03. December 2012 · Comments Off · Categories: Uncategorized

Let’s start with the serious bit. Proficiencies! For those of you who are reading this and are not familiar with this term and how it applies to optometry school I have provided the following as my interpretation: Proficiencies are the equivalent of the road test part of the driving test. They are there is make sure you know the rules and when to apply them and most importantly that you are comfortable and safe to be in the drivers seat.

We had a proficiency last semester that tested basic optometric skills such as entrance tests, refraction, and a direct fundus examination.  As ASIP students we were all trained as optometrists in our respective countries, but the level that we practiced the profession varied. The ASIP course has helped us develop the skills and knowledge we need in order to work as optometrist in the USA.  In other words, we all came in as experienced clinicians and now we are building upon those skills.  The best way I can describe it is like having a driver’s license for many years and then moving to a different country and learning how they drive there. Fundamentally the skills are the same, but the rules and the skill levels change.  In the USA,  the rules change state to state for driving and for that matter optometry too.

We had our proficiency exam yesterday.  The set up of the exam was intended to help prepare us for part 3 of the National Board exam. Our last proficiency exam consisted of the following: Biomicroscopy, Punctal plugs, Goldmann tonometry, Gonioscopy, Binocular Indirect Microscopy, Optic Nerve head drawings and Blood pressure checks. Most of the techniques, like the slit lamp exam, required us to mention the magnification, illumination and patient instructions. So verbalizing your understanding of the procedure to the examiner as well as performing it was key.  We also had to do a station where we mounted what looks like a helmet with a bright light, which is called a Binocular Indirect Microscope. We had to carefully balance a magnifying lens in front of the patient’s eye and maintain alignment of the patient’s eye, the magnifying lens, and the oculars of the headset all at the same time. Very fine movements can distort what should be a clear magnified view of the fundus. We had to also locate 3 shapes that were concealed in a box with a small hole in the middle which represents a patient’s pupil. It was fun hunting around and looking for the objects using our BIO headsets.  The box unlike a real patients eye did not mind being subjected to the the bright light of the headset. We also had to insert collage punctal plugs into our classmates’ eyes. The idea behind the punctal plug in layman’s terms is to ‘insert a small plug into a small opening in the inner corner of a patients eye in the hopes of relieving dry eye symptoms by blocking the drainage of the their tears. Depending on the severity of a patient’s dry eye, they may benefit from having anywhere from one to all four of their puncta blocked. It is a simple and fun procedure to learn and one which I never had a chance to do when I worked in Europe.

Blood pressure is now part of the Board examination and so we were assessed on our ability to perform this technique. As one of our lectures pointed out, patients expect optometrist, as health care providers, to be competent at measuring blood pressure. There are many eye correlations with hyper/hypotension and so it is an important diagnostic consideration.  The main thing with any of these techniques is to know in which situations you need to perform them and then prepare the equipment and the patient for the procedure. For the last few weeks in the lead up to the proficiencies, we dilated each other. Collectively I would wager a bet that we were dilated well over 100 times. That is a lot of eye drops. I myself was dilated nine times in the past 4 weeks.  It felt good to work together as a class and share tips as well as challenge each other to tweak our techniques. Now that the big day is behind us, I am happy to report that the last I checked we are all still alive and breathing and none of our mock patients were blinded in the process, so all ended well.

Now onto the even more fun stuff which is the second P of the blog: Packing for Thanksgiving break. I can sum this up in one sentence by the following: Open a big travel bag  put in a few pairs of clothes/personal items and lots of books/notes/chargers/and your laptop you are all done. Oh and leave room to bring back freezer bags of food from home.  Oddly enough, on this trip I also decided to bring along my ophthalmoscope to do a round robin fundus check of my friends/family around the dining table after Thanksgiving dinner. Think of it as a vision screening.  I will keep you posted on the outcome.

Luckily, Boston is a city with well connected bus/train/and airport links and so getting out of Boston is not an ordeal. I literally booked my bus ticket a few hours before I caught the bus out of town. I have tried all 3 modes of transport and find for me taking the bus is the most comfortable and convenient way back to New Jersey.  It takes approximately 7 hours after a short transit through New York City, but the journey is worth it. My favorite part of the trip is when the bus pulls off the highway and drives through Harlem.  I never realized what an architecturally beautiful part of the city Harlem is. For anyone who is living in Boston, I would highly recommend taking the four hour bus to New York City and enjoying the views.

Lastly, I feel my blog will not be complete without making a reference to some sort of food item, as I have done in my previous blogs.  In the spirit of Thanksgiving, pumpkin is the flavor of the month. When November rolls around you can literally find anything pumpkin: pie, cake, muffins, bread, pancakes, coffee, tea, candles, jam, lotion, lip gloss and I’m sure the list could go on! I love this time of year! Everyone is happy being off from work and studies, albeit for a short time. It is a great time to reconnect with family and friends and indulge in home cooking guilt free.  Warm regards to you all for a very Happy Thanksgiving. Eat lots and enjoy!!!