#optho

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.

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.

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

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

Every medical school in the USA has completely different requirements for fourth year. Seriously, every single one. Some require a few specific rotations in geriatrics or emergency medicine or rural health - meet those and you’re otherwise free to plan your year. Some have online courses. 

Mine requires a certain amount of medicine months and a certain amount of surgery months. Exact same requirement, regardless of what specialty you’re going into, which is how yours truly has three months of surgery scheduled, beginning now. 

Opthalmology is up first and I can already tell you it’s probably going to be my favorite. 

- Laid back surgeon

- Laid back surgeon who is constantly urging me to go home

- Gotten marginally better with my optho exam!!!

- Laid back surgeon who emphasizes putting things in the context that would be useful for an IM doc 

- Actual diversity (I am genuinely shocked, I thought it was going to be cataracts all the way down) 

- YOU GET TO SIT DOWN FOR SURGERY. EVERYONE GETS A STOOL. I GET A STOOL!!!! THIS IS AMAZING. 

and It’s been AWESOME!!

I start Optho on Monday.

Meet SOLSTICE! "Sol" went blind about 4 years ago, gradually, due to an illness. He now sees via a 3-D-wave echolocation device called BlindSight by Jordycanid.com. 

He came to CWER in March 2015, and was fitted with the 1st ever equine version of the BlindSight earlier this year. The device sends out a grouping of sound waves similar to that of a dolphin approximately every second, so he gets 'snapshots' of the world, like a child's flipbook cartoon. Watch the whole video to see how incredibly well "Sol" is able to navigate his world!!!

This is working AMAZINGLY well for our Solstice and in fact we now have a 2nd blind horse here who is just starting to learn to use one. We are working with the designer to just to the eye positioning and views of a prey animal rather than predator, and think the next box will be a huge step forward for Sol's vision

-- Crosswinds Equine Rescue Inc.

Additional information from the Paulick Report:

Solstice, a 10-year-old, blind Quarter Horse that resides at Crosswinds Equine Rescue in Sidell, Ill., recently gained the ability to “see.”

The first horse to be fitted with BlindSight, “Sol” as he is known, is quickly learning to use the device to help him navigate his environment. The device sends out a grouping of sound waves every second, similar to those a dolphin uses. Sol is able to get “snapshots” of the world, like a cartoon flipbook.

Sol quickly learned to “read” the pictures and see what is in front of him. He can now “see” an object about 3 inches in diameter (he will still trip over a 2” x 4”). He has become very dependent on the box—he even learned to shake his head when a wire was loose to get it clicking again. When his halter is taken off for whatever reason, Sol stands rooted to the spot until it is placed back on his head.

The rescue and engineer Paul Propst are working on adjusting the eye positions of BlindSight to that of a prey animal rather than a predator; Sol will get another box soon, allowing him to understand his environment even better.

Originally designed for his sister-in-law’s blind Golden Retriever, Propst created BlindSight to use a sound frequency above the human hearing range to provide echo information to dogs. The dog’s brain then provides a virtual picture of its surroundings. While people tend to lose the ability to hear higher frequencies first, dogs actually lose low frequency hearing first, which allows them to still hear this high-pitched tone.

Though horses lose the higher frequencies first, because they can hear a wider range than humans, BlindSight can still be beneficial for many horses.

A second blind horse at Crosswinds Equine Rescue, Inc. is beginning to learn to use BlindSight, as well.

Catboy Nong Youhui

This boy from china was born with bright blue eyes... and several tests show that his eyes are like those of a cat's, he has extremely clear vision at night and in dark places.

Experts believe that the child was born with a rare condition that leaves less protection for your eyes and make them more sensitive to light.