Grades are all posted and Winter Quarter is Over! Recap

*Insert huge sigh of relief here*

Firstly, I know I've been slacking on the posts. Once we came back from Christmas break, we were immediately hit with multiple tests and practicals, and honestly there for a while, it was all I could do to get enough study and practice time and still manage to just get an okay amount of sleep. Most Fridays after class was done, I would just come home and sleep.

Looking at my last post, I almost chuckled a little because the big thing we were doing was learning to flip a person's eyelid inside out. And we considered that mildly invasive. Since then, we've come a very, very long ways on our clinical skills as well as what we now consider "invasive". And it'll probably just keep getting worse from here on, haha.

So, since it's been a while, here are the things I've learned how to do and have been tested over and considered proficient in thus far:

1. Slit Lamp

Late night practicing with one of my fellow classmates, Celine

I mentioned in a previous post that we were just getting into the basics of slit lamp when we first came back from Thanksgiving break. Now, I am able to perform an entire slit lamp exam on the anterior segment of the eye - meaning I know how to look at all the different structures of the front part of the eye like the conjunctiva of the eyelids (lid flipping), sclera, the cornea, the iris, the lens inside the eye, etc. Although it sounds easy to just "look" at something on the eye, each structure requires a different illumination technique in order to really get a proper look at it. For example, my left hand is on the illumination tower and it moves on a full 180 degree axis. I can create different widths of light with it too. Depending on what you're looking at, you need a different width of light with a certain angle of the illumination tower to look at the cornea as opposed to the lens. It was a little overwhelming trying to learn how to do everything, but with many hours of practice (and 2 practicals), I've finally gotten the hang of it.

When we are tested over the use of this in our practicals, our proctors can view what we are looking at through a "teaching tube", which you can actually see coming out the other side of the instrument right by my head.

2. Goldmann Tonometry

I'm pretty sure I'd never heard of this before school. I kind of knew the word "tonometry", but that was it. Tonometry is just the act of measuring someone's eye pressure. Lots of clinics will have the "air puff" machine that can do this (worst machine ever), but this is another way of doing it.

This also required us getting used to putting drops in each others eyes. Since this thing actually touches your eye, your eyes have to be numbed (otherwise it'd probably hurt a lot). Essentially, the tip touches the cornea and flattens it out with "x" amount of pressure. However much pressure it takes to flatten the cornea is said to be the intraocular pressure. We do this on the slit lamp and we're looking at something like this when we do it.

The half green circles show up when the tip is on the cornea and is made by a fluorescein (yellow) dye put in the eye (the yellow turns green because of the blue light we use). We know we have the pressure right when those circles are equal size to each other and they are just barely touching on the insides...as opposed to this.

Essentially, we have to move the slit lamp to vertically/horizontally align those circles. Then we make the insides "touch" my adjusting the pressure applied.

I know the tip consists of a type of prism that makes these circles, but I'm not entirely sure of how the light/optics work going through them to give us what we're seeing. I just know this is how we do it, haha.

This took a lot of practice to get good at. The thing that stinks about anything like this in school though is to get practice, you have to be willing to sit for other people to practice on you. So I had my eyes numbed plenty of times in order to get decent at this technique. It also took a bit to be "not afraid" of this, considering the nature of it.

3. Direct Ophthalmoscopy
Last one, I promise, for this quarter anyways.



This is something we learned pretty recently and had to get semi decent with because we had a practical over it 2 weeks after we learned it.

So this tool just allows us to look at the back of someone's eye through their pupil. So you can see the different parts of the retina and the optic nerve, along with the blood vessels and everything. The first time we worked with it, we all had one eye dilated to make it easier.

Once I got the hang of it, it was actually really cool. We learned how to asses the optic nerve, the blood vessels, and the background of the retina.



Essentially, we're looking at bits and pieces of the picture above. That round yellowish circle is the optic nerve. We all had these pictures taken of our eyes last quarter in the clinic.

Then, to test us over it, during our practical I had to look at my patient's optic nerve with my ophthalmoscope, get it in focus (the person's prescription will affect if it is in focus or not), and try and get a good look at the back of the eye eye. During the test we had to do this undilated, which is much much harder because the pupil is so much smaller and constricts a lot because of the light shining in. Once I was done, I was given 4 pictures that looked similar to the one above and I had to identify which one was my patient's. This was actually pretty difficult, but I did get it right, so woot!

My other classes for the quarter

So, everything above was just for one of my classes this quarter, which is my clinical skills and methods class.

We were still taking our basic science class (10-14 lecture hours a week) with our test every Tuesday at 7 AM over the previous week's material. I think we are all slowly burning out on this class. It's a huge time commitment itself between class time and study time, especially while trying to manage stuff for our actual optometry classes.

We finished our ocular anatomy class, which had a lot of memorization. Our tests were pretty tricky and long. Our midterm was over 60 multiple choice questions and the final that I had earlier this week was 105 questions. Not easy multiple choice questions either. Our professors love "which of the following is not true" type questions and will have 3 different answers for some followed by "all of the above" or "only two of the above". Sometimes one question will require you to know at least 3, 4, or 5 different facts about what they're asking. I hate those types of questions, haha.

And I just finished our geometric optics class yesterday. This class was very much like a math or physics type class, which are the types of classes that I actually like better, even though the tests were a little brutal. The picture below is our equation sheet from just this quarter. To be completely honest, after all the studying, I pretty much knew the majority of these and didn't really use it much on our final. But it gives you an idea of how much we covered in the last 10 weeks or so. Fun stuff.

And really, that about sums it all up. This quarter was definitely way more challenging than the fall quarter just with the amount of everything. Just in the last 10 days, I had 7 separate exams. A few weeks ago, we had a crazy 2 and a half week time period where we had 8 exams.

We actually had 20 exams just this quarter - over a 10 and a half week time period. That's not counting all the homework, assignments, presentations, and quizzes either. I've really had to crack down on how I manage my time because it really does matter. But, I'm still hanging in there. I definitely slept a lot yesterday and last night. I probably needed it. :)

And now we are off and out of school all next week for Spring Break. I think we're all relieved to get a little bit of time off and rest.

Hope you all have a great weekend!