Glaucoma Fellowship

Program Description

The one-year 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 two-year program adds an additional year during which the fellow can concentrate on a specific research area within glaucoma. This work can be either laboratory or clinical in nature. 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.
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 20 year data.
2. Dr. Siegfried leads an innovative translational investigation on the role of oxygen and oxygen metabolism in the development of glaucoma.
3. Dr. Bhorade is investigating the impact of glaucoma on a patient’s ability to perform their basic activities of daily living.
4. Dr. Lind is a Principle Investigator in the study of injectable prostaglandin analogues for the treatment of glaucoma.
5. Dr. Sheybani is involved in the development of investigational surgical devices for glaucoma and anterior segment surgery.

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. For example, clinic with Dr. Kass provides unique insight into glaucoma patients, some of whom have been followed for >40 years.

Surgical Diversity:
The fellow will perform glaucoma lasers and surgical procedures including SLT, ALT, trabeculectomy, tube shunts (Baerveldt, Molteno, Ahmed), MIGS (iStent, Trab360, trabectome) as well as surgical revisions and novel glaucoma surgeries as they are developed. With Dr. Sheybani, 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 several weekends of trauma call in the adult hospital throughout the year. Weekends are split between all other subspecialty fellows. The first and third year resident are responsible for ER and inpatient consults. The fellow, when on call, will attend surgical trauma cases (usually 1 per call weekend).
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.