What Should You Expect During Your Initial Visit at MSU?
After checking in with our receptionist, you will initially be greeted by a 3rd or 4th year veterinary student. All of our students have already completed their undergraduate degrees and the first 2 ½ years of an intense pre-clinical curriculum. The veterinary student will ask you various questions to ascertain the problem for which we are seeing your pet, the progression of the problem, and all current medications, as well as any co-existing health problems. Please do not be concerned if the clinician handling your case asks some of the same questions later. We want to ensure that all of the information is recorded accurately and that everyone has a complete understanding of your pet’s presenting problem.
After the student obtains all of the needed historical information, he/she will begin to perform a complete ophthalmic examination. Your regular veterinarian may have previously performed some portions of the examination. Other portions of the examination will involve specialized testing and equipment only available with a veterinary ophthalmologist. The initial portion of the examination will involve testing to determine how well your pet can see. Depending on your pet’s presenting complaint, this may involve navigating a maze of orange pylons (cones) in both light and dark conditions. The student will then assess the response of the pupils to light to ensure that they constrict normally. Next, the student may place a small strip of white paper beneath the eyelid to assess tear production (a Schirmer tear test). As some of our patients do not produce enough tears, this is an important component of the examination. The paper strip causes only minimal discomfort. The hardest part for most patients is sitting still. A drop of green dye (fluorescein stain) may then be placed on the surface of each eye to check for the presence of corneal ulcers (scratches in the outer clear layer of the eye). A drop of topical anesthetic will then be placed in each eye to numb the eye’s surface. The intra-ocular pressure (pressure inside the eye) can then be measured using a specialized instrument (Tonopen) to ensure that your pet does not have glaucoma (increased intra-ocular pressure). This provides us with the same type of reading as does the “puff of air” you may have experienced in your own ophthalmologist’s office, but with much less of a surprise than you probably experienced. A set of dilating drops will then be placed in your pet’s eyes. Usually the pupils are not fully dilated until 20-25 minutes have passed. Therefore, your pet’s examination with the ophthalmology service may take longer than the examinations you typically have with your regular veterinarian. As your pet’s pupils dilate, the student will complete his/her examination of the eyelids, conjunctiva, cornea, iris, lens, anterior chamber, and retina. While your pet’s pupils finish dilating, you may continue to wait in the exam room or you may wait in the adjoining ophthalmology waiting area.
While we are waiting for the pupils to finish dilating, the student will present their findings to the ophthalmology clinician who will be handling your case. The presentation and their initial examination allow the students to build their ophthalmic skills such that MSU can continue to produce the finest veterinarians in the country. The student and the ophthalmology clinician will then complete a thorough ophthalmic examination together. The clinician will often make remarks about the exam findings to the student in order to facilitate his/her learning process. At the end of the examination, we will discuss with you our exam findings, our diagnosis, any recommended diagnostic tests, and any recommended therapy, either medical or surgical. We will discuss the reasons behind any tests and therapy, as well as potential complications and expected outcomes. Especially if further diagnostic testing or surgical therapy is needed to address your pet’s condition, we will discuss the costs of the various options with you. It is our goal that you as your pet’s owner feel integrally involved in all decisions regarding your pet’s health care. If you have any questions or concerns or need further clarification on any topic, please ask. We have all chosen to work at a veterinary teaching hospital because we enjoy teaching. Therefore, we want to be sure we have answered all of your questions and that you understand your pet’s eye condition.
What Should You Expect During Recheck Visits at MSU?
Oftentimes, the recheck examinations do not take as long as the initial examination. This is because all of the initial testing does not usually have to be repeated. Also, we may not dilate your pet’s eyes for every examination, depending on their ocular condition. We will monitor and discuss your pet’s response to therapy. Again, if you have any questions or concerns, please be sure to address those with us during the examination. You are also welcome to call with questions or concerns at any time. In case of emergency, you can reach us at any time, as a member of the ophthalmology service is on call 24 hours a day, 7 days a week.
What if my Pet has to be Hospitalized?
If your pet has to be hospitalized, rest assured that we will do our very best to make the stay as comfortable as possible. The veterinary student you meet during the examination will provide one-on-one care for your pet during their entire stay in the hospital. While we realize that we cannot spoil them as well as you do at home, we certainly try our best. The ophthalmology clinician will closely supervise the veterinary student attending to your pet at all times. If your pet needs surgery, the ophthalmology clinician will perform the surgery. The student may “scrub-in” for the surgery and act as a surgical assistant. We will call you at least once daily with an update on your pet’s condition and again, you are welcome to call with questions or concerns. We can also arrange for you to visit your pet if they have to remain in the hospital. At the time that your pet is admitted to the hospital, an estimate of the cost of services will be provided. You will be asked to leave a deposit that is one-half the amount of the estimate. The balance of the bill will be due in full at the time of your pet’s discharge from the hospital.
We hope that you have a pleasant visit with the ophthalmology service. If you have any suggestions of ways to improve the quality of our service, we would appreciate your sharing those ideas with us.