Hallelujah! I saw the macula!

today is a day of celebration! why? i finally saw the macula today with my ophthalmoscope!

the direct ophthalmoscope exam (when your doctor looks in your eyes with a light and gets really close to your face) has been the bane of my existence for the last four years. the idea is that you can look through the pupil to see structures in the back of the eye, but it's like using a telescope to find a specific constellation in the night sky when you're too zoomed in. you can only see a small part of the "sky" in your circle of vision, and you have to figure out how to navigate towards your destination with only a vague idea of where you are. in the eye, you should see blood vessels be able to follow them towards the optic disc (where all the vessels converge). then, you say "look into the light" and the macula, a part of the retina that is mostly for central vision, comes into focus.



i spent hundreds of dollars on an ophthalmoscope my first year, and i have been looking and looking into people's eyes with it. however, the best i have seen are blood vessels before my hand shook or the patient moved. maybe i imagined some of the optic nerve a few times, but that's it. i was starting to think i would never get it, and it would be best just to sell the darn thing and refer all my patients to optometrists or ophthalmologists.

however, today was magic. i was on fire! i saw the optic disc, was able to see the sharp borders and estimate the cup to disc ratio. then i said "look into the light," and there it was! the macula!!! i was surprised (and lucky) i didn't drop my ophthalmoscope. i did do a little victory dance in the hall, though.

i feel like i just climbed mt. everest, and i can't wait to do it again!