hello07

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I recently looked over the National Board of Optometry format exams just to see how much they might have changed from when I went thru it. Part 3, the clinical exam, in the last section tests candidates on intramuscuar, intradermal and intravenous injections- simulate on a dummy. Are these injections now taught in OD school? If so, WHY? What purpose do they serve in Optometry?
I was staggered, really thrown off when I read this.
Can anyone out there- President of the Amer. Optometric Assoc. State Board personnel, Presidents and CEO of Optometry schools and colleges and veteran OD working in VA hospitals etc........tell me about this.
 

vsarge0708

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I recently looked over the National Board of Optometry format exams just to see how much they might have changed from when I went thru it. Part 3, the clinical exam, in the last section tests candidates on intramuscuar, intradermal and intravenous injections- simulate on a dummy. Are these injections now taught in OD school? If so, WHY? What purpose do they serve in Optometry?
I was staggered, really thrown off when I read this.
Can anyone out there- President of the Amer. Optometric Assoc. State Board personnel, Presidents and CEO of Optometry schools and colleges and veteran OD working in VA hospitals etc........tell me about this.
While the injections isolated might not hold much value, teaching these procedures does lay down a path for continuing education and procedure expansion--again this idea of evolving. The injections do not count towards part 3 scores, at least not yet.
 

jefguth

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Yes, at ICO we are taught IM, IV, SubQ, Sub-conjunctival, and intra-lesional injections. The reason; a handful of states now allow OD's to administer these injections so I suppose they have to test our competency in the event that we plan to practice in such a state.
 

cunikki

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at scco we are also taught these injections.... in states that allow you to administer injections you can do intralesional injections of steriods to get rid of chalazions, you can use an epi pen or insulin to someone in anaphylactic or hypoglycemic shock, you can inject sodium fluorescein intravenously for FANG photography purposes... there are many many reasons/indications for optometrists to use injections especially with the expansion of scope. further if the california bill passes doctors will be able to do procedures in california 'as taught' meaning that since we learned how to do these things we can do them in practice
 

KHE

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at scco we are also taught these injections.... in states that allow you to administer injections you can do intralesional injections of steriods to get rid of chalazions, you can use an epi pen or insulin to someone in anaphylactic or hypoglycemic shock, you can inject sodium fluorescein intravenously for FANG photography purposes... there are many many reasons/indications for optometrists to use injections especially with the expansion of scope. further if the california bill passes doctors will be able to do procedures in california 'as taught' meaning that since we learned how to do these things we can do them in practice
When you are taught these procedures, do you perform them on actual patients under the supervision of your attendings?
 

prettygreeneyes

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When you are taught these procedures, do you perform them on actual patients under the supervision of your attendings?
We performed the IV, IM, SubQ (arm and lid) and sub-conj on each other under the watchful eye of our attendings. The intra-lesional was performed on an unsuspecting chicken leg with a "chalazion" (or chickpea in its former life).
 

cunikki

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we also do them on each other and also on dummy arms.... not on actual patients. however i believe that many of our VA rotation sites allow us to perform them on actual patients there... especially for FANG
 

KHE

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we also do them on each other and also on dummy arms.... not on actual patients. however i believe that many of our VA rotation sites allow us to perform them on actual patients there... especially for FANG
Do you all not see a large part of the problem here?

You all are thinking that you are "trained" to perform ocular injections and FANGs, but judging from these different stories here, it seems highly probably that a significant number of students from your schools are graduating without having ever done a single one of these procedures on a live human other than a lab partner. Isn't that akin to an ophthalmic surgeon graduating from residency having never performed a cataract extraction on anything other than a dissected cow eye?

And some of you are thinking that this process adequately prepares you to train for surgery?
 

jefguth

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Do you all not see a large part of the problem here?

You all are thinking that you are "trained" to perform ocular injections and FANGs, but judging from these different stories here, it seems highly probably that a significant number of students from your schools are graduating without having ever done a single one of these procedures on a live human other than a lab partner. Isn't that akin to an ophthalmic surgeon graduating from residency having never performed a cataract extraction on anything other than a dissected cow eye?

And some of you are thinking that this process adequately prepares you to train for surgery?
Right as always, the only injections I expect to perform on real patients during the rest of my training are IV for FANG.
 

prettygreeneyes

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Do you all not see a large part of the problem here?

You all are thinking that you are "trained" to perform ocular injections and FANGs, but judging from these different stories here, it seems highly probably that a significant number of students from your schools are graduating without having ever done a single one of these procedures on a live human other than a lab partner. Isn't that akin to an ophthalmic surgeon graduating from residency having never performed a cataract extraction on anything other than a dissected cow eye?

And some of you are thinking that this process adequately prepares you to train for surgery?
:confused::confused:

I would not call myself "trained" at this point, but a practicing optometrist who completed the same course I did would be "trained" to do injections in Oregon.

Do you take issue with optometrists doing injections in general, or in the way that current students are being trained? Is there a different or better way to do it? I guess I fail to see how your analogy of ophthalmic surgeons practicing on cow eyes applies to me doing an injection in my lab partner's eyes. One is a real live human who could lose vision if I did the procedure incorrectly, and one is an unattached sphere of bovine origin with little to say if I mess up.

Does doing this procedure once on a lab partner mean that I am ready to run out and willy nilly give injections to every patient I see? Of course not. In the real world, I would know what procedures I would and would not be comfortable performing, regardless of "training", and would proceed accordingly. I need a lot more experience with injections before I graduate to even remotely feel comfortable.

And not that you were speaking to me, but I never once said anything about surgery. I apparently am in the minority of students on this board who feel surgery is about the last thing we should be thinking about.
 

KHE

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:confused::confused:

I would not call myself "trained" at this point, but a practicing optometrist who completed the same course I did would be "trained" to do injections in Oregon.

Do you take issue with optometrists doing injections in general, or in the way that current students are being trained? Is there a different or better way to do it? I guess I fail to see how your analogy of ophthalmic surgeons practicing on cow eyes applies to me doing an injection in my lab partner's eyes. One is a real live human who could lose vision if I did the procedure incorrectly, and one is an unattached sphere of bovine origin with little to say if I mess up.

Does doing this procedure once on a lab partner mean that I am ready to run out and willy nilly give injections to every patient I see? Of course not. In the real world, I would know what procedures I would and would not be comfortable performing, regardless of "training", and would proceed accordingly. I need a lot more experience with injections before I graduate to even remotely feel comfortable.

And not that you were speaking to me, but I never once said anything about surgery. I apparently am in the minority of students on this board who feel surgery is about the last thing we should be thinking about.
No...I was not trying to single anyone out. The point I was trying to make is the following:

The argument that many in the pro-surgery crowd make is that medical school education is for all intents and purposes useless in preparing someone to become an ophthalmic surgeon and that since optometry school is 4 years of concentrated study in "the eye" it is a more appropriate, or at the very least a very viable alternate route to train someone to be an ophthalmic surgeon.

Yet you and a few others have described a scenario where you or a significant number of your classmates can graduate from optometry school without ever having performed some of the most incredibly basic medical procedures out there. How does that even come close to preparing anyone to study or train for surgery? Can you imagine someone graduating from medical school without having ever injected anything other than a lab partner or a chicken leg? It's ridiculous.
 

prettygreeneyes

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Can you imagine someone graduating from medical school without having ever injected anything other than a lab partner or a chicken leg? It's ridiculous.
No, I can't imagine that. But I don't think anyone here is trying to claim that doing injections on lab partners means we are ready to do surgery. (At the very least - I'm certainly not implying that.) I thought you were taking issue with the way optometrists are trained to perform injections, which is why I responded. Chicken legs and lab partners aren't ideal, but you've got to start somewhere.

I should probably be studying for finals instead of posting right now. I'll let gochi and the pro-surgery crowd take over from here. ;)
 

Nebolt

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at scco we are also taught these injections..... you can use an epi pen or insulin to someone in anaphylactic or hypoglycemic shock
I may be acting like a jerk for nitpicking when I assume you just misspoke; but injecting insulin in a hypoglycemic pt is likely to kill them. I would be interested though as to why you would need to be taught insulin injections. Treating uncomplicated hyperglycemia with injections is not an emergency, and without appropriate training in dosing and management can be dangerous. In addition to being trained in the injection, would you feel comfortable being able to diagnose a pt who would truly need emergency insulin injections (ie DKA or hyperglycemic/hyperosmolar syndrom) in an office setting? If not, I don't really see the point of recieving the training as I have a hard time imagining a situation where you would actually be able to use it.