Ophthalmology is complicated! If you are trying to master new ophthalmic content or training someone else, you could probably benefit from some helpful memory techniques.

Mnemonics are clever techniques that aid in learning and memorizing new content¹ using a variety of learning methods including visual, auditory, and kinesthetic learning methods. This may include acronyms, acrostics, chunking, keywords or phrases, comparisons and connections, poems or rhymes, short stories, musical aids, visual aids, and more. Creatively linking new ideas to current understanding is what will help make a new concept seem more familiar.^2,3,4,5,6,7

The more vivid — and sometimes bizarre — the mnemonic is, the more it can stand out in your memory.

The Journey Method

Used since ancient Greek times, the Method of Loci, or the Journey Method, associates a specific piece of information with familiar items on your journey.^4,7,8 In other words, you imagine walking through your house, along a familiar path, or other well-known experience in a pre-determined order and the assigned visual clues along the way would be reminders to the specific content.

For example, the order of painting your nails is like the layers of the tear film. The first layer, the base coat, helps build the foundation, much like the mucin layer helps spread the tears over the ocular surface. Then the main part is applied, the nail polish, which is like the aqueous tears. Lastly, the top coat of clear polish is applied for longevity, much like the lipid layer holds in the tears by preventing evaporation.

Acronyms and acrostics

Acronyms and acrostics both use the first letter of the words or phrases you are trying to memorize to make a creative memory technique.^4,5,6,7,8 Acronyms use the first letter to spell a real, or made-up, word. Acrostics use the first letters of a phrase or list of word(s) to build a substitute phrase or sentence.

Here are some great examples:

Acronyms

1. Layers of the tear film, LAM: Lipid, Aqueous, Mucin
2. Steps to refractions, SACS: Sphere, Axis, Cylinder power, Sphere
3. Red-Green Duochrome Test: RAM GAP: If the patient sees the Red side as clearer, you Add Minus power, but if the Green side is clearer, Add Plus power. (If they are equally clear, stop offering lens options.)

Acrostics

1. The five layers of the cornea: Epithelium, Bowman’s, Central Stroma, Descemet’s, Endothelium    Every Body Sleeps During Eye class    Every Boy Slow Dances Easily    Every Baby Smiles Daily Eternally    Every Body Seeks Divine Energy
2. The retinal layers used for training OCT techs: (Note: Bruch’s membrane, choriocapillaris and choroid are added onto the end, as they are imaged in OCTs.)  

   Internal Limiting Membrane	Impatience
   Nerve Fiber Layer	Never
   Ganglion Cell Layer	Gets
   Inner Plexiform	Images
   Inner Nuclear	In
   Outer Plexiform	Ophthalmology;
   Outer Nuclear	Only
   External Limiting Membrane	Exceptional
   Photoreceptor Cell Layer	Patience
   Retinal Pigment Epithelium	Reveals
   Bruch’s Membrane	Beautiful
   Choriocapillaris	Clinical
   Choroid	Content

3. Tropias and Phorias: To remember which cover test is first, remember TP, like Toilet Paper, on your grocery list. You need it for No. 1 (perform the Cover-Uncover tests to reveal if a Tropia is present) and No. 2 (perform the Cross-Cover to assess the presence of Phorias).

Chunking

Chunking is a method that breaks numerous individual items into smaller chunks that are easier to memorize.^4,7,8 (See also, Figure 1.)

1. LR6, SO4, all the rest are 3. This quippy little saying helps to sort out which of the six extraocular muscles are innervated by different cranial nerves (CN).
   • LR6= Lateral Rectus is innervated by CN 6
   • SO4= Superior Oblique is innervated by CN 4
   • All the rest are 3= IR, SR, IO, and MR are innervated by CN 3
2. Both OBliques ABduct, The OB’s and the AB’s do the same thing. (Superior OBlique and the Inferior OBlique) both ABduct.
3. Remember the O’s: The Obliques do the Opposite of what you may think:
   • Superior rectus ELEVATES the eye, but thesuperior oblique DEPRESSES the eye
   • Inferior rectus DEPRESSES the eye, but the
     inferior oblique ELEVATES the eye

Rhymes, poems, and musical devices

This method creates a rhythmic cadence to, most likely, a process allied health staff perform.

For example: pupil assessment and cover-testing for assessing ocular alignment. For those of you who know music, imagine a ¾ time rhythm in your head, like a Waltz. ONE, two, three… ONE, two, three… There are four tests — direct response testing, RAPD testing, cover-uncover test, and cross-cover test — that benefit from this beat to help examiners avoid rushing the test and avoid missing an important finding. Note that the 1-2-3 cadence is slow and easy, not rushed. In practice for direct response testing would look like: SHINE, two three… RELEASE, two, three… to indicate that the allied health staff should shine the light into the pupil and hold, and then release and wait to let the retina and iris recover.

Another example: When evaluating for Horner’s Syndrome, remember the rhyme for the common symptoms: MiOSIS, PtOSIS, and AnhidrOSIS.

Visual aids, drawings, and sketches

Visual mnemonics, including symbols, drawings and sketches, work by associating an image with the information to be remembered. For example, prism symbol looks like an arrow and points in the direction of deviation. The base is the direction to which the eye should move to be aligned properly. (See Figure 2.)

Additionally, “down and out” describes the direction the arrow points for third nerve palsy. Palsy within the third cranial nerve causes significant limited motility because four of the six extraocular muscles (EOM) are affected. There will be unilateral lid droop, blurred near vision, and anisocoria from mydriasis in affected eye. If you had all these things going wrong with your eye, you would feel “down and out” too.

What works for you

Each of us learn and retain information in different ways. Ultimately, you will want to choose the method that works well for you. OP

Special thanks to Darrin Landry, Jacqueline Pullos, Aaron Shukla, Joan Wilson, the Ophthalmic Techs on Facebook group and Ophthalmic Professional who provided their memory devices and contributed to this article.

Find more memory tips from Ms. Jost in upcoming issues of Ophthalmic Professional.

REFERENCES:

1. Merriam-Webster. (n.d.). Mnemonic. In Merriam-Webster.com dictionary. Retrieved October 8, 2021, from https://www.merriam-webster.com/dictionary/mnemonic
2. Sousa, DA. How the brain processes information. How the Brain Learns. 5th Edition. Thousand Oaks, CA: Corwin A Sage Company; 2017:78.
3. Sousa, DA. Memory, retention, and learning. How the Brain Learns. 5th Edition. Thousand Oaks, CA: Corwin A Sage Company; 2017:150-151.
4. Higbee, KL. Your Memory, How It Works, and How to Improve It. https://marshallcf.com/wp-content/uploads/2017/02/Your-Memory-How-it-Works-How-to-Improve-it-Ver-2.pdf . Accessed October 8, 2021.
5. Congos, DH. 9 Types of Mnemonics for Better Memory. file:///C:/Users/amyjo/OneDrive/Documents/.OP%20magazine/9%20Types%20of%20Mnemonics%20for%20Better%20Memory.html. Accessed October 8, 2021.
6. Univ. of Central Florida. Student Academic Resource Center. 9 Types of Mnemonics for Better Memory. https://sarconline.sdes.ucf.edu/wp-content/uploads/sites/19/2017/07/9_Types_of_Mnemonics_NF1.pdf . Accessed October 8, 2021.
7. The Peak Performance Center. Memory Techniques. https://thepeakperformancecenter.com/educational-learning/learning/memory/memory-techniques/ . Accessed October 8, 2021.
8. Drumm, M. TCKpublishing. 4 Types of Mnemonic Devices and How to Use Them. https://www.tckpublishing.com/mnemonic-devices/ . Published October 8, 2020. Accessed October 8, 2021.