Norristown Site Offers a Unique Learning Experience

One of the things Luis Trujillo, OD ‘09, Pediatric Resident ‘12, wants his Pennsylvania College of Optometry (PCO) at Salus University students to learn is they can do a lot to help their patients without saying a word. 

That is particularly relevant for PCO/Salus students rotating through the Optometry/Eye Care Service at the Norristown Regional Health Center (NRHC) in Norristown, Pennsylvania, because the patient population at the facility, part of the Delaware Valley Community Health System, is primarily Hispanic, and not all students speak Spanish.

In that service, there are two major patient demographics: diabetics who need annual exams and young children who tend to have amblyopia, also called “lazy eye,” a disorder in which the brain fails to process input from one eye due to a variety of reasons such as a refractive error or an eye turn. Over time the visual system may learn to favor the non-amblyopic eye which could have a lasting effect on the patient’s binocular vision. 

“Without health insurance, it’s not very likely that they would be able to get care otherwise, so serving those two populations are the strengths of this service. Having the interns see that and understand how they can learn and help there,” said Dr. Trujillo. “I just tell students there are a lot of things you can do on a patient without them even saying a word, and I think that gives the students a little bit of confidence once they go in. It’s not the case that the patients can’t speak any English, but the students see that there is nothing to be afraid of. That provides for a valuable learning experience.”

As an example, Dr. Trujillo said, students, when working with patients who they might be able to verbally communicate with, can figure out the patient’s prescription for glasses using objective testing. They can see if there are any neurological issues related to the eye and vision, the health of the front part of the eye can be evaluated, and the inside structures of the eye can also be looked at after dilating their pupils. 

“You have to have the tools to understand that something is a little bit different, and you need to go into your head and figure out what you can do to get the answer that you don’t have,” he said. “That’s one of the biggest things that the students get to see.”

The Spanish-speaking Dr. Trujillo joined the Norristown clinical facility, which has an agreement with PCO/Salus to provide eye care and educate optometric interns, three years ago. In 2013, due to his qualifications, he was recruited by PCO/Salus to serve as the primary optometrist in the Norristown Area School District’s School Vision Program. In that patient care model, Dr. Trujillo provides full eye exams for students in the district’s schools, often the only eye care the students receive. Through the program, if glasses are necessary, they are supplied to the students. Follow-up evaluations have been either completed in the schools, at the Norristown Regional Health Center or The Eye Institute’s Chestnut Hill satellite facility. Dr. Trujillo also continues to maintain his faculty status at The Eye Institute (TEI). 

When the pandemic hit, Dr. Trujillo was determined to do what was necessary to ensure the students could continue to learn and treat patients. Specific patient procedures and the appropriate use of personal protective equipment is required because of the face-to-face nature of an eye exam, an important aspect of their education and of a patient’s care. Dr. Trujillo is also very involved in each exam and directs the interns in order to limit the time with each patient because of COVID-19. The clinical facility is currently administering COVID-19 testing through the state and is in the process of also ensuring the vaccine will be administered to those in need once it becomes more widely available. 

“There is a sense when I’m at clinic, when we’re by ourselves and we feel we can teach where we’re comfortable, it just helps the students,” he said. “We like the students to feel more relaxed and not that they’re being graded all the time and that focusing on the patient’s well-being is what is most important. In my opinion it just makes for a better learning experience.”

Note: The photos accompanying this story were taken pre-pandemic.