Albright and Schnulo Internship

For my STEP Signature Project, I chose to accept a student internship position at Albright and Schnulo Family Eye Care. There, I worked as a student technician over this past summer. The main responsibilities my Project entailed was completing preliminary testing for patients. This included pre-tests such as autorefraction, Amsler grid, blood pressure, iOP eye pressure, visual fields, Optomap retinal imaging, and much more. I worked one-on-one with patients in also recording their medical history and pathology symptoms during visits.

My STEP Signature Project definitely changed my viewpoints, or assumptions, of the optometry career-field and patient care. During my time at Albright and Schnulo, I learned just how essential it is for doctors to be communicative and clear with their patients. I didn’t realize how important it was for doctors to communicate with each other, too. For example, many patients under our care had pre-existing health conditions, such as hypertension, hypercholesteremia, and diabetes. Prior to the patients’ visit to our clinic, their PCP (primary care physician) would fax reports regarding the patients’ health to our optometrists. During the patients’ appointment, the optometrists would determine the need for dilation or retinal pictures, and if they’re blood pressure was under control. Afterwards, our optometrist would compile a report regarding the patients eye-health, and fax it back over to the PCP. All of these connections—between optometrist and PCP—are essential to ensuring that the patient is getting the best health care possible. Without this communication between offices, doctors can’t individualize visits and determine what’s best for that patient specifically. Seeing this first-hand, it really highlighted how comprehensive health care is, with all its different specializations.

One specific interaction with a patient always comes to mind when considering my changing my initial assumption about health care. For HIPAA regulations, I will refrain from using any names or identifying aspects towards the patient’s identity to keep full confidentiality. This patient had not visited an eye doctor in many years—something that I observed a lot in my time there. It was the patient’s first time at our clinic. Looking at the patient’s medical history, she appeared to be in perfect health. There were no complications in regards to blood pressure, family history, cholesterol, or medications. The patient hadn’t been dilated in 10 or more years, so it’s been quite some time since her retinal health had been assessed. Without dilating a patient’s eyes, optometrists cannot assess the health of the retina. The pupil needs to be enlarged enough to view the back of the eye through the optometrist’s optical lenses. When it was time for the patient to see Dr. Jay Lytle, I informed them of their over-due dilation, and what to expect in the doctor’s examination room. Afterwards, when the patient had finished their appointment and left our clinic, Dr. Jay called me into his examination room. In there, he showed me the patient’s fundus—the pictures of the retina (the back of their eye). He pointed to a very small occlusion in the patient’s right fundus. There, Dr. Jay had pictured the very beginnings of a horseshoe retinal tear. Horseshoe retinal tears are dangerous, as it can lead to the patient being completely blind in the affected eye. Had this patient not seen an eye doctor, and had Dr. Jay not dilated, this patient would have been at high-risk for losing complete vision in their right eye.

Horseshoe retinal tears are a specific type of tear that can occur in the retina. These tears can lead to a number of complications, such as retinal detachments and severe vision loss. In most cases, leaving tears unattended results in total vision loss of either central or peripheral quadrants of the affected eye. What makes these tears so dangerous, however, is the little to no symptoms that they display. One common symptom is patients experiencing “floaters,” or black spots obscuring one’s vision. Other than that, there are virtually no symptoms.

In this patient’s case, diagnosing was not the only important step in getting their treatment. The next move was to refer the patient to an ophthalmologist for treatment. The patient would need emergency surgery to mend this retinal tear—usually via lasers. Dr. Jay new just the right specialist to refer her to, as he had referred many patients to this same ophthalmologist. Dr. Jay suggested the patient visit this specialist’s office as soon as possible, and that he would schedule a follow-up appointment. Dr. Jay actually was able to show me the papers he faxed over to the ophthalmologist’s office, and how it specifically documented the retinal tear OD and other health assessments. Just a couple days later, the ophthalmologist faxed paperwork of the results of the patient’s surgery. Dr. Jay was able to compile this into his own notes, and was able to determine the best after-care solutions for the patient to ensure a swift healing process. It was through this patient’s case that I was able to see first-hand the communication between different medical professions’ offices. Because of this comprehensive out-patient care, I was able to understand the importance of communication and interconnections within the health field.

This change of how I regarded the medical field relates specifically to my academic and professional goals. One way it relates is that many of my classes overlap with many pre-med, pre-PT, and other health majors—so many of my classmates have professional school in mind in becoming a specialized doctor. Even though many of us will take different routes to get our medical degrees within our respected professions, I foresee myself having multiple interactions with these different doctors within my own career. My professional goal is to become an optometrist, and as my internship showed me, I will be in communication with my patient’s primary care physicians, ophthalmologists, cardiologists, immunologists, and much more. These interconnections between doctors are crucial in providing the best, individualized care for a patient.