Sorry it's been a while since my last update, but here it is! I unfortunately forgot all the details of my last week of my internship. But here are some observations I have made based on my experience with Army optometry:
1) Army optometrists have a very wide breadth of practice; you have the potential to use your entire scope if you want to, including the knowledge you'll learn with low vision, vision therapy, ocular disease, etc. In fact, the optometrist I worked with at Schofield has had training in minor surgeries as well!!! She has practiced just about everything in the limits of her scope and probably even beyond because Army optometry is not under State law, but Federal law, so there are different limits in that case. A huge reason for advances in optometric practice was really because of military optometry, and this dates back to the Vietnam War when the military trained optometrists way beyond their scope, including minor eye surgeries. So then these optometrists came back home from the war and lobbied to practice what they learned during the war. Here is an article that talks more about the history (MS Word document).
2) Educational advancement is definitely available for you, and the Army has various programs for you to further your knowledge and in some cases pays for such programs, including residencies and residency + MBA programs. The Army also allows extra leave time for Continuing Education (CE) every year.
3) There will always be lots of "consults," which are referrals from other military doctors who need your ocular expertise. The optometrists that I worked with got a lot of exposure to eye diseases this way...just look at all the interesting cases you've seen in my previous blog entries! Basically, in the civilian world you'll have to know the other docs around town to get referrals but in Army optometry, such referrals are basically a given!
4) The optical tech training that the Army provides is exceptional; the techs that I met at Schofield and Tripler were very knowledgeable about their work. I have a lot of respect for their expertise and surprisingly some of them knew a great deal of what optometrists know including refractions, direct ophthalmoscopy, retinoscopy, and slit lamp!
5) This internship provided me the opportunity to practice the skills I have learned in first year, and also has given me a head start on what I will be learning in the coming year. On top of that, I got more exposure to patients than I have had in my entire undergrad and first year of optometry school combined (over 250 hours of patient care time). This is definitely a huge advantage of the Army HPSP.
6) However, there are some negative aspects to Army Optometry as well. Two big ones are paperwork and admin duties. As you go up higher in rank, your responsibilities increase as well and so your patient care time could be reduced since you have to attend to such duties. This includes operational tasks (running the clinic), charting patient data on the computer, keeping track of supplies and equipment, etc. But I know these responsibilities are true anyway for private practice owners. That's why you have a right hand person, your Optometry NCOIC (Noncommissioned Officer In Charge), who basically acts as the office manager. But the one thing that you can't avoid that much is paperwork, and this is just a fact of life in the military.
By the way here are some pictures from my actual vacation in Hawaii, after my internship. My girlfriend came near the end of my internship and we did tons of stuff in Hawaii!!!
The rest of my Hawaii trip
August 01, 2007Hawaii internship - Week 5
July 11, 2007
Monday (at TAMC)
- Practiced a refraction on a cyclopleged patient (cyclopleged = focusing system is paralyzed). When refracting a cyclopleged patient, if their refraction is more plus than their uncyclopleged result then the patient is accommodating therefore straining their eyes when they are not wearing correction. Since the patient is accommodating, they will probably complain of headaches when doing near work e.g. reading.
- Observed an RGP (Rigid Gas Permeable) contact lens fit, through the slit lamp and fluorescein (see past blog)
- Practiced a refraction on a cyclopleged patient (cyclopleged = focusing system is paralyzed). When refracting a cyclopleged patient, if their refraction is more plus than their uncyclopleged result then the patient is accommodating therefore straining their eyes when they are not wearing correction. Since the patient is accommodating, they will probably complain of headaches when doing near work e.g. reading.
- Observed an RGP (Rigid Gas Permeable) contact lens fit, through the slit lamp and fluorescein (see past blog)
Hawaii internship - Week 4
July 01, 2007
Monday
- Learned how to use the Goldmann tonometer, which is a device that is attached to the slit lamp and gets a reading of the patient’s eye pressure (high eye pressure is a red flag for glaucoma).
- Helped with tech screenings including taking pictures with the fundus camera and conducting pachymetry (corneal thickness measurement) for the first time. Pachymetry is pretty interesting since you have to push a probe onto the surface of the often anxious patient’s eye.
- Learned how to use the Goldmann tonometer, which is a device that is attached to the slit lamp and gets a reading of the patient’s eye pressure (high eye pressure is a red flag for glaucoma).
- Helped with tech screenings including taking pictures with the fundus camera and conducting pachymetry (corneal thickness measurement) for the first time. Pachymetry is pretty interesting since you have to push a probe onto the surface of the often anxious patient’s eye.
