Low vision and much, much more

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.

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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.”

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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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