Oculoplastics and Trauma

[MPMD]

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Just a quick question about the scope of Oculoplastics:

I really enjoyed my trauma surgery rotation, but hated the lifestyle. I also found that I enjoyed the trauma in ENT, which at my institution overlaps somewhat with Oculoplastics when orbital trauma is present. I wasn't crazy about the nasal fractures and airway stuff though. Seems like most of the plastics programs are affiliated with a major trauma center, but how much exposure to trauma does the typical plastics program provide?

Thanks in advance for any help!

 

[bucknut101]

At my residency program our oculoplastics service did not directly take part in facial trauma call (that was done by ENT and OMFS) but if there was any orbital involvement, ENT or OMFS had to consult us to see the patient. Those two services, particular OMFS, had a history of missing critical things (like retrobulbar hemorrhages, open globes) and peforming poor repairs of orbital fractures with less than satisfactory results. As a result it was policy that our ocuolplastics always be involved. The ophthalmology residenct on call also was primary call for the oculplastics service. As a result I'm guessing I probably saw over a hundred orbital fractures while on call and I know our oculoplastics fellow did several hundred orbital fracture repairs by the end of his fellowship.

 

[MstaKing10]

Also, oculoplastics is usually involved in lid laceration repairs as a result of trauma, particularly those involving the lid margin or canaliculus. These turn out to be quite common, and although general ophthalmologist can certainly handle most of these, it is not uncommon for the oculoplastics service to become involved.

 

[MPMD]

Thanks for the replies! Glad to know I could do some trauma as an ophtho res.

 

[Dusn]

You can do plenty of trauma as an ophtho resident, depending on your program. But be careful what you wish for. Trauma can get old fast and too much of it will put a hamper on your lifestyle, even in ophtho.

 

[MPMD]

That's a good point. Everything is exciting as a med student, but I can see how anything can becoming taxing when you're getting hauled in at 4am.

 

[orbitsurgMD]

Almost all residents, regardless whether they have a particular subspecialty interest or not, will get plenty of exposure to trauma, at least early evaluation. Repairs of ruptured globes and eyelid lacerations typically are resident cases. Canalicular lacerations will probably get a plastics person involved, at least a fellow, if the program has one, or the attending plastics specialist. The same is also true for fracture repairs.

Trauma is fun as a resident, or if not fun, it isn't as much a burden. As an attending, in private practice, it isn't as much so, as most trauma is late at night, commonly involving intoxication, or criminal activity and is usually not paid. That gets old fast, especially if you have to spend your night without sleep and have a day of clinic ahead to work through (or, worse, scheduled surgery to do.) Rest matters.