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Clinical Program
The Department of Ophthalmology provides consultant, diagnostic and treatment services for all conditions affecting the eye. Services are provided in the highly modern Joseph and Helen Regenstein Eye Center at Rush. Corneal and vitreoretinal surgery are also strong clinical services at Rush. Both have the largest academic faculties in the Midwest. A major focus of the patient care, education and research activities of the department involves refractive surgery, including laser vision correction. The excimer laser is used to treat refractive disorders (photorefractive keratectomy or PRK and LASIK), resurface the cornea (phototherapeutic keratectomy or PTK) and conduct research on future applications of the technology.
The Department of Ophthalmology at Rush provides patient care services in the
following subspecialty areas:
Comprehensive Ophthalmology
As a two resident-per-year program, one of the strongest aspects of ophthalmology training at Rush is the ability
to learn comprehensive ophthalmology continuously for all three years. Residents follow their patients throughout
their residency, developing a strong sense of continuity-of-care as a primary care doctor.
State-of-the-art cataract extraction techniques are taught, including clear corneal phacoemulsification,
with the most modern equipment. The cataract surgery experience is quite busy, with most residents performing
more than 150 procedures during their training. Residents benefit from having preoperative, operative,
and postoperative contact with patients. The advantage of the rotational schedule ensures that patients
will be followed for one year or longer by the same resident. In general, routine procedures are performed
during the first and second year, with more complicated operations and techniques being performed by the senior
residents. Residents depart this program with the knowledge and expertise to be superb anterior segment surgeons.
The Comprehensive Ophthalmology Section faculty includes Section Director Richard J. Grostern, MD,
Thomas A. Deutsch, MD, William E. Deutsch, MD, Joseph B. Garber, MD, Andrew O. Lewicky, MD, Robert M. Stein, MD,
Elise Torzynski, MD, and Ronald S. Weiss, MD.
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Contact Lens and Visual Rehabilitation
There is a heavy emphasis on refraction during the training period, and residents perform refractions at the time of most patient visits. Only a small number of refractions are performed by technicians and usually only on emergency patients. Two three-month contact lens rotations are scheduled during the first year, during which the residents are responsible for fittings and follow-ups under the supervision of a contact lens specialist. Rush maintains a close alliance with the renowned Chicago Lighthouse, a premier visual rehabilitation service for Chicago. The low vision aids specialist, Alfred A. Rosenbloom, OD, is available along with his staff from the Chicago Lighthouse one-half day every other week during the contact lens rotation. By the end of the third year of training, residents are competent at refraction (having performed more than 6,000 refractions) as well as modern contact lens fitting. The resident experience with low vision is invaluable. It gives our residents firsthand experience working up patients with low vision and trying the variety of low vision aids.
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Cornea and External Diseases
The Cornea and External Disease Section is proud to have some of the country’s finest and most respected
anterior segment specialists in the country. Corneal clinics are held four half-days per week, with
approximately 50 patients seen each week. Penetrating keratoplasties are performed by residents, with
faculty supervision. By the end of the training period, residents are able to examine and treat patients
with all aspects of corneal disease. Strong emphasis is placed on modern microbiologic evaluation and
therapy. Residents also gain experience in a variety of complex corneal surgical procedures, including
combined keratoplasty/cataract extraction, penetrating and lamellar keratoplasty, keratoplasty associated
with anterior chamber reconstructions and intraocular lens exchanges, and suture fixation of intraocular
lenses. Strengthening the educational program is a monthly cornea journal club supervised by the corneal
attendings and fellow. The Cornea and External Disease Section faculty consists of Section Director Richard F.
Dennis, MD, Randy J. Epstein, MD, Jonathan B. Rubenstein, MD, and Parag A. Majmudar, MD.
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Glaucoma
Specialty glaucoma clinics are held one to one and a half days per week. Approximately 25 to 30 patients
are seen in each of these clinic sessions. Additionally, glaucoma patients are seen in the general clinic
with general ophthalmology attendings throughout the week. One resident rotating with Michael L. Savitt, MD,
reads automated visual field tests one day per week in a one-on-one session. An excellent experience in
surgical glaucoma therapy is provided; approximately four glaucoma surgical procedures are done each week,
with residents performing approximately half of these as the primary surgeon. Surgical experience is gathered
in standard trabeculectomy, antimetabolite assisted procedures, peripheral iridectomies, goniotomy,
and placement of seton tubes and valves. Residents are expected to become proficient in all procedures as
primary surgeon. Additionally, experience is gained in cyclodestruction procedures with either cryotherapy,
contact YAG or contact diode laser, selective laser trabeculoplasty, thermal laser trabeculoplasties and laser
peripheral iridotomies. Emphasis is placed on modern nerve fiber analysis with the GDX system.
By the end of the training, residents are able to examine and treat all aspects of glaucoma – medically and surgically.
The Glaucoma Section faculty includes Section Director Steven V.L. Brown, MD, Madhu S.R. Gorla, MD,
Anjali S. Hawkins, MD, PhD, and Michael L. Savitt, MD.
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Neuro-Ophthalmology
During the neuro-ophthalmology clinic, which meets each Tuesday afternoon, 10 to 15 patients with a wide
range of neuro-ophthalmologic problems are seen. Residents are expected to become proficient at complex
neuro-ophthalmic examination, including visual fields, tangent screen, pupil analysis, MRI and CT scan,
and CNS electrophysiology. Residents actively participate in surgical procedures, including orbitotomy,
temporal artery biopsy, muscle surgery for cranial neuropathies and orbital thyroid disease, and they
assist in optic nerve sheath fenestration. As neuro-ophthalmology is a cross-discipline field, residents
learn the appropriate interaction with the related fields of neurology, neurosurgery, otolaryngology,
oculoplastics, and radiology on a case-by-case basis. A monthly evening neuro-ophthalmic case conference
and semiannual journal club enhance the educational program. At the completion of training, the residents
are competent in the comprehensive evaluation of neuro-ophthalmological problems, both central and orbital,
and perform complete neuro-ophthalmologic examinations. The Neuro-Ophthalmology Section faculty includes
Section Director Thomas R. Mizen, MD, and Janet C. Rucker, MD.
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Ocular Oncology
Rush residents have the unique opportunity to evaluate and manage patients who have benign and malignant tumors of the eye and adnexa. The ocular oncology
service is under the direction of Jack A. Cohen, MD, the only fellowship trained ocular oncologist in Chicago. Each year, approximately 20 patients are seen with a variety of eye tumors. Dr. Cohen emphasizes preoperative, operative and postoperative management of these patients with the residents. Residents are exposed to the evaluation and follow-up of these patients, including standardized ultrasonography, radiology, MRI and CT scanning, and biomicroscopy. Additionally, experience with various surgical procedures is obtained, including fine needle biopsy, vitreous and conjunctival biopsy, plaque brachytherapy, external beam teletherapy, dosimetry, spray cryotherapy, transpupillary thermotherapy, chemoreduction and cryotherapy. Surgical therapy of orbital and adnexal tumors are coordinated with the Cornea and External Disease, Oculoplastic, and Neuro-Ophthalmology Sections. At the completion of training, residents are proficient in the recognition, management and referral of patients with a variety of ocular tumors.
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Oculoplastics and Reconstructive Surgery
The Oculoplastic and Reconstructive Surgery Section provides an excellent balance of functional, reconstructive
and cosmetic surgery throughout the residency. An oculoplastic clinic, attended by a faculty member, is held
five days per month. Residents participate as primary surgeon and assistant on a wide variety of surgical
procedures, including ptosis and lid malposition repair, blepharoplasty, lid and orbital tumor removal and
reconstruction, repair of orbital fractures and tear drainage abnormalities, repair of congenital abnormalities
and surgical rehabilitation of the thyroid eye patient. As part of an interdisciplinary team, the Oculoplastic
and Reconstructive Surgery Section faculty works closely with the ENT, neurosurgical and the general plastics
service to provide comprehensive facial reconstructive services. At the end of training, residents are able
to perform a variety of basic plastic procedures seen in a comprehensive ophthalmic practice. The Oculoplastic
and Reconstructive Section faculty consists of Section Director Tamara R. Fountain, MD, Daniel L. McLachlan MD,
and Mary R. Szatkowski, MD.
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Ophthalmic Pathology
Richard J. Grostern, MD, and Elise Torczynski, MD, are both fellowship trained in ocular pathology and oversee the department's clinical and educational pathology program. The resident laboratory experience takes place during the first year. Each first-year resident participates in two three-month rotations on the ophthalmic pathology service. Time is allotted on Tuesday afternoon to gross specimens and prepare them for fixation. Thursday morning is allotted to formalize one-on-one teaching with Dr. Grostern in the pathology lab. Although the volume of specimens derived from Rush patients is sufficient for the educational experience, additional unknown cases from the Ocular Pathology Library fortify the rotation. Both Drs. Grostern and Torczynski serve as ocular pathologists for the Cook County Medical Examiner. Emergency specimens can be processed and reviewed on virtually any day by the team. There is a one-hour block each month to conduct a pathology conference with the residents in morning didactic conferences.
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Pediatric Ophthalmology and Strabismus
The pediatric clinic meets two half-day sessions per week, and approximately 15 to 20 patients are seen
each day. Pediatric patients are seen by all residents, especially by those in the first- and second-year.
All residents may schedule strabismus operations with a pediatric specialist or any of the general ophthalmology
attendings. Residents become proficient in amblyopia therapy, basic exotropia and esotropia surgery, and
oblique dysfunction. Complex adult strabismus due to trauma, cranial nerve palsies, and thyroid ophthalmopathy
are also part of the experience and are managed by David Mittleman, MD, and Thomas R. Mizen, MD,
a neuro-ophthalmologist. The challenges of pediatric examination are taught by the experienced faculty,
who all have busy pediatric private practices. Additionally, residents participate in biweekly retinopathy
of prematurity screenings and treatments in the neonatal intensive care unit, overseen by retinal specialist,
Dr. Jack Cohen. By the end of the training period, residents are competent in examination and measurement of
ocular deviations and the evaluation of all strabismus problems. The residents are also capable of making surgical
decisions to engage in muscle surgery encountered in the average comprehensive practice.
The Pediatric Ophthalmology & Strabismus Section faculty consists of Section Director Nancy A. Hamming, MD,
David Mittelman, MD - adult strabismus, and Diany S. Morales, MD.
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Refractive Surgery
Rush is one of the few academic programs to have implemented a separate section of refractive surgery with a
strong commitment and emphasis on resident education. The Eye Center has an on-site state-of-the-art excimer
laser supported by wavefront guided ablation. Second- and third-year residents rotate on the refractive
surgery service and actively participate in the screening program, surgery and postoperative management.
Residents are exposed to and become proficient in PRK, LASIK, conductive keratoplasty, Intacs, and refractive
lens exchange for a variety of myopic, hyperopic and astigmatic refractive errors. Complex cases due to
keratoconus, and corneal thickness abnormalities are managed. Monthly morning refractive surgery rounds
enhance the training. By the end of training, residents are able to implement refractive surgery into their
practice. The Refractive Surgery Section faculty includes Section Director Jonathan B. Rubenstein, MD,
Richard F. Dennis, MD, Randy J. Epstein, MD, and Parag A. Majmudar, MD.
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Retina and Vitreous Disease
Rush is proud to have one of the busiest and most respected retinal programs in the Midwest. The resident
retina clinics are held on Wednesday and Friday mornings with Drs. Cohen and Merrill, at which approximately
50 patients are seen per week. Additionally, a second- or third-year resident sees private patients with the
Chairman and Section Director Kirk H. Packo, MD, one half-day per week, and participates in their surgical
care on Tuesday mornings. Second- and third-year residents rotate through the retina service one quarter per year,
but all residents see retina patients in the clinic when faculty members are present. The residents are the
first assistant or the primary surgeon in retinal and vitreous cases. Residents are exposed to all modern
retinal surgical procedures, including 20 and 25 ga technology, wide-field imaging, surgical adjuvants and
tamponades, and a variety of surgical treatments for age-related macular degeneration. Throughout the
three-year period, residents perform a high volume of laser and cryo procedures and intravitreal injections
in the office, stressing diabetic retinopathy and macular degeneration. A second-year resident spends alternate
weeks learning interpretation of fluorescein angiography and electrophysiology. Enhancing the training experience,
residents participate in a monthly retina journal club and bimonthly fluoresein and OCT conferences. By the end
of the training period, each resident is competent in retinal examination and drawing, cryotherapy, panretinal
photocoagulation, focal laser ablation of diabetes, and fluorescein angiography interpretation. The Retina and
Vitreous Disease Section faculty includes Section Director Kirk H. Packo, MD, Joseph M. Civantos, MD,
Jack A. Cohen, MD, Fellowship Director Mathew W. MacCumber, MD, PhD, Pauline T. Merrill, MD, David H. Orth, MD,
and George Wyhinny, MD.
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Uveitis and Inflammatory Disease
Uveitis patients are seen in the general clinics and during a specialty uveitis clinic on Friday mornings with Section Director Pauline T. Merrill, MD, and Richard J. Grostern, MD. Approximately 30 to 40 patients are followed on a continuous basis. Residents become proficient in the complex workup of patients with uveitis, AIDS and immune disorders, including blood work, radiologic testing, and diagnostic tissue techniques such as PCR testing of aqueous, vitreous and retinal biopsy specimens. Residents learn the appropriate consultation needs with the rheumatology, infectious disease, and oncology services at Rush. In the training program, therapy with all levels of immune suppression and drug implant surgery are provided.
The Uveitis and Inflammatory Disease Section
faculty includes Section Director Pauline T. Merrill, MD, and Richard J. Grostern, MD.
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Residency Ophthalmology
Department of Ophthalmology