PGY-3 Goals & Objectives

(in addition to PGY-2 Level goals)

Medical Knowledge

  • To describe more advanced eyelid, lacrimal, and orbital anatomy and physiology (e.g., lacrimal apparatus, orbital vascular anatomy).
  • To describe the genetics (where known), clinical features, evaluation, and treatment of congenital eyelid deformities (e.g., coloboma, distichiasis, epicanthus, telecanthus, blepharophimosis, ankyloblepharon, epiblepharon, euryblepharon, and Goldenhar, Treacher-Collins, Waardenburg syndromes).
  • To describe the clinical features, evaluation and management of congenital orbital deformities (e.g., synophthalmia, anophthalmia, microphthalmia, cryptophthalmia, hypertelorism, hypotelorism).
  • To describe the genetics, clinical features, evaluation, and management of common craniosynostoses and other congenital malformations (e.g.,Crouzon, Apert).
  • To recognize and describe the indications for referral for treatment congenital eyelid abnormalities (see Basic Level, above).
  • To perform pre-operative and post-operative assessment of patients with simple and more serious oculoplastic and skull base disorders (e.g., multi-disciplinary procedures).
  • To describe the mechanisms and indications for treatment of more advanced eyelid, orbital, and lacrimal trauma (e.g., more complicated full thickness lid laceration, chemical burns to the face).
  • To describe features of, recognize, evaluate, and treat more complicated cases of nasolacrimal duct obstruction, canaliculitis, dacyrocystitis, acute and chronic dacryoadenitis, preseptal cellulitis, and orbital cellulitis.
  • To recognize, evaluate and treat thyroid ophthalmopathy (e.g., epidemiology, symptoms and signs, orbital imaging, differential diagnosis, surgical, medical, and radiation indications, side effects of treatment).
  • To recognize, evaluate and treat orbital inflammatory pseudotumor (e.g., epidemiology, symptoms and signs, orbital imaging, differential diagnosis, biopsy indications, choice of treatments).
  • To recognize, treat, or refer blepharospasm or hemifacial spasm.
  • To recognize common orbital tumors and to describe the differential diagnosis of orbital tumors in children and adults.
  • To recognize and treat floppy eyelid syndrome.
  • To describe the differential diagnosis of lacrimal gland mass (e.g., inflammatory, neoplastic, congenital, infectious).
  • To recognize common skull base pathology (mucocele, fibrous dysplasia, sellar tumors, etc.)
     

Patient Care

  • To describe indications for and to perform more advanced examination techniques for less common oculoplastic and orbital abnormalities (e.g, measurement of levator function).
  • To identify indications for and to perform more advanced assessment of eyelids and eyebrows (e.g., hypoglobus, facial asymmetry, brow ptosis).
  • To identify indications for and to perform more advanced lacrimal assessment (e.g., interpretation of dye testing, canalicular probing in trauma).
  • To identify indications for and to perform more advanced assessment of the orbit (e.g., enophthalmus).
  • To identify indications for and to perform more advanced socket assessment (e.g., extrusion of implants, anophthalmic socket complications).
  • To perform more complicated minor lid procedures (e.g., larger benign skin lesions) or surgery (e.g., recurrent or multiple chalazion).
  • To recognize the indications and complications and to perform more complex minor operating room or limited operating room procedures (e.g., incision and drainage of recurrent or larger chalazia, excision of moderate sized benign eyelid lesions).
  • To identify common orbital pathology (e.g., orbital fractures, orbital tumors) on imaging studies (e.g, magnetic resonance imaging, computed tomography, ultrasound).
  • To treat common presentations of preseptal or orbital cellulitus.
  • To describe, recognize the indications and complications, and to perform the basic lacrimal procedures below:
    • Lacrimal drainage testing (irrigation, dye disappearance test)
    • Lacrimal intubation
  • To describe, recognize the indications and complications, and to serve as surgical assistant for dacryocystorhinostomy (external)
  • To recognize facial nerve palsy with exposure keratopathy and to indentify indications for and to perform surgical treatments for this condition (e.g. tarsorrhaphy, gold weights)