Department of Ophthalmology




The First Year of Residency

Residents:
» Dr. Scott Cole
» Dr. Adam Luka
» Dr. Azam Qureshi
Highlights:
» No call approx. last 2 months
» Topical, clear cornea cataract surgery training
» Chopping techniques and limbal relaxing incisions
» Tube shunts and trabeculectomies
» Penetrating keratoplasty procedures with observation on keratoprostheses
» Some opportunity to perform LASIK
» Competitive fellowship matches
» Protected research time

The three rotations for the third year residents (PGY-4) include a combined cornea/retina rotation, combined glaucoma/general rotation, and a block at the VAMC. During the retina oriented clinics of the cornea / retina block the senior resident will work alongside Dr. Julian Nussbaum. The clinical impressions are investigated further in our diagnostic imaging department where a full array of instruments are available. Included are standard retinal photography, fluorescein and indocyanin green angiography. These are generally done in a digital format with available optimization to guide impression and / or treatment. Standard 35mm photography is also available though less often employed given the capability of digital systems. Other modalities include standard OCT and a soon to be installed spectral domain high resolution OCT. Electrophysiology is also routinely available being administered by Dr. Alan Saul. The resident is expected to understand the indications for these and other studies as well as the interpretation of them. Approximately once per month an imaging conference is held presented by a resident and moderated by Dr. Nussbaum. The resident is also heavily involved with the retina service at the Augusta State Medical Prison where there is a very diverse extent of retinal pathology not as routinely seen at the main campus. The surgical retinal experience includes many lasers and injections done by the resident. While non-laser, non-injection based retinal procedures are generally performed by Dr. Nussbaum there are some which may be done partially or entirely by the resident.

The cornea rotation is generally at the main campus. The clinical experience is also bolstered by diagnostic imaging. Part of this experience includes an ultrasound biomicroscopy, corneal topography, the Pentacam, the anterior segment module for the HRT. Dr. Gupta is the director of the cornea and external disease service. On this service many advanced corneal pathologies are managed together with the resident. Typical surgeries the resident will have exposure to include, DSAEK, penetrating keratoplasty, lamellar keratoplasty, and the keratoprosthesis.

While refractive surgery is generally performed by Dr. Bogorad there can be opportunity for resident performed surgery depending upon how these patients are identified and patient consent. Additionally, the senior residents are typically primary surgeons on trauma surgery.

There is a uveitis clinic that runs monthly on this service as well. Dr. Nussbaum, Gupta and a rheumatologist make up the attending staff for this clinic. This service was established in academic year 2010 and provides a valuable service to our patients and experience for the residents.

The service at the VA hospital is widely scoped and provides considerable surgery. There is a close team of physician and resident staff in these clinics. Dr. Killingsworth is cornea trained and additionally has wide experience in glaucoma surgical management. Dr. Riffle is retina trained and also has considerable experience in general ophthalmology and plastics. Dr. Thomas provides oculoplastics and neuro-ophthalmology consultant services in that arena as well. A considerable number of the resident cataracts are done at this facility. Dr. Amie Squires does a majority of surgery with the seniors and they typically are doing clear cornea procedures with vertical chopping techniques.

The final rotation of the year is the general / glaucoma rotation. Dr. Ulrich's approach is that of providing comprehensive care of the eye patient. It can be easy to get highly focused onto a specific subspecialty while on those services. One of the key aims in Dr. Ulrich's clinic is to make sure all the various aspects of a patient's eye care are coordinated being careful to try to avoid overlooking specific issues. The bulk of your senior year MCG cataracts are done with Dr. Ulrich. His cases are nearly entirely topical and clear corneal. While the vertical chopping techniques are obtained at the VA much progress will be made in learning the horizontal techniques with Dr. Ulrich. Limbal relaxing incisions (considered by the ACGME to be a refractive procedure) also are routinely taught and done by the residents. The rotation involves weekly visits to the Augusta State Medical Prison where the diversity of pathology is considerable and the resident experience enhanced. There are a number of traumatic cataract cases in this venue and the resident may have opportunity to place capsular tension rings.

The glaucoma service is managed by Dr. Katie Bollinger. She works closely with her own clinic as well as the pediatric, retina and uveitis services. Being a referral service there will be much advanced glaucoma exposure to the resident staff. The resident will be able to perform tube shunts and trabeculotomies on Dr. Bollinger's service as well as learn the post-operative management of these procedures. OCT and HRT are readily available to enhance the diagnostic abilities. Humphrey and Octopus visual field systems are in place as well.