Eye Surgeons of Indiana Optometry Residency Program Curriculum Outline
Program Description:
Eye Surgeons of Indiana Optometry Residency is a 13-month post-graduate ocular disease and per-operative care program. Our program will help develop exceptional clinical skills and an extensive ocular disease knowledge base for one optometrist under the guidance of the doctors at Eye Surgeons of Indiana. The new optometry graduate will be secured through the ORMatch process. The resident doctor will train at our practice from July 1st to July 31st of the following year. During the first month of the program there will be an overlap between the incoming resident doctor and outgoing resident doctor. The outgoing resident will assist the Eye Surgeons of Indiana faculty and staff in helping the new resident become acclimated with the practice schedule, clinical flow, and electronic health records. The resident doctor will work closely with all the doctors at Eye Surgeons of Indiana, as well as assist in precepting 4th-year optometry externs. During the program, learning will be promoted through instruction during the clinic day and assigned didactic work. Some administrative time will be allotted for the resident as seen fit, but some study time will be required outside of clinic hours. At the conclusion of the program, the resident doctor will be expected to have mastered clinical skills, a broad ocular disease knowledge base, confidence in evaluating anterior segment surgical cases and assisting in developing surgical plans, performing various ocular procedures, managing ocular emergencies, and being a confident public speaker.
Section I: Conditions/Skills/Cases to be Mastered
Standard and Refractive Cataract Surgery Peri-operative Care
- Master the clinical skills needed to complete a thorough cataract
- Understand how to interpret the diagnostic tools used for a cataract This will include biometry, topography, b-scan, and optical coherence tomography.
- Become knowledgeable on the different intraocular lenses (IOLs) used with cataract Know how the optics of each work, and the pros and cons of each IOL.
- Develop the confidence to routinely make an IOL recommendation to patients, as well as a refractive target.
- Become proficient in discussing refractive goals and patient visual demands to develop a refractive target and final surgical
- Master a post-operative exam and understand how to manage and treat post-operative
- Be trained to perform YAG
- Develop communication skills to assist with the co-management process with our practice's 40o+ referring optometrist.
Advanced ocular surface disease diagnosis and treatment
- Master the clinical skills needed to complete a thorough ocular surface disease evaluation, including using a meibomian gland expresser, an applicator assessing corneal innervation status, and corneal stain.
- Understand how to interpret the diagnostic tools used for an ocular surface disease This will include dry eye questionnaire, topography, and meibography.
- Become proficient in discussing and developing a plan to rehabilitate a patient's ocular
- Become proficient in completing thermal lid procedures including LipiFlow, iLux, TearCare, and Intense Pulsed Light (IPL).
- Learn the benefits of using amniotic membranes to promote corneal healing and become proficient in inserting and removing.
- Learn how to diagnosis, manage, and treat neurotrophic keratitis with advanced therapeutics including autologous serum tears and neurotrophic growth factor.
Cornea Clinic - Therapeutic and Surgical Management
- Master the clinical skills needed to complete a thorough cornea
- Understand how to interpret the diagnostic tools used for a cornea This will include topography, anterior segment optical coherence tomography, and endothelial cell count.
- Be trained to evaluate and educate patients on what to expect when signing up for surgical cornea cases. Such surgical cases will include foreign body removal, superficial keratectomy, lamellar keratectomy, pterygiectomy, corneal collagen cross-linking,endothelial keratoplasty, and penetrating keratoplasty.
- Understand the risks/benefits/alternatives of such surgical cases and how to manage them post
- The resident doctor will be trained to perform procedures that fall within the scope of optometry practice, including foreign body removal, superficial keratectomy, suture removal, and assisting with corneal collagen cross-linking.
- Learn the benefits of using amniotic membranes to promote corneal healing and become proficient in inserting and removing.
- Develop the confidence to routinely manage infectious keratitis with advanced Learn how to culture infectious ulcers and use interpretation to guide treatment.
- Learn how to diagnosis, manage, and treat neurotrophic keratitis with advanced therapeutics including autologous serum tears and neurotrophic growth factor.
Glaucoma evaluation and treatment
- Master the clinical skills needed to complete a thorough glaucoma
- Understand how to interpret the diagnostic tools used for a glaucoma This will include pachymetry, corneal hysteresis, optical coherence tomography, optical coherence tomography - angiography, and fundus photography.
- Become proficient in making diagnosis and recommended treatment
- Emphasis will be made on the benefits of interventional glaucoma, including selective laser trabeculoplasty and micro-invasive glaucoma surgery (MIGS).
Retina evaluation/triage
- Master the clinical skills needed to complete a thorough retinal
- Understand how to interpret the diagnostic tools used for a retinal This will include optical coherence tomography, optical coherence tomography - angiography, and fundus photography.
- Review of the key studies that guide recommendations for nutritional supplements for optimal retinal
- Review of the key studies that guide treatment patterns for retinal specialists with intravitreal injected therapeutics.
- Become proficient in describing retinal pathology to a retinal specialist and understand retinal urgencies and emergencies.
Refractive surgery peri-operative care
- Master the clinical skills needed to complete a thorough refractive surgery evaluation for LASIK, PRK, phakic IOL, and refractive lens exchange.
- Understand how to interpret the diagnostic tools used for a refractive surgery evaluation. This will include topography/tomography, anterior segment optical coherence tomography, and posterior segment optical coherence
- Become proficient in discussing refractive goals and patient visual demands to develop a refractive target and final surgical
- Master a post-operative exam and understand how to manage and treat post-operative
Collaborative Health Care
- Develop clinical skills to assess ocular pathology that has correlation to systemic
- Learn how to order lab panels and diagnostic imaging that will help guide clinical diagnosis and
- Develop skills to communicate concisely with health care providers to manage systemic complications suggestive from ocular findings.
Emergency Eye Care
- Develop the clinical skills to evaluate, manage, and treat ocular emergencies that will include acute infectious pathology, acute ocular disease progression, trauma, and ocular manifestations from systemic
- Develop communication skills to coordinate care with ocular specialists and health care providers
- Develop triage skills while covering call for the practice approximately six weekends a
Didactic Pursuits
Time each week will be dedicated to the resident working on developing requested case reports, presentations, or studying recommended journals. At the residency director's discretion, this time may be adjusted so the resident can shadow in our practice's Retina Clinic, LASIK Center, and Surgical Care Center. It will be expected for the resident to do some didactic work outside of clinic hours.
Phases of Clinic Autonomy
Phase 1: This phase is expected to last for one month. During this phase, the incoming resident and outgoing resident will overlap. The outgoing resident will play a key role in helping the incoming resident become acquainted with our practice. The resident will learn our clinic flow, electronic health records (EHR), and become proficient in all diagnostic testing. The incoming resident will be working patient's up from start to finish and consulting with the outgoing resident. The incoming resident will master the skills of a post-operativeexam. Regular chart reviews will be completed by the residency director to assure the incoming resident has become competent with the EHR and proper documentation. The resident will be expected to complete cataract surgery post-operative exams independently by the end of phase 1.
Phase 2: This phase is expected to last for three months. During this phase, the resident will be working closely with our staff doctors. The resident will be expected to work surgical consult patients up from start to finish, develop an assessment and plan, document accurately in the EHR, and consult with the staff doctor concisely. The resident will be expected to independently see and check out post-operative patients and some medical eye-examination follow-ups. Training will begin under close observation for the resident to perform advanced procedures, including foreign body removals, use of amniotic membranes, and dry eye thermal lid procedures. The resident will begin being placed in the on-call rotation with other staff doctors. Regular chart reviews will be completed by the residency director to ensure proper billing and coding.
Phase 3: This phase is expected to last for nine months. This phase will include all initiatives from phase 2, but autonomy will expand. The resident will have the opportunity to independently fill-in and cover a staff doctor's schedule when a doctor is out. This clinic schedule may include a broad patient variety including surgical consults, medical eye exams, post-operative visits, and emergency eye care. Advanced procedure training will expand and include superficial keratectornies and YAG capsulotornies. The residency director will be available for consultation and chart review when requested.
Section III: On-Call Requirements
The resident will be placed in a rotating on-call schedule with other Eye Surgeons of Indiana staff doctors. When on-call, the resident is expected to be available to cover emergency calls from Friday at 5pm until Monday at 8am. Eye Surgeons of Indiana will have another staff doctor on back-up call for support if needed. The resident doctor should be expected to cover call approximately six weekends out of the year.
Section IV: Sample Presentation Schedule and Publishable Quality Work
The resident will have dedicated time on a weekly basis to meet with Eye Surgeons of Indiana faculty for presentations,case review, and discussion. In some cases, this may coincide with meetings with fourth year IUSO students.
Week 1-Eye Surgeons of Indiana OD presentation Week 2 - Resident Case Report
Week 3 - Eye Surgeons of Indiana MD presentation Week 4 - Journal Club
Publishable Quality Work Requirements
- The Resident will be required to develop one COPE-approved continuing education course and present it at Eye Surgeons of Indiana-sponsored CE or outside seminar/conference.
- The Resident will be expected to develop at least one publishable quality paper, case report, or poster.