Introduction to the Glaucoma Fellowship at TEI
The Glaucoma Clinical fellowship 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. Vikas Gulati, Deepta Ghate, and Shane Havens. Dedicated weekly research time is allotted to meet Heed Fellowship requirements. Current research in the Glaucoma department involves all aspects of aqueous humor dynamics, neurodegenerative conditions and their association with glaucoma, and ophthalmic evaluation in the setting of repetitive head trauma in athletes.
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 introduces the concept and career opportunities of the Clinician-Scientist and their role in basic science, translational, and clinical research in advancing the management of glaucoma.
Experience of the Glaucoma Clinical Fellow
This 1 year fellowship is designed to provide a broad clinical and surgical experience in establishing 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.
- Surgical experience: The fellow will work under the close supervision of Drs. Shane Havens, Vikas Gulati, and Deepta Ghate 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 clinic.
- Academic Conferences: The Fellow will participate in Glaucoma Grand Rounds presentations, Glaucoma Journal Clubs, and work with the residents in the clinic, operating room, and in modifying the current glaucoma lecture series. The fellow will be encouraged to present original research at national meetings including ARVO, American Glaucoma Society, and the American Academy of Ophthalmology annual meetings.
- Research: Each Wednesdays is dedicated to research and includes a 1 hour research meeting with Dr. Carol Toris and the entire Glaucoma research team. 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.
By the end of the Fellowship Program, he/she should be competent in preparing and delivering informal teaching lectures as well as presentations of a more formal nature at conferences.
Emphasis is placed on both clinical care and research. Fellows are expected to fully manage their patients, including diagnostic, medical, and surgical aspects, and to participate in research.
The clinical fellow is actively involved in the preoperative preparation, surgical performance, and postoperative care of patients with glaucoma and complex cataracts. This includes 2 half days each week in the operating room, with time spent in preoperative preparation and postoperative care. The surgical experience varies depending upon the fellow's skills and interest, and is designed to enable him or her to perform all surgical procedures related to glaucoma and complex cataract surgery.
The fellow is encouraged to participate in clinical research projects, supervised by various members of the staff. The fellow is also encouraged to present research projects in oral form and to prepare papers suitable for publications. They are assisted by members of the staff in the design and performance of these projects, and in the analysis of data and the preparation of papers and presentations.
Evaluation of the Fellow
Responsibility for evaluation of the fellow lies with Drs. Gulati, Ghate, 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 make oral presentations
- Ability to prepare papers for publication
- Leadership abilities
- Communication skills
- Overall assessment
Applications for the glaucoma fellowship should reach us before the beginning of October, because we plan to interview selected applicants during mid-October into late November in order to meet the deadline for submitting the match list in December. Information and forms relating to the fellowship matching program can be obtained from: Ophthalmology Fellowship Match, P.O. Box 7584, San Francisco, California 94120-7584, tel: (415) 447-0350.