Through the Looking Glass: Conducting a Slit Lamp Exam for the First Time

October 30, 2017 by Michelle Bookless

On Monday, October 23, after a full day of classes, a group of 17 medical students from the UVM Larner College of Medicine attended a Slit Lamp Exam clinic hosted by the Ophthalmology Student Interest Group (SIG) and the Ophthalmology Department at the UVM Medical Center.

Purvi Shah '20 exams Nick Haslett's '21 eye as UVM assistant professor of surgery David Diaz, M.D., instructs the two students on how to properly conduct a Slit Lamp Exam

On Monday, October 23, after a full day of classes, a group of 17 medical students from the UVM Larner College of Medicine attended a Slit Lamp Exam clinic hosted by the Ophthalmology Student Interest Group (SIG) and the Ophthalmology Department at the UVM Medical Center.

The group was welcomed to Level 5 of the West Pavilion by faculty advisors to the Ophthalmology SIG, Brian Kim, M.D., an associate professor of ophthalmology at UVM and vitreoretinal surgeon at the UVM Medical Center, and Elizabeth Houle, M.D., an assistant professor ophthalmology at UVM and ophthalmologist at the UVM Medical Center. 

Although somewhat subdued while enjoying pizza before the clinic began, it was hard for the seven second-year and 10 first-year students to stay quiet for long as each of the seven ophthalmology attending physicians volunteering for the clinic walked into the room and introduced themselves. The energy and enthusiasm displayed by Drs. Kim and Houle and their colleagues, Sujata Singh, MD, Phil Aitken, MD, Stephen Pecsenyicki, MD, Jessica McNally, MD, David Diaz, MD, Robert Millay, MD, and Lisa Alexander, MD was contagious and the sound of excited gasps, cheers, and exclamations of wonder, and laughter soon bubbled out of exam rooms around the suite.

To give the students the best experience possible, each attending physician paired with only two to three students a piece. The thoughtfulness and impact of the decision was not lost on Collin Love ‘20. “I expected to have a group of doctors more or less demoing the exam to a group of us. I really didn’t expect that it was going to be just 2 students and 1 physician,” he said. “We spent the whole time with our hands on the different equipment and seeing exactly what an ophthalmologist would see and do during a Slit Lamp Exam.”

Throughout the clinic, each attending physician approached the material they were teaching in their own unique and engaging way.

In one exam room, Dr. Alexander, an assistant professor of ophthalmology at UVM explained the basics of administering a Slit Lamp Exam and then led students Collin Anderson ’21 and Flora Liu ’21 in a game of “Find the Nerve.” As Dr. Alexander turned off the light, Anderson, a bit timidly at first bent toward Liu and peered into her eye using a handheld retinoscope. After a bit of muttering and some nervous laughter, Anderson shouted triumphantly. He had won is round of “Find the Nerve.” Turning the light back on Dr. Alexander asked Anderson to describe what he’d just seen and he happily and excitedly obliged.  

Down the hall, Kalle Fjeld ’21, Susan Campbell ’21, and Nate Benner ’20, were walked through the different aspects of the Slit Lamp by Dr. Millay including how to adjust it, how to avoid postural injuries after prolonged use, different lenses and their distinct purposes, and how to adjust the beam of the slit lamp while looking for specific things within the eye. Peering into Dr. Millay’s eye, Benner says he was “mesmerized by the iris,” and was “struck by the physical manifestation of the content [he’s] been learning about.” “I was able to remember some of its structure and function,” he said, “[and] appreciate the anterior chamber and begin to imagine how it might look different in pathological states.”

Nearly all of the student attendees agreed that the clinic exceeded their expectations. The physicians’ down-to-earth personalities, willingness to answer questions, and enthusiastic explanations of their specific careers coupled with the thrill of seeing “a crystal-clear close-up of the iris for the first time,” guaranteed that most, if not all, will most certainly be attending the next Ophthalmology SIG event.