September 27, 2018

New equipment expands Shade Tree’s ophthalmology services

It’s been five years since the Shade Tree Clinic incorporated ophthalmology services into its student-run health clinic.

It’s been five years since the Shade Tree Clinic incorporated ophthalmology services into its student-run health clinic.

And since 2013, the eye specialty clinic has seen growth in patient volume, increased the level of care it is able to provide after acquiring new diagnostic equipment and enhanced the teaching possibilities for medical students.

“Two of the biggest pieces of equipment added that have allowed us to expand ophthalmology at Shade Tree and provide more resources to our patients include a retina camera and an auto refractor,” said Yuxi Zheng, a third-year medical student and co-director of the ophthalmology clinic at Shade Tree.

Students and directors involved with the specialty eye clinic at the Shade Tree Clinic include (back row, from left) Raymond Zhou, Kari Fossum, Sushmitha Divakar, Nina Farivari, MD, Mark Breazzano, MD, Janice Law, MD, Russell Day, (front row, from left) Sneha Lingam, Yuxi Zheng and Andrew Bowl.

“Shade Tree has a panel of more than 300 patients,” said Zheng. “The clinic actively follows a good number of hypertension and diabetes cases, which are two of the chronic conditions we are very interested in because they can show up in the eye.

“And we can provide care because we also have the necessary equipment to perform the exams, which is a huge help.”

Most of the patients at Shade Tree require regular vision care. The ophthalmology clinic addresses a range of eye care needs using equipment like the retina camera and autorefractor.

A digital retina camera takes a photograph of the back of the eye. It shows the retina (where light and images hit), the optic nerve (which sends information to the brain) and blood vessels. This picture helps confirm a healthy eye or detect the presence of disease. An autorefractor is a computer-controlled machine used during an eye examination to provide an objective measurement of a person’s refractive error and prescription for glasses.

According to Janice Law, MD, assistant professor of Ophthalmology with the Vanderbilt Eye Institute, medical schools around the country have free clinics, but not many offer ophthalmology care at this level.

“It is less common for student-run clinics to offer ophthalmology services and what is available is not as extensive as what is provided at Shade Tree,” said Law. “Ophthalmology care like this is very rare.”

Law attributes the newest vision care enhancements at Shade Tree to the ingenuity and drive of the students operating the clinic. The equipment was purchased through grants and other donations.

“The students are the force behind the changes and improvements in the eye clinic,” said Law. “Both Yuxi Zheng and Katherine Sumarriva have stewarded the student initiative to acquire state-of-the-art technology as well as ensure the primary care clinic has use of the equipment for routine medical exams.”

Of the total number of patients seen regularly at the Shade Tree Clinic, about 100 are actively followed for ophthalmology care and many more have received care for acute vision problems.

“We are able to provide all of the primary care for our patients as well as refer them directly to specialists at VEI if necessary for additional services because of complex care requirements,” said Sumarriva, a fourth-year medical student and co-director of the Ophthalmology clinic at Shade Tree. “This is the first year that we were able to upload images of the retina to patient’s medical records.

“We know that these improvements in screenings and testing will positively impact our clinical care. But our advancements are not all about how it impacts out patients.

“We want to emphasize how students are learning — they are checking vision, checking pressures inside the eye and learning first-hand how to do examinations all within the first year.”

Both Sumarriva and Zheng say the introduction of high-tech equipment allows ophthalmology students to get the extra practice that often is hard to obtain during clinical rotations.

“What is really cool, outside being able to help our patients, is that as students we are able to learn,” said Zheng. “We have our own slit lamp, indirect ophthalmoscope and lenses as well as a side observer scope for students to look through to learn in real time with the examiner.

“Those students who know they want to go into ophthalmology can use all of this and learn to evaluate patients using this equipment,” added Zheng.

Shade Tree offers an ophthalmology clinic on the second Saturday of each month. Glasses clinics are held on a quarterly basis. Moving forward, Zheng and Sumarriva hope to incorporate subspecialty clinics for retinal disease and glaucoma within the ophthalmology practice.