Primitive exams

[RetiredRespTher]

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I read carefully to see if non-physicians could join. I'm a retired respiratory therapist. All that means to anyone responding to this is that I do know common medical terminology, so speak as you normally would. If I don't know your word I'll look it up. I'm about six months post vitrectomy and cataractectomy. Each time I visit my ophthalmologist or retina specialist I'm reminded how primitive the vision acuity exam is. I've learned from asking that the typical administrators of the tests may not even be junior college grads. The physician stakes his practice, to a large extent, on the results of these exams. Time spent reading the lines is no more than a couple of minutes, and, (for all I know) the examiner may have filled in the answers before I even tell him/her what I see. After all-- they have it memorized. It wouldn't take much imagination to come up with a more meaningful exam. Even I could do it. I'd like to know what you guys think about what I have said.

 

[PBEA]

I read carefully to see if non-physicians could join. I'm a retired respiratory therapist. All that means to anyone responding to this is that I do know common medical terminology, so speak as you normally would. If I don't know your word I'll look it up. I'm about six months post vitrectomy and cataractectomy. Each time I visit my ophthalmologist or retina specialist I'm reminded how primitive the vision acuity exam is. I've learned from asking that the typical administrators of the tests may not even be junior college grads. The physician stakes his practice, to a large extent, on the results of these exams. Time spent reading the lines is no more than a couple of minutes, and, (for all I know) the examiner may have filled in the answers before I even tell him/her what I see. After all-- they have it memorized. It wouldn't take much imagination to come up with a more meaningful exam. Even I could do it. I'd like to know what you guys think about what I have said.

by "vision acuity exam" I presume you are referring to a vision screening done by say the DMV, school nurses, pediatricians, etc?

 

[Shnurek]

by "vision acuity exam" I presume you are referring to a vision screening done by say the DMV, school nurses, pediatricians, etc?

He/she might mean technician. When I worked for a retinologist, I did the visual acuity exam and so did a woman that had no college credits but she was a nurse in another country. Not to mention we both applied dilating/anaesthetizing drops and took fundus photos / OCT.

 

[taco bell]

Although I am not sure what you are asking, here is my thought on your comment.

While "primitive", the Visual acuity examination is essentially the main vital sign for ophthalmologists. The same can be said for nurses, crna's, medical students, pre-med students taking blood pressure measurements, pulse, resp rate, etc.. (although I understand that all of these populations have some sort of advanced training). I guess, if the VA is in doubt, a retinoscopy might be done by the MD..

 

[Eyefixer]

Word of the day:

cataractectomy

my favorite!

 

[Slide]

The same could be said about a lot of things; blood pressure, pulse, respiration rate, temperature, reading an O2 sat can be done by kids. Clinical experience lets you know if the measurements actually are on par with the patient's symptoms.

 

[Visionary]

I read carefully to see if non-physicians could join. I'm a retired respiratory therapist. All that means to anyone responding to this is that I do know common medical terminology, so speak as you normally would. If I don't know your word I'll look it up. I'm about six months post vitrectomy and cataractectomy. Each time I visit my ophthalmologist or retina specialist I'm reminded how primitive the vision acuity exam is. I've learned from asking that the typical administrators of the tests may not even be junior college grads. The physician stakes his practice, to a large extent, on the results of these exams. Time spent reading the lines is no more than a couple of minutes, and, (for all I know) the examiner may have filled in the answers before I even tell him/her what I see. After all-- they have it memorized. It wouldn't take much imagination to come up with a more meaningful exam. Even I could do it. I'd like to know what you guys think about what I have said.

It shouldn't take long to assess Snellen visual acuity, though if refracting (checking for corrective lenses) it should take longer. Ophthalmic technicians are certified in performing a history and certain aspects of the exam (such as checking visual acuity, intraocular pressure), as well as administration of anesthetic and dilating drops.

That said, Snellen acuity is not a very good measure. A better measure is contrast sensitivity, but that's not very practical in a clinic environment. Tends to be a research tool.

 

[Mirror Form]

I read carefully to see if non-physicians could join. I'm a retired respiratory therapist. All that means to anyone responding to this is that I do know common medical terminology, so speak as you normally would. If I don't know your word I'll look it up. I'm about six months post vitrectomy and cataractectomy. Each time I visit my ophthalmologist or retina specialist I'm reminded how primitive the vision acuity exam is. I've learned from asking that the typical administrators of the tests may not even be junior college grads. The physician stakes his practice, to a large extent, on the results of these exams. Time spent reading the lines is no more than a couple of minutes, and, (for all I know) the examiner may have filled in the answers before I even tell him/her what I see. After all-- they have it memorized. It wouldn't take much imagination to come up with a more meaningful exam. Even I could do it. I'd like to know what you guys think about what I have said.

Visual acuity is a tried and true vital sign for the eye. Yes there are other methods that take tens time longer and give a tiny bit of additional (but not generally clinically useful) information.

So you're a retired respiratory therapist? Did you think you were qualified to check a patient's respiratory rate when you were still working? Wouldn't it have been better to have a pulmonologist carefully check every patient's respiratory rate? Why have ancillary staff? Just have doctors do everything right?

 

[Shnurek]

Why have ancillary staff? Just have doctors do everything right?

Haha, that would be the ideal world, the classic doctor. Probably only the case in small towns nowadays.