Week 4:
Children’s Hospital Colorado

July 2, 2014

This week I was able to shadow an ophthalmology clinic.  Optometry is my career interest, and before my shadowing, I knew the main difference between ophthalmology and optometry. Ophthalmologists perform eye surgeries and deal with complicated issues, such as cataracts, glaucoma, and eye infections. Optometrists specialize in vision care, prescribing eyeglasses and contacts. While I shadowed Dr. Schaffer in cardiology, he was telling me that I should look into ophthalmology because I might change my mind about optometry. From my shadowing experience though, I am leaning more towards optometry. Some individuals would say optometry is boring because you just deal with vision care, while ophthalmologists deal with a variety of eye problems that could be quite interesting, However, ophthalmologists are medical doctors and would require more time and dedication to see patients during emergencies, and more schooling as well. Moreover, I like clinical work; I do not think that I will be able to perform surgeries on a patients eyes. Each career has its advantages/disadvantages, but I will see how things go in the future.

I also learned about a patient with severe cataracts, his cornea was small and cloudy. This patient suffered from mental/ behavioral problems, he would constantly pick/rub his eyes. In the past, a splint was put on his arm to prevent him from picking his eyes, but he would remove it. Eye patches did not work either. He was on very aggressive steroids to control the inflammation and irritation in his eyes that could help him from picking at his eyes, but there was not much the doctors could do. The medicine he was on was the maximum amount, and some of the side effects are cataracts, but he is already permanently blind from this condition, so it makes no difference. I also learned more about eye-surgery. A patient had right eye drifting he noticed while reading or on his iPad. A test was done to evaluate his drifting, as objects were presented closer to his face/eyes, it was prominent that his right eye would begin to drift. The doctor recommended tightening the inner muscle of his right eye. This  would help the right eye stay aligned and strengthen it. Muscle surgeries are done at the surface of the eye. It is basically changing the placement of the muscle in order to loosen or strengthen the it.

In addition, I did more data collecting. While inputting data in REDcap, I made changes to the variables we were reviewing to match the terminology and listing found in EPIC. Since I read a bunch of retrospective articles, I had multiple drop-down lists for complications and mechanisms of injury, but they were not consistent with how the surgeons filled out their paper work. Having the possible choices match the EPIC review would make the process of data collecting more effective and faster. Also, I decided to remove variables I felt were unimportant or was not reported in EPIC, and added more variables I felt would be useful for our study.  It seems that the more I look through patient’s records/results, the more I want to make changes to REDcap. Over the course of the week, I keep finding variables that I wanted to add or variables that does not seem to fit. Since I made these changes, I had to go back to update the patients I already did. Having a my project designed for me prior to my arrival, would have been nice, but I am able to learn how to design a project, a very useful skill.  Moreover, having to go back to update the patients chart review, allowed me to catch some mistakes that I made.