Ophthalmology rotation: Any advice on skills to learn?

[GoodDoggy]

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Currently on my last rotation of medical school before (hopefully) starting EM residency. I am bored like 90% of the day and would like to pick the docs brains in clinic between patients and try to get them to teach my some valuable skills while I am here.

So far I have focused on the basics of slit lamp exams, recognizing acute glaucoma, uveitis, various conjuctivitis, retinal detachments, CRAO, venous occlusion, etc.

Any insight on topics to discuss or skills to try and learn while I'm on this rotation so I'm not wasting my time?

Thanks!

 

[wysdoc]

do a good cranial nerve exam for II, III, IV, and VI and don't forget a quick vision check (Reading a card is quick screen)
get good at the swinging flashlight test and its implications if abnormal Marcus Gunn pupil - Wikipedia
know a normal optic nerve from a swollen one
don't prescribe combo antibiotic/steroid drops especially if zoster is a possibility

 

[TheComebacKid]

Make sure you feel comfortable with all aspects of the "vital signs" of the eyes: visual acuity, EOMs, pressures

If you can get good with the slit lamp exam I think it's a good skill to have. As is a fundoscopic exam.

I don't know how much the ophthalmologists use it, but I think ocular US is really cool and it would be worthwhile to know some of the basics given how ubiquitous US is in EM now.

And obviously try to know all the red flags/emergent conditions in the ED and how we manage them acutely.

Otherwise... it's the last rotation of medical school... Going outside should take precedence over education right now. Congrats on being done

 

[Angry Birds]

Slit lamp. Learn how to use it and then teach it to me.

Haha just kidding. I know how to use it. Barely. Just barely.

 

[emergentmd]

Slit Lamp. Slit Lamp. Slit Lamp.

 

[mauricekenter]

Man everyone must see more eye pathology than me. Ophthalmoscope? Throw it away. Use the crappy one for red reflex and see if they have a vitreous hemorrhage. Slit Lamp? I only use it when removing foreign bodies from the eye. This is Emergency Medicine....you can try to learn a lot, but honestly most patients you will just be sending to optho the next day or 2. Here is my 2c

1) learn to properly use the tonopen to diagnose acute angle closure glaucoma

2) obviously know how to use flourescein strips to diagnose abrasions

3) learn how to pluck metal objects out of the cornea with a needle using the slit lamp. This is honestly this only time I use the slit lamp

4) know the lingo and know what is “off” on a good EOM exam. You likely won’t remember exact CN palsies, just know what isn’t “right” and look up the rest. Opthobook.com is a good website to look this stuff up

5) know how to do a lateral canthotomy. It’s surprisingly easier than you think.

6) learn how to prescribe eye drops that aren’t $100. Not every red eye needs cipro.

 

[Angry Birds]

Slit Lamp. Slit Lamp. Slit Lamp.

This guy is onto something.