition and classification of astigmatism.
4. Master the definition of anisometropia and presbyopia.
5. Master the correction methods of refractive errors.
Con tent of pres enta tion
1. Eye optics: Refraction, accommodation, convergence and pupillary reflex.
2. The definition of emmetropia and ametropia.
3. Myopia: definition, classification, clinical manifestations and correction.
4. Hyperopia:definition, classification, clinical manifestations and correction.
5. Astigmatism: definition, classification and correction.
6. Anisometropia: definition and correction.
7. Presbyopia: definition, clinical manifestations and correction.
8. Methods of refraction:objective refraction, subjective refraction, cycloplegic
refraction.
9. The correction methods and advances of refractive errors.
Pra ctic e:
1. Definition: accommodation, convergence, emmetropia, ametropia, myopia, hyperopia,
presbyopia, anisometropia.
2. The classification and clinical manifestations of .
3. The correction methods of refractive errors.

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 Department of Ophthalmology, Weifang Medical College(2006)

Chapter 16 Strabismus and amblyopia

Obj ecti ves and requ irem ents :
1. Understand Motility of extraocular muscles.
2. Master the classification and clinical manifestations of esotropia and
exotropia.
3. Understand examination methods of strabismus.
4. Master the classification, clinical manifestations and treatment of
amblyopia.
Con tent of pres enta tion
1. Primary action of extraocular muscles.
2. synergist, antagonist and yoke muscles.
3. The generation and characteristics of the single binocular vision, stereopsis and
diplopia.
4. examination methods of strabismus and diplopia testing.
5. esotropia:the classification，clinical manifestations and treatment.
6. exotropia:the classification，clinical manifestations and treatment.
7. amblyopia：the classification，clinical manifestations and treatment.
8. nystagmus: the classification，clinical manifestations and treatment.
Pra ctic e:
1. Definition: synergist, antagonist, yoke muscles, amblyopia, strabismus, single
binocular vision and diplopia.
2. Examination steps of diplopia testing.
3. The classification and clinical manifestations of esotropia.
4. The classification and clinical manifestations of exotropia.
5. Treatment methods of amblyopia.

Chapter 17 Orbitopathy
Obj ecti ves and requ irem ents :
1. Understand anatomy of orbit.
2. Understand primary diagnostic examination methods of Orbitopathy.
3. Master the clinical manifestations and treatment of inflammatory
pseudotumor and orbital cellulites.
4. Understand the primary characteristics of orbital tumor.
Con tent of pres enta tion
1. Anatomy of orbit.
2. Symptoms and primary diagnostic examination methods of Orbitopathy
3. Orbital cellulites: etiology, clinical manifestations and treatment Principles.
4. Inflammatory pseudotumor: definition, clinical manifestations and treatment.
5. Thyoid-related Orbitopathy: etiology and clinical manifestations.
6. The primary characteristics of orbital tumor (dermiod cyst, cavernous hemangioma,
rhabdomyosarcoma).
Pra ctic e:
1. The structure of orbital interspace.
2. The etiology and clinical manifestations of orbital cellulites.

Chapter 18 ocular trauma

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 The Curriculum Outline of Ophthalmology for Nepalese Medical Students

Obj ecti ves and requ irem ents :

1. Understand the classification and early management of ocular trauma
2. Master the clinical manifestation and therapeutic principle of ocular trauma
Con tent of pres enta tion
1. Classification of trauma ,primary treatment and examination attention
2. Ocular trauma
The clinical manifestation and therapeutic principle of Corneal contusion
The clinical manifestation and therapeutic principle of iris and ciliary body
contusion
The clinical manifestation and therapeutic principle of chamber angle recession
The clinical manifestation and therapeutic principle of len contusion
The clinical manifestation and therapeutic principle of vitreous hemorrhage
The clinical manifestation and therapeutic principle of choroids contusion
The clinical manifestation and therapeutic principle of retinal commotion and
contusion
3. The clinical manifestation and therapeutic principle of eyeball rupture
4. Penetrating injures of the eyeball
Classification: corneal , corneoscleral and scleral penetrating injures.
Clinical manifestation and therapeutic principle
5. Ocular foreign body
Extraocular foreign body: eyelids, conjunctiva ,cornea , orbit
Intraocular foreign body: diagnosis and therapeutic principle
6. Accessory organs of the eye trauma
Eyelids
Orbit : cause orbital fracture ,hemorrhage and optic nerve contusion
7. Chemical injures of acid and base:
Reason and feature ,emergency medical treatment
Pra ctic e:
1. The clinical manifestation and therapeutic principle of all kinds of trauma
2. The emergency principle of the chemical injures
3. The classification of anterior chamber hyphema , clinical manifestation and
treatment

Chapter 19 Ocular manifestation of systemic diseases

Obj ecti ves and requ irem ents :
1. Master the ocular manifestation of arteriosclerosis and hypertension.
2. Master the ocular manifestation of diabetes.
3. Understand the etiology and clinical manifestation of retinopathy of prematurity.
Con tent of pres enta tion
1. Eye and morbus internus
a) Arteriosclerosis and hypertension: heart failure caused by primary
hypertension can occur eyelid edema ,hemorrhage and infarction caused by
cerebral sclerosis can occur papillary disfunction ,visual field defect and
paralyze of ocular nerve .
b) Renal diseases: diffuse glomerulonephritis is classified by acute and chronic
. Ocular manifestation of all kinds
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 Department of Ophthalmology, Weifang Medical College(2006)

c) Diabetes : clinical manifestation of DR, diabetic cataract , refractor error ,

iridocyclitis, iris new vessels and neovascular glaucoma
2. Hepatolenticular degeneration(Wilson’s disease) kayser-Fleischer ring
3. The etiology and ocular manifestation of retinopathy of prematurity
4. Ocular manifestation and diagnosis of myasthenia gravis
Pra ctic e:
1. Words: Kayser-Fleischer ring
2. Ocular complications of diabetes

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