The goal of the Ophthalmology Residency Program is to train young physicians to become future leaders in both private and academic spheres of ophthalmology. This is to be achieved through a balanced curriculum, with emphasis on excellence in the diagnosis and management of general and complex ocular disease, as well as an understanding of the essentials of sound clinical and basic science research. We also acknowledge our responsibility as mentors to promote honesty and the highest ethical standards in the practice of medicine and the conduct of medical research.”

About the Yale Eye Center

The Retina Section is equipped with argon, krypton-red and diode lasers, electrophysiology and digital angiography.  A procedure room is equipped for retinal cryopexy.  The Cornea Section is equipped for corneal pachymetry, specular microscopy and anterior segment photography.  A minor surgery room is equipped with an operating microscope. The Glaucoma Section is equipped with YAG, argon, and diode lasers, Humphrey and Octopus automated perimeters, fundus photography, and confocal laser tomography.
The Yale Eye Center is a dynamic institution.  More than 18,500 outpatient visits are performed each year, generating approximately 1,000 major ocular surgeries. The subspecialties available for patient care will be comprehensive, including cataract, glaucoma, retina, uveitis, neuro-ophthalmology, ophthalmic plastic, pediatric-strabismus, cornea/refractive, low vision and contact lens service. These services will be provided by approximately 11 full time ophthalmologists, 8-10 part time ophthalmologists, 2 optometrists and one optician. There are 12 ophthalmology residents (four in each year of a three-year program). There are two fellowship opportunities - a two year program in retina and a one year program in glaucoma.

Third year residents spend six weeks at Princess Margaret Hospital, Nassau, Bahamas, which is the largest acute care facility located in the commonwealth of the Bahamas.  There are two dedicated ophthalmology operating rooms equipped with Zeiss microscopes.  Phacoemulsification with a wide variety of intraocular lens styles is available.

First Year

During the first year of training, residents typically spend six months at the West Haven VA Medical Center staffing the general ophthalmology clinic.  Three months are spent on the Comprehensive Eye Service (CES) at Yale running the Inpatient Consultation Service at Yale-New Haven Hospital. Three months are spent on the combined Ophthalmic Plastic Surgery, Ophthalmic Pathology, Neuro-ophthalmology and Pediatric Ophthalmology/Strabismus rotation.  During the first year of training, residents typically perform, as primary surgeon, one extracapsular cataract extraction, 5-10 glaucoma laser procedures, and 20 ophthalmic plastic surgery procedures, including temporal artery biopsy, blepharoplasty, ptosis repair, lid tumor resection, and lid laceration repair.  During the Comprehensive Eye Service and Ophthalmic plastic rotations, there is also an extensive opportunity to assist senior surgeons in a wide variety of anterior segment and ophthalmic plastic procedures.

Second Year

During the second year of training, residents spend three-month rotations each in Cornea and External Disease/Uveitis, Glaucoma, and Vitreoretinal Surgery, as well as three months at the VA Medical Center.  While on the Cornea and External Disease service, residents are exposed to a wide variety of corneal and external disease problems.  Surgical experience includes assisting on penetrating keratoplasty with a graded introduction to placing corneal sutures of high structural and refractive quality.  The Cornea rotation also includes exposure to the Contact Lens service. During this rotation, residents also spend three half-days per week in the Uveitis Clinic with exposure to a wide range of tertiary care uveitis patients.

During the Vitreoretinal rotation, residents work with medical and surgical retina faculty members and clinical fellows. The nuances of a peripheral retinal examination, including scleral depression and retinal drawings are taught.  The evaluation of ophthalmic echography, fluorescein angiography, and electro-physiology is also stressed.  Operative experience includes scleral buckles and opening and closing vitrectomy cases, and assisting on complicated vitrectomies.

On the Glaucoma rotations, residents interact with three full-time attendings and a clinical fellow. Residents learn examination techniques including anterior chamber angle evaluation, optic nerve evaluation and the use of diagnostic studies such as visual field testing, ultrasound biomicroscopy, and optic nerve and nerve fiber layer imaging. The resident is exposed to a wide range of medical and surgical therapeutic modalities for glaucoma.

The second year resident at the VA Medical Center is responsible for running a busy, general clinic.  Subspecialty clinics are held at the VA in all major areas.  During this rotation, the resident typically performs 10 to 15 extracapsular cataract extractions (ECCE) and begins to make the transition to phacoemulsification.  Typically, two ophthalmic plastic surgery cases per week are performed by the second year resident at the VA.

Third Year

The third year of residency training includes three months rotations each at the VA Medical Center, Hill Health Center, and the combined Ophthalmic Plastic Surgery, Low-Vision, Neuro-ophthalmology and Pediatric Ophthalmology/Strabismus rotation.   The remaining time is divided between the Comprehensive Eye Service and the Princess Margaret Hospital in Nassau, Bahamas.

The VA Medical Center provides the bulk of the Class 1 (primary surgeon) anterior segment surgical experience during the residency.  With the introduction of modern cataract surgery technology, including phacoemulsification, clear cornea incisions, foldable lenses, and topical anesthesia, a dramatic increase in OR efficiency has ensued.  As a result, the cataract surgery volumes at the VA Medical Center have doubled over the past five years.  Annually, third year residents at the VA typically perform between 80 and 100 phacoemulsifications.  In addition, third year residents usually perform 4-8 trabeculectomies, several vitrectomies and scleral buckles, and 1-2 penetrating keratoplasties.

The rotation at Hill Health Center provides additional clinical and surgical experience in a public health care community eye clinic. The Yale full time faculty and voluntary community faculty supervise the clinics. An expansion is underway to include diagnostic and laser treatment.
The three-month the combined Ophthalmic Plastic Surgery, Low-Vision, Neuro-ophthalmology and Pediatric Ophthalmology/Strabismus rotation allows the 3rd year resident the opportunity to hone specialized surgical techniques on the ophthalmic plastic and pediatric ophthalmology/strabismus rotation while mastering examination techniques in neuro-ophthalmology and low vision.
A unique aspect of the Ophthalmology residency at Yale is the six-week rotation at Princess Margaret Hospital in Nassau, Bahamas.  During this time, the senior resident provides a large portion of the eye care for the island’s indigent population.  Typically, 30 anterior segment procedures are performed, including ECCE, phacoemulsification, anti-metabolite trabeculectomy, and traumatized globe repair.  Two U.S. fellowship trained ophthalmologists, who practice on the island, work closely with the resident in a supervisory and consultative fashion and a Yale faculty member visits for one week during each rotation.  Nevertheless, this rotation allows residents to develop a newfound sense of autonomy in patient management, as well as an appreciation for the epidemiologic issues facing a developing country.

Contact the Yale Eye Center

Mailing Address: 40 Temple Street
New Haven, CT 06510
Telephone: 203-785-2020
You may also call us at our toll-free number from anywhere in the United States at
1-800-395-7949.
Fax: 203-785-6123
http://info.med.yale.edu/clinop/teaching.html

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