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Pediatric Ophthalmology and Adult Strabismus

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History and Structure of the Fellowship

members of Wilmer's pediatric ophthalmology team The Wilmer Pediatric Ophthalmology team enjoying an evening of fun

This fellowship program provides broad exposure to both medical and surgical treatment of pediatric eye conditions and adult strabismus. The Zanvyl Krieger Children’s Eye Center at the Wilmer Eye Institute is a tertiary referral center where clinical fellows enjoy well-rounded exposure to both the clinical and academic sides of pediatric ophthalmology and adult strabismus. We are privileged to have our pediatric and adult facilities combined in a unified, modern, and child-friendly center, providing excellent exposure to a wide variety of pediatric eye diseases as well as to strabismus in adults

We have trained over 75 clinical fellows in pediatric ophthalmology and adult strabismus since 1979. They have come from a wide cross-section of residency programs, both from the United States and abroad, and a few have come from private practice to start a new career. About 40% are now in private practice, with the other 60% in academic positions, including five professors and seven department chairs.

Program Overview

members of the pediatric ophthalmology team at dinner The Pediatric Ophthalmology team enjoying a staff dinner

Fellowship at Wilmer is stimulating and enjoyable in a supportive atmosphere that we experienced ourselves during a most productive time in our own careers. One-on-one contact with faculty - learning, operating, and teaching in the field of pediatric ophthalmology and adult strabismus takes place within a full-service ophthalmology department. The division has seven full-time pediatric ophthalmologists, one pediatric optometrist, and three orthoptists. Our fellows can take advantage of continued exposure to world-renowned ophthalmologists in all ophthalmic subspecialties, via lectures, conferences and weekly departmental Grand Rounds.

Curriculum

Wilmer pediatric ophthalmology doctors at an event Fellows participate in a Vision for Baltimore health care in celebration of World Sight Day

We encourage academic pursuits during the fellowship year. We host departmental Grand Rounds four times each year and have six Pediatric Ophthalmology Journal Clubs each year. We also have a year-long pediatric ophthalmology didactic curriculum that is held weekly on Tuesday evenings. The curriculum covers a comprehensive pediatric ophthalmology textbook, landmark articles from the pediatric ophthalmology literature, and noteworthy new studies. The clinical schedule allows the fellow to attend these lectures and conferences. Our faculty also conduct surgical skills training sessions in strabismus and anterior segment surgery for both fellows and residents.

Clinical Year Schedule (Sample)

Day

Fellow 1

Fellow 2

Monday

ROP - Dr. Repka (a.m.)
Clinic - Dr. Doyle

Bethesda Clinic - Dr. Kraus
Tuesday

OR - Dr. Repka or Dr.  Kraus 

Clinic - Dr. Guyton
Wednesday

Clinic - Dr. Collins
OR - Dr. Kuwera (p.m.)

OR - Dr. Guyton or Dr. Kuwera
Thursday

Clinic - Dr. Repka, Dr. Richardson or Dr. Kuwera

Clinic - Dr. Kraus
Friday

OR - Dr. Collins

OR - Dr. Doyle or Dr. Richardson

Surgery

Wilmer's pediatric team before heading to the OR The team getting ready for a day in the operating room

The fellow will gain comprehensive experience in a wide variety of strabismus surgeries, with exposure to hang-back techniques, cyclovertical surgery, and adjustable sutures in both children and adults. In addition, experience is gained in congenital cataract and glaucoma surgery, nasolacrimal probings, and ROP screening and treatment. 

Typical surgical numbers for our fellows between 2014-2015 to 2018-2019. 

Procedure

Primary Surgeon 

Assistant

Strabismus Surgery

  
Horizontal strabismus99 (62-21875 (8-159
Vertical strabismus16 (7-38)14 (2-26)
Inferior oblique12 (5-26)10 (2-18)
Superior oblique4 (0-15)4 (1-8)
Muscle transpositions6 (0-20)5 (0-20)
Adjustable sutures62 (4-153)50 (4-78)
Botox injections0 (0-1)2 (1-8)

Non-strabismus Surgery

  
Exams under anesthesia9 (2-20)8 (0-20)
Probings and other nasolacrimal procedures2 (0-6)4 (0-15)
Ptosis0 (0-1)0 (0-1)
Cataract with IOL2 (0-9)6 (1-12)
Cataract without OIL1 (0-5)7 (1-24)
Secondary IOL0 (0-1)1 (0-6)
Glaucoma1 (0-5)3 (0-6)
Other oculoplastic1 (0-4)0 (0-1)
Chalazion0 (0)0 (0-2)
Open globe repairs*0 (0)0 (0)
ROP laser1 (0-5)1 (0-5)

* Wilmer residents provide primary coverage for ER and inpatient consults

Research

Fellows are required to complete a research project during their fellowship. This can be either a project of their own choosing or one of the many projects being conducted by our faculty. We encourage fellows to submit their research to AAPOS, ARVO, and/or AAO.

wilmer mentorship Fun mentorship activities at the Wilmer Eye Institute

Stipend

We provide a PGY-5 stipend for our fellows (plus fringe benefits, including individual health insurance). The stipend is supported in part by the Judith and Paul Romano "Binocular Vision and Strabismus" Fellowship Endowment Fund. To help defray part of this expense, the department requires accepted fellows to apply to sources of outside funding when applicable, such as the Heed Ophthalmic Foundation, which provides partial fellowship support to U.S. applicants.

Mentorship and Evaluation

Fellows meet weekly with Dr. Collins, the Pediatric Ophthalmology Fellowship Program Director, for didactics, as well as bi-monthly to discuss fellowship progress, research and career plans.  At these meetings, curriculum and performance are addressed. There are many opportunities to select additional mentors within the Wilmer/Hopkins community.

To Apply

Application deadline for 2021-2022 is September 2020

Note: 2020-2021 application cycle has closed

Fellowship start date: July 1, 2021, with a few days allowance for relocating as necessary.

Interviews: We invite promising applicants to an interview at Johns Hopkins. We are sometimes able to interview international applicants at the Annual Meeting of the American Academy of Ophthalmology.

Submission process: All applications will be submitted centrally to the SF Match. Please refer to the SF 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 for all required documents.

U.S.-trained residents apply for a Maryland medical license. Upon receipt, they will be appointed as junior faculty at the Wilmer Eye Institute. 

Prerequisites for International Medical Graduates: Applications from other countries are encouraged, particularly from applicants seeking to return to an academic training program in their home country. 

  • Successful completion of the ECFMG examinations and award of certificate 
  • USMLE step 1 and 2 

All fellows, whether from U.S. or international residency programs, receive the same fellowship experience with the same responsibilities.

Fellowship Director

Dr. Megan Collins is an Assistant Professor of Ophthalmology and an Associate Faculty member at the Johns Hopkins Berman Institute of Bioethics. She provides comprehensive care to pediatric patients and performs surgery for adult and pediatric strabismus. Dr. Collins also sees patients with vascular anomalies and craniofacial malformations. In addition to her clinical practice, she directs the Wilmer pediatric ophthalmology fellowship program and is the course director of the residency ethics and professionalism curriculum. Her research interests include the doctor-patient relationship, public health ethics, and barriers in access to pediatric eye care. Dr. Collins is Co-Principal Investigator on Vision for Baltimore and Vision for Chicago, two public-private research partnerships to develop sustainable models of school-based vision care and to evaluate the impact of eyeglasses on academic performance. Dr. Collins also founded and co-directs the Johns Hopkins Consortium for School-Based Health Solutions.  

Faculty

Dr. David Guyton is the Zanvyl Krieger Professor of Pediatric Ophthalmology. His primary interests are in complicated strabismus, ophthalmic optics and ophthalmic instrumentation (currently vision screening devices). Time spent with Dr. Guyton will be mostly in strabismus, with a mix of pediatric and adult cases. Adult strabismus cases, comprising approximately 75% of Dr. Guyton’s practice, provide the fellow a unique opportunity to become familiar with more advanced diagnostic and treatment modalities in strabismus. Adult strabismus is more surgically focused than pediatric strabismus because of less long-term follow-up needed. Exposure to adult strabismus cases allows the fellow to become comfortable and familiar with surgical techniques needed for re-operations, as well as crucial diagnostic techniques. More subtle problems that are not always easily appreciated in children, such as those of torsional and vertical strabismus, are magnified in adults, and mastery of management techniques in such situations allows for optimal treatment to be applied to all age groups.

Dr. Courtney Kraus specializes in pediatric ophthalmology and adult strabismus with particular interest in pediatric cataracts and corneal diseases. Surgical experience with Dr. Kraus will include pediatric cataracts with and without primary IOL implantation, secondary IOLs and IOL exchanges, and specialty lenses. In addition, she provides medical and surgical care of glaucoma, ptosis, and nasolacrimal duct disorders.

Dr. Michael Repka is the David L. Guyton, M.D., and Feduniak Family Professor of Ophthalmology. He joined the Wilmer faculty in 1985 and currently serves as the chief of the division of pediatric ophthalmology and adult strabismus and the Vice Chair for Clinical Practice at Wilmer. He is nationally and internationally known for his contributions in the fields of pediatric ophthalmology, strabismus, retinopathy of prematurity, and pediatric neuro-ophthalmology. Time spent with Dr. Repka provides exposure to all of these areas.

Dr Jefferson Doyle is an Assistant Professor of Ophthalmology and Genetics. He specializes in pediatric ophthalmology and genetic eye diseases. His main focus is pediatric and juvenile forms of cataracts, glaucoma, and anterior segment dysgenesis. His genetics interests include Marfan syndrome and related connective tissue disorders, complex inherited forms of strabismus in both children and adults, and pediatric retinal dystrophies. Surgical experience with Dr Doyle will include pediatric cataracts with and without primary IOL implantation, scleral sutured IOLs for ectopia lentis, and glaucoma angle surgery. Clinic experience will include a wide range of genetic disorders, both ocular and systemic, including use and interpretation of handheld and formal electroretinography.

Dr. Cody Richardson specializes in pediatric ophthalmology and adult strabismus with the main focus on comprehensive pediatric care. Surgical experience with him includes adult and pediatric strabismus as well as pediatric cataract surgery. 

Dr. Edward Kuwera specializes in complex strabismus, including the surgical management of cyclovertical diplopia, reoperations, and thyroid eye disease. He also treats nystagmus, amblyopia, and manages cataracts from toddlers to adults. He is actively involved in improving medical education and is working on several projects, among them to enhance retinoscopy and Lancaster red-green testing. Dr. Kuwera is a member of PEDIG and is the Co-Division Education Champion in optics along with Dr. Guyton, providing instruction on clinical techniques and review of the basic sciences.

Dr. Eleanor Min is a pediatric optometrist who completed a residency which focused on pediatric eye care and binocular vision with emphasis on diagnosis, management, and vision therapy for developmental visual anomalies, including strabismus and amblyopia. She provides comprehensive eye care to pediatric patients and currently interested in expanding her myopia control practice.

Contact Us

For administrative inquiries:

Diane Almony
Wilmer 233
Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, MD 21287-9028
Phone: (443) 287-0066
Fax: (410) 955-0809
E-mail: dalmony@jhmi.edu 

For programmatic inquiries or other questions:

Megan E. Collins, M.D.
E-mail: mcolli36@jhmi.edu
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