Orthoptics in the Big Apple

In 2015, I was fortunate enough to secure my final placement as an Orthoptics student in New York City at the New York Eye and Ear Infirmary. This opportunity to date was the most valuable experience for both myself personally and also as a new graduate Orthoptist about to embark on my first ‘real’ job after completing my studies.

I remember in my second year of University setting myself a goal that I was going to save money every week so I could afford flights to the US and accommodation in East Village, Manhattan by the time my last year of University came around. I guess this proved to me, dreams do come true! I can still feel that overwhelming excitement of when the placements were released and I was selected to be one of the four final year students to go to NYC.

22nd August 2015: Touchdown in NYC. The magnitude of the city blew me away. I felt overcome with feelings of anxiety yet endless possibility and recall looking out the window of my yellow cab and being able to see nothing but skyscrapers surrounding me. I suddenly understood why they call it a concrete jungle. These anxious feelings soon left me on entering the shoebox apartment I was sharing with two other American girls (and of course their pet cat Ebert) who welcomed me with open arms. The apartment I was staying at was walking distance to the NYEEI so of course I could not wait to get a glimpse of where my final placement was going to be.

I was working in the paediatric ophthalmology department on the ocular motility clinic which basically means I was assessing children’s eyes, specifically eye movement disorders.

The team consisted of three Orthoptists, two consultant Ophthalmologists and numerous registars.  As final year students we were expected to observe for the first few sessions and by the end of the placement we would be given mystery patients which we would have to independently consult and present the clinical findings, diagnosis and treatment plan. The work ethic, knowledge and dedication of the paediatric Ophthalmology unit at the NYEEI is astounding. Each morning I would arrive at clinic early and the supervisor would quiz us on difficult content or case studies. Another incredibly valuable learning tool was the weekly conference where a real patient whom volunteered their time would come in and the consultant Ophthalmologist would cover a specific topic, break down the clinical findings and appropriate management would be open for discussion. I began to understand why New Yorker’s are renowned as being such hard workers. These Orthoptists lived and breathed their profession and had such a contagious passion for their work, a kind of passion I aspire to.

The NYEEI is the largest provider of eye care in America which enabled me to observe a vast range of eye disorders including:

• Strabismus (eye misalignment)
• Cranial nerve palsies
• Nystagmus
• Diplopia
• Refractive error and amblyopia
• Neurological vision disorders
• Rare disorders such as ‘Ocular motor apraxia’

I discovered the scope of practice for an Orthoptist is quite different when comparing Australia to the USA. The traditional role of an Orthoptist involves the management of eye movement disorders; specifically strabismus (eye alignment), diplopia (double vision) and amblyopia (lazy eye). In New York an Orthoptist purely works on the ocular motility clinic where as in Australia an Orthoptist is able to work in many other sub-specialities of Ophthalmology. I found this very interesting as in Australia I may only complete a handful of ocular motility assessments on paediatric patients each week. However if I worked in NYC I would be performing motility assessments on almost every patient and any other general ophthalmology patients would be sent to another department of the hospital.

The most valuable lesson I learnt while working at NYEEI… Being an Orthoptist can be a life-long rewarding career. No two days will ever be the same, just as no two patients are ever the same.

If I had to pick one scenic stand out moment in NYC… It would have to be the morning I woke up super early to beat the sunrise. I made my way by subway down to the Brooklyn bridge and watched as the sun come up and the whole of Manhattan come to life as the light reflected off each of the buildings. It was breathtaking and certainly a sunrise I will never forget.

Time to leave the big apple – I recall being on my way to JFK airport and calling Mum saying how I wanted to purposefully miss my flight home and stay longer. I certainly was not ready to come back as I had never felt more alive. I met some incredible and inspiring individuals who taught me to bring out the best parts of myself and encouraged me to strive for the upmost success as an Orthoptist. I personally feel travelling alone to a place far form the comforts of your own home truly helps to shape and define the person you are.

Eye’m out,

B