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- Nov 21, 2006
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Hi all.
So, I'm 3 days into my ophtho residency. I haven't done much so far, basically the attending examines the patient, then it's my turn to repeat the procedure. For some reason none of the attendings seem to fancy the BIO, they just go for the slit lamp. As I'm having some doubts regarding my technique, I'd greatly appreciate if someone could give me some tips. The docs I'm working with have 15+ years of experience, and although they're very kind and helpful, they keep repeating the obvious - do it a few hundred times, and you'll get the hang of it. I appreciate the importance of experiance, but surely there must be some useful tricks to make slitlamp fundoscopy easier for a newbie 😀
1.) I'm only able to focus on the retina in dilated patients.
2.) If I manage to focus on the retina, which can easily take a minute or so, I only observe a narrow section of the retina, corresponding to the width of the light beam (yes, I'm aware of the fact it's logical, although I did expect the field of observation to be somewhat wider). The problem is, that if I then procede to examining the periphery by asking the patient to redirect his gaze, I'm basically lost as to how much of the fundus I've "lost" between the 2 directions of his gaze, ie. I'm afraid I'll miss some important finding. Am I being paranoid?
3.) Reflections are all over the place. Adjusting the angle of the (90D) lens by tilting it along it's horiz./vertic. axis makes no difference whatsoever; neither does adjustment of the illumination angle.
The only thing I've found helpful so far, is starting with a low mag. (6x), focusing on the fundus, then increasing to 10x and 16x. It works ok, but takes time, and for some reason at times I'm not able to focus at all, even though I follow the same procedure. Any advice is greatly appreciated. 🙂
So, I'm 3 days into my ophtho residency. I haven't done much so far, basically the attending examines the patient, then it's my turn to repeat the procedure. For some reason none of the attendings seem to fancy the BIO, they just go for the slit lamp. As I'm having some doubts regarding my technique, I'd greatly appreciate if someone could give me some tips. The docs I'm working with have 15+ years of experience, and although they're very kind and helpful, they keep repeating the obvious - do it a few hundred times, and you'll get the hang of it. I appreciate the importance of experiance, but surely there must be some useful tricks to make slitlamp fundoscopy easier for a newbie 😀
1.) I'm only able to focus on the retina in dilated patients.
2.) If I manage to focus on the retina, which can easily take a minute or so, I only observe a narrow section of the retina, corresponding to the width of the light beam (yes, I'm aware of the fact it's logical, although I did expect the field of observation to be somewhat wider). The problem is, that if I then procede to examining the periphery by asking the patient to redirect his gaze, I'm basically lost as to how much of the fundus I've "lost" between the 2 directions of his gaze, ie. I'm afraid I'll miss some important finding. Am I being paranoid?
3.) Reflections are all over the place. Adjusting the angle of the (90D) lens by tilting it along it's horiz./vertic. axis makes no difference whatsoever; neither does adjustment of the illumination angle.
The only thing I've found helpful so far, is starting with a low mag. (6x), focusing on the fundus, then increasing to 10x and 16x. It works ok, but takes time, and for some reason at times I'm not able to focus at all, even though I follow the same procedure. Any advice is greatly appreciated. 🙂