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NBEO Part 3, the Mother of all Practicals

NBEO Part 3, the Mother of all Practicals

Posted by on Nov 25, 2015 in Blogs

Two done, one to go!

Several weeks ago, I traveled with a handful of my classmates to North Carolina to take Part 3 of our board exams. Unlike Part 1, which we took in March, and Part 2, which we will take in a a couple of days in December (yikes!), Part 3 can be taken on a multitude of dates throughout the academic year. Finishing up Part 3 was exciting- just one more exam and then we’re all done with exams and even closer to that glorious end-point.

Part 3 is akin to practical exams at ICO. Objectives for skills are provided and tasks are grouped together into different stations. I spent the bulk of the weeks leading up to Part 3 reviewing highlighted notes and practicing with classmates. When the fateful day arrived, we were all butterflies and jitters. In Charlotte, we stayed at the Hyatt House which was just a five minute walk to the testing site. At the testing center, we were able to play with all of the equipment and tools we would be using during the exam, which was most helpful.

Hours later, when I reached the end of my final station, I felt relief. A weight was taken off my chest. Finally, the mother of all practicals was over.


With my ICO colleagues all smiles post exam

Traveling to Charlotte to take this practical was nerve-racking, but traveling with friends was enjoyable. Before and after the exam, we got to explore the little downtown and somewhat enjoy our stay in Uptown Charlotte.


Deliciousness. Left: Lunch at Mimosa Grill. Right: Gelato from Bar Cocoa

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Streetcar making Charlotte look like San Francisco


Bechtler Museum of Modern Art

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Low vision and much, much more

Low vision and much, much more

Posted by on Oct 29, 2015 in Blogs

This quarter, I am rotating at the Sidney Hillman Health Center and 3 other sites. Together, they encompass not only low vision, but also primary care, contact lenses, retinal disease, and advanced care.


Sidney Hillman Health Center

Sidney Hillman (SHHC) is a union and not a VA, which kind of took me off guard. During externship site selection, it was included in the VA category for Chicago-only students. Working at SHHC takes me back to clinic shifts at IEI; we have ICO faculty members as preceptors and our exams are primary care. Primary care exams are familiar, and working with some of the friendliest preceptors has been a treat. There are 3 of us students during each shift and three rooms. Sometimes equipment like a slit lamp won’t function (burnt bulbs?) and we play musical chairs with our patients moving between our exam rooms. The majority of patients we see are Spanish-speaking, which can be difficult since none of us speak Spanish. I have learned a number of new Spanish terms working here, though I wish an elective course existed for completing an eye exam in Spanish. I am at Sidney Hillman on three weekdays and every other Saturday.

IMG_5065On Monday and Tuesdays, I fulfill my low vision hours at the Chicago Lighthouse, a center for the blind and visually impaired. My time at the Chicago Lighthouse is divided into shifts in the Pangere Center and in the Low Vision Clinic.

The Pangere Center is a hereditary retinal disease clinic where I work with an OMD and an OD. The majority of patients I have seen there have had one of the four types of Retinitis Pigmentosa, while dozens of other patients have had retinal diseases that I may never see again. We have managed patients with Choroideremia, Stargardt, Occult Maculopathy, Cone/Rod/Cone-Rod Dystrophy, Usher’s Type I and II, Leber’s congenital amaurosis, Achromatopsia, Oguchi disease and two hereditary diseases I had not heard of: Wolfram’s Syndrome and Autosomal Dominant Cystoid Macular Edema.

In the Low Vision Clinic, we work with optometrists to prescribe a plethora of low vision devices from hand held magnifiers and cocoon fit-overs to telescopes and bioptics. The clinic is attached to a store with even more devices and electronic instruments for patients to purchase and maintain their independence with.

IMG_5066The Chicago Lighthouse is a pretty neat facility.
Housed within it is a school for children aged 3-21 years with visual impairments. There are work opportunities for people who are visually impaired including a clock-making factory and numerous call-centers.

When you call Illinois Tollway, you could be speaking to someone at the Lighthouse. Or, when you’re in a hospital waiting area, you may notice that the wall clock you’re counting the minutes on has an inscription that reads “the Chicago Lighthouse.”


Lenscrafters at the Oakbrook Center

Mid-week, we get a taste of the corporate world with a full day at LensCrafters in either Oakbrook or Skokie. LensCrafters is a more laid back corporate setting where the optometrist makes his own schedule and decides exactly what he wants to do for patients. At LensCrafters, I see up to 10 patients a day for routine exams – the majority of which include contact lens fittings and evaluations. Most of the patients are fit in soft contacts, while a handful are fit in gas permeable lenses.

Every third week, I am back to where it all began for urgent care at the Illinois Eye Institute. I have rotated there three times so far and have enjoyed it. During a recent shift there, I saw four patients. One patient came in for a follow-up for an internal hordeolum, which was simple. A second patient came in with recent onset photosensitivity, had signs of raised grey stellate lesions within the corneal epithelium and anterior stroma, and was diagnosed with Thygeson’s superficial punctate keratopathy. A third patient came in with recent onset unilateral central scotoma, had signs of ongoing proliferative diabetic retinopathy that resulted in bilateral tractional retinal detachments. A unilateral tractional detachment at the macula was the mischief behind the scotoma. A fourth patient came in with ongoing unilateral redness and lids swollen shut, a possible result of a few differential diagnoses. After thorough case history and tests including my first AdenoPlus (which came back positive), viral conjunctivitis was diagnosed.

These cases each taught me sometime new, which was exciting. Yes, how nerdy.

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ICO in Florida

ICO in Florida

Posted by on Sep 11, 2015 in Blogs

Last April, I received an invitation to an all-expenses paid conference with the Vision Care Institute in Florida. Free airfare, hotel, and conference in the Sunshine State? Sign me up!

Fast forward a few months later. It was late August and the conference was finally here.

Along with six of my classmates, I flew to Jacksonville for two days to attend the conference with the Vision Care Institute (TVCI.) TVCI is home to Vistakon, a Johnson and Johnson company, that produces the Acuvue products that I have grown up using and now prescribe in clinic.

On the Thursday when I arrived, a driver picked me up and delivered me to the Sheraton Hotel, my home for the next two nights. After quickly checking in and receiving my welcome packet, myself and a few others took to Jax Beach for brunch and fun in the sun. With only a welcome reception on schedule for that night, we saw no reason not to take advantage of the beautiful weather and the nearby beaches in the Sunshine State.

The welcome reception began with cocktail hour snacking on coconut shrimp and empanadas while meeting some of the other 30 or so optometry students from other schools. Once the doors to the reception hall opened, we took our seats, listened to a welcome address from Dr. Millicent Knight and Dr. Charissa Lee, then helped ourselves to a plethora of food.

The morning of the conference began with breakfast at the hotel followed by a drive to the  Vision Care Institute and a second breakfast. TVCI was huge, modern, and beautifully designed. Having signed their secrecy form promising not to share company details, I took a single picture outside, then said goodbye to my camera for some hours.

The conference began with a couple of lectures from optometrists on practicing in the real world and succeeding in patient care. Topics of discussions included handling the tough stuff in patient care and prescribing for presbyopic patients. We took a lunch break and got to chat with some of the ODs on an informal basis.

Following lunch, we broke up into three groups to rotate through three activities. In the first activity, we worked in pairs to fit two different presbyopic patients in the Acuvue Moist multifocals. During the second activity, we learned about the different uses for the Acuvue Define lenses and tried them on ourselves. Because of the enhancing pigment at the limbal region, the lenses are also perfect for aging patients and those with arcus. We also learned about the level of UV protection Acuvue products have in comparison to other familiar soft lenses. The last activity included a tour of the large manufacturing facilities. Seeing how much thought and engineering goes into the production of a single lens was pretty neat. The program ended with a panel and Q&A with the five optometrists that had been with us for the day: Drs. Dortheanne Roberts, Edward Wygnoik, Drew Dayton, Patricia Poma-Nowinski, and Sharokh Kapadia.

At the end of the seminar, we were taken to Seasons 52 for a fancy dinner complete with flatbread, salad, entrees, and some incredible desserts. During dinner, we were given certificates celebrating our participation and completion of the program. Each of us getting called Dr. So-and-so as we received our certificates was icing on the cake.

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Beautiful palm trees and a lovely yellow house on the beach


White sandy beaches  


Atlantic Ocean 


Pretty dinner reception set up on arrival day 


The Vision Care Institute 


With my ICO crew at the Sheraton


Dinner at Seasons 52 on a very long table post conference


Salmon dinner


At dinner we were called doctors and received certificates for completing the program 


Pina coladas at the beach at our post-conference celebration

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Walking through Andersonville

Walking through Andersonville

Posted by on Jun 22, 2015 in Blogs

The past five weeks have zoomed by and I am loving the change in pace. Gone are the days of classes, homework, and tests. From morning to evening for five days a week, I’m a clinician tasting what real life could be like in one of many clinical settings.

My clinical rotation site this summer is Visionary Eye Care, a private practice with two locations – one in Andersonville and the other in the South Loop. My time at the practice is spent doing routine eye exams, contact lens fits and evaluations, lasik pre and post-ops, dry eye work ups and treatments, binocular vision management, macular degeneration evaluations, and more. My favorite thing about being a fourth year is the level of autonomy I have. In clinic, I can make my own decisions. Outside of clinic, I am free to spend my leisure time as I please. Well, until Part II and III start to creep up.

The Andersonville location, where I am stationed 4 days a week, is set amidst a bustling neighborhood of restaurants, mom-and-pop shops, galleries, bakeries, and more. In the past few weeks, exploring and getting to know more about the diverse and vivid Andersonville community has been a delicious treat.

Before the work day begins or somewhere in between, I delight in coffee trips to La Colombe. Their mochas are delicious and my weakness!


I usually bring a “brown bag” lunch, but on occasion check out what the neighborhood has to offer. I lunched at Polygon Cafe, a thai restaurant and sushi bar, with a opened wall perfect for people-watching and awkwardly responding to greetings from my patients. The shrimp tempura and spicy tuna maki were yummy and my first-try of thai iced tea was delicious! There’s a lovely and often packed Swedish Bakery nearby where I’ve often disappeared into for mid-day treats. When National Donut Day rolled around, I popped in to claim one of the last two sugary fruit-filled pockets of goodness.


Across the street from Visionary, I got a manicure at Nail Palette complete with an oh-so-good neck and back massage which was so perfect after a long day at work. A few steps away is Marguerite Gardens, a ethereal flower shop with a expansive collection of glass and ceramic vases.


Throughout Andersonville, there are these neighborhood maps and history boards that are such clever touches. The Coffee Studio, just a few short blocks away, is another great caffeine cafe where I’ve savored delicious cold-brew iced coffee.


My favorite treat this summer has been at George’s Ice Cream and Sweets. The ice cream is delicious and the waffle cone is the perfect balance between chewy and crispy.


On one summery weekend (I do work on Saturdays but not on Mondays), the Andersonville Midsommarfest was in full swing. It was a treat to be front and center at the fest. During eye exams, concert music streamed in and wafts of grilled goodness touched our noses. So, it made perfect sense that during lunch break, I walked through the seemingly endless stands and indulged in a fresh and hot churro.


There are just five weeks left at my summer externship. I’m looking forward to further increasing my clinical experience, improving my skills, and learning from the doctors and a staff I have been enjoying working with, all while having a great time.

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Optometry Students and Lasers: In a Pig’s Eye!

Optometry Students and Lasers: In a Pig’s Eye!

Posted by on Apr 27, 2015 in Blogs

Alas, NBEO board exams have come and gone. My classmates and I are free again. Free from studying at all hours of the day and night without end. Except, we’re not free. At any moment, we’re haunted by the bone-chilling thought of having failed boards. But that aside, life is pretty great right now.

After those two dreaded days of exams, we picked up where we left off and spring quarter classes began. In our last quarter here at ICO, we are taking four classes:  Injections for the Optometrist, Business of Optometry, Strabismus & Amblyopia II, and Ophthalmic Lasers. Back when spring quarter had began and we were off for a month to study for boards, my classmates and I got a taste of Ophthalmic Lasers during an evening workshop with TLC. TLC is a company of ophthalmologists and optometrists providing eye surgery and LASIK in Mid-Michigan and Northwest Ohio. TLC providers specialize in “cataracts, glaucoma, macular degeneration, diabetic retinopathy, retinal tears and detachments, eye infections, and laser vision correction.”

The event with TLC brought in optometrists and technicians that taught us how to perform a number of refractive laser procedures complete with hands-on demonstrations. In some states, namely Kentucky, Louisiana and Oklahoma, optometrists can perform these laser procedures.

In our gymnasium, stations were set up to teach three techniques. The first station that I visited was set up to teach corneal epithelium removal, an initial set in PRK. In PRK surgery, the corneal epithelium is removed and then the corneal stroma is treated with laser. Once an overview of the technique was given, I gloved up to perform epithelium removal on pig eyes. Since pig eyes are pretty similar to human eyes, the simulation was great and comparable to doing the procedures on real patients.

The second station I visited demonstrated how to create a flap for Lasik using a femtosecond laser. During Lasik, a flap is made from corneal epithelium, then laser is applied to correct refractive error and the flap is laid back down. Like in the first station, we carried out the procedures using pig eyes. While we used the more precise femtosecond laser to create the flap, corneal flaps can also be made mechanically using a device called a microkeratome. In a way, the last station I visited finished the story. While listening to an ICO grad talk about his own experience working at TLC, one by one we got the opportunity to apply the corrective excimer laser to pig eyes that already had flaps created.

All in all, the workshop was pretty neat. We learned a lot about refractive surgery techniques and how to perform them ourselves. And if time takes any of us to places like KY, LA or OK, performing these skills will be well within our scope of practice. Now that boards are done and classes have resumed for us, we’re learning the intricacies of how lasers work, about the multitude of other lasers used in eye care, and much more.


Work station for corneal epithelium removal 


A closer look at the days old pig eye and our instruments of choice


Work station for femtosecond laser guided epithelial flap creation 

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