giovedì, giugno 30, 2005
:: blinded ::hmmm finally have some time to blog... sigh. i miss blogging. (i think) i just don't miss it as much as being evil. finally, i'm kind of free and not in a rush to do something or go somewhere... guess where? i'm at the NUH student's lounge. got to vacate it soon though. bbbs!
ok these are my LAST words before i get blinded by 'apley's gang'. haiyo my cg is still stuck in the primitive ortho ages... anyway, they're going to dilate me (my eyes... ) later and i think the evil ones will attempt to view BOTH my optic discs simultaneously!!!
haha... nvm, i'm a lao3 jiang4 at this liao. i shall sacrifice my vision for a couple of hours! lolz...
hmm now on to ophthalmology - eye la... it's a very fun AND tiring posting... siao one... stand in almost the exact same location from like 9 to 130... and then from like 2 to 530?!?! i'd rather be walking around... it's hard to stand for long periods of time, much less tiring to walk around. hmmm the place is usually rather dim... and it's the same thing for every patient... use the direct opthalmoscope on him, slit lamp, fluoroscein dye... the GAT (goldman applanation tonometer)... gets a bit sian.
the cleanest OT session for all... can be found in ophthalmo. yucks, i don't like such clean procedures... i like those like GI and open surgery... lots of blood and matter all around hahaha... tt's MY type of surgery ;)
i was rather lucky in the OT yday... instead of spending all my time looking at PHACOs, i saw 3 DIFFERENT types of surgery...
~ Cataract removal ~
Got 2 ways... the manual ECCE (extracapsular cataract extraction) and the PHACO (phacoemulsification) method. phaco is ok la... insert two pods... one has a silicon sleeve with a vacuum like thingy... so gotta break up the cataract (heard it can be VERY hard in some pple... prob the nuclear sclerosis type ba...) and then break it up to pieces <0.9mm so tt it can be sucked up and removed... also need to infuse fluid at the same time of cuz... or else i guess the anterior chamber's going to be sucked dry! haha... the cataract is broken apart via ultrasound... must be very very careful not to rupture the posterior capsule or else.... can lead to the vitreous humor extravasating into the ant. chamber... and then might get the retinal detached and so on... then got to put the anterior chamber lens instead of the intraoc. lens la... effect isn't as good.
~ Pterygium excision ~
Hehe... a pterygium is a non-neoplastic fibrovascular growth from the interpalpebral conjunctiva beneath the corneal epithelium. usually it shouldn't obscure vision and removal is mostly for cosmesis. anyway, so first do a retrobulbar block. in a retrobulbar block will see ptosis, miosis as well. so the pterygium is excised and then a piece of conjunctiva is grafted from the superior aspect and then patched over the defect and sutured in place... cool eh? (haha but not much blood to go... )
~ Vitrectomy ~
Ok, this pt had diabetic retinopathy. so in DR, all those changes.. and stuff can lead to a vitreous haemorrohage... but since vision thru the vitreous is obscured by all that blood, laser photocoagulation can't be done... which means tt they've got to go in... (sometimes the h'ge will clear in a few days... ) anyway... imagine doing a surgery for the back of the eyeball through an aperture as small as the pupil! wa... damn tough la... haha... tt's y i prefer those where u can just open up the whole 'damn' thing. so put the pod in... add on the extra lens so magnify... and put in a light pod.. and start sucking out the vitreous and blood, meanwhile there's some infusate to replace the vitreous tt's getting sucked out. vitreous humour is really interesting, imagine some gelatinous colloid structure... like with some collagen in it as well. so when all the muck is taken out... then WAAOOO nice view of the retina... (ok this one wasn't tt nice, had haemorrhages and laser scars) next, the probe is placed really close to the retina to carefully remove the rest of the h'ge... finally, we do endolaser... quite cool hehe... shoot shoot shoot... tt's the only part i like la... hehe...
ok... i feel like a flu incoming. CANNOTTTT tomorrow got BCLS! cannot fall sick la... cham!
now going to dilate me eyes meself... and look very like a pretty italian woman hahah... belladonna manz...
*pregnant pause* -> ok guys u can puke now...
ciaoz!
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francesca chiu
2 eyebags & 5 wrinkles
on long-term dormicum drip
KIV IMH
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