Scope of Clinical Practice

Dr. David Zacks instructing a resident during surgery

The Department of Ophthalmology and Visual Sciences includes a Comprehensive Ophthalmology and Cataract Surgery clinic and seven subspecialty clinics, each with exceptional depth of experience. The Department is the tertiary care center for the State of Michigan and serves as a major referral center for the region. Our patients come from across the country and around the world. For a look inside the Kellogg Eye Center, visit the Why Train at the Kellogg Eye Center page.

The Department is part of the University of Michigan Health System and shares its mission of excellence in clinical care, research, and education. Physicians at UMHS represent virtually every medical specialty and conduct some 1.5 million patient visits each year. The UM Medical School graduates 170 physicians annually, and, like the larger Health System, is consistently ranked as one of the top institutions in the nation.

Clinical Training During COVID-19

Residency directory, Bradford Tannen, MD, JD, talks about the creativity and the teamwork that has gone into creating opportunities to continue vigorous resident training during the COVID-19 pandemic and what we are doing to keep our residents safe.

Clinical Practice

Comprehensive Ophthalmology and Cataract Surgery

The Comprehensive Ophthalmology and Cataract Surgery Service conducts 17,500 patient visits each year, treating and acting as a triage unit for the full spectrum of ophthalmologic disorders and diseases, including traumas such as chemical burns, ruptured globes, and intraocular foreign bodies.

Faculty

Common Procedures

  • Cataract extraction with implantation of IOL
  • Surgery for ocular lacerations and ruptured globes
  • Removal of corneal and conjunctival foreign bodies
  • Removal of chalazion and other minor skin and eyelid lesions
  • Laser treatment for diabetic retinopathy, glaucoma, and retinal problems
  • Punctal plugs for lacrimal system defects

Snapshot of Patient Pool

  • Routine eye examinations
  • Cataract extraction with implantation of IOL
  • Screenings for diabetic patients
  • Ocular manifestations of systemic diseases and medications
  • Glaucoma of all kinds
  • Ocular trauma
  • Blepharitis and lacrimal system problems
  • Floaters and vitreous detachment
  • Blurred vision
  • Urgent and emergent ocular problems: corneal abrasions, corneal and conjunctival infections, iritis, vitreous and retinal hemorrhages, contact lens problems

Cornea and External Ocular Disease and Refractive Surgery

The Cornea Service specializes in corneal and external disease and refractive surgery with an emphasis on keratoplasty, including penetrating keratoplasty, lamellar keratoplasy, femtosecond laser assisted keratoplasty, and endothelial keratoplasty. Cornea specialists conduct some 17,000 patient visits annually, and our contact lens clinic conducts more than 9,800 patient visits.

Faculty

Common Procedures

  • Corneal transplants
  • Cataract extraction with implantation of IOL
  • Refractive surgery
    • LASIK
    • LASEK
    • Intralase
    • Wavefront
    • PRK
    • CK
    • Corneal ring segments

Snapshot of Patient Pool

  • Corneal dystrophies
  • Dry eyes
  • Corneal infections
  • Herpes simplex keratitis
  • Cataract
  • Myopia
  • Hyperopia
  • Keratoconus
  • Corneal ulcers
  • Ocular surface problems
  • Corneal and conjunctival tumors

Eye Plastic, Orbital and Facial Cosmetic Surgery

The Eye Plastic, Orbital and Facial Cosmetic Surgery service conducts approximately 8,300 patient visits a year at Kellogg and Mott Children's Hospital, treating children and adults for the whole range of ophthalmic plastic problems. We repair and reconstruct facial trauma, birth defects, skin cancer, ptosis, and orbital tumors. Over 250 orbital decompressions are performed annually, along with almost 600 blepharoplasties and nearly 500 tumor excision/lid reconstructions.

Faculty

Common Procedures

  • Enucleation
  • Lacrimal system repair (traumatic and functional)
  • Lid reconstruction
  • Fracture repair
  • Botox treatment (cosmetic and therapeutic)
  • Ptosis repair
  • Blepharoplasty (cosmetic and therapeutic)
  • Orbital decompression
  • Socket reconstruction (with mucous membrane or amniotic membrane)
  • Dacryocystorhinostomy
  • Removal of chalazion and other minor skin defects

Snapshot of Patient Pool

  • Orbital tumors (pediatric and adult)
  • Blepharospasm and hemifacial spasm
  • Graves eye disease
  • Microphthalmos/anophthalmos
  • Trauma (dog bites, MVAs)
  • Lid lesions and malpositions
  • Birth defects (blepharophimosis and other syndromes)
  • Dermatochalasis
  • Entropion/Ectropion

Glaucoma

Each year the Glaucoma Service conducts over 15,000 patient visits, treating people who have various types of glaucomas, as well as the full spectrum of anterior segment disorders, diseases, and trauma. Visual field testing, pachymetry, high resolution ultrasound biomicroscopy, and various disc imaging methods using HRT and OCT are used to evaluate our patients.

Faculty

Common Procedures

  • Cataract with implantation of IOL
  • Filtration surgeries including trabeculectomy, thermal sclerostomy, and posterior lip sclerectomy
  • Drainage angle surgeries including trabeculotomy and goniotomy
  • Glaucoma drainage implants
  • Bleb revisions
  • Laser procedures including trabeculoplasty, iridotomy, and both external and endoscopic cyclophotocoagulation
  • Cyclodialysis cleft closures

Snapshot of Patient Pool

  • Ocular hypertension
  • Normal tension glaucoma
  • Open-angle glaucoma including pigmentary and pseudoexfoliation
  • Angle-closure glaucomas including nanophthalmos
  • Complex glaucomas due to neovascularization, epithelial downgrowth, uveitis, steroids, carotid/dural cavernous fistulas, corneal dystrophies, trauma, and tumors
  • Congenital glaucoma
  • Glaucoma associated with syndromes, including aniridia, Marfan's Syndrome, Sturge-Weber/Klippel-Trenaunay-Weber Syndrome, Rieger's Anomaly, neurofibromatosis

Neuro-ophthalmology

The Neuro-ophthalmology Service conducts 4,100 patient visits each year, treating the full range of neuro-ophthalmologic disorders and diseases, as well as ocular complications associated with systemic diseases such as multiple sclerosis, Parkinson's, lupus, intracranial tumors, and seizure disorders.

Faculty

Common Procedures

  • Botox injections for chronic headaches and migraine
  • Temporal artery biopsy
  • Lumbar puncture

Snapshot of Patient Pool

  • Diplopia
  • Hydrocephalus
  • Optic neuropathy
  • Migraine
  • Arteritis
  • Parkinson's disease
  • Papilledema
  • Cranial neuropathies
  • Pseudotumor cerebri
  • Unexplained visual loss
  • Bell's Palsy
  • Traumatic brain injury
  • Craniosynostosis
  • Gaze palsies
  • Benign essential blepharospasm and hemifacial spasm
  • Progressive supranuclear palsy
  • Chronic progressive external ophthalmoplegia
  • Visual hallucinations

Pediatric Ophthalmology and Adult Strabismus

The Pediatric Ophthalmology and Adult Strabismus Service conducts more than 13,900 patient visits each year, treating the full spectrum of pediatric diseases and disorders, as well as adult strabismus patients. Given the large geographic area we serve and the tertiary referral nature of our practice, we see a high frequency of unusual cases, such as Duane syndrome, restrictive strabismus, Graves eye disease, slipped and lost muscles, neurofibromatosis, and craniofacial syndromes. The service is also staffed by four orthoptists who run an orthoptics training program of national reputation.

Faculty

Common Procedures

  • Adjustable sutures
  • Dermoid cysts
  • Pediatric cataract extraction and IOL implantation
  • Pediatric strabismus surgery
  • Complex adult strabismus surgery

Snapshot of Patient Pool

  • Retinopathy of prematurity
  • Congenital cataracts
  • Congenital glaucoma
  • Strabismus (pediatric and adult)
  • Amblyopia
  • Birth defects, syndromes
  • Retinoblastoma
  • Trauma
  • Nystagmus
  • Hemangiomas
  • Botox for strabismus
  • Graves eye disease
  • Cranial nerve palsies
  • Nasolacrimal duct obstruction
  • Failed school screening examinations

Retina and Uveitis

The Retina and Uveitis Service conducts more than 28,000 patient visits each year, treating the full spectrum of retinal disorders and diseases like macular degeneration, CMV retinitis, diabetic retinopathy, sickle cell retinopathy, cystoid macular edema, choroidal melanoma, trauma, and retinal detachment. The service receives referrals for unusual cases such as Stargardt's syndrome, Coats disease, retinoschisis, and angiomas. The Department is home to the Retinal and Macular Dystrophy Center, a world-renowned research facility, which carries on numerous collaborations with the retina clinicians.

Faculty

Common Procedures

  • Vitrectomy
  • Laser photocoagulation
  • Scleral buckle
  • Membrane peel
  • C3F8 injection/Silicone oil placement
  • Steroid injection, periocular/intravitreal
  • Pneumatic retinopexy
  • Photodynamic therapy

Snapshot of Patient Pool

  • Retinal detachments
  • Macular degeneration
  • Diabetic retinopathy
  • Uveitis, anterior/posterior
  • Central/branch retinal vein occlusion
  • Cystoid macular edema
  • Trauma
  • Macular holes
  • Scleritis
  • Vitreous hemorrhage
  • Endophthalmitis
  • CMV retinitis
  • Sickle cell retinopathy
  • Myopic degeneration
  • Ocular melanoma
  • Retinoblastoma
  • Retinal dystrophies