Diary of an eye resident doctor

Today, my patient is a little girl. One of her eye had already shrunken, we called it pthisis of eye. It had been damaged due to her history of prematurity, resulting a condition of severe stage of retinopathy of prematurity. Now she only left with her left eye but sadly due to its compensation, she couldn’t see with 6/6 vision on her left eye. So the best thing for her is saving her last eye as best way as possible, and accurate refraction and glasses will help her. The ironic thing is that she had a younger baby brother, with the same resulting condition, with severe retinopathy of prematurity. It’s so sad. As far as I concerned, it is not genetic. But the father of these two kids were so brave and wholeheartedly bring these kids, and when we asked them to do an examination (eye examination for kids could take a long time), he encourage the kids with “c’mon let’s go!” with pleasurable vibe. He cheers them up. I’m just so amazed by how the father could pull up this heartwarming attitude despite the situation of both the kids.

My last patient today was another kids ( I am on my rotation of eye pediatric, that’s why my patients were all children ), it’s a six months old baby with both eye having the suspicious cancer, which is retinoblastoma. It’s a devastating news for the parents. They had been aware for the last three months that the baby had “cat-eye” apperance but they did not take it as an alarm. Cat eye appearance or leukokoria is a high chance of suspicion of eye cancer. I urgently referred this patient to the oncology unit for further work up. I hate to be the one breaking the bad news, but that’s one of the suckiest thing to be a doctor. You had to tell the truth.

I just hope all of the family of these children had the strength they need to have. Having eye disease is a problem, but having your kids’ eye a disease, is a way bigger problem. It takes a whole lifetime to the kids to adapt for their vision and increase the quality of life. I just hope they could see the world as bright as it ever be.

Eye series : Strabismus

So here’s a short list about the pearl and point what needs to be understand about strabismus and pediatric ophthalmology

All the Strabismus Tests : Hirshberg,Cover, Uncover Tests

Basically there are 3 test to measure ocular alignment :

  1. Corneal Reflex Test
  2. Cover uncover Test
  3. Subjective Test (Maddox Rod )

-Corneal Reflex Test (Hirsberg )

Then if you suspect some deviation, you could use Krimksy Test to evaluate the amount of deviation :

2. Cover Test only used if there is a constant fixation.

There are three types :

-Cover uncover tests -detect manifest strabismus and differ between tropia or phoria(appear after cover)

-Alternate cover tests- detect both latent and manifest strabismus

-Alternate Prism and cover tests- to quantified the deviation with prims

-Simultaneous Prism and cover tests – to detect monofixation syndrome

3.Subjective Test (Maddox Rod)

uses devices consisting of series of parallel cylinders that converts a point source of light into line image

Sources for Study From Home

Here’s some sources for your study during the self-isolate. I know that doctors can not work from home, we have to work on shifts on the hospital, but we minimise the study lecture on hospital class, so we should had some study time as well at home. Here’s some source that I could collect for increasing my fun learning study time, if you’re a little bit bored with book lately.

Photo by Lisa Fotios on Pexels.com
  1. Online webinar or conference call study

There are some online webinars out there that you could join. It will trigger you to stay active like in class, but you have to make sure to match the time appointment due to different country timezone. If you’re having difficulty to match the time zone, make one yourself with your peers! It will create an amazing atmosphere and let your brain active yet a good way to say hello to your friends as well. Make sure you are on the same time appointment, I’ve tried this and it’s an amazing technique to study.

2. Youtube lecture

It’s amazing that if you use it wisely there are some online lectures on youtube. For ophthalmology student or anyone who’s interested in ophtho, here are some channels that worth to watch :

  • Moran CORE — it has a huge collection of lectures, and every lectures represented with slides, so you’ll feel like joining a seminar- only this time you could wear your pyjamas
  • Cybersight – it has great source of studying, and lots of surgical videos – if you’re looking tips for increasing your surgical ability with adding the theory then it’s the channel
  • Tim Root – he’s like on of the most charming professor in ophtho, he explains everything so clearly and easy so we could understand difficult topics
A lecture on Cybersight channel Youtube

3. Collection of cases

Here’s a good atlas of cases that you could check on if you’re interested about eye, I think it’s a very good way to study from cases – so it will keep you active.

4. Active searching on google image

Why google image? Because it contains lots and LOTS of pictures that you are asking for so you could have a quick visual memory, and google image will show some important slides for points and notes about what you’re asking for. So during your study session, it’s best to prep some google image in front of you.

So, basically you need to give some variety on your study session and be more interactive so it will increases your motivation for studying at home. Cheers!

Eye Series Project : The Angle

One of the reason why ophthalmology ( study about eye) is interesting mainly because we could see lots of beautiful pictures, mentioning that I am a huge fan of watching movies, so visual is a treat for me. So, I want to dedicate this series to help learning more about the amazing part of eye. This chapter will discuss about the angle of the eye, where if any abnormalities found will result in a disease called Glaucoma. We used an equipment named Gonioscopy to assess the depth of the angle of the eye.

A normal angle of eye. Source : Springer
Source :reviewofoptometry
source : review of optometry
Source :review of optometry
Source :