PGY-3 Goals & Objectives
(In addition to PGY·2 Level goals)
1) Medical Knowledge
• Fundamentals: to describe and demonstrate understanding of:
- Advanced retinal anatomy and physiology
• Diagnostic Studies: to describe the principles behind and indications for:
o fluorescein/indocyanine green (ICG) angiography as applied to retinal vascular and other diseases (e.g., phases of the angiogram, indications)
o ocular coherence tomography
o 8-scan ultrasonography
o basic electrophysiological tests (e.g., electroretinogram [ERG], electro-oculogram [EOG], visual evoked potential (VEP), dark adaptation).
• Peripheral Retinal Disease: to describe and demonstrate basic understanding of the signs of and treatment for:
- peripheral retinal disease and vitreous pathology (e.g., vitreous hemorrhage, retinal breaks).
- peripheral retinal degenerations: lattice degeneration, pavingstone degeneration and indications for prophylactic treatment
- various types of retinal detachment (e.g., exudative, rhegmatogenous, tractional)
- retinoschisis (e.g. juvenile, senile)
- choroidal detachment
• Macular Disease: to describe and demonstrate basic understanding of the signs of and treatment for:
o age-related macular edema
o Choroidal neovascularization (e.g., ARMD, histoplasmosis)
o High myopia
o Macular dystrophies
o Macular pucker (e.g., epiretinal membrane)
o Macular holes
o Cystoid macular edema
o Central serous Choroidopathy (retinopathy)
o Optic pit and secondary serous detachment
o Parafoveal telangiectasia
• Retinal Inflammatory Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:
- Serpiginous Choroidopathy
- AMPPE
- Birdshot Choroidopathy
- PIC
- Multifocal choroiditis
- Retinal vasculitis
• Retinal Infectious Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:
o ARN
o Toxoplasmosis
o Acute Bacterial Endophthalmitis
o Fungal Endophthalmitis
o Syphilis
• Hereditary Retinal and Choroidal Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:
- Gyrate atrophy
- Choroideremia
- Retinitis pigmentosa
- Cone dystrophies
- Stargardt's disease
- Best's disease
- Congenital stationary night blindness
• Hereditary Retinal and Choroidal Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:
o Phenothiazine
o Hydroxychloroquine/chloroquine toxicity
o Tamoxifen
• Retinal Vascular Diseases: to describe and demonstrate basic understanding of the signs of and treatment for:
- Arterial and venous obstructions
- Diabetic retinopathy
- Hypertensive retinopathy
- Peripheral retinal vascular occlusive disease
- Acquired retinal vascular diseases
- Ocular ischemic syndrome
- Sickle cell retinopathy
• Principles of surgery: to describe indications for and complications of:
- retinal detachment repair (e.g., pneumatic retinopexy, scleral buckling, vitrectomy).
- surgical vitrectomy (e.g., mechanics, instruments, indications, and technique).
- special vitreoretinal techniques
- Macular hole repair
- Epiretinal membrane peeling
- Complex vitrectomy for proliferative vitreoretinopathy
- Use of heavy liquids and intraocular gases (e.g., perfluorocarbons)
- laser photocoagulation for conditions including
- diabetic macular edema
- diabetic retinal neovascularization
- other causes of retinal neovascularization
- retinal tears
• Major studies in retinal diseases: describe the findings of studies including:
- Diabetic Retinopathy Study (DRS)
- Early Treatment of Diabetic Retinopathy Study (ETDRS)
- Macular Photocoagulation Study (MPS)
- Diabetes Control and Complications Trial (DCCT)
- o Branch Vein Occlusion Study (BVOS)
- Central Vein Occlusion Study (CVOS)
- Comparison of AMD Treatment Trials (CATT)
- Standard Care Versus Corticosteroid for Retinal Vein Occlusion (SCORE)
- Collaborative Ocular Melanoma Study (COMS)
- Diabetic Retinopathy Vitrectomy Study (DRVS)
- Endophthalmitis Vitrectomy Study (EVS)
- Age-Related Eye Disease Study (AREDS)
- Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal
- Neovascularization in AMD (ANCHOR)
- Minimally classic/occult trial of the Anti-VEGF antibody Ranibizumab In the treatment of Neovascular AMD (MARINA)
2) Patient Care: To perform:
o indirect ophthalmoscopy with scleral indentation
o ophthalmoscopic examination with contact lenses, including pan-funduscopic lenses
o interpretation of fluorescein and ICG angiography
o interpretation of retinal imaging technology (e.g., ocular coherence tomography)
o interpretation of basic ocular imaging techniques (e.g., B-scan echography, nerve fiber layer analysis)
o fundus drawings of the retina, showing complex vitreoretinal relationships and findings
o surgical assisting with scleral buckling
o surgical assisting with vitrectomy