Duke's Vitreoretinal Division has a high-volume referral center that has continued to grow. The service primarily attracts patients from all over North Carolina, Eastern Tennessee, South Carolina, and Virginia. In addition, patients come from across and outside of the United States. The vitreoretinal service was among the first at the Duke Medical Center to develop an off-site satellite clinic. The first clinic was begun in Wilmington, NC, which was subsequently followed by satellites in Wilson, Raleigh, Danville, Cary, and, most recently Page Road. These satellites have been very successful, and since the first satellite was formed, clinical volume from the vitreoretinal satellites has continued to increase. To increase Vitreoretinal Service productivity on a year-by-year basis we have maintained a high profile among ophthalmologists in North Carolina, surrounding states, and across the country through educational activities, presentations at local and national meetings, participation in clinical research that draws patients from referral practices, and dissemination of research results. In addition, we have continued to develop several new referral sources over the past year from within North Carolina and the surrounding states, and have continued to develop active off-site satellites.