RHJVAMC PROGRAM DESCRIPTION

Residency in Low Vision and Primary Care Optometry

Ralph H. Johnson VA Medical Center

affiliated with

SOUTHERN COLLEGE OF OPTOMETRY

MEMPHIS, TENNESSEE

 

Program Mission

The mission of this residency program is to provide residents with the clinical education necessary to become practitioners who are able to deliver low vision/rehabilitative eye care and primary care optometry, including therapeutic management of ocular disease, in a multidisciplinary environment.  This program will provide academic and clinical experiences that will enable residents to expand their knowledge base, strengthen their patient care skills, and participate in clinical and academic education.  Individuals who complete the program are expected to be able to deliver a high level of clinical care with advanced sub-specialty Low Vision experience and to serve as optometric educators. 

 

Standard I:

Mission, Goals, Objectives, Outcomes, and Program Improvement

 

Goal 1:        Provide the resident with experience in Primary Care Optometry including the role of ocular diagnostic and therapeutic drugs in the diagnosis and management of complex ocular conditions.

 

Objective 1:  Provide the resident with adequate experience and training in the management of complex ocular conditions.

 

Outcome:         The resident will manage and treat an adequate number of patients with complex ocular disease presentations.

 

Measure:         Using data collected from the Encounter Forms (CPRS) and the patient care log (maintained by the resident), the resident will report quarterly on the numbers of patients seen with complex ocular disease presentations (as defined as those patients with three or more ICD-9 diagnoses relating to the eye).

 

Objective 2: Ensure the resident gains adequate experience with advanced diagnostic ocular procedures.

 

Outcome:         The resident will perform and/or interpret advanced diagnostic procedures (including gonioscopy, fundus contact lens examination, optical coherence tomography, visual fields, B-scan ultrasonography, and posterior segment photography) when clinically indicated.

 

Measure:         Using data collected from the Encounter Forms (CPRS) and the patient care log, the resident will report quarterly on the number of advanced diagnostic procedures performed (including gonioscopy, fundus contact lens examination, optical coherence tomography, visual fields, B-scan ultrasonography, and posterior segment photography).

 

Objective 3:  Ensure that the resident gains experience in ordering non-ophthalmic diagnostic tests and procedures necessary for the evaluation of complex ocular disease

 

Outcome:         The resident will order non-ophthalmic diagnostic tests and procedures when clinically indicated.

 

Measure:         Using data collected from the Encounter Forms and the patient care log, the resident will report quarterly on the numbers and types of diagnostic tests and procedures ordered. Review of the resident�s records in accordance with the resident supervision policy will be used as an opportunity to educate the resident on the need for special diagnostic tests and procedures on a case-by-case basis

 

Objective 4: Provide the resident with experience in the fitting and management of medically indicated prism, or partial ocular occlusion management of diplopia due to ocular disease

 

Outcome:         The resident will perform binocular vision evaluations on patients with diplopia who require the use of ophthalmic prisms or partial ocular occlusion.

 

Measure:         Using data collected from the Encounter Forms, the resident will report quarterly on the number and type of ophthalmic prism evaluations performed

 

Objective 5:  Provide the resident with experience in the triage and management of urgent ocular conditions

 

Outcome:         The resident will serve as a referral source for urgent eye care consultations requested of the Eye Clinic

 

Measure:         Using data collected from the Encounter Forms and the patient care log, the resident will report quarterly on the number of urgent ocular consultations performed

 

 

Goal 2:        Provide the resident with experience in Low Vision / Vision Rehabilitation Optometry to strengthen clinical competence in delivering Vision Rehabilitative eye care

 

Objective 1:  Ensure the resident performs a minimum number of low vision/rehabilitative eye care evaluations

 

Outcome:         The resident will perform a minimum of 200 new and/or follow up low vision/rehabilitative eye exams

 

Measure:         Using data collected from the Encounter Forms and the patient care log, the resident will report quarterly on the number and type of low vision/rehabilitative eye exams performed

 

Objective 2: Expose the resident to a diverse range of low vision patient presentations

 

Outcome:         The resident will examine patients with a variety of levels of visual impairments, representative of the visually impaired population at the Ralph H. Johnson VAMC and the Storm Eye Institute of the Medical University of South Carolina (MUSC) Low Vision Rehabilitation Clinic.

 

Measure:         Using data collected from the Encounter Forms, the resident will report quarterly on levels of visual impairments encountered as defined by the ICD-9 diagnostic codes.

 

Objective 3:  Ensure the resident gains experience in the prescribing of the full scope of low vision devices

 

Outcome:         The resident will prescribe the full range of non-optical, optical, and electronic low vision devices as clinically indicated and appropriate for the visually impaired patient population

 

Measure:         Using data collected from the Encounter Forms and the patient care log, the resident will report quarterly on the categories and types of low vision devices prescribed

 

 

Goal 3:        Provide the resident with clinical teaching experiences and training to enable them to become Attending Optometrists in outpatient clinical or hospital-based primary eye-care settings. 

 

Objective 1: Ensure that the resident gains experience and training in functioning as a clinical attending optometrist.

 

Outcome:         The resident will experience consultative/attending training by discussion and provide co-attending services for the optometry externs that are doing rotations at RHJVAMC.

 

Measure:         Using data collected from the patient care log, the resident will report quarterly on the number and types of consultation/attending services made for optometry externs. 

 

Objective 2: Provide the resident with opportunities to train optometry student externs in clinical procedures in preparation for their board examinations.

 

Outcome:         The resident will spend a minimum of 1-2 hours clinical procedural training for each optometry student extern during their 3 month clinical rotation at RHJVAMC.

 

Measure:         The resident clinical schedule will be arranged to provide ample time to provide attending optometry services and clinical procedural training to the optometry student externs.

 

 

Goal 4:        Provide the Resident with didactic teaching experiences and training to enable them to become Academic Optometrists or to pursue academic sub-specialty lectureships

 

Objective 1:  Develop the resident�s ability to effectively share knowledge and disseminate information

 

Outcome:         The resident will help prepare and present Low Vision Rehabilitation  lecture/workshops for Occupational Therapy Master�s degree students from the College of Health Professions MUSC, and for Ophthalmology residents from Storm Eye Institute at MUSC

 

Measure:         Documentation available includes Power Point presentations, and handouts for lectures presented.

 

 

Objective 2: Develop the resident�s instructional and clinical teaching skills.

 

Outcome:         The resident will participate in bi-weekly optometric journal club type presentations and in the clinical supervision and training of optometric externs.

 

Measure:         A record will be kept of the topics covered during case review or journal clubs and the resident will report quarterly on the number of patients where extern supervision or assistance was provided.

 

 

Goal 5:        Provide the Resident with research experiences and training to enable them to not only appreciate the significance of research in clinical practice, but to engage in, and conduct worthwhile clinical research and other scholarly activity.

 

Objective 1:  Develop the resident�s ability to critically evaluate clinical research from the ophthalmic literature.

 

Outcome:         The resident will read clinically relevant ophthalmic research literature for discussion with the Program Supervisor and/or staff.

 

Measure:         Each month, an article from the current issue of �Optometry and Vision Science� will be chosen by the resident and discussed with the Program Supervisor and/or staff.  A log of these articles will be maintained by the resident.

 

 

Objective 2: Develop the resident�s ability to use library resources to investigate clinically relevant topics.

 

Outcome:         The resident will become familiar with methods of library research, including literature searches.

 

Measure:         The resident will present a library search based on a chosen �virtual� vision research question.  This �virtual� project will be used to facilitate discussion of the step-wise development and conduct of a research question.

 

Objective 3: Guide and educate the resident as to the process of preparation of a manuscript of publishable quality.

 

Outcome:         The resident must prepare a manuscript/case report of publishable quality.

 

Measure:         The resident will be evaluated quarterly on the progress of his or research paper or case report manuscript preparation.  Again, the �virtual� project will be used to facilitate discussion of the step-wise development and conduct of a research project.

 

Goal 6:        Provide the Resident with community service experiences and training to enable them to not only appreciate the significance of community service to public health, but to engage in, and conduct worthwhile community service activities

 

Objective 1:  Develop the resident�s ability to identify worthwhile projects that will help the community by improving eyecare in some way.

 

Outcome:         The resident will have the opportunity to participate in and help organize a vision screening project that will take place during their tenure.  This project is organized and conducted by the ophthalmology residents from MUSC as a class project each year.

 

Measure:         The resident will prepare a written after-action report of the project.

 

Objective 2:  Develop an appreciation for providing community low vision services to the visually impaired, and develop the the ability to conduct community low vision examinations for the Commission for the Blind in South Carolina.

 

Outcome:         The resident will have the opportunity to participate in and help organize a low vision clinic for the SC Commission for the Blind that will take place during their tenure.

 

Measure:         The resident will prepare a written after-action report of the project.

 

 

Standard II: Curriculum

The residency program has a strong clinical emphasis, with a diverse patient base and clinical experiences.  The resident examines and evaluates low vision patients as part of the clinical  Low Vision program, which includes working directly with a full time vision rehabilitation specialist.   The resident also manages patients with ongoing and chronic ocular diseases as well as fitting contact lenses for medically indicated conditions such as keratoconus and aphakia. Academic and didactic activities include a weekly case review session at the VAMC as well as weekly Grand Rounds at MUSC.

With its emphasis on direct patient care, the curriculum is designed to provide a significant number of patient encounters as well to ensure a diverse range of experiences.  In the clinic, the resident is given priority with regard to number of patient encounters, urgent or emergency consultations, and complex or challenging cases.  Approximately 80% of the residents� time is spent in direct patient care (50% general clinic, 30% low vision), and the remaining 20% in observation, didactic, research, administrative or academic activities.

Approximately 30% of the residents� clinical time will be spent in low vision care as part of the Ralph H. Johnson�s VAMC�s Low Vision Clinic.  This clinic includes a full time low vision specialist as well as a fully equipped low vision examination room and comprehensive array of low vision devices.  The resident will gain experience in full scope of low vision care, including the prescribing of optical, nonoptical, and electronic and computer based devices., as well as developing a team-based approach to visual rehabilitation.

The resident will also gain experience in managing patients with complex ocular disease.  Established patients requiring ongoing care for chronic and/or acute ocular diseases are scheduled in the resident designated clinic, thus ensuring that the resident can establish ongoing follow care for his/her own patients. Ocular disorders managed by the resident include but are not limited to diabetic retinopathy, glaucoma, macular degeneration, uveitis, anterior segment disease, peripheral retinal disease, and neurologic disorders.  The resident is also given priority for evaluating patients with acute or emergent eye conditions.

 

When clinically indicated, the resident orders diagnostic tests from the laboratory (serology, blood chemistry, etc.), imaging (X-rays, computed tomography, MRI, etc), peripheral vascular lab (carotid doppler studies), and cardiology (echocardiograms). Within the Eye Clinic, advanced diagnostic procedures such as ultrasound scanning are performed independently by the resident after a period of supervised training by the Program Coordinator.  When necessary, consultative services outside the Eye Clinic can be obtained through Neurology, Otolaryngology, Vascular Surgery, Infectious Diseases, and other specialties and subspecialties.

 

The resident also has the opportunity to participate in specialty contact lens fitting for medically indicated ocular conditions. This includes the fitting and follow-up of contact lenses for keratoconus, aphakia, high myopia, and corneal irregularities or scarring.  This clinical opportunity will be made available for the resident at the MUSC Storm eye Institute contact lens clinic, typically as a half-day rotation once a month.

 

The vast majority of patients are examined on an outpatient or ambulatory basis.  However, the resident also evaluates patients undergoing long-term intermediate (domiciliary) care, short term inpatient care, and long term inpatient care (e.g. Nursing Home or Spinal Cord Injury patients) when requested by their providers.  Inpatient bedside examinations on the hospital wards are also performed when indicated.

 

Academic and didactic activities include the following:

 

Ophthalmology Grand Rounds

The resident is eligible to attend the case report talks at the Ophthalmology Resident Grand Rounds at MUSC. Presentations include a well-researched literature review of the topic, a 15-20 minutes discussion of the condition involved, and frequently a handout. Ophthalmology grand rounds are routinely attended by local practitioners in the area. Grand Rounds are held on the second and fourth Tuesday of each month for ten of the 12 months of the residency year.

 

Journal Review

Throughout the year, (monthly) the resident is assigned journal articles to read which are reviewed and discussed with the Program Coordinator and Optometry staff.

 

Bi-Monthly Case Review/Discussion

The first and third tuedsay afternoon, usually 3:30 – 4:30pm, the resident will lead a case discussion or review topic discussion regarding interesting cases encountered during the week.

 

Monthly Friday Conference

The third Friday afternoon of each month an academic conference is held in which case presentations and lecture topics are presented. The presentations are given by the optometry externs, resident or attending staff.

Ophthalmology sub-specialty rotations

The resident has the opportunity to rotate through other ophthalmology sub-specialty clinics at MUSC, Storm Eye Institute, depending on the interests of the resident.  These rotations are scheduled in the second or third quarter of the year and are designed to give the resident experience with and exposure to secondary eye care specialties and other supportive disciplines.

 

Virtual� Research Project

The resident will identify a research topic of interest that will become a �virtual� research project.  It is to be a �virtual� project in that it will not be conducted, but will provide a vehicle for instruction of methods of design and analysis of a research project. 

 

Resident�s manuscript

One of the requirements for the awarding of a residency certificate is the completion of a manuscript of publishable quality. This paper may be a case report with literature review or a research project.  The Program Coordinator will help the resident plan for the conduct of any research or case report project to ensure adequate time is allowed to develop and conduct a worthwhile project.  There are options for the resident to submit a manuscript to the open literature, or to submit a poster or presentation to an annual optometric continuing education meeting, or to present their project at the Storm Eye Institute Kiawah Update 2012 meeting where the ophthalmology residents present their research projects.  These options will be carefully explored and the final decision regarding presentation will depend on the caliber, and topic of the project.

 

The educational objectives of the curriculum are intended to ensure attainment of the mission, goals, and objectives of the program.  Consequently, each educational objective reflects a specific program goal. Specifically:

 

CURRICULUM GOALS

Program Goal 1

 

Objective:

Provide the resident with experience in Primary Care

Optometry including the role of ocular diagnostic and

therapeutic drugs in the diagnosis and management of

complex ocular conditions.

 

Learning Activity:

The resident will provide primary eye care services involving a minimum of 1500 patient encounters, 60% of which will include obtaining a case history, visual acuity, refraction, tonometry, and external and internal ocular health assessment during the encounter. 

Outcome:

The resident will develop enhanced skills in the management of primary eye care patients.

 

Program Goal 2

 

Objective:

Provide the resident with experience in Low Vision / Vision Rehabilitation Optometry to strengthen clinical competence in delivering Vision Rehabilitative eye care

Learning Activity:

The resident will provide services to a significant number of patients with low vision (approximately 200 patients) and will formulate a diagnosis based on the results of the procedures performed. 

Outcome:

The resident will become highly proficient in the performance and interpretation of basic and advanced ocular examination techniques on patients with visual impairments, and will attain advanced skills in the management of these patients.

 

Program Goal 3

 

Objective:

Provide the Resident with clinical teaching experiences and training to enable them to become Attending Optometrists in outpatient clinical or hospital-based primary eye-care settings

Learning Activity:

The resident will learn to interpret ophthalmic fluorescein angiography, B-scan ultrasonography, anterior segment photography and relevant laboratory and radiological procedures.  The resident will teach optometry externs the clinical significance of the specialty testing as they gain expertise in each area.

Outcome:

The resident will develop advanced knowledge of specialized diagnostic procedures and instrumentation.

 

Program Goal 4

 

Objective:

Provide the Resident with didactic teaching experiences and

training to enable them to become Academic Optometrists

or to pursue academic sub-specialty lectureships

 

Learning Activity:

The resident will prepare and present didactic style lectures (Power Point computer presentations) for optometry externs and assist the Program Coordinator in the presentation of classroom lectures in low vision to the ophthalmology residents at MUSC.

Outcome:

The resident will be able to communicate effectively with optometry students and ophthalmology residents in providing specialty eye care in the field of low vision.  The resident will also prepare case reports and or journal article reviews for the optometry externs that rotate through the RHJVAMC.  The resident will be providing small group discussions, small group didactic presentations, journal article review and discussion – in short, all those types of teaching activities that produces an experienced educator.

 

Program Goal 5

 

Objective:

Provide the Resident with research experiences and training

to enable them to not only appreciate the significance of

research in clinical practice, but to engage in, and conduct

worthwhile clinical research and other scholarly activity.

 

Learning Activity:

The resident will have several options to decide about before committing to one particular project.  Initially, the Program Coordinator (who has experience with all the potential types of projects) will conduct one-on-one discussions covering the following options:  a case report format of an interesting case or cases encountered during clinic; a literature review of a topic the resident is deeply interested in; a clinical research project conducted with the Program Coordinator (who would help get the project thru the review process and human subjects approval). 

Outcome:

The resident will produce a publishable quality manuscript designed as either a case report, literature review, or clinical research project.  Presentation of the project will be both written and oral.  It must be completed as a written submission to a journal for review and publication, and as a verbal presentation (at Kiawah in the Spring, and/or at SCO resident project day or both, or as a small group discussion project report at RHJVAMC).

 

Program Goal 6

 

Objective:

Provide the Resident with community service experiences

and training to enable them to not only appreciate the

significance of community service to public health, but to

engage in, and conduct worthwhile community service

activities

 

Learning Activity:

The resident will have the opportunity to participate in and help organize a vision screening project that will take place during their tenure.  This project is organized and conducted by the ophthalmology residents from MUSC as a class project each year.  There is also an opportunity to organize and participate in a community low vision clinical project through the Commission for the Blind.

Outcome:

The resident will develop skills in organizing and providing specialty eye-care to the community.

 

 

APPLICATION PROCEDURES

A.    All applicants must complete and return the Southern College of Optometry application forms by January 15. Supporting documents should be submitted to the Director of Residency Programs of Southern College of Optometry no later than January 31.  This program will use the Optometric Residency Matching Service.  Applicants must complete the ORMS application and forward it to the ORMS as directed in the application. Applicants are responsible for ensuring that all supporting documentation is submitted to each entity involved, e.g., the College, ORMS, and the residency site if required.

B.    Applicant must have earned an O.D. degree, or will have earned such a degree by the time of matriculation from an accredited school/college of optometry.

C.   Applicant will furnish an official transcript from his/her school/college of optometry.  An applicant should have a cumulative grade point average greater than 3.0 on a 4.0 scale in the professional optometric curriculum.

D.   Applicant must pass all parts of the National Board of Examiners in Optometry examinations required for South Carolina license and furnish official transcripts when available.

E.    Three letters of recommendation are required.

F.    A brief essay stating reasons for applying to this program.

G.   A personal interview is required.

H.   Southern College of Optometry affirms that all residency candidates will be evaluated without regard to sex, race, color, creed, national origin or disabilities.

LETTER OF INTENT

All applicants selected for admission must sign a standard letter of intent.

 

LENGTH OF RESIDENCY

Each residency is one calendar year in length, commencing in July.

LEAVE POLICY

The resident is eligible for thirteen days annual leave.

 

STATUS OF THE RESIDENT

A.    The resident is defined as an employee of the Ralph H. Johnson VAMC and the residency stipend is paid by the VAMC.  No tuition or fees are applicable.

B.    The resident should for apply for optometric license in at least one of the fifty states prior to the beginning of the residency.

C.   Professional liability protection for residents for work done at the Ralph H. Johnson VAMC is provided under the Federal Tort claims act.

D.   Health insurance benefits are available through RHJ VAMC Federal Health Insurance Benefits Program.  Residents also have the option of purchasing health insurance through the affiliate, SCO.  Leave benefits include 13 days annual leave and 13 days sick leave at a rate of 4 hours per pay period.  Additional educational leave, or authorized absence, is typically allowed.  Many factors are weighed before granting such leave, but history has shown that this has been generous with  prior approval of the residency site-director in conjunction with the DRP and the Chief of the Optometry Service.          

 

E.    Residents will have access to the Internet for research purposes, the RHJVAMC and the MedicalUniversity of South Carolina Medical School libraries, and remote access to library search capabilities at Southern College of Optometry.

CRITERIA FOR COMPLETION OF RESIDENCY

 

A.    The resident is required to deliver clinical services at a level that is satisfactory to the Residency Supervisor, the Residency Committee, Director of Residency Programs, and the SCO and Ralph H. Johnson VAMC administrations.  Normal clinic hours are from 8:00 A.M. until patient care is completed, usually around 4:30 P.M., Monday through Friday.  The resident is expected to be present during all working hours, except attending conferences and doing study or research.  The resident will carry a pager while in the clinic in order to address urgent eye problems.  However, optometry residents are not required to answer calls during off-duty hours.

B.    The resident is required to keep a record of patient contacts.  Cases will be reviewed periodically by the Supervisor of the Residency Program, the Director of Residency Programs, and the Residency Committee.

C.   The resident is required to write a publication quality paper based on original research, literature review, or a clinical case.  The resident will be encouraged submit this paper to an approved journal.

D.   The resident is expected to perform in a professional manner in the delivery of patient care services and to observe those proprieties of conduct and courtesies that are consistent with the rules and regulations governing Ralph H. Johnson VAMC.

E.    The resident is required to participate in and complete the requirements set forth in the curriculum.

F.    Upon successful completion of the Residency Program, the Residency Supervisor and the Director of Residency Programs will recommend the granting of certification to the Vice President of Academic Affairs.

H.   Any resident accepted for training can be dismissed, without receiving a certificate of completion, for infractions of the rules and regulations of the Ralph H. Johnson VAMC or those set forth by Southern College of Optometry, or for any action which jeopardizes the safety of patients, personnel, or physical facilities.

STIPEND

A residency stipend will be provided for the year of training paid by Ralph H. Johnson VAMC.  The total financial compensation package is $31,965.

 

OTHER EMPLOYMENT

Other employment (moonlighting) during the residency year is allowed by the Ralph H. Johnson VAMC optometry program provided that the resident does not let outside employment interfere with ANY residency activities and that such employment does not take place during normal working hours.  Residents who choose to moonlight will not be allowed to leave their post at the Ralph H. Johnson VAMC during normal office hours or before patient care duties are finished.  Using sick leave or annual leave to work in the private sector is prohibited.

ACCREDITATION

The residency program at the Ralph H. Johnson VAMC will be fully accredited by the Council on Optometric Education, 243 N. Lindbergh Blvd., St. Louis, MO 63141, 314-991-4100.

CERTIFICATE OF COMPLETION

Upon satisfying all the requirements for completion of the program as determined by the Supervisor of the Residency Program and the Director of the Residency Programs, a Certificate of Completion will be awarded to the resident by Southern College of Optometry.

REPORTING STATUS

The resident reports to the Supervisor of the residency program.  The Supervisor reports directly to the SCO Director of Residency Programs who in turn reports directly to the Vice President of Clinical Programs at Southern College of Optometry.

FOR FURTHER INFORMATION, PLEASE CONTACT:

Cheryl E. Ervin, O.D.

Director, Residency Programs

Southern College of Optometry

1245 Madison Avenue

Memphis, TN  38104

(901) 722-3201

email: cervin@sco.edu

 

 

 


SUMMARY OF RESIDENT ACTIVITY

 

Resident_______________________________________________

 

Summary period:         From                _____________

                                    Through           _____________

 

I.          Comprehensive General Eye Examinations

            Age

            0-10                                                                 _______

 

            11-20                                                               _______

 

            21-30                                                               _______

 

            31-40                                                               _______

 

            41-50                                                               _______

 

            51-60                                                               _______

 

            61-70                                                               _______

 

71-over                                                                        _______          Level of Involvement

 

            TOTAL                                                      _______1      P____S____O____

 

II.         Brief & Limited Visits                                       _______2        Level of Involvement

                                             P____S____O____         

III.        Contact Lens Procedures (NOT included in categories 1 & 2)

                                                Fittings &                     Brief office                                                                               Re-fittings                    visits

                                                                                    (PC, Disp., etc.)

            Soft Lens                     ___________              ___________

            Rigid Gas Permeable  ___________              ___________

            Other                           ___________              ___________

         TOTALS                     ___________3                     ___________4

Level of Involvement                    Level of Involvement

P____S____O____                      P____S____O____

            Sub-categories (included in categories 3 & 4)

                        Spherical         ______                        Bifocal             ______

                        Toric                ______                        Monovision      ______

                        Keratoconus    ______                        Other               ______

 

IV.        Binocular Vision Examinations (NOT included in       categories 1 & 2)

 

            Vergence problems                                         ________

            Accommodative problems                               ________

            Strabismus                                                       ________

            Oculomotor dysfunction                                              ________

            Amblyopia                                                       ________

            Visual perceptual                                            ________        Level of Involvement

            TOTAL                                                                        ________5     P____S____O____


V.         Special Visits (screening patients, patients seen while performing special procedures, etc.)

 

            Patients seen on vision screenings                  ________

 

            __________________________________    ________

 

            __________________________________    ________

Level of Involvement

            TOTAL                                                      ________6         P____S____O____

 

VI.        Objective-related Encounters (included in categories 1, 2, 3, 4, 5, & 6)

            Ophthalmic angiography analyses                  ________

            Laboratory/radiological orders/analyses                      ________

            Systemic disease consults                               ________

            Low vision encounters                                     ________

            __________________________________            ________

            __________________________________            ________

            __________________________________            ________

 

VII.       Contact Lens Procedures (included in categories 1, 2, & 5)

                                                            Fittings &                     Brief office                                                                               Re-fittings                    visits

                                                                                                (PC, Disp., etc.)

            Soft Lens                                 ___________              ___________

            Rigid Gas Permeable              ___________              ___________

            Other                                       ___________              ___________

            Sub-categories (included in above totals)

                        Spherical         ______                        Bifocal             ______

                        Toric                ______                        Monovision      ______

                        Keratoconus    ______                        Other               ______

 

VIII.      Problems of binocular vision & ocular motility (included in categories 1, 2, 3, 4, 5, & 6)

 

            Amblyopia

               Refractive                                                     ________

               Strabismic                                                    ________

               Congenital                                                    ________

               Other                                                                        ________

            Strabismus

               Esotropia                                                      ________

               Exotropia                                                      ________

               Vertical                                                         ________

            Visual perceptual

               Visual motor dysfunction                              ________

               Visual memory                                              ________

               Laterality/Directionality                                ________

            Accommodative Insufficiency/Inflexibility                   ________

            Convergence Insufficiency/Excess                  ________

            Divergence Insufficiency/Excess                                 ________

            Phoria related problems

               Esophoria                                                     ________

               Exophoria                                                     ________

               Vertical                                                         ________


IX.        Ocular Disease (included in categories 1, 2, 3, 4, 5, & 6)

            Adnexa                                                                        ________

            Lacrimal system                                               ________

            Conjunctiva                                                     ________

            Cornea                                                             ________

            Anterior chamber & angle                               ________

            Glaucoma suspect                                           ________

            Glaucoma                                                       ________

            Iris                                                                    ________

            Lens                                                                 ________

            Vitreous                                                           ________

            Retina                                                              ________

            Choroid                                                                        ________

            Optic nerve                                                      ________

 

X.         Systemic Disease (included in categories 1, 2, 3, 4, 5, & 6)

            Hypertension                                                    ________

            Diabetes                                                          ________

            Degenerative joint disease                              ________

            Cardiovascular (excluding HTN)                                  ________

            CVA/Neurological                                            ________

            Dermatological                                                            ________

            Endocrine                                                        ________

            ENT                                                                 ________

            Gastrointestinal                                                            ________

            Hematologic                                                    ________

            Immunological/Allergic                                               ________

            Infectious/Parasitic                                          ________

            Musculoskeletal/CT/Collagen                          ________

            Neoplastic                                                       ________

            Nutritional/Metabolic                                       ________

            Psychological/Psychosomatic                         ________

            Pulmonary                                                       ________

            Renal/Urologic                                                            ________

            Other                                                               ________

 

XI. Referrals & Follow-up visits

            Referrals

                        Optometry                                            ________

                        General medicine                               ________

                        Ophthalmology                                                ________

                        Other                                                   ________

            Follow-up visits (included in categories 1, 2, 3, 4, 5, & 6)

                                                                                    ________

                                                                                                            Level of Involvement

TOTAL PATIENT ENCOUNTERS*                           ________      P____S____O____

*Sum of 1, 2, 3, 4, 5, & 6.

Remember: The sum of P, S, and O for each category should equal the total encounters for that category. The total of all categories (1 through 6) should equal the total encounters above.

 

I certify that this document is an accurate record of my activities for the stated period.

_____________________________________________ Date_____________

Resident signature


XII.           List other activities such as CE, presentations                    given, conventions attended, etc.