Pediatric Ophthalmology

Faculty | Overview | How to Apply | Contact

Faculty

  • Fellowship Coordinator: Christopher J. Lyons, MD
  • Maryam Aroichane, MD
  • Roy A. Cline, MD
  • Jane Gardiner, MD
  • Ross A. Kennedy, MD
  • Megan Rees, MD

Overview

There is one funded fellowship position (McCormick Fund) in Paediatric Ophthalmology and Adult Strabismus per year. A second position may be funded through the John Pratt-Johnson Endowment Fund, primarily aimed at applicants from developing countries.

The fellowship is based at the British Columbia Children’s Hospital, the only tertiary care facility for BC’s children. It offers considerable exposure to complex paediatric ophthalmological problems. In addition, adult strabismus patients are seen and their surgeries performed at the Vancouver Hospital.

Heavy emphasis is placed on diagnosis and management of the whole range of paediatric ophthalmological conditions but there will be ample surgical exposure to adult and paediatric strabismus. The fellow would be trained in strabismus surgery, including vertical, oblique and complex adjustable surgery.

Regular tutorial sessions occur in relation to the clinical material as well as formal didactic teaching sessions. Clinical research projects, other academic pursuits and publications of clinical papers would be expected from the successful candidates.

Learning goals and objectives:

The goal of the fellowship program is to provide postgraduate specialized training in Pediatric Ophthalmology. The program is available to fully trained ophthalmologists who have indicated their intent to practice Pediatric Ophthalmology, as a major part of their practice. Fellows will gain competencies that will allow them to manage the broad range of eye disorders affecting the pediatric population. It is generally a one year program, but can be extended and tailored, depending on the specific needs of a trainee.

Throughout the training, a high standard of doctor-parent/patient/staff relationship is expected as well as a high standard of ethical behaviour.

The fellow is to become knowledgeable and competent in:

  • Obtaining a detailed history from children and parents
  • Ocular examination of the potentially apprehensive and uncooperative child
  • The place of special investigations in pediatric ocular disease
  • A wide variety of clinical problems including, but not limited to congenital abnormalities, eye problems in association with systemic disease and syndromes, pediatric anterior segment, retina and neuro-ophthalmology
  • Strabismus and amblyopia diagnosis, assessment and management (including management of complex strabismus, adult strabismus and adjustable sutures)
  • Assessment of pediatric cataracts and glaucoma and surgical exposure to these conditions
  • Assessment and treatment of retinopathy of prematurity

Fellows may also gain:

  • Exposure to subspecialty areas such as pediatric oculoplastics and orbit, electrophysiology as desired
  • Exposure to retinoblastoma care, if desired

The fellow will be expected to become competent in all aspects of patient care including, but not limited to:

  • Care of outpatients in the eye clinic
  • Inpatient consultations both emergent and routine and triaging of such patients
  • Examinations under sedation or anaesthesia
  • Surgical care, when indicated, both elective and emergent

In addition to gaining a broad clinical experience, the fellow will be expected to:

  • Participate in teaching of medical students and residents
  • Participation and presentation at regular pediatric ophthalmology teaching rounds
  • Participate in research projects which could range from case reports of interesting patients seen to randomized prospective studies
  • Collaborate in research publications

Contributions of fellows to patient care, education and research at BCCH:

The fellows in Pediatric Ophthalmology contribute greatly to the daily running of the Department of Ophthalmology; they are the first point of contact for incoming calls from referring physicians both on- and off- site. In consultation with the “on call” ophthalmologist, they learn to become competent in triaging patients appropriately. In clinic, they see and assess patients before the supervising ophthalmologist and gain the opportunity to refine their clinical skills, in eliciting a clear and concise history and in accurate patient clinical assessment. The fellow is asked to suggest a management plan, which is reviewed by the supervising ophthalmologist. In doing so, the fellows gain invaluable experience and the patient care provided at BCCH is enhanced by the fellows’ contributions.

Fellows prepare and present at Pediatric Ophthalmology Rounds, approximately once a month, during the academic year. Most of the fellows have prepared projects and presented research papers at international conferences including the Vancouver Pediatric Ophthalmology and Strabismus biannual meeting, the Canadian Ophthalmological Society annual meeting and/or the American Association for Pediatric Ophthalmology and Strabismus annual meeting. Many of these presentations result in publications in the peer-reviewed literature. See below for a list of recent publications.

The fellows are also actively involved in teaching medical students and residents. They regularly participate in clinical teaching of the 3rd year medical students on their ophthalmology clerkship rotation and also participate in teaching 2nd year medical students during small group, clinical skills sessions. Our recent fellow, Dr Daniel Pharaoh, was recognised for his excellence in teaching ophthalmology residents by being awarded the annual Resident Teaching Award, by the Department of Ophthalmology and Vision Science.

Our fellows have also been involved in teaching other specialties within the hospital. For example, in the past year, the pediatric residents had a few sessions with our fellows, for their academic half day and this will continue in the current academic year. Also, in the past year they have contributed to an educational session for the BCCH Emergency doctors – including a didactic lecture, hands on demonstration of exam techniques and a wet lab for lateral canthotomy practice.

Funding

At present, our fellows are funded by 2 endowments. The money from the endowments is administered by the UBC Department of Ophthalmology and Visual Sciences and payment of the fellows comes from the University of British Columbia.

The John Pratt-Johnson Endowment is used to fund a fellow from the developing world. This endowment was created by the late Dr John Pratt Johnson, the first Head of Pediatric Ophthalmology at BCCH.

This Andrew McCormick Endowment was set up in memory of the late Dr. Andrew McCormick, who worked along-side Dr Pratt Johnson, in Pediatric Ophthalmology, at BCCH, until his retirement in 2000.

Our past fellows are sharing their skills both in Canada and around the world. Fulfilling Dr Pratt-Johnson’s vision, we are helping bring excellence in Pediatric Ophthalmology to the developing world. This is something that our department is very proud of. We also benefit greatly from the perspective and experience brought to us by these ophthalmologists.

FELLOW PUBLICATIONS

Some of the peer-reviewed publications in which Pediatric Ophthalmology Fellows (Marked (F) ) have contributed since 2010 are listed below:

– Bilateral subacute lacrimal gland emlargement mimicking dacryoadenitid in a 7-year-old boy:a rare adverse effect of valproic acid 9sodium valproate). Lyons,C, Godoy F, driessche KV. JAAPOS. 2017 jun:21(3):257-258. doi:10.1016/jaapos.2017.02.002.Epub 2017 Mar 27.

– Disc drusen complicated by asymptomatic hemorrhage in childhood. Neffendorf J, Quinlan M, Mulholland C (F), Lyons C. Can J Ophthalmol 45;537-8: 2010

– Red reflex mimicking lens subluxation in a child undergoing orthokeratology. Witwatwongwana A(F), Connolly M, Lyons CJ.  Eye 24(1);182:2010

– Dramatic visual recovery after prompt radiotherapy and chemotherapy for leukaemic infiltration of the optic nerve in a child. Puvanachandra N (F) Goddard K,  Lyons CJ. Eye 24(5);927-8:2010

– Primary iris neovascularization in NF1. Mulholland C (F), Rootman J, Lyons CJ. J Neuro-Ophthalmol 30(4)340-1:2010

– Determining the age of unilateral cataract using family photographs. Kim P (F), Lyons CJ. Arch Dis Child 95;689:2010

– The effect of changing oxygen saturation protocols on the incidence of severe retinopathy of prematurity. Wiwatwongwana A (F), Kersey JP (F), Gardiner JA. CJO 2010 Dec; 45(6): 585-89

– Cataract surgery in the first year of life: aphakic glaucoma and visual outcomes. Comer R (F), Kim P (F), Cline R, Lyons CJ . Can J Ophthalmol 2011 46(2) 148-52

– Ophthalmic Complications of Pediatric Otitis Media. Pollock T(F), Kim P (F), Sargent M, Aroichane M, Lyons CJ, Gardiner J. JAAPOS June 2011 15(3)272-5

– Genetic-environmental interaction in a unique case of Muenke syndrome with intracranial hypertension. Agochukwu NB, Solomon BD, Zajackowska-Kielska A, Lyons CJ, Pollock T(F), Singhal A, Van Allen MI, Muenke M. Childs Nerv Syst 2011; 27 (12)2183-5

– Pre-natal presentation of Fronto-orbital Congenital Infantile Fibrosarcoma : a clinicopathologic report. Tsang H (F), Senger C,  Dolman P, Courtemanche D, Lyons CJ.  JAMA Ophthalmol 2013; Jul 13(7) 965-7

– Ocular and systemic associations of against-the-rule astigmatism in children from tertiary ophthalmology clinic. Peter Kim (F), Salma KC Rai (F), Hughie H. Tsang (F), Maryam Aroichane, Jane A. Gardiner, Christopher J. Lyons Journal of AAPOS, February 2013 (Vol. 17, Issue 1,Page e19)

– Cranial Nerve Palsies in Childhood. Lyons CJ, Godoy F (F), AlQahtani E (F). Eye. 2015;29:246-51

– Congenital bilateral retinal detachment in two siblings with osteoporosis-pseudoglioma syndrome. Wellinder L (F), Robitaille JM, Rupps R, Boerkoel CF, Lyons CJ. Ophthalmic Genet 2015;May 6:1-5 (E Pub ahead of Print)

– Enlarging Corneoscleral cyst in a 2 year-old girl. AlQahtani E(F), Godoy F(F), Lyons C J. JAAPOS 2015;19:389-91

– Clinical Pearls and Management Recommendations for Strabismus due to Thyroid Orbitopathy. AlQahtani ES(F), Rootman J, Kersey J(F), Godoy F(F), Lyons CJ.  Middle East Afr J Ophthalmol 2015;22:307-11

– Painful Acute Corneal Ulceration Mimicking Infectious Keratitis in a Teenager with Reactive Arthritis (Reiter’s Disease). Lyons CJ, AlQahtani E (F), Godoy F (F) Moloney G, Gardiner J, Journal of Pediatric Ophthalmology and Strabismus (Accepted 2016, in publication)

How to Apply

Interested applicants MUST contact the supervisor as there are no applications available.  Further instructions will be sent to the applicant once they are accepted into the fellowship program by the supervisor.

Contact

Dr. Christopher J. Lyons
Department of Ophthalmology
BC Children’s Hospital
4480 Oak Street
Vancouver, B.C. CANADA V6H 3V4
Tel: (604) 875-3117
Email: Dr. C.J. Lyons care of Chloe Gregg: Chloe.Gregg@cw.bc.ca