Vision Screenings at the Special Olympics

During these past few weeks, I have mainly been working and attempting to coordinate and pack for my move into a new apartment. I’ve also had opportunities to explore more of Boston and experience a few crucial aspects of summer here. However, I’m going to wait to fill you in on all of these things until my next post.

A few weeks ago, I was lucky enough to be able to participate in the most powerful vision screening experience I have been involved in thus far. NECO students in Boston for the summer were given the opportunity to participate in vision screenings at the Massachusetts Special Olympics, held at Harvard Stadium in Cambridge. I’ve been trying to take advantage of any screening opportunities I hear about this summer, and I felt that the chance to volunteer at the Special Olympics was particularly important. I actually knew very little about the event prior to my participation; I hadn’t anticipated the Special Olympics to take place on such a large scale, or to have the concept of healthy living to be so integrated into the festivities.

When I arrived in Cambridge, I immediately recognized how intricately the events had been planned and how many different athletic activities were represented, from weightlifting to gymnastics to volleyball to track and field. In addition to the various sports that were represented, the Special Olympics also had been working on a “Healthy Athletes” initiative that we optometry students were able to be part of; dental students were present as well to perform dental screenings, and people were handing out salads and healthy crackers for athletes and volunteers.

Since I have only completed one year of optometry school so far, I haven’t yet learned about the different eye disorders associated with certain kinds of developmental disabilities; for example, that, as we discussed during the screenings, Down’s Syndrome can often be associated with ocular problems such as refractive error, astigmatism, weak accommodation, nystagmus, and eye infections. Participating in screenings at the Special Olympics gave me the chance to learn that there is a higher prevalence of eye disorders among the athletes of the Special Olympics in general and consequently a high demand for eye care.

After helping to organize our tent for the vision screenings, we divided into pairs to screen the athletes. We were able to see a wide variety of visual disorders, like nystagmus, strabismus, and high refractive error, but the most significant part of the screenings wasn’t the added clinical knowledge—it was getting the opportunity to speak with the athletes. The first athlete I screened was running in several track events later in the day, and when I asked if he thought he would win, he replied that since he had won all of his events last year, he absolutely expected to win them again today. I spoke to another athlete who had won a silver medal in swimming that morning and was anticipating another medal from his next race. I talked to a few more athletes who were also running track, another swimmer, and a few volleyball players, and I was extremely impressed with the positive outlook they all had on their participation in the Special Olympics. Many of them expected to win, or had already won medals earlier in the day, but even those who had suffered a loss were extremely proud of their accomplishments and glad to be a part of the event.

I found my screening experience at the Special Olympics to be not only a learning opportunity, but a source of inspiration. I am continually learning about different eye disorders and the needs of differing populations, but I am also learning more about how to interact with patients and how knowing more about their lives and interests can make me a better and more relatable clinician. I would highly recommend the screening experience to any NECO students who will be in Boston next summer or who have a Special Olympics that takes place in their hometown, and I am very grateful that I was able to be a part of such an inspirational event.

First Summer in Boston

 

IMG_0646 (1)Summer in Boston feels surreal. Classes and labs are suspended, summer jobs have started, and the absence of studying is a strange, if transient, relief. This will be my only summer at NECO without classes or clinic, and I have been urged strongly to take advantage of it by working, exploring, and experiencing as much of Boston as I can…but at the same time practicing my clinical skills and trying not to forget too much of what I learned this year!

It’s a huge relief to be done with final exams; finals were difficult, but I was also impressed with how they brought my class together. The night before our last final exam, Optics, everyone was extremely stressed but still found time to help teach each other the more difficult concepts. I’ve found there to be a really great sense of community here at NECO; we all recognize how challenging our courses are, but rather than having this separate us, we try to work together so that we all are able to understand the material. When I visited NECO last year for my interview, I remember being told that the competitiveness that many college students are used to finding in courses, especially difficult ones, is not present at NECO, but it’s different to experience that for yourself. When it comes to studying for finals or practicing for a proficiency exam, your classmates are your support system and your resources, not your competition. Everyone recognizes that we are all here for the same reason–to become the best optometrists we can–and this enables us to teach and learn from each other.

After finals ended, I started working at New England Eye, a large eye clinic in Boston that is affiliated with NECO. This summer I’m working as an operations assistant for the New England Eye On-Sight Mobile Clinic, which is a mobile van that provides access to eye care to people in the greater Boston area. So far, I’ve mainly been working at New England Eye organizing data from vision screenings, making follow-up calls to patients, and filing patient information, but this week I was also able to go on a vision screening to screen students for a research project through the Department of Public Health. I’m looking forward to getting to go on the On-Sight van to assist with eye exams in the next few weeks. In addition to working at NEEI, I’m also working as a clinical education assistant at NECO.

This weekend, along with some other NECO students, I’ll be giving vision screenings at the Massachusetts Special Olympics, which should be a really great opportunity. I’m hoping to take advantage of as many screening opportunities as I can this summer, since screenings are a great way to volunteer and also to keep clinical skills sharp over the summer.

Beyond work and screenings, I’m finding that there is really no shortage of things to do in Boston over the summer; I finished my last final exam, Optics, on May 18, and the very next day there was a free outdoor concert on the Esplanade for EarthFest featuring Spin Doctors and Third Eye Blind. In the next few weeks, I’m looking forward to going to my first Red Sox game and taking some time to experience more of the city.

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Proficiencies, Finals, and the Taste of Summer: Last Blog of the Semester

I’m having a hard time comprehending that my first year of optometry school is already almost over. It seems like such a short time ago that I arrived at the NECO Welcome Back Barbecue, excited to begin my journey to becoming an optometrist but nervous about the fact that I had no idea how to do something as simple as take a patient’s visual acuity since I had never even worked at an optometrist’s office before. I didn’t know what to expect from my classes or my new classmates, or whether I would feel completely out of my league since my experience as a writing major in college hadn’t exactly emphasized eye care or vision science. What I found at NECO was so much more than I anticipated; beyond being a school, NECO is a community. As students, we’re able to perform screenings within a few months of starting classes, but not before we’re ready; classes are challenging, but the support system created by the college and my classmates helps to mitigate the pressure. I’ve gone from feeling completely out of my element in the pre-clinic bays to passing my second proficiency exam on Monday, which included performing entrance tests, retinoscopy, a refraction, and contact lens insertion and removal.

In some ways I didn’t anticipate the difficulty of completing my first year of optometry school, but I also didn’t anticipate ending the year feeling I had accomplished as much as I have. I feel like I’ve learned so much about the depth of knowledge there is to explore in optometry, from optics to eye disease to treatments to patient care. I’ve learned information that I will be able to apply as a clinician in the future, but I’ve also learned about how to interact with patients not only in class but through screenings at elementary schools, where I’ve screened children from ages three to fourteen; through working with my age-related macular degeneration patient for clinical reasoning; and even by inserting and removing soft and hard lenses into my contacts-wary boyfriend’s eyes. I’ve gained more confidence as both a student and clinician, and I’m looking forward to the additional experience I will gain in my next few years at NECO.

I’ll be staying in Boston this summer, working through NECO and hoping to find some opportunities to go on screenings. Also, because I love to make lists, I’ve also come up with a lot of things I’d like to accomplish this summer: start learning Spanish, take a trip to Cape Cod, visit my family and friends, explore some new areas of Boston, kayak on the Charles, and practice techniques at school so I don’t get rusty. I also love to read, which can be difficult during the semester since I have so much to read and study for classes, and this summer I’d like to try to make a dent in my reading list. A few people have recommended I read Susan R. Barry’s Fixing My Gaze due to my interest in strabismus and vision therapy, and right now that’s number one on my list.

I’ll be back blogging next year, but until then, have a great summer and wish me luck on finals!

Projects, Presentations, and Marathons…Spring at NECO!

I’m three weeks away from final exams and it’s been a crazy semester so far. I recently finished three different projects, one of which I will be presenting tomorrow along with all of the other first years at NECO’s Public Health Poster Presentation Day, and I’ve also been able to cross off a few more items on my Boston Bucket List. Even though so much has happened, it’s hard to believe that I’m almost finished with my first year at NECO.

The first project we started at NECO was for our Clinical Reasoning course. We were divided into groups and assigned real patients who we were able to meet and talk to about their various eye conditions; we continued to keep in contact with them throughout the semester and gave presentations to our classes in small group sections. Our patients all had different eye conditions that we researched and learned about in greater depth; my group’s patient has age-related macular degeneration, and I think that researching the disease on our own led me to a greater understanding of the disease process on a cellular level as well as its more manifest effects. More than researching our patients’ eye conditions, however, we also learned how to comprehend our patients as a whole, integrating their eyes with their emotions, support systems, needs, and interpretations.

I finished my second project right after spring break: a research paper about the demographics and eye care needs of my hometown of Buffalo, New York, and the surrounding county of Erie. I haven’t been able to do much writing this year other than this blog, and as a former writing major, I’ve been in a bit of withdrawal. This paper gave me a chance to do some professional writing as well as learn more about the area where I grew up. I found in my research that Buffalo and Erie County have more eye care resources than I previously realized, but there still seems to be a demand for future practitioners. For my third project of the semester, tomorrow my group and I will be presenting a poster we created after researching our public health topic: the ocular complications of HIV/AIDS.

In addition to these three projects, I’ve been trying to get the most I can out of living in Boston this semester. I was able to go to both a Celtics game and a Bruins game (although, being from Buffalo, I did root for the Sabres…quietly), and I’m planning on seeing a Red Sox game this summer. Last weekend was the Boston Marathon and I went to Commonwealth Ave. to check it out, intending on making it a quick study break, but I ended up staying for a few hours to watch the runners. I found it by far the most inspirational event I’ve been to in Boston because it was the one where the crowd was so solidly united. Every runner that passed by got loud and enthusiastic cheering, and since I was watching only a few blocks from the finish line, the cheers were especially loud and frantic. If a runner looked like he or she was limping or faltering, the crowd would rally in support until he or she broke back into stride. I was impressed by both the devotion of the marathoners and the dedication of the crowd, and it made me think about the importance of not only self-motivation, but a solid support system, in accomplishing a goal that seems insurmountable.

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Exploring Vision Therapy

When I was applying to optometry school, I heard about vision therapy through a doctor I was shadowing and instantly was entranced with the idea of a therapeutic approach to vision care. I watched children take an active role in improving their vision by performing various exercises that ranged from computer programs to walking along a balance beam, and I thought that vision therapy would be something I would want to explore with my patients someday. I promised myself that when I got to school that I would try to learn as much about it as I could, although as an alternative approach to optometry, it’s still relatively rare.

The summer before I left for NECO, about a year after my shadowing experience, I was motivated to revisit the practice where I learned about vision therapy–as a patient this time. When I was seven, I was diagnosed with a right intermittent exotropic strabismus. If you haven’t started optometry school yet, essentially this means that my right eye will sometimes turn outwards, especially when I’m tired, and only my left eye will be fixating on what I’m trying to see. Then I will see double, and I can move my right eye back in to fixate as well. I had surgery to correct this when I was twelve, and for a long time after that I rarely experienced any symptoms; but during college, I began to get headaches more and more frequently, and started noticing more double vision later at night and after I’d been studying for long periods of time. I wasn’t sure if my headaches were connected to the strabismus or if I was just prone to headaches.  I remembered my experience shadowing an optometrist and vision therapist and thought there was a good chance that the headaches had something to do with my vision. Visiting the optometrist again to talk about my own vision, I was told that most likely I was right. I was able to start a type of vision therapy, light therapy, based on the exam, where I was given a blue-green light and instructed to look at it for twenty minutes a day in the darkness.

When I got to NECO, I started listening for opportunities to find out more about vision therapy. Through the College of Optometrists in Vision Development club, I heard about an opportunity to visit Dr. Loewenstein’s practice, where he practices vision therapy on both children and adults. Along with a few other NECO students, I visited the practice a few months ago and was intrigued by the different methods of therapy that Dr. Loewenstein spoke about. I am extremely interested in working with children as an optometrist, and vision therapy offers an interactive way to do that. The type of vision therapy Dr. Loewenstein practices especially gets children off of a chair immediately and has them moving around, coordinating their body movements with their vision. He will have his patients perform certain tasks while timing their movements with a metronome, or coordinate their hands and feet while hitting a swinging ball on a string. I was able to try one of the therapy techniques, the Brock string method, where the patient holds one end of a long string attached to a wall up to the level of his or her head. The string has three beads along it at different intervals: red, yellow, and green. The patients are asked to focus on one bead at a time, reporting the appearance of the rest of the string as they do so. The patients will see the parts of the string that they are not focusing on as double or single, and are asked to change fixation at various points during the exercise. I found it challenging to switch fixation and to keep the denoted target clear, and also to adequately describe whether I saw one or two strings, since one had the illusion of disappearing. I was glad to be able to attempt this type of therapy, however, and we were also able to fill out vision questionnaires during the visit that Dr. Loewenstein gives to his patients.

During my time at NECO, I want to keep pursuing opportunities to observe or learn more about vision therapy, not only to see if it can be applied to my strabismus, but to learn about how I might incorporate it into how I practice optometry. Its methods may be unconventional, but I find the use of unconventional techniques for vision extremely interesting.

Until next time,

Emmy

In the middle of Midterms, but it’s almost Spring Break!

It’s midterms week at NECO, and so far I’ve taken three of my five midterms: Principles and Practices of Optometry (or PPO, as we call it), Anatomy and Physiology, and Neuroanatomy. Studying for midterms can get very intense, and I’m definitely looking forward to spring break after I take my last two exams, Optics and Etiology of Diabetes and Glaucoma. Two more exams and three more days of studying and coffee to go!

Although most people are leaving the city for spring break, I decided I wanted to stay in Boston so that I can explore the area more. It’s hard to believe I’ve already been here for seven months; I’ve already seen a lot of Boston, but there are still a lot of “essential” Boston things I need to accomplish. Over break, I’m looking forward to exploring the North End more and experiencing some of the amazing Italian food I’ve heard about; taking advantage of the weather that will (hopefully) be in the fifties and going for a run on the Esplanade, which I haven’t done since the fall; going to Chinatown for the first time; finding a farmer’s market nearby; and potentially exploring Cambridge, which I’ve only seen briefly. I’m definitely not going to be able to accomplish everything on my Boston bucket list in a week (going to a Red Sox game will have to wait for baseball season, and I know there are a lot of things I probably haven’t even heard about yet) but I can at least make a dent in it.

I love that Boston is made up of several different neighborhoods; it makes the city multidimensional and an extremely fun place to live. A lot of my favorite things in Boston so far are right in Back Bay, like the Esplanade, which runs along the Charles River and is a great place to walk or run, and Newbury Street, which has so many interesting stores, restaurants, and especially lots of delicious frozen yogurt places. A few weeks ago I went to the top of the Prudential Center and was able to see the city right when the sun was setting. I was actually able to point out landmarks from up there, and I found NECO and my apartment building, which made me feel I was better at getting around Boston than I thought, at least from an aerial perspective.

In addition to spending my break enjoying Boston, I’m also going to be finishing a project during spring break for my Vision Health Care class. The project involves analyzing a community where you could expect to one day practice optometry; I chose my hometown of Buffalo, New York, and the greater Buffalo area. Our purpose is to analyze the community’s population and eye care needs using research and interviews with two optometrists in the area. I’m looking forward to finding out more about my community through my research, and it definitely makes me think about where I’ll be practicing someday, even though that’s still a long way off. I hope everyone has a great spring break!

The Top 5 Things I Learned in My First Year at NECO

It’s already February, which means that I officially survived my first semester at NECO and the second half of the year is already well underway. Since midterms are coming up in a few weeks, I wanted to look back and remind myself about all of the things I’ve learned since I’ve gotten here–and give any prospective applicants an idea of what your first semester here will be like!

When I arrived in Boston in August, I was venturing into completely unfamiliar territory. I’d never spent any time in the city other than for my interview and to search for an apartment, and I was launching myself from four years at a small liberal arts college in Ithaca, New York–where my classes spanned a wide range from science to science fiction writing–to a completely novel experience at NECO. I wasn’t quite sure what to expect, but found myself quickly submerged into an entirely unique experience:

1. We start working with patients not just in our first year, but in our first few months at NECO.
I started classes in the first week of September, and my first vision screening at a Head Start program outside of Boston was in October. I was both excited and intimidated by the prospect of practicing procedures on patients so early, especially when I arrived at the school and realized that I was going from working with my classmates in their twenties to Head Start students who ranged in age from two to four years old. Generally, when you tell a classmate to “look at the big E,” they will look at the big E, but working with children is a lot more challenging because you have to be both clinician and entertainer, coming up with new ways to hold their attention. Although difficult, it was extremely rewarding to be able to work with children so early on, because you learn very quickly how much more complicated patient care can be outside of a classroom and that part of dealing with patients means learning to adapt and improvise. It may even mean dancing around and pointing at different things on the wall of a classroom to try and distract a child long enough for one of your classmates to look at her pupils.

2. We work really hard, but we also have a lot of fun.
I have been extremely impressed by the large number of school events, especially during the beginning of the semester. The NECO community is small enough that almost everyone attends the events, and they were a great way to meet and get to know a lot of my classmates. In addition to NECO-sponsored events at local bars and clubs, like a Halloween party where our class president dressed up as a transilluminator, there are also events at the school itself, like the VOSH casino night fundraiser, where I played blackjack (and didn’t do too badly!).

3. We don’t just read about eyes in textbooks–we literally hold eyes in the palm of our hands.
It’s a lot easier to understand difficult concepts when they’re reinforced in lab. Since there’s a lab for essentially all of our classes, we are able to learn things in different ways and see in real life what we are discussing. In one of my more memorable lab experiences, we dissected cow eyes and I was able to feel the toughness of the sclera and see the clarity of the lens in person–and even hold the eye on my fingertip to flip it inside-out and examine it from all angles. It’s easy to struggle with learning something when you can’t picture it clearly, but when you’re holding a brain in your hands in Anatomy and Physiology lab, or performing retinoscopy on a classmate in PPO lab, or experimenting with optical illusions in TMVT lab, it’s a lot more interesting–and a lot more fun!

4. We spend a lot of time staring into each others’ eyes.
Although we do go on screenings every few weeks to work with real patients, the first place we learn procedures is in PPO lab, by practicing on each other. It was nerve-wracking at first to try new procedures on someone you didn’t know, but it’s also a great way to meet your classmates and bond over understanding something new. You’ll find out a lot of your classmates’ eye issues–we all decided to become optometrists, which means that the majority of us have some refractive error (at least!) to work with. It makes the labs more challenging, since it’s rare that you’ll be working with a classmate with perfect eyes, and it also better prepares us for seeing different types of patients in the future.

5. We don’t just learn about eyes.
As a beginning optometry student, it was easy to assume that my classwork would be mainly eye-related; and it is, to a point. But I also learned very quickly that as optometrists, we can’t merely look at a patient and see a floating pair of eyes–we need to consider the person as a whole. Even in our first year, we start learning about how the body functions systemically in order to get a better picture of why certain eye disorders occur and how crucial it is to understand the emotional experience of the patient along with the medical aspect.

My first year so far has been filled with so many new experiences, and I’m excited to see what else is ahead.

Until next time!

Emmy