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First Year Ophthalmology

In August and September of each year, the eye chief residents arrange a series of faculty lectures to introduce the new residents to ophthalmic surgery. These lectures are a minimum of four hours, and include the following:

  • Technical aspects - sutures, needles, instruments, microscopes, etc.
  • Basic surgical techniques - skin, conjunctival and corneoscleral incisions, suturing and tying, wound healing, ophthalmic anesthesia, surgical physiology and pharmacology, etc.
  • Common surgical procedures - cataract/IOL, glaucoma, YAG and argon/dye laser, scleral buckle, vitrectomy, etc.

By August 1 of each academic year, the eye chief residents have arranged operating room in-services with the eye operating room (OR) head nurse at all sites to familiarize all residents with the following procedures and equipment:

  • Location of all OR facilities - PACU, eye ORs, perioperative care, lockers, lounges, etc.
  • Eye OR procedures - scrubbing, prepping, gowning/gloving, hospital chart requirements, dictation, OR supplies, etc.
  • Set up of the following OR equipment:
    1. OR and
    2. clinic microscopes
    3. Video equipment and monitors (OR and clinic)
    4. Eye stretchers, chairs and basic sterile instrument set-up

Eye residents must obtain 2.0 to 3.5X loupes by September 1 of their first year.

After observing in surgery in the afternoons during the basic science course, residents begin, where appropriate, to first assist in the ORs. It is the responsibility of the eye chief residents to rotate junior residents through a wide-ranging experience as first assistants.

Residents begin their online surgical log, a print out of which they present at monthly morbidity & blindness (M&B) rounds, and which all residents maintain for inspection by the program director or his/her designee at any time.

Through September, a senior resident or attending physician assists residents on all minor trauma and minor surgery. Residents become proficient in subspecialty, non-refractive laser procedures.

Residents become proficient in keratometry, optical and ultrasonic pachymetry and biometry, and are familiar with the basics of ophthalmic microsurgery. They prepare themselves for their rotations at the VA, MGUH, CNMC and WRB by:

  • Becoming proficient at hand and instrument tying, and suturing appropriate practice materials with their loupes
  • Practicing microsurgical incision and 22 micron tying on cadaver and/or fresh animal eyes with a surgical microscope
  • Using a surgical simulation tool, if available

At the end of the first year, residents have a complete understanding of the technical aspects of ophthalmic surgery, including major equipment, disposables, basic procedures and operating room decorum.