Part 1 Membership Syllabus in relation to General Principles of Basic Sciences

The Orbit and adnexa

• Osteology, orbital foramina 
• Eyelids 
• Conjunctiva 
• Lacrimal gland and lacrimal drainage system 
• Extraocular muscles 
• Intraorbital nerves, vessels 
• Orbital fascia 

• Conjunctiva 
• Cornea 
• Sclera 
• Limbus and anterior chamber angle 
• Iris and pupil 
• Lens and zonule 
• Ciliary body 
• Choroid 
• Retina and retinal pigment epithelium 
• Vitreous 
• Optic nerve 

• Osteology of the skull 
• Meninges, blood supply, nerve supply 
• Venous sinuses 
• Foramina and their contents 
• Cranial fossae 
• Pituitary gland and its relations 

• Cerebral Hemispheres and cerebellum including - 
• surface appearance, cortical areas, ventricles, formation and circulation of cerebrospinal fluid, blood supply and venous drainage, microscopic anatomy of the visual cortex 
• Brain stem and cranial nerve nuclei 
• Cranial nerves 
• Spinal cord 
• Visual pathways 
• Control of eye movements 
• Autonomic nervous system and the eye 

• Nose mouth and paranasal sinuses 
• The face and scalp, muscles nerve and vessels 
• Salivary glands 
• Temperomandibular joint 
• Infererotemporal fossa and pterygopalatine fossa 
• Carotid arteries and jugular veins 
• Respiratory system, anatomy of the mouth, pharynx, soft palate, larynx, trachea 
• Lymphatic drainage of the head and neck 

Gross anatomy of the heart, and major blood vessels. Microscopic anatomy of arteries, veins and capillaries

Embryology

General embryology of relevance and detailed knowledge of the embryology of the eye, orbit, adnexae and visual pathways, with particular emphasis on the understanding of embryology relevant to the understanding of congenital anomalies of the eye.

MOLECULAR AND CELL BIOLOGY

• Cells and cell membranes 
• Cytoskeleton 
• Cell motility and contractility 
• Nucleus 
• Cell-cell communication 
• Protein synthesis 
• Receptor physiology - secondary messenger systems and intracellular signalling 

• Polymerase chain reaction 
• Northern and Southern blotting 
• In situ hybridisation 
• Extracellular matrix with particular respect to ocular structures (see biochemistry) 

General principles including:

1) Acute inflammation including
a) chemical mediators
b) cellular mechanisms

2) Wound healing

3) Chronic inflammation
a) types
b) granulomata
c) immune mechanisms
d) ulceration

4)Chronic inflammation II
specific examples 

5)Immunological mechanisms
(types I to V) of tissue injury

6) Graft rejection

7) Degenerations including
a) amyloidosis
b) calcification

8) Ageing and atrophy

9) Hypertrophy, hyperplasia and metaplasia

10) Vascular disorders including
a) atheroma
b) thrombosis
c) embolism (including pulmonary embolism)
d) ischaemia and infarction
e) congestion and oedema
f) angiogenesis
g) hypertension
h) aneurysms
i) diabetic microangiopathy

11) Shock

12) Neoplasia
a) definition, terminology, concepts
b) benign and malignant tumours
c) carcinogenesis
d) gene control
e) oncogenes
f) geographical and environmental factors
g) pre-neoplastic conditions
h) effects of irradiation and cytotoxic drugs 

BIOCHEMISTRY

General principles including:

1) Cellular biochemistry
Organisation of the cell organelles, plasma membrane, cytoskeleton, nucleus, cell-cell communication, ion and solute transport
Protein and nucleic acid synthesis
Transport processes in systems and tissues
Molecular biology

2) Connective tissue and extracellular matrix
Collagen, synthesis/degradation
Basal lamina type 4 collagen, laminin, fibronectin, proteoglycans, glycoproteins

3) Receptors, signal-transduction and second messengers
Adenylate cyclase, hormone receptors, G-proteins
Phosphoinositide system (P1)
Atrial natriuretic factor

4) Retinal neurochemistry and photochemistry

5) Active oxygen species
Free radicals and H₂O, scavengers, lipid peroxidation, phospholipase A

6) Eicosanoids
Prostaglandins, leukotrienes

7) Aerobic and anaerobic metabolism

8) Role of calcium in regulating cell processes

9) Drug metabolising enzymes
(Cytochromes and mixed function oxidases)

PHARMACOLOGY

General principles including:

1) Mechanisms of drug actions (including receptor pharmacology and biochemical pharmacology)

2) Mechanisms of drug toxicity

3) Pharmacokinetics and pharmacodynamics- absorption, distribution, metabolism and excretion of drugs

4) Catecholaminergic pharmacology
Adrenergic, non-adrenergic, peptonergic, cholinergic

5) Cholinergic pharmacology

6) Serotonergic pharmacology

7) Histaminergic pharmacology

8) Pharmacology of drugs used in inflammation

9) Pharmacology of drugs used in glaucoma

10) Local anaesthetics

11) Analgesics

These principles apply to the drugs commonly used in ophthalmology both systemic and local. 

PHYSIOLOGY

A: General principles including:

1) Maintainance of homeostasis
a) characteristics of control systems - nervous and hormonal
b) body fluids - volume, osmolarity, osmotic and oncotic pressure, and electrolyte (including H+) concentrations

2) Excitable tissues - nerve and muscle
a) structure and function of nerve cell
b) membrane potential
c) action potential
d) nerve conduction
e) synapse
f) the motor unit, neuromuscular junction, motor end-plate
g) muscle

3) Blood
a) plasma composition and functions
b) immune mechanism
c) blood groups
d) haemoglobin and red and white cell formation and destruction
e) anaemias
f) clotting and fibrinolysis

4) Cardiovascular system

a) pressure resistance and flow in blood vessels
b) blood pressure and blood flow
c) the activity of the heart and its control
d) cardiac output
e) control mechanisms within the CVS
f) transcapillary exchange, tissue fluid formation

5) Respiratory system
a) structure
b) lung volumes
c) composition of respiratory gases
d) lung mechanics
e) gas exchange in the lung
f) carriage of O₂ and CO₂ in blood
g) ventilation-perfusion relationships
h ) chemical and neural control of ventilation

6) Nervous system and special senses
a) receptors
b) synapses
c) afferent pathways
d) efferent pathways
e) cerebral cortex
f) control of movement
g) hearing
h) pain and its control
i) autonomic nervous system
j) cholinergic transmission
k) adrenergic transmission

7) Endocrinology
a) hormonal control
b) hypothalamus
c) pituitary
d) thyroid / parathyroid
e) adrenals
f) pancreas

8) Nutrition
a) dietary requirements
b) absorption
c) vitamins

9) Kidney and adrenal cortex
a) glomerular and tubular function
b) osmolality and pH of body fluids 

B: Ocular physiology including

• Biochemistry of tears and lacrimal system 
• Physiology of aqueous production and drainage including principles of intraocular pressure measurement 
• Physiology and biochemistry of the cornea 
• Lens metabolism 
• Biochemistry of the vitreous 
• Retinal physiology including phototransduction 
• Retinal pigment epithelium 
• Choroid 
• Blood ocular barrier 

• Visual acuity 
• Accommodation 
• Pupillary reflexes 
• Light detection 
• Dark adaptation 
• Colour vision 
• Electrophysiology of the visual system 
• Visual fields 
• Contrast sensitivity 
• Eye movements 
• Stereopsis 
• Motion detection 
• Visual perception 
• Magnocellular and parvocellular pathways 

General principles including:

• The biological and clinical behaviour of the micro-organisms responsible for infection 
• Elementary principles of microbial pathogenesis e.g. concepts of colonisation, invasion, endotoxins, exotoxins, virulence and pathogenicity etc. 
• Gram staining and classification 
• Commensal eye flora 
• Viruses including classification, structure and replication, antiviral agents, and laboratory methods of viral detection. Viral infections of the eye. 
• HIV and AIDS 
• Fungi, classification, factors which predelict to fungal infection, antifungal agents. 
• Toxoplasmosis, Chlamydia, Acanthamoeba, helmithic infections 
• Principles of sterilisation, disinfection and asepsis, and the application of these to current practice and practical procedures 
• Spectrum of activity, mode of action, and pharmacokinetics and of the principal antimicrobials, bacterial resistance 

• Principles of immunology e.g. non-specific resistance, genetic basis of immunity, cellular and humoral mechanisms 
• Host defence mechanisms with particular reference to the eye 
• Mechanisms of immunologically-induced tissue damage with special reference to the eye 
• MHC antigens, antigen presenting cells and antigen processing 
• Immunodeficiency and immunosuppression