Eye Defects and Ophthalmology

[Eye Daddy]

Dear Ophtho Friends,

This may seem like a stupid question, but it has been bothering me for some time.

I recently heard from one of the Ophtho residents at my home institution that he was asked to state his refractive error, any error in stereopsis and a few other similar questions pertaining to his visual acuity when he interviewed for a ophtho residency position a couple years back.

First of all, is this legal? If so, is this practice widespread among ophtho programs? Is there a requirement of a certain visual acuity in order to be considered for certain ophtho fellowships (i.e retina, cornea, etc) which are more surgical?

I can understand that we don't want to have blind people becoming ophthalmologists, but at the same time, I'm wondering whether visual acuity is also taken into account along with things like board scores, grades, and recommendations when choosing a suitable candidate. In short, is the candidate with perfect vision favored over the guy or gal with glasses?

Thanks for your input.

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[rubensan]

In short, is the candidate with perfect vision favored over the guy or gal with glasses?

Thanks for your input.

No! I'm -1.25 O.U. and still matched! Some programs (UT San Antonio comes to mind) require that you undergo an ophthalmologic exam as part of their application process. I think they want to know if you have normal stereopsis. now, after spending 2 years in lab popping off rat corneas and flat mounting their retinas, i can see why stereo vision is important for ophthalmologic surgery. whether all of this is legal, i'm not sure.

 

[Caffeinated]

No! I'm -1.25 O.U. and still matched! Some programs (UT San Antonio comes to mind) require that you undergo an ophthalmologic exam as part of their application process. I think they want to know if you have normal stereopsis. now, after spending 2 years in lab popping off rat corneas and flat mounting their retinas, i can see why stereo vision is important for ophthalmologic surgery. whether all of this is legal, i'm not sure.

There are some that would argue that -1.25 OU is perfect vision, evolutionarily speaking. 🙂

 

[Eye Daddy]

I think they want to know if you have normal stereopsis.

Thanks for your reply Dr. Sanchez. Can you please define exactly what you mean by normal stereopsis, for those of us still in medical school?

Thanks again

 

[splice]

Only a small percentage of programs require an eye exam from applicants - perhaps 10-20% from my limited experience. UTSA is one such program and will not even look at your application until you send the exam results to them. They ask for acuity, stereopsis, color vision, and even a fundus exam to be recorded on a generic form they send you and signed by an ophthalmologist. Other programs require the exam only after you are selected for an interview, and some actually examine you on the day of the interview.

One interview I had with the PD at a program actually asked what I thought of the whole issue of requiring an eye exam as one of his interview questions. He said that faculty had mixed feelings about this, and made the point of where does one draw the line with applicant medical screening. He said that obviously it is important to have decent vision to practice ophthalmology, but one could still become an excellent ophthalmologist even with certain visual problems depending on their specialty. I have also heard of some ophthalmologists with vision problems that seem to have been inspired to go into the field because of their personal experiences and such with their own condition. It makes sense that people who have suffered with vision problems might turn out to be exceptionally motivated and passionate ophthalmologists. I heard another story on the trail about an applicant that was a ultrasuperstar perfect student with a touching story about having come from an impoverished background and risen to success, was class president at a top school, insane board scores, etc... but is monocular and apparently was unable to find any program that would take him. I suppose this is understandable but it does raise an interesting ethical situation.

It would be interesting to hear people's thoughts about this.

 

[rubensan]

You mean they don't teach you about stereopsis on the first day of medical school anymore? I seem to remember learning about it along with Kreb's cycle and all the branches of the brachial plexus 😉 . kidding, of course. i'm sure an ophtho resident, fellow or optometrist could probably give a better definition but the way it was explained to me was that stereopsis is that part of our visual system that allows us to perceive the depth or distance of an object. we have 2 eyes, right? but we see (or should see) one image. you can think of steropsis as our visual system's ability to fuse both images from each eye and allow us to perceive it as 1 image in 3 dimensions. you'll have to ask others on this forum all the reasons why this is important in clinical ophtho, but one example that comes to mind is how stereo vision becomes important when you are evaluating optic nerve heads in glaucoma clinic. once you learn how to use the 90 lens correctly you can see cupping of the optic disc in three dimensions. i suspect stereo vision is important in microscopic surgery as well, i just don't have enough experience to say.

re: splice's post. much of the diagnosis of ophthalmologic diseases was set up by describing what we "see" when we look at or into the eye. perhaps with OCT and other modalities this is changing, but for better or for worse, so much of ophthalmology is "+ SPK or + MGD or + optic nerve head pallor or cupisc ratio of 0.8. i believe that all of these observations require a high level of visual function to assess. however, whether it's legal to make sure people have normal stereovision or have VA that can be corrected to 20/40 OU, i'm not sure. of course, it would be interesting to see what others who have more experience think.

ok, back to studying for step 3. Henoch-Schonlein purpura, remember that?

Thanks for your reply Dr. Sanchez. Can you please define exactly what you mean by normal stereopsis, for those of us still in medical school?

Thanks again

 

[Eye Daddy]

Does anyone know what is the range of acceptable values for visual acuity, stereopsis, and color vision?

Thanks

 

[shiro1]

Interesting thread. I too knew a medical student (from an osteopathic school that only opened 4 years prior...hmmm) who desperately wanted to go into pediatric ophthalmology. She herself was amblyopic and had NO stereopsis. At the late stage of being a third year med student she asked if she would have trouble getting into residency programs. I told her that she probably would. Retina docs especially would wonder if this person could accurately diagnose macular edema, epiretinal membranes, etc. Although MOST of our sense of depth perception relies on visual clues and not necessarily your depth perception, I think most would wonder if they could really cut it even as a general ophthalmologist. She may not have problems with pediatric ophthalmology, but she still needs to get through a general residency program to get to that goal... I don't know what happened to her, but perhaps her background of going to an osteopathic school that is so new would be her rate limiting factor, who knows?

BTW, your actual refraction shouldn't matter. Many ophthalmologists are high myopes and have no problem. I sometimes used my built-in loups (took off my glasses) when I forgot mine somewhere. 👍

 

[bolnoi]

One interview I had with the PD at a program actually asked what I thought of the whole issue of requiring an eye exam as one of his interview questions. He said that faculty had mixed feelings about this, and made the point of where does one draw the line with applicant medical screening. He said that obviously it is important to have decent vision to practice ophthalmology, but one could still become an excellent ophthalmologist even with certain visual problems depending on their specialty. I have also heard of some ophthalmologists with vision problems that seem to have been inspired to go into the field because of their personal experiences and such with their own condition. It makes sense that people who have suffered with vision problems might turn out to be exceptionally motivated and passionate ophthalmologists. I heard another story on the trail about an applicant that was a ultrasuperstar perfect student with a touching story about having come from an impoverished background and risen to success, was class president at a top school, insane board scores, etc... but is monocular and apparently was unable to find any program that would take him. I suppose this is understandable but it does raise an interesting ethical situation.

It would be interesting to hear people's thoughts about this.

i'm one of those people whose mom wants me to be an eye doctor. the reason being that i lack "stereopsis" and i went to eye doctors a lot to try to correct it as a child... now that i know, i obviously wouldn't go into ophalmology because you really do need depth perception to perform those surgeries. I wonder what other surgical specialties require this(i wouldnt want to become a bad dr just because someone was shy about testing me for this condition)?