Glaucoma Fellowship Opportunities At The Wilmer Institute

Glaucoma Fellowship Opportunities At The Wilmer Institute 

Since 1977, a formal program for post-doctoral fellowship training in glaucoma related clinical science and research has been offered at the Wilmer Institute. We offer both a one year clinical fellowship and a multiple year training pathway intended for those seeking a full-time academic career.

The application deadline is September 30.

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 600 surgical procedures per year and see 10,000 outpatients. Only one clinical fellow per year is chosen to assure maximal clinical and surgical experience. The latest in diagnostic equipment is used, including networked HFA2i perimeters, OCT, HRT, and other imaging modalities. 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 that meet on a weekly basis.

The fellows in recent years have had an individual surgical experience that is the equal of any other glaucoma fellowship.  The full range of surgery is performed, including trabeculectomy and its revisions, tube shunt surgery, phaco lens surgery, 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 nearby 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 meetings is provided for the fellow.

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. While the majority of time is spent in research, we also encourage fellows in this program to develop advanced clinical skills in glaucoma management. The clinical fellowship is embedded in an extended research training environment. Typically, at most 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:

1. 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.

2. 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.  We are studying the similarity and differences among views of the effects of glaucoma that are gained by questionnaires to patients, their clinical testing outcomes, and actual measurements of their ability to perform normal life functions.

3. Imaging the disc and nerve fiber layer: We have an ongoing program of study in longitudinal change in the disc/nerve fiber layer with several imaging technologies, including OCT, GDx, HRT, RTA, and experimental imaging systems.

4. Neuroprotection: We are engaged in studies with animal models of agents that protect ganglion cells from death by means other than lowering of eye pressure. These include gene therapy studies, along with pharmacological testing.

5. 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.

6. 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.

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.

Clinical experience is gained by participating in the care and surgery of patients with Drs. Quigley, Jampel, Zack, Friedman, Boland and Ramulu at the Wilmer Institute/Johns Hopkins.

Application Process for Both One Year and Multiyear Fellowships

The following pages require specific information that we request in evaluating your application. Typically, we interview some candidates in the late summer and fall. We have been participants in the Fellowship Match Program for the one year clinical fellowship. Those who are applying through this mechanism will receive a decision in November/December at the time of the match. Since the multi-year fellowship is an individually developed plan, it is handled outside the match.

Please fill out the application completely, and include a copy of your curriculum vitae. We would appreciate copies of reprints or manuscripts you have written. Note that we are asking two senior clinicians or scientists who know you personally to send recommendation letters. Please ask these recommenders to place your letter in a sealed envelope that you will submit together with the application. In this way you can be sure that letters have been sent. We will begin consideration of applications only when they are complete. It is particularly important for us to receive from you a statement about your career goals and how this fellowship will fit into them. Describe your intended research directions and suggest projects on which you would like to work.

The application deadline is September 30, 2008.
> download the application (Word template)

If you have further questions about the fellowship, please contact Patricia Tracey, Administrative Assistant, at ptracey@jhmi.edu.

CURRENT FELLOW

Travis Frazier, MD, Wilmer Eye Institute, Johns Hopkins Hospital

PAST FELLOWS

Sunita Radhadkrishnan, MD, private practice, San Francisco, California
Kimberly Brown Smith, MD, PhD. Department of Health & Human Services, Washington, D.C.
Dana Blumberg, MD, Assistant Professor, Duke University, North Carolina

Michael Boland, MD, Assistant Professor, Wilmer Eye Institute, Johns Hopkins Hospital
Ralf Buhrmann, MD Assistant Professor Ottawa University, Canada
Claude Burgoyne, MD Professor LSU Eye Center
Edward Burney, MD Professor, Case Western Reserve University
Anne L. Coleman, MD Professor, Jules Stein Eye Institute, UCLA
Lalit Dandona, MD Ministry of Health, India
Lucian del Priore, MD Professor, Columbia University
Robert Derick, MD Assistant Professor,Ohio State University
D.L. Chris Diehl, MD Clinical Instructor, Univ. Of Washington
Ronald Farkas, MD Assistant Professor, Johns Hopkins
David Friedman, MD Associate Professor, Johns Hopkins
Stephen C. Gieser, MD Private Practice, Chicago
Yoseph Glovinsky, MD Associate Professor, Goldshleger Eye Institute, Israel
Agnes S. Huang, MD Private Practice, Seattle
Henry D. Jampel, MD Professor, Johns Hopkins University
Jonathan Javitt, MD Faculty, Johns Hopkins University
Mark Juzych, MD Associate Professor, Kresge Eye Institute, Detroit
Scott Laborwit, MD Private Practice, Baltimore
Hana Levkovitch-Verbin, MD Assistant Professor, Goldshleger Institute, Israel
Keith Martin, MD Assistant Professor, University of Cambridge, United Kingdom
Lorraine (McGuigan) Brancato, MD Clinical Instructor, New Jersey Med School
Stuart McKinnon, MD Associate Professor, Duke University
John Morrison, MD Professor, Oregon Health Sciences University
Jack Nordlund, MD Private Practice
Louis Pasquale, MD Director Glaucoma Service, Harvard Medical School
Alan Robin, MD Associate Professor, Johns Hopkins University
Scott Smith, MD Associate Professor, Cleveland Clinic, Ohio
Donald Zack, MD Professor, Johns Hopkins University
Rohit Varma, MD Associate Professor, University of Southern California

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.