Career

Interdisciplinary Ophthalmology

Eyes are unimaginably complex. Within one small orb there are numerous fine layers performing various different functions in harmony with one another to form the images that are sent to our brains for us to see. Optometrists and general ophthalmologists see the bulk of eye care patients but when someone with a specialized disease or injury comes in, they are often sent to a subspecialist.

Corneal specialists, vitreoretinal surgeons, oculoplastics physicians, neuro-ophthalmologists, glaucoma specialists and low vision physicians all work independently in their respective fields but there are times when these specialties cross. In addition to working beside fellow subspecialists, there are times when ophthalmologists work closely with general health practitioners, nutritionists, endocrinologists and oncologists for the best outcomes for their patients.

The old saying “the eyes are the window to the soul” is not too far off from the truth. Often times, a routine eye exam is the first place where a patient will get a diagnosis for their hypertension or, more commonly, diabetes. One optometrist I previously worked with diagnosed a man with a mysterious lung disease that confounded his primary care physician with histoplasmosis. A more holistic approach to caring fore patients like these is highly beneficial for the patient of course, but also for the practitioner, as increased communication paints a better HPI. Within eye care alone, certain subspecialties work very closely beside each other.

Oculoplastics surgeons and neuro-ophthalmologists work together at times to tackle the many issues presented with thyroid eye disease. At the University of Pennsylvania, plastics and neuro doctors have teamed up to form the Thyroid Eye Clinic, where issues like proptosis, lid retraction, diplopia and optic neuropathies can be treated comprehensively and simultaneously. At its inception in 2018, the clinic had a few hiccups relating more to scheduling and patient flow, but as the months passed, a rhythm formed and the seamless patient care became more fluid.

I personally had the privilege of being the lead technician for this program and saw first hand the difficulties of merging two fields together for patient care but I can say wholeheartedly that this is the best way to practice for the people we treat. Dr. Mark Abelson, author of the 2005 Review of Ophthalmology article “Interdisciplinary Work: The Wave of the Future” agrees: “Collaboration between various fields will improve our knowledge of certain disease pathologies and our ability to develop beneficial treatments”. Working with other specialties, practices and hospital systems improves the care that our patients receive and potentially the future of disease treatment.

Joining forces with physicians and specialties outside of your current field can be challenging at first, but with patience and time, it will come together. Listening and accurate record keeping is a major facet to interdisciplinary work, especially when you are hearing terms and phrases that may be foreign to you in your current role. When a patient presents with multiple ailments, documenting the pertinent information and using critical thinking skills to determine which test or physician they should encounter first helps tremendously with work flow. Lastly, working as a team is the biggest part of any collaboration.

Respecting the staff of the other discipline and their protocols, even when vastly different from what you may be accustomed to, is key to making the office flow harmoniously. Our job is to help our patients first and foremost; if helping them means working alongside with our medical professionals for the best outcome, then that is what we must do.

Abelson, M. & Plumer, A. (2005, April 29). Interdisciplinary work: the wave of the future. Retrieved from https://www.reviewofophthalmology.com/article/interdisciplinary-work-the-wave-of-the-future

Mulvihill, K. (2018). Scheie launches thyroid eye disease progam. Retrieved from https://www.pennmedicine.org/departments-and-centers/ophthalmology/about-us/news/department-news/thyroid-eye-disease-program

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