Byers Eye Institute at Stanford University

Optometry Student Extern Director: 
Katherine Warner, OD
ktwarner@stanford.edu

Administrative Coordinator:
Samuel DeKlerk
samueldk@stanford.edu

Type of Practice:

The Byers Eye Institute at Stanford is a free standing, state-of-the-art medical and surgical facility dedicated to combating blindness and preserving vision.  Home to over 40 full-time faculty members of the Department of Ophthalmology at Stanford spanning every clinical subspecialty of eye and vision care, the Institute is equipped with state-of-the-art technologies that allow comprehensive care for patients with diseases that range from simple refractive disorders to the most complex ocular and visual disease states.  Attended by a faculty comprised of internationally renowned ophthalmologists and optometrists specializing in the complete range of ophthalmic disorders, patients receive treatment in a comfortable environment from staff who are dedicated to alleviating suffering caused by ocular diseases.  Patients can receive diagnostic services using the most advanced and up to date equipment and when surgery is required, receive therapy in a state-of-the-art-equipped surgical facility, assisted by a perioperative and anesthesia staff dedicated solely to the care of patients requiring ophthalmic surgery.  Each year, more than 70,000 patients receive clinical and surgical care at the Byers Eye Institute.  The department is actively involved in clinical and basic research, with over 30 open clinical trials enrolling patients, helping Stanford Department of Ophthalmology in its goal to remain a leader in the forefront of new scientific advances to preserve and restore vision.

The Byers Eye Institute offers a clinical externship in optometry to fourth-year students from the University of California, Berkeley, School of Optometry.  The rotation is structured to give the student exposure to both acute and chronic ocular conditions that require accurate diagnosis and appropriate therapeutic intervention.  50% of the clinical rotation will involve working with full-time ophthalmic faculty in primary care, urgent care, and cornea.  The remaining 50% of the clinical experience will be electives among neuro-ophthalmology, uveitis, oculoplastics, or glaucoma.  The student will participate in direct patient care under the oversight of attending faculty four and a half days a week.  The remaining half day will be spent attending educational sessions, which will include will grand rounds, clinical case conferences, journal clubs, research conferences and didactic lectures.

Demographics

• Patients cared for by the Byers Eye Institute come from a diverse background of all socioeconomic and ethnic backgrounds from infancy to elderly.

Prerequisites for Student Interns

• Please see Externships Documentation and Immunization Requirements page for requirements.
• Student must contact Externship coordinator at least 30 days prior to rotation to allow time for credentialing, EMR training and Immunization requirements.

Educational Objectives

This rotation emphasizes learning through direct patient care, in most cases with adults and children, with the following goals and objectives:

• Goal I – To be familiar with the diagnostic modalities needed to care for patients with acute ocular and visual disorders by examining patients seen at the urgent care clinics.
• Goal II – To be familiar with the appropriate therapeutic modalities necessary to treat patients with acute ocular and visual disorders.
  1. Working closely with the faculty, the students will initiate diagnostic workups as well as institute therapies to treat patients with acute ocular problems.
• Goal III – To become familiar with patients with congenital, degenerative and acquired corneal conditions.
  1. The students will have exposure to advanced diagnostic corneal testing such as use of topography, confocal microscopy, anterior segment OCT, and corneal hysteresis.
  2. The students will have exposure to patients with acute keratitis, corneal ulcers, corneal edema, peripheral ulcer keratitis, corneal dystrophies and degeneration.
  3. The students will have the opportunity to observe keratorefractive surgery and lamellar keratoplasty.
• Goal IV – To enhance the student’s proficiency and competency in performing a complete neuro-ophthalmic examination.
  1. Students will enhance their ability to obtain a comprehensive neurologic history.
  2. Students will perform a comprehensive neuro-ophthalmic examination including assessment of visual function, motility, visual fields, optic nerve and retinal findings
  3. Students will improve upon interpretation of functional and imaging modalities useful for the neuro-ophthalmologist.
• Goal V – To be exposed to a variety of patients with early and advanced forms of glaucoma.
  1. They will become familiar with the diagnostic examination techniques required in the accurate diagnosis of the type of glaucoma including gonioscopy, OCT, visual field interpretation, and ultrasound biomicroscopy.
  2. They will observe surgical treatment of glaucoma including minimally invasive glaucoma surgery, filtering setons, ciliary ablative therapies and trabeculectomy.
• Goal VI – To be exposed to a wide variety of oculoplastics patients with disorders of the eyelids, periorbita and orbit including patients with orbital and eyelid tumors, ectropion, entropion, periorbital trauma, orbital fractures, thyroid eye disease, ptosis, lacrimal disorders, and patients undergoing reconstructive and aesthetic procedures.
  1. They will become familiar with the appropriate diagnostic techniques necessary for patients requiring oculoplastic and reconstructive surgery.
  2. They will be exposed to aesthetic intervention including the use of botox, ocular fillers, and ocular resurfacing.
  3. They will participate in the care of patients both in the clinic and the operating room setting.
• Goal VII – To stimulate the students’ knowledge of eye care and to stimulate the students’ scholarly development.

Student Responsibilities

• Students have direct patient care responsibilities under faculty supervision four and one-half days per week.
• Complete accurate patient records in electronic medical record and obtain faculty co-signature on all notes.
• Review pathophysiology and treatment of disorders seen in clinics.
• Come prepared each day having reviewed the patients scheduled for visits.
• Students must come to the clinic in professional attire and must wear clinic jackets with identification.
• Bring hand held lenses.
• Participate in clinical conferences

Miscellaneous Information

• Please know that there are many providers at this site other than the Optometry Student Extern Director. You will be working with the Optometry Student Extern Director and the other providers in patient care.
• Normal clinic hours are Monday through Friday from 8:00am to 6:00pm.
• Educational conferences are held on Thursdays from 7:00am to 12:00pm.
• Directions from Berkeley: Get on CA-24 W in Oakland from Shattuck Avenue. Take I880 S and CA-84 W to Embarcadero Road in Palo Alto.  Take Embarcadero Road/Oregon Expressway exit from US-101 S.  Continue on Embarcadero Road.  Byers Eye Institute is on your right.