Learning About Diversity Through Community Health Eye Care

I feel very lucky to have worked in community health programs. Each community health center has its own character due to the unique community it serves. Each has a similar mission to provide exceptional care for its patients and families, to understand the cultures of thinking within that community, and to serve its individual needs. I have worked at the Dorchester House Multi-service Center in the past serving Vietnamese, Haitian, Hispanic/Latino, and old neighborhood Italian/ Irish families. I’ve been able to provide eye care to generations within families, but also to offer them primary care resources. I now work in a family practice that serves a diverse population that includes Albanian, Greek, and Lebanese patients. Different demographics are at risk for different systemic conditions and eye conditions. Each family or family member has a different story. They may have grown up in the community seeing the same doctor for years. They may have emigrated here and are adapting to a new culture and are experiencing the challenges of finding new health resources.

Today, the students that I work with had a discussion about different types of patients and the advantage of working in a family practice because exposure can vary from infants to elderly, English speaking to multi-lingual, teenagers to working moms, mechanics to attorneys. Every day brings a new perspective and challenge. This exposure is what drives my own passion daily. Often students are apprehensive about facing the challenges of this diversity and about being able to adapt to various situations that may present themselves. They agree, though, that this is one of the things that makes the profession fulfilling.

The students also discussed their concerns about their next clinic site experience, wondering if they are prepared to work at a veteran’s hospital, pediatric practice, or low vision clinic. They are almost finished working with me at this site. It really felt good for me to be able to encourage them that they are ready to move on and to tell them they have been successful. They have a good foundation to build upon in other clinical sites. More importantly, they needed to hear that part of their success in a clinical environment is due to being proactive in learning and being as best prepared as possible for the type of patient they may see.

I also see these students as more prepared to work with any patient, more comfortable having transformed didactic knowledge to clinical care. They aren’t just doing tests, but they are understanding why they do a test. They understand better that their actions help patients. They are eager to see the same patient for follow-up. Their patients are eager to see them. Some patients bring treats or simply their thanks for caring. Recently, one teenager of a patient wanted to look through the teaching tube to see what we were seeing on her mom. She is now interested in becoming an optometrist. Another young patient wanted pamphlets about diabetes for her younger brother. An elderly patient who grew up in the community wanted to bring in a friend to have his eyes examined and to get glasses.

Community health encompasses many special experiences. It is normal for interns to feel a bit anxious at the end of their year. Are they ready to move on to the next experience? I think experience in community health helps them to be ready with a variety of tools to have for a variety of best outcomes.

“If You Hold It This Way, It’s Much Clearer. See?”

“If you hold it this way, it’s much clearer. See?” I smile when I see the look on my student’s face as she pulls the lens into focus correctly. It’s what all teachers live for, the “Ah-ha!” moment when the clinical skill and the classroom knowledge finally blend together. She straightens in her chair, feeling more confident now in her diagnosis for her elderly male patient. Together, we discuss with him our findings and concerns, and I listen as she instructs him on our plan for his future care.

It wasn’t long ago that I was the student, excitedly trying instruments and practicing my newly learned skills. I remember holding a lens and seeing the optic nerve in three dimensions for the first time. It was amazing! I could see the contour of the surface, the blood vessels, the changes in coloration of the structures inside the eye. I remember my first full eye exam on a patient, a sweet woman who was enthralled by the thoroughness of my exam (my instructor was not as enthralled with the time it took me to perform such an exam!). I remember classes and tests and board exams. But my favorite memories are those times when the knowledge finally clicked, when I had my own “Ah-ha!” moments and I was able to really see and understand what was happening in my patient’s eyes. It’s an incredible experience, because it is then that you realize that all the hours spent studying and practicing were all worth it. This is what I love about my job as a NECO instructor. Helping my students “see” for the first time, and (hopefully!) remember forever.

I feel lucky to have found a profession and a career that I feel so passionately about. I never expected to enjoy myself so much at my job! I work with second and third year optometry students at a community health center in the outskirts of Boston, and together we tackle challenging cases and manage a diverse array of problems. I have great colleagues at NECO and in the community of Boston. We often get together and talk about eye diseases and teaching and our craziest case of the day. And when I’ve over-loaded myself on optometry (which happens often), I try to relax with some mindless reality TV or watching the Red Sox (only when they’re playing well, of course!). But by morning, as always, I’m ready to do it all over again.

Blue Book of Optometry? Check. Will’s Eye Manual, online version? Check. Photographs of students from the 1930’s? Check. A laptop to use in the study room? Here!

The NECO library and archives offer a world of resources to help you with your work and beyond. While NECO’s collection of print books, journals, skulls and light meters, and many e-books, journals, and selected links to resources by topic (Research Guides) via our website are focused on optometry, vision science and medicine, we also offer you access to books and other materials on just about any topic you can imagine.

Since 2010, the library has been a member of the FLO (Fenway Libraries Online) consortium which, in addition to supporting library systems and services from behind the scenes, offers you many resources from borrowing privileges at other member libraries (Wentworth Institute of Technology, Massachusetts College of Pharmacy and Health Sciences, among others) to a collection of 50,000 academic e-books right from the online catalog on the library’s website. In addition to our membership in FLO, we maintain connections with many other libraries and organizations across the country to help get you what you want.

The NECO Archives and Special Collections house a wide range of materials pertaining to the history of the college as well as older, canonical books in the vision sciences. While these materials are available to use only in the library due to their physical condition or rarity, most are accessible to you. (Some access restrictions do apply.) For more information about the collections, see our Archives and Special Collections Guide.

The library staff — Heather, Judy, Lisa, Marek, Tara and I, and the students who work with us at the circulation/information desk – strive to support your every information need, whether it is to find the best places to find appropriate information, to use the latest edition of Netter’s or to borrow a copy of The Girl with the Dragon Tattoo. Simply: If you need help finding appropriate information resources or locating materials that you want, we will gladly help you. If we don’t own something in our collection, we’ll get it for you. Don’t hesitate to ask!

Lose the Competition – and Win the Knowledge

Do you like to win?
Who doesn’t like to win?
Whether it be at athletics, test scores, or term grades, it just feels good to be the best.

What does it take to win? Determination, practice, and competitive spirit are traits that winners have.

What is competition? Competition can be defined as “a test of skill or ability; a contest.” It can also be thought of as a “rivalry” (from www.thefreedictionary.com). These are important distinctions.

The first, in the case of grades, is a test of your own talents or expertise. You are, essentially, competing against yourself. How well did you study? How prepared for the exam were you? In a rivalry you are competing against others. How well did they study? How prepared for the exam were they – in comparison to you?

When you think of it, you have been competing most of your lives. You competed to be on the team in your sport. You competed for summer jobs. Your biggest competition, your rivalry among the greatest numbers of applicants, was to be admitted to the college of your choice. You competed for the highest scores on the SAT or ACT. You competed to have the best admissions essay and the best admissions interview.

Once in college, the competition started yet again. Perhaps you competed for leadership roles, perhaps for internships, perhaps for sports. And then – you decided to be an optometrist. More competition loomed: OATs, great grades on prerequisites, great grades overall. Did you also compete for a job in an optometrist’s office?

All this competition! It can be exhilarating. It can also be exhausting and anxiety-producing. And here is the absolutely best news: you can turn it off. You can say goodbye to competition, although it has become such a part of you that it may be hard to for you to consciously, deliberately lose it.

Why do I advise you to lose the competitive part of your personality in optometry school? The genuine answer is that I want you to become the best optometrist you can be. You might argue that to become the best involves competition, and in a way it does. Becoming the best optometrist you can be involves the following:
• Realizing that you have reached your end goal – you’ve been accepted to NECO.
• Truly understanding that grades are no longer to get you to another place somewhere – they are to give you the knowledge and skills to diagnose and treat your patients.
• Recognizing that both competing and winning now have new definitions.

At NECO, you and your classmates learn together. You are with one another in lecture. You practice on each other in lab. You may be roommates. You attend social events together. The key word here is TOGETHER. You and your classmates, the faculty and staff at NECO are in this together. We Are All Here For You.

How do you relate to each other in this new non-rivalry world?
• First, ironically, you compete with yourself to find the determination and commitment to sit down and study for depth of knowledge.
• Next, you continue to compete with yourself to go to the lab and practice, practice, and practice even more.
• Then, maybe you form a study group. You may decide to become class note taker.
• You leave no question unanswered. If you don’t understand, you ask the faculty, you ask upper class students, you ask your classmates.
• You answer your classmates’ questions.

Losing competition now means winning.

Saying goodbye to competition means becoming the best OD you can be.

Don’t you feel better already?

A Personal Encounter with Students

This week was a sad week for me. It comes around every few months, because that is when some of my students leave, after having spent several months with me at the Martha Eliot Health Center. One of my favorite parts of my job is working with the students and getting to know them. Each student is unique, having come from a certain culture, region, family, and educational background, and they each have different goals in life.

I have met students with such wonderful stories. I once had a student who wanted to open a butcher shop when he retired because he enjoyed slices of fine meat. Another student loved to make pastries, and would have become a pastry chef if she hadn’t become an optometrist. And of course she brought delicious cupcakes to clinic and shared them with us! Professional ballroom dancer, salsa dancer, marathon runner, boba tea fanatic, handyman…these are just some of the personalities I have gotten to meet when they come to my clinic.

I have also shared some interests with my students. When the Twilight book craze was going on (and I guess it still is), I saw my interns reading during lunch. They asked me if I was reading them and I scoffed and said that I didn’t want to read a teen book about vampires. The next day, the first book appeared on my desk, and my intern said, “Dr. Moy, you HAVE to read this.” I suppose if I can assign reading, I should be open to my intern assigning reading to me! I took the book home for a weekend trip, and by the end of my 2nd day, I had devoured Twilight. And yes, I have now read all the books and seen all the movies so far. I also make it no secret that I am a Florida Gators fan. One time I had a student who was a Georgia fan. When the two football teams played each other, there was a bit of trash talking going on. When Florida won, I could tell my student was sad, so I didn’t rub it in…too much.

When I know my students on a personal level, it makes it so much more enjoyable to see them on a daily basis. The most memorable students are the ones who have gotten to know our staff and the patients, and who take ownership of the clinic when they arrive. When we acquired a new Optical Coherence Tomographer (OCT) at Martha Eliot, I loved it when my students were just as excited as I was about a new “gadget.”

This week was bittersweet in saying goodbye to some of my students, but I’m also looking forward to getting to know my incoming students. They will be unique in their own way, and I look forward to telling them more about myself as well. Maybe someone else will share my love for Jeremy Lin on the New York Knicks.

Eye Care and Culture on the Atlantic Coast of Nicaragua


Williams College students providing care on recent Nicaragua trip.

Williams College students providing care on recent Nicaragua trip.

Earlier this year, I participated in a tremendous collaborative effort to provide eye care to over 4,700 people in the developing region of the Atlantic Coast of Nicaragua. In cooperation with Ray Hooker, President and Founder of FADCANIC (Foundation for the Autonomy and Development of the Atlantic Coast of Nicaragua), Williams College, and NECO, we have been able to provide this service for the last 10 years. This effort embodies the mission of FADCANIC; “…to nurture, strengthen and develop the process of autonomy of the Atlantic Coast of Nicaragua from civil society through the qualitative transformation of social, economic, cultural and political relations that benefit the indigenous and ethnic communities of the region.” Williams College, a small liberal arts school in Williamstown, MA, has been funding this effort as part of a winter study course for a selected number of students entitled “Eye Care and Culture on the Atlantic Coast of Nicaragua” and headed by faculty member Robert Peck.

NECO has been a part of this humanitarian effort since its inception ten years ago. For the last seven years, I have been helping to head the trip and organize all of the eye care related aspects of the trip. Before the trip, I teach the participating Williams College students (on average 12-14) about ocular anatomy, refractive error and rudimentary aspects of ocular disease. The students then go through a training to learn how to take visual acuity and determining the plus lens powers needed for distance and/or near vision.

During the 12-day trip, 3-4 optometrists, all of whom are NECO alumni and/or faculty and oversee the vision screenings and perform comprehensive exams when needed, accompany students. In addition to myself, the other optometrists that participate are local alums of the College. Of note is Dr. Katie Field (Class of ’03), who has been a trip optometrist for the last eight years, providing unsurpassed service.

Seeing patients in Kukra Hill, Nicaragua.

Seeing patients in Kukra Hill, Nicaragua.

To date, a total of 61 Atlantic Coastal communities have been serviced in the last ten years and a total of 28,951 eye exams performed. While almost all of the patients seen receive sunglasses, approximately 20,250 pairs of distance and/or reading glasses have also been dispensed. In addition, the Commonwealth practice of New England Eye (NEE) has been donating lenses and fabrication services for the last 5 years for those patients who have significant refractive errors that can’t be corrected with the over-the-counter reading glasses typically dispensed during the trip. In total, approximately 250 pairs of glasses have been made by NEE and shipped back to the appropriate patients.

While these trips wouldn’t be possible without the leaders of this endeavor, I want to acknowledge the hard work of the participating Williams College students each year. I am proud to be a part of the NECO community and the service they have provided in this endeavor over the last 10 years! Members of the NECO faculty who have participated over the years are myself, Bruce Moore, Catherine Johnson, Nicole Quinn, Stacy Lyons and Jacky Kong. NECO alum who have participated are Drs. Katie Field, Wendy Crusberg, Jenelle Mallios, Yos Priestley, Marcia Thiel, Scott Huffer, Jennifer Hartzell, Angela Langthorne, Layli Toutounchian, Tammy Gray, Irwin Schwom.

For an article highlighting this 10th anniversary trip, visit this link.
For more information on FADCANIC, visit its website.

What You Learn in First Year Is Not Only Optometry

Being the Associate Dean of Students allows me to share in and be a part of all of the experiences you have during your time at NECO, from your first day (orientation) to your last (commencement).

You have had many first days and first years and new ways of learning, forming and maintaining new relationships, and taking on more and more responsibility for yourself, your decisions, and your intellectual, emotional, and social life.

Your first day and first year of optometry school offer you the same opportunities, challenges, and adjustments, only magnified (no pun intended). You will find that there is more volume of work, less free time to study, and that a greater depth of knowledge is required of you. As you study, you are constantly wondering how what you are learning relates to patient care.

You will also enjoy a common bond among all of us in the NECO community. Since you and every one of your classmates have the same career goal, becoming an optometrist, all of your classes relate to optometry. We are all here to support you in achieving the OD degree.

As Dean, I so enjoy getting to know you, especially in the first year because I see so much growth in you, and because I know that each year you continue to grow in response to the opportunities before you.

Here are examples of your growth during first year.

• If you are living on your own for the first time, you truly learn to manage a household. You conquer grocery shopping, cooking, laundry, housecleaning and bill paying.

• You learn how to manage your time. Your priority is to study well, and you find the needed time.

• You adjust the way you study. You conquer exam anxiety. You seek out study partners or request peer tutoring.

• You become active in one of our many student activities.

• You bond with your classmates. You help each other out when needed.

• You realize that asking for help is encouraged. You find that proactively seeking assistance provides great relief and allows you to accomplish your goals. You leave my office happier than you arrived.

• You take good care of yourself. You eat well, sleep well, and exercise.

• You fall in love with Boston and find wonderful places to go with friends.

Being Associate Dean of Students allows me to find a little space within each of your hearts. You each have a big space in mine. On your first day at orientation, you are excited to arrive and I am excited to welcome you. On your last day, commencement, I am proud of you, but the day is bittersweet for me, because I must say farewell as you begin your new life. And when you do contact me as an alum, I am delighted.