Learning Critical Skills to Save Sight

Banner, Jamie Rosenberg, M.D., with medical student Russ Levine. Above, eye exams can reveal not only early signs of eye disease, such as retinopathy and glaucoma, but complications of diabetes, hypertension, increased intracranial pressure and other conditions, says Roy S. Chuck, M.D., Ph.D.
Top, Jamie Rosenberg, M.D., with medical student Russ Levine.
Above, eye exams can reveal not only early signs of eye disease, such as retinopathy and glaucoma, but complications of diabetes, hypertension, increased intracranial pressure and other conditions, says Roy S. Chuck, M.D., Ph.D.

Over the years, many medical schools in the United States have stopped teaching medical students how to use ophthalmoscopes for eye examinations. But the ophthalmoscope may one day make a comeback, taking its place alongside the stethoscope and blood pressure cuff as a basic tool in routine checkups.

Eye exams can help enormously in picking up health problems early—and not only problems involving the eye, such as retinopathy and glaucoma, says Roy S. Chuck, M.D., Ph.D., professor and chair of ophthalmology and visual sciences at Einstein and Montefiore, and the Paul Henkind Chair in Ophthalmology at Einstein.

Diseases such as diabetes, hypertension and increased intracranial pressure can visibly affect the eye. But when primary care physicians don’t perform eye exams, patients must visit specialists such as ophthalmologists, which they frequently don’t do, says Jamie B. Rosenberg, M.D., an assistant professor of ophthalmology and visual sciences and of pediatrics at Einstein and director of medical student education in ophthalmology and visual sciences at Montefiore. “Often, by the time a patient visits an eye specialist, it can be too late,” she says.

The ophthalmoscope may one day make a comeback, taking its place alongside the stethoscope and blood pressure cuff as a basic tool in routine checkups.

In her role at Montefiore, Dr. Rosenberg has developed a curriculum for ophthalmoscope training. The new curriculum evolved from a summer research project by third-year medical student Russell Levine, under Dr. Rosenberg’s supervision. The study was designed to evaluate students’ comfort with using the ophthalmoscope. “The exam typically takes less than one minute, and the information gleaned can be very meaningful,” notes Mr. Levine.

The new program, geared to third-year medical students during their internal medicine rotation at Montefiore, consists of a half-day curriculum that includes simulation sessions, followed by practice on patients in the eye clinic and on each other. Thanks to a $10,000 donation from the Bronx Lions Club, Dr. Rosenberg was able to purchase 50 low-cost ophthalmoscopes for the program.