Behind the Lens: A Day-to-Day View of the Wilmer Technician Experience

There are about 120 ophthalmic technicians working across the nine locations of the Wilmer Eye Institute, Johns Hopkins Medicine. Among them are ophthalmic technician assistants, certified ophthalmic assistants, certified ophthalmic technicians, certified ophthalmic scribes and certified diagnostic ophthalmic sonographers, with many years of experience ranging from six months to nearly four decades. They serve as clinic leaders, supervisors and managers, mentors and confidants. I am one of them. Recently, I had the opportunity to do something I’ve always wanted to do: experience a day in the life of a technician outside of where I work, the Patient Access Center for the Eye (PACE). I traveled to the White Marsh and Green Spring Wilmer locations — two dynamic clinics, each with its own unique characteristics.

Today is an active day in clinic for technician Stephen Chott, a certified ophthalmic assistant. It’s Wednesday, and he’s working with Irene Kuo, cornea specialist, division chief and medical director at White Marsh. The schedule is composed of pre- and post-operative refractive surgical appointments, glaucoma screenings and comprehensive eye exams — all of which require their own protocols and diagnostic testing.

Chott commands the clinic with ease. He works empathetically with the patients. After measuring the vision and pressure of one of Kuo’s post-op patients, he carefully reviews and explains postoperative instructions to the patient, including proper timing and administration of eyedrops and how to care for the eye after surgery.

Chott says the most rewarding part of his job is interacting with patients and seeing their reactions after surgeries like cataract removal. He recalls a time when a patient came into the office a day after surgery. Her vision had improved so much that she cried while in the exam room with him. “It’s rewarding when patients come in and you know that you’ve been a part of their journey in improving their vision and helping them see better,” he says.

In addition to screening patients, Chott’s responsibilities include ordering clinic supplies and stocking exam rooms, calibrating and troubleshooting testing equipment, handling medication refill requests and managing patient calls.

Chott graduated from college in 2016 with a communications degree. Two years later, he was hired as a tech in Wilmer’s float pool. The following year he completed Wilmer’s training program, earned his ophthalmic assistant certification and settled down at the White Marsh location as a permanent full-time technician.

“Stephen is wonderful,” says Kuo with fondness and admiration. “He is a great asset to our clinic. Ophthalmic technicians are critical to [the work of] optometrists and ophthalmologists. He has a great bedside manner; he’s hardworking, intelligent, personable and diligent.”

Sixteen miles west of Wilmer–White Marsh sits Johns Hopkins’ sprawling Green Spring campus. The Wilmer Eye Institute is situated inside Pavilion II. Although the two clinics are miles apart, their mission is the same: compassionate, quality patient care.

Today, Darlene Taylor-Lee, certified ophthalmic assistant and certified ophthalmic scribe, is one of three technicians assigned to testing — which involves, in this case, conducting visual fields for neuro-ophthalmologist Shahnaz Miri.

Taylor-Lee has been a technician at Green Spring since 2013, but she began working at Wilmer 12 years ago as a medical records clerk at PACE. Subsequently, Taylor-Lee was recruited by Mike Hartnett, clinical supervisor of the float pool, to become an ophthalmic technician assistant trainee. In the years following, she earned her certification as both an ophthalmic assistant and an ophthalmic scribe.

Throughout the week, Taylor-Lee works with retina and oculoplastic specialists. When working alongside retina specialist Cindy Cai, not only does she work up patients, but she acts as an “extender,” placing patients in rooms for the doctor to examine and pulling up diagnostic imaging results on the computer. If the doctor decides the patient needs treatment, Taylor-Lee pulls the medication and preps the patient for treatment. When working with Sharon Solomon, the Katherine M. Graham Professor of Ophthalmology at Wilmer, Taylor-Lee not only prepares patients for treatment, but also scribes — staying by the doctor’s side at all times to document exam findings as well as diagnoses and treatment plans.

“I love interacting and working closely with patients,” says Taylor-Lee. “I enjoy assisting with procedures and scribing because you see things that you typically wouldn’t when only doing basic work-ups.”

Lead technician Tammy Kephart, certified ophthalmic assistant and certified ophthalmic scribe, serves as Taylor-Lee’s back up when working with the retina team. While every day in clinic is unique, she says Fridays are most interesting. On those days, she works alongside Kraig Bower, director of refractive surgery at Wilmer, assisting with laser-assisted in situ keratomileusis (LASIK) cases, in which a specialized laser is used to alter the shape of the cornea.

In addition to preparing the patients for surgery, Kephart manages the laser during procedures and pulls up patients’ information in the IRIS Registry (Intelligent Research in Sight) — a fingerprint-like database of the iris used to ensure greater accuracy during the procedure by identifying and matching 24 distinct markers in the iris to the patient.

Kephart became an ophthalmic technician 25 years ago, but she calls the past nine years at Wilmer the highlight of her career. She takes pride in being able to encourage and mentor the younger technicians and enjoys being a point of contact in clinic. She also values the day-to-day interactions with patients.

“Often times, patients are scared. Sometimes they haven’t had an exam in years and sometimes not at all,” she says. “My favorite part of my job is working with patients and being able to settle the nerves.”

In addition to Taylor-Lee and Kephart, there are 10 ophthalmic technicians at Green Spring, with nearly 100 years of ophthalmic technician experience among them. They complement each other well by communicating effectively with one another. Davette Gray, manager of the Green Spring clinic, says technicians are invaluable to the success of the clinic.

“They are the heart of the clinic. We’re a multispecialty clinic with 32 doctors, and our technicians’ skill set has to allow for them to be wherever we need them, day after day,” she says. “Everything they do here is impactful.”