CORNEA
Training in cornea and external disease occurs at the main campus, the VAMC, and in our West Augusta office. Dr. Amy Estes is chief of this service and she came to us from Wake Forest in 2013. Basic and advanced corneal pathologies are managed together with the resident with ready access to a procedure room for minor immediate interventions. Typical surgeries the resident will have exposure to include DSAEK, DMEK, penetrating keratoplasty, lamellar keratoplasty, ocular surface reconstruction techniques, management of ocular surface tumors, and keratoprosthesis. We have an award-winning ophthalmic photography team on staff. Modalities we currently employ include ultrasound biomicroscopy, Pentacam corneal tomography, and the anterior segment OCT.
RETINA/UVEITIS
Dr. Diego Espinosa works in the retina practice. Retina practice is mature with great breadth of pathology from standard to unusual diagnoses. Laser treatments and injections are done in our clinics and minor procedure rooms. Residents are heavily involved in these procedures.
A full array of imaging systems are available. Included are standard retinal imaging platforms. We have Optos, Spectral domain OCT, OCT-A, standard retinal photography, fluorescein and even ICG angiography remains available. Two full-time ophthalmic photographers orchestrate this and other clinical imaging. 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 one of the retina faculty. While non-laser, non-injection based retinal procedures are generally performed by faculty there are some which may be done partially or entirely by the resident. Dr. Sohail Khan (private retina specialist, and Class of 2010 alumnus) performs retinal surgery at the VAMC.
There is dedicated comprehensive uveitis clinic that runs monthly on this service as well. Dr. Oliver (AU Rheumatologist) make up the attending staff for this clinic. This service was established in FY2010 and provides a valuable service to our patients and experience for the residents.
GLAUCOMA
The glaucoma service is managed by Dr. Katie Bollinger. She manages not only her own clinic, but work closely with the pediatric, retina and uveitis services. Given the high number of referrals for management of complex glaucoma, residents will be exposed to a high volume of pathology while on this service. The resident will be able to perform tube shunts, trabeculectomies, and glaucoma lasers, as well as learn the post-operative management of these procedures. OCT and HRT are readily available to enhance diagnostic capabilities. Humphrey and Octopus visual field systems are in place, as well. Residents are also exposed to a large volume of glaucoma patients at the VA, where the perform MIGS procedures and glaucoma lasers. While Dr. Lane Ulrich does not perform glaucoma surgery, he has a large medical glaucoma practice on the main campus.
PEDS
We have three pediatric ophthalmologists on our staff who routinely work with our residents. Dr. Steven Brooks rejoined our faculty as Chair in 2021. Dr. Stephanie Goei joined our faculty in 1999 after completing her fellowship at The Hospital for Sick Kids in Toronto. Dr. Andrea Prosser joined our faculty immediately upon conclusion of her residency and then practiced pediatric ophthalmology in Cincinnati for two years before returning to our department in 2015. The clinical pediatric ophthalmology experience is comprehensive, providing a sufficient base in common diagnoses and management (vision screenings, refractions, strabismus, amblyopia, nasolacrimal obstructions, etc.). Because we are connected to a full-service adjacent children's hospital, residency training will also include ROP screening and treatment, genetic disorders, craniofacial disorders, metabolic problems and other less typical processes.
The clinical experience is divided between the main campus and a satellite office in West Augusta (about 15 minutes from the main campus). The Children's Hospital of Georgia (CHOG) is an adjoining hospital which is entirely devoted to primary and subspecialty pediatric care. The pediatric surgical experience occurs in that facility. In the operating room, the resident will be assisting in pediatric cataract surgeries and will be primary surgeon for strabismus surgery, nasolacrimal duct obstructions, ptosis repair, examinations under anesthesia, etc. As we have no fellows, there is opportunity to perform re-operations and vertical muscles. There is an accompanying adult strabismus clinic with surgical involvement, as well. While the graduating resident will not function at the level of a pediatric-trained ophthalmologist they should feel very comfortable examining children and doing horizontal muscle surgery.
OCULOPLASTICS/ NEURO
During the months you are on the oculoplastics rotation, your time will chiefly be spent at Augusta University. Most of the training deals with functional oculoplastic issues, e.g. nasolacrimal duct obstruction, ptosis, facial and eyelid reconstruction, nerve palsies, enucleation and exenteration, orbital fracture repair and thyroid eye disease. While there is an emphasis on functional oculoplastics, cosmetic procedures are also performed. Our plastics case volume has consistently been in the highest quartile in the nation.
Dr. Narayana is an outstanding neuro-ophthalmologist and manages this service for us. This is a referral-only service and provides suitable educational exposure to this subspecialty.
VAMC
The rotations at the VA Medical Center provide extensive medical and surgical exposure. There are 4 full-time staff members (Drs. Bloomquist, Lovas, Bogorad, and Sakhalkar), and several part-time providers (Drs. Khan, Singh, Nussbaum, Kim, and Squires) that are involved with resident education. Residents get their initial exposure to minor procedures and surgeries during their VA rotation. First and second years perform a number of YAG, SLT, PI, and PRP lasers at the VA laser clinic, as well as perform the first steps of cataract surgery with Dr. Bloomquist in the OR. Second and third year residents continue to hone their cataract skills 2-3 days a week in the OR with Drs. Lovas, Squires, Sakhalkar and Bloomquist. When not in the OR, residents are immersed in a robust clinic that serves veterans with a comprehensive range of problems, including general ocular complaints, glaucoma, corneal, and medical retina patients. Residents learn to read tests and imaging (HVF, OCT, FAs, etc) and also perform many intravitreal injections with the VA retina faculty (Drs. Bloomquist, Khan, Nussbaum, and Singh).
GENERAL
We recently implemented resident continuity clinics that are staffed by various members of our faculty in addition to the general ophthalmic experiences that are provided throughout residency. Residents help manage the on-call emergency clinic throughout all years of their residency. They also spend time with both Dr. Ulrich in his comprehensive ophthalmology clinic. The VAMC also provides exposure to a great deal of general ophthalmology.
Our senior residents spend time on rotation with Dr. Lane Ulrich.
Dr. Ulrich's approach is that of providing comprehensive care of the eye patient. 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. Having these months with Ulrich at Augusta University helps the resident focus a bit more broadly.
The bulk of senior year Augusta University cataracts are done with Dr. Ulrich. His cases are nearly all topical and clear corneal. Most residents are capable of performing horizontal chop techniques upon graduation. Limbal relaxing incisions (considered by the ACGME to be a refractive procedure) also are routinely taught and completed by the residents. In AY2018 Dr. Ulrich began recording resident surgery videos, reviewing them and then composing a narrative of his thoughts on each case which he shares with the residents. Once per month, cases will be reviewed and discussed with all of the residents as a group.
