Rotations

First year

Durham VAMC - (20 weeks) Residents work in a broad range of subspecialty and comprehensive clinics under the supervision of Duke attendings. This rotation also offers a surgical introduction to clear cornea cataract surgery as well as numerous laser procedures and minor-room plastics procedures.
Neuro-Ophthalmology – (10 weeks) First-year residents work with two full-time neuro-ophthalmology attendings in a busy referral neuro-ophthalmology clinic.
Consults, Research – (10 weeks) This rotation covers daytime inpatient and emergency department consults at Duke Hospital and offers time for research and exploring subspecialty clinics at the Duke Eye Center.
Cornea, Plastics, and Comprehensive – (10 weeks) First-year residents are introduced to comprehensive ophthalmology at the main Eye Center. This rotation also provides a chance to explore select subpecialites of ophthalmology both in clinical setting as well as the operating rooms.

Second year

Retina – (10 weeks) Residents spend time in a busy retina clinic focusing on clinical skills as well as the diagnosis and management of vitreoretinal disorders, working closely with full-time faculty members in medical retina, uveitis, ocular oncology and surgical retina. Residents may assist in a wide variety of surgical cases including retinal detachment repair, radioactive plaque placement for ocular tumors and macular translocation for advanced macular disease. A cutting-edge ocular imaging department at Duke offers exposure to the latest advances in diagnostic retinal imaging.

Glaucoma – (10 weeks) The large number of full-time Duke glaucoma faculty provide residents with unparalleled perspective on the diagnosis and management of all forms of glaucoma. Residents will also have the opportunity to perform filtration and tube shunt surgeries.
Pediatrics – (10 weeks) Residents gain experience in the management of a wide variety of pediatric ophthalmologic conditions in a busy clinical setting. Four full-time orthoptists offer a solid base in strabismus diagnosis and measurement. Time is also spent in the NICU on Retinopathy of Prematurity rounds and in the operating room performing strabismus surgeries and observing the removal of childhood cataracts and treatment of pediatric intraocular tumors.
Durham VAMC - (10 weeks) Second-year residents function with more autonomy as they run a busy comprehensive ophthalmology clinic. In addition, one day per week is dedicated to the operating room where residents perform sutureless clear corneal cataract extraction as well as a number of glaucoma surgeries.
Asheville VAMC - (10 weeks) Time is spent in both the clinic and operating room at the Asheville VA hospital. Residents also have the opportunity to spend time with ophthalmologists at Asheville Eye Associates, a local private practice.

Third year

Chief, Durham VAMC - (10 weeks) The third-year resident at the Durham VA runs spends two days per week in the chief’s clinic and three days in the operating room performing a large number of sutureless clear corneal cataract extractions, vitrectomies, oculoplastics procedures and glaucoma surgeries.
Cornea – (10 weeks) Time is spent both in the clinic and OR learning the fundamentals of the management of corneal and external disease. Residents are exposed to the latest techniques in corneal transplantation, including DSAEK and deep lamellar transplants, as well as refractive surgery.
Oculoplastics – (10 weeks) Residents work with two full-time faculty in both the clinical and operative setting learning both cosmetic and reconstructive oculoplastic procedures.
Chief, Asheville VAMC - (10 weeks) Time is spent in both the clinic and operating room at the Asheville VA hospital. Residents also have the opportunity to spend time with ophthalmologists at Asheville Eye Associates, a local private practice

Research elective – (10 weeks) This unique rotation at Duke offers residents the opportunity to conduct basic science or clinical research at Duke, spend time studying ophthalmology abroad or pursue other related activities. Previous residents have used this time to travel abroad to eye hospitals in Tanzania, East Africa, spend time working for the FDA on Capitol Hill, and collaborate with other Duke departments on biomedical engineering endeavors.

Call

First-year residents take first call and second-year residents serve as second/backup call. Third-year residents have limited call responsibilities. All call is taken from home. All emergency surgery is done by the second-year resident with the on-call attending physician. The call schedule is made by the residents after the first month.

Surgical Experience

Resident experience in performing eye surgery is extensive and is distributed over the three-year training period. Most residents perform well over 400 intraocular cases as the primary surgeon, including topical clear cornea cataract extraction, glaucoma filtration and tube shunt surgery, corneal procedures, scleral buckle placement, strabismus and oculoplastics procedures. Patients operated on by the residents include patients on the private services of Duke as well as patients at the VA Hospitals. The surgical equipment in the Duke and VA operating rooms is of the highest quality including video recording systems. In addition, a practice surgery suite with phacoemulsification equipment is maintained at the Eye Center for use by the residents.

Facilities

Two buildings, directly adjacent to the main Duke Hospital, now house the Duke Eye Center. The Joseph A.C. Wadsworth Building, originally built in 1973 and expanded to 93,000-square-feet in 1990, contains most of the Eye Center's clinical services. On the third floor, six fully equipped and modern operating rooms form the core of the center's surgery complex. Other clinical services in the Wadsworth Building include Contact Lenses, the Low Vision Service and a large Ophthalmic Photography Service.

Opened in April 2005, the Albert Eye Research Institute (AERI), a five-story 72,000 square-foot state-of-the-art building, has two full floors dedicated to cutting-edge research laboratory space. The other three floors house the expanded Pediatric and Adult Strabismus Service, faculty offices, an auditorium, and a resident resource center.

The Eye Center maintains close affiliations with two regional Veterans Administration Hospitals. Rotations at these institutions afford residents the opportunity to care for patients with graduated levels of autonomy. The VA Hospitals have active surgical programs.

The Durham VA Medical Center

is directly across the street from the Eye Center. Work is currently underway for a new outpatient eye clinic at the VA. The new clinic will completed in late 2009, and will be a spacious and superbly equipped clinical facility. It will include over 10 examination lanes, two laser rooms, a minor procedures room, a photography room, a visual field room, a nursing intake area, and a resident workroom which will serve as a combined library, computer center, and lounge. The Ophthalmology Service operating room and OR staff work full shifts three to four days per week. The equipment in the operating room is state-of-the-art, including instrumentation for anterior segment surgery, advanced vitrectomy, and endolaser.

The Asheville VA

is located in Asheville, North Carolina, one of the most scenic areas in the Southeastern United States. Second and third-year residents rotating through Asheville reside in comfortable apartments near the medical center. The rotation is jointly organized by the chief of ophthalmology at the Asheville VA and by the Duke Eye Center. Resident responsibilities include general clinics, subspecialty clinics, and one to two days of surgery per week.