The fellowship program at the Glaucoma Center of Excellence, Wilmer Institute, has trained 50 fellows who occupy leadership positions as Directors of academic glaucoma services nationally and internationally, as well as clinicians in private practice throughout the United States. We annually accept one or two fellows for a one-year, intensive surgical fellowship stressing expertise in complex glaucoma problems and the development of independent clinical decision-making. Our fellows are encouraged to design the optimal learning situation during the year, selecting which faculty they wish to work with.
A second program for post-residency training is our multiple year Clinician--Scientist pathway intended for those seeking a full-time academic career. This can be combined with a fellowship or entered after glaucoma fellowship elsewhere. It carries a faculty appointment and 75% protected time for mentored training in either clinical or laboratory research.
One-Year Clinical Fellowship
Wilmer offers a one year clinical training fellowship focusing on the diagnosis and management of the glaucomas. The program allows a flexible plan for observing and participating directly in medical, laser and surgical glaucoma care with 6 full-time Wilmer faculty members, who perform more than 1,000 surgical procedures per year and see 12,000 outpatients. One or two clinical fellows per year are chosen to assure maximal clinical and surgical experience. The latest in diagnostic equipment is used, including networked HFA2i perimeters, SD-OCT, HRT, and anterior segment OCT imaging. The full range of lectures, seminars, and conferences of the Wilmer Institute is available to the fellow, along with glaucoma-specific clinical and research discussion groups. These include a weekly “fellows conference” that informally discusses individual cases with faculty and a bi-monthly journal club.
Wilmer fellows have an individual surgical experience that equals or exceeds any other glaucoma fellowship in number of full procedures and in its diversity, including trabeculectomy and its revisions, tube shunt surgery, phacoemulsification, ciliodestruction, Trabectome procedures, and examinations and surgery on children with glaucoma. In addition to working in parallel with each faculty member in the faculty outpatient practice, the fellow has an individual clinic at the Bayview satellite center, an established part of the Wilmer department 10 minutes from the main facility. The fellowship is accredited by the Residency Review Committee for certification.
While many past fellows have chosen to carry out clinical research projects during fellowship, this is not required. The fellow is not viewed as a service provider (physician extender) but a colleague in training who is a valued member of our team. We are open to flexible schedules that are designed by the fellow in consultation with the faculty allocating time among outpatient exams, surgery, and rotations with different faculty members.
Funding is provided at the PGY-5 level. Medical and other benefits are quite generous. Office space and travel to at least one meeting is provided for the fellow.
Faculty who participate in clinical training are:
The application deadline is September 30.
We participate in the matching program for glaucoma fellowships. Please refer to the San Francisco Match website to register for the match and read about the process for applying to Ophthalmology Fellowship Training. Once registered, you can view our program listing on the SFMatch directory website. To complete the application process, go to the website and follow the instructions at http://www.sfmatch.org/. For further information, contact firstname.lastname@example.org.
Applicants will be selected and contacted for personal interviews at the Wilmer Glaucoma Center of Excellence, typically in late October.
Multiyear Research/Clinical Fellowship
This course of training is designed for those who wish to explore the possibility that they will develop new information about the causes, diagnosis, and treatments of glaucoma. Extensive training is undertaken in at least one area of research methodology. It is a multi-year program, between 2 and 4 years, often funded by an NIH K series (K08, K23, or K12) Clinician—Scientist grant (see Wilmer Clinician-Scientist training program). While the majority of time is spent in research training, fellows in this program develop advanced clinical skills in glaucoma management in their own, faculty level practice that begins after the first year. A clinical fellowship can be embedded in an extended research training environment for those who have not already finished fellowship. Typically, one clinician--scientist fellow per year will be chosen, leading to a program with preceptorship by a primary faculty mentor or mentor group, at least one of whom is a senior glaucomatologist. Other faculty mentors may be scientists within the Wilmer Institute or selected from appropriate departments of the Johns Hopkins Medical School and School of Public Health.
The subject areas for research include:
- Molecular biological studies of glaucoma pathogenesis: Using our Molecular Biology Facility, we are investigating ganglion cell gene expression in normal eyes and the changes induced by glaucoma and experimental optic nerve injury.
- Glaucoma epidemiology: We are conducting studies to improve screening for both angle-closure and open-angle glaucoma, assessing the incidence and prevalence of glaucoma in population-based samples, including work outside the United States, and studying the impact of glaucoma on patient function.
- Imaging the disc and nerve fiber layer: We have an ongoing program of study in imaging the iris, the choroid, and the disc and nerve fiber layer with several imaging technologies, including SDOCT, HRT, and anterior segment OCT.
- Neuroprotection: We are actively studying in vitro and animal models of glaucoma and optic nerve injury to identify and test approaches that protect ganglion cells from death by means other than lowering of eye pressure. These include gene therapy studies, along with pharmacological testing, including sustained release intravitreal drug delivery.
- Adherence to medical therapy: Studies are ongoing into how often patients fail to take their eyedrops and why, using electronic monitors and large claims databases. Interventions to improve adherence are being studied.
- Structure and function research: Investigations are being conducted into both imaging and visual field technologies and how they can better be utilized to monitor the presence and progressive worsening of glaucoma patients. Very large databases of visual field and imaging data are being studied to construct better paradigms related to management of glaucoma, outcomes assessment, risk assessment, and field progression.
- Functional effects of glaucoma damage: We are studying the similarity and differences among views of the effects of glaucoma that are gained by self-report, clinical testing, and actual measurements of the ability to perform normal life functions, such as reading, walking, and driving.
- Mechanisms of angle closure glaucoma: The participation of the dynamic behavior of the iris and choroid in angle closure disease is studied by clinical imaging and provocative test development, as well as epidemiological studies in China.
Faculty available to begin development of a mentored training program in the multiyear fellowship include:
Harry A. Quigley, MD — Program director, Pathogenesis, Neuroprotection, Imaging
David S. Friedman, MD, PhD — Program director, Epidemiology
Donald J. Zack, MD, PhD — Molecular biology, Neuroprotection
Henry D. Jampel, MD MHS — Clinical research
Kevin Frick, PhD — Health Policy
Thao Nguyen, PhD — Biomechanics
Pradeep Ramulu, MD — Functional effects
Michael Boland, MD PhD — Structure/Function, Computer applications
Sheila K. West, PhD — Epidemiology
Joanne Katz, ScD — Epidemiology
James M. Tielsch, PhD — Epidemiology
Robert Massof, PhD — Psychophysics
Derek Welsbie, MD PhD -- Neuroprotection
Funding for the multiyear fellowship is possible through a variety of mechanisms. Clinician-scientist awards (K08, K12, K23), and private foundation applications have been utilized, as has a Neurosciences training grant to the Wilmer Institute. Once an initial research plan is agreed upon, the faculty will help in the development and production of appropriate applications. Please refer to the section on Clinician-Scientist Training at the Wilmer Institute for further details of this program.
Application Process for Multiyear Fellowships
To initiate our interaction regarding a multiyear fellowship, contact Patricia Tracey, Administrative Assistant, at email@example.com, to arrange a personal conversation with Dr. Quigley.
Past Fellows (alphabetical)
Eiyass Albeiruti, MD, Assistant Professor, University of Pittsburgh
Sarah Anis, MD, Rhode Island Eye Institute, Brown University (affiliated)
Dana Blumberg, MD, Assistant Professor, Columbia University, New York
Michael Boland, MD, Assistant Professor, Wilmer Institute, Johns Hopkins, Baltimore
Ralf Buhrmann, MD, Assistant Professor, Ottawa University, Canada
Claude Burgoyne, MD, Professor, Devers Eye Institute, Portland, Oregon
Edward Burney, MD, Professor, Case Western Reserve University, Cleveland
Anne Coleman, MD PhD, Professor, Jules Stein Eye Institute, UCLA, Los Angeles
Nathan Congdon, MD, Chinese University of Hong Kong, China
Lalit Dandona, MD, Ministry of Health, India
Lucian del Priore, MD, Professor, Columbia University, New York
Robert Derick, MD, Assistant Professor, Ohio State University, Columbus
D.L. Chris Diehl, MD, Clinical Instructor, Univ. of Washington, Seattle
Ronald Farkas, MD, Food and Drug Administration, Washington DC
Travis Frazier, MD, Walter Reed Army Medical Center, Washington, DC
David Friedman, MD, Professor, Wilmer Institute, Johns Hopkins University, Baltimore
Stephen Gieser, MD, Private Practice, Chicago
Yoseph Glovinsky, MD, Associate Professor, Goldshleger Eye Institute, Israel
Phenpan Hirunyachote, MD, Faculty, Thailand
Agnes S. Huang, MD, Private Practice, Seattle
Henry Jampel, MD, Professor, Wilmer Institute, Johns Hopkins University, Baltimore
Jonathan Javitt, MD, Faculty, Johns Hopkins University, Baltimore
Mark Juzych, MD, Associate Dean for Education, Kresge Eye Institute, Detroit
Scott Laborwit, MD, Private Practice, Instructor Wilmer Institute, Baltimore
Hana Levkovitch-Verbin, MD, Associate Professor, Goldshleger Institute, Israel
Yang Li, MD PhD, Private Practice, Northern California
Keith Martin, MD, Professor, University of Cambridge, United Kingdom
Lorraine (McGuigan) Brancato, MD, Clinical Instructor, New Jersey Med School, Newark
Stuart McKinnon, MD, Associate Professor, Duke University, Durham
John Morrison, MD, Professor, Director Glaucoma Service, Oregon HSUniversity, Portland
Jack Nordlund, MD, Private Practice, Virginia
Louis Pasquale, MD, Associate Professor, Director Glaucoma Service, Harvard Medical School
Jose Paczka, MD, Universidad de Guadalahara, Mexico
Sunita Radhakrishnan, MD, Private Practice, San Francisco
Alan Robin, MD, Associate Professor, Johns Hopkins University, Baltimore
Gail Schwartz, MD, Associate Professor, Wilmer Institute, Johns Hopkins, Baltimore
Kimberly Brown Smith, MD, PhD, Department of Health & Human Services, Washington, D.C.
Scott Smith, MD, Associate Professor, Columbia University, New York
Angelo Tanna, MD, Assistant Professor, Director Glaucoma Service, Northwestern U. Chicago
Rohit Varma, MD, Professor, Director Glaucoma Service USC Doheny Institute, Los Angeles
Derek Welsbie, MD PhD, Assistant Professor, Johns Hopkins University, Baltimore
Donald Zack, MD PhD, Professor, Johns Hopkins University, Baltimore
Selected Publications of Wilmer Glaucoma Fellowship Projects
Jampel HD, McGuigan LJB, Dunkelberger GR, L'Hernault NL, Quigley HA. Cellular proliferation after experimental glaucoma filtration surgery. Arch Ophthalmol 1987;106:89-94.
McGuigan LJB, Quigley HA, Lutty G, Enger C, Young E.. The effects of d-penicillamine and daunorubicin on conjunctival fibroblast proliferation and collagen synthesis. Invest Ophthalmol Vis Sci 1988;29:112-118.
DelPriore LV, Robin AL, Pollack IP. Neodymium: YAG and argon laser iridotomy: Long-term follow-up in a prospective clinical trial. Ophthalmology 1988; 95: 1207-1211.
Morrison JC, L'Hernault NL, Jerdan JA, Quigley HA. Ultrastructural location of extracellular matrix components of the optic nerve head. Arch Ophthalmol 1989;107:123-129.
Morrison JC, Brown AE, Quigley HA. Aging changes in the rhesus monkey optic nerve. Invest Ophthalmol Vis Sci 1990;31:1623-1627.
Diehl DLC, Quigley HA, Miller NR, Sommer A, Burney EN. Prevalence and significance of optic disc hemorrhage in a longitudinal study of glaucoma. Arch Ophthalmol 1990;108:545-550.
Morrison JC, Dorman-Pease ME, Dunkelberger GR, Quigley HA. Optic nerve head extracellular matrix in primary optic atrophy and experimental glaucoma. Arch Ophthalmol 1990;108: 1020-1024.
Coleman AL, Diehl DLC, Jampel HD, Bachorik PS, Quigley HA. Topical timolol decreases plasma high-density lipoprotein cholesterol level. Arch Ophthalmol 1990;108:1260-1263.
Dandona L, Hendrickson A, Quigley HA. Selective effects of experimental glaucoma on axonal transport by retinal ganglion cells to the dorsal lateral geniculate nucleus. Invest Ophthalmol Vis Sci 1991;32:1593-1599.
Pasquale LR, Thibault D, Dorman-Pease ME, Quigley HA, Jampel HD. Effect of topical mitomycin C on glaucoma filtration surgery in monkeys. Ophthalmology 1992;99:14-18.
Glovinsky Y, Quigley HA, Drum B, Bissett RA, Jampel HD. A whole-field scotopic retinal sensitivity test for the detection of early glaucoma damage. Arch Ophthalmol 1992;110:486-489.
Varma R, Quigley HA, Pease ME. Changes in optic disk characteristics and the number of nerve fibers in experimental glaucoma. Am J Ophthalmol 1992;114:554-559.
Glovinsky Y, Quigley HA, Pease ME. Foveal ganglion cell loss is size dependent in experimental glaucoma. Invest Ophthalmol Vis Sci 1993;34:395-400.
Burgoyne CF, Varma R, Quigley HA, et al. Global and regional detection of optic disc change by digitized image analysis. Arch Ophthalmol. 1994;112:261-8.
Congdon NG, Quigley HA, Hung P.T., et al. The impact of age, cataract and visual acuity on whole-field scotopic sensitivity screening for glaucoma in rural Taiwan. Arch. Ophthalmol. 1995;113:1138-1143.
Derick RJ, Pasquale LR, Pease ME, Quigley HA. A clinical study of peripapillary crescents of the optic disc in chronic experimental glaucoma in monkey eyes. Arch Ophthalmol. 1994;112:486-50.
Varma R, Hilton SC, Tielsch JM, Katz J, Quigley HA, Sommer A. Neural rim area declines with increase in intraocular pressure in urban Americans. Arch Ophthalmol. 1995;113:1001-8.
Wang F, Tielsch JM, Ford DE, Quigley HA, Whelton PK. Evaluation of screening schemes for eye disease in a primary care setting. Ophthalmic Epidemiol 1998;5:69-82.
Smith SD, Katz J, Quigley HA. Effect of cataract extraction on the results of automated perimetry in glaucoma. Arch Ophthalmol 1997;115:1515-9.
Kosoko O, Quigley HA, Vitale S, Enger C, Kerrigan LA, Tielsch JM. Risk factors for non-compliance with glaucoma follow-up visits. Ophthalmology 1998;105:2105-11.
Huang AS, Smith SD, Quigley HA. The efficacy of the Dicon screening field to detect eyes with glaucomatous field loss by Humphrey threshold testing. J Glaucoma 1998;7:158-164.
Congdon NG, Qi Y, Quigley HA, Hung P.T., Wang TH, Ho TC, Tielsch JM. Biometry and primary angle-closure glaucoma among Chinese, White, and Black populations. Ophthalmology 1997;104:1489-95.
Laborwit SE, Quigley HA, Jampel HD. Revision of bleb-related complications of trabeculectomy. Ophthalmology 2000;107:712-718.
Buhrmann RR, Quigley HA, Barron Y, West SK, Oliva MS, Mmbaga BBO. The prevalence of glaucoma in a rural east African population. Invest Ophthalmol Vis Sci. 2000;41:40-48.
Paczka JA, Quigley HA, Friedman DS, Barron Y, Vitale S. Diagnostic
capabilities of frequency-doubling technology, scanning laser polarimetry and nerve fiber layer photographs to distinguish glaucomatous damage. Am J Ophthalmol 2001;131:188-197.
Levkovitch-Verbin H, Quigley HA, Kerrigan-Baumrind LA, D'Anna S, Kerrigan DF, Pease ME. Optic nerve transection in monkeys may result in secondary degeneration of retinal ganglion cells. Invest Ophthalmol Vis Sci. 2001;42:975-982.
McKinnon SJ,Lehman DM, Kerrigan-Baumrind LA, Merges CA, Pease ME, Kerrigan DF, Ransom NL, Tahzib NG, Reitsamer HA, Levkovitch-Verbin H,
Quigley HA, Zack DJ. Caspase activation and amyloid precursor protein cleavage in rat ocular hypertension. Invest Ophthalmol Vis Sci. 2002;43:1077-1087.
Martin KRG, Quigley HA, Zack DJ, Levovitch-Verbin H, Kielczewski J, Valenta D, Baumrind L, Pease ME, Klein RL, Hauswirth WW. Gene therapy with brain-derived neurotrophic factor protects retinal ganglion cells in a rat glaucoma model. Invest Ophthalmol Vis Sci. 2003;44:4357-65.
Farkas RW, Chowers I, Hackam AS, Kageyama M , Nickells RW, Otteson DC,Duh EJ, Wang C, Valenta DF, Gunatilaka TL, Pease ME, Quigley HA, Zack DJ. Increased expression of iron-regulating genes in monkey and human glaucoma. Invest Ophthalmol Vis Sci 2004;45:1410-1417.
Blumberg D, Congdon N, Jampel H, Gilbert D, Elliott R, Rivers R, Munoz B, Quigley HA. The effects of sevoflurane and ketamine on intraocular pressure in children during examination under anesthesia. Am J Ophthalmol. 2007; 143:494-9.
Boland MV, Zhang L, Broman AT, Jampel HD, Quigley HA. Comparison of optic nerve head topography and visual field in eyes with open angle and angle closure glaucoma. Ophthalmology. 2008;115:239-245.
Radhakrishnan S, Quigley HA, Jampel H, Friedman D, Ahmad S. Congdon N, McKinnon S, Zack D. Outcomes of surgical bleb revision for complications of trabeculectomy. Ophthalmology 2009;116:1713-1718.