Where has this summer gone?  As I sit here and write this blog, I ask myself, what have I done with my time this past month?  At first, I have the embarrassing thought of “I have done absolutely nothing!”  But after I think about it for a few seconds, I reassure myself that I have been quite productive.

After school was finished for the year, I traveled down to Pensacola, FL, where I have been volunteering in an optometry office.  This has been a great experience so far, as I have had the chance to see many things that I have never seen before!  During first year, I was able to see patients during screenings.  The patients were usually not much older than 8 or 9 years old.   Thus, my first time seeing a patient in this office, I was not really sure what to expect.  Many of the patients here are elderly, and have various ocular conditions.  Part of my responsibility is to help “work up” these patients by completing entrance tests and other tests including OCT, visual fields, and fundus photos.  I learned about these tests in school, but never had the chance to actually perform them.  When I heard that I would be able to do these tests, I was really excited.

One of the first patients that I performed a visual field test on was an elderly man with glaucoma.  While in lab, I only performed visual fields on fellow students and fortunately had never come across any field defects.  Looking at this patient’s previous tests, I knew that I could expect some loss in his peripheral field of view.  I knew that this loss was not a good sign, but I was eager to see what his test results would be to see if I could pinpoint any patterns that I learned while in class.  After dialing all of his information into the machine, I had to calculate the lens to put in front of his eye so that he could see the lights during the test.  I never had to put a lens in place in a visual field machine before, and I learned very quickly that it was not as easy as it looked.  I put the lens in the holder multiple times, and each time when I asked the patient to put his head forward, the lens would fall out and I would have to do it all again.  Luckily, the patient was really friendly and he just kept making jokes about the lens situation!  I finally was able to get the lens in place and was able to start the test.  As the test progressed, I could see field loss become evident and it looked very similar to what I had predicted.  It was a very rewarding experience to understand what I was looking at and to have a good idea of what to be looking out for while reading the test results.  After working this patient up, I presented him to the doctor and she confirmed that his glaucomatous field loss was progressing.

In addition to performing entrance tests on patients, I had the opportunity to observe a LASEK surgery at the ophthalmologist’s office located next door to the practice I work in.  I was not expecting to see a LASEK surgery that day, but when asked if I wanted to observe, there was no hesitation.  The ophthalmologist just received a grant that enabled him to use a brand new machine to perform the procedure and I was allowed to observe his last procedure of the day.  I didn’t really know what to expect, as again, I only learned briefly about the procedure in class, but had never seen it performed in person.  After being suited up in scrubs and a face mask, I went into the OR and was introduced to all of the instruments being used.  I didn’t realize that LASEK involved multiple machines and lasers, so it was really cool to see everything performed all at once.  First, the doctors calculated the patient’s Rx as well as the thickness of the cornea.  This was to ensure that the flaps being cut and the layer being reduced would not result in the eye being too thin and unhealthy.  After the calculations were complete, the first laser (I was not completely sure if this was an actual laser or if they just called it one) was used to cut the flap, and it did so by using bubbles that created a “Velcro” like surface.  This roughened surfaced allowed the flap to be easily lifted by the surgeon.  After the flap was removed, the laser was put into place, and the procedure was performed.  It took a total of 13 seconds per eye, an astonishingly small number that I did not expect!  I found it really intriguing to see how the setup of the room and machines was crucial for the procedure to be performed safely and smoothly.  The surgeon sat in a chair with wheels on the bottom to allow him to move from machine to machine, and the patient was in a supine position in a moveable chair that was controlled by the surgeon.  When the surgeon needed to use a machine, he would just wheel over to it and position the patient’s chair to where he needed it.  Everything went so smoothly and I was surprised at how quickly the entire procedure lasted.

So far, summer has been great!  It has been awesome to apply things from school to what I am seeing in the clinic.  Can’t wait for more great experiences to come, and I will be sure to write about them next month!

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