One of the things Luis Trujillo, OD wants his optometry students to learn is that they can do a lot to help their patients without saying a word.
 
That is particularly relevant for students at Salus University who are rotating through the Optometry Service at the Norristown Regional Health Center (NRHC) in Norristown, Pennsylvania, because the patient population at the center, part of the Delaware Valley Community Health System, is primarily Hispanic, and not all students speak Spanish.Patient getting an eye exam
 
In that service, there are two major patient demographics: diabetics who need yearly exams and young children who tend to have amblyopia, also called “lazy eye,” a disorder of sight in which the brain fails to process input from one eye due to a variety of reasons such as 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 going on 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.Eye exam
 
“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 site, which has an agreement with Salus to provide eye care and educate interns three years ago. In 2013, due to his qualifications, he was recruited by PCO to serve as the optometrist in the School Vision Program for the Norristown Area School District.  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, glasses are supplied to the students.  Follow-up evaluations have been either in the schools or at the Norristown Regional Health Center. Dr. Trujillo 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 that the students could continue to learn and treat patients. The appropriate use of personal protective equipment is required because the interns are seeing patients face-to-face, an important aspect of their education.
 
Dr. Trujillo is also very involved in each exam and directs the interns in order to limit the time with each patient given that the area and patients served was and continues to be hit particularly hard by the COVID-19 virus. The clinic 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.Norristown Clinic registration
 
“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.”