Location: Fry 33
Meeting Called by: Pre-Optometry Club
Duration: 1 hour
Guest Speaker: Dr Flom: Low Vision Rehabilitation
- Why does Dr Flom do this work? Dr Flom puts it into “mastery and meaning”, where mastery is feeling in the zone, feeling important and solving problems, and meaning corresponds to the satisfaction of having the ability to alleviate suffering of patients.
- Low vision: a vision deficit that impedes performance of everyday tasks thats permanent and not correctable in typical ways (glasses, contacts, surgery, etc)
- Causes of low vision include albinism (missing pigmented layer in the retina), macular degeneration, diabetic retinopathy, retinitis pigmentosa, etc
- Prevalence of visual impairment and blindness in US adults over 40: 1.5% of adults are considered visually impaired (< 20/70 visual acuity), 0.5% are legally blind (<20/200 visual acuity), functionally blind is 0.05% which entails mild degrees of visual impairment
- Risk factors of impairment and blindness include age, socio-economic status, gender (among low vision patients, males > females, among older low vision patients, females > males)
- Low vision approach: “We can’t give you vision back but help you use the vision that you have to be as active and independent as you would like”
- Optometric Low Vision Rehabilitation Purpose: help patient with visual impairment to overcome visual disabilities and handicaps by compensating for lost function
- Assessing nature and severity of visual impairment:
- visual acuity testing: for the purpose of assessing a baseline for that person, to classify them for eligibility for something in particular, gives an idea for how string prescriptions need to be , to describe visual capabilities
- ETDRS: adapted eye chart for getting highly systematic measurements, adapted for the early treatment pf diabetic retinopathy study
- Low contrast conditions prevent detection of objects, facial recognition, reading facial/emotional cues, walking and avoiding hazards
- The Low Vision Exam: Preparation, history (medical/ocular, goals), preliminary testing(
Rx verification, SLE and optos eval), refraction (objective and subjective), reading assessment (initial and re-test), device evaluation, rehabilitation plan, ocular health testing, counseling, coordination of care
- Options could include magnifiers, using your own phone/technology (seeing AI app)
Location: Fry 33
Meeting Called by: Pre-Optometry Club
Duration: 45 minutes
Guest Speaker: Dr Fries: Mode of Practice in Optometry
- There are many ways to be an optometrist outside of private practice, including group practice, ophthalmology/optometry, public health/military/VA, interdisciplinary care, academic/research, corporate or professional affairs, etc.
- Most optometrists practice in some form of a private practice, corporate is second and the OD/MD or multidisciplinary is third in popularity.
- Private Practice: individual, primary care, specialty (contact lenses, low vision, vision therapy, pediatrics, clinical trials, etc), or group practice.
- Advantages : freedom, quality of life, control, contentment
- Disadvantages: no freedom (?), find work life balance, control, requires self discipline
- Retail/Corporate Optometry: you don’t work for Walmart/Costco but lease the space within their facilities. The companies do all the marketing for you, but don’t pay you. You make an earning from patients; You are incharge of the exam fees but no investment is necessary within the business (ie. sign a contract for a couple years and then leave). Limited starting salaries and opportunities but easy to find openings due to high turnover.
- Interdisciplinary: hospital or clinic, FQHC, health clinic, hospital. As an optometrist, you would be a part of a team of providers for a patient, all coordinating care quickly. OSU has ties to an FQHC, Lower Lights Christian Health Center, students care for a diverse population with many conditions and lifestyles.
- Military: 3 branches (air force, navy and army) employ optometrists. They offer scholarship opportunities for schooling in return for service as well. No basic training is necessary, opportunities to practice and travel around the world.
- OD/MD: when optometrists work with/for opthamologists in a medical setting. Usually very large practices focused on pre/post surgical care or disease specific treatment. Examples: Cincinnati Eye Institute, Columbus Ophthalmology.
- VA Medical Center: veterans administration, hospitals run by the federal government treating veterans. Optometrists can practice to the highest level of scope of practice (because it is federally run) , usually requiring a residency, traditionally in a VA, and offers a benefit structure.
- Indian Health services: working on reservations, providing health care and eye exams. Unique patient population with unique eye conditions. Usually in rural settings, decent pay and benefits including loan repayment opportunities.
- Public Health: combines optometry and the world of population health, community based care (promote eye health, epidemiology and biostatistics). Opportunities may exist within public health departments. Expanded role of a lecturer or educator, educating the general population instead of one person. Work in health policy and research, working in labs for federal agencies (CDC, FDA…)
- Academia/Research: Teaching at an academic institution (clinical or didactic). Research at an academic institution, government agency (grants, grant writing publishing, presenting). Usually requires advanced degrees beyond OD (ex. T-35 Program at OSU)
- HMO: doctors employed by insurance companies (such as an HMO) to see their patients. Working as a salaried employee for insurance companies.
- Industry: Contact lens company (J&J, Cooper, B&L), Optical lab(Hoya, Shamir), Pharmaceutical companies, surgical companies. Less practicing more human relations.
- Consultant: lecturer, practice consultant or key opinion leader. Older optometrists looking for a change/less practicing. Usually comes later in career when some experience and knowledge has been gained about the industry.
When: March 1st, 2022 from 5-9pm
Where: North Campus Chipotle- 2130 N High St.
Proceeds of the donations will be given to Fighting Blindness Columbus!
See you there!
Meeting Called by: Pre-Optometry Club
Duration: 1 hour
Guest Speaker: Dr Yuhas, The Retina: An Overview
- Dr Yuhas is a professor at the OSU Optometry school, teaching courses in glaucoma and ocular disease. He does research and clinical work with the retina, blue light exposure and traumatic brain injury.
- If the eye was a camera, the retina would be the film within the camera, light being focused on it via the lens and cornea. The retina transduces light into signals sent into the brain.
- The retina is the only place in the body where we can observe the nerves and blood vessels as they are, which is a powerful diagnostic tool. In the cross section, the macula shows a dip in the tissue and all the layers of tissue, 10 layers total within the retina. In the bottom layer are the rods and cones which collect the light information.
- Time spent on screens is increasing for all age groups, will it damage our eyes? Blue light is the wavelength of light that is emitted from computers, phones and most/all technology. The danger with blue light has to do with the amount of energy the short wavelength light emits. Blue light lies within 400 nm wavelengths, so among the shortest wavelengths we can register.
- Sunlight is mostly blue light, similar to electronics. When its absorbed by the retina, free radicals are created within the back of the eye, which can damage cell membranes, proteins and DNA. Studies have shown RPE cells % of survival decrease with longer exposure time to blue light.
- Blue light can also cause damage to photoreceptors, causing an overall loss of them within the retina. The rods will shrink down in response to blue light and will become encased within inflammatory material and be destroyed. A study done on genetically modified cells shows that as blue light exposure increased, an increase of calcium intake also occurred into the cell. Too much calcium can cause apoptosis of the cells, showing “that retinal cells can die of an over saturation of calcium in response to blue light.”
- Most studies show no risk of blue light exposure and retinal disease , even though some suggest eye damage and worsening of existing diseases. In summary, lab studies show its danger, but evidence in humans contradicts this correlation.
- Melanin is a protective element pigment that absorbs high energy light in the retina, and as an antioxidant. It “eats” the free radicals and prevents the damage they can cause. Studies show higher levels of melanin can withstand higher blue light exposure in comparison to those with less. MAC pigments also act as antioxidants within the retina.
- How can electronics be worse than the sun? Screens we view daily can be as high as 50 lux (units of brightness). A cloudy day is also about 1000 lux, but a sunny day is roughly 100,000 lux. Even under long term viewing conditions, none of the current technology screens can cause serious concern to damage the retina. This also means blue light blocking products don’t do much to protect us or make us more comfortable when using our technology. This does not mean the light cannot affect sleep, only that it is not significantly more dangerous than the sun itself.
- TBI: an acquired brain injury that occurs when a sudden trauma causes damage to the brain. Globally about 10 million cases a year, in America, about 2.5 million but TBI is severely underreported. 70-90% of cases are mild, meaning brief or no loss of consciousness and no more than a day loss of memory.
- TBIs are often repetitive, 35% of sports related TBIs follow a previous injury.
- Diffuse axonal injury: coup countercoup injury, when we initially bang our head nut its movement within the skull damages another area. Causes DAI, axonal deformation and swelling. Damage to the axons causes malfunctions. Enough of these injuries can cause an inflammatory response and an increase of white matter surrounding damaged neurons and tau protein phosphorylation, which disables it to no longer support microtubules within neurons. Changes to neurons within the brain alter cognitive function.
- This pathology is not able to be detected with MRI or any other imaging systems, it can only be observed postmortem.
- There is possible potential for the retina to tell us about these conditions in patients before they die. The retina is like a “brain slice”, showing us neural tissue, and it is susceptible to this pathology change. As the axons that travel from the eye to the brain, they are able to be damaged in a TBI accident. There can also be transsynaptic degeneration, the spreading of neurodegenerative disease to healthy tissues. This begs the option that the disease can spread to the eye even if the eye is not initially affected.
- TBI can decrease the amount of retinal ganglion cells due to a blast injury, studies show. It also occurs for repeated TBI injuries. This could allow clinicians to observe evidence of brain damage by using the accessibility of the retina. Some human based studies have come out in support toTBI causing an increased thinning in the retina, but not all studies show significance in this finding.
- Dr Yuhas’s research is incorporating microtubule structural damage within the retina and repeated TBIs.