This morning was my first day in The Eye Center at the Southern College of Optometry in Memphis. At SCO, second year students shadow third and fourth year students to learn about procedures and get more clinical experience before we’re on our own with patients. I was in Low Vision, where I shadowed for three patients. Here are some of the lessons I learned in my first day at The Eye Center.
I could tell immediately that the first patient was different from the healthy students I have practiced on in my labs. This patient had albinism and congenital nystagmus. He was in his forties and said he had been coming to SCO for his exams since he was a child. This patient had many diagnoses and treatment options in his chart, most of which I hadn’t heard of yet. But that wasn’t why he was in today. The patient was in because he had gotten bug spray in his eye two weeks ago and had felt continued itching and irritation. After examining him, the student doctor determined that the patient had allergies and prescribed drops for his symptoms, which the staff doctor confirmed and approved. The patient was satisfied with his treatment and eye drop samples. Since the patient was being seen by a specialist as well, he did not need any further follow up care.
Lesson learned: A patient’s chief complaint may not be his or her primary diagnosis, and it’s up to us as optometrists to meet the needs of the chief complaint, while keeping in mind the patient’s diagnoses and treatments.
The second patient I encountered had Stargardt’s disease, a genetic disease that causes damage to the central retina and results in progressive central vision loss. Due to the changes in visual acuity, this patient was no longer legal to drive. While I was shadowing, I heard and saw how both the student doctor and the staff doctor spoke to this patient about his vision and how he would need further visual intervention, like a device, or need a driver to maintain his driving abilities. This was a difficult conversation to hear, and was clearly difficult for the patient, whose job as a real estate agent depended on his ability to drive. This case and patient taught me how important it is to speak to a patient with respect, care, and empathy, but also with a stern tone to keep in mind that his vision could affect others on the road.
Lesson Learned: Doctor-patient interaction is a clinical skill that must be practiced and perfected the same way that other clinical skills are mastered. Patients are dependent on us to tell them all the information that they need to know, but it is up to us as well to keep the patient informed of the risks that their conditions carry for both the patient and those around the patient.
For my final patient exam, I shadowed Erick Henderson, SCO 2017, AOSA President, as he performed a low vision exam using trial frames and the just noticeable difference. The patient had degenerative myopia and needed new glasses, along with a clip for reading. The patient’s glasses were two years old and were held together by tape! This patient was so happy to see better, saying that her grandchildren were full of energy and that she needed to see her best to take care of them. The staff doctor, Dr. Adrienne Chan, a former writer for OptometryStudents.com, approved the diagnosis, treatment, and plan for this patient.
Lesson learned: Optometry is a small world. Networking now in your time as a student can help you build professional relationships that will continue far after graduation.
More information about Low Vision can be found here and here.
