July has been a pretty productive month so far! Volunteering at the eye clinic here in Florida has been great and has proven to keep me busy and on my toes! I saw numerous eye conditions this month, many of which I have never seen before. One patient in particular was a young male who has keratoconus. Keratoconus is an eye condition involving the cornea. Unlike the normal round shape of the cornea, patients with keratoconus have a cone shaped cornea. I remembered learning about this in one of my first year classes, but this was the first time I had seen a patient with this condition in a clinical setting. Many patients with this condition are prescribed hard contact lenses, which allow the structure of the cornea to maintain a more rounded shape and help to prevent the cornea from progressing in steepness. These lenses are also prescribed to help correct the patient’s refractive error.
While the doctors at this clinic had a few pairs of trial lenses, they did not have a lens that was steep enough to fit this patient’s eye. In order to find a lens that would create a comfortable fit, the doctors had to order a trial fitting set, which contained various hard lenses with different radii of curvature. Each lens therefore was designed to fit a specifically shaped cornea with a specific steepness. When the fitting kit finally arrived (they are very expensive and the doctors at this clinic had to borrow it from another clinic), the patient was asked to try a variety of lenses, each with a different shape, to see which one was the most comfortable. Due to these lenses typically being larger (to compensate for the steepness in its design), finding a comfortable fit is not very easy. The doctors at the clinic told me that many patients who wear these lenses later present with sores and sites of irritation on their eyelids, resulting from the edges of the lenses rubbing against the skin. After a few hours of trying on lenses, the patient and doctors came to an agreement on one of the lenses. The lens was ordered and the patient was eventually fitted with the lens. This was an excellent learning experience for me, as I have learned about this condition, but never had seen it before. Being able to interact with the patient and hear about how this condition has affected him as well as his vision gave me great insight into how some of the smallest structures in the eye can result in big changes in a person’s life.
Aside from working in the clinic this month, I took a little vacation and traveled back to Rochester, New York, to visit my family. Of course it felt like everyone and anyone asked me questions about their eyes, and I had to pull the “I haven’t had that course yet” excuse! A few days before I went home, my sister had taken my 22-month old niece to the optometrist for an exam, as she was presenting with symptoms of pink eye (conjunctivitis). While at the optometrist, I was told my niece was very talkative and when asked to recite the letters on the chart, she did very well. She has just started to learn her letters and apparently has a new found obsession with the letter “w” (which she calls “dubee”). As we all know, in traditional Snellen eye charts, only 10 letters are used (C, D, E, F, L, N, O, P, T, Z). This was not okay with my niece because she could not find “dubee!” She was very distraught over this observation and proceeded to look all over the room for “dubee” while saying “uh oh, dubee, oh no!” After leaving the exam room and finally finding a “W” to ease her worries, she was prescribed an antibiotic eye drop. I came home right in the nick of time to be deemed the one who was to administer these drops at home, and boy was that fun (actually it was really difficult, but between my sister and myself, we were able to use the birds and planes in the sky as a distraction for her to look up while we snuck the eye drops in!). This story and experience of helping with the eye drops has made me extremely excited for the pediatrics courses I will be taking over the next couple of years at NECO! You never know how the patient (especially children) will react and that type of challenge (and finding ways to overcome it) is just what I am looking forward to!