Rotation and Clinical Responsibilities
Cincinnati Eye Institute
At any one time, there are at least two to three retina specialists seeing private patients in the main office. In addition, there is also a wide variety of pathology. These are very busy clinics and it would not be unusual for one of the attending physicians to see upward of 100 patients in a day. Fellows interpret ancillary testing, examine patients independently, and develop assessments and plans. The attending clinics provide the opportunity to develop clinical skills under the tutelage of fellowship faculty. The doctors run their clinics independently, but greatly enjoy the opportunity to teach fellows in clinic. Unlike many other fellowships, there is no fellow-run injection clinic, and faculty perform intravitreal injections and in-office procedures on their own patients, allowing fellows to maximize learning opportunities.
Retina Officer of the Day
A highlight of the fellowship is the Retina Officer of the Day clinic, termed “ROOTD.” This clinic is staffed by one fellow at a time and is fully staffed with technicians, photography, and a scribe. This is an urgent, same-day referral retina clinic used by referring eye doctors to triage and manage patients with acute retina problems. In addition, established patients are often seen in this clinic when they have an acute problem. In a typical half day, the fellow may see 10-25 patients, the majority of which are new patients with urgent referrals or new symptoms. The fellow sees and manages patients independently, but at all times has the support of a faculty member running their own clinic simultaneously in the same hallway, and is immediately accessible for questions. The ROOTD clinic is an innovative teaching approach to the triage and management of urgent retina consults, and is considered by alumni to be an important aspect of the fellowship.
University of Cincinnati Ocular Oncology
Fellows spend several months with Dr. Zelia Correa and Dr. James Augsburger at the University of Cincinnati Ocular Oncology clinic. This clinic provides exposure to management of ocular tumors, with a primary focus on tumors of the posterior segment. Fellows learn to diagnose, follow, and treat choroidal melanomas, including ultrasound echography, I-125 plaque radiotherapy, and fine-needle aspiration biopsy. Every other week while on the oncology rotation, fellows spend a half-day performing exams under anesthesia on children with retinoblastoma at the Cincinnati Children’s Hospital, widely considered among the top pediatric hospitals nationwide. Fellows graduate with a fellowship certificate in Vitreoretinal Surgery and Ocular Oncology, and are trained to incorporate ocular oncology into their future clinical practice.
University of Cincinnati Hoxworth Retina Clinic
Fellows see patients in the ophthalmology clinic at the University of Cincinnati Hoxworth Center, the main eye clinic for the UC ophthalmology residency program. Fellows have great responsibility in this setting. Resident retina clinics are staffed with fellows autonomously or with the fellows and a retina faculty member. Lasers are performed in the mornings before clinic, and all intravitreal injections are performed in a separate, resident-run injection clinic, freeing up valuable time for fellows to see patients in this busy, weekly retina clinic. The UC retina clinic provides ample opportunity for fellows to interact one-on-one with the residents, and provides a healthy balance of autonomy and graduated supervision. The fellows have block time each week with a retina faculty member to operate on patients from the Hoxworth clinic. In addition, second-year fellows will soon be able to perform routine retina surgeries autonomously at UC.
Cincinnati Children’s Hospital Medical Center
Fellows get in-depth exposure to pediatric retina at Cincinnati Children’s Hospital, consistently among the top-ranked Children’s Hospitals in the nation. Patients travel from all over the world for care at CCHMC. On select rotations, the fellow will spend a half day bi-weekly in the pediatric retina clinic with Dr. Robert Sisk. Clinical evaluations include inherited retinal diseases, developmental malformations, trauma, retinal detachments, and retinopathy of prematurity, among other diseases. While on this rotation, fellows spend one day every other week in the operating room at Cincinnati Children’s Hospital performing examinations under anesthesia, electroretinography, laser and intravitreal pharmacologic treatments, and various surgical procedures on infants and children. There is the option of additional training in ROP screening and treatment for those interested.
Cincinnati Veterans Affairs Medical Center
Fellows have a weekly resident-run retina clinic at the VA. These clinics are staffed either by a retina faculty member or by the second year fellow.