Ophthalmology Commons^™

Pentosan Polysulfate Sodium (Pps, Elmiron) Maculopathy Demonstrates The Importance Of Coordinated Care From A Low Vision Perspective, Charlotte I. Spada Od, Stephanie Schmiedecke Barbieri Od, Patricia Sanchez Diaz Dvm, Phd, Jeffrey Rabin Od, Phd

Optometric Clinical Practice

Background: Pentosan polysulfate sodium (PPS, Elmiron®) is a widely used medication to reduce pain caused by interstitial cystitis, a bladder disorder most often affecting females. PPS maculopathy is a novel form of toxic retinal disease often not recognized or mistaken for other retinal conditions such as macular degeneration due to the initial similarities on fundus exam. However, when visualized using fundus autofluorescence, affected eyes show characteristic hyper/hypo-autofluorescent patterns.

Case report: A patient taking PPS for 10 years presented with macular changes and complaints of blurry vision and nyctalopia. Clinical, electrodiagnostic, and genetic testing were performed including fundus autofluorescence and …

Independent Associations With Research Productivity Among U.S. Academic Ophthalmologists Using The Us-Aofd, Brenton T. Bicknell, Josephine Rudd Zhong Manis, Yejin Heo, Haley Chishom, Lance Dzubinski, Taylor L. Aaserud, Alvina Liang, Shayan Massoumi, Thanushri Srikantha, John Stoffer, Guihua Zhai, Basil K. Williams Jr, Steven E. Brooks, Robert Tauscher

Journal of Academic Ophthalmology

Background: Scholarly productivity is a key marker of achievement in academic ophthalmology, influencing promotion, research support, and leadership opportunities. Prior studies have reported variation by gender, subspecialty, and rank, but few applied regression methods to identify independent predictors.

Purpose: To evaluate demographic, academic, and subspecialty factors associated with research productivity among U.S. academic ophthalmologists and to identify independent predictors through multivariable regression.

Methods: This cross-sectional study included 4,028 ophthalmologists across 126 accredited U.S. residency programs using the U.S. Academic Ophthalmology Faculty Database (US-AOFD). Faculty demographics and academic information were obtained from institutional websites, and bibliometric data (publications, …

Evaluating The Efficacy Of Dry Lab Cataract Simulation For Medical Students, Ashley Choi, Andrew Chen, Miel Sundararajan, Karine D. Bojikian, Anthony Chung, Shu Feng

Journal of Academic Ophthalmology

Background: Cataract surgery is a major component of ophthalmologic surgical training. However, medical students often lack early exposure to intraocular surgery, limiting their ability to assess their interest in the field.

Purpose: To evaluate the educational impact of a cataract surgery dry lab workshop for medical students using the Kitaro Anterior Segment Dry Lab Kit.

Methods: The workshop included a faculty-led presentation on eye anatomy, cataract formation, and cataract surgery, followed by hands-on practice. Pre- and post-workshop questionnaires were conducted to evaluate students’ knowledge in cataract surgery, interest in ophthalmology, interest in microsurgery, and evaluation of the …

Effect Of Pre-Training Patients Using A Self-Directed Slideshow Presentation On Visual Field Reliability In First-Time Test Takers, Lillian M. Centlivre B.S., Derek Zahnleuter B.S., Rahul Babu B.S., Chaesik Kim, Kaitlin Ziadeh Md, Hanna Simmons Md, Vivian Rajeswaren Md, Aleskey Parker Williams Do, Jacob Im Md, Aleksey Mishulin Md, Faisal Ridha Al-Timimi Md, Hassan Tokko

Medical Student Research Symposium

Title: Effect of Pre-Training Patients Using a Self-Directed Slideshow Presentation on Visual Field Reliability in First-Time Test Takers

Authors: Lillian Centlivre BS, Derek Zahnleuter BS, Rahul Babu BS, Chaesik Kim BSEE, Kaitlin Ziadeh MD, Hanna Simmons MD, Vivian Rajeswaren MD, Aleksey Parker Williams DO, Jacob Im MD, Aleksey Mishulin MD, Faisal Ridha Al-Timimi MD, Hassan Tokko MD

Background: Visual field (VF) testing is essential for detecting glaucoma, but reliability is limited by patient inexperience and poor fixation. Prior studies report VF test reliability around 59%, primarily attributed to increased fixation loss (FL). Other studies note 75.9% reliability using training videos …

Expansion Of A Self-Guided Curriculum And Validation Of A Self-Assessment Tool For Ocular Examination Skills, Maria Lee, Irene Pak, Aryan Chaychian, Isabell Kassaye, Adam Alyafaie, Neeti Parikh, Madeline Yung

Journal of Academic Ophthalmology

Background: Public interest in vision health is growing, yet ophthalmology remains underemphasized in medical education due to time constraints associated with in-person instruction.

Purpose: To demonstrate effectiveness of self-guided e-learning modules for ocular examination skills and to determine whether self-assessments can reliably assess medical student proficiency in these skills.

Methods: Medical students at a single institution participated in a skills workshop. Group 1 completed self-guided modules for visual acuity, confrontational visual field testing, pupil examination, and extraocular motility evaluation. Group 2 completed a self-guided module for the slit lamp anterior segment examination. Afterward, each student completed a …

Rare Case Of Visual Hallucinations In A 60-Year-Old Female With A Recurring Pituitary Macroadenoma, Angelica Alday, Farah Qureshi, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Pituitary adenomas are the third most frequently occurring primary intracranial tumor and are benign neoplasms that can have profound clinical implications. While most of these masses cause hormone hypersecretion, they may also be clinically silent until they elicit symptoms of mass effect, including severe headaches and visual field defects such as bitemporal hemianopia. This report highlights an atypical presentation of a pituitary adenoma that could be valuable for internists to consider when forming a differential diagnosis for patients with hallucinations. We discuss a case of a 60-year-old woman with a recent history of multiple emergency department visits for ongoing urinary …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Low-Dose Bevacizumab Treatment For Retinopathy Of Prematurity, Makayla Ayres, Katherine Brown Md

Research Days

Background: Retinopathy of prematurity (ROP) is an eye disease that affects very premature infants and causes blindness. Treatment for ROP consists of anti-VEGF intravitreal injections (e.g., bevacizumab), laser therapy, and cryotherapy. The concern of anti-VEGF intravitreal injections is systemic toxicity and potential detrimental effects on these developing infants. In research trials, doses as low as 0.031 mg of bevacizumab have been shown to be effective in treating ROP. However, in clinical practice, the most common doses used are 0.125-0.25 mg.

Objectives/Goal: At CMKC, 0.075 mg doses of bevacizumab have been used to treat Type 1 ROP since 2022. We aim …

Impact Of The Acgme Merger On Ophthalmology Match Success: A Pre- And Post-Merger Comparative Analysis, Anna Flts

Rowan-Virtua Research Day

Background

In 2020, the ACGME merger unified the residency match process for MD and DO applicants into a single, standardized system. The merger aimed to promote equity in graduate medical education by streamlining training pathways and matching processes across applicant backgrounds.

Hypothesis

Despite the merger’s goal of standardization and equity, disparities in ophthalmology match outcomes between MD and DO applicants may persist.

Methods

Data from the SF Match and AUPO were collected for ophthalmology applicants from 2016 to 2024. Applicants were divided into pre-merger (2016–2019) and post-merger (2020–2024) cohorts. Match rates for MD and DO applicants were calculated and compared …

Cross-Sectional Analysis Of International Rotations Among Ophthalmology Residency Programs, Malcolm M Kates, Riley Ct Duke, Krupa H. Patel, Russell W Read

Journal of Academic Ophthalmology

Background: Applicants to ophthalmology residency programs have increasingly expressed interest in international surgical rotations. As such, ophthalmology residency program directors (PDs) have expanded international offerings to meet this desire but the true number of residency programs with international offerings is unknown. Methods: In February 2023, the official residency websites of all 125 accredited US-based ophthalmology residency programs were analyzed for any mention of international rotations. Websites were identified using a Google™ search by entering the program name and “ophthalmology residency.” All websites were surveyed for information regarding international rotations including the presence/absence of an international rotation and any additional information …

A Diagnostic Challenge—Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md

Books, Presentations, Posters, Etc.

Introduction: •TINU Syndrome: Tubulointerstitial Nephritis and Uveitis  rare multi-system syndrome  has renal manifestations typical of acute interstitial nephritis (AIN), in addition to bilateral anterior uveitis  not well-understood •Thought to be an immune-mediated process, although mechanisms for disease remain unclear  Likely secondary to a combination of genetic predisposition and certain environmental exposures •Genetic predisposition:  specific HLA phenotypes  possibly an auto-antigen to modified C-reactive protein (mCRP) •Potential triggers:  Infections: tuberculosis, EBV, varicella zoster, chlamydia, toxoplasma  Medications: antibiotics (β-lactams, meropenem, azithromycin, levofloxacin), NSAIDs, goreisan (Chinese herb)  Endocrine diseases: hypoparathyroidism, hyperparathyroidism, rheumatoid arthritis, IgG4-related autoimmune …

Representation Of Women At Select Academic Ophthalmology Institutions In The United States, Hazem M Mousa, Camryn Thompson, Sri Meghana Konda, Keke Liu, Jay Rathinavelu, Terry Lee, Katherine Peters, Kevin J. Jackson, Laura Enyedi, Pratap Challa, Sharon Fekrat

Journal of Academic Ophthalmology

Purpose: To investigate the representation of women among ophthalmology faculty members at select academic institutions in the United States (US).

Design: Cross-sectional study

Subjects: Clinical faculty members at the top 20 academic ophthalmology institutions in the U.S. according to US News and World Report ranking

Methods: Gender as reported on institutional websites either directly or via pronouns, academic rank, medical school graduation year, and subspecialty were collected about clinical faculty members with MD, MD/PhD, MBBS or DO from their respective institutional websites. The number of publications for each faculty member was collected using Scopus ® (Elsevier, …

Cataract Simulator Training And Medical Student Attitudes Towards Ophthalmology, Victor Sanchez, Christian Diaz, Zachary Elkin, Laura Palazzolo, Andrea Blitzer, Manjool Shah, Christina R. Prescott

Journal of Academic Ophthalmology

Introduction: Simulation-based learning offers novel opportunities to teach ophthalmology to medical students and inspire interest in the field. Eyesi surgical simulators have become widely adopted by ophthalmology departments and may serve a purpose in medical student education. The purpose of this study was to evaluate the effect of cataract simulators on medical student attitudes towards ophthalmology and to assess their performance/improvement on a series of simulator tasks.

Methods: This was a prospective, cross-sectional study of 31 medical students. Participants were recruited through an email sent via the school’s listserv. Enrolled students completed a series of tasks on the …

Real-World Assessment (Rwa): Validity Evidence For Cataract Surgery With A Tool Your Faculty Will Actually Use, Grace L. Paley, Hui Zhao, Victoria M. Addis, Casey J. Beal, Geetha K. Davis, Gabriela M. Espinoza, Michael S. Lee, Stacy L. Pineles, Jamie B. Rosenberg, Robert T. Swan, Misha F. Syed, Evan L. Waxman, Susan M. Culican

Journal of Academic Ophthalmology

Background: We developed and implemented a real-world assessment tool (RWA) for resident surgery. It was designed to improve utility by reducing faculty and trainee cost (completion and training time, cognitive burden). RWA uses an entrustability scale where higher scores indicate a resident’s readiness for independent surgical practice. We describe a two-phase implementation of RWA and report validity evidence for cataract surgery assessment.

Methods: RWA was developed iteratively with resident and faculty input and piloted at a single residency program in phase 1. Phase 2 implemented RWA at 11 ophthalmology residency programs. The main outcome measures were 1) number …

Student Perceptions Of A Novel No-Cost Mobile Application For Ophthalmic History And Physical Examination, Soryan Kumar, Anagha Lokhande, Spandana Jarmale, Arnav Kumar, Samantha Rosenthal, Grayson W. Armstrong, Michael Migliori, Jamie Schaefer

Journal of Academic Ophthalmology

Background: Mobile applications have shown promise in enhancing medical trainee performance. In ophthalmology, a comprehensive mobile app can streamline the trainee education process by providing guidance for patient intake. Language barriers pose additional challenges impacting the quality of care for Spanish-speaking patients; literature has documented the adverse impacts of inadequate translation on quality of medical care for both trainees and patients. We aim to develop a free mobile application to guide medical trainees through the ophthalmic patient intake process and assist with Spanish-language translation.

Methods: We developed EyeCheck as a free mobile application for ophthalmology trainee education with …

Community Outreach Vision Screenings With Student-Led Eye Health Education Improves Student Eye Health Knowledge And Ophthalmic Health Disparities Awareness, Tannia M. Rodriguez, Karim Dirani, Samantha M. Arsenault, Ryan Lee Freedman, John-Michael Guest, Kathleen George, Collin Richards, Leo Hall, Mark S. Juzych, Anju Goyal

Journal of Academic Ophthalmology

BACKGROUND: The high prevalence of vision impairment and discordant lack of eye care utilization makes it essential to develop effective avenues to educate the future physician work force regarding basic eye health knowledge and ophthalmic health disparities. The public is often not aware that blinding eye diseases can begin asymptomatically. It is important for medical students to understand basic eye health knowledge, such as blinding eye diseases can begin asymptomatically. The purpose of this study was to assess the impact of an eye health knowledge 5-Point Teaching Intervention (5PTI) and structured patient intake form on student eye health knowledge and …

Investigation Of Change And Stability In Medical Students’ Ophthalmology Specialty Intention From Matriculation To Graduation: Gender And Racial/Ethnic Differences, Douglas Grbic

Journal of Academic Ophthalmology

Purpose

Using data from a national sample of graduating medical students, this study describes the patterns of change and stability in ophthalmology intentions relative to various other specialties and explains how those patterns vary by the intersection of gender and race/ethnicity.

Method

National survey data from MD-granting medical school graduates who matriculated between 2013-2014 and 2018-2019 and graduated by 2021-2022 were examined. The outcome consisted of four groups based on ophthalmology specialty intention at matriculation and graduation: non-ophthalmology, switched out, switched to, and reaffirmation. Percentages for “reaffirmation” and “switched to” were each compared to the median values for 13 major …

Emergency Department Slit Lamp Interdisciplinary Training Via Longitudinal Assessment In Medical Practice, Samara Hamou, Shayan Ghiaee, Christine Chung, Maureen Lloyd, Kelly Khem, Xiao Zhang

Department of Emergency Medicine Faculty Papers

INTRODUCTION: Eye emergencies make up nearly 3% of US emergency department (ED) visits. While emergency physicians (EP) should diagnose and treat these ophthalmologic emergencies, many trainees report limited ocular exposure and insufficient training throughout their residency to confidently conduct a thorough slit-lamp exam.

METHODS: We created an interdisciplinary, simulation-based mastery learning (SBML) curriculum to teach emergency attending physicians how to operate the slit lamp with multimodal learning methodology at a tertiary academic center. The EPs first demonstrate their initial slit-lamp competency with a 20-item checklist, and they then review the necessary curricular content to pass their independent readiness test before …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Using Three-Dimensional Printed Models For Trainee Orbital Fracture Education, Martina Rama, Lauren Schlegel, Douglas M. Wisner, Robert S. Pugliese, Sathyadeepak Ramesh, Robert Penne, Alison Watson

Wills Eye Hospital Papers

BACKGROUND: Three-dimensional printing is an underutilized technology in ophthalmology training; its use must be explored in complex educational scenarios. This study described a novel approach to trainee education of orbital fracture repair utilizing three-dimensional (3D) printed models as a teaching tool.

METHODS: Ophthalmology residents and oculoplastic fellows from multiple training institutions underwent an educational session on orbital fractures, learning through four different models. Participants analyzed orbital fractures through computerized tomography (CT) imaging alone and then utilizing CT imaging with the aid of a 3D printed model. Participants completed a questionnaire assessing their understanding of the fracture pattern and surgical approach. …

Factors Influencing Fellowship Training Among Ophthalmology Residents: A Pilot Study., Craig N Czyz, Rahul Kashyap, Laura L Wayman

Medical Education Articles

OBJECTIVE: There has been an increase in ophthalmology fellowship training programs and applicants. The current ophthalmology literature lacks any recent study examining factors influencing residents' decisions to pursue subspecialty fellowship training.

METHODS: An anonymous, 16-item survey was distributed to residents from a convenience sample of ophthalmology residency programs by their program directors or administrators.

RESULTS: A total of 72 residents and 9 interns from 9 distinct programs completed the survey. Eighty-two percent of respondents reported they have either applied or will apply for a fellowship position. Gender and race showed no significant association with fellowship application. Respondents perceived that obtaining …

The Transitional Year Internship: Five Classes Of Former Interns Reflect On Their First Clinical Year, Hana L. Haver, Kush K. Patel, Robert Chow

Advances in Clinical Medical Research and Healthcare Delivery

Objective:

The clinical internship (postgraduate year-1), which precedes many advanced residency training programs, are traditionally fulfilled by a transitional year (TY) or preliminary year of training in medicine or surgery. TY programs can take place in a variety of settings, ranging from community hospitals to large academic medical centers. In the present study, we sought to evaluate if resident physicians who completed a community hospital-based TY internship felt prepared for their subsequent specialty residency training.

Methods:

A cross-sectional survey was adapted and distributed to resident physicians who completed their TY internship at a university-affiliated community hospital in Baltimore, Maryland, between …

Insight, Volume 1, Issue 1, 2021

inSIGHT

Contents

10 - An Experience in the Wills Academic Global Ophthalmology Fellowship and Beyond
By Crystal Lee

14 - A Career of Honor and Humility: Interview with a Pioneer in Ophthalmology
By Eli Cehelyk

19 - Off Label Innovation: Discovering New Uses for Glaucoma Drops
By Glenn Oh

22 - The Present and Future of Artificial Intelligence in Ophthalmology
By Robert Abishek & Elliot Cherkas

26 - An Inside Look: Oculoplastics and “Droopy Eyelids”
By Payton Boere

31 - Narrative Medicine in Ophthalmology
By Martina Rama

Professional Coaching In Residency: A Novel Approach To Decrease Resident Burnout, Matthew Silbergleit, Shibandri Das, Mark S. Juzych, Pradeepa Yoganathan

Medical Student Research Symposium

Purpose: To implement and analyze an organizational level coaching program for ophthalmology residents at the Kresge Eye Institute (KEI) as the front-line method for prevention and management of physician burnout.

Background: Burnout is a well-documented stressor in medicine and has been shown to significantly increase unprofessional conduct and medical errors. A recent, promising model to tackle burnout in the medical field is coaching. The Harvard Business Review and American Medical Association have demonstrated the positive effects of coaching on professional performance and well-being.

Methods: We plan on utilizing the Kern Method to develop a resident wellness curriculum addressing resident burnout. …

Complication Rates In Resident Cataract Surgery After Elective Operating Room Shutdown During The Covid-19 Pandemic, Michael Schneider, Christian Mehregan Md, Collin Richards, Shibandri Das Md, Xihui Lin Md

Medical Student Research Symposium

Purpose: To assess the types of cataract surgeries being performed at one large eye institute from before and after the COVID-19 induced shutdown of elective surgeries in Spring 2020.

Methods: This is a retrospective chart review study of operative reports from resident performed cataract surgeries from January 1st, 2020 through July 31st, 2020. Cataract surgeries were categorized into Pre-COVID (Jan – Mar 2020) if they occurred prior to operating room (OR) shutdown on March 18th, 2020 and Post COVID for all cases which occurred after the shutdown orders were lifted (May – July 2020). A resident survey was also used …

The Role Of Simulators In Improving Vitreoretinal Surgery Training - A Systematic Review, Taha Muneer Ahmed, Rehman Siddiqui

Medical College Documents

Objective: To conduct an appraisal of current evidence regarding the effectiveness of EyeSi®-based training of vitreoretinal surgery.
Methods: The systematic review was conducted in July 2020, and comprised literature search on Cochrane Library, PubMed and Embase for articles regarding simulation training in vitreoretinal surgery. The shortlisted articles were subjected to qualitative analysis. Existing evidence was assessed, and predictions on how outcomes may be applied to improve vitreoretinal surgery training were made. The risk of bias of each study was calculated in line with the guidelines of the Cochrane Handbook.
Results: Of the 124 articles identified, 7(5.6%) were shortlisted; 5(71.4%) established …

Blue Light And Adult Sleep Outcomes, Andrew Caddas

Undergraduate Distinction Papers

This study investigated the effects blue light from self-luminous devices has on adult sleeping patterns. We investigated sleep quality and duration qualitatively with a randomized, double-blind, cross-over, placebo-controlled design with a wash-out period. Participants wore blue light blocking lenses or placebo lenses whenever they were using a self-luminous device throughout each day for one week. Each morning, participants filled out a survey to report their number of hours slept, time to fall asleep, and amount of time spent on self-luminous devices. Participants took the Pittsburgh Insomnia Rating Scale (PIRS) at the end of the one week trial (See Appendix A). …

Covid Intensive Care Unit Through The Eyes Of Ophthalmologists, Laura Drayer Turner, Dharshana Ramanathan, Sneha Melmane, Geeta Menon

HCA Healthcare Journal of Medicine

The disproportionate impact of COVID on the mortality and morbidity of people of black, Asian and minority ethnic (BAME) backgrounds has been recognised and is under investigation. Here we present a different impact: that on the psyche. As three doctors of BAME heritage, we shared an experience of being redeployed from ophthalmology to the COVID Intensive Care Unit. We share our reflections on the experience and lessons learned.

A Comparison Of Emoji Characters To Picture Optotypes, Simran Brar

Research Days

No abstract provided.

Antiviral Prophylaxis May Not Provide Benefit In Patients With Posner-Schlossman Syndrome, Patrick Lee

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Chee SP, Jap A. Cytomegalovirus anterior uveitis: outcome of treatment. Br J Ophthalmol. 2010 Dec;94(12):1648-52. https://doi.org/10.1136/bjo.2009.167767 for a patient on antiviral prophylaxis for recurrent episodes of Posner-Schlossman Syndrome.