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Claiming My Weekends and My Place at the Health Care Table

By Inrava Khasnabish, OD, FAAO

Any new optometry grad will say that having all Saturdays off is unheard of.

When I was in school studying for classes, exams, and ultimately national boards, the last thing on my mind is what “type” of optometry I wanted to practice after I walked across the stage with my diploma. We all think “Man (or woman), I just want to be a doctor already”—but here’s the thing; there are so many types of practice styles that it’s worth exploring all the options.

I first learned about hospital-based optometry as a second year student from my neuro-optometry professor. In her “previous life” as she liked to call it, she was the only optometrist in the ophthalmology department. She highlighted the fact that she always had full weekends off (two whole days!) and was rarely on-call. I never paid it much mind, but after completing my residency, the opportunity fell into my lap.

Upon completion of my ocular disease residency in rural Virginia, I moved to New York City to pursue an opportunity at a high-volume private ophthalmology office, where my associate became the chair of the department of ophthalmology at a local hospital. He inquired if hospital-based optometry interested me. I immediately thought back to my second year and consequently agreed to try it out on my day off from private practice. At the hospital, I work with a uveal specialist at a level 1 trauma center, which permits me access to all the best emergency physicians if ever I am in need of a consult.

Most hospitals are more medically oriented and located in inner cities. The demographic variation lends itself to common diseases like diabetes and glaucoma as well as uncommon things like retinal parasites. One of the most wonderful aspects about hospital optometry is the direct access, readily available, to all facets of health care: hematology, radiology, neurology, endocrinology, etc. Additionally, there exists a sense of camaraderie among all levels of health care professionals—we are all on one playing field with our patient’s best interest in mind. However, the pinnacle of hospital optometry is the seamless access to a patient’s full medical history, because let’s admit it, all patients are poor historians.

The last American Optometric Association scope of practice survey revealed that only 11 percent of optometrists have hospital privileges. Some hospitals don’t even have an ophthalmology department and, with that being said, aren’t well equipped to handle ocular trauma or emergencies. As medically oriented optometrists, it is our role to offer guidance in triaging the common “red eye” that walks through the door as well as ocular and orbital trauma in addition to managing routine care. While some optometrists are wary about ordering tests, whether it is blood work, CT/MRIs, carotid duplexes, etc.—being in the hospital setting removes that uneasiness.

Working alongside ophthalmologists at the hospital provides the scope for continuous learning and growth. This environment also lends itself to a more academically oriented setting where the opportunity to host optometry externs, optometry residents and ophthalmology residents can arise. Working with students allows us to remain up to date with the most current research, medication and technology in addition to shaping the minds of the next generation.

Now don’t get me wrong; the hospital pace isn’t for everyone. There will be busy days where I come home later and spend hours looking up all the unique and strange things I saw that day. There will be days that I get to leave early. There will be days that are challenging, and there will be days where everything just clicks. But at the end of it all, it is a beautiful amalgam of camaraderie among health care providers and medical optometry all rolled in one.

Dr. Khasnabish is a 2018 graduate of Massachusetts College of Pharmacy and Health Sciences University in Boston and currently practices in Staten Island, New York.

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