This must be a case report of a patient the candidate has managed after graduation/licensure/accreditation in optometry.
Step 1: Submitting Case Reports
All case reports are to be submitted to the online candidacy system. A minimum of one, and up to five, will be required based on the point system. All clinical candidates must write at least one case report. The first case report should be submitted to the system no later than February 1, 11:59 pm EST, of the year you’d like to sit for the oral exam. Your second case report must be submitted to the system no later than April 1, 11:59 pm EST, of the year you’d like to sit for the oral exam. All remaining written work is due no later than May 15, 11:59 pm EST, of the year you plan to sit for the oral exam.
Step 2: Purpose
The purpose of written case reports is to demonstrate one’s commitment to the Academy’s goal of lifelong learning. Case reports should display technical skills and knowledge, level of professionalism, and ability to care for patients. Keep in mind, the case reports you write are a reflection of you and your skills more than the patient about whom you are writing.
Step 3: Patient Selection
Cases should be representative of the patients you work with and care for on a daily basis. They should reflect different aspects of your optometric practice and should be cases that are/were either entirely managed by yourself or co-managed to conclusion. Exotic cases are interesting, but any case chosen should be representative of your best work and clinical judgment. It is recommended that at least one case involving disease, treated by you or referred to another professional for treatment, should be included. You may not submit case reports about any patients you saw before becoming a practicing optometrist.
Step 4: Building a Case Report
- A case report is a scientific writing and should ideally follow the writing style exhibited in peer-reviewed journals.
- It should be written in third person, past tense.
- Carefully spell-check and grammar-check all work.
- Support clinical conclusions and be able to justify clinical decisions during the oral exam.
- Patients should be followed to the conclusion of the condition reported.
- All writing should be your original work. Plagiarism is grounds for termination of your candidacy. Have a colleague review your case report prior to submission.
- Please keep in mind the Fellowship Dates and Deadlines for your submissions to ensure eligibility for your preferred oral exam date.
- Written case reports, required as part of your application for Fellowship, must include a discussion section that includes information referenced from literature. It is expected that all your writing represents your own work. Be familiar with what needs to be cited and how to reference information taken from other sources.
- Visit the Member Dashboard when logged in at www.aaopt.org to find access to select journals through the Academy as well as the AVSL-AAO Information Resource Hub, which houses information regarding books and journals, citation managers, and more information that could aid in your research.
All written work is expected to be the candidate’s own original writing. Information taken from references or other source documents must be properly attributed. Plagiarism is considered a violation of the Standards of Conduct of the AAO, and, if verified, is grounds for termination of your application for Fellowship. Admittance Committee members check every case report for evidence of plagiarism (written work offered as original when in fact it was copied word-for-word without proper attribution to the original source).
Plagiarism is defined by the Merriam-Webster dictionary as 1) stealing and passing off (the ideas or words of another) as one’s own; 2) using (another’s production) without crediting the source; or 3) committing literary theft: presenting as new and original an idea or product derived from an existing source.
Copying extensive portions of other’s works, even with referencing, is seen as plagiarism by the Academy. Before submitting your case report, seek the advice of your Subcommittee Chair or request a mentor if you have questions or are unsure about what constitutes plagiarism.
Step 5: Organizational Guidelines for Case Reports
Cover Page: The first page is a cover sheet with the candidate’s name, address, telephone number, e-mail address, case report title and number, and a brief abstract (approximately 10 lines) of the attached case report. Include keywords used.
Introduction: The paper should begin with a 1-2 paragraph introduction that provides background information on the topic of the case report.
Case Report: Thoroughly describe each visit when the patient was seen and examined. Maintain HIPAA compliance and eliminate any references to health-protected information of your patient. Each visit should be thoroughly documented including history, examination findings, decision-making, treatment, and patient education.
The initial visit should include the patient’s chief complaint, age/ethnicity, sex, and date of examination as well as a thorough documentation of history (history of present illness: medical, ocular, family, and social histories; medications; allergies).
Documentation of the examination should identify all findings, including pertinent negatives. All medications instilled in the patient’s eyes as part of the examination should be recorded by concentration and quantity. A complete differential diagnosis should be included, indicating how the final diagnosis was determined. Treatment protocol should demonstrate depth of knowledge and be justifiable should it vary from the current standard of care. Separate each follow-up visit so there is a clear chronology of your examination and treatment of the patient.
If the patient was referred to a specialist, the reason for the referral, differential diagnosis, and expected outcomes should be discussed. If the patient was referred to another provider for a procedure or for further testing, include a copy of that provider’s report as well as any follow-up with the patient after the procedure.
You must clearly identify when the patient was examined by another eye care provider. This includes an optometrist or ophthalmologist from another practice, within your same practice, or through co-management.
Discussion: This section should describe the diagnosis in greater detail, including the epidemiology and pathophysiology where appropriate. Use this section to further discuss your decision-making process. Explain variations from normal relating to your specific patient’s presentation. Discuss the standard of care for the condition and why you may have deviated from it. If there are any alternative treatments, explain each and discuss the advantages and drawbacks.
The discussion should be your original writing and should refer to the specifics of your case report. Any information gathered from outside sources should be properly documented.
Step 6: Elements of Evaluation of Case Reports
The quality of the case report will be considered by the committee as an indication of the quality of care that you provide your patients on a daily basis. Primary elements evaluated include:
- Complexity of the Case Report: An extremely complex case report is usually an interesting one, but it requires the candidate to thoroughly support their clinical decisions. Remember the assessment of case reports is based on how the case was managed, not the uniqueness of the case (no matter how interesting.
- Appropriate Data Collection: Each visit should be thoroughly documented. Ensure patient confidentiality in all documents. The initial examination should be a comprehensive one and all findings must be documented. Subsequent visits should follow the same format with all findings documented in a detailed manner. If a patient is referred to another provider for a procedure or further testing, include a copy of that provider’s report as well as your follow-up with the patient after the procedure. In the discussion, explain the reasons for further testing and/or referral as well as the results and what impact they had on the diagnosis and treatment plan. Patients should be followed to conclusion.
- Appropriate Diagnosis: Clinical decisions based on a differential diagnosis should be thoroughly explained in the discussion section of the case report. If the patient has more than one problem (i.e., a diabetic with binocular vision anomalies), the clinical issues surrounding all problems must be addressed in the final diagnosis. All problems with which the patient presents should be evaluated and managed. If the patient has less than 20/20 visual acuity, a clinically substantiated reason must be found.
- Appropriate Treatment: The treatment protocol should demonstrate depth of knowledge and be justifiable should it vary from the current standard of care. In the discussion, describe the alternative treatments for each diagnosis and the advantages and drawbacks of each. Be prepared to discuss the reasons for choosing the selected course of action. The case report should demonstrate the patient’s problems were resolved over the course of time you managed the patient (if resolvable). The chosen treatment should be supported by the cited references and explained in the discussion.
- Terminology, grammar, spelling, and organization: A well-written case report is a pleasure to read; a poorly written one is torture, no matter how interested the case or how adept the clinician is. Although writing alone does not have much impact on the total score, it cannot help but affect how the reviewer evaluates the paper. Use the best writing skills, spell-check and grammar-check all work, and have someone proofread the paper. The case report should be entirely your original work. Writing that is plagiarized from other sources will not be accepted and may be cause for dismissal as a candidate.
Step 7: Case Report Submissions
Upon notification of acceptance of the candidate’s application, the candidate should submit the first case report by February 1 of the year they intend to sit for the oral exam.
The Subcommittee Chair will review the first case report and provide written evaluation. You may be asked to revise the article based on the suggestions from three members of the Admittance Subcommittee. This may mean adding information, clarifying references, and cleaning up confusing grammar, syntax, etc. The intent of revision(s) is to assist the candidate as they prepare for the oral examination. Revisions requests are very common.
The Academy has a number of mentors eager to assist candidates throughout the Fellowship process. Mentors can be assigned by request to your Subcommittee Chair or at the recommendation of your Subcommittee Chair.
You must complete all requested revisions to your written work no later than July 15 in order to be cleared for the oral examination in the same calendar year. We highly recommend submitting revisions as soon as possible, however, as it is not uncommon to need two or more rounds of revisions and this can delay your oral exam eligibility.
Step 8: Questions
For assistance or guidance in the preparation of the case reports, please contact your Subcommittee Chair.
Step 9: Notification of Acceptance of Written Work
You will receive a notification from the candidate portal once your written work has been approved and you are eligible to schedule the oral exam. Your Subcommittee Chair will email you an invitation letter in the summer before the oral exam with instructions on how to schedule your exam time. It is your responsibility to follow these instructions to schedule your exam time by August 15 of the year you intend to sit for the oral exam. Oral examinations will be scheduled on a first-come, first served basis and are held on the Thursday of the Academy’s annual meeting.