01-08-2004, 04:28 PM
Hi, I'd like to know what are the important aspects of ophthalmology that are useful and valuable for family practice. I know the direct ophthalmoscope is important, but what about the slit lamp exam and other techniques and instruments?
01-16-2004, 06:59 AM
Well I'll take a stab at this one since I'm an ophtho hopeful.
Learn how to recognize and treat conjunctivitis. Learn what an ocular emergency is (ie acute angle closure, central retinal artery occlusion), how to recognize it and refer it.
You won't be using a slit lamp. I've seen FP's that have them (in academics) but they don't use them, and who can blame them...they don't know what they're looking for. I mean, I'm sure you could gain some proficiency with it, but what's the purpose?
You certainly will have no use for an indirect ophthalmoscope or any of the more advanced instruments. Oh...and don't ever try to remove a corneal foreign body using the "burr"...lots of eyes get trashed like that. Don't try to treat ulcers and stuff like that. I'd say the only thing you should try treating as an FP would be conjuntivitis.
Just refer your diabetic patients appropriately. Immediately upon diagnosis with Type II then every year. Every year for Type I starting 5 years after diagnosis. Studies seem to indicate you just can't do a good thorough fundus exam that these people need without the training. The field of view through a direct ophthalmosope is just too narrow, even with the dilated pupil (which FP's never do).
Oh, know how to recognize strabismus in kids. You can save a lot of people's vision by doing this, because it actually goes unnoticed in a lot of cases.
Maybe you can learn to do LASIK and cataracts....just kidding.
01-16-2004, 11:09 AM
it's all about identifying who need to see an ophtho. Forget the slit lamp, you'll only get your ass sued.
Conjunctivitis, corneal abrasions, allergies, foreign bodies, fairly straightforward stuff will keep you plenty busy.