A summary of ophthalmology in three words? Death by clinic.
So. Many. Clinics.
I had no idea that ophthalmology had so many sub-specialties within it, as a lot of our teaching sessions were in different clinics. From eyelid disorders, to corneal disease, to glaucoma and strabismus (squints), we saw a wide range of patients, so that was really good.
My favourite clinic was the paediatric one, where I was with a consultant that specialises in squints seen in children, and this is when the eyes point in different directions. The consultant really grilled me, but he wasn’t mean about it, so I learned quite a lot in his clinic. The best part was he asked me to help distract the children, so I had to keep them focused by playing games that ensured they were looking behind the consultant, in order for him to examine their eyes properly. Such fun! It made me even more determined to go into paeds when I qualify.
Anyway, you know how I said otoscopy was hard when I did ENT? Yeah, it’s a walk in the park compared to fundoscopy. FUNDOSCOPY IS SO HARD.
It involves the use of an ophthalmoscope to look into the back of eyes, and I really struggled with it. The hardest thing about it is that when you’re looking into someone’s left eye, you have to use your own left eye, and that’s difficult for me because I struggle with closing just my right eye. So I’ve been practising winking with that eye, and it’s helped, sort of? I guess this is another one of those things that will get better with time, I hope!
Examining the eyes is very #longforman in general to be honest; there are so many steps to remember! I was taught ‘AFRO’ as a good way to ensure you don’t miss things out, and it’s been really helpful:
A – acuity (Snellen chart, Ishihara plates)
F – fields (as well as inattention and blindspot)
R – reflexes (direct, consensual, RAPD, and accommodation)
O – ophthalmoscopy
So good! Again, practise practise PRACTISE.
Finally, the week in ophthalmology taught me that I’m really not my best when I haven’t had much sleep. As it was our final week at this hospital, we still had to get the 8am bus from campus, so it was early starts all week. The smart thing to do would have been to go to bed early to ensure proper rest, but I’m more productive at night, you see, and that’s why I end up going to bed late.
The lack of sleep definitely showed every day, because I was crankier, more impatient, and got irritated more easily. Apologies to anyone I was snappy with- it’s not you, it’s me. I really need to start sleeping earlier because the more sleep you get, the more energy you have for the next day. Who knew?