StemCell Therapy

The Department of Ophthalmology at the Icahn School of Medicine at Mount Sinai consists of faculty and staff based at The Mount Sinai Hospital and New York Eye and Ear Infirmary of Mount Sinai, the nations oldest specialty hospital. The long-term goal of the Department is to advance new diagnostic and therapeutic innovations by enhancing, expanding, and integrating collaborative efforts between our leading clinicians and researchers.

The Department has partnered in research with interdisciplinary institutes at Mount Sinai, including The Friedman Brain Instituteand The Icahn Institute and Department of Genetics and Genomics. Our focus areas for translational research are:

In addition, the Department has continued its longstanding commitment to providing the highest quality, compassionate, and patient-centric care, as well as training and educating the next generation of leaders in eye care and research.

The Department of Ophthalmology at the Icahn School of Medicine at Mount Sinai is committed to upholding a tradition nearly two centuries old of training outstanding residents who will advance the field of ophthalmology.

The Departments training programs, at both New York Eye and Ear Infirmary of Mount Sinai and The Mount Sinai Hospital, provide a wide spectrum of clinical activity. This includes extensive experience in hands-on patient care, as well as cataract surgery, glaucoma procedures, strabismus surgery, eyelid and orbital surgery, cornea and refractive surgery, and retina-vitreous surgery by the completion of the respective residencies. In addition, a comprehensive schedule of lectures and conferences provides an excellent didactic program to complement the clinical experience.

Learn more about the Ophthalmology Residency at New York Eye and Ear Infirmary of Mount Sinai

Learn more about the Ophthalmology Residency at The Mount Sinai Hospital

Research faculty in the Department of Ophthalmology at the Icahn School of Medicine at Mount Sinai engage in both NIH-funded and foundation-funded research, as well as industry-funded clinical trials. The research encompasses bench eye and vision science research, with concentrations in cornea, anterior segment physiology, retina, stem cells, and glaucoma, and all facets of clinical research. Department investigators play national leadership roles in NIH-funded multi-center clinical trials and epidemiologic studies in the fields of Cornea and Uveitis. Department members also participate in NIH-funded clinical trials in glaucoma, retina, and pediatric ophthalmology.

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Department of Ophthalmology | Icahn School of Medicine

Ophthalmology, the journal of the American Academy of Ophthalmology, serves society by publishing clinical and basic science research and other relevant manuscripts that relate to the sense of sight. Excellence is pursued through unbiased peer-review, the advancement of innovation and discovery, and the promotion of lifelong learning.

Disclaimer Notice: Statements and opinions expressed in Ophthalmology are those of the author(s) and are not necessarily those of the Academy or publisher, or indicative of Academy views, policy or editorial concurrence. The Editor(s), the Academy, and the Publisher assume no responsibility for any injury and/or damage to persons or property as a matter of product liability, negligence, or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein including those in a language other than English. No suggested test or procedure should be carried out unless, in the reader's judgment, its risk...

Ophthalmology, the journal of the American Academy of Ophthalmology, serves society by publishing clinical and basic science research and other relevant manuscripts that relate to the sense of sight. Excellence is pursued through unbiased peer-review, the advancement of innovation and discovery, and the promotion of lifelong learning.

Disclaimer Notice: Statements and opinions expressed in Ophthalmology are those of the author(s) and are not necessarily those of the Academy or publisher, or indicative of Academy views, policy or editorial concurrence. The Editor(s), the Academy, and the Publisher assume no responsibility for any injury and/or damage to persons or property as a matter of product liability, negligence, or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein including those in a language other than English. No suggested test or procedure should be carried out unless, in the reader's judgment, its risk is justified and the patient has received information sufficient to give a fully informed consent. Because of the rapid advances in the medical sciences, medical practitioners should obtain independent verification of diagnoses and drug dosages. Discussions, views, and recommendations as to medical procedures, choice of drugs, and drug dosages are the responsibility of the authors. Consumers should consult with their own doctors about their individual health status before making any health decisions. The Academy does not endorse companies, drugs or other products.

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Ophthalmology - Journal - Elsevier

Overview of the Specialty

Ophthalmology deals with the structure, function, diagnosis and treatment of the eye and the visual system. It provides patients with total eye care using medical, surgical and rehabilitative services. Ophthalmologists typically work with a broad range of patients and usually over a long period of time.

Training Requirements

The length of training in ophthalmology must be at least three years. All applicants entering an ophthalmology training program must have taken a general postgraduate clinical year of training in a program accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada. There were 116 ophthalmology residency training programs accredited by the ACGME for 2014/15 that offered 465 advanced positions.

Matching Program Information and Match Statistics

Ophthalmology residency training programs participate in the Ophthalmology Matching Program through SF Match (sfmatch.org). Match results are summarized in the U.S. Match Statistics table below. The ophthalmology matching process is one of the "early match" programs: the matching process is generally completed in late-January (about six weeks prior to the NRMP).

Source:SF Match (sfmatch.org)Opthalmology Residency Match Report.*Competitiveness is based upon the percentage of U.S. Seniors who ranked each specialty as their only choice.

WUSM Match Statistics

For a list of WUSM match statistics for the past several years, please visit Search for WUSM Statistics. You will need to log in with your Medpriv account.

Subspecialty/Fellowship Training

Subspecialty/fellowship training following completion of an ophthalmology training program is available in cornea/external disease, glaucoma, neuro-ophthalmology, ophthalmic pathology, oculoplastics, pediatric ophthalmology, vitreoretinal disease, and uveitis/immunology. Detailed information about the scope of these subspecialty training programs, number of positions offered and length of training is available in the GMED. Further information can be obtained from the American Medical Association and the Fellowship and Residency Electronic Interactive Database Access page. American Medical Association (AMA) FREIDA

Career Information

FREIDA physician workforce information for each specialty includes statistical information on the number of positions/programs for residency training, resident work hours, resident work environment and compensation, employment status upon completion of program and work environment for those entering practice in each specialty.

Washington University Resources

Washington University Graduate Medical Education: GME Information about graduate medical education at Washington University

Washington University Department Website: Department Ophthalmology & Visual Sciences

Faculty Contacts: Ophthalmology

Susan M. Culican, MD, PhD

362-5722

Morton E. Smith, MD*

747-5559

John Lind, MD

362-3857

747-6554

Ophthalmology Elective Recommendations

Search for WUMS Alumni

To search by Specialty, Year, and/or State

National Organizations

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Ophthalmology - Residency Roadmap

Jeffrey L. Goldberg, M.D., Ph.D. Professor and Chairman Department of Ophthalmology

Welcome to the Byers Eye Institute in the Department of Ophthalmology, at Stanford University School of Medicine, a top-tier, internationally recognized, multidisciplinary center combining world-class resources with a commitment to providing the highest level of diagnostic and therapeutic care to our patients.

Through an integrated, personalized approach to healthcare delivery, our dedicated team of specialists, surgeons, nurses, and technicians provides the latest therapies in treating eye disorders such as glaucoma, cataracts, uveitis, and retinal, pediatric, and corneal disease. Associated with Stanford Health Care, and the Lucille-Packard Children's Hospital, our faculty and staff has been providing excellence in ocular and vision healthcare to patients across Northern California and from around the world, while our cutting-edge team of researchers carries out some of the most innovative laboratory research and clinical trials anywhere in the world.

The Department of Ophthalmology's educational mission is focused on clinical service, cutting edge research and innovation, and training the next generation of clinicians and scientists in ophthalmology and visual science. Stanford faculty are trained specialists in Retina, Glaucoma, Cornea and Refractive Surgery, Pediatrics, Oculoplastics, and Neuro-ophthalmology, and are prepared to serve your needs.

I am very proud of our exceptional faculty and staff and their accomplishments in our mission areas of patient care, research, education and community outreach. Whether you are a patient, a resident, or a leader in academic or clinical ophthalmology, I invite you to explore our programs, visit our clinics and operating rooms, and receive your eye care from our premier faculty.

We are here for you.

The new Eye Institute at Stanford, which opened to patients in September 2010, was named for its lead donors, Brook and Shawn Byers. The state-of-the-art facility was formally named The Byers Eye Institute at Stanford. More on The Byers Institute at Stanford

PHILLIPS HEALTHSUITE HACKATHON March 2015

Team 6 Analytics and their app: MediDash In this recent developer "Hackathon", Team 6 and its leader, Robert Chang, MD., Stanford assistant professor of ophthalmology, developed the winning application over one weekend. See the video below:

Read more about the Phillips Healthsuite Hackathon

EyeGo Adapters

EyeGo adapters let you perform eye exams using a smartphone

Developed by Stanford Ophthalmology assistant professor Robert Chang, MD., and ophthalmology resident, David Myung, MD., the system consists of two adapters that are added to an existing smartphone camera. MORE >>

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Ophthalmology - Stanford University School of Medicine

UI Health Care is recognized as one of the best programs in the nation for eye care. Our compassionate staff and skilled specialists provide a comprehensive array of vision and eye health services. Services range from routine vision screenings and eye care to the diagnosis and treatment of complex and rare eye conditions. We also offer the convenience of on-site services for ordering contact lenses and prescription eyewear and solutions such as laser vision correction and refractive surgery.

In addition to our main clinics on the University of Iowa Health Care Campus, several of our eye care services are available for patients and families at Iowa River Landing. Located at the Coralville interchange on Interstate 80 (exit 242), UI Hospitals and Clinics - Iowa River Landing offers patients easy access, free parking, and a state-of-the-art building for delivering outstanding patient care. General eye exams are now available from 8 a.m. to noon on Saturdays at UI Health CareIowa River Landing. Enjoy the convenience of free parking and finding all of your follow-up needs under one roof.

Read more about UI Department of Ophthalmology and Visual Sciences Referrals

We provide a broad range of general eye care services from routine eye examinations to expert prescription and fitting of eye wear and contact lenses.

Eye care services are also available at UI Health Care - River Crossing in Riverside.

UI Healthcare eye specialists are ranked among the best in the world at diagnosing and treating eye diseases. Patients from around the world come to the UI Hospitals and Clinics and UI Children's Hospital to be treated by our staff.

University of Iowa clinicians and researchers provide cutting-edge diagnosis and treatments of eye cancers to patients of all ages.

Our oculoplastic surgeons provide a full range of cosmetic and reconstructive eye services.

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Ophthalmology

Ophthalmologymjmedina2016-06-24T21:45:51+00:00

We have dedicated ourselves to a multidisciplinary approach with an emphasis on efficient and compassionate bench to bedside care. We provide superior facilities and services to our physicians, scientists, residents, and staff to enable them to best serve the needs of our patients. We are committed to furthering research and patient care objectives as we teach the next generation of ophthalmologists and vision scientists.

About the Department of Ophthalmology

Looking ahead, its my mission to build on our vision research programs by investing and recruiting and developing strong faculty who are dedicated to discovery, innovation and collaboration within the rich network of talent and resources we enjoy at USC. Rohit Varma, MD, MPH Interim Dean, Keck School of Medicine of USC Grace and Emery Beardsley Professor and Chair, USC Department of Ophthalmology Director, USC Roski Eye Institute Chairs Corner

The Department of Ophthalmology supports a wide spectrum of endeavors to promote and provide the best clinical care to patients of all ages. Our faculty members, representing every ophthalmic specialty, are both nationally and internationally renowned. Their clinical expertise touches the full range of patient care from consultation to specialized testing and treatment and includes tertiary care. The ophthalmologists of the Keck School are actively involved in clinical trials at LAC+USC Medical Center, in addition to The Vision Center at Childrens Hospital Los Angeles.

Our clinical services include:

Learn more about patient care

View All Department News

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Ranked among the top 10 ophthalmology programs in the nation

Message from the Chairman:

In accepting the positions of Chairman of the University of Pittsburgh School of Medicine Department of Ophthalmology and director of the UPMC Eye Center, I have discovered that one of the most exciting aspects is the opportunity to interact across the entire spectrum of the field. In a typical week, I have the opportunity to work with students, residents, fellows, faculty, the community, and the population at large. Each of these groups' needs defines the purpose of the UPMC Eye Center and its mission.

As Chairman, driving new developments and striving for excellence in patient care, research and teaching are my top priorities.

Patient Care: UPMC Eye Center is rated among the top ophthalmology programs in the United States in the delivery of patient care. Our most fundamental function is to serve the community through patient care. As we see patients daily by referral, our primary goal is to offer them quality care and provide needed information to the referring doctors as soon as possible so that patients may return to their care.

We continue to expand our subspecialty areas by adding new faculty and positions, leading to a higher quality of oveall care.

Research: The Department of Ophthalmology recently ranked eighth in the country for National Institutes of Health funding for departments of ophthalmology and has one of the top basic and clinical research programs in the country. Research focuses on ocular immunology, infectious disease, molecular genetics, molecular biology of retinal disease and glaucoma, and advanced diagnostic imaging technology development.

Teaching: The Department of Ophthalmology has an outstanding residency program, training six residents each year in a three year program. Graduates have gone on to clinical, research, and combined clinician-scientist careers. The department is at the forefront of continuing medical education and provides both ongoing and specialized educational opportunities. This year, in addition to our 18 residents, we trained retina, cornea, glaucoma, oculoplastic and pediatric ophthalmology fellows.

Innovative changes will steadily filter through to each area of service. In view of these accomplishments, I can safely say that I am very proud of the department, and I look forward to keeping you up to date on future progress.

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Department of Ophthalmology

The Scheie Eye Institute, founded by Harold G. Scheie in 1972, is a leader in the field of ophthalmological research, education and patient care.

Our physician-scientists focus on translational research ranging in topic from age-related macular degeneration to glaucoma to retinitis pigmentosa.

Our full-time residency and fellowship program is devoted to training 15 residents and 8 fellows to become leaders in the future of ophthalmology. In fact, Scheie was the first institute to receive a training grant in Ocular Genetics and Bioinformatics from the National Institutes of Health. This will enable us to train scientists and ophthalmologists to interpret the huge amount of genetic information which will become available to us within the next five years as whole genome sequencing becomes widely affordable.

The Scheie Eye Institute employs 60 physicians and researchers to consult and treat eye problems of every kind. Last year alone Scheie received 81,129 patient visits. We have three locations in the city of Philadelphia, and locations in Radnor, and Media Pennsylvania.

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Ophthalmology | Penn Medicine

I've been to their NOVA two locations, Fairfax and Falls Church. The first is just a review of the Falls Church location for Dr. McAteer.

I first went to see a specialist at their Fairfax location, but then was sent to see Dr. Mary Beth McAteer at their Falls Church location because I was told I needed a different specialist than the one in Falls Church for my eye issue. Ok, frustrating.

My appointment started off well because the doctor was on time, but she seemed to be in a big rush from the moment she walked in. Because of her hurried nature and brusqueness of her replies, I left at the end of my appointment feeling even more frustrated because I felt like none of my concerns and questions had been properly addressed. I was told I would need to go to yet another location, to a different eye specialist, to see about another test which would determine her recommendation.

I felt like I was being shuffled off.

Dr McAteer's office made an appointment with the third doctor that same morning. I verified I'd be in and out of the appointment in plenty of time to get to an important work meeting. If I couldn't make the meeting, I'd have to let my work know ASAP and take the entire day off. I was assured the test was very quick and there would be no problems getting to work.

When I arrived, the new doc's office, they said there was indeed an appointment for me, but they had no information about which test I needed. They got on the phone with Dr. McAteer's office and left repeated messages. It took about 30 mins before Dr McAteer's office returned the call and they finally took me to an exam room. It was there, I was told I could get the testing done by a technician, but the 3rd specialist I was supposed to see (who could interpret the results wasn't in the office) Regardless if I had the testing done, I'd need to make ANOTHER appointment to come back to see the 3rd doc . WHAT?!?!?

Not only did I miss my meeting and have to take the day off for no reason, I had to give pay the 2nd specialist a co-pay from my health insurance to basically sit around waiting... Grrr!!! I blame Dr McAteer's office for not getting all of the details of the test I needed to the new doc and wasting my time.

A week later, after taking a third day off, and yet another co-pay, I went to their Tyson's Corner location for the testing I needed, as well as a very extensive explanation of the results. I felt ALL my questions were answered. He said he would send to results to Dr. McAteer's office. The next day, Dr. McAteer left a 30 sec v/m with little explanation of the results.

Overall, very disorgainzed. Little communication. Felt I ran around more than I needed to resulting in a waste of time and multiple co-pays. Left with questions and uncertainty. Will NOT be going to see Dr McAteer again.

The ONLY reason I'm giving two stars (which I think is more than generous) is because Dr. McAteer was onto for my appointment. _____________________________________

Second review: After the Dr. McAteer fiasco, I saw Eye Doc #1 at the FC office. When I got there and signed in, I noticed someone else had signed in before me for the SAME APPT time!!! I asked and as told that the doctor was running on time, but when I went back to the waiting area, it wasn't just one person ahead of me, it was three patients.I ended up having to wait an additional 45mins past my appointment time to be seen by the doctor only after I told them I couldn't wait much longer as I had kids I needed to pick up after school.

I was told my appointment was late because patients before me had to have their eyes dilated. Couldn't the doctor have seen other patients in that time? I was also told that patients are told their appointments can run 1 to 1.5 hours. It's not because YOUR appointment runs that long, it's because the doctor may be running late.

I'm disappointed but will continue to see this doctor. Just probably not at this location. 🙁

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Northern Virginia Ophthalmology Associates PC ...

Welcome to Freehold Ophthalmology

Healthy eyes and good vision are important to your quality of life. That is why our doctors and office staff are committed to exceeding your expectations and providing the best comprehensive ophthalmic eyecare.

Freehold Ophthalmologyprovides a full range of eye related services including the diagnosis and treatment of eye diseases such as cataracts, glaucoma, diabetes, macular degeneration, dry eyes, infections, and eye trauma. Routine eye care and contact lens fitting are also a priority, and there is a fully staffed on-site optical shop in all 3 offices.

Our doctors specialize in cutting edge cataract surgery as well as state-of-the-art Laser Vision Correction. Cosmetic Botox treatments and plastic surgery around the eyes are also available.Types of Payment Accepted We accept cash, personal checks, MasterCard, and Visa.

Insurance Plans We participate with VSPand most major medical insurance and vision plans.

Facilities and Equipment Lasers for treatment of eye diseases. Visual field testing, HRT/OCT, Pachymetry for glaucoma Retinal photography and angiography Full Optical and Contact Lens service

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Eye Doctor NJ Freehold Ophthalmology

The Section of Ophthalmology and Visual Science provides medical and surgical treatment of eye diseases. The section members' interests include cataract surgery with lens implantation, transplantation including corneal diseases plus refractive surgery, vitreo-retinal surgery, and medical diseases of the retina including special treatment of diabetic retinopathy and age-related retinal degenerations, eye plastic surgery, strabismus surgery, and neuro-opthalmology.

Refractive surgery is based on special imaging of the cornea obtained by the computer. The surgery is employed to correct irregularities in the cornea. In selected cases, we also use surgery to correct refractive errors, eliminating the need for glasses.

The Retinal Imaging and Laser Treatment Center uses a computer to analyze retinal diseases in preparation for laser treatment. The vitreo-retinal center also specializes in difficult diagnostic problems including hereditary defects of the retina.

Glaucoma diagnosis and treatment is based on special computer-generated visual field testing and optical nerve imaging. The treatment includes outpatient laser as well as surgical intervention.

Strabismus surgery is based on television analysis and orthoptic testing of ocular motility. Treatment is carried out, in special cases, with sutures that can be adjusted after surgery for perfect alignment. Chemical injection replaces surgery in selected cases.

Neuro-ophthalmology consultation is available, as is ocular plastic surgery for external and eyelid defects.

All eye care services are located on the University of Chicago medical campus:

Duchossois Center for Advanced Medicine 5758 S. Maryland Avenue, Clinic 1B Chicago, IL 60637

UCH_004213 (11)

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Ophthalmology - The University of Chicago Medicine

The mission of the Pan-American Association of Ophthalmology is the prevention of blindness through lifelong education and cultural exchange among ophthalmologists in the Western Hemisphere.

This Portal will provide a virtual meeting place for professionals from all over the world to gather as a Pan-American Community and focus on ways to standardize and improve ophthalmic knowledge and skills for the improvement of patient care.

The Pan-American Association of Ophthalmology (PAAO) was founded in 1939 by Moacyr E. Alvaro MD (Brazil), Conrad Berens MD (USA), and Harry S. Gradle MD (USA). The Pan-American Ophthalmological Foundation (PAOF) was founded in 1959 to support the PAAO and its educational programs. The Pan-American strives to provide continuing education for ophthalmologists, prevention of blindness programs, and cultural exchange.

Pan-American Ophthalmological Foundation

For over 70 years, the Association has been instrumental helping to restore sight in countless numbers of people and has been a leader in elevating the standards of practice of ophthalmology and quality of eye care in the Western Hemisphere.

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PAAO - Pan-American Association of Ophthalmology

Ophthalmology is the medicine discipline which deals with the anatomy and diseases of the eye. An ophthalmologist refers to a specialist in both medical and surgical eye problems, as ophthalmologists perform operations on eyes.

The word ophthalmology has Greek , as ophthalmos means eye and logos means a word or a thought. Thereby ophthalmology can literally be translated as the science of eyes. As a discipline, it applies to animal eyes also. However, veterinary medicine is regulated separately in many countries and states. Therefore ophthalmologists treating both humans and animals are rare.

Ophthalmologists are medical doctors (MD/MBBS or D.O.) who have completed a college degree, medical school, and residency in ophthalmology. Ophthalmology was the first medicine discipline to offer board certification which is now a standard practice among all specialties. In many countries, ophthalmologistscan also undergo specialized training in one of the many subspecialities, as the ones listed below.

Ophthalmology sub-specialities:

* Ocular oncology. * Oculoplastics & Orbit surgery. * Ophthalmic pathology.

* Refractive surgery. * Uveitis/Immunology. * Veterinary Formal specialty training programs in veterinary ophthalmology now exist in some countries. * Vitreo-retinal surgery, deals with surgical management of retinal and posterior segment diseases and disorders.

* Anterior segment surgery * Cataracts most general ophthalmologists perform cataract surgery, is not usually considered a subspecialty. * Cornea, ocular surface, and external disease. * Glaucoma. * Medical retina,which deals with treatment of retinal problems through non-surgical means. * Neuro-ophthalmology. * Pediatric ophthalmology/Strabismus (mis-alignment of the eyes)

In america, certification by the American Board of Ophthalmology is a voluntary process. This process involves a written and an oral examination. A candidate who successfully passes becomes a Board Certified Diplomate of the American Board of Ophthalmology. Thus this person is entitled to use the letters D.A.B.O. after his or her name.

The American Academy of Ophthalmology (AAO) is the largest national membership medical association of ophthalmologists in America. +90 percent of practicing U.S. Eye M.D.s are AAO Academy members, and the Academy has more than 7,000 international members. The group has its headquarters in San Francisco, California.

The academy originated as American Academy of Ophthalmology and Otolaryngology (AAOO), founded in 1896 as a medical association of both ophthalmologists and otolaryngologists, but was split in 1979 and divided into separate academies for each specialty. Outside the medical community it promotes public health information.

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OPHTHALMOLOGY. What is Ophthalmology? (Opthalmology)

Neuro-ophthalmology is an academically-oriented subspecialty that merges the fields of neurology and ophthalmology, often dealing with complex systemic diseases that have manifestations in the visual system. Neuro-ophthalmologists initially complete a residency in either neurology or ophthalmology, then do a fellowship in the complementary field. Since diagnostic studies can be normal in patients with significant neuro-ophthalmic disease,[1] a detailed medical history and physical exam is essential and neuro-ophthalmologists often spend significantly more time with the patient than specialists in other disciplines.

Common pathology referred to a neuro-ophthalmologist includes afferent visual system disorders (e.g. optic neuritis, optic neuropathy, papilledema, brain tumors or strokes) and efferent visual system disorders (e.g. anisocoria, diplopia, ophthalmoplegia, ptosis, nystagmus, blepharospasm and hemifacial spasm). The largest international society of neuro-ophthalmologists is the North American Neuro-Ophthalmological Society (NANOS),[2] which organizes an annual meeting and publishes the Journal of Neuro-Ophthalmology.

Neuro-ophthalmology focuses on diseases of the nervous system that affect vision, control of eye movements, or pupillary reflexes. Neuro-ophthalmologists often see patients with complex multi-system disease and zebras are not uncommon. Neuro-ophthalmologists are often faculty at large university-based medical centers, typically in the ophthalmology department but may also be housed in other departments or be in private practice. Patients often have co-existing disease in other fields (rheumatology, endocrinology, oncology, cardiology, etc.), thus the neuro-ophthalmologist is usually a liaison between the ophthalmology department and other departments in the medical center.[3]

A neuro-ophthalmologists office is filled with patients who have been misdiagnosed or incorrectly diagnosed and drag literally pounds of diagnostic studies, which often reiterate that neuroimaging is normal, incorrectly performed, or incorrectly interpreted in many neuro-ophthalmologic disorders.[4] Neuro-ophthalmologists are often active teachers in their academic institution, and the first four winners of the prestigious Straatsma American Academy of Ophthalmology teaching awards were neuro-ophthalmologists.[5] Most neuro-ophthalmologists are passionate about their discipline and report high job satisfaction, stating that they think the field continues to be both fascinating and challenging.

Neuro-ophthalmology is mostly non-procedural, however, neuro-ophthalmologists may be trained to perform eye muscle surgery to treat adult strabismus, optic nerve fenestration for idiopathic intracranial hypertension, and botulinum injections for blepharospasm or hemifacial spasm.

Frank B. Walsh was one a pioneer of neuro-ophthalmology, helping to popularize and develop the field. Walsh was born in Oxbow, Saskatchewan in 1895 and earned a degree for University of Manitoba in 1921. He joined the Wilmer Ophthalmological Institute at Johns Hopkins University and began organizing Saturday morning neuro-ophthalmology conferences. Walsh compiled the first neuro-ophthalmology textbook, which was published in 1947 and has been updated over the years by generations of his students.[6]

Ophthalmologists have been decreasing the time spent with a patient due to economic pressures, the use of nonphysicians, and increasing reliance on laboratory tests. Neuro-ophthalmology has been affected more so than other specialties due to the complexity of the patients and the time required to do a neuro-ophthalmic history and physical exam.[5] Additionally, the current medical reimbursement system rewards quantity of service (performing assembly line procedures) rather than quality of service (making a correct diagnosis, patient education, and counseling), and seeing complex patients is not adequately recognized.

Improved functional neuroimaging is paving the way for better understanding, assessment, and management of many neurologic and neuro-ophthalmologic conditions. As our understanding of neuroscience evolves, neuro-ophthalmologists are becoming increasingly better at treatment, rather than only diagnosis, and novel therapies are emerging to treat traditionally vision-devastating disease.[7] For example, clinical trials began in February 2014 to use gene therapy to treat Leber hereditary optic neuropathy,[8] which is one of the first uses of gene therapy in the central nervous system. Progress has also been made in understanding retinal ganglion cell regeneration and in re-establishing synaptic connections from the optic nerve to the brain,[1] more than in other regions of the central nervous system.[9][10] One of the goals of the National Institutes of Health is to use the visual system as a window to understand neural plasticity and regenerative medicine in the central nervous system,[11] an area of neuroscience that has a promising future and is intimately intertwined with neuro-ophthalmology.

The weakening financial environment for academic neuro-ophthalmologists must be addressed so that there is the clinical infrastructure to treat patients, assess and implement emerging technologies and treatments, and train the next generation of neuro-ophthalmologists. Data is needed to quantify the problem (the revenue provided to other departments, the amount of money wasted on unnecessary tests, visits, and procedures before seeing a neuro-ophthalmologist, the average time a patient spends with the neuro-ophthalmologist, etc), and given the direction of ophthalmic and neurologic research, it is imperative to continue to have a vibrant academic neuro-ophthalmologic community for the future.

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Neuro-ophthalmology - Wikipedia, the free encyclopedia

Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye.[1] An ophthalmologist is a specialist in medical and surgical eye problems. Since ophthalmologists perform operations on eyes, they are both surgical and medical specialists. A multitude of diseases and conditions can be diagnosed from the eye.[2]

The word ophthalmology comes from the Greek roots , ophthalmos, i.e., "eye" and -o, -logia, i.e., "study of, discourse";[3][4] ophthalmology literally means "the science of eyes". As a discipline, it applies to animal eyes also, since the differences from human practice are surprisingly minor and are related mainly to differences in anatomy or prevalence, not differences in disease processes.[citation needed]

The Indian surgeon Sushruta wrote Sushruta Samhita in Sanskrit in about 800 BC which describes 76 ocular diseases (of these 51 surgical) as well as several ophthalmological surgical instruments and techniques.[5][6] His description of cataract surgery was more akin to extracapsular lens extraction than to couching.[7] He has been described as the first cataract surgeon.[8][9]

The pre-Hippocratics largely based their anatomical conceptions of the eye on speculation, rather than empiricism.[10] They recognized the sclera and transparent cornea running flushly as the outer coating of the eye, with an inner layer with pupil, and a fluid at the centre. It was believed, by Alcamaeon and others, that this fluid was the medium of vision and flowed from the eye to the brain by a tube. Aristotle advanced such ideas with empiricism. He dissected the eyes of animals, and discovering three layers (not two), found that the fluid was of a constant consistency with the lens forming (or congealing) after death, and the surrounding layers were seen to be juxtaposed. He and his contemporaries further put forth the existence of three tubes leading from the eye, not one. One tube from each eye met within the skull.

Rufus of Ephesus recognised a more modern eye, with conjunctiva, extending as a fourth epithelial layer over the eye.[11] Rufus was the first to recognise a two-chambered eye, with one chamber from cornea to lens (filled with water), the other from lens to retina (filled with an egg white-like substance). The Greek physician Galen remedied some mistakes including the curvature of the cornea and lens, the nature of the optic nerve, and the existence of a posterior chamber.

Though this model was a roughly correct modern model of the eye, it contained errors. Still, it was not advanced upon again until after Vesalius. A ciliary body was then discovered and the sclera, retina, choroid, and cornea were seen to meet at the same point. The two chambers were seen to hold the same fluid, as well as the lens being attached to the choroid. Galen continued the notion of a central canal, but he dissected the optic nerve and saw that it was solid. He mistakenly counted seven optical muscles, one too many. He also knew of the tear ducts.

Medieval Islamic Arabic and Persian scientists (unlike their classical predecessors) considered it normal to combine theory and practice, including the crafting of precise instruments, and therefore found it natural to combine the study of the eye with the practical application of that knowledge.[12]

Ibn al-Haytham (Alhazen), an Arab scientist with Islamic beliefs, wrote extensively on optics and the anatomy of the eye in his Book of Optics (1021).

Ibn al-Nafis, an Arabic native of Damascus, wrote a large textbook, The Polished Book on Experimental Ophthalmology, divided into two parts, On the Theory of Ophthalmology and Simple and Compounded Ophthalmic Drugs.[13]

In the 17th and 18th centuries, hand lenses were used by Malpighi, and microscopes by van Leeuwenhoek, preparations for fixing the eye for study by Ruysch, and later the freezing of the eye by Petit. This allowed for detailed study of the eye and an advanced model. Some mistakes persisted, such as: why the pupil changed size (seen to be vessels of the iris filling with blood), the existence of the posterior chamber, and of course the nature of the retina. In 1722, van Leeuwenhoek noted the existence of rods and cones,[citation needed] though they were not properly discovered until Gottfried Reinhold Treviranus in 1834 by use of a microscope.

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Ophthalmology - Wikipedia, the free encyclopedia

The Wilmer Eye Institute at Johns Hopkins, founded in 1925, is an internationally-renowned eye institution that specializes in the diagnosis and management of complex medical and surgical eye disease; and serves as a preeminent provider of routine eye care and refractive, optical, cosmetic, and eye trauma services for the Mid-Atlantic region. Wilmer is also recognized as a national leader in research and in the training of medical students, residents, fellows, and ophthalmic technicians. As the largest department of ophthalmology in the United States, the Wilmer Eye Institute has earned recognition for bringing together ophthalmologists and optometrists consistently regarded as being amongthe finest in the field.

On this website, we provide an overview of the Wilmer Eye Institute's various departments, care providers, and research activities. You will also find information on making appointments at Wilmer, along with directions to our multiple service locations.

Were connecting to improve your care. Johns Hopkins Medicine is implementing a new electronic medical record system that will help you be an active partner in your health care and improve the high-quality care you already receive. We appreciate your patience as we put this new system in place. For more information, visit http://www.hopkinsmedicine.org/myrecord.

If you need general assistance, please call the Wilmer Call Center at 410-955-5080, or toll free at 1-800-21JOHNS (1-800-215-6467)

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Wilmer Eye Institute - Johns Hopkins - Baltimore, Maryland

Written by Lois Alcosser Saturday, 26 May 2012 07:00

Though macular degeneration is rarely discussed as a health topic, it is a fearful possibility, especially as people age. That could account for the standing-room-only audience when Dr. Jeffrey Oberman, chief of opthalmology at Norwalk Hospital, spoke recently at the Greens at Cannondale. He explained in detail the causes, symptoms and latest advances in the treatment of macular degeneration.

The macula, he explained, is at the back wall of the eye. It is only 1% of the eyes physiology, but responsible for 90% of vision problems, and is the most common cause of visual loss in the developed world.

Painless and progressive, there are two forms of macular degeneration: dry and wet. The most frequent, the dry form, occurs when the light-sensitive cells in the macula slowly break down, blurring the central vision of the affected eye. Reading becomes difficult, so does recognizing faces. In the more severe, wet form, abnormal blood vessels form and leak into the macula area of the eye. Straight lines appear wavy, and there is a blind spot in the center of the eye.

Before there are any symptoms or vision loss, yellowish spots, called drusen, can be detected with a comprehensive eye exam, which is why it is so important to have regular eye examinations. The dry form can turn into the wet form, which is much more likely to affect vision, and is much more difficult to treat.

Risk factors for macular degeneration include age, smoking, obesity, family history and lifestyle. Dry degeneration can be treated with antioxidants, which are only helpful in the intermediate stage. A formulation called AREDS, consisting of Vitamins A, C, E, zinc and copper, is recommended. Something as simple as wearing sunglasses is helpful, to block out ultraviolet light.

The wet form of macular degeneration has been treated with lasers, photodynamic therapy and injections, but none is a cure. Injections, however, can potentially improve vision and stabilize the condition. Though these injections are into the eye, they are relatively painless. They are usually done monthly or bimonthly. Lucentis has stabilized degeneration 95% and improved acuity 34%. The problem is, it costs around $2,000 per injection. A much less expensive injection, Avastin, ($75 per dose) can slow the rate of progression and may cause some improvement.

There are many studies underway to find better, more affordable ways to improve treatment. The use of stem cells to create a healthy macula has proven successful in mice. But considering the fact there are 1.4 million fibers from the eye to the brain to create sight, this is clearly a complex and daunting challenge.

Dr. Oberman expressed great hope in further research. Meanwhile, be sure and get your eyes examined regularly.

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Macular degeneration: Causes, symptoms, cures

Stem cells reverse blindness caused by burns

By ALICIA CHANG (AP) – 1 day ago

LOS ANGELES — Dozens of people who were blinded or otherwise suffered severe eye damage when they were splashed with caustic chemicals had their sight restored with transplants of their own stem cells — a stunning success for the burgeoning cell-therapy field, Italian researchers reported Wednesday.

The treatment worked completely in 82 of 107 eyes and partially in 14 others, with benefits lasting up to a decade so far. One man whose eyes were severely damaged more than 60 years ago now has near-normal vision.

"This is a roaring success," said ophthalmologist Dr. Ivan Schwab of the University of California, Davis, who had no role in the study — the longest and largest of its kind.

Stem cell transplants offer hope to the thousands of people worldwide every year who suffer chemical burns on their corneas from heavy-duty cleansers or other substances at work or at home.

The approach would not help people with damage to the optic nerve or macular degeneration, which involves the retina. Nor would it work in people who are completely blind in both eyes, because doctors need at least some healthy tissue that they can transplant.

In the study, published online by the New England Journal of Medicine, researchers took a small number of stem cells from a patient's healthy eye, multiplied them in the lab and placed them into the burned eye, where they were able to grow new corneal tissue to replace what had been damaged. Since the stem cells are from their own bodies, the patients do not need to take anti-rejection drugs.

Adult stem cells have been used for decades to cure blood cancers such as leukemia and diseases like sickle cell anemia. But fixing a problem like damaged eyes is a relatively new use. Researchers have been studying cell therapy for a host of other diseases, including diabetes and heart failure, with limited success.

Adult stem cells, which are found around the body, are different from embryonic stem cells, which come from human embryos and have stirred ethical concerns because removing the cells requires destroying the embryos.

Currently, people with eye burns can get an artificial cornea, a procedure that carries such complications as infection and glaucoma, or they can receive a transplant using stem cells from a cadaver, but that requires taking drugs to prevent rejection.

The Italian study involved 106 patients treated between 1998 and 2007. Most had extensive damage in one eye, and some had such limited vision that they could only sense light, count fingers or perceive hand motions. Many had been blind for years and had had unsuccessful operations to restore their vision.

The cells were taken from the limbus, the rim around the cornea, the clear window that covers the colored part of the eye. In a normal eye, stem cells in the limbus are like factories, churning out new cells to replace dead corneal cells. When an injury kills off the stem cells, scar tissue forms over the cornea, clouding vision and causing blindness.

In the Italian study, the doctors removed scar tissue over the cornea and glued the laboratory-grown stem cells over the injured eye. In cases where both eyes were damaged by burns, cells were taken from an unaffected part of the limbus.

Researchers followed the patients for an average of three years and some as long as a decade. More than three-quarters regained sight after the transplant. An additional 13 percent were considered a partial success. Though their vision improved, they still had some cloudiness in the cornea.

Patients with superficial damage were able to see within one to two months. Those with more extensive injuries took several months longer.

"They were incredibly happy. Some said it was a miracle," said one of the study leaders, Graziella Pellegrini of the University of Modena's Center for Regenerative Medicine in Italy. "It was not a miracle. It was simply a technique."

The study was partly funded by the Italian government.

Researchers in the United States have been testing a different way to use self-supplied stem cells, but that work is preliminary.

One of the successful transplants in the Italian study involved a man who had severe damage in both eyes as a result of a chemical burn in 1948. Doctors grafted stem cells from a small section of his left eye to both eyes. His vision is now close to normal.

In 2008, there were 2,850 work-related chemical burns to the eyes in the United States, according to the Bureau of Labor Statistics.

Schwab of UC Davis said stem cell transplants would not help those blinded by burns in both eyes because doctors need stem cells to do the procedure.

"I don't want to give the false hope that this will answer their prayers," he said.

Dr. Sophie Deng, a cornea expert at the UCLA's Jules Stein Eye Institute, said the biggest advantage was that the Italian doctors were able to expand the number of stem cells in the lab. This technique is less invasive than taking a large tissue sample from the eye and lowers the chance of an eye injury.

"The key is whether you can find a good stem cell population and expand it," she said.

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Online:

New England Journal: http://www.nejm.org