(in addition to PGY-3 level goals)

Medical Knowledge 

• To describe typical and atypical features, evaluation, and management of the most advanced and least common optic neuropathies (e.g., chronic or recurrent optic neuritis, and posterior ischemic, autoimmune, toxic/nutritional).
• To describe typical and atypical features, evaluation, and management of the most complex and least common ocular motor neuropathies and their mimics (e.g., progressive supranuclear palsy).
• To describe typical and atypical features, evaluation, and management of the most complex and least common forms of nystagmus (e.g., surgical treatment options, using the null point in either prism or surgical therapy).
• To describe typical and atypical features, evaluation, and management of the most advanced and least common pupillary abnormalities (e.g., pupil findings in coma, transient pupillary phenomenon).
• To describe typical and atypical features, evaluation, and management of the most complex and least common visual field defects (e.g., combination or bilateral lesions, cortical visual impairment).
• To describe the most advanced aspects of visual field indications, selection, and interpretation (e.g., variability in automated perimetry, application of specific testing and thresholding strategies for different patient populations with different neuro-ophthalmic conditions, different testing abilities (e.g., young or old age, mental status, hand-eye coordination, reaction time).
• To describe, evaluate, and treat the neuro-ophthalmic aspects of systemic diseases (e.g., malignant hypertension, diabetic papillopathy, toxicity of systemic medications, pseudotumor cerebri).
• To describe, evaluate, and treat the neuro-ophthalmologic manifestations of trauma (e.g., corticosteroid or surgical therapy in traumatic optic neuropathy).
• To describe, evaluate, and provide appropriate genetic counseling for neuro-ophthalmologic diseases (e.g., Leber’s hereditary optic neuropathy, chronic progressive external ophthalmoplegia, von Hippel-Lindau syndrome).
• To recognize, evaluate, and treat (or refer) more complex forms of nystagmus.
• To recognize, evaluate, and treat (or refer) transient monocular or binocular visual loss.

Patient Care

• To perform and interpret the results of tests for myasthenia gravis, and to recognize and treat the complications of the procedures.
• To perform and interpret the complete cranial nerve evaluation (e.g., testing of trigeminal and facial nerve function) and basic neurologic exam in the context of neuro-ophthalmic localization and disease.
• To interpret neuro-radiologic images in neuro-ophthalmology (e.g., interpretation of orbital imaging for orbital pseudotumor and tumors, thyroid eye disease, intracranial imaging modalities and strategies for tumors, aneurysms, infection, inflammation, and ischemia), and to appropriately discuss, in advance of testing, the localizing clinico-radiologic features with the neuroradiologist in order to obtain the best study and intrepretation of the results.
• To recognize patients with “functional” visual loss (non-organic visual loss) and provide appropriate counseling and follow-up.