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To present 5 cases of alemtuzumab-induced thyroid eye disease (AI-TED) and review the literature to highlight the natural history, severity, and outcomes as compared with conventional thyroid eye disease (TED).Methods: A multi-institutional retrospective case series of patients with AI-TED was compiled. Chart review evaluated for clinical characteristics, imaging findings, and treatment for AI-TED. Additionally, a comprehensive review of the literature identified all previously published cases of AI-TED.Results: Five new patients with AI-TED were included in this series. The average clinical activity score on presentation was 2.8 (range 1-4) and reached an average peak of 5.0 during the active phase of the disease (4-7). Patients were treated medically with selenium (40%) or monoclonal antibodies including teprotumumab or tocilizumab (40%). Surgical treatment with orbital decompression for compressive optic neuropathy was performed on 2 (40%) patients. Combined with 11 previously reported cases, these 16 patients with AI-TED had an average clinical activity score on presentation of 3.3. The average length of the AI-TED phase was 14.0 months, and all patients were treated with medical and/or surgical interventions for their disease.Conclusions: Clinical and imaging findings in AI-TED mirror that of conventional TED, however, AI-TED may present with greater severity. AI-TED may develop many months after Graves' disease; therefore, providers should be aware of this association and monitor patients for the development of severe TED.

Objective: To evaluate the experiences and preferences of applicants applying for the 2020 - 2021 application cycle for ophthalmology residences during the COVID – 19 pandemic. Methods:A cross sectional survey was conducted online. All applicants to the Henry Ford ophthalmology residency program during the 2020-2021 application cycle were invited to complete the survey. The survey was open for completion from June 4, 2021, to July 4, 2021.Results:Survey responses were collected from 94 applicants (17.2% completion); 71 (75.5%) US MD, 10 (10.6%) DO, and 13 (13.8%) IMG MD. Applicants reported a mean (SD) USMLE Step 1 score of 243.10 (12.59) and 5.60 (5.33) publications accepted and/or submitted. Applicants applied to a mean (SD) of 82.31 (22.12) programs, were offered 8.90 (11.47) interviews, and attended 8.26 (5.56) of them. The most important factors respondents believed in choosing programs to apply to were geographical location (n = 73 (81.1%)), perceived fit in a program (n = 72 (80.0%)), and program reputation (n = 68 (75.6%)). Most respondents believed they were adequately able to assess their fit through virtual interviews (n = 56 (59.2%)). In the event of another year of virtual interviews, respondents were asked for changes they would like to see changed/improved in the match process. The most frequent response was a better assessment of a programs (n = 16 (32.0%)), followed by a stronger cap on the number of programs applied to and/or number of interviews an applicant could attend (n = 10 (20.0%)), and better opportunities to speak and connect with residents (n = 8 (16.0%)).Conclusion:Applying for ophthalmology residencies continues to be recognized as a highly competitive process with many complexities involved. Future cycles may investigate the value of replacing in-person interviews with virtual ones or may adopt a hybrid model to ease applicant financial burden and stress from travel. Given another cycle for virtual interviews, program directors may find value to offer more opportunities to interact with residents, improve virtual tours of facility, and limit technical difficulties during these interviews.

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