Introduction to the Glaucoma Fellowship at TEI
The Glaucoma Fellowship Program in the Department of Ophthalmology and Visual Sciences at the University of Nebraska Medical Center’s Truhlsen Eye Institute provides ophthalmology residency-trained physicians with a comprehensive experience in the clinical evaluation, specialized ancillary testing, diagnosis and medical and surgical treatments of all types of glaucoma. The fellowship also provides extensive clinical and basic science research opportunities in conjunction with the glaucoma clinician-scientist faculty, Drs. Deepta Ghate, Vikas Gulati, and Shane Havens. Dedicated weekly research time is provided, and faculty members will assist the design and conduct of research projects, and in the analysis of data and the preparation of papers and presentations.. Current areas of glaucoma research in the department include all aspects of aqueous humor dynamics, neurodegenerative conditions and their association with glaucoma, visual perception and glaucoma, activities of daily living and glaucoma and biomarkers for intracranial disease.
The purpose of this fellowship is to train physicians to become knowledgeable and skilled experts in the clinical and surgical management of glaucoma and anterior segment surgery. Additionally, the fellowship provides training and career opportunities for aspiring clinician-scientists who wish to play a role in basic science, translational, and clinical research to advance the management of glaucoma.
Experience of the Glaucoma Clinical Fellow
This one-year fellowship is designed to provide a broad clinical and surgical experience to establish a solid foundation in routine and complex glaucoma, anterior segment, and cataract surgeries. This is accomplished through several routes:
- Clinical Experience: Glaucoma and anterior segment clinics will include exam pearls and techniques, appropriate use and critique of specialized ancillary testing, diagnoses, and the management of all types of glaucoma under the supervision of glaucoma clinical faculty at Truhlsen Eye Institute and at the Omaha VA Medical Center Eye Clinic. Review of each clinic is held at the end of each day with the corresponding faculty member. Fellows are expected to fully manage their patients, including diagnostic, medical, and surgical aspects.
- Surgical experience: The fellow is actively involved in the preoperative preparation, surgical performance, and postoperative care of patients with glaucoma and complex cataracts. The surgical experience is designed to enable him or her to perform all surgical procedures related to glaucoma and complex cataract surgery. The fellow will work under the close supervision of Drs. Deepta Ghate, Vikas Gulati, and Shane Havens as primary surgeon and assistant on a large variety of surgical cases and techniques. Surgical experience will include selective laser trabeculoplasty, laser peripheral iridotomy, traditional trabeculectomy with anti-fibrotics and it revision, glaucoma tube shunt placement and revision, trabeculotomy, Micro Incision Glaucoma surgeries (iStent, gonioscopic assisted transluminal trabeculotomy or GATT), complex anterior segment surgery to include traumatic cataract, IOL scleral suturing, iridodialysis/cyclocialysis repair, trans-scleral cyclophotocoagulation and more. Clinical exposure to congenital glaucoma, juvenile glaucoma, primary open angle glaucoma, angle closure, routine and complex cataract and IOL dislocations, and secondary glaucoma is expected in this tertiary care center hospital-based ophthalmology center.
- Academic Conferences: The fellow will participate in Glaucoma Grand Rounds presentations, Glaucoma Journal Clubs, and work with the ophthalmology residents in the clinic and operating room. The fellow will have opportunities to prepare and deliver both informal and formal lectures, and will be encouraged to present original research at national meetings including ARVO, American Glaucoma Society, and the American Academy of Ophthalmology annual meetings.
- Research: There will be allocated research time for fellows interested in research. The 1 year Fellowship is Heed Compatible. Fellows that match at UNMC with an interest in future research are encouraged to apply for the prestigious Heed Fellowship awards.
Evaluation of the Fellow
Responsibility for evaluation of the fellow lies with Drs. Ghate, Gulati, and Havens. It will include the following areas:
- Clinical competence (ophthalmoscopy, gonioscopy, performance and interpretation of visual fields, overall diagnostic evaluation of the patient, formulation of a plan of management, general and specific knowledge regarding therapeutic options and techniques, understanding of the special problems attendant to the long-term management of a chronic disease like glaucoma). Patient education and interactions will also be evaluated.
- Surgical competence (appropriate indications for surgery, patient selection, anesthesia selection, preoperative preparation, intraoperative management, and postoperative care).
- Design of clinical studies (preparation of the protocol, patient selection, management, evaluation and analysis of the results)
- Ability to give oral presentations
- Ability to prepare papers for publication
- Leadership abilities
- Communication skills
- Overall assessment