Hospital Optometry

Hey there! So university is just starting back up after Christmas and starting to get busy with clinics in City Sight, revision for finals and finishing my project dissertation!

I mentioned in one of my previous blogs that I had acquired some hospital work experience so I’ll fill you in on that. The placement was in Luton and Dunstable hospital so the commute was quite long and definitely made me sympathise more for those who commute in to uni from far distances! On the 1^st day I was mainly in a glaucoma clinic. Glaucoma is a condition that can lead to permanent sight loss, where the optic nerve head becomes damaged due to mechanical force from increased eye pressure or due to poor nutritional supply. Here you will have a specialist ophthalmologist as well as a few specialist optometrists. We saw some rather interesting cases where we’d either monitor the patient looking at whether the pathology had progressed or whether it had remained stable and the patient could be discharged. In some cases we needed to change medication due to side effects or no signs of the visual loss stabilising. During the clinics, we look at visual field plots, the pressure of the eye by applying a small amount of force with a probe (it’s not as bad as you may think!) and things we would like to look at in terms of ocular health whether that be the front of the eye or the retina. I found these clinics very stimulating as the clinicians allowed me to come up with ideas of what things needed to be checked and give my verdict to the professional on what I think is going on.

The next day I was able to sit in a medical retina clinic. Here they mainly look at conditions such as age-related macular degeneration, hypertensive retinopathy (high blood pressure affecting the eye), retinal artery/vein occlusion (blood clots) and diabetic retinopathy. Again, these clinics were very interesting as I’d just learnt about eye disease in one of the 2^nd year modules so putting together my knowledge from studying as well as what I could see on the patient’s retina, I was able to comment on the progression to the specialist and what could be done for the patient. This is a field I’m very interested in as many retinal conditions are the leading causes of sight loss in the UK and so having the ability to monitor and help these patients who have progressed to sight threatening stages, would be very rewarding.

In the afternoon I shadowed an ophthalmologist in an acute eye clinic. This is slightly similar to A&E but the conditions are less of an emergency. I saw a wide variety of cases from people that had brain damage/stroke to people with haemorrhages at the back of the eye! It sounds quite gory but when you’re taught about the conditions, you learn to look past the gore and become more interested in why did this happen and how can we help the patient.

For the rest of the week I spent time in surgery where I saw cataract surgeries, laser iridotomy for patients with glaucoma and a very rare case where the front of the globe had ruptured due to the patient having a fall! This was by far one of the most interesting things I’ve ever seen. From understanding the anatomy of the eye, we were able to work out what structures were damaged and how it could be repaired in order for the patient to have the best visual and cosmetic outcome. The manual dexterity of the practitioners performing the surgery as well as their knowledge was remarkable and quite frankly inspiring.

All in all, the experience was unforgettable. The variation in what I saw as well as actually understanding what was happening during the consultation was incredible and definitely enhanced my enthusiasm for eye care. Hospital optometry is definitely the place for people interested in pathology and how it can be treated/monitored. You are provided with a lot of clinical exposure to these conditions, some of which you’d be less likely to see in a high-street practice. Seeing just how clinicians communicate with patients showing high levels of empathy is definitely something to learn from, as it’ll help you to develop these skills which is a necessary requirement for future practice.

Hopefully this has given you a little insight into hospital optometry and what you could potentially look forward to! Though if this does not sound like something you’d be down for, in my next blog I can cover the high-street version of optometry! Until then, have a great half term!