The Glaucoma Fellowship at Mayo Clinic's campus in Jacksonville, Florida, is a robust and well-balanced program that incorporates cutting-edge patient care, education, and research in a way that helps you to succeed in any future direction you choose to take. 

Your mentors come from diverse training and practice backgrounds (both private and academic practice). They are extremely supportive and invested in teaching you and ensuring your future success.

Clinical experience

Throughout your training, you will see many community and tertiary referral complex glaucoma patients requiring aggressive IOP lowering with traditional and newer subconjunctival (e.g., trabeculectomy, tube shunts, Xen, Preserflow), and cyclodestructive procedures (MicroPulse TLT and cyclocryotherapy).

You will become adept with co-managing those cases with other ophthalmology subspecialties within our department, as well as other specialties (e.g., rheumatology, endocrinology, dermatology, radiology, laboratory medicine, and pediatric ophthalmology at our partner site – Nemours Children’s Health System). 

You will become even more skilled in managing glaucoma in patients with corneal transplants, uveitis, neovascularization, ocular tumors, and steroid response.

In addition, you will be exposed to a high-volume refractive cataract and glaucoma surgery practice (utilizing SLT, conventional and femtosecond laser-assisted cataract surgery, monofocal and premium IOLs, and MIGS procedures). 

You will become adept in assessing and addressing concomitant refractive disorders and ocular surface disease, as well as complex cataract issues (e.g., pseudoexfoliation, loose zonules, synechiae, small or irregular pupils) in your glaucoma patients. 

Moreover, you will train alongside two neuro-ophthalmologists and become an expert in differentiating other causes of visual field defects and optic neuropathies from glaucomatous optic neuropathy.

Clinical and surgical training

Using modern and state-of-the art equipment, you will acquire and increase your diagnostic and treatment proficiency in:

• Medical therapies
• Selective laser trabeculoplasty (SLT)
• Minimally (or Microscopically) Invasive Glaucoma Surgery (MIGS)
• Complex cataract surgery using OMIDRIA, trypan blue dye, Malyugin ring, Iris retractors, CTR, and others
• Diagnosing and treating narrow angles/acute and chronic angle closure glaucoma using both AS-OCT and UBM
• Performing laser peripheral iridotomy (LPI) and laser peripheral iridoplasty (LPIP)
• Trabeculectomy
• Bleb management with anti-fibrotics (5-FU and MMC)
• Tube shunts
• Cyclodestructive procedures
• Complex anterior segment procedures (goniosynechiaelysis, iris/pupilloplasty, cyclodialysis cleft closure, dysphotopsia management)

Call schedule

Fellows share supervised subspecialty call for the glaucoma ophthalmology division.

Academics

During the glaucoma fellowship, you will be expected to organize and give educational presentations (e.g., grand rounds, journal club) and will have the opportunity to conduct and participate in cutting-edge research, including clinical trials, clinical outcomes and epidemiology, new surgical device evaluations, and even develop and patent your inventions (Mayo Clinic Innovation Exchange).

Research training

Glaucoma research has a long and productive history at Mayo Clinic. Current research areas include:

• Clinical outcomes studies
• Aqueous humor dynamics
• Genetics
• Epidemiology
• Development of novel diagnostic instruments

You have time dedicated to participate in and complete at least one research project. You participate in weekly glaucoma research meetings.

In addition, you have the opportunity to attend a series of research seminars that are presented annually in the department.

Research mentorship is provided by the glaucoma fellowship faculty and other members of the department who are actively involved in research. Research projects may be related to clinical or basic science.

You are encouraged to present your research findings at a meeting that appears appropriate for the subject material, such as those sponsored by the American Glaucoma Society, the Association for Research in Vision and Ophthalmology (ARVO), or the American Academy of Ophthalmology (AAO).

Before the meeting date, you are able to present your research within the department for critique and feedback.

Evaluation

To ensure you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout this program. 

Glaucoma fellowships involve a continuous period of intense and focused training in:

• Developing and maintaining sub-specialized knowledge
• Clinical and surgical skills
• Educational and presentation experience
• Academic scholarship (publications)
• Leadership
• Practice-management
• Professionalism

You are formally evaluated by your supervising faculty member monthly (and quarterly), and then meet accordingly with the program director to review these evaluations.

In addition, we regularly monitor the glaucoma fellowship goals and target quotas with you to ensure your educational goals are being met. 

Fellows are expected to carry out at least one research project leading to publication and to present their research findings at local, regional, and national conferences and meetings.