Glaucoma Fellowship

Program Description

Our one-year glaucoma fellowship program is primarily clinical with an emphasis on outpatient care, glaucoma surgery (traditional and investigational), and clinical research. There is also a significant focus on advanced anterior segment surgery including complex cataracts, iris repair, and intraocular lens repositioning and exchange. The reputation of the program is strong and is now getting stronger as we offer diverse and innovative surgical and clinical training that can be rivaled by only a few places in the United States. The program is AUPO Compliant.

More about the program

Unique aspects:

1. Surgical and clinical teaching is highly diverse given the background of our 5 full-time faculty members with 4 still involved in clinical care.
2. Excellent balance between autonomy and supervised training. You will leave the program well prepared when you become solely responsible for patient care.
3. Exposure to many different populations from the uninsured, to privately insured to the veteran population.
4. Surgical preparation and teaching involves surgical video review of cases before and after procedures. The video recording equipment is hi-definition and the fellow has the opportunity to build a video library for presentations and teaching.
5. Weekly case meetings are held with the fellow, resident on service, and glaucoma faculty to review challenging diagnostic and therapeutic cases in a friendly setting.
6. The fellow is highly involved in teaching the residents surgically and clinically. This is by far the best way to learn. A fellow who does not want to teach is not a good fit for the program.
7. Chief Resident system means that there is a dedicated consult and trauma attending allowing fellows to focus on their fellowship. This minimizes the load for all subspecialty fellows regarding call and consult staffing.
8. There is minimal travel to clinical sites. In fact, many fellows and residents walk to work from the Central West End. The VA is less than 2 miles away from the main campus. Time is not wasted on commuting.

Research Opportunities:

(these are just highlights, many smaller scale projects are added continually)

1. This is the home of the Ocular Hypertension Treatment Study led by Dr. Kass. This is one of the most referenced prospective studies in the field of glaucoma and is now collecting 25 year data.
2. Dr. Liu leads a prospective trial on tube shunt surgical technique and is interested in AI-integrated glaucoma screening systems.
3. Dr. Sheybani is involved in the development of investigational surgical devices for glaucoma and anterior segment surgery.
4. Dr. Sieck works with the uveitis team to investigate surgical outcomes and also participates in investigational device trials.
5. Dr. Siegfried leads an innovative translational investigation on the role of oxygen and mitochondrial metabolism in the development and racial disparities of glaucoma.

Clinical Duties:

1. Primary Fellow Clinics: these clinics and patients are solely the responsibility of the fellow.
   1. UES – The University Eye Service is a resident and fellow run clinic staffed by attendings. This clinic is high in volume and pathology. The fellow is responsible for all glaucoma care and can see patients independently when comfortable. Surgical cases can be performed independently after the fellow is deemed competent to do so. Anterior segment, complex cataract, and MIGS surgeries are also abundant through this clinic.
   2. VA – The VA hospital glaucoma clinic is the fellows’ responsibility. The clinic has a high volume with a significant glaucoma and anterior segment surgical load. The fellow operates 1 ½ day a week at the VA under supervision; however once competence is assured, he/she can perform cases independently. Urgent cases are performed at the main campus hospital.
2. Attending Clinics: The fellow is expected to be in the attending clinics when not performing other duties. The burden of work is not onerous. Clinics are varied in regards to clinical volume and breadth of practice.

Surgical Diversity:

The fellow will perform glaucoma lasers and surgical procedures including SLT, ALT, trabeculectomy, tube shunts (Baerveldt, Molteno, Clearpath, Ahmed), MIGS (TM stents, goniotomy techniques, viscodilation, XEN) as well as surgical revisions and novel glaucoma surgeries as they are developed. The fellow will perform IOL repositioning/exchanges, dislocated cataract surgery requiring sutured bag/lens support, iris reconstruction and vitrectomy.

Call:

The Fellow will be responsible for trauma call in the adult and pediatric hospital throughout the year. Weekends are split between all other subspecialty fellows for adult cases. Weekdays and Weekends are split between certain subspecialty fellows and our pediatric ophthalmology faculty. The first and third year resident are responsible for ER and inpatient consults.
The fellow will be responsible for urgent glaucoma issues that the resident service cannot handle. This load is remarkably small given the quality of the residency.

Research time:

The fellow has one half day every other week for research and is encouraged to submit a minimum of 1 publication.

Vacation:

The fellow is given 3 weeks vacation with dates provided to the program well in advance.

Scientific Meetings:

The fellow is encouraged to attend at least 1 meeting with a scientific presentation.

Career Planning:

Prior fellows from our Department are practicing around the world. They hold chair and faculty positions at academic departments, leadership roles in ophthalmology, run efficient private practices, and are involved in medical consulting.

Media:

The fellow will have access to over 6 terabytes and growing of Dr. Sheybani’s surgical library, which includes edited surgical videos (>100) used for surgical teaching.

Additional duties and resources:

Fellows will attend Grand Rounds on a weekly basis and will present at Grand Rounds at least once during the year. There are numerous educational lectures and research conferences that the fellow may attend if interested. Journal club occurs several times a year and is mandatory. The fellow has the opportunity to participate in a board review course, and mock oral board review held on campus in the spring.