The End of My Time in Ophthalmology

4 months later, and I have finished my first rotation as a junior doctor, time flies!

How best to sum up how much I enjoyed being the Ophthalmology F1? Well by the end of the rotation I had one more day of annual leave I could take, as I had only taken eight of the allocated 9 days we get per rotation, but I didn’t end up taking it because I didn’t want to miss a day on the ward, so if that’s not love I don’t what is tbh!

Ophthalmology has really been the nicest start to life as a doctor. The ward wasn’t too busy, so I didn’t feel overwhelmed when I started, and with getting to go to clinics, and theatre, as well as having medical outliers on the ward and AMU/ward cover shifts, I got eased into working life, and also got to see a variety of different things. The best of both worlds, really!

On my last day, the registrars surprised me with a cake with a ‘T’ on it for Tai… yeah, I cried. Best. Team. EVER.

My First Time In Theatre As A Doctor

Guess who got to help intubate in theatre???

As you can tell, I was quite excited about this, haha. Nearly two months into life as one of the ophthalmology ward doctor, and I’ve gotten more confident/into a routine, so I get to do cool things like go into theatre and clinics.

I still don’t think ophthalmology is for me, but cataract surgery and cornea cross linkings are SO COOL.

One Month in Ophthalmology

I may not really know how to use a slit lamp yet, but I did get the chance to appear in the department recruitment video so that’s something, right?

One month of ophthalmology down, three to go! Gotten more used to the routine of day to day life – my day starts at 8am with the ophthal patient ward round with the registrars, then board round with nurses and preparing patients for surgery (VTE assessements and discharge letter prep).

After this, we (the F2 doctor and I) start reviewing medical patients on the ward, which leads to the med patient ward round with the acute medicine consultants, then doing jobs till lunch and after lunch, as well as admitting any ophthlmology emergencies, and reviewing any patients flagged up by the nurses up till home time at 5pm.

Sometimes we get called to clinic to help with tricky cannulations, and I’m proud to say I have a 100% success rate so far!

Overall it’s a pretty chilled rotation to be on – the team are super nice and encouraging, and I’ve even had free time to start working on audits and quality improvement projects for my portfolio.

The plan going forward is to start doing some med student teaching, getting more involved with clinics and observing procedures in theatre, and ofcourse, becoming a pro at using a slit lamp…

Module 7 Placement: Ophthalmology

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?