Ophthalmology Education
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Read PDF Edition
THE MEDICARE APPEALS PROCESS P. 16 • RESEARCH BRIEFS P. 60 OCTA AND GLAUCOMA P. 62 • THE LATEST TECHNOLOGY AND DRUGS P. 70 WILLS EYE RESIDENT CASE SERIES P. 77 Review of Ophthalmology Vol. XXV, No. 5 • May 2019 • Charting Your Own Course • The Questionable Cataract • EHR Glaucoma Own Course • The Issues • Uveitic 2019 • Charting Your No. 5 • May Review of Ophthalmology Vol. XXV, MAMAYY 22019019 reviewofophthalmology.comreviewofophthalmology.com CHARTING YOUR OWN COURSE Experts share tips on how to go solo, but note that there are many challenges to overcome as well. P. 20 ALSO INSIDE: • EHR: Room for Improvement? P. 32 • The Questionable Cataract: Who Decides? P. 40 • How to Manage Uveitic Glaucoma P. 48 • Strong Moves for Weak Zonules P. 54 001_rp0519_fc.indd 1 4/16/19 10:03 AM +3.25 D RP0519_J & J Surgical.indd 1 4/5/19 9:57 AM REVIEW NEWS Volume XXV • No. 5 • May 2019 Calcium Intake and Age- Related Macular Degeneration In a recently published study, a secondary the association between calcium in- analysis of patients enrolled in the take and AMD have produced mixed Age-Related Eye Disease Study was results. Findings from the Blue conducted to determine whether an Mountains Eye Study show that Emily Chew, MD Emily Chew, association exists between dietary and calcium may be an important factor supplementary calcium intake and in limiting AMD development/pro- age-related macular degeneration. gression.1 Conversely, fi ndings from Emily Chew, MD, director of the di- the Nutrition Examination Survey vision of epidemiology and clinical ap- suggest that increased calcium in- plications at the National Eye Institute take is harmful in terms of macular at the National Institutes of Health, degeneration.2 However, Dr. -
Emily Y. Chew, M.D
CURRICULUM VITAE Name: Emily Y. Chew Place of Birth: Canton, China Citizenship: United States Marital Status: Married, three children Education 1971-1972 University of British Columbia, Vancouver, B.C., Canada (1st year sciences) 1972-1973 University of Toronto, Canada (2nd year of arts and sciences) 1974-1977 University of Toronto, School of Medicine (6-year program post-high school) 1977-1978 Internship in Internal Medicine, University of Toronto 1978-1981 Residency in Ophthalmology, University of Toronto 1982-1983 Fellowships in Medical Retina & Genetics Johns Hopkins University, Baltimore, (Irene Maumenee, MD, Arnall Patz, MD) University of Nijmegen, Nijmegen, the Netherlands (August Deutman, MD) Brief Chronology of Employment: 1983-1984 Lecturer, University of Toronto, Dept. of Ophthalmology 1985-1986 Assist. Professor, University of Toronto, Dept. of Ophthalmology 1987-1991 Visiting Scientist, Biometry & Epidemiology Program, NEI/NIH 1991-now Medical Officer, Division of Biometry & Epidemiology, NEI/NIH 2000-2017 Deputy Director, Division of Epidemiology and Clinical Applications, NEI. 2008-now Deputy Clinical Director, National Eye Institute 2009-now Chief of Clinical Trials Branch, National Eye Institute 2017-now Director, Division of Epidemiology and Clinical Applications, NEI/NIIH Honors and Other Scientific Recognition: 1981 Research Prize, Ophthalmology, U. of Toronto 1982 E.A. Baker Scholarship for Advanced Training in Ophthalmology 1986 Best Teacher’s Award, Ophthalmology, U. of Toronto 1996 American Academy of Ophthalmology Honors Award 2001 NEI Director’s Award (Achievements in the Age-Related Eye Disease Study) 2001 NEI Director’s Award (Compassion in patient care) 2003 NIH Director’s Award for Excellence in Mentoring 2004 Award of Merit in Retina Research, Schepens Lecture (Retina Society) shared with F.L. -
Plastics-Roadmap
Oculoplastics Roadmap Idea for New Intern Curriculum Interns should spend at least 1 Friday afternoon in VA Oculoplastics OR; Friday PM is already protected time. Interns should practice 100 simple interrupted stitches and surgeon’s knots in the Wet Lab before PGY2. Lectures (2 hour interactive sessions) Basic Principles of Plastic Surgery and Oculoplastics (Year A = Year B) Trauma Management (Year A: Orbit trauma. Year B: Eyelid trauma.) Eyelid malpositions and dystopias (Year A: Entropion, Ectropion, Ptosis. Year B: spasm, dystonias) Eyelid Lesions: benign and malignant (Year A = Year B) Lacrimal Disorders (Year A: Pediatric. Year B: Adult.) Orbital Disorders (Year A: Acquired. Year B: Congenital.) Core Topics (to be discussed on rotation) Thyroid eye disease management Ptosis evaluation and recommendations Ectropion/entropion management Orbital fracture management Orbit imaging modalities Home Study Topics Orbit anatomy Congenital malformations Surgical steps and instruments Clinical Skills (to be learned on rotation) External photography Lid and orbit measurements Chalazion and lid lesion excisions Punctal plug placement Local anesthetic injection of lids (important for call!) Schirmer Testing, Jones Testing NLD probing/irrigation Canthotomy/cantholysis (in the OR) Directed Reading (residents will read BCSC and article abstracts at home) BCSC Henderson et al. Photographic standards for facial plastic surgery. Arch Facial Plast Surg. 2005. Strazar et al. Minimizing the pain of local anesthesia injection. Plastic and Reconstructive Surgery. 2013. Simon et al. External levator advancement vs Müller’s muscle–conjunctival resection for correction of upper eyelid involutional ptosis. American Journal of Ophthalmology. 2005. Harris and Perez. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus. -
Contributing Lecturers
2019 CONTINUING EDUCATION PROGRAM June 14, 15 & 16 CONTRIBUTING LECTURERS Emily Chew, MD Emily Chew is the Director of the Division of Epidemiology and Clinical Applications (DECA), at the National Eye Institute, the National Institutes of Health in Bethesda, Maryland. She is also the Chief of the Clinical Trials Branch. Emily received her medical degree and her ophthalmology training at the U. of Toronto, School of Medicine, in Toronto, Canada. She completed her fellowship in Medical Retina at the Wilmer Eye Institute, the Johns Hopkins Medical Institutes and the U. of Nijmegen, the Netherlands Her research interest includes designing and conducting phase I/II clinical trials and epidemiologic studies in chronic retinovascular diseases such as age-related macular degeneration, diabetic retinopathy, the leading causes of blindness in the US. She also studies rare diseases such as ocular manifestation of von Hippel-Lindau Disease and others. She works extensively in large multi-centered trials headed by the staff of DECA including the diabetic studies, the Age-Related Eye Disease Study and the Age-Related Eye Disease Study 2, which she chairs. She also chairs the Actions to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study in participants with type 2 diabetes, working in collaboration with NHLBI and NIDDK colleagues. Emily Chew is the director of the clinical program in the Macular Telangiectasia Project (Mac Tel Project) which is an international study conducted in 22 clinics in 7 countries along with four basic science laboratories. She chairs the current international study, known as the AMD Ryan Initiative Study (ARIS), which evaluates the natural course of early AMD. -
Online Ophthalmology Curriculum
Online Ophthalmology Curriculum Video Lectures Zoom Discussion Additional videos Interactive Content Assignment Watch these ahead of the assigned Discussed together on Watch these ahead of or on the assigned Do these ahead of or on the Due as shown (details at day the assigned day day assigned day link above) Basic Eye Exam (5m) Interactive Figures on Eye Exam and Eye exam including slit lamp (13m) Anatomy Optics (24m) Day 1: Eye Exam and Eye Anatomy Eyes Have It Anatomy Quiz Practice physical exam on Orientation Anatomy (25m) (35m) Eyes Have It Eye Exam Quiz a friend Video tutorials on eye exam Iowa Eye Exam Module (from Dr. Glaucomflecken's Guide to Consulting Physical Exam Skills) Ophthalmology (35 m) IU Cases: A B C D Online MedEd: Adult Ophtho (13m) Eyes for Ears Podcast AAO Case Sudden Vision Loss Day 2: Acute Vision Loss (30m) Acute Vision Loss and Eye Guru: Dry Eye Ophthalmoscopy and Red Eye Eye Guru: Abrasions and Ulcers virtual module IU Cases: A B C D E Red Eye (30m) Corneal Transplant (2m) Eyes for Ears Podcast AAO Case Red Eye #1 AAO Case Red Eye #2 EyeGuru: Cataract EyeGuru: Glaucoma Cataract Surgery (11m) EyeGuru: AMD Glaucoma Surgery (6m) IU Cases: A B Day 3: Intravitreal Injection (4m) Eyes for Ears Podcast Independent learning Chronic Vision Loss (34m) Chronic Vision Loss AAO Case Chronic Vision Loss reflection (due Day 3 at 8 and and Systemic Disease pm) Systemic Disease (32m) EyeGuru: Diabetic Retinopathy IU Cases: A B Eyes Have It Systemic Disease Quiz AAO Case Systemic Disease #1 AAO Case Systemic Disease #2 Mid-clerkship -
The Evolving Management of Diabetic Retinopathy: Lessons from Wisconsin and Beyond
The Evolving Management of Diabetic Retinopathy: Lessons from Wisconsin and Beyond AuthorBlock: Lloyd P. Aiello1,2 1Joslin Diabetes Center, Boston, Massachusetts, United States; 2Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States; DisclosureBlock: Lloyd P. Aiello, KalVista Code C (Consultant), KalVista Code I (Personal Financial Interest), Novo Nordisk Code C (Consultant), Optos Code R (Recipient) Presentation Description Less than 50 years ago, diabetic retinopathy was a severe blindng disease with few therapeutic options and often poor outcomes. The advent of laser photocoagulation ushered in a new era where severe visual loss from proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) could be averted in the majority of patients. However, some degree of visual loss was still frequent and laser photocoagulation destroyed areas of retina leading to side effects and complications. The discovery that VEGF played a central role in both PDR and DME led to development of VEGF inhibitors and a revolution in the care of diabetic eye disease. As a result, visual loss was further reduced, previously unseen magnitudes of visual improvement were realized, and amelioration nonproliferative diabetic retinopathy severity was also observed. The clinical benefit in various patient cohorts and therapeutic differences between VEGF inhibitors have also been evaluated. These and numerous other developing therapies contiunue to make the clinical care of diabetic eye disease one of the longest and most rapidly evolving areas in ophthalmology. Throughout these many remarkable advancements, the fundamental robust understanding of the natural history and epidemiology of diabetic retinopathy provided by the Klein's and others have supported and guided the many clinical trial evaluations of these therapies. -
Print This Issue
January 2011 National Institutes of Health • Department of Health and Human Services • newsinhealth.nih.gov Inside News: 3 Protein Shapes... 4 Dialysis and Kidney Patients... College Drinking... Dietary Supplements Your Aging Eyes “You might find you’re holding your book farther away to read it. You How You See as Time Goes By might even start thinking your arms You may barely notice the changes just aren’t long enough,” says Dr. at first. Maybe you’ve found Emily Chew, a clinical researcher at yourself reaching more NIH’s National Eye Institute. “A good often for your glasses to and simple treatment for presbyopia see up close. You might is reading glasses.” have trouble adjusting to Cloudy areas in the lens, called glaring lights or reading cataracts, are another common eye when the light is dim. You problem that comes with age. may even have put on blue More than 22 million Ameri- socks thinking they were cans have cataracts. By age black. These are some of 80, more than half of us the normal changes to will have had them. Some your eyes and vision as cataracts stay small and have you age. little effect on eyesight, but As more Americans others become large and head toward retirement interfere with vision. Symp- and beyond, scientists toms include blurriness, expect the number of people with of disability in older adults,” says Dr. difficulty seeing well at night, lights age-related eye problems to rise Cynthia Owsley, an eye researcher at that seem too bright and faded color dramatically. You can’t prevent all the University of Alabama at Birming- vision. -
Oculoplastics/Orbit 2017-2019
Academy MOC Essentials® Practicing Ophthalmologists Curriculum 2017–2019 Oculoplastics and Orbit *** Oculoplastics/Orbit 2 © AAO 2017-2019 Practicing Ophthalmologists Curriculum Disclaimer and Limitation of Liability As a service to its members and American Board of Ophthalmology (ABO) diplomates, the American Academy of Ophthalmology has developed the Practicing Ophthalmologists Curriculum (POC) as a tool for members to prepare for the Maintenance of Certification (MOC) -related examinations. The Academy provides this material for educational purposes only. The POC should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all the circumstances presented by that patient. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any information contained herein. References to certain drugs, instruments, and other products in the POC are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved FDA labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law. -
University of Rochester Flaum Eye Institute
University of Rochester Flaum Eye Institute State-of-the-art eye care… it’s available right here in Rochester. No one should live with vision that is less than what it can be. People who have trouble seeing often accept their condition, not knowing that treatment is available — from the simplest of medications and visual tools to state-of-the-art surgical procedures. Now you can easily refer them to the help they need — all at the Flaum Eye Institute at the University of Rochester. See the dierence we can make in your patients’ quality of life. Refer them today to 585-273-EYES. University of Rochester Flaum Eye Institute A world-class team of ophthalmologists, sub- specialists, and researchers, the faculty practice is committed to developing and applying advanced technologies for the preservation, enhancement, and restoration of vision. Working through a unique partnership of academic medicine, private industry, and the community, we are here to serve you and your patients. One phone number for all faculty practice appoint- ments and new centralized systems make the highest quality eye care more accessible than ever before. Working together, our physicians provide a full range of treatment options for the most common to the most complex vision problems. Glaucoma Cataract Macular Degeneration Diabetic Retinopathy Orbital Diseases Low Vision Dry Eye Syndrome Refractive Surgery Optic Neuropathies Corneal Disease Oculoplastics Motility Disorders Comprehensive Eye Care All-important routine eye exams and a wide range of procedures are oered through the Comprehensive Eye Care service. Consultative, diagnostic, and treatment services are all provided for patients with conditions or symptoms common to cataracts, dry eye, glaucoma, and corneal surface disorders. -
ARMD from Spinach to Injection
1/19/17 Risk Factors determined by the Mayo Clinic • Age. Your risk of macular degeneraon increases as you age, especially aer age 50. Macular ARMD degeneraon is most common in people older than 65. • Family history of macular degenera6on. If someone in your family had macular degeneraon, you're more likely to develop macular degeneraon. From Spinach to Injec9on • Race. Macular degeneraon is more common in whites (Caucasians) than it is in other races. • Smoking. Smoking cigareTes increases your risk of macular degeneraon. • Obesity. Being severely overweight increases the chance that early or intermediate macular degeneraon will progress to the more severe form of the disease. • Diet. A diet that includes few fruits and vegetables may increase the risk of macular degeneraon. • High blood pressure. Diseases that affect the circulatory system, such as high blood pressure or high cholesterol, may increase the risk of macular degeneraon. Steven M. Newman, O.D., C.N.S. • Inflammaon. Your immune system can cause swelling of your body 9ssues, which may Board Cer9fied Optometric Physician increase the risk of macular degeneraon. Florida Board of Optometry • Cardiovascular disease. If you have had diseases that affected your heart and blood vessels (cardiovascular disease), you may be at higher risk of macular degeneraon Board Cer9fied Nutri9on Specialist American College of Nutri8on ARMD gene9cs Hippocrates – Alternate complement pathway – ARMS2/HTRA1 – HDL cholesterol pathway “He who does not know – Extracellular matrix – Angiogenesis pathway food, how can he – Vitamin D pathway understand the diseases of man?” 1 1/19/17 Our body was designed to absorb nutrients the old fashioned way…by eang natural foods rich in an9oxidants. -
ED Ophthalmology Guidelines
Ophthalmology Guidelines for Family Physicians & the Emergency Department Revised March 2018 Department of Ophthalmology Introduction 1 Referral Guidelines 2 Referral Categories 3 Driving to Ophthalmology Appointments 3 Patients Known to Ophthalmology 4 Contacting Ophthalmology 5 Contacting Winnipeg Ophthalmologists 5 On Call Ophthalmologist in Brandon 7 Contact Details for Retina Specialists 7 Management Guidelines 8 Chemical Injuries 8 Visual Phenomena 10 The Chronic Red Eye 11 The Acute Red Eye 12 Ocular & Peri-Ocular Pain 16 Blurred Vision & Loss of Vision 17 Orbital & Peri-Orbital Swelling 19 Eyelid and Lacrimal Pathology 20 Diplopia 21 Pupils 22 Trauma 23 Specific Paediatric Ophthalmic Presentations 29 Appendices 30 Triage Guidelines 30 Minimal Standards of Documentation 30 Visual Requirements for Driving 31 Eye Patches and Eye Shields 32 Ophthalmology Guidelines, revised March 2018 Department of Ophthalmology Use of Eye Drops and Eye Ointments 33 Everting the Upper Eyelid 34 Analgesia for Painful Eyes 35 Slit Lamp Basics 36 Using a Tonopen 39 Using an iCare Tonometer 41 Image Gallery 42 Ophthalmology Guidelines, revised March 2018 Department of Ophthalmology Introduction This document has been compiled by the Department of Ophthalmology to assist emergency physicians and family doctors in the management of patients presenting with ophthalmic complaints. It is not intended to be a comprehensive text on ophthalmic emergencies, but rather provide reasonable guidelines for acute management and referral. The first sections give advice on how and when to refer patients, how to deal with patients who have perviously been seen by an ophthalmologist, and contact details for the ophthalmologists who take call. The latter half details common presentations, recommendations for management in the Emergency Department and how urgently they should be referred. -
ICO Residency Curriculum 2Nd Edition and Updated Community Eye Health Section
ICO Residency Curriculum 2nd Edition and Updated Community Eye Health Section The International Council of Ophthalmology (ICO) Residency Curriculum offers an international consensus on what residents in ophthalmology should be taught. While the ICO curriculum provides a standardized content outline for ophthalmic training, it has been designed to be revised and modified, with the precise local detail for implementation left to the region’s educators. Download the Curriculum from the ICO website: icoph.org/curricula.html. www.icoph.org Copyright © International Council of Ophthalmology 2016. Adapt and translate this document for your noncommercial needs, but please include ICO credit. All rights reserved. First edition 201 6 . First edition 2006, second edition 2012, Community Eye Health Section updated 2016. International Council of Ophthalmology Residency Curriculum Introduction “Teaching the Teachers” The International Council of Ophthalmology (ICO) is committed to leading efforts to improve ophthalmic education to meet the growing need for eye care worldwide. To enhance educational programs and ensure best practices are available, the ICO focuses on "Teaching the Teachers," and offers curricula, conferences, courses, and resources to those involved in ophthalmic education. By providing ophthalmic educators with the tools to become better teachers, we will have better-trained ophthalmologists and professionals throughout the world, with the ultimate result being better patient care. Launched in 2012, the ICO’s Center for Ophthalmic Educators, educators.icoph.org, offers a broad array of educational tools, resources, and guidelines for teachers of residents, medical students, subspecialty fellows, practicing ophthalmologists, and allied eye care personnel. The Center enables resources to be sorted by intended audience and guides ophthalmology teachers in the construction of web-based courses, development and use of assessment tools, and applying evidence-based strategies for enhancing adult learning.