Surgery and eye exams

Today I did surgery on a "boxer" cross named Angel. She looks like a pitbull to us, but who are we to judge the parentage of our patients? She had entropion surgery on her right eye this morning. Her eyelids were so rolled in that the eyelashes were almost completely and totally rolled under and rubbing against her cornea. She's been like this for a year, and the owners just got around to surgery for it today (just got it check out last week!). I scrubbed in on the procedure, it took about 45 minutes, and we completely remade the outer corner of her eye (lateral canthus), and then did a little face lift on her lower lid (modified hotz-celsus) to pull the eyelid all the way down to a normal position. She recovered slowly but beautifully. She is seeing well, looks amazing, is in so much less pain, and is my little Frankenstein. Her mom is supposed to come get her tonight and take her home! Unfortunately, her suture removal is in two weeks - and I'll already be on a different rotation.

After waking Angel up and calling her mom to let her know how the surgery went, I headed back to ophtho where the doctors and other students had preceded me (I was instructed to stay until they extubated her). I stared at the two closed exam room doors for a moment, discovered from the tech that there was one student in each with an appointment, and went into the room closest to me. There I joined J looking at a little Shih tzu who quite possible redeemed the entire breed for me. His name was Elvis and I'm in love with him.

Elvis was completely blind, though he did have some light perception in his left eye. He had a cataract in his right eye, as well as a superficial infected corneal ulcer. His left eye has glaucoma. We opted to treat the ulcer with ciprofloxacin (!!) and cefazolin, both compounded for the eye, and treat the glaucoma with two anti-glaucoma meds (which come together as a drug called Cosopt). The owner is a really sweet paramedic who was just wringing his hands as he watched J and I, and then Dr P do the work-up on him. I did try to explain to him what was going on, and give him an opportunity to look over our shoulders at some of the more noticeable changes to make him feel like he was a part of it. I know how hard it is to know so much and yet be completely helpless in a situation with someone you love. When Dr P asked J to turn off the lights so she could do part of the exam, he reached over (longer arms) and flicked them off. He joked that he was "glad to help in any way he could", and I joked back that we liked to empower the owners :) He seemed to enjoy that, and I think he appreciated that I respected his knowledge. I, in turn, respected that he stood back and let us do our work. A good working relationship all along. Also, he worships his dog, which gives him major brownie points in my book.

After lunch (which was harried and very short), we headed to teach the sophomores how to do ophthalmic exams. This is a lab that was optional last year, but they've made mandatory this year. In teaching all of the components and trying to explain the various details and giving hints and tricks, I suspect that the four of us got more out of helping with the lab than the students who took it. Fortunately for them, a couple of days on rotation will really solidify what they know and make them super duper happy that they had the lab this year! I'm glad I went to the lab last year even though it was optional - it's really helped me out this year.

The lab disbanded at about 4:15, and I headed back to Ophtho to do a rDVM letter, where we write a letter to the animal's normal vet to thank them for the referral and let them know what the heck is going on with their patient, and write up Angel's discharge. It took me 'till about 5:45. Then I sat in the locker room and read all about eye enucleations (we're removing a horse's eye tomorrow and putting in an implant) and biked home.