Oculoplastic and Orbital Fellow

Western Eye Hospital and Eye Department Charing Cross Hospital

Summary of Post

This is a 12 month full time Clinical Fellowship attachment in London under the supervision of Miss Jane Olver who has developed the Fellowship post over 6 years.

Special interests

Her major interests are oculoplastic, lacrimal, orbital and aesthetic surgery. This includes: thyroid eye disease (including orbital decompression), blepharoplasty, ptosis and other eyelid malpositions, botulinum toxin, eyelid tumours, socket disorders, facial palsy, watering eye in adults and children and endo-lacrimal surgery.

The Post

The post is aimed towards someone who wishes to train in the sub speciality of Oculoplastic, Lacrimal and Orbital surgery. The Fellowship provides a balanced training in peri-ocular reconstructive surgery, Lacrimal surgery including endonasal techniques, and relevant orbital surgery including decompression. This post is suitable for a year 4/5 Specialist Registrar seeking an advanced sub speciality training opportunity or post-CCST candidate.

The Hospitals

The Oculoplastic and Orbital service is based at the Western Eye Hospital (St Mary's NHS Trust) and also in the Eye Department of the Charing Cross Hospital (Hammersmith Hospitals NHS Trust). The Western Eye Hospital is a dedicated Eye Hospital in West London with inpatient beds and a 24 hour Accident & Emergency department. The hospital has 11 Consultants covering all Ophthalmic sub specialties and serving the local population of West London (over 3 million people) as well as serving a wider extended population for tertiary referrals.

The Oculoplastic and Orbital Service provides a tertiary and quaternary referral service with referrals from all over the South of England. At the Charing Cross Hospital there is Neurosurgery, Maxillofacial, Head and Neck, and Plastic Surgery, Neurology and Dermatology, which provide a wide range of orbital tumour and oculoplastic referrals based on liaison with these sub specialties. There is a monthly dedicated Children's Eyelid Clinic.

The Fellows' Responsibilities

The Fellow is responsible for out patient care of all patients referred to the Unit and liaisons with General Practitioners, referring Ophthalmologists, co-management consultants and allied specialists included in the continued care of patients. The organisation of monthly Radiology and clinicopathologic orbital meetings at the Charing Cross Hospital is the responsibility of the Fellow. The duties include administrative work and the management of theatre lists and timetables of theatre for junior staff. The Fellow also supervises juniors at the level of Specialist Registrar and Senior House Officer.

Teaching

This is an important component of the post. The Fellow is expected to contribute actively to the Postgraduate teaching programme, to local General Practitioners and to the Juniors and Medical Students.

Research

There is an active research programme. The Fellow is expected to participate in ongoing projects and new projects selected for them, to prepare material for presentation at scientific meetings and for publications.

Previous experience

Candidates should have a wide previous general ophthalmic surgical experience. Prior experience in oculoplastics surgery is essential to meet the clinical responsibilities of this post.

What this post offers

The successful candidate would be expected to become proficient in the investigation and management of common Oculoplastic, Lacrimal and Orbital conditions: This post offers the following proportional training: Oculoplastic 50% Lacrimal 25% and Orbits 25%

Oculoplastic Surgery

Adult and Paediatric surgery. Ptosis, entropion, ectropion, peri-ocular malignancy reconstruction including Mohs' micrographic surgery and exenteration, facial palsy and lagophthalmos, eyelid retraction and brow ptosis (direct and endoscopic).

Lacrimal Surgery

Investigation of patients (adults and children) with watering eyes including ancillary investigation and the use of the nasal endoscope in the clinic; they should become proficient in external approach dacryocystorhinostomy and endonasal DCR using powered tools. They should be able to manage and replace Jones tubes.

Orbital Surgery

Learn the accurate and systematic assessment of patients with orbital disease and surgical management of more common orbital problems including orbital fracture, orbital volume augmentation techniques, anophthalmos and Grave's ophthalmopathy.

Trauma

Eyelid and orbital trauma referred direct via the Accident & Emergency department including orbital fracture, lacerated Lacrimal drainage, globe rupture and also delayed repair of blunt soft tissue injury to the orbit such as traumatic ptosis and late repair orbital trauma. There is close collaboration with maxillofacial surgeons.

Aesthetic(Cosmetic) Surgery

Training in blepharoplasty and related techniques is available via assisting with Privately paying patients as long as the Fellow has appropriate medical insurance.

Other duties

The Fellow is expected to take part in the Accident and Emergency rota as per the job description. Out of hours duties are a recognised source of trauma experience. The Fellow should make themselves available for eyelid, lacrimal apparatus and orbital emergencies attending the Accident and Emergency department.

Funding

The post is partially funded and the successful candidate is expected to arrange some self-funding.

Links

Information about oculoplastic fellowship training opportunities in the UK