Hey! Are You In Your Optometry Internship? Confused from where to start?

Hey Interns! You just finished 3 years of theory with some practicals. Tried to find opportunities at the best hospital for your optometry internship. So now you are rolling around in an observation period or trying to understand how an eye hospital runs an OPD and IPD and what the role of an optometrist is...

And what to do, and from where to start your learning. 

Most of the eye hospitals, starts with very basics which include AR, NCT and Clinical History taking.

Few hospitals run 1 month training period at there training centre wherever the facility available they will keep you in induction period or where you dont directly interact with patients.

So you should start your learnings or training from very first day of observation. 

Like They Have Put you at Auto refractometer. Here you can learn some points which I'm putting down in points below -

1. Mostly there will be two circles like mires on the AR when you're doing the AR. Which says a lot about status of cornea itself, and also refractive error.

2. Sometimes a patient having accommodative infacility or any kind of accommodative anomaly. In most of the cases you may get more refractive error difference than the normal. You should be checking it twice.

3. You can also find out about Lazy Eye, Exo or esotropia or can say squint.

4. By Doing keratometry on AR, you can also alter if there's any refractive surgery was done or can get a basic idea of corneal thickness.

5. Difference in Pupil diameter of Two's.

6. Cataract

Here by I say you can find out more about eyes just by doing an AR. That's not punishment.

Then if you have been put on NCT(Non contact tonometry).

1. If there's an patient with raised IOP, you can simply observe the signs by looking at eye using Pen torch. Which let's understand symptoms included with such findings.

2. Also in case of lower IOP what can be the associated signs and symptoms with this.

When you have been put in Refraction room. There you should learn every steps from basic to advanced refraction. Also you should learn the retinoscopy which is the compulsory insturment for optometrist which also tells you a lot of eye findings or signs of and other disease in eye.

1. Refractive status of eye which includes myopia, hyperopia and astigmatism, also keratoconus. 

2. Can identify cataract and somewhat idea about what kind of cataract it can be. 

3. You can also find the cause of diminution of vision whether it is pathlogical or an refractive error.

4. Can get values of latent hyperopia or pseudomyopia.

5. Accommodative status by doing MEM or Knott retinoscopy.

At every step wherever you have been placed in intership period.

You must have a torch pen which enables you to analyses eyes at any step till dilating of eyes.

1. Gross amount of deviation.

2. RAPD Grading

3. Being patient is Pseudophakia or phakic or aphakic. you can just identify this by observing the beautiful eyes with torch.

4. Whether it's redness or SCH.

When you're the first one in clincal OPD interacting with Patient. You must be starting with Confirming there name and demographic details. It is must to confirm whether you had taken correct patient or not.

Taking clinical history , Plays a vital role in identifying or travelling from the chief complaint to the final diagnosis. You must be asking W's like which, when, what, where and there's more ques that you should be asking to the patient. Also don't forget to ask about present or past illness or any surgical intervention. There's a lot of things what to ask or when to ask to the patient it all goes till the slit lamp examination. It all leads to a diagnosis or final disease or what steps to be taken next.

So always take care of history taking. From here you can learn about the signs and symptoms related to eye diseases and which systemic illness causes problems in eyes.

Also you should learn about the disease whichever case you see on daily basis. At least two cases which have been seen by you.

Also you can learn while you're checking out Visual Acuity with pinhole to check whether it is a pathological error or just an refractive error or something else.

Never forget to check EOM, if patient complaints of double vison even after Best corrected visual acuity.

Learn basics of manual lensometry or auto lensometer which helps you understand the headache or eye strain even after giving best corrective lenses. Some times problem may be associated with fitting of the glasses.

This way you can learn from very basic to advanced level of optometry workup. And can learn about signs and symptoms related to ocular diseases or anomalies. Later you can align your findings when you're on slit lamp.

Thank you for reading our blog!

I am also an optometrist. Had experience more than 2 years where I learnt a lot of things and Williing to share more content similar to this. Let me know Am I able to let you understand what to do what to not do.