Resident Teaching Materials
Consult Syllabus
Create a consult syllabus for new incoming first year residents which can help them prepare for on-call responsibilities. This syllabus can feature a list of eye diagnoses, landmark articles, and surgical procedures specifically relevant for the consult setting.
Consult Topics:
1. Trauma
- Ruptured Globe
- Intraocular Foreign Body
- Orbital Foreign Body
- Orbital Fracture (Adult vs Pediatric)
- Orbital Compartment Syndrome (Retrobulbar Hemorrhage)
- Eyelid Laceration (Margin involving, Canalicular)
- Corneal Abrasion
- Corneal Foreign Body
- Corneal Chemical Burn
- Hyphema
- Commotio Retinae
- Retinal Detachment
- Traumatic Optic Neuropathy
- Sympathetic Ophthalmia
2. Cornea
- Corneal Ulcer
- Exposure Keratopathy
- HSV Keratitis
- VZV Keratitis
- Conjunctivitis (viral, bacterial, allergic)
- Ocular GVHD
- Steven Johnson Syndrome
- Wilson's Disease
3. Orbit
- Preseptal Cellulitis
- Orbital Cellulitis (Bacterial, Mucormycosis, etc)
- Subperiosteal Abscess
- C-C Fistula (Direct vs Indirect)
3. Retina
- Posterior Vitreous Detachment
- Retinal Detachment
- Retinal Artery Occlusion
- Retinal Vein Occlusion
- CMV Retinitis
- Leukemic Retinopathy
- Endophthalmitis (Exogenous vs Endogenous)
- CNS Lymphoma
- Terson's Syndrome
4. Inflammatory/Rheumatologic
- Anterior Uveitis (HLA-B27, etc)
- Scleritis (RA, GPA)
- GCA (CRAO, AAION, cranial nerve palsy)
- SLE Choroiditis
- Orbital Pseudotumor (myositis, etc)
5. Neuro-ophthalmology
- Optic Neuritis
- Idiopathic Intracranial Hypertension (IIH)
- Ischemic Optic Neuropathy (NAAION, PION)
- Pupil-Involving CN III Palsy
- Horner's Pupil
- Parinaud Syndrome
- Sellar Mass
6. Glaucoma
- Acute Angle Closure
- Neovascular Glaucoma
- Blebiitis
7. Pediatrics
- Neonatal Conjunctivitis
- Nasolacrimal Duct Obstruction (NLDO)
- Dacryocystitis
- Septo-Optic Dysplasia
- CHARGE Syndrome
- Craniosynostosis
- Sturge Weber Syndrome
- Non-Accidental Trauma (Shaken Baby Syndrome)
8. Glaucoma
- Congenital Glaucoma
- Acute Angle Closure
- Neovascular Glaucoma
- Blebiitis
Articles
1. A Randomized, Controlled Trial of Corticosteroids in the Treatment of Acute Optic Neuritis, 1992, (Original ONTT Trial).
2. Results of the Endophthalmitis Vitrectomy Study: A Randomized Trial of Immediate Vitrecomty and of Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis, 1995 (EVS Study).
3. Abusive Head Trauma (Shaken Baby Syndrome), Overview and Guidelines from the American Academy of Ophthalmology, 2010.
Surgical or Laser Procedures
Corneal Foreign Body Removal
Lateral Canthotomy/Cantholysis
Ruptured Globe Repair (anterior vs posterior)
Eyelid Laceration Repair (lid margin vs canalicular involving)
Lateral Tarsorrhaphy
Laser Peripheral Iridotomy
Consult Proficiency Exam
Create a Consult Proficiency Exam for new incoming first year residents which can be administered before they take start solo call responsibilities with indirect supervision. This usually occurs at some point in the fall or winter for most academic programs.
Using content from the Consult Syllabus, the exam can feature a variety clinical cases relevant for the on-call setting. The exam can be conducted in either a written or oral format.
By passing the exam, a resident can show that they have reached a competency milestone for safely managing patients on-call. The exam can also help identify trainees who might benefit from further specific study.
IPAD Consult Rounds
Consults are busy and we are often on the move! It can be challenging to find dedicated time/space for providing educational content for trainees outside of a typical office setting. We suggest downloading a variety of clinical cases, OKAP style questions, and surgical videos on to an IPAD which you can carry with you on rounds. Teaching opportunities are now right at your fingertips whether you are waiting for patients to dilate, eating lunch, or happen to have some unexpected down time in between patients.
Consult Conference
Hospital consults yield a wonderful and exciting array of teaching cases! Design a monthly or quarterly conference with all the residents to review and discuss interesting cases. Invite other specialists (both within and outside of ophthalmology) to provide added expertise for relevant cases to enrich learning through an interdisciplinary discussion.
Consult Journal Club
Host a fun "Dinner with Consults" journal club for all the residents. Select interesting articles that provide a relevant and timely discussion of ongoing consult cases. It's a great opportunity to look at emerging new data that may suggest better evidence based guidelines, highlight innovations, or even confirm that traditional management remains valid.
Ocular Trauma Surgical Wetlab
Host an annual trauma wet lab which features lectures and surgical videos for ruptured globe repair (anterior vs posterior), lateral canthotomy, AC wash out, traumatic cataract removal, intraocular foreign body removal, etc. Invite relevant faculty from cornea, retina, and oculoplastics.
Recommended Consult Bag Items
You will find variety in terms of what people carry on consults but theses are some items which we have found to be helpful.
Consult Bag Items
- roller bag with pull handle
- portable indirect (Heine Omega 500 Indirect Ophthalmoscope Bio Unplugged)
- 20D, 28D, 90D, gonio lens
- tononopen with tip covers
- muscle light
- visual acuity card
- pinhole occluder
- loose lenses or +1.50D and +3.00D readers
- Maddox rod
- Qtips
- Alcohol swabs
- culture swab (bacterial, viral, fungal)
- pH paper
- ishihara plates
- Eye shield
- Eye Medications
Proparacaine
Phenylephrine (adults)
Tropicamide (adults)
Cyclogel (peds)
Cyclomydril (under 6 months)
Fluorescein dye or strips
Timolol
Azopt
Cosopt
Brimonidine
Prostaglandin
Pilocarpine
- Surgical Instruments
Desmarres retractors
Westcott Scissors
Needle Driver
Forceps
Speculum (adult and peds)
Lacrimal probe and irrigation tip
15 blade
- corneal burr
- 30 gauge needle
- syringe
- Xylocaine or other comparable injectable local anesthestic
- Betadine swab
- sterile eye drape with hole opening (for tarsorrhaphy placement)
- Gut sture (lid lac repair)
- Vicryl suture (lid lac repair)
- Portable slit lamp (when needed)
- Portable b-scan ultrasound (when needed)
- Portable fundus camera: Iphone, Volk Pictor Plus, Retcam (when needed)
- Business cards
