To describe the more complex anatomy, embryology, physiology, pathology, microbiology, immunology, genetics, epidemiology, and pharmacology of the cornea, conjunctiva, sclera, eyelids,lacrimal apparatus, and ocular adnexa.
To describe the more complex congenital abnormalities of the cornea, sclera, and globe (e.g.,hamartomas and choristomas).
To describe, recognize, evaluate, and treat peripheral corneal thinning (e.g., inflammatory, degenerative, dellen-related, infectious, allergic).
To recognize the common conjunctival neoplasms (e.g., benign, malignant tumors).
To recognize and treat less common corneal or conjunctival presentations of degenerations (e.g., inflamed or atypical pterygium, band keratopathy).
To describe the epidemiology, differential diagnosis, evaluation, and management of Bitot’s spots.
To describe the epidemiology, differential diagnosis, evaluation, and management of Thygeson’s superficial punctate keratopathy.
To understand more complex corneal optics and refraction (e.g., irregular astigmatism).
To correlate the concordance of the visual acuity with the density of media opacity (e.g., cataract) and to evaluate the etiology of discordance between acuity and media examination findings.
To describe more complex ocular microbiology and describe the differential diagnosis of more complicated corneal and conjunctival infections (e.g., complex or atypical bacterial fungal, Acanthamoeba, viral, or parasitic keratitis).
To describe differential diagnosis, evaluation, and treatment of interstitial keratitis (e.g., syphilis, viral diseases, inflammation).
To describe more complex differential diagnosis of the “red eye” (e.g., autoimmune and inflammatory disorders causing scleritis, episcleritis, conjunctivitis, orbital cellulitis).
To describe key features of trachoma, including epidemiology, clinical features and staging, complications (e.g, cicatricization), prevention (e.g., facial hygiene), and topical and systemic antibiotic treatment (especially in hyperendemic regions) and surgery (e.g., tarsal rotation).
To describe more complex mechanisms of traumatic and toxic injury to the anterior segment (e.g., long-term sequelae of acid and alkali burn, complex lid laceration involving the lacrimal system, full-thickness laceration).
To describe the differential diagnosis and the external manifestations of more complex anterior segment inflammation (e.g., acute and chronic iritis).
To describe the more complex principles of ocular pharmacology of anti-infective, antiinflammatory and immune modulating agents (e.g., use of topical non-steroidal and steroidal agents, topical cyclosporine).
To recognize and treat large or atypical pterygia that may require surgery.
To describe and treat corneal and conjunctival foreign bodies.
To diagnose and describe the treatment of severe corneal exposure (e.g., lubrication, temporary tarsorrhaphy)
To recognize and treat common malpositions of the eyelids (e.g., entropion, ectropion, and ptosis) as they apply to secondary corneal disease.
To recognize and treat recurrent corneal erosions.
To recognize and treat foreign body, animal, and plant substance injuries.
To recognize, evaluate, and treat chronic conjunctivitis (e.g., chlamydia, trachoma, molluscum contagiosum, Parinaud’s oculoglandular syndrome, ocular rosacea).
To describe the epidemiology, clinical features, pathology, evaluation, and treatment of ocular cicatricial pemphigoid.
To recognize, evaluate, and treat the ocular complications of severe diseases, such as chronic exposure keratopathy, contact dermatitis, and Stevens-Johnson syndrome.
To describe the epidemiology, clinical features, pathology, evaluation, and treatment of peripheral corneal thinning or ulceration (e.g., Terrien’s marginal degeneration, Mooren’s ulcer, rheumatoid arthritis-related corneal melt).
To understand ocular surface transplantation, including conjunctival autograft/flap, amniotic membrane transplantation, limbal stem cell transplantation.
To understand the surgical indications (e.g., Fuchs’ dystrophy, aphakic/pseudophakic bullous keratopathy), surgical techniques, and recognition and management of postoperative complications (especially immunologically-mediated rejection) of corneal transplantation (e.g, penetrating, lamellar).
To understand the preoperative assessment, patient selection, surgical management, and postoperative care of refractive surgical techniques, including keratotomy (radial, astigmatic), photoablation (photorefractive, phototherapeutic, LASIK), corneal wedge resection, thermokeratoplasty, intracorneal rings, phakic intraocular lens and clear lens extraction.
Patient Care
To perform more advanced techniques, including keratometry and pachymetry.
To understand the indications for and techniques for performing stromal micropuncture.
To understand the indications for and techniques for application of corneal glue.
To assist in more complex corneal surgery (e.g., penetrating keratoplasty and phototherapeutic keratectomy).
To perform more advanced tests for dry eye (e.g., modified Schirmer tests, assessment of tear break up time, fluorescein dye testing, Rose Bengal dye).
To perform a more complex pterygium excision, including conjunctival grafting.
Professionalism
To treat patients with respect and compassion at all times
To treat clinical and administrative staff with respect
To treat medical students with respect and strive to create an atmosphere conducive to education
To arrive on-time for clinical experiences
To prepare in advance for surgical experiences
To work to become part of the clinical team
To work with the faculty, staff, fellow and other residents on the service to determine your responsibilities
To remain flexible and offer to help out with the responsibilities of others when you can
To remain visible and available to participate in clinical care throughout the clinical session. If you leave the clinical care area make sure that other members of the service know where you are and why
answer your pager within 10 minutes of being paged.
Interpersonal and communication skills
To communicate your name and role on the service to patients and their families.
"Hello, I'm Dr. Resident, I'm a resident working with Dr. Attending today."
To present patients to the attending in a succinct but complete way
To maintain timely and legible medical records
To talk when you should be talking, listen when you should be listening
Practice-based learning and improvement
To learn to recognize feedback from faculty, fellows, fellow residents, patients and students
To accept that feedback constructively and work to improve based on it
To accept your role as a teacher as well as a learner. Work to educate students, fellow residents, faculty, staff and patients
Systems based practice
To work for the benefit of your patients to communicate with other health care provider
To act as an advocate for your patient within the health care system
To become aware of the costs of diagnostic and therapeutic interventions. Consider these costs as you recommend and prescribe these interventions.
