Sunday, 19 October 2014

Three weeks into third year

It's now three weeks into 3rd year and I've just about survived all my clinics without killing, hurting or mentally scarring my patients (I think I have anyway).

I'll start with the lectures, they've been challenging, interesting and scary at the same time. From the sheer amount of detail in abnormal ocular conditions to the real life knowledge of occupational optometry via the life changing low vision and special assessment. First year is all about bringing everyone up to the same level and getting people used to the university way of teaching whilst instilling basic principles and some background knowledge. Second year builds on this and you start to learn practical applications such as binocular vision and contact lenses. Third year is where it all comes together, it's all about applying principles in practice and smoothing out the rough edges in knowledge and patient interaction. It is knowledge gained in third year is what I will be using on a daily basis in my future career, assuming it actually goes into my brain.

Onto clinics, which are the main part of the third year, I've had 2 primary care patients, 1 contact lens patient, sat in on 3 special assessment clinics, done 2 dispenses and 1 collection. What have I learnt from all that? That at the moment I am nowhere near ready to see patients unsupervised or finish my degree. Have they really been that bad, probably not but they have certainly shown how much more I have to learn. The main problem has been me getting myself into a flap and not following a logical order with tests or allowing small little things to throw me and knocking my confidence for the rest of the test. Both my first contact lens and primary care were a bit of a fluster and whilst I recovered in primary care, I was still a mess at the end of my contact lens clinic. Thankfully I had a really nice patient who knew what they were doing for the teach but it still really annoyed me that I was such a mess. The plan, is to create a little crib sheet so that I have something to refer to if I lose the plot again. I don't intend to constantly refer to it, that would ruin the flow of the test but at least it gives me a fallback and hopefully writing it out will settle things in my mind better. The other main learning I have taken away from primary care is the need to refine my funduscopy technique with Volk style lenses, I should have plenty of time for that during my dissertation (more on that in a bit).

Special assessment has been the most challenging clinic but the most rewarding at the same time. I've seen three very different patients, a young child with Down's, a 44 year old with severe learning difficulties and a 14 year old who really didn't need to be in the special assessment clinic. The tests have shown just how much a simple eye test can vary based on the patient, from using glowing gloves as a fixation target for ophthalmoscopy to having music on to calm a patient down so you can test them.

Finally my dissertation: "Can an everyday mobile phone camera be used to image the retina instead of an expensive commercial retinal camera?". This was my first choice based on my previous history with mobile phones and I'm really looking forward to the challenge and gaining the experience with Volk style lenses. I've got lots of ideas where to take this, possibly too many for the time and word count I have for the project but it's going to be fun.

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