Ophthalmology intro

Just like ENT, this posting is 3 weeks long. Although there are only 20 fundoscopes pictures are to be filled, do not be fooled. You still have to do a CWU in ophthalmology. The format may depend on your supervisors. Mine required us to write more on history taking and physical examination, with lesser emphasis on investigations.

The department is on the 9th floor, just opposite of the ENT dept. As in ENT, briefing starts at 8am in the room where you had your JKM lectures on 9th floor(the seminar room just as you exit the lift). This is continued by lectures. The lectures are concentrated on the 1st week. Therefore, you might have your clinic time compromised.

The clinics (1st floor) is the place where you'll be filling in your logbook. Each group is assigned to each doctor along with his/her team. Therefore, it is advisable to stick with your supervisor on the day they have clinic. However, in desperate times, you may try joining other groups, but preferably ask the group's permission, or be the non-aggresive by not competing directly with the group to examine patients.

Approach the patients and seek consent before you examine them. Patients who had been given drops would have their pupils dilated, making it easy to do a fundoscopy. Some doctors may require you to take history from the patient and present them as well, before they sign your logbook. So, make full good use of the chance in the clinic to do whatever it takes to get your logbook signed. A pocket atlas is recommended for reference while in the clinic. Certain days have certain cases, such as diabetic retinopathy day on wednesday (or thursday, not sure bout that), so be on the look out.

Be sure to look around and get to know all the field charts, from Amsler to any other possible perimetry or eye chart.

There are times when it's stated that you should be in the ward. Most of the time, all the patients are there mostly for cataract or surgical correction of strabismus(rare cases). With the haziness and undilated pupil, there's no point hanging much in the wards. However, the evenings(4-6pm) are the best time to hang around the wards. This is when new patients are admitted in for op the next day (check for daycare surgery where there's no pre-op admission!), thus their eyes are dilated by then. This is the best chance to practice fundoscopy on the patients. Some doctors may opt to put drops the morning before surgery, so you can also come in the morning to practise fundoscopy and appreciate the findings. Cataract may have no significant finding, but a further probe into history may reveal glaucoma or chronic diabetes, which may reveal some interesting fundoscopic findings!

Ophthalmology doctors do not encourage students to enter the OT as most procedures are done under microscopy. Therefore, take the time to explore the wards or clinics or the equipment in the clinic. Be sure to know all of it!

In the end, there is also a mini assessment, where you'll have to show your eye examination techniques and fundoscopy as well! Some doctors may require you to do just either one, so it all really bores down to your own supervisors.

In the end, remember to enjoy this posting!

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