Ophthalmoscopes and the Eternal Wow

by Joceline

Within a few days of getting to med school, we were instructed to drop a lot of cash on various things, like 1) tuition and 2) an ophthalmoscope.  Although both were exorbitantly expensive, only one was really necessary (hint: it’s the really expensive one).

What is an ophthalmoscope?  It’s a device you use to look inside someone’s eye, at their retina.  It’s actually pretty fun to use, but it’s about $500 for something you rarely use–and anytime you really do need one, it’ll be on the wall in the patient room. So I never bought one.  And accordingly, never really learned how to use one, until my Neurology clerkship this past month.

You use the lens to look through the patient’s pupil onto the back of the eye, or the retina (the orange thing).

The pupil is such a small opening, you have to get really close in order to see–like close enough to kiss, although that’s generally discouraged.  Imagine trying to look at the inside of a ping-pong ball with a magnifying glass, through a small hole in the side.  You end up having to move around to see bits of the retina at a time, from all different angles.  It’s like trying to see a mural through a hole in a wall, or looking a painting in the dark aided only by a tiny flashlight.

So maybe this is burying the lede a bit–but what does this have to do with the Eternal Wow? (You know, those times I completely geek out about living in the moment and the limits of our existence.  Otherwise known as being extremely high on life.)  Well, as I was kissing-close to a patient’s eyeball one day, my face screwed up in concentration, trying to see through her constricted pupil–I realized that she was seeing the world through the same tiny opening.  I was looking in, she was looking out.

Think flashlight metaphor earlier.  If my view of the retina was limited by her pupil, our view of the world is just as limited–by our senses, our perceptions, our biases, tiny fractions of experiences that shape how we “see” life.  Sometimes I get caught up thinking my life is so big, and then little moments like this give me a little perspective.

“There’s a metaphor rolling around in there!”