Train-the-Trainer Program Optometric leaders from around the world receive comprehensive education and training to screen Special Olympics athletes at Opening Eyes events, such as this one in Peru. The Train-the-Trainer program is designed to combine educational information and clinical experience as it relates to providing care for people with intellectual and developmental disabilities. The first component of Train-the-Trainer is a one- to two-day educational program to train optometric leaders from around the world how to bring Opening Eyes to their location. This is followed by at least two days of participation in a Opening Eyes vision program. Special Olympics used the excitement of the 2003 World Summer Games in Dublin, Ireland to attract volunteer clinicians to attend the Special Olympics Healthy Athletes Train-the-Trainer program. In the words of ophthalmologist Mohammed Yassin from Egypt, “I treat people everyday in my home country of Egypt. However, it is only today that I feel as though I have gotten my humanity back. Thank you, Special Olympics.” Didactic program History of Opening Eyes Description of the vision program Presentation of curriculum recommendations for education of the optometric volunteers Nuts and bolts of creating a local Opening Eyes vision program Guide to cultivating optometric, Lions Club members and lay person volunteers Course outlines to prepare the optometric volunteers, including what the educational curriculum should include Clinical Program Observe the organization and set-up of the program Observe preparation of volunteers Actively participate in each station of vision program Interact with Special Olympic athletes, their coaches, families and other volunteers Educational Programming — Guide For Clinical Directors The education program includes the following: Preparation of Volunteers Determine skill level of volunteer — where do your volunteers fall? Review of basic vision examination skills Teach or elaborate on skills needed for the nonverbal or non-literate patient Normal and abnormal visual development Highlight the importance of case history Basic Clinical Skills Visual acuity Brief historical information Describe types of visual acuity — recognition, resolution, detection Share VA methods for each type Review of our testing protocols Entrance Tests Present background on benefits of evaluating specific skills — EOMs, posture, color vision, depth perception Provide information on tests available that can be used with this population Allow hands-on training Refractive Errors Describe types of refractive error and prevalence in the population with ID or DD Present assessment techniques: keratometry retinoscopy subjective refractive cycloplegic (if appropriate) Eye Health External — review techniques and emphasize things to look for and record Pupils Internal — explain the value of non-dilated compared to dilated exam Review commonly seen problems Assessment & Plan Emphasize this area and how much or how little it may differ from the assessment and plan for the average patient seen who is not handicapped Normal & Abnormal Visual Development Review normal development of visual system Highlight the abnormal development Share assessment techniques used for the patient with ID or DD Discuss common syndromes with their visual implications Review prescribing for the patient with ID or DD Include resources for assistance to patient population with special needs Review of cases Do the data make sense, e.g., do the VAs go along with the refraction? Does the athlete need additional testing? Does the data support the complaints? Does the patient need new rx? Does the patient need to be referred out? To whom? Does the patient understand the recommendations? What Do I Do If the Findings Don't "Jive"? Be critical in reviewing the findings. Consider where errors may fall: Peeking Malingering Comprehension Clinician error The Final Frontier To Prescribe or Not To Prescribe Case Examples Mandatory Stations Lensometry / PD History Visual acuity — far Visual acuity — near Stereopsis Cover test Color vision Eye health Autorefraction Check out Stations for selected athletes only Retinoscopy NPC EOMs Refraction Dispensing