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Jullia A Rosdahl, Wenlan Zhang, Varsha Manjunath Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC, USACorrespondence: Jullia A RosdahlDepartment of Ophthalmology, Duke Eye Center, Duke University, DUMC 3802, 2351 Erwin Road, Durham, NC 27710, USAEmail jullia.rosdahl@duke.eduObjective: Chart rounds have traditionally been used effectively for clinical teaching in ophthalmology. The introduction of the electronic health record has altered practice patterns and some evidence suggests interference with resident education. The purpose of this study was to investigate the use of chart rounds in our ophthalmology department and to see if a simple intervention, an “education button”, could positively impact clinical teaching.Design: We used a cross-sectional survey, and pre- and post-intervention surveys to assess the utility of an intervention – an “education button”.Setting: Department of Ophthalmology at Duke University, a tertiary care academic ophthalmology practice, in Durham, North Carolina.Participants: Ophthalmology trainees (37), including residents and clinical fellows, and clinical faculty (50) in the department were surveyed anonymously. The overall response rate for the cross-sectional survey was 83% (72/87). The overall response rate for the educational study was 53% for the first time-point and 59% for the second time-point.Results: For the cross-sectional survey, trainees found chart rounds to be useful and would like to increase their frequency. Most faculty reported doing them regularly, although not having enough time was the most common barrier (76% of the faculty). In the pre- and post-assessment of the “education button” (overall response rate 53%), the overall impression was positive with the button easy to use, but the implementation of the button did not appear to change the quality or frequency of chart rounds; nor did it appear to have an effect on covering learning objectives.Conclusion: While the “education button” could help with communication between the faculty and trainees during a busy clinic session to identify cases for discussion, it did not address the most common barrier identified by faculty members, that of not having enough time.Keywords: electronic medical record, electronic health record, resident education, fellow education, chart rounds, digital

PURPOSE: To utilize high-resolution spectral domain optical coherence tomography (SD-OCT) in the characterization of retinal and vitreal morphological changes overlying posterior lattice degeneration. METHODS: A cross-sectional, retrospective analysis was performed on 13 eyes of 13 nonconsecutive subjects with posterior lattice degeneration seen at the New England Eye Center, Tufts Medical Center between October 2009 and January 2010. SD-OCT images taken through the region of lattice degeneration were qualitatively analyzed. RESULTS: Four characteristic changes of the retina and vitreous were seen in the 13 eyes with lattice degeneration: (1) anterior/posterior U-shaped vitreous traction, (2) retinal breaks, (3) focal retinal thinning, and (4) vitreous membrane formation. The morphological appearance of vitreous traction and retinal breaks were found to be consistent with previous histological reports. CONCLUSIONS: It is possible to image posterior lattice degeneration in many eyes using SD-OCT and to visualize the spectrum of retinal and vitreous changes throughout the area of lattice degeneration.