#Optho

[mcatmemoranda]

Patient who receive toradol in the ED have to wait 8 hours after that to take additional NSAID.

Procedural sedation = propofol 1 mg/kg

I stitched up a face laeration and the guy had a swollen eye. He could move his eyes up and down. The attending said you would be concerned if the pt can't move the eye or had an inferior orbital fracture or proptosis. He said you would do a canthotomy for orbital compartment syndrome.

Lateral canthotomy, the emergency treatment for orbital compartment syndrome, is the surgical exposure of the lateral canthal tendon. Cantholysis is canthotomy plus incision of the inferior branch (crus) of the tendon.

[volfoss]

Everyone loves me and I'm so so so employable<- affirmations

[singlethread]

I fucking start clinicals in less than nine hours and I’m so beyond terrified

[cicada-candy]

cicada its 4am and that last post you made wont load and im scared

Thank you 👍

No one tell my optho about this I'm already doing Contact Crimes

[eddiegettingshot]

the med school thing!! it always bugged me so hard bc it’s like … why! like I could never figure out if hen was going part time or something which … is not possible (or whatever, idk, it’d be more realistic if she’d went to PA school — many paramedics do end up being physician assistants which are fantastic providers in their own right, and there are part time PA schools) my brother’s a optho resident and he’s got SO MUCH DEBT rn omg but he tells me his classmates kind of assume they’ll eventually pay it off w their attending salary so I think abt that too w hen …. damn u 911 and ur inconsistencies

it KILLS me because obviously it's just another one of those storylines they start and then drop because... well... of course. but oh my god she's probably like 200k in debt 😭😭😭😭 and i bet karen has loans from grad school too. someone save them

[arctic-hands]

What's going on with Cigna? I don't have it, which is good because when I was in the ER two weeks ago the doctor who was about to admit me was like "please say you don't have Cigna" because they have been causing so much grief for patients lately, but he didn't go into detail. Meanwhile at my neuro-optho last week they had a sign saying Cigna was no longer accepted at the clinic. I've also seen rumblings of discontent on the internet, but no one's gone into detail

[teachingrounds]

Q. Retinal hemorrhages are thought to be pathognomonic for non-accidental trauma (NAT). Can't increased intracranial pressure (ICP) cause retinal hemorrhages, too?.

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A. Only if there is optic disc swelling, and only limited to the peripapillary area. If there are retinal hemorrhages located away from the optic disc, then the cause must be (non)accidental trauma.

[missnoodliness]

Ophthalmology

I will preface this with saying that I very much do not like eyes when they go bad. Traumatized eyes turn my stomach a bit. Not sure why, but they always have. It’s the one thing aside from cracking ribs in veterinary medicine that still bothers me.

I was fortunate to have several rotation-mates, which spread out the workload of this busy service. We saw any kind of species that wanted a referral, but were required to take both a large animal case (most common is horses) and a small animal case. I was really let off the hook by being told that I only had to take one horse case due to my allergies (which is the first time in my clinical rotations that has been considered). It was very sad that we did not see any exotics because the rotation before me had rabbits. Rabbits have a cool fundus (see below)! So, I borrowed some equipment to look at Coriander’s fundus which is even better because of his tyrosinase mutation.

Ophthalmology is a lot more subjective than many other specialties I have encountered because there are so many nuances and it’s all about what you can see.  I have gotten good at doing a basic ophthalmic exam and I still got to see a lot of every day problems. I know that I will not wait on eyes and I encourage people who see changes in their pet’s eyes to get the problem figured out early.

I learned how to enucleate (surgically remove) an eye relatively quickly. It is not my favorite surgery, but I can do it which is more than I could say before this rotation. As a side note, horses post-enucleation sink in and look like they should be thestrals, so they often opt to insert a prosthetic simply for cosmetic effect.

At this juncture, I have to add that non-bird species do extremely well as blind animals. So often owners want to pursue treatment to ‘save’ vision despite an extremely poor prognosis for return of vision and continued pain for their pet. Our companion species do not rely on sight as heavily as we do. A lot of the owners that came in were not even aware their pet was blind! I remember having a diabetic Golden growing up who we thought was seeing around his cataracts fine until we moved to a new home. They truly have great spatial orientation, remember where things are.

I am currently on my pathology rotation and studying for (panicking about) the NAVLE.

[smilesandsimplicities]

Outfits of week

Really enjoying dressing up after 10 weeks of scrubs!

Also here’s a close up of my eyes in honour of optho week. I took this photo after the opthomologist told me my eyes were hazel 👀

I’d like to hear what you guys think, I’ve always thought hazel but some people like to give me a hard time and say they’re brown

Next week I’m writing my final exams for optho, ENT and anesthesia so it’s time to grind!

[gomerblogworld]

Read more: http://bit.ly/2Ycd7l8

Orthopaedic Surgeon Pays $400,000 to Prevent Son From Matching Into Ophthalmology Residency

https://gomerblog.com/wp-content/uploads/2019/03/This-is-an-ACL.jpg

Boston, MA- Inspired by the recent college admissions cheating scandal, local Orthopaedic Surgeon Brock Hammersley took matters into his own hands when his son ranked only Ophthalmology residencies in the ACGME Match. “I couldn’t believe it when I saw his rank list! Ophthalmology Harvard, Oph...

Read more on https://gomerblog.com/2019/03/ortho_dad_prevent_ophtho/?utm_source=TR&utm_campaign=DIRECT

www.gomerblog.com

[ejacutastic]

I'm pet sitting for this chunky man and his loud brother rn

[singlethread]

And I’ve heard my next rotation is hell and they’ve been having fourteen hours days

[kangals]

mlurp

[kaoticspoonie]

Mischief's cardiac alerts are getting super accurate but not up to Kaos's level yet (he alerts before her, is more insistent, and alerts more often).

So stressed about flying and all, but also I gotta trust her sometime? It's weird to not be reliant on Kaos, and scary in another way.

Only a few more days till I fly! Then a week on the beach with just Mischief and I! (And my sister)

Switching between excited and anxious at any given moment!!

[arctic-hands]

Damn. Went into my neuro-optho ready to give my doctor a piece of my mind for saying I should have gastric bypass surgery over shunt surgery, and then he disarmed me by saying it was a misunderstanding, he merely said that was an option, he wouldn't push it and if I said no then that was the end of that. So now I have an actual shunt surgery consult in the works

Damn him for being so considerate!

[teachingrounds]

This week's topic is CHARGE Syndrome, which stands for Coloboma/Cranial nerve defects, Heart defects, Atresia of the choanae, Restricted growth/development, Genitourinary abnormalities, and Ear abnormalities.

A coloboma is a defect in the symmetrical structure of the iris.

Image: Jmarchn, CC BY-SA 3.0, via Wikimedia Commons