Last week, I finished my pediatric ophthalmology rotation, so I want to write a ‘pediatric ophthalmology rotation at Mayo Clinic review’. I have kind of failed at this… I really should have been writing recaps of all my residency rotations like I did intern year and in medical school. You can check out some of those below.
Medical School Rotations
But alas, I am 1.5 years into ophthalmology residency and I haven’t reviewed any of the rotations. Whoops! I think I might try to go back and do small reviews, just for my own sake so that I can look back and remember things like the
terrible wonderful times on the retina service.
So anyway. Without delay, here is my:
Pediatric Ophthalmology Rotation at Mayo Clinic Review
Pediatrics is a 2 month rotation we complete during our second year of ophthalmology residency. There are 4 pediatric ophthalmologists at Mayo Clinic, and they are all slightly different. Dr. Mohney is what I would call the most “classic” pediatric ophthalmologist in that his practice sees a lot of kids with strabismus, amblyopia, kids who need glasses, congenital nasolacrimal duct obstructions, etc. He also sees a lot of retinopathy of prematurity babies, as well as some unusual cases each week too. Dr. Brodsky is a pediatric neuro-ophthalmologist. I think his practice is fascinating! While he does still see kids with normal strabismus, he is also an expert on neurologic conditions and optic nerve disorders affecting vision.
Dr. Bothun specializes in pediatric cataract surgery which is incredible, but he does seem to be a ‘jack-of-all-trades’ and does almost everything within pediatric ophthalmology and strabismus. Lastly, Dr. Holmes specializes in adult strabismus. His practice is mostly adults with very complicated problems. Most of his patients have already had multiple surgeries and have multiple issues causing double vision or eye misalignment. Dr. Holmes is a master when it comes to managing tough, complicated strabismus problems. All the faculty are also heavily involved in research and academia (publishing a lot, writing textbooks, etc), which I found to be so inspiring!
We also work with 2 incredible orthoptists who are so knowledgable, and I found to be a great resource during my rotation. (Thanks for all the help Lindsay and Andrea!!)
When I first started my peds rotation, I was overwhelmed with the complicated nature of strabismus. The eyes have 6 muscles that all work together to keep your eyes fixated on one object. When one or multiples of these muscles don’t work, it can cause all kinds of difference patterns of eye movement. Figuring out which muscles are involved based on how the eyes are moving wasn’t easy at first, but by the end of my 2 months I actually felt like I was getting the hang of it!
Our rotation has a great balance of clinic and OR time. I spent about 4 half days in the OR per week (1-2 full days, and 1-2 half days) and the rest of the time in clinic. Because we have 4 difference faculty members with a wide range of clinical practice, I got to see a huge variety of patients and conditions.
I was involved in 40-50 strabismus surgeries, several nasolacrimal duct probings and stent placements, several chalazion excisions, and even some lasers for babies with ROP.
Every Monday morning, we had a pediatric ophthalmology conference with all the attendings and the orthoptists. We discussed difficult cases and management options. I love the team-based approach in the sub-specialty, which ultimately benefits the patient the most.
Tuesdays were full OR days. Dr. Holmes uses adjustable sutures, so that he can see the patient several hours after surgery, and adjust things if needed. This made for long days, but the surgeries were always interesting. One night, we came by to adjust a lady who had undergone surgery earlier that morning. When we walked in the room, she was unhappy because she was still having double vision. This was her third surgery, and I think she felt hopeless when she woke up from surgery #3 still having double vision.
Dr. Holmes did a small adjustment to her sutures, and suddenly she started to cry. She was looking at her husband and told us that it was the first time he wasn’t double. Finally, she was seeing single vision! Our patient continued to cry tears of joy while we finished the exam. This was such an emotional moment, and it is something I will never forget.
Wednesdays were a mixture of clinic and OR. Often, we would have a few cases in the morning, followed by clinic in the afternoon.
Thursdays were similar. OR in the morning followed by clinic in the afternoon. We have lectures on Thursday afternoons as part of our residency program, so I left clinic at 3 to attend lecture.
Fridays were ORs with Dr. Bothun, and I got to see several pediatric cataract cases which was very cool.
We also spent a Friday late in the OR lasering a tiny baby with ROP.
My little puppy was always happy to see me after coming home from a long long day!
The Best Part
The best part of the peds rotation was by far all the kids. Interacting with kids all day is SO fun. I honestly loved it. Kids are funny, honest, and always in different moods. It’s a challenge to figure out how to get a good eye exam in a difficult kid. But, there are so many joyful moments with children that make it worth it. I know I am applying for oculoplastics fellowship, but I think I would enjoy a pediatric oculoplastic practice, so I’m looking into that.
***This will likely only pertain to you if you are an ophthalmology resident. So if you’re not, sorry! Please skip ahead 🙂
I had heard a few cautionary tales about the pediatric ophthalmology rotation. My co-residents told me that the end of rotation test was one of the hardest, and many people fail. Hearing this, I was terrified! I definitely didn’t want to fail the test, so I made an intense study schedule and studied a lot.
To start, I made lots of my review sheets, and did a lot of reading in my book.
I used both the BCSC and Friedman to study.
The weekend before my test, I did all the peds ophthoquestions, the BCSC questions, and the Friedman questions.
Luckily, all that studying paid off and I did well on my exam. Phew!
And that concludes my pediatric ophthalmology rotation at Mayo Clinic review! I hope it wasn’t too boring 🙂
Do you like working with kids?