The Daily Schedule Of An Ophthalmologist

Ophthalmologists are specialists who treat conditions of the eye including all its associated anatomy. Diseases and disorders that affect the eye can be managed either medically or surgically by an ophthalmologist. Ophthalmologists are medical doctors who specialise in medical and surgical disorders of the eye, and shouldn't be confused with optometrists who are healthcare professionals who provide primary eye-care by performing comprehensive eye examinations to diagnose and treat various visual problems.

Training 

A doctor wanting to specialise in ophthalmology first needs to complete their undergraduate training, in order to qualify as a medical doctor, and this programme takes 5-6 years to complete. Thereafter, a 1-2 year internship phase needs to be completed in order to qualify to apply for a specialist position in ophthalmology. The residency programme for this specialty takes 3-4 years to complete. If a qualified ophthalmologist wants to specialise further in a specific discipline, then they may apply for a fellowship position which can take 1-2 years to complete.

These fellowship programmes include specialties in the following areas: 

• Glaucoma
• Retinal ophthalmology - includes managing pathologies with laser treatment and surgery of the retina.
• Medical retinal concentration - managing retinal issues medically.
• Uveitis.
• Anterior segment surgery.
• Posterior segment surgery - this includes the surgical management of the retina, posterior segment diseases and disorders through vitreo-retinal surgery.
• External eye diseases, the ocular surface and the cornea.
• Refractory pathology.
• Neuro-ophthalmology.
• Oculoplastics.
• Orbital surgery - overlaps with oral and maxillofacial surgery.
• Ocular oncology.
• Paediatric ophthalmology managing issues such as strabismus.
• In some countries, a specialty training programme in veterinary ophthalmology exists.

Procedures 

The following are the most common surgeries performed by ophthalmologists.

• Cataract surgery - removal of the lens of the eye due to it becoming opaque from illnesses or aging.
• Laser eye surgery - used to manage refractive (correcting near-/far-sightedness and astigmatism) and non-refractive issues (repairing a tear in the retina).
• Glaucoma surgery - this is done when a patient is diagnosed with glaucoma that causes increased pressure in the eye itself. The procedure then allows excess aqueous humour from the eye to escape, and this allows for the pressure in the eye to decrease.

READ What Your Doctor Probably Won't Tell You About Glaucoma

• Eye removal surgery - via enucleation (removing just the eye), evisceration (removing the eye and leaving the sclera behind) or exenteration (removing the eye and all its contents including the muscles and connective tissue in the orbit).
• Orbital surgery - such as orbital reconstruction, placing of ocular prosthetics (false eyes) and orbital decompression.
• Corneal surgery - includes corneal transplant surgery, keratoprosthesis, pterygium excision, penetrating keratoplasty and corneal tattooing.
• Vitreo-retinal surgery - includes a vitrectomy, retinal detachment repair, macular hole repair, macular translocation surgery, posterior sclerotomy and radial optic neurotomy
• Oculoplastic and eyelid surgery - includes reconstructive procedures of the eye such as repairing drooping eyelids, removal of tumours in or around the eye, repair of the tear duct and aesthetic procedures such as eye and brow lifts.
• Eye muscle surgery - includes strabismus surgery, extra-ocular surgery and tightening and loosening procedures.
• Canaloplasty - is a non-penetrating procedure that is done so that raised intra-ocular pressure (IOP) is reduced.
• Surgery involving the lacrimal apparatus.

The Daily Schedule Of An Ophthalmologist 

Ophthalmologists will see their hospital patients on a daily basis and provide them with post-surgical and medical care until they are ready to be discharged. 

Ophthalmologists will usually be on call for one week at a time since they don't have to consult too much after hours. That isn't to say that emergency cases, such as traumatic injuries to the eye, don't occur and these cases need to be managed urgently. Primary healthcare workers will also consult these specialists on how to care for problems such as foreign objects in the eye and severe eye-related infections.

Monday

On a Monday morning, the ophthalmologist will deal with administrative duties such as confirming patient consultations and the surgical lists for the week, confirming meetings with hospital management and medical reps and completing important documentation. The specialist will thereafter begin consulting with patients. The management of these patients will depend on the issue at hand. Some eye-related problems such as conjunctivitis and keratits can be managed medically with oral or topical antibiotics and analgesia.

Procedures that can be done under local anaesthesia, such as removal of a foreign body from the eye or lancing a sty, will be done in the specialist's office. Procedures that need to be done under general anaesthesia will be done either at a day-surgery clinic or at an acute hospital. Patients will then have a surgical date booked for them.

Tuesday  

Tuesdays are surgical days and the ophthalmologist will spend the rest of this day in theatre performing surgeries. 

The procedures that are done on this day can include laser surgery to correct any refractive problems, pterygium removal and other corneal surgeries, large hordeolum or sty incisions, removal of traumatised eyes and placement of eye prosthetics and procedures to relieve raised intra-ocular pressure.

Wednesday

The removal of opacified lenses of the eyes (cataracts) is one of the most common surgery of any surgical discipline. An ophthalmologist would be able to fill an entire day's surgical list with just this procedure alone. Therefore, Wednesdays will be used exclusively to perform cataract surgeries.

READ Cholesterol-Lowering Drugs Linked To Increased Risk Of Cataracts: Ten Things You Need To Know

Thursday

Thursday mornings may be spent operating in the day-surgery clinics or the acute hospitals.

The afternoons may be used for teaching under- and post-graduate students if the doctor is involved with the academic curriculum of the training school. The specialist may also use this time for their own academic training and professional development, for writing motivation letters to medical insurance companies or for providing feedback to referring healthcare professionals.

Friday

The mornings may be used to consult with patients and to perform minor surgical procedures in the specialist's office. The afternoon is then used to settle any unfinished administrative duties and to confirm the surgical lists for the following week. 

The ophthalmologist will make sure that all patients that need to be discharged are done so. They will then either hand the care of the remaining patients to the specialist who is on call for the weekend, or accept the care of their colleagues patients if they are working.