Ophthalmology e-logbook

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Information about Ophthalmology e-logbook

Published on March 1, 2014

Author: NourAin1

Source: slideshare.net


As a part of continuous assessment for fourth year medical students doing specialised posting in Opthalmology department, International Islamic University Malaysia Kuantan Campus. This one is mine.

[ ophthalmology e-logbook ] Sy Nurul Ain bt Sy Badaruddin Group B3 Year 4 Block 2 (17/2/14 – 28/2/14)

DAY 1 : All Things New 800am – Standing meeting started with gathering of doctors, staffs and students in the clinic. We were introduced to all and had been given a warm welcome. We took turns in reciting surah, hadith, prayer times and motivational words from 101 Ways. It was a new experience for us. 830am – We had our first class in the Seminar Room with Optometry students. Dr. Khairidzan taught about Dry Eyes. The Seminar Room was very comfortable for teaching session.

DAY 1 : All Things New 930am – We were given an Introduction to Ophthalmology by Dr. Khairidzan as well. He is the Head of Department, and he seemed very busy - with his work and teaching us at the same time. We met Adil and Maadh, international medical students who did their elective posting here, from Oman. They are very friendly – and clever too. Things that we should bring : Funduscope, Pen torch, Colour pencil and Pins.

DAY 1 : All Things New 1030am – Dr. Khairidzan brought us to tour around the department. There were many rooms and doors that we thought that we could probably get lost in it! Maybe we need some time to adjust to the new environment. It would be better if the rooms were labeled with signs (eg. VA/IOP room, Refraction room) so that we know which one is which. After all, we are not so familiar with the equipments and stuff. 1105am – Brother Razi took us for Visual Acuity and Intraocular Pressure class. Purpose, Perform, Principle and Findings – must remember that!

DAY 1 : All Things New 1130am – We get to do hands-on activity to measure IOP and do VA on ourselves. Brother Razi explained to us regarding the clerking sheet and how to fill in the forms. He also taught us the correct way to use IOP machine. Besides that, we learned about Near Vision, Red Reflex and a bit about eye examination. It was a fun activity!

DAY 1 : All Things New 230pm – Basic Procedures in Ophthalmology was held in Seminar Room with Sister Fatin. At first, we were given a brief lecture and then – we get to do the procedures by ourselves! We were taught to put eye drops (artificial tears used) and do eye dressings.

DAY 1 : All Things New

DAY 1 : All Things New 330pm – The class ended. Since we had to go to JHC for common lecture, we had to rush a bit. It would be better if we could end the class an hour early. Because the journey to JHC took about 15 minutes from IMC, provided that the traffic was not busy. Plus, it was difficult to find a parking space in JHC, especially in the evening. 400pm – Radiology class with Dr. Radhiana started. The topic was Imaging of the CNS and spines. 500pm – Class dismiss. Not a bad day after all!

DAY 2 : Lectures and Lectures 800am – As usual, we started the day with standing meeting. 830am – We watched Dr. Khairidzan’s recorded clinical video on Anterior Chamber examination. It was a good video. We felt like we were watching Dr. Khairidzan teaching us in front of the class! We get to know about tests like Light Reflex (direct, indirect, RAPD), Accomodation and Visual Field (central, quadrant, peripheral, blind spot). 1000am – It was time for tutorial. We were asked to draw anatomy of eye on a piece of paper, label the segments and submit it. I have to admit, I was only 40% sure of my own drawing! Lesson learned – must know anatomy of eye by heart! We also learned about signs and symptoms in anterior segment diseases such as dry eyes, grittiness, itchiness, redness, watery eyes, glare, burning, foreign body sensation, tired eyes and many more.

DAY 2 : Lectures and Lectures 1145am – After that, we did Anterior Chamber examination to one another. The things that we have to examine are Lids (Folllicles, Meibomian gland, Lid margin), Conjuctiva (Vessel, Colour, Lesion) and Cornea (Vessel, Clarity, Lesion). By practicing the technique on our friends, we can learn about the correct way to do the examination. It was an effective way of learning.

DAY 2 : Lectures and Lectures 300pm – We had lecture on Ocular Triaging with Dr. Aidilla in the Meeting Room. The topic was broad and covered a lot of eye diseases. We even had a practical session where each one of us took turns to draw fundus on the white board without looking at the picture. We had to draw based on our friend’s description. It was an interesting activity! 530pm – The class ended. We had lot of reading to do when we go back home. It was a tiring day.

DAY 3 : Meet the Patients 800am – Standing meeting was held as usual with all doctors and staffs. 830am – It was our first time working in the eye clinic. This time we had to share the patients with Optometry students. We had to check VA and IOP for the patients, and clerk them. If their eyes need to be dilated, or dressed, we had to do that too.

DAY 3 : Meet the Patients

DAY 3 : Meet the Patients Patients that I clerked today: No Patients IC No Diagnosis Treatment 1 Rosnidar bt Nahar 760418-03-5924 Post-op Cataract 1/52 G.Vigamox 4x/day G.Nevanac 3x/day G.Maxidex 4x/day O.Maxitrol ON T.Paracetamol 1mg PRN T.Diamox 250mg NIL 2 Mahamad Naser b Disa 640425-02-5701 Presbyopia Eye drops Pre-op LASIK

DAY 3 : Meet the Patients 1115am – The clinic had ended. It was quite an experience. After that, Brother Hafidz came in and asked us if it’s okay to do his class at that moment, so that we will have plenty of time to go to JHC in the evening. We agreed. 1130am – We had lecture on Refraction and Refractive Error with Brother Hafidz. We learned about myopia, hyperopia, astigmatism as well as different type of lenses. The class ended at about 130pm. 400pm – Seminar on Intensive Care Unit with Dr.Basri was held in JHC. We had plenty of time to get ready for the session.

DAY 4 : Funduscopy 800am – We attended the standing meeting as usual. 900am – Class with Dr. Adzura started with us presenting our assigned topic. Few days earlier, we made sure that the tasks were divided by a fair draw. We prepared the topic and included more photos, as asked by Dr. Adzura. After each presentation, Dr. Adzura gave us a brief explanation on her slides. She stressed on the importance of mastering the topic of Diabetic Retinopathy. She said that overall, we did a very good job. We felt appreciated for our work.

DAY 4 : Funduscopy 245pm – Dr. Khairidzan presented a lecture on Anterior segment diseases. We learned a few diseases on the eyelids (preseptal cellulitis, blepharitis, chalazion, allergic reaction), conjunctiva (conjunctivitis), limbus (pterygium, pinguecula), cornea (ulcer, opacity, dendritic ulcer) and anterior chamber (hyphaema, hypopyon). The lecture was simple and easy to remember since Dr. Khairidzan highlighted the important diseases that we should know. 400pm – Since Dr. Adzura was not feeling well, we were left to do funduscopy on Adam Roullie by ourselves. There were times when Dr. Aidila and Dr. Fadzilah came by to help us with the technique. They were very helpful.

DAY 4 : Funduscopy

DAY 4 : Funduscopy

DAY 4 : Funduscopy 500pm – Even though we did see the fundus inside Adam Roullie (with the help of light shining from inside his skull), most of us were not able to do that on a real person. I only managed to see a line of blood vessel when I practice on my friend’s eyes. Dr. Aidilla said that it would be easier if the eyes were dilated. Using a funduscope is not easy, it takes a lot of practice. We locked the Seminar Room and went back home. Hopefully we will be able to practice more tomorrow.

DAY 5 : Dilated Pupils 800am – We had standing meeting as usual. The staffs were updating their work on the upcoming events, something to do with Biometric course and World Glaucoma Day. They are a very hardworking group of people. May Allah ease their work. 830am – The clinic had started and we did our work diligently. Patients that I clerked today: No Patients IC No Diagnosis Treatment 1 Ahmad Niza Syazre b Abdullah 871227-11-5413 Post-op LASIK 1/52 Eye drops TCA 1/52 2 Norfadhilah bt Johari 830307-11-5236 Dry eyes BE Cataract FP/OCT G.Systane 5x/day Pre-op cataract

DAY 5 : Dilated Pupils 1000am – There were not many patients today. We went to the consultation room to see the doctors attending patients. We even had a mini group discussion with Dr. Aidilla after the clinic ended. We had received many inputs from the doctors and staffs for the day. It was very educational.

DAY 5 : Dilated Pupils

DAY 5 : Dilated Pupils 1130am – Since it was quite early to go back home, we decided to practice funduscopy on dilated pupils. Ida helped me to DBE. After half an hour, my friends took turn to examine my eyes. They said that it was much easier to see. Some of my friends even managed to see my optic disc!

DAY 5 : Dilated Pupils 1230pm – It was an eye-opening day for me. The dilation effect took about 4 hours to subside. 330pm – IIMP seminar was held at Lecture Hall 3, IMC with Dr. Nazli. The topic was on Plastic and Cosmetic Surgery. We had survived the first week in Ophthalmology. Now moving on to the second!

DAY 6 : Of Second Week 800am – First day of standing meeting in our second week was held as usual. 830am – We were assigned to the clinic. There were many patients today! It was a hectic day for all of us. My sister also came to the clinic for her post-op LASIK follow-up. She was clerked by Adil, the bright Oman student 

DAY 6 : Of Second Week Patients that I clerked today: No Patients IC No Diagnosis Treatment 1 Ismail b Yusuf 450622-03-5223 Post-op Cataract 1/52 2 Riah bt Tawang 390417-06-5050 3 Nahhat @ Nahariah bt Shafii 440901-10-5328 G.Vigamox 4x/day G.Nevanac 3x/day G.Maxidex 4x/day O.Maxitrol ON T.Paracetamol 1mg PRN T.Diamox 250mg NIL 4 Khafsah bt Mohd Shaieh 560907-10-5552 Ocular allergy G.Patanol BD BE G.Gentanol 5x/day BE

DAY 6 : Of Second Week 1000am – After clerking patients, we went to attach with Dr. Adzura in her room. We even had a mini VIVA on how to use ophthalmoscope correctly. We also observed Dr. Adzura consulting her patients in the room.

DAY 6 : Of Second Week

DAY 6 : Of Second Week

DAY 6 : Of Second Week 200pm – We had a session with Dr. Wan Norliza in the Seminar Room in Eye Clinic, HTAA. She taught us about Ocular emergencies and Red eyes. Her slides were organised nicely - we were able to understand the topic well.

DAY 6 : Of Second Week 400pm – Seminar with Dr. Azura was held at Lecture Hall, JHC. The topic was Imaging of Genitourinary System. She showed us pictures of her trip to Istanbul with Dr. Fahmi which were really amazing. They are both good lecturers! Personally, I think that attending lectures in the late evening is not very effective (as we are always tired and bored at this particular time), but Dr. Azura’s slides managed to keep me awake the entire one hour. Anyway, Radiology stuff aside - have to focus on Ophthalmology for tomorrow!

DAY 7 : HTAA Eye Clinic 800am – We did not attend the Standing meeting in IMC because we had to attend lecture with Dr. Aziz Husni from HTAA. He is a very experienced specialist (in Glaucoma) and lecturer. He explained the definition of Red Reflex and RAPD in simple ways so that we can understand.

DAY 7 : HTAA Eye Clinic 930am – After class with Dr. Aziz finished, some of us went to the ward to see cases, while some of us stayed in the clinic and attach with specialists and MOs here.

DAY 7 : HTAA Eye Clinic

DAY 7 : HTAA Eye Clinic

DAY 7 : HTAA Eye Clinic 115pm – Being in the eye clinic was a good experience for us to see how the system works in a hospital and compared them to IIUM eye clinic. We also get to see OCT and Fundus photo being done to the patients. Before clinic ended, we gathered in the Seminar Room and worked on our fundus logbook together. Then we went to get signatures from specialists there. We rushed to get to IMC because we had class with Dr. Aidila in the evening.

DAY 7 : HTAA Eye Clinic 300pm – Dr. Aidilla’s class was on Cataract. We also had a bit of revision on Diabetic Retinopathy. Hopefully the slides that were shown to us would come out in the exam this Friday. Exam – just around the corner but I am not sure if I am prepared for it or not. *sigh* Funny thing - it always make me feel depressed when I think of exam. *sigh* End of Day Seven in Ophthalmology posting. *sigh*

DAY 8 : Self-Revision 800am – Standing meeting as usual. I should ask someone to take picture of us in the meeting, but I always forget. I do not own any single photo of us in this meeting. How sad. This is like the coolest new thing that is only done in Ophthalmology! 830am – Sister Firdaus brought Adam in for us to practice. We went out for a moment to take pictures in front of the iconic RM15,000 signboard at the entrance of eye clinic. Yes, it was expensive – and so worth taking pictures of!  Dr. Fadzilah and Dr. Heliza passed by and we invited them to join us too.

DAY 8 : Self-Revision

DAY 8 : Self-Revision 1200pm – We had lunch in OCD cafe. There was a variety of food there. We enjoyed eating and hanging out in the spacious cafe. Then we went to take pictures at the autumn-like area on our way back to KOM. Yes I know these are so not related to Ophthalmology - but I love to see those trees!

DAY 8 : Self-Revision 200pm – We had to stay outside the Seminar room for a few minutes since Dr. Khairidzan had class with Optometry students. After the class ended, we went in and did self-revision (more like preparing for PBA presentation and finishing up this e-logbook). I love that we get to have a few hours of ‘self-revision’ slotted in the second week because boy, do we need to get our things done! Like fundus book, e-logbook and presentations! A good thing that we are not required to submit a Case Write up! Thank you doctors!

DAY 8 : Self-Revision 400pm – Dermatology revision class with Dr. Anil was held in Lecture Hall 3, JHC. We went out at about 315pm from IMC so we managed to get to JHC on time. Dermatology. Radiology. Ophthalmology. All mixed up inside my head. Not to mention the other two – Anaesthesiology and Otorhinolaryngology. Okay cool. Do not panic. Calm down. EXAM IS IN A FEW DAYS! Okay relax. YOU CAN DO THIS!

DAY 8 : Self-Revision 900pm – This is interesting. Motivational talk with the famous Dr. Khairidzan  I wish that I can record his talk and play it when I feel demotivated. He is such a good motivator – and he values time as well. I like that he ends the talk on time – just before 11pm. Not many speakers be able to do that. *respect* Clinical Years now have been demystified!

DAY 9 : Late Class 800am – Standing meeting as usual. This time we had Prof. Ariff joining us  830am – After that, we did our ‘self-revision’ in the Meeting room because the Seminar room was used for lecture. The Meeting room was small, I miss Seminar room already. Did I tell you that I love the Seminar room? We used that time to finish up some stuff – as usual. The lack of internet connection (iium community) made it difficult for us to find information for our presentation this evening. Please give back our internet.

DAY 9 : Late Class 1030am – We asked for Dr. Fadzilah’s help to check our fundus book – and to get her signatures as well. Despite her busy assignment, she was able to spend some time with us. She also entertained our questions, that was so nice. The we moved to Seminar room where we can have internet access on the computer there. We stayed there until 1200pm when we had to go to JHC for PBA.

DAY 9 : Late Class 230pm – We were asked by Dr. Carmen to prepare for PBA before she comes later in the evening. So we did present our respective slides first. 520pm – Dr. Carmen came and we did our PBA. She taught us a lot of information. 750pm – The class finally ended. I wish that we did not have to stay up to that time, because we will have exam tomorrow. We all think that Dr. Carmen’s class should be held in the first week, maybe Thursday or Friday. Exam is tomorrow 

DAY 10 : Exam! 800am – Our last standing meeting! Argh. No picture of the meeting! 830am – Today is the day where we have to submit this e-logbook, before exam. So I guess at this very particular moment, we would sit for our ophthalmology exam. I hope that all of us will be able to answer the questions well. 1000am – By this time, we should be in the eye clinic, clerking patients and do VA, IOP on them. Usually there are not many patients on Friday, but I would not know since this e-logbook has been submitted already. 1200pm – The last day in Opthalmology. I am so going to miss this posting!

REFLECTION The best things about this posting: 1. 2. 3. 4. 5. 6. We are allowed to take pictures! A LOT OF THEM!  The unique Standing meeting held every morning The amazing specialists, doctors and staffs  Students are allowed to work in the eye clinic The cool Seminar room and everything else inside the department The self-revision slot in the schedule

REFLECTION Suggestions/Comments: 1. It would be nice if we get to see an eye operation being done on a patient. I have never set foot inside the OT. It looks so cool from the outside though. 2. It would be better if classes are conducted within office hours, if possible. 3. I would like to suggest IIUM Ophthalmology department to have their own book published for students – like the one in Anaesthesiology. I would love to own that! 

THANK YOU ALL DOCTORS!  From left : Ali, Farisham, Zulaikha, Nurul Ain, ‘Ayunni, Fatimah, Farrah Wahida, Afiq

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