Best glaucoma fellowships

[clayito]

I've seen similar threads in the past, but they never get many/any responses. Which programs do you consider to have the best clinical glaucoma fellowships?

I've heard very good things about:
Duke
Bascom

But mixed reviews about several others. Any opinions?

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[taehong81]

Agree that Duke and Bascom Palmer probably the two best glaucoma fellowship (clinically and academically). Then there are lots of other fellowships that are good too and give you a good clinical training. What locations were you looking at?

 

[Hemichordate]

Generally speaking, what's the best draw/selling point for people to go into glaucoma? I've heard retina is good for the $$$ and comprehensive ophtho is good if you want to work in rural areas, but I haven't heard much about glaucoma.

 

[guttata]

Generally speaking, what's the best draw/selling point for people to go into glaucoma? I've heard retina is good for the $$$ and comprehensive ophtho is good if you want to work in rural areas, but I haven't heard much about glaucoma.

pros:

1. in-demand subspecialty (at the moment)
2. ability to incorporate general ophthalmology (cataract surgery)
3. patients require constant follow-up (faster practice build)
4. slightly better reimbursement due to ancillary testing (gonio, HVF, OCT)

cons:
1. dealing with a chronic disease with no cure
2. black hole of patients - there are only two ways to cure glaucoma - death or blindness
3. surgery may be rewarding for you (but not for the patient - who usually notice no difference)

 

[orbitsurgMD]

pros:

. . . .

1. dealing with a chronic disease with no cure
2. black hole of patients - there are only two ways to cure glaucoma - death or blindness
3. surgery may be rewarding for you (but not for the patient - who usually notice no difference)

If I had a nickel for every minute I have spent trying to dispel the first two myths, I could retire.

The good news: you can usually help these people. While there is a grim truth to the saw "the patient's best vision is what they had when they came into your office," better treatment and earlier diagnosis makes long term stability and preservation of vision far more likely. I remember Dr. Douglas Gaasterland saying that many of your patients are older and that your job is to keep them seeing until they die. That is what makes glaucoma practice different even from other subspecialties is that all of your patients are long-term patients.

 

[guttata]

I would argue that the earlier treatment and diagnosis is being done by the generalists. I am a generalist and I typically refer if I cannot control IOP on meds/lasers or if the glaucoma progresses on MMT. Perhaps, we (generalists) are holding onto these patients too long. Or, perhaps my view is skewed by the mainly academic exposure to the glaucoma service.

IMO, as minimally invasive glaucoma procedures improve, the spectrum of disease will shift further - meaning the glaucoma specialists will be consulted for severely progressed glaucoma (pts who need a trab/tube).

In most cases, glaucoma progresses so slowly, I think it is difficult for patients to appreciate the benefit of IOP lowering surgery unless they have already lost vision in one eye. But then again, I don't usually follow these patients.

 

[cubsrule4e]

Any idea about how many applicants there have been for glaucoma for the last few years? SF match statistics shows how many positions there are and how many filled but not how many applicants