sjkpark said:
Sounds incredibly interesting... What did you get to do as a medical student? I'm very enthusiastic about ophthalmology and spending some time in a mission environment. However I'm wondering whether I'll be better off doing something where I would get some hands-on experience, such as general surg.
No formal training in ophthalmology is required for the internship. In fact, out of the 5 people in our group, 2 were undergrad students and 3 were med students (myself included). I was the only one who had previous training in ophthalmology.
Our screening tools were very basic, a flashlight to check for gross abnormalities of the anterior segment and a reading chart to check vision. One person would stand by the chart and point to letters while the others sat next to the patient and gave instructions and recorded findings. If vision was less than 6/18 (equivalent of 20/40) they were referred to the optometrist for on-site refraction using trial frames and lenses. A pair of glasses was then issued matching the patients prescription as closely as possible. (This is why we brought glasses with us from the U.S.).
If refraction was not helpful and if cataracts were suspected, they were referred to the eye clinic for further work-up and eventual cataract extraction (This is why we each raised at least $300). If you had an interest in seeing cataract surgery, you could go to the OR in the afternoons/evenings. I did this often and finally got to see several cases of cataract surgeries, using different surgical approaches: Suture-less Small Incision Cataract Surgery (SICS), phaco, and extra-cap. I even observed some LASIK cases
on paying, wealthy patients of course.
A little over 10 years ago, there was a HUGE back-log of cataracts India. The government decided that this was unacceptable and began offering financial incentives to hospitals and eye clinics who were willing to provide free medical/surgical tx for the poor. Realizing that phaco was not efficient and not financially-feasible for large scale cataract camps, ophthalmologists at the Aravind Eye hospital perfected the Suture-less SICS approach. It costs half the price and is done in half the time. In fact, the chief of the hospital in Erode, India (Arasan Eye hospital) could do a SICS in under 5 minutes!
Not only did I get to observe several surgical cases, I saw more corneal pathology (fungal infections, big time!), foreign bodies, traumatic cataracts, RP's, pterygia, etc than I'll probably ever see in my training as a resident (hopefully) in the U.S.
I'd highly recommend this trip to any medical student interested in international eye missions. You'll see a different side of ophthalmology, one that will definitely deepen your appreciation for this field.
