Clinical Internship at UIWRSO

As my third year comes to an end, I get a chance to look back and think about how great my clinical internship at UIWRSO was. During your first and second years, you are so busy trying to do well in your classes and sharpen your skills to prepare for clinic. Once you are there, however, everything changes! You rely on your skills that you have practiced countless of hours on, but you learn the most once you are giving examinations to real patients and interacting with your preceptors.

To be completely honest, your first day of clinical internship is so scary. You go through a few days of training and orientation before you actually begin, but it’s a lot of vague information just so you have a foundation to what you need to do once you start. They give you tips on how to use the EMR (electronic medical record), the dos and don’ts in the clinic, and also how to use some of the equipment that you only used a few times before (OCT, Visual Field, etc.).

The night before we started I could barely sleep; I was so anxious! At the moment, our school has two different schedules for third years: you either have Monday and Thursday clinic, or Tuesday and Wednesday clinic, seeing about 5 patients a week with 2 hours of optical experience. We started school (the summer semester) and clinic on the same day! Talk about rough! We also have different locations we go to, either at our school at the Datapoint Eye Clinic, or our two other locations, Bowden Eye Clinic and another clinic on the West side of town. I was happy that I was at the Datapoint clinic, which I was the most familiar with at the time.

At 9:30 am, I showed up to the area where we (my clinic mates and I) were to set up. My hands were shaking so vigorously as I pulled out the equipment I needed from my kit. I am generally not so nervous unless it is time for a proficiency or something of that nature, so you can probably imagine the type of stress this felt like to me! We logged into the EMR and saw that a few patients were ready. For the first day of clinic, the preceptors allow you to work in a pair, so it’s not as intimidating. Two hours are allowed for each patient’s exam, which you definitely need for the first few weeks in clinic. My partner and I walked into the waiting room, picked up the paper with our patient’s name on it and I started thinking, “What if I pronounce their name wrong? What if they don’t like me?” I called out the patient’s name, and luckily a smile ran across their face as they followed us into the exam room.

I honestly can’t remember much about my first patient encounter, other than he was a very nice, older gentleman who was extremely patient with us. We had had some training on ICD9 codes (what you need to bill their insurance), but it was so new to us and nerve wrecking with the patient in the room that I am surprised we had finished everything within two hours! You are not used to using all of your skills in one sitting, and checking in with preceptors frequently, either, so it was a fast-learning environment.

A few weeks in, and it became routine like the back of my hand. Just like with anything, practice makes perfect. The amount of information you receive and pick up from your preceptors, your clinic mates, and even your patients is incredible during the 11 months you are in clinic at UIWRSO. Even though I am about to leave to fourth year externships, I feel like I have even more to learn from outside preceptors and locations. I am so grateful for the experiences and knowledge I have learned over this past year, and the feeling that I will be happy doing this for the rest of my life overjoys me!

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My Last Year at RSO!

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After spending a whole year with my third year clinic group, it was hard to part ways! I would not get to see many of my classmates until graduation in the spring ’16. It was a bittersweet moment indeed. The summer semester went by before I knew it, and we went off on our externships. Some students moved to Florida, some decided to live with family in the East coast, and some stayed in Texas. Dr. Majcher, our externship coordinator, made sure to find the best places for externships. There are many locations and modes of practice to choose from. For example, I picked all private practice externships because that is what I wanted to pursue (you probably figured that out from all my previous private practice club posts). However, some students picked VA sites or eye hospitals to see more ocular disease, while some classmates wanted to specialize in vision therapy so they went off to a pediatric/vision therapy based practice. All in all, I think picking the right externship for yourself is very important part of your education and growth.

Allow me to introduce to you the layout of RSO’s 4th year. There are three semesters (summer, fall, and spring) in the 4th year, however you spend only 1 semester on campus, this semester is called your 4th year in-house rotation. The in-house rotation is broken up into mini-rotations where you are focused on a subspecialty of optometry. The other two semesters will be considered your externship, meaning you will pick two externship sites to spend 3-4 months in.

Here’s a recap of my 4th year experience so far.

I was in-house for the summer. I got to know my classmates, who were in my in-house clinic group, really well. My clinic group was so much fun, we went out to eat, inside jokes lightened up the day, and helping each other out made the day go by so much smoother. I really appreciate working with them because they shared with me their tips on patient care and their experience with challenging cases. I consider them more than just colleagues but life-long friends and I will truly miss them.

The in-house rotation was full of learning. I wish I could write a blog for each, but for briefness’ sake, here is a summary of each mini-rotation. We worked with visually impaired patients at the Low Vision and Rehabilitation Clinic. After seeing cataract and LASIK surgeries. we learned how to manage those patients at the Peri-Op rotation. At the Glaucoma Clinic, we watched glaucoma laser treatments and monitored the patients’ conditions. If you are wondering what the Visual Neurophysiology Service is, there is only a couple in Texas. Challenging patients, most often tertiary referrals from retinal specialists, neurologists, etc, came to see us for special testing. Contact lens services made me more confident in fitting all sorts of contact lenses (scleral, hard, soft, astigmatism, multifocals, etc).  Also we saw infants to high-school students in the pediatrics rotation. Vision therapy rotation gave us week-to-week interaction with the same patient and it was a great feeling to see them improve over the time.

Location, Location, Location!

In addition to the tremendous academic and clinical opportunities, one of the biggest reasons I came to UIWRSO was that it was located in San Antonio, Texas. I grew up in the Alamo City before moving to El Paso, Texas, so it has always been in my heart. If you have never been to Texas or have no idea what’s around, you might be a little skeptical about coming here. When people hear “San Antonio”, they often associate it with the River Walk. I’m here to tell you that we have much, much more than that!

Texas is the second largest state in the US and San Antonio is the second largest city in the state (and 7th largest in the country). The weather here is considered “humid subtropical climate,” which really means that it is hot in the summer, a little cool in the winter (not too cold), and humid all year round. It’s a great type of weather for trees, grass, and taking a nice dip in the pool when it’s hot in summer.

Here is just a small list of some of the attractions found at my home here in San Antonio:

The River Walk is a huge tourist attraction, but also a local favorite, admittedly, I still love going to the River Walk every now and then; it hasn’t lost its luster for me! There are tons of restaurants, shops, and it’s nice to get on the riverboats. The source of the famed Riverwalk river is actually at the UIW main campus!

riverwalk

Six Flags Fiesta Texas, Sea World, and Splash Town are also huge attractions here in San Antonio. They all have events almost all year round, and don’t forget that UIWRSO always holds a “Welcome Back Weekend” for new and returning students at Six Flags every year.

Welcome Back

The 5-time NBA Champion San Antonio Spurs plays in the AT&T Center, but that’s not all that goes on there. The San Antonio Rampage (hockey team) also plays here, and many concerts are held there throughout the year. For the sports enthusiast, San Antonio also has a soccer team (Scorpions), and a baseball team (Missions). There’s a little something for everyone!

Spurs game 1

If you’re big into shopping, San Antonio has many shopping centers such as La Cantera, various shopping malls including North Star Mall, and for local heritage El Mercado. I also appreciate the variety of stores around the area, many of which I would not find in El Paso. Feeding into my love of the outdoors, I love Bass Pro Shops and REI, and they definitely have both here. Finally, if you’re a foodie, then you’ve definitely come to the right place! There are so many restaurants. I haven’t been to the same restaurant in the two years I’ve been here, and I haven’t run out of great restaurants yet.

If you want to explore the surrounding area, there are also amazing cities near San Antonio, all with their own attractions:

Austin, Texas is only about an hour and fifteen minutes away and I find myself visiting regularly, as do many of my classmates. The food is amazing there and Austin has many activities for outdoorsy people. I go very often for kayaking, water biking, and disc golf. If you haven’t heard of these activities, check them out soon!

kayaking austin

Boerne, Texas is only about 20 minutes away from our school location. Boerne is a beautiful, smaller city, but offers great parks and activities such as fishing and boating. My dogs enjoy joining me on my visits to the dog parks when I am looking for a smaller city experience.

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New Braunfels, Texas is located between Austin and San Antonio and features one of the largest water parks in the world, Schlitterbahn! I absolutely love Schlitterbahn. Not only is the water park amazing, New Braunfels has deep German roots and the restaurants there reflect that.

schlitterbahn

For all you shopping aficionados out there, San Marcos is the place for you! Similar to New Braufels, it is also located between Austin and San Antonio about 45 minutes away. San Marcos has two outlet malls that feature more than 350 stores. It’s nice to take some time from studying and go shopping every once in a while! After a day of shopping, it is great to relax at the area rivers and lakes where I can go tubing or swimming.

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If you are feeling adventurous, you can head southeast towards the beach! Corpus Christi and South Padre Island are only a few hours (two to three) away from San Antonio, and offer the warm water of the Gulf any time of the year.

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I could go on and on about the activities in and around beautiful San Antonio. UIWRSO is in the middle of all this entertainment. I can’t tell you how happy I am that I chose this school, not only for its academic benefits, but also for the location of this school. Come visit UIWRSO, and see what all the hype is about in San Antonio, Texas!

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UIW Eye Institute Optical

imageHere at RSO we have a fully functional optical lab. We have at least five clinics for which we trace, cut, edge, and fit lenses into frames. This means there is always an abundance of orders to be completed on a daily basis.

You will learn and be competent on all the lab equipment, so you will be able to take a frame with no lenses all the way to the end product, and be able to fit them on the patient correctly.

In the optical, you not only learn the art of making glasses, but you also will be interacting with patients; helping them pick out a frame to fit their needs, dispensing their completed glasses, and fitting and adjusting their glasses before they leave. You will also learn how to interact with frame companies and how to look up benefits from insurance carriers.

Each week, during your 3rd year, you will have at least one day of optical. Some of your days will be extremely busy, with many patients looking for new glasses or adjustments, other days will be slower, and you will get to spend more time in the lab cutting lens and making sure the final products are within tolerances. In the optical, we carry hundreds of frames, from economic frames to higher end frames like Ray Ban and Fendi.

You will have to learn how to establish what style and price range a patient is looking for. This is an art, and not so much a science. In our optical, you will be lead by some excellent opticians that will teach you their art.

Sunglasses Rack
Sunglasses Rack

You may be wondering, “what exactly goes into making a pair of glasses?”

Well first, you start out with a frame, which has no lenses. Depending on what lenses the patient orders will determine how soon we will receive the stock lenses from the vendor. We have a few vendors that we order our lenses from: Paragon and Hoya are the major companies.

The patient also has many other choices to make; will they choose anti-glare coating, transitions, high index, single vision, bifocal, or progressive. We make many single vision lenses, meaning there is only one power of prescription in the lens, where bifocals and progressives have a separate prescription in the top portion for distance vision and in the bottom for near vision. Anti-glare coating reduces the amount of reflections that people will see on your glasses from the sun or overhead lights.

It will also decrease the glare from on-coming headlights when driving at night or reflections from computer screens.

Many of you know what transition lenses are, they react to UV radiation from the sun and darken when outside in the sunlight, but when you come back inside the lenses lighten until they are almost completely clear. People will either love or hate transition lenses. It all depends on the patient and their needs.

High index allows the lens to be thinner and is useful in high prescriptions. Any of these upgrades make the lens a premium lens, so there is an extra price the patient will pay.

So, now that we have the lenses in our hands, we are ready to trace and edge the lenses, so we can fit them in the frame. First, we use the tracer. This machine takes thousands of readings per millimeter, so the lenses will fit perfectly in the frame.

Lens Tracer
Lens Tracer

After we have the frame traced, we can get the lenses cut. This is when we put the lens in the edger, and it uses the readings from the tracer to cut and edge the lenses perfectly.

Lens Edger
Lens Edger

Once the machine is done cutting the lens, we can fit it in the frame, and now you are halfway done with the pair of glasses. Now you will complete the same process for the other lens. Lastly, we will clean and check the lenses on the lensometer to make sure they meet the tolerances set for every type of lens. A lensometer allows us to check the prescription in a pair of glasses.

Auto Lensometer
Auto Lensometer

Now the glasses are ready to be dispensed to their owner!

There are many choices to navigate your patient through, but we are always trying to give the patient the lens that will suit their needs well. It may seem confusing right now, but through the many different courses during your first two years, you will be well equipped to help these patients!

This year our optical hosted a trunk show at the Rosenberg School of Optometry. A trunk show is an event where the vendors for our optical bring in many styles of frames and offer discounted rates on the glasses for that day. This year we had many vendors come in, such as: Ray Ban, Dolce and Gabana, Fendi, and a few others. These shows are a great way to see a variety of different style frames from the vendors and get an amazing deal on some designer frames!

Frame Styles
Frame Styles

In the UIW Eye Institute Optical you will learn everything you need to know in order to measure, cut and fit frames and lenses on patients. At first it may feel overwhelming because of the many different elements to being successful in the optical, but with time you will master the skills required. Have no fear; you will have plenty of chances to become comfortable with the many different machines that we use in the optical lab. This is just one aspect of your optometric career that will prove to be very rewarding!

Andrew Yoder

I am a 3rd year intern at the UIW Rosenberg School of Optometry. I was home grown in Dyersville, IA. I have a brother and sister, of which I am the youngest. My hobbies include playing ultimate frisbee, basketball, tennis, and anything else my friends want to play, and jamming out on my guitar.

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2nd Annual Frame Style Show 2013

Location and Time: UIW Eye Institute from 1:00 pm – 6:00 pm, Aug. 29, 2013.

So many pretty frames!
So many pretty frames!

 After one year of learning about why UVA and UVB rays are harmful, I thought it was about time to get my first pair of sunglasses. A month ago, Mr. Homer-an awesome UIWRSO optician, saw me struggling to pick a pair of sunglasses from the optical.

Some of my classmates have worked as an optician and found it easy to find frames that fit their face, but I had no experience in this field. Homer told me to wait on ordering a pair if I’m not sure what style I wanted, “we’re going to have vendors bring in all their products for you to try on!”

I’m glad he saw through my uncertainty in picking out a frame, because  a month later, I found a pair of sunglasses that I really liked at the Frame Style show in the optical.  The Frame Style show is an event the UIW Eye Institute puts on to sell frames for eye glasses and sunglasses.

Oscar, UIWRSO optician and Joey Allen, UIWRSO Intern helping a patient fill out paperwork for a pair of glasses.
Oscar, UIWRSO optician and Joey Allen, UIWRSO Intern helping a patient fill out paperwork for a pair of glasses.

There were so many high-end brands (Rayban, Burberry, D&G, and etc ), in different colors, of popular styles, all in one place!

I spent nearly an hour trying on frame after frame. There were also faculty, student, clinic patients, and their family joining in on the festivities. Nathan, Clinic Practice Coordinator, brought his fancy camera to take pictures.

It was then when I was politely greeted by UIWRSO intern, Joey Allen, who said “How do you like these frames? May I help you choose another? I can hold on to those while you pick out another pair.”

Initially I found his formality strange because we were friends, but I realized that he along with the other 3rd and 4th years interns were “on duty,” and there to help the people browsing. I appreciate how professional the UIWRSO interns are and I hope I can set a good example for my underclassmen as well!

Dr. Chapman, UIWRSO Clinic Director, trying on some frames!
Dr. Chapman, UIWRSO Clinic Director, trying on some cool, new, frames!

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How did they get this picture of me?
Me trying on some Raybans.