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    Academy News from AAO 2008 Atlanta Academy News from AAO 2008 Atlanta Document Transcript

    • EyeNet MAGAZINE S C I E N T I F I C H I G H L I G H T S O F AT L A N TA 2 0 0 8 Sunday, Monday & Tuesday
    • TABLE OF CONTENTS FROM THE EDITOR Welcome to Atlanta. This IN THIS ISSUE: A chat with the Keynote Speaker . . . . . . . 4–6 year’s Joint Meeting is spon- In this second edition of The Carter Center saves vision . . . . . . . . .9–10 sored by the Atlanta’s Academy News, Best of Show videos . . . . . . . . . . . . . . .11–12 Academy and our colleagues from meet the Opening Session’s Make coding easy (or easier) . . . . . . . . . . . .13 the European Keynote Speaker, glimpse highlights of the Best of See the Museum of Vision exhibits . . . . . . .15 Society of Oph- thalmology, and Show Videos, and learn about Atlanta’s renowned San Francisco in 2009 . . . . . . . . . . . . . . . .16 that international Carter Center. Volunteer abroad with your colleagues . . . . .17 spirit is reflected in the depth and breadth of the presentations. Among the many excellent Symposia to which the EyeNet team is looking forward: Sunday, from 3:45 to 5:15 p.m.— “Infectious Disasters: Are We Seeing Fewer or Are We Treating Better?” Monday, from 3:30 to 5 p.m.—“War and Terror-Related Injuries: From Triage to Management to Rehabilitation.” Monday, from 4:15 to 5:35 p.m.— “Around the World in 80 Minutes: Inter- national Symposium on Devices for Complicated Cataract Cases.” (This is just one offering from the all-day Cataract Monday program.) Tuesday, from 10:45 a.m. to 12:15 p.m.—“Business, Ethical and Medical- Legal Aspects of Treating Glaucoma Patients.” Beyond taking in these presenta- tions, enjoy your stay in Atlanta, and make sure to meet new colleagues from around the world. Richard P. Mills, MD, MPH Chief Medical Editor, EyeNet Magazine ON THE COVER Penetrating Keratoplasty Photo by Marshall E. Tyler, CRA, FOPS Wake Forest University Eye Center CORRECTION The Academy Seniors Special Meeting and Reception takes place on Monday from 2:30 to 5 p.m. in Room B406. Archivist Ted Ryan will present the Keynote Speech, “10 Things You Might Not Know About Coca-Cola.” Nancy J. Newman, MD, will present “Mitochondrial Disease: It’s Not All Your Mother’s Fault.” This supersedes the agenda published in October’s EyeNet. e y e n e t ’ s a c a d e m y n e w s 3
    • KEYNOTE SPEAKER THE INSTITUTE OF MEDICINE’S HARVEY V. FINEBERG, MD, PHD: ADVANCING THE NATION’S HEALTH AGENDA Seeing the Trees and the Forest by annie stuart, contributing writer A s president of the Institute of Medi- any and all primary problems that appear knowledge and experience to this her- dents, breast cancer cine (IOM) of the National Acade- on the U.S. health agenda. Provost of Har- culean task. or AIDS.1 mies, Harvey V. Fineberg, MD, PhD, vard University from 1997 to 2001, dean Keynote Speaker at this year’s Joint Unmasking the has a job with mind-boggling scope. Any of the Harvard School of Public Health Meeting, Dr. Fineberg has special interests forces of legislation, attempt at encapsulation seems to do his for 13 years and recipient of five honorary in public health practice, the evaluation of regulation and work an injustice. He and the IOM tackle degrees, Dr. Fineberg brings a wealth of diagnostic and screening tests and the eth- market activity that ical and social implications of new med- influence quality ical technologies. He is coauthor of three of care, the report books, Clinical Decision Analysis, Innova- greatly increased tors in Physician Education and The Epi- public awareness DR. FINEBERG gives demic That Never Was, the last of which and led to the con- the Keynote analyzes the controversial 1976 federal vening of a White Address from 9:08 immunization program against swine flu. House conference to 9:28 a.m. dur- Dr. Fineberg’s address to the Academy by President Clin- ing the Opening is titled “Seeing the Future of Health ton and the appro- Session, which Care,” and it will describe some of the key priation of funds takes place from forces that will affect medical practice by Congress to the 8:30 to 10, this over the next 10 years. Rather than be Agency for Health- morning (Sunday) passive participants, Dr. Fineburg said, care Research and in Hall A-3 Ses- ophthalmologists and other physicians Quality. sion Room. have an opportunity to reexamine and Where medicine reinforce their professional roles and to had failed in the matter of hospital errors, shape the future of health care. said Dr. Fineberg, was by asking the The IOM is one of four organizations wrong questions—who was at fault, rather of the National Academies—which also than what system had created the condi- include the National Research Council, tions that enabled errors. In contrast, a the National Academy of Engineering and focus on the forest, not just the trees, is the National Academy of Sciences—that emblematic of the work of the IOM, are authorized by charter of the U.S. Con- which followed up with its blueprint for gress. Operating independently of govern- addressing the problem: Crossing the ment, the IOM is a private organization Quality Chasm: A New Health System for created in 1970 for the purpose of advis- the 21st Century (2001). Since its publica- ing policy makers, health care profession- tion, said Dr. Fineberg, some progress has als and the public on topics as wide-rang- been made at improving systems and ing as vaccine safety, health care delivery, tracking prescriptions, but errors are still nutritional standards and cancer preven- a significant problem. He said that tech- tion and management. nology could play a much greater role in “Everything from the quality, safety reducing transcription and dispensing and cost of health care; the availability errors. Computerized order entry, auto- of health insurance; the issues that foster mated pharmacy packaging, individual scientific progress; the conflicts of interest dosing and labeling, and bar-coding are among professionals in their roles as teach- just a few examples of ways to reduce ers, caregivers and researchers; to child- error. hood obesity and global health,” said Dr. Fineberg, “all of these are on our agenda.” THE EXPANDING ROLE OF TECHNOLOGY And each year the IOM produces dozens Dr. Fineberg is a measured proponent of of reports to contribute to informed deci- new technologies. He points, for instance, sion making. A sampling of this year’s to bipartisan agreement in Congress about includes reports on the topics of emer- the need for better information technolo- gency preparedness, foodborne disease gy investment. (In the case of IT, however, and genomic innovations in health and cultural resistance—getting doctors to medicine. embrace new technology—can be one of the biggest stumbling blocks.) SHEDDING LIGHT ON MEDICAL ERRORS Overall, Dr. Fineberg considers tech- Among the IOM initiatives with the biggest nology to be the proverbial two-edged impact was one leading to the publication sword. “I think that our challenge is both of the report To Err Is Human: Building a to encourage creative and innovative Safer Health System (1999). This unsettling advances that solve real health problems report revealed that close to 100,000 U.S. and to discourage marginally or negatively patients die annually from hospital errors —more than die from motor vehicle acci- Keynote Speaker, continued on page 6 T I M E C H A N G E S & C A N C E L L AT I O N S This publication was printed in advance of the Joint Meeting. Check the Ticket Sales area in Hall A-2 for cancellations or changes in meeting times. 4 s u n d a y ● m o n d a y ● tuesd a y e d i t i o n
    • KEYNOTE SPEAKER Keynote Speaker, continued from page 4 $130 billion each year.2 IOM’s subsequent a single-payer system,” he said. “You can important, in dealing with population- 2004 recommendations called for univer- see in places like France how access to ser- level health problems, to be open to solu- useful applications of technology,” he said. sal, continuous and affordable health care vices is very widely distributed in both the tions that are both medical and public “Technology is the pathway to progress for all individuals and families. cities and throughout the smaller towns health–oriented in character.” and at the same time it is a very substan- Dr. Fineberg called the current deficien- and villages. You can see in Scandinavia tial source of the high cost of health care cies in health coverage a travesty, with examples of integration of medical ser- GLOBAL HEALTH AND BIOTERRORISM in the United States.” progress largely stalled by a political stale- vices with public health systems. We can With the anthrax story back in the news He added that a variety of incentives mate between two entrenched camps— benefit from looking at a variety of other earlier this year, Dr. Fineberg reflected encourage overuse. It can be easier to order those who favor a single-payer, govern- countries and adapting to our particular on the risks of bioterrorism. Though tests than to take a thorough history. There ment-run program and those who oppose needs what works and avoiding the things bioterrorism is a serious threat, he cou- is pressure from patients to use what’s avail- expansion of government programs. The that haven’t worked very well.” pled it with natural biological threats— able. And currently, the more diagnostic presidential candidates comprise a third pandemics and other manifestations of tests and technology that physicians use, group and suggest building on our cur- PRESSING PUBLIC HEALTH ISSUES natural diseases—observing that nature the greater their reimbursement. A smarter rent system through mandates or incen- Dr. Fineberg said the principal driver for can be the worst terrorist of all. way, he said, would be to pay for both tives, or a mix of the two. U.S. public health challenges is the demo- “From the point of view of national value and efficiency, encouraging evi- Despite the historical failures, Dr. Fine- graphic and epidemiological transition preparedness, we are better prepared than dence-based guidance for optimal use berg is optimistic. “I believe that we’re in generated by the aging of the population. we were five or even three years ago,” said of technology. the strongest position of any time in the Though small in numbers, the fastest- Dr. Fineberg. “This recent investigation past decade to see genuine health reform,” growing segment of the population is over of the anthrax episode is a good example HEALTH CARE REFORM IMMINENT? he said. “All other industrialized countries age 100. Despite healthy older populations, of where advancing science enabled the While leading the world in health care —with widely disparate systems of govern- the total burden of chronic disease will detailed location or identification of the expenditures, the United States is the only ment, patterns of social interaction, and rise dramatically due to huge numbers of particular anthrax strain. That wasn’t pos- wealthy, industrialized nation that does levels of capitalism or socialism—have people living longer. “It means also that sible earlier, so there is progress. At the not ensure coverage for all citizens. In a solved this problem. So, I have no doubt features of behavior that are conducive to same time, the surveillance systems in the review of the hidden costs of uninsurance, the United States can do it, too.” chronic diseases like obesity and diabetes, world are still very much less than we the IOM found that if the 45 million While pointing to a need for a distinctly to pick prominent examples, are especially want, particularly in some parts of the uninsured U.S. citizens were to be covered, U.S. solution, Dr. Fineberg said there are problematic,” he said. “It means that we world where the natural disease problems the cost of insuring them would be far many lessons to learn from other countries. have to organize our health services to may occur earliest.” outweighed by the potential economic “You can see how Germany, for example, meet the needs of people in their homes Advancing global health is a matter of gain of better health outcomes from unin- has worked out a system of insurance that as well as in our clinics. It means we need enlightened self-interest for the United terrupted coverage—an estimated $65 to involves multiple participants, not simply to organize services that actually deliver States, he said, especially since borders are the care and the prevention that older becoming less of a barrier to the spread of Americans require.” disease. A global economy means people, Using cancer care as an example, Dr. goods, food—every imaginable form of Fineberg described the implications of the animal and plant—are coming from all fact that cancer is increasingly changing corners of the world. “We cannot assure into a manageable, chronic condition. and protect the health of the American “One of the key implications is that we people unless we have done more to pro- need to adopt a strategy of cancer care for tect the health of people everywhere,” said the whole patient,” he said. “We have to Dr. Fineberg. “And we need to have sys- look at advancing science, at treatment tems of cooperation in everything from and at better statistical and epidemiologic surveillance for potential outbreaks of analyses about what works and what the influenza, for example, to the manage- causes are. But we need to do it with a ment of ill travelers who may be moving framing that is healing in its intent and from one place to another across interna- looks to care for patients in the home as tional borders.” well as in the hospital and as human Because health represents an interna- beings, not merely as clinical material.” tional common aspiration, he added, Solving the challenges of health care advancing global health has indirect bene- for the elderly, while not neglecting the fits for the U.S. public as well. “The degree needs of children and other segments of to which we can exert our soft power the population, he said, will require a 21st through science and health is the degree century set of strategies to establish the to which America’s strength and projection preventive and curative services that an in the world will have benefits in a wide aging and growing population is going to array of interests, from our national secu- require. rity to our commercial success to our Mobilizing families, schools and health desire to promote good government and care providers—not to mention food pur- democratic principles around the world,” veyors, city designers, manufacturers and said Dr. Fineberg. “So America has many restaurant owners—will be required to interests in global health—both for our solve problems like childhood obesity and own health and for our national interests.” the remaining one in five adults who still smokes in this country, said Dr. Fineberg, 1 National Academies Press Web site. www.nap. who added that it’s sometimes said that edu/catalog.php?record_id=9728#description. the hardest problems often require the 2 Institute of Medicine Web site. www.iom. softest science. “And that’s why it’s very edu/CMS/3809/4660/12313.aspx. GLOBAL EYE M.D.S On Monday from 4:30, Brad Feldman, MD, will convene a course titled “Young Ophthal- mologists in International Ophthalmology” to identify the opportunities for reducing the global burden of eye disease. (Event Code 457, $35.) 6 s u n d a y ● m o n d a y ● t u e s d a y e d i t i o n
    • NOTABLE HONORS SPECIAL AWARDS The Academy Recognizes Contributions in the Field T he Academy’s 2008 president, David Dr. Aaberg was senior associate editor W. Parke II, MD, has extended an of the American Journal of Ophthalmology invitation to three individuals who from 1982 to 2002 and is past president of have made significant contributions to the Macula Society and of the Association ophthalmology and the Academy to be of University Professors of Ophthalmology. his Guests of Honor at this year’s Joint He is a member or past member of the Meeting. He also is pleased to announce American Ophthalmological Society, the recipient of this year’s Distinguished American Board of Ophthalmology, Asso- Service Award. These honorees and others ciation for Research in Vision and Oph- are recognized during the Opening Ses- thalmology, American Medical Association, sion, which takes place Sunday from 8:30 American Eye Study Club, Pan-American to 10 a.m. in the Hall A-3 Session Room. Ophthalmological Society, Club Jules HONOREES. The 2008 President’s Guests of Honor are Dr. Aaberg Sr., Dr. Koch and Gonin, Retina Society and American Soci- Dr. Parke Sr. This year’s Distinguished Service Award goes to the Knights Templar THREE GUESTS OF HONOR ety of Retina Specialists. Eye Foundation. THOMAS M. AABERG SR., MD, MSPH, The focus of Dr. Aaberg’s surgical and FACS research activities has been the manage- surgical instrument design. His engaging unit. He maintained an active compre- The Academy is pleased to recognize Dr. ment of complicated retinal detachment style, command of the literature and prag- hensive ophthalmology practice until Aaberg Sr. as a Guest of Honor for his and diabetic retinopathy, but he also has a matic approach to complex clinical prob- 1988. contributions to ophthalmology as an strong interest in medical retinal disorders. lems have made him an extraordinary In a brief “retirement,” he retrained in outstanding contributor to the art and sci- His main career interest, however, has been teacher and role model. low vision and has since devoted his life ence of vitreoretinal disease and surgery teaching. He has been honored with clini- Dr. Koch was associate editor of the to promoting low vision rehabilitation. and as a superb teacher and role model. cal teaching awards from residents at the Journal of Cataract and Refractive Surgery He is serving now as associate clinical pro- A graduate of Dartmouth College, Dr. Medical College of Wisconsin and at Emory from 1994 to 2001 and co-chief editor fessor at Yale University and as director of Aaberg received his medical degree from University School of Medicine, where in from 2001 to 2007. He is a past president low vision rehabilitation at both Yale Eye Harvard Medical School and completed 2006 the annual clinical teaching award of the American Society of Cataract and Center and Masonicare. his residency in ophthalmology at the was named the Thomas M. Aaberg Sr., Refractive Surgery and of the International Dr. Parke’s incisive analytical ability Massachusetts Eye and Ear Infirmary. He MD, Clinical Teaching Award. Intraocular Implant Club. He is now a and strong organizational skills have then worked in the U.S. Public Health Ser- The Academy expresses its admiration member of both the council of the Ameri- made him a popular choice for leadership vice for two years and graduated from the and gratitude for Dr. Aaberg’s many con- can Ophthalmological Society and the in every organization to which he has University of Oklahoma with a Master of tributions to ophthalmology and wel- executive committee of the American belonged, and his involvement in orga- Science in Public Health before starting comes him as a Guest of Honor in 2008. Society of Cataract and Refractive Surgery. nized ophthalmology has been extraordi- an 18-month fellowship in retinal disease Dr. Koch combines expertise in medi- nary. He has been an active member of the and surgery at Bascom Palmer Eye Insti- DOUGLAS D. KOCH, MD cine with expertise in music. He plays Academy for more than 50 years and has tute. While in Miami, he collaborated with Dr. Koch is honored by the Academy for trumpet in both the Houston Brass Band greatly enriched the Academy with his Robert Machemer in developing a primate his contributions to ophthalmology as a and a brass choir. Dr. Koch is president of knowledge and guidance through com- model to study the histopathology of reti- mentor, investigator and clinician. His the Bach Society of Christ the King Luther- mittee service on the Academy’s Council, nal detachment and giant retinal tears. colleagues hold him in the highest esteem an Church in Houston and a member of Committee on National Governmental They also worked together in developing for his professional leadership and his the boards of the Houston Brass Band and Relations, Academy Seniors (formerly the early instrumentation and techniques for personal traits of humanism, humility the Holocaust Museum in Houston. Senior Ophthalmologist Interest Group) vitreous surgery. Upon completing his fel- and integrity. Dr. Koch is honored today for his dedi- and Committee on State Affairs (which he lowship, Dr. Aaberg became assistant pro- Dr. Koch was born and raised in Port cation to our specialty. It is with pride and chaired for six years). He is currently edi- fessor of ophthalmology and director of Huron, Mich., and graduated from Har- pleasure that the Academy welcomes Dr. tor of Scope, an Academy quarterly for the retina service at the Medical College vard Medical School in 1977. He complet- Koch as a 2008 Guest of Honor. senior ophthalmologists. of Wisconsin, remaining on the faculty for ed residency training in ophthalmology at At the state level, Dr. Parke has served nearly 18 years. Under his direction, the the Cullen Eye Institute, Baylor College of DAVID W. PARKE SR., MD several terms as president of the Con- Milwaukee vitreoretinal fellowship train- Medicine, in 1981. He completed fellow- The Academy is proud of the accomplish- necticut Society of Eye Physicians as well ing program became one of the top-rated ship training in refractive and cataract ments of Dr. Parke Sr. and is delighted to as 10 years as chairman of the Committee programs in the country, with graduates surgery at Moorfields Eye Hospital and in welcome him as a 2008 Guest of Honor. on Legislation for the Connecticut State of the program directing vitreoretinal sec- the United States under the guidance of His dedication to education and advocacy Medical Society. He is a member or past tions and departments nationwide. David McIntyre, James Rowsey and Clif- has benefited not just his patients but all member of the editorial board of Con- In 1988, Dr. Aaberg was appointed ford Terry. of ophthalmology. necticut Medicine, the executive commit- chairman of ophthalmology at Emory In 1982, Dr. Koch joined the depart- Dr. Parke received his medical degree tee and ophthalmology advisor of Lions University School of Medicine, as well as ment of ophthalmology at the Cullen Eye from College of Medicine, Ohio State Low Vision Centers of Connecticut, the Phinizy Calhoun Sr. Professor of Ophthal- Institute, Baylor College of Medicine. He University and his residency in ophthal- board of Connecticut Lions Eye Research mology and director of the Emory Eye was promoted to associate professor in mology from the Wilmer Institute, Johns Foundation and the Committee on Access Center. He built on the work of his prede- 1991 and to full professor in 1998. In 1999, Hopkins Hospitals. His fellowship in to Care of Uninsured and Underinsured, cessors to develop the Emory department he received the Allen, Mosbacher and Law ophthalmic pathology was at the Armed State of Connecticut. of ophthalmology into a nationally respect- Chair in Ophthalmology. He served as Forces Institute of Pathology in Washing- Dr. Parke’s career reflects his involve- ed and highly ranked program in clinical director of residency training from 1992 ton, D.C. He served as chief of ophthal- ment and generosity in volunteering his ophthalmology, with an extensive scientif- to 1996. mology at Meriden-Wallingford Hospital time and talents to the development of ic faculty. He has personally been involved Dr. Koch’s clinical and research inter- (now MidState Medical Center) for 27 organized ophthalmology. He has been a in the training of 62 vitreoretinal fellows ests are in cataract and refractive surgery. years, was chief of medical staff there tireless champion of low vision patients in who are in academic or private practice His primary areas of interest have includ- as well, and later served as an elected regu- Connecticut and throughout the country. throughout the United States and Canada. ed astigmatism analysis and management, lar member of its board of directors. Through the Lions and Masonic organiza- These fellows revere him for his kindness, corneal topography, wavefront technology, While a consultant in ophthalmology tions, he has helped develop low vision clinical acumen, skill as a surgical instruc- surgical techniques, prevention of compli- at Gaylord Rehabilitation Hospital, Dr. clinics in Connecticut and has kept a reg- tor and unwavering concern for patients. cations, intraocular lens calculations and Parke cofounded its closed head trauma ular schedule as a volunteer, providing his e y e n e t ’ s a c a d e m y n e w s 7
    • NOTABLE HONORS expertise in directing many of these clin- DISTINGUISHED SERVICE AWARD States of America, was chartered in 1956 The Knights Templar is part of the ics. He also serves as a consultant on low KNIGHTS TEMPLAR EYE FOUNDATION in Maryland with the ultimate goal of pre- Masonic Fraternity, with members vision to several national organizations. The Academy recognizes the Knights venting blindness. Its mission is to pro- throughout the United States and many Dr. Parke continues to play an active Templar Eye Foundation as the recipient vide assistance to those who need sight- other countries. It has been funded by role in teaching and serving the commu- of the Distinguished Service Award for its saving surgical treatment. Assistance is annual assessments from the members nity and almost never refuses an opportu- contributions to the prevention of blind- provided without regard to race, color, of the Knights Templar, donations by the nity to speak on behalf of low vision reha- ness through its innovative foundation creed, age, sex or national origin to those individual Knights Templar, local fund- bilitation, medical professionalism or services available to patients and ophthal- who are unable to pay or who do not raising efforts by the Knights Templar, access to care for the uninsured. mologists. receive adequate assistance from govern- estates, trusts and insurance policies, and The Academy is pleased to acknowledge The Knights Templar Eye Foundation, ment or other agencies. The foundation some grants from charitable foundations. Dr. Parke’s many contributions and wel- the major charity of the Grand Encamp- also provides funds to support promising Since its inception, the Eye Foundation come him as a Guest of Honor. ment of Knights Templar of the United vision research projects. has handled in excess of 84,000 patient cases and disbursed more than $104 mil- lion to health care providers. Patient cases are sponsored by the local volunteer Knights Templar organizations. Seventy- five percent of all foundation expendi- tures are paid to health care providers, 13 percent fund vision research, and only 12 percent support administrative and printing expenses. Together with ophthal- mologists, hospitals and other health care professionals, the Eye Foundation contin- ues to provide critical assistance in the prevention of blindness. The Knights Templar Eye Foundation research grant program has a particular focus on pediatric ophthalmology. To date, the Eye Foundation has awarded in excess of $10 million to young investigators for both clinical and basic research to impact the care of infants and children. The Knights Templar Eye Foundation also supports America’s seniors as a co- sponsor with the Foundation of the Amer- ican Academy of Ophthalmology in its EyeCare America–Seniors EyeCare Pro- gram. The Academy is honored to present the Distinguished Service Award to the Knights Templar Eye Foundation. This award pays tribute to the foundation’s boundless con- tributions to ophthalmology and to its advocacy on behalf of patients worldwide. ETHICS COURSES Follow your ethical compass to these sessions. Each offers one hour of ethics- specific CME credit. Everyday Ethics: Practical Case Studies From the Ethics Committee Files Event Code 195, $35, Sunday, 11:30 a.m. to 12:30 p.m. Ethically Managing and Disclosing Con- flicts of Interest: A Case-Based Approach Event Code 206, $35, Sunday, 2 to 3 p.m. Breakfast With the Experts—International Ophthalmology and Codes of Ethics Event Code B111, $40, Sunday, 7:30 to 8:30 a.m. Breakfast With the Experts—Marketing Your Practice Ethically Event Code B282, $40, Monday, 7:30 to 8:30 a.m. Breakfast With the Experts—Expert Wit- ness Testimony: What You Should Know Event Code B474, $40, Tuesday, 7:30 to 8:30 a.m. 8 s u n d a y G m o n d a y G tuesd a y e d i t i o n
    • CARTER CENTER ATLANTA’S CARTER CENTER Saving Sight From U.S. president to Nobel in the Poorest laureate to elder statesman, of the Poor Jimmy Carter has been trying to reverse the inter- national tragedies of poverty, war and disease. by annie stuart, contributing writer STAGES OF TRACHOMA. Infection with BLINDING DISEASE UNDER SIEGE. Four years in the C. trachomatis may be mild and resolve within weeks. However, sometimes it White House and a Nobel Peace Prize were not enough for Jimmy Carter and leads to severe inflammation, causing his wife, Rosalynn. Now they are working to eliminate preventable blindness pain, photophobia and a white, watery discharge. Repeated reinfection forms a around the world. network of scars that contract, shortening the palpebral conjunctiva. Over time, the eyelid turns inward, transforming once pro- Founded in 1982 by former President are examples of The Carter Center’s work. tective eyelashes into lacerating “thorns.” Jimmy Carter and his wife, Rosalynn, The Here is a brief report on progress The The result is trichiasis—or, as the Ethiopi- Carter Center, in partnership with Emory Center has made, in alliance with other ans say, “hair in the eye.” Some pluck their University, nurtures no small goals. Its organizations, in battling these diseases. eyelashes to relieve the pain, but the respite mission is defined by a “fundamental is brief since bristly lashes quickly regrow. commitment to human rights and the TRACHOMA: The Leading Infectious And because they are stubble, they don’t alleviation of human suffering,” and Cause of Blindness bend easily, and abrade the cornea. “seeks to prevent and resolve conflicts, An infection caused by the bacterium Women are around three times as likely enhance freedom and democracy, and Chlamydia trachomatis, trachoma affects as men to develop trichiasis. “It’s generally improve health.” more than 80 million people in 56 coun- believed that children are the reservoir,” Although that task might seem Sisyph- tries. “Trachoma was a major problem said Dr. Emerson. “Because of their role as ean at times, The Carter Center has been in Europe and here in the U.S. until the caregivers—particularly sharing a bed with successful at identifying and intervening 1950s when it disappeared in the face of young kids who have trachoma—women in many health problems that are not only improved hygiene and sanitation,” said get more frequent, repeated infections and A “SAFE” APPROACH. Fortunately, a strat- treatable but also preventable—and doing Paul Emerson, PhD, director of The Carter more scarring.” Disabling pain makes it egy developed by the World Health Orga- T H E C A R T E R C E N T E R / E M I LY S TA U B , VA N E S S A V I C K so among some of the poorest people of Center’s Trachoma Control Program. But difficult to work and perform household nization and adopted by countries in which Asia, Africa and Latin America. Seventy in addition to the millions affected by chores—cooking over fires, collecting water the disease is endemic is helping to elimi- nations around the world have benefited active trachoma, another 500 million in in the sun, farming in dry, dusty environ- nate blinding trachoma. Implemented by from Carter Center initiatives. the developing world are living at risk of ments. This magnifies the disease’s annual The Carter Center and its partners, the Projects to fight trachoma and oncho- contracting trachoma. The Carter Center’s economic impact, estimated at $2.9 billion. strategy involves a four-pronged approach: cerciasis, diseases that have stolen the sight present goal is not to eradicate the disease “Blindness in trachoma is caused by a surgery, antibiotics, facial cleanliness and of nearly 8 million people and visited havoc completely but to eliminate blinding tra- combination of physical damage to the environmental improvements, or “SAFE.” on communities where they’re endemic, choma, the late stage of the disease. cornea from aberrant lashes and infection Dr. Emerson says the approach has been by many other opportunistic pathogens particularly successful in Ethiopia. And Above, a man in Ethiopia blinded by onchocerciasis (river blindness). Merck has donated because the corneal epithelium is compro- Ghana may become the first country in its microfilarcidal drug ivermectin for the treatment and prevention of river blindness mised by the scratching,” said Dr. Emerson. sub-Saharan Africa to apply for WHO since 1987. Right, to relieve the suffering and the risk of blindness associated with tra- Sight can only be restored by corneal trans- certification showing it has eliminated choma, fairly simple lid surgery can be performed in the community or at rural health plants—virtually unheard of in the devel- blinding trachoma. Following are some centers. oping world. details of the rationale behind SAFE. e y e n e t ’ s a c a d e m y n e w s 9
    • CARTER CENTER Above left, trichiasis results from advanced trachoma, which scars the upper eyelid, caus- ing the lid to fold inward, rubbing the lashes against the cornea with every blink and eventually leading to irreversible blindness. Above right, trained examiners assess eyelids to determine the grade of trachoma. G Surgery. Although surgery can’t undo Clubs International Foundation, millions corneal damage, it can relieve pain and of doses of azithromycin (Zithromax), stop further injury. Requiring little train- which is manufactured by Pfizer, have ing and only $10 in materials, a 15-minute been distributed to trachoma-affected operation can be performed by ophthal- communities. All told, Pfizer has donated mic nurses or trained health workers, said around 135 million doses. Dr. Emerson. After injecting the eyelid with G Facial cleanliness. Discharge from eyes local anesthetic and positioning a retrac- and noses attracts flies, which can transmit tor, the health worker makes a small inci- the infection, and wiping or rubbing faces sion along the tarsal conjunctiva at the lid with infected hands or materials can also margin. The side of the lid fringed with quickly transmit the disease. Therefore, eyelashes is lifted outward; then the two an essential part of the SAFE campaign is sides are stitched together in the outfrac- promotion of cleanliness. is spread through the bites of another fly Above, health workers in Latin America tured position. This relieves tension on G Environmental improvements. Among species, Simulium damnosum. The fly is distribute ivermectin in a campaign to the damaged eyelid and prevents eyelashes other changes, construction of pit toilets a host for Onchocerca volvulus, a parasite eradicate onchocerciasis. from scraping the cornea. is essential to eliminate Musca sorbens, a that takes up residence under the skin for G Antibiotics. With the help of the Lions fly that breeds in human feces and swarms seven to 15 years. The females can produce around eyes and noses, feeding on mois- thousands of offspring (microfilariae), 90 million are at risk, the goal is control ture and infecting eyelids and then trans- which migrate to the upper layer of skin, of onchocerciasis through annual drug mitting the infection. Reducing the vector’s where they cause intense itching when administration of ivermectin. In the breeding ground could stem the tide of they die. These tiny parasites also can Americas, where about 500,000 people are trachoma. In early 2002, The Carter Center migrate into the eye, causing inflamma- at risk in six countries, the goal is more began training masons, providing materi- tion, irritation and diminished vision. ambitious: The Carter Center is leading a als and supervising the construction of PATHOLOGY FROM PESTS. “The microfilariae multinational partnership, which includes household latrines. With sanitation a cause an immune response in the eye, Lions Clubs, to completely eliminate the national priority and the infrastructure which leads to an opaque cornea,” said disease by administering ivermectin every T H E C A R T E R C E N T E R / L O U I S E G U B B , VA N E S S A V I C K , PA U L E M E R S O N , P H D in place to deliver behavior change and Dr. Emerson. The second leading cause of six months. No new cases of blindness from hygiene promotion, Ethiopia increased infectious blindness, onchocerciasis results the disease have surfaced in the Americas latrine coverage on a district level from 4 from not just one but hundreds—some- since 1995.“It looks like blinding onchocer- to 60 percent within just a couple of years, times thousands—of bites by infected ciasis is history in the Americas now,” said Dr. Emerson. There and elsewhere, flies. Named for the fast-flowing streams said Dr. Emerson. “And with a concerted women have taken the lead, helping build where the black flies breed, river blindness and continuous effort, particularly in the hundreds of thousands of latrines. has infected 17.7 million people world- Amazon region of Venezuela, transmission G Added benefits. Although difficult to wide, visually impairing a half-million can be halted.” The goal is to declare the measure, the collateral benefits of SAFE and blinding more than a quarter million. disease in Latin America eradicated by are many, said Dr. Emerson. “It is not only Endemic in 37 countries—mostly in Africa 2012—and that appears to be right on taking care of trachoma, it’s like a guerilla —river blindness has forced farmers to schedule, said Dr. Emerson. action for development—freeing commu- abandon fertile bottomlands. Above, a Sudanese girl takes a dose of nities from a number of neglected tropical In the 1980s, Merck developed a micro- For more information on The Carter Center, banana-flavored azithromycin, donated by diseases,” he said. “I think the future is very filarcidal drug, ivermectin (Mectizan), and visit www.cartercenter.org. Pfizer, to protect herself from the bacterium bright for a world free of blinding tra- began donating it free for treatment and that causes trachoma. Young children carry choma, provided we can keep the pressure prevention of river blindness in 1987—for the highest burden of active infection and on and continue delivering the programs.” as long as is needed. The Carter Center VOLUNTEER annual mass distribution of antibiotics River Blindness Program has assisted in Want to help provide eye care in devel- is recommended for communities where ONCHOCERCIASIS: Blindness by a administering more than 100 million treat- oping nations? See page 17 for a list of more than 10 percent of young children Thousand Bites ments in both Africa and the Americas. events and other resources. suffer from the disease. Onchocerciasis, also called river blindness, REALISTIC GOAL SETTING. In Africa, where 10 s u n d a y G m o n d a y G tuesd a y e d i t i o n
    • BEST VIDEOS SURGEONS OF THE Silver Screen This year, seven videos from four subspecialties were chosen as “Best of Show” and will be honored at Monday’s awards ceremony. The full video program Glaucoma: Video V23 features 39 short films from nine subspecialties. In this film, Angunawela and colleagues Theater screening times: Sunday—3:36 ATTEND THE “BEST OF SHOW VIDEO AWARDS” CEREMONY. present a new fish-tail technique for the ■ p.m.; Monday—4:21 p.m. and Best of Show The highlight of this year’s video program will be the Best of Show awards insertion of a capsular tension ring in the screening (see intro). situation of capsular instability arising ceremony. It takes place in the Video Theater on Monday at 12:15 p.m., and from zonular insufficiency. CORNEA will be followed by a special screening of the seven Best of Show videos. Insertion of a capsular tension ring can Endothelial Keratoplasty: Please Don’t Fold at times be difficult and give rise to further (V14; 10 minutes) Video Theater hours. It will be open Sunday from 10 a.m. to 5 p.m., Mon- complications. The fish-tail technique The current method of donor insertion in day from 9 a.m. to 5 p.m. and Tuesday from 9 a.m. to 3 p.m. Check your allows placement of the tension ring Descemet’s stripping automated endothe- without the need for dialing or injection, lial keratoplasty requires folding and Final Program (page 281) for a full schedule of all 39 films. thereby avoiding further tangential stresses unfolding donor tissue, which damages on the zonules. endothelium. Where is the Video Theater? It is located in Hall A-3. ■ Theater screening times: Sunday—10:42 In this short video, Tan and colleagues Videos on Demand. Watch what you want, when you want. Look for the a.m.; Monday—9:27 a.m. and Best of Show present a pull-through, gliding technique screening (see intro); Tuesday—10:13 a.m. that is less traumatic to endothelium and monitors that are located in Halls A-2 and B-5. You can search the video reduces primary graft failure rates. program by subspecialty, video title, video number or key word. Understanding the Dropped Nucleus This method utilizes a purpose-designed (V1; 10 minutes) microforceps, which is employed to pull a It is well-known that the dropped nucleus previously dissected graft into the anterior CATARACT and suture knots are safely covered with is a serious complication of contemporary chamber over a viscoelastic-coated IOL Scleral Fixation Without Conjunctival the roof of the scleral pocket. cataract surgery. glide. Dissection ■ Theater screening times: Sunday—4:06 In this video, Osher and colleagues As a result, their experiences with pri- (V4; 10 minutes) p.m.; Monday—4:51 p.m. and Best of Show review a cadaver eye study designed to mary graft failures have decreased from In this film, Hoffman and colleagues show screening (see intro). understand why the nucleus drops. Fac- 20 to 1.7 percent, and endothelial counts how a new technique for scleral fixation tors evaluated include gravity, high infu- have improved. utilizes a scleral pocket originating from a Capsular Tension Ring Complications sion pressure, turbulence, pressure gradi- ■ Theater screening times: Sunday— clear corneal incision. and Fish-Tail Technique for Stress-Free ent, excessive manipulation, machine 11:15 a.m.; Monday—10 a.m. and Best Conjunctival dissection, scleral cautery Insertion parameters and the role of the vitreous, of Show screening (see intro); Tuesday— and sutured wound closure are eliminated (V11; 11 minutes) among others. 10:46 a.m. Cataract: Video V4 Cataract: Video V11 Cataract: Video V1 Cornea: Video V14 e y e n e t ’ s a c a d e m y n e w s 11
    • BEST VIDEOS Deep Anterior Lamellar Keratoplasty Hurler-Scheie syndrome. The big-bubble sion of the stromal layers. Finally, a 0.5- Using the “Big-Bubble Technique” in technique includes a 7.5-mm trephination mm oversized donor lenticule is secured. Hurler-Scheie Syndrome at a depth of 300 µm and a 27-gauge needle At three years, the patient’s best corrected (V19; 11 minutes) used to inject an air bubble between Des - visual acuity was 20/40 in both eyes. In this film, Sharma and colleagues per- cemet’s membrane and the host corneal ■ Theater screening times: Sunday—noon; form deep anterior lamellar keratoplasty stroma. After the debulking of the anterior Monday—10:45 a.m. and Best of Show using the big-bubble technique bilaterally two-thirds of the corneal stroma, an screening (see intro); Tuesday—11:31 a.m. in a patient with Hurler-Scheie syndrome. opening is created in the stromal tissue. Because of the sparing of Descemet’s Following air egression from the inci- GLAUCOMA membrane and a decreased chance of glau- sion site, viscoelastic is then injected in the Late Secondary Angle-Closure Glaucoma coma, deep anterior lamellar keratoplasty supernumerary space above the membrane Following DSEK and Its Management Cornea: Video V19 is one of the safest options in cases of along with quadrantic splitting and exci- (V23; 10 minutes) Basak and colleagues demonstrate a unique late complication of Descemet’s stripping endothelial keratoplasty. Five out of 104 patients presented with acute pain and visual loss in the operated eye three to 18 weeks after the procedure. There was 360-degree adhesion between donor lenticular edge and the iris in all cases, causing secondary angle-closure glaucoma. Endothelial cell density was measured after controlling the IOP. Sim- ple mechanical separation of the irido- donor lenticular adhesion was performed with Sinsky’s hook in two cases where the endothelial cell density was good. Donor replacement was done in three cases where the density was poor. ■ Theater screening times: Sunday— 12:45 p.m.; Monday—11:30 a.m. and Best of Show screening (see intro); Tuesday— 12:16 p.m. PEDIATRICS The Surgical Correction of the Palpebral Fissure Narrowing and the Vertical Devia- tion on Adduction in Duane Syndrome (V30; 11 minutes) In this film, Lee and colleagues introduce a new technique of correcting specific characteristics in Duane syndrome that is an efficient and less-invasive procedure for improving ocular alignment. They report two type 1 Duane syndrome patients with upshoot or downshoot on adduction. The lateral rectus muscle was disinserted and reattached to the adjacent posterior tenon. The patients were treated with partial tendon transposition of the vertical rectus muscles augmented with Foster fixation. Lateral rectus posterior tenon fixation markedly reduced co-contraction and globe retraction. Palpebral fissure widened on adduction. Also, all patients demon- strated a marked decrease in the upshoot or downshoot and improvement of abduction after surgery. ■ Theater screening times: Sunday—1:53 p.m.; Monday—2:38 p.m. and Best of Show screening (see intro); Tuesday—1:24 p.m. Pediatrics: Video V30 12 s u n d a y ● m o n d a y ● tuesd a y e d i t i o n
    • 2009 CODING COACH 1 2 3 A handy reference to improve coding accuracy 4 Speed-Up 7 Your Coding 5 8 6 ALL YOU NEED AT A SINGLE GLANCE. Coding. What a nuisance! If you feel like you spend too much time flipping through reference materials and working out which codes to use, then you should consider investing in the 2009 Ophthalmic Coding Coach. Published by the American Academy of Ophthalmic Executives, this reference provides all the data you need for each ophthalmic CPT code. QUICKER CODING. With detailed con- 2 Global Surgical Period Coding Coach tent on each CPT code that relates to oph- lists the global thalmology, Coding Coach is the most surgical period for both Medicare and pri- vides the AMA’s official description, along HOW TO BUY IT. Visit the Academy Resource comprehensive reference available. The vate payers. Note that while Medicare rec- with a layperson’s definition. Center (Booth #3532) to place an advance 2009 edition will be available as both a ognizes a minor surgical period of one or order for next year’s Coding Coach. As a book and a CD-ROM. 10 days, private payers recognize a 0-, 10- Each of the coding book (Product #012354) or a CD-ROM 6 Coding Clues EVERYTHING AT A GLANCE. To illustrate or 15-day global period. For major sur- experts who contrib- (#012355), it costs $195 for members; how Coding Coach will help your practice geries, Medicare recognizes a 90-day glob- uted to Coding Coach has at least 18 years $263 for nonmembers. Or buy both to code more accurately and efficiently, al period, while private payers recognize of experience in the field. The “Coding together and get a 30 percent discount consider CPT codes 65780 to 65782 a 45-, 90- or 120-day global period. Clues” section allows you to tap their dis- (#012356) at $275 for members and $368 (see sample page). On one page, you have tilled wisdom. for nonmembers. This product is expect- eight key sets of information at your finger- 3 Assistant at Surgery The final column ed to ship by Jan. 31. tips: under each code 7 Modifiers For such petite codes— indicates whether or not an assistant at just two digits long— For each procedure, Coding surgery may be a covered benefit. modifiers can cause big problems. The 1 RVUs Coach lists two numbers in the trouble is that there are dozens to choose Surgical Coding relative value units (RVU) column—one 4 CCI Edits The Correct Coding Initia- from, and the wrong choice can lead to Code This Case features examples of sur- for when the procedure is performed in the tive (CCI) edits are codes denied claims, lost reimbursement and, in gical cases and provides the appropriate office; the other for when it is performed that have been deemed not separately the worst cases, an audit. By listing which CPT, ICD-9 and in a facility. This enables you to verify payable when performed in the same modifiers apply to a particular procedure, HCPCS coding whether there is a site-of-service differen- operative session. If you overlook these Coding Coach allows you to apply them for surgeons, as tial where you may be paid a higher amount bundling edits and submit two claims that with confidence. well as coding in your office than when the procedure is are mutually exclusive, the carrier will pay for ambulatory performed in the hospital. And when you the primary code. In the case of compre- 8 Diagnosis Codes To ensure that surgical centers. perform different procedures in the same hensive codes, the insurance company will you are paid for a It also provides operative setting, the codes with the high- pay for the lesser dollar amount of the two procedure, you must record a symptom, examples of oper- est RVUs should be listed first—and Cod- billed codes. By listing the CCI edits for diagnosis or complaint that provides ative reports that ing Coach provides an easy way to see each procedure, Coding Coach helps you justification for performance of that pro- will be instructive which code that would be. to avoid making these mistakes. cedure. for the young ophthalmologist. Code This (Note: the RVUs listed here are reprint- For each CPT code, Coding Coach lists Case (Product #012357) costs $145 for ed from the 2008 Coding Coach. Those For each code, the ICD-9 codes that would establish this 5 Defining the Code members and $175 for nonmembers. values may change in 2009.) Coding Coach pro- “medical necessity.” e y e n e t ’ s a c a d e m y n e w s 13
    • THE MUSEUM ART AND OPHTHALMOLOGY Eye Seeing Eye by jenny benjamin, museum director he Academy Foundation’s the visual medium of art. Not surpris- T Museum of Vision (Hall B-4, Booth #3440) explores the cross- roads of art and medicine with “Eye See- ingly, artistic movements have signifi- cantly influenced the design of diagnostic and surgical instruments. ing Eye: Art and Ophthalmology.” As pro- The museum has therefore created an fessionals devoted to vision and the exhibit specifically devoted to ophthal- prevention of blindness, many ophthal- mology and vision. Enjoy a sample of mologists have a special affinity toward these artistically created artifacts below. 1 2 3 4 6 5 (1) INSTRUMENT SET, 1870. This silver instrument set exemplifies Victorian design, so named for its popularity during the reign of the United Kingdom’s Queen Victoria (1837–1901). Victorian design was noted for being intricate and luxurious. (2) SELF TESTING OPTOMETER, 1880. This box contains several sets of lenses on a rotating wheel. A person would look through the oculars and turn the wheel to determine which lenses improved their eyesight. (3) PERFECSCOPE, 1900. This scope was likely a souvenir from the 1900 World’s Fair held in Paris. The fair is best known for intro- ducing the Art Nouveau style to the world, but this stereoscope is undoubtedly a nod to Victorian aesthetics. (4) TILLYER TRIAL LENS SET, CIRCA 1900. This Victorian trial lens set features an unusual painted lid. (5) OPHTHALMOSCOPE, CIRCA 1950. During the early 20th century, the design world became obsessed with the pared-down sim- plicity of International Style. Its clean lines have inspired product design every decade since. (6) REALIST PROJECTOR MODEL 81, CIRCA 1950. This visual acuity chart projector exemplifies the Streamlining movement, popular from 1934 to 1959. This aesthetic became design shorthand for fast, modern and cool. e y e n e t ’ s a c a d e m y n e w s 15
    • 2 0 0 9 PR E V IE W NEXT YEAR THE CITY BY THE BAY PLAYS HOST Two Local Ophthalmologists on the Sights of San Francisco by barbara boughton, contributing writer rom its Victorian homes to its eth- F nic neighborhoods to its sweeping vistas of the Pacific Ocean, San Francisco is a treasure trove of sights and sounds. For decades, the city’s mixture of temperate climate, cultural diversity and natural beauty has made it one of the top tourist attractions in the United States. As host to the 2009 Joint Meeting of the Academy and the Pan-American Asso- ciation of Ophthalmology, San Francisco offers something for every visitor. With such a diverse array of attractions, it can be overwhelming to select a few sites to see during your downtime or after meet- ing hours. EyeNet spoke to city residents Richard L. Abbott, MD, and Susan H. Day, MD, to get the inside scoop on the best places to spend time in San Francisco. FERRY BUILDING MARKETPLACE. Unique sights and cuisine await at the Ferry Build- ing. On Saturday morning, the market- place is host to a farmers’ market that offers certified organic produce and flow- ers, as well as regional artisan specialties such as breads, cheeses and jams. Inside SAN FRANCISCO IS A WORLD-RENOWNED TOURIST DESTINATION. Discover the city’s mix of historic landmarks, cosmopolitan culture the Ferry Building is the Nave, an impres- and eclectic cuisine when you visit for next year’s Joint Meeting. sive indoor street that showcases a range of food and wine specialty shops selling wonder, the Golden Gate Bridge. For more more information, visit www.sfcityguides. restaurant in picturesque Sausalito, home everything from gourmet teas to gelato, as information, visit www.crissyfield.org. org. to San Francisco’s houseboat community, well as several top-of-the-line restaurants. NEIGHBORHOODS OF SAN FRANCISCO. One THE MARIN HEADLANDS. The attractions or Dr. Abbott’s personal favorite—down- “It’s such a fun scene,” said Dr. Day. “The of the sheer joys of visiting San Francisco of the Marin Headlands include vast num- town Mill Valley. “It’s a well-kept secret produce is amazing, and the specialty shops is walking the hills of the city and viewing bers of hiking trails, beautiful beaches, the with charming shops and terrific restau- are extraordinary. It’s also a great place to the sights and scenes of its ethnic neighbor- 150-year-old Point Bonita lighthouse and rants, all at the foot of Mount Tamalpais.” people watch.” The building’s beautiful hoods.“At the top of every hill is a wonder- panoramic views of the coast and the city This 2,571-foot peak—replete with oak clock tower has come to define the San ful vista,” said Dr. Day. “Walking through —all only a 20-minute drive from San woodlands, redwood groves and sweeping Francisco waterfront. Jetting 240 feet into the city is a great way to view the bay, the Francisco. “There are several hikes around views of the surrounding hills and cities— the sky, the tower was part of the Ferry parks and the urban beauty of this city.” the Marin Headlands that are amazing,” is well worth an outing as well. For more Building’s original 1898 design and was However, be sure to bring comfortable said Dr. Abbott. “You can hike to an old information, visit www.nps.gov/goga/ intended to be a beacon to those who walking shoes, Dr. Day cautioned. Some World War II gun installation and see vis- marin-headlands.htm and www.parks. traveled to the city by water. For more infor- of the neighborhoods that Dr. Abbott tas that are fabulous. The Tennessee Valley ca.gov. mation, visit www.ferrybuildingmarket likes to visit are North Beach, which is the hike is also wonderful!” The Tennessee place.com. Italian section of the city, famed for its Valley Trail goes 1.7 miles down to the Dr. Abbott is a health science clinical profes- CRISSY FIELD AND THE GOLDEN GATE coffee shops and neighborhood bakeries, Tennessee Beach, and there are also hikes sor of ophthalmology at the University of Cal- BRIDGE. The restored Crissy Field, a unique and Chinatown, where tourists and city for the more adventurous to the hills above. ifornia, San Francisco. Dr. Day is chairwoman and lovely park near the Golden Gate dwellers alike sample the wares of neigh- After spending time in the Headlands, and program director of ophthalmology at the Bridge, features a flat, hard-packed prom- borhood merchants, including clothing, you can finish your day with dinner at a California Pacific Medical Center. enade perfect for walking or biking, as well jewelry, produce and fresh fish. Dr. Day as a beach in the midst of the city. The recommends a walk down Stockton Street waves deposit crab shells, jellyfish and in Chinatown, where the locals shop. “It The Joint Meeting of the Academy and the pebbles to examine, and there are drift- will transport you to China itself,” she Pan-American Association of Ophthalmol- wood “seats” for picnics and shoreline said. ogy will take place in San Francisco, contemplation. East Beach is one of the Another wonderful neighborhood is Oct. 24 to 27. It will be preceded by most popular and challenging windsurf- the Mission district, the Hispanic neigh- Subspecialty Day, Oct. 23 and 24. As ing and parasailing sites in the world. “If borhood that surrounds the historical information on the programs for the you’re a jogger, there’s no better or more Mission Dolores, founded in 1776. The Joint Meeting and Subspecialty Day becomes available, it will be published in EyeNet beautiful place than Crissy Field,” noted oldest intact building in San Francisco, Magazine and on the Academy’s Web site (www.aao.org/2009). Dr. Day. You also can rent a bike on near- the beautiful mission is still a lively parish This is only the beginning of things to do while you are in San Francisco. Explore Yerba by Lombard Street to view Crissy Field as and “gives you a view of California’s early Buena Gardens, a five-acre park of trees, waterfalls and public art (www.yerbabuena well as the streets and Victorian houses of days and the Spanish influence that was so gardens.com). Immerse yourself in the infamy of Alcatraz Island (www.alcatrazcruises. nearby Russian Hill. important here,” said Dr. Abbott. San com). View the wide-ranging art collections of the Museum of Modern Art (www.sfmoma. Another treat is to take a long walk or Francisco City Guides offer free walking org), the de Young Museum (www.famsf.org/deyoung) and the Legion of Honor (www.fam bike ride along the waterfront, past a wild- tours of many neighborhoods, ranging sf.org/legion). For city information, visit San Francisco’s official visitor site at www.only life preserve and windsurfers, and end up from Chinatown to North Beach to Nob insanfrancisco.com. just beneath San Francisco’s architectural Hill, as well as the Ferry Building. For 16 s u n d a y G m o n d a y G tuesd a y e d i t i o n
    • VOLUNTEER HOW TO BE AN INTERNATIONAL VOLUNTEER Get Tips and Learn Skills for Overseas Service E ver thought of volunteering in devel- tions that are seeking volunteers to serve find a volunteer site in a developing coun- causes of blindness in developing coun- oping countries? If you don’t know the visually impaired worldwide. These try. Visit www.eyecarevolunteer.org. tries. how to get started, the Joint Meeting are located in Hall B-5. BUY THE VOLUNTEER’S HANDBOOK. Eye To see a sample copy, visit the Acad- is a great place to learn how you can help. GO ONLINE FOR THE EYECARE VOLUNTEER Care in Developing Nations describes in emy Bookshelf display at the Academy ENJOY DEBATES AND DISCUSSIONS AT MON- REGISTRY. Developed by the Academy’s practical detail best practices to prevent, Resource Center (Hall B-4, Booth #3532), DAY’S INTERNATIONAL FORUM. You may find Foundation, this service will help you to treat and surgically correct the major where it also is available for purchase. yourself reappraising your thoughts on eye care in developing countries. In one debate—“Something Is Better Than Nothing, or Is It?”—Mohammed Babar Quereshi, MD, (Pakistan) and Petja Vassileva, MD, PhD, (Bulgaria) will discuss the donation of equipment. A second debate—“Fee for Service, Yes or No?”—will feature R. D. Thulasiraj, MBA, (India) and Amel Meddeb-Ouer- tani, MD (Tunisia) discussing how to fund eye care. And in the third debate—“Is the Grass Greener in High Income Countries?”— Pecos T. A. Olurin, MBBS, (Wilmington, Del.) and Mariano Yee, MD, (Guatemala) will tackle brain drain. This free event takes place on Monday from 8:30 to 11 a.m. in Room B406. ATTEND AN INSTRUCTION COURSE. Tickets are available at Ticket Sales in Hall A-2. ■ Development of a Comprehensive High-Quality, Sustainable, Rural Eye Care Model in a Developing Country. Learn how institutes in India have used management principles to develop effec- tive systems and to improve networking and outreach activities. The goal: financial self-sustainability. (Instruction Course #262; Sunday from 4:30 to 5:30 p.m.; $35.) ■ Eyes of Africa. Review ocular pathology rarely seen in North America, including anthrax, kwashiorkor, Luapua eye, myco- sis, trachoma and war trauma. (#335; Monday from 9 to 10 a.m.; $35.) ■ Young Ophthalmologists in Interna- tional Ophthalmology. Learn about the organizations that are battling blindness, the role that you can play and how to bal- ance your U.S. responsibilities with inter- national service. (#457; Monday from 4:30 to 5:30 p.m.; $35.) VISIT THE SCIENTIFIC POSTERS. Two are on display on Sunday—Trachoma Elimi- nation: Solving the Latrine Problem in Nomadic Tribes (#PO136) and Risk Fac- tors for Microsporidial Keratoconjunc- tivitis in the Tropics: A Case Series (#PO137). You can talk to the authors on Sunday from 12:30 to 2 p.m. in Hall B-5. Two more Scientific Posters will be on display on Monday and Tuesday—Triam- cinolone-Assisted Needling: A Simple Procedure to Tackle Posterior Capsular Opacity (#PO429) and Seven-Year Inci- dence of Postoperative Bacterial Endoph- thalmitis in a Costa Rican Teaching Hos- pital (#PO430). You can talk to the authors on Monday from 11 a.m. to 12:30 p.m. in Hall B-5. BROWSE THE INFORMATIONAL POSTERS. Many of these are presented by organiza- e y e n e t ’ s a c a d e m y n e w s 17
    • ADVOCACY CODING AND REIMBURSEMENT Ophthalmologists and Medicare Victories A s the voice of ophthalmology in expansion of the number of services that ing on behalf of patients and ophthalmol- 4,000 ophthalmologists e-mailed and Washington, D.C., the Academy has can be performed (and reimbursed) in ogy does make a difference, as proven by countless others called their senators, urg- realized many successes during the ambulatory surgical centers and, most the participation of the Academy’s mem- ing them to vote for legislation that would year. These triumphs include equity for notably, halting a 10.6 percent Medicare bers and the leadership of the Academy’s stop the devastating physician payment eye visit codes resulting in a $154 million payment cut last summer and a 5.5 per- Health Policy Committee. cuts. In addition, many of the Academy’s increase for ophthalmology, significant cent cut slated for January 2009. Advocat- Over a two-month period, more than congressional advocates used their long- standing relationships with key senators to persuade them to override President Bush’s veto and vote in favor of physicians and Medicare beneficiaries. While passage of the new Medicare law guarantees 18 months of relative stability for Medicare physician payments, all physicians are threatened with additional cuts in January 2010. Those 18 months buy time to work with Congress to develop a plan to replace the sustainable growth rate (SGR) formu- la for determining physician Medicare payments. The Academy, the American College of Surgeons and other surgical specialties have begun discussions about new approaches. Besides replacing the SGR, other chal- lenges exist for ophthalmology. Come and hear leaders discuss these issues during the following free sessions: ■ PHYSICIAN PROFILING AND ACCOUNTABILITY Examine profiling and other physician accountability initiatives tied to payment, including the outlook for CMS’ Medicare Physician Quality Reporting Initiative and Physician Web Compare plan. A new Medicare e-prescribing incentive bonus will also be highlighted. Monday, 12:15 to 1:45 p.m. Event Code Spe28 Room A412 ■ SURGERY BY SURGEONS FORUM Attend this segment of the Fall Council Meeting to learn how scope of practice battles on both state and federal levels are affecting all ophthalmologists’ ability to deliver quality eye care. Sunday, 11:30 a.m. to 1 p.m. Event Code Spe14 Omni Hotel at CNN Center, Grand Ball- room E ■ A GUIDE TO OPHTHALMIC DRUG AND DEVICE EVALUATION Experts from the FDA will provide an overview of the ophthalmic device and drug approval processes. A question-and- answer session will follow. Sunday, 12:45 to 1:45 p.m. Event Code Spe18 Room A401 ■ COMBAT-RELATED RESEARCH OPPORTUNI- TIES IN THE DEPARTMENT OF DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS Explore combat-related eye and vision research opportunities available in the Department of Defense and the Depart- ment of Veterans Affairs. There will be a special focus on the visual challenges of traumatic brain injury. Monday, 12:15 to 1:45 p.m. Event Code Spe30 Room A401 18 s u n d a y G m o n d a y G tuesd a y e d i t i o n
    • HONORARY LECTURES TEN LEADERS IN THE FIELD Honor Some of Ophthalmology’s Great Names BY LESLIE BURLING-PHILLIPS AND LORI BAKER SCHENA, CONTRIBUTING WRITERS S ome of the symposia during the Joint a starting point. There are professional at the University of Buffalo. In addition Physician Consortium for Performance Meeting include lectures named for and ethical challenges ahead for all of us to serving on the Institute of Medicine’s Improvement, the Ambulatory Care the profession’s seminal figures. that must be approached thoughtfully.” Roundtable on Evidence-Based Medicine, Quality Alliance and the Quality Alliance Catch up on the latest developments in ABOUT THE SPEAKER. Dr. Nielsen is the Dr. Nielsen represents the AMA on many Steering Committee. She has collaborated ophthalmology while honoring some of current president of the AMA, as well as quality-related initiatives, including on the formulation of policy positions for the most respected names in medicine. senior associate dean for medical education the National Quality Forum, the AMA debates about the diagnosis and treatment The Monday and Tuesday lectures are highlighted below, along with background information on the speakers and their thoughts on what lies ahead. Lectures tak- ing place on Sunday were previewed in the Friday/Saturday Academy News. PA R K E R H E AT H LECTURE Nancy Nielsen, MD, PhD, will present The AMA Plan for Health System Reform: The Future for Ophthalmologists (9:45 to 9:58 a.m.) during the Monday Symposium titled Health System Reform: Paths and Oppor- tunities for Ophthalmology (8:30 to 10 a.m.). This combined meeting with the AMA Ophthalmology Section Council takes place in the Thomas B. Murphy Ballroom 4. Note: This lecture was prerecorded and will be presented on DVD. ABOUT THE LECTURE. “Rising health care costs have brought the medical field under attack in recent decades, and most will agree that the Unit- ed States health care system is in need of a change,” said Nancy Nielsen, MD, PhD. In her lecture, she will outline how these issues should be approached by the medical com- munity. “We need to The U.S. health provide health care care system is in for the uninsured, need of change, and the American says AMA President Medical Associa- Dr. Nielsen. tion’s plan is merely GET EYESMART In 2008, the focus of the Academy’s EyeSmart campaign has been the impor- tance of wearing protective eyewear to help prevent eye injuries. Learn more in Atlanta about the new recommendation for wearing proper eye protection around the home. FREE MATERIALS AND FREE EYEWEAR. Come by the EyeSmart desk at the Acad- emy Resource Center (Hall B-4, Booth #3532) and sign up to receive free Eye- Smart educational materials on eye dis- eases and injuries. Those signing up for the first time or ordering additional materials will receive a free pair of ANSI-approved protective eyewear. For more information on EyeSmart, visit www.aao.org/eyesmartcampaign. e y e n e t ’ s a c a d e m y n e w s 19
    • HONORARY LECTURES of depression, alcoholism among women, toma is one of the great success stories in time fulfilling unproductive mandates people who had high pressures between Alzheimer’s disease, priorities in clinical human cancer, with survival rates approach- designed by bureaucrats who are largely 22 and 29 mmHg experienced an average preventive services, colorectal cancer ing 100 percent,” said Dr. Eagle. “Chemo- from nonmedical backgrounds and reduction of 7 mmHg following cataract screening, asthma control, the nicotine therapy saves lives when it is administered understand little about the science and the surgery, with those having lower pressures content of cigarettes and others. to patients who are at high risk for metas- practice of medicine,” said Dr. Savino. experiencing a proportionate reduction.”1 CHALLENGES AHEAD. Two of the greatest tasis—those with histopathologic markers “The greatest challenges for ophthalmolo- ABOUT THE SPEAKER. Dr. Lindstrom’s challenges ahead for health care are “design- such as retrolaminar invasion of the optic gy are the roadblocks and unnecessary background is well-tailored to this topic. ing a health care program for the unin- nerve and extensive choroidal invasion. bureaucratic activity imposed by the gov- He completed his fellowship training in sured and financing it,” said Dr. Nielsen. However, the importance of other putative ernment, managed care organizations and cornea at the University of Minnesota, “For example, some are in favor of a single- risk factors such as anterior chamber inva- insurance companies, which have sapped and was a Heed Fel- payer system and others are not. I will dis- sion and infiltration of the iris stroma and much of the time and enthusiasm from low in glaucoma at cuss the pros and cons of each perspective trabecular meshwork is less certain and many ophthalmologists.” —L.B.P. University Hospital as well as the challenges of meeting the needs further exploration. The Children’s in Salt Lake City, needs of two distinct populations— Oncology Group is now conducting a KELMAN LECTURE Utah, before spend- those who have insurance through their chemotherapeutic study that is evaluating Richard L. Lindstrom, MD, will present ing 10 years on the employers and those who do not. We prognostic factors in a prospective fashion.” Cataract Surgery in the Glaucoma Patient full-time faculty at should learn from other countries but —L.B.P. (11:37 a.m. to noon) during the Monday the University of fashion a uniquely American solution.” session titled Spotlight on Cataract Surgery: Minnesota and 20 —L.B.P. WILLIAM F. HOYT LECTURE Cataract Complications—Video Case years at Minnesota Peter J. Savino, MD, will present Evaluation Studies: Why? What Now? How? (8:15 a.m. Eye Consultants. He Simple cataract Z I M M E R M A N L E CTURE of the Retinal Nerve Fiber Layer: Descrip- to noon). This meeting takes place in the served as president surgery provides Ralph C. Eagle Jr., MD, will present Retino- tive or Predictive (11:43 a.m. to 12:08 p.m.) Thomas B. Murphy Ballroom 1–3. of the American significant reduc- blastoma: New Developments (9:25 to during the Monday Symposium titled Top ABOUT THE LECTURE. Glaucoma is a Society of Cataract tions in IOP, says 9:58 a.m.) during the Monday Symposium Five to Stay Alive: Five Neuro-Ophthal- common comorbidity in patients with and Refractive Sur- Dr. Lindstrom. titled Relevance of Clinical and Pathologi- mology Pearls and Pitfalls for the General- cataract, second only to age-related macu- geons in 2007. cal Staging of Benign and Malignant ist (10:15 a.m. to 12:15 p.m.). This com- lar degeneration—“a key statistic for RESEARCH OPPORTUNITIES. Dr. Lind- Ophthalmic Tumors for the Practicing bined meeting with the North American comprehensive ophthalmologists,” said strom noted that with advances in micro- Ophthalmologist (8:30 to 10 a.m.). This Neuro-Ophthalmology Society takes place Richard L. Lindstrom, MD, founder, Min- incision surgery, ophthalmologists can combined meeting with the American in the Sydney J. Marcus Auditorium. nesota Eye Consultants, a private practice become more aggressive with refractive Association of Ophthalmic Pathologists ABOUT THE LECTURE. The utility of visual- in Bloomington, Minn. lens exchange in glaucoma patients who takes place in Room A412. izing the retinal nerve fiber layer in neuro- “Ten years ago, we would routinely do are poor medication compliers or who ABOUT THE LECTURE. Ralph C. Eagle ophthalmologic disease—“an important a combined procedure—phacoemulsifica- are not responding to other surgical Jr., MD, will discuss a retrospective observation made by William Hoyt,” said tion with a trabeculectomy—for these approaches. “On the other side of the histopathologic review of approximately Peter J. Savino, MD—and the development patients,” Dr. Lindstrom explained. “How- argument, improvements in glaucoma 400 enucleated eyes from retinoblastoma of modern equipment that enables us to ever, with advances in phacoemulsification, surgery are making filtering techniques patients who were image this area will be addressed in this including clear corneal incisions and the less invasive as well,” he said. cared for by the lecture. Dr. Savino will also discuss the advent of better medications to control CHALLENGES AHEAD. “Though our tech- ocular oncology clinical application of these instruments glaucoma, we now believe most of these nical capabilities are expanding exponen- service at the Wills in neuro-ophthalmologic disorders. patients are best treated with cataract tially in what we can do for people, who Eye Institute—a ABOUT THE SPEAKER. Dr. Savino, who surgery alone.” will pay for this care?” Dr. Lindstrom study designed to specializes in optic neuropathies, is a pro- He pointed to new data indicating that asked. He said the field is headed for the assess the incidence fessor of ophthalmology, neurology and simple cataract surgery provides significant “perfect storm,” a burgeoning senior pop- of high-risk histo - neurosurgery at Thomas Jefferson Univer- reductions in IOP, with the IOP reduction ulation in which people over age 65 use 10 pathologic features sity and director of the neuro-ophthalmol- proportional to the preoperative IOP. “We times as much eye care as those under 65 in a large urban ogy service at Wills Eye Institute. He is a reviewed a series of 588 eyes and found that while the number of ophthalmologists is ocular referral cen- contributing author of a few textbooks: Retinomas or ter. “It is currently Neuro-Ophthalmology: Color Atlas and retinocytomas may believed that benign Synopsis of Clinical Ophthalmology and retinal tumors with transform into Clinical Decisions in Neuro-Ophthalmology. L E A R N A B O U T P AY M E N T I N C E N T I V E S retinoblastoma, photoreceptor dif- Besides writing more than 300 scientific B says Dr. Eagle. eginning in January, physicians can earn up to a 2 percent bonus for e-prescrib- ferentiation called articles, chapters, reviews, abstracts and ing plus up to an additional 2 percent bonus for participating in the Physicians retinomas or retinocytomas may undergo posters, Dr. Savino has served as a journal Quality Reporting Initiative (PQRI). Find out more at these free sessions: malignant transformation into retinoblas- reviewer for 16 scientific publications toma,” said Dr. Eagle, who also plans to including the American Journal of Oph- Introduction to E-Prescribing: Improving the Safety and Efficiency of Medication Management determine how many retinoblastomas thalmology and Ophthalmology. This session will review what e-prescribing is and how to implement it. An Academy contain residual foci of these presumed RESEARCH OPPORTUNITIES. “The most representative will be on hand to discuss the Medicare incentive program, and an precursor lesions. promising areas in administrator will share her experience with e-prescribing. ABOUT THE SPEAKER. Dr. Eagle is the neuro-ophthalmol- Event Code Spe54, Sunday 1:15 to 1:45 p.m. Noel T. and Sara L. Simmonds Professor ogy research relate Room A412 of Ophthalmic Pathology at Wills Eye to optic neuritis and PQRI Implementation: The Nuts and Bolts of 2009 Reporting Institute and director of pathology. He has other nondemyeli- This session will address all quality-reporting measures affecting ophthalmology, as well written more than 350 articles and book nating optic neu- as step-by-step practical implementation, CMS 1500 form examples and tips from suc- chapters and given more than 430 lectures ropathies,” said Dr. cessful reporting practices. about ocular pathology and retinoblas- Savino, who also Event Code Spe47, Sunday, 12:30 to 1 p.m. toma. He is also the author of Eye Patholo- pointed out other Room A412 gy: An Atlas and Basic Text. Dr. Eagle’s areas with consider- Optic neuritis and research interests include the morpholog- able potential such as Physician Profiling and Accountability other nondemyeli- ical characterization of ocular neoplasms chronic neurode- This session will cover profiling and other physician accountability initiatives tied to nating optic neu- and other ocular and adnexal diseases, generative diseases. payment, including the outlook of CMS’ Medicare Physician Quality Reporting Initiative ropathies are using light and electron microscopy and CHALLENGES and Physician Web Compare plan. promising areas of special modalities such as immunohisto- AHEAD. “Physicians Event Code Spe28, Monday, 12:15 to 1:45 p.m. research, says Dr. chemistry. are spending much Room A412 Savino. RESEARCH OPPORTUNITIES. “Retinoblas- of their valuable 20 s u n d a y ● m o n d a y ● tuesd a y e d i t i o n
    • HONORARY LECTURES slowly shrinking. “We must become much of health care in the United States. than 200 publications. Dr. Bartley is also ongoing research is conducted to deter- more efficient in the next 15 years.” ABOUT THE SPEAKER. Dr. Bartley is the the former editor-in-chief of Ophthalmic mine the causes of and possible therapies —L.B.S. Louis J. and Evelyn Krueger Professor of Plastic and Reconstructive Surgery; has for age-related macular degeneration. Ophthalmology at the Mayo Clinic, where served on the editorial boards of Ophthal- Ultrasound imaging of the retina and 1 Poley, B. J. et al. J Cataract Refract Surg 2008; he is also the CEO of Mayo’s Florida oper- mology, the American Journal of Ophthal- choroid are also a focus of study. 34:735–742. ations and the Mayo Clinic’s vice president mology and the Archives of Ophthalmolo- CHALLENGES AHEAD. “The continued for quality—a position entailing the over- gy; and is a former director of the research of imaging techniques, both opti- W E N D E L L H U G H E S LECTURE sight of about two dozen medical centers. American Board of Ophthalmology. cal and acoustic, is imperative in ophthal- George B. Bartley, MD, will present From “My current responsibilities are far from CHALLENGES AHEAD. “We are on a mar- mology,” said Dr. Coleman, who added, the Operating Room to the Board Room: the familiar territo- velous frontier of medicine today, but we “Imaging modalities are expensive and An Oculoplastic Surgeon’s Perspective on ry of the orbit, eye- have extraordinary challenges,” said Dr. may only be available in limited centers, Health Care in America (3:03 to 3:23 p.m.) lids and lacrimal Bartley. He offered the following analogy however. This presents a challenge in many during the Monday Symposium titled New drainage system that when asked about the future of medicine: communities. Dramatically reduced com- Technologies in Oculofacial Diagnosis and was the focus of the “In biology, form follows function. In pensation for difficult and expensive pro- Treatment (2 to 3:30 p.m.). This combined first 20 years of my business, function follows finance. The cedures, lack of access to emergency treat- meeting with the American Society of Oph- career, but the expe- implication for medicine is that we are ment and the increased elucidation of thalmic Plastic and Reconstructive Surgery rience has given me where we are and we’re headed where healing mechanisms are also hurdles that takes place in the Sydney J. Marcus Audito- a different perspec- we’re headed, in large part because of the must be overcome.” —L.B.P. rium. tive to apply to the way health care is financed.” —L.B.P. ABOUT THE LECTURE. “Taking care of issues confronting CA S T ROV I E J O M E DA L L E C T U R E In business, func- patients and serving their needs is why ophthalmology,” HELEN KELLER OCULAR T R AU M A Shigeru Kinoshita, MD, PhD, will present tion follows each of us went into medicine,” said George said Dr. Bartley, who LECTURE Therapeutic Modalities for Ocular Surface finance, says Dr. B. Bartley, MD, who will share his thoughts has authored or D. Jackson Coleman, MD, will present Disorders (9:20 to 9:45 a.m.) during the Bartley. about the current and future environment coauthored more Imaging and Innovation in the Evolution Tuesday Symposium titled Commonly of Ocular Trauma Management (4:39 to Missed Diagnoses Seen by a Corneal Spe- 4:59 p.m.) during the Monday Symposium cialist (8:30 to 10:30 a.m.). This combined SOCIETY REPORT titled War and Terror-Related Eye Injuries: meeting with the Cornea Society and the From Triage to Management to Rehabili- European Cornea Club takes place in the tation (3:30 to 5 p.m.). This combined Sydney J. Marcus Auditorium. C ongratulations to this year’s ISRS/AAO award recipients. The nine individuals below were honored during Friday’s ISRS/AAO Gala Dinner and Dance for their contribu- meeting with the American Society of Ocu- ABOUT THE LECTURE. While a cure for tions to the profession. lar Trauma takes place in Room A411. severe ocular surface disease has yet to be ABOUT THE LECTURE. Imaging and its discovered, researchers continue to devel- Casebeer Award The Troutman Prize recognizes the sci- synthesis with surgical innovations used op innovative medical and surgical treat- Graham D. Barrett, MD (Australia) entific merit of a young author publishing to treat and manage ocular trauma will be ment approaches. Shigeru Kinoshita, MD, The Casebeer Award recognizes an in the Journal of Refractive Surgery and the focus of this lecture, said D. Jackson PhD, will discuss his latest work, including individual for his or her outstanding con- includes a $5,000 honorarium from the Coleman, MD, referring to a quote attrib- transplantation of cultivated mucosal tributions to refractive surgery through Troutman Endowment. uted to Sigmund Freud to summarize his epithelial stem cells for ocular surface nontraditional research and development theme: “Once you understand the prob- reconstruction, and the use of immuno- 2009 Barraquer Lecture and Award activities. lem, you can deal with it.” suppressive agents and keratoepithelio- Jorge L. Alió, MD, PhD (Spain) ABOUT THE SPEAKER. Dr. Coleman is a plasty with or without tectonic lamellar Lans Distinguished Award The José I. Barraquer Award honors a vitreoretinal surgical specialist who has keratoplasty to treat peripheral corneal Ronald R. Krueger, MD (United States) physician who has made outstanding con- been treating ocular ulcers. The Lans Distinguished Award is tributions in the field of refractive surgery trauma for 40 years Dr. Kinoshita and colleagues also have named in honor of Leedert J. Lans, MD, a during his or her career, exemplifying the and using ultra- made progress in understanding Stevens- young, innovative researcher who defined character and scientific dedication of Jose sound and other Johnson syndrome and toxic epidermal the basics of refractive surgery by working I. Barraquer, MD. This year’s award winner imaging techniques necrolysis, a type of hypersensitivity reac- to improve the techniques used to correct will present the Barraquer Lecture during for evaluating ocu- tion that occurs in response to medications, astigmatism. next year’s Joint Meeting. lar trauma for more infections or illness. The award is given to an individual who Founders’ Award than 30 years. He is ABOUT THE SPEAKER. Dr. Kinoshita has has made innovative contributions in the Jack T. Holladay, MD (United States) the John Milton served as professor and chairman of oph- field of refractive surgery. The Founders’ Award recognizes the McLean Professor thalmology at the Kyoto Prefectural Uni- Kritzinger Memorial Award vision and spirit of the society’s founders of Ophthalmology versity of Medicine since 1992. He is also Gustavo E. Tamayo, MD (Colombia) by honoring an individual who has made at Weill Cornell Med- The continued chief of the Kyoto Prefectural University The Kritzinger Memorial Award was extraordinary contributions to the growth ical College and has research of imag- Hospital. Over the past 30 years, Dr. Kino- established to honor the accomplishments and advancement of the society and its written more than ing techniques is shita has focused his work on ocular sur- of Michiel Kritzinger, MD. mission. 500 peer-reviewed imperative, says face wound healing, Each year, a recipient is chosen who papers, abstracts Dr. Coleman. ocular surface innate 2008 ISRS/AAO Presidential Award embodies the clinical, educational and and book chapters. immunity and ocu- José L. Güell, MD (Spain) investigative qualities of Dr. Kritzinger to His textbook Ultrasonography of the Eye lar surface recon- Ana Maria Torres (Colombia) advance the international practice of and Orbit is in its second edition. struction. In the This year’s ISRS/AAO Presidential refractive surgery. His work in the development of ultra- early 1980s at Har- Award is being given to Dr. Güell in recog- sound technologies led to a collaboration vard Medical School, Lifetime Achievement Award nition of his important contributions to with Frederic L. Lizzi, EngScD, in which Dr. Kinoshita helped Stephen L. Trokel, MD (United States) refractive surgery and his position as a they developed the first commercially avail- establish the con- The Life Achievement Award honors an leader in the field and to Ms. Torres in able B-scan ultrasound equipment for cept of centripetal ISRS/AAO member who has made signifi- recognition of her dedication to refractive ocular use. He has garnered more than a movement of cant and internationally recognized contri- surgery and the society. Regenerative med- dozen patents for his inventions, which corneal epithelium butions to the advancement of refractive icine and advanced To join ISRS/AAO, visit the Member Ser- include an ultrasonically vibrated surgical and the importance surgery during his or her career. laser technology vices desk at the Academy’s Resource knife and an ultrasound system for corneal of the limbal epithe- may help revolu- 17th Annual Richard C. Troutman MD DSC Center (Booth #3532) where you can pick biometry. lium. These findings tionize treatment (HON) $5,000 Prize up an application form. You can also visit Dr. Coleman also established the Mar- have contributed to of corneal disease, José Luis Rodriguez-Prats, MD (Spain) www.isrs.org. garet M. Dyson Vision Research Institute the development of says Dr. Kinoshita. at Weill Cornell Medical College, where the corneal stem cell e y e n e t ’ s a c a d e m y n e w s 21
    • HONORARY LECTURES theory by Tuen-Tien Sun. Cole Eye Institute. He holds editorial posi- director of ophthalmic plastic, recon- his current research projects include the Dr. Kinoshita served as the former pres- tions at Ophthalmic Genetics and the structive and orbital surgery at IOVS. In evaluation of families with inherited ident of the Japanese Society of Cataract American Journal of Ophthalmology and 2007 he received the American Academy glaucomas, comparison of glaucoma sur- and Refractive Surgery. He is the ARVO has published nearly 300 articles, book of Ophthalmology’s Secretariat Award. gical techniques, evaluation of pigmen- Trustee of the Cornea Section and serves chapters, professional correspondence RESEARCH OPPORTUNITIES. “The greatest tary glaucoma and advanced methods of as the associate editor of Investigative and multimedia presentations. He has research opportunities in graduate med- combined cataract and glaucoma surgery. Ophthalmology & Visual Science. also written four books, including Genetic ical education lie in surgical simulation, He has written two books as well as RESEARCH OPPORTUNITIES. “Stevens- Diseases of the Eye and A Compendium of which gives residents the ability to prac- more than 200 peer-reviewed papers, Johnson syndrome is rare, yet the infor- Inherited Disorders and the Eye. tice surgery in a virtual reality setting,” Dr. chapters and abstracts and developed mation gained from studying this disease Dr. Traboulsi trained with Marshall M. Langer noted. “This technology is anal- Gonioscopy.org, an online tutorial that can be applied to other more common Parks at the Children’s National Medical ogous to a flight simulator. We can expose teaches basic and advanced gonioscopy disorders,” Dr. Kinoshita said. “I liken it to Center in Washington, D.C. “He was my residents to both common surgical maneu- techniques using videography. investing in the development of advanced mentor and role model and is one of the vers and rare complications a multitude of Dr. Alward’s research has garnered technology for Indy and Formula One true icons, not only in pediatric ophthal- times, and they can learn to respond with- 12 domestic and international patents. cars. Eventually, this technology can be mology but in ophthalmology in general,” out the need to operate on a human eye. It “I have been fortu- used to increase the performance of regu- said Dr. Traboulsi. will be the most important change in the nate to work with a lar cars.” CHALLENGES AHEAD. “One of the chal- training of surgeons since the apprentice group of brilliant CHALLENGES AHEAD. “In the near future, lenges in pediatric ophthalmology is system was developed more than 100 molecular geneti- regenerative medicine and advanced laser attracting new graduates,” said Dr. Tra- years ago. This field will provide many cists. Our research technology, including femtosecond boulsi. “We have a shortage of pediatric opportunities for research as we study led to the first genet- laser–assisted keratoplasty, are positioned ophthalmologists for a variety of reasons. how to implement this groundbreaking ic linkage for open- to revolutionize the treatment of corneal For some, other specialties are attractive technology on a day-to-day basis.” angle glaucoma diseases, and that is quite exciting.” because they are more lucrative, technically CHALLENGES AHEAD. “Our most impor- (GLC1A). We then —L.B.S. challenging or better advertised, for exam- tant challenge will be to continue to demonstrated that ple. And the results of treatment in pedi- attract the best and brightest medical stu- this area contained a M A R S H A L L M . PARKS MEMORIAL atric ophthalmology often take years to dents into our field. The future of our gene called myocilin A great challenge LECTURE see as opposed to immediate vision field and our patients depends on it.” and that mutations is the decline in Elias I. Traboulsi, MD, will present Making improvement that can be achieved in —L.B.S. in this gene caused government Sense of Early Onset Childhood Retinal other specialties. Fortunately, those who glaucoma. We also research funding, Dystrophies (11:17 to 11:43 a.m.) during are attracted to the subspecialty come ROBERT N. SHAFFER L E C T U R E identified genes for says Dr. Alward. the Tuesday Symposium titled Genetic with a genuine love of children and a Wallace L. M. Alward, MD, will present Axenfeld-Rieger syndrome and continue Basis of Pediatric Eye Diseases (10:15 to desire to take care of them. That’s what The Molecular Genetics of Glaucoma to search for other disease-causing genes,” 11:45 a.m.). This combined meeting with keeps us going irrespective of all the other (11:50 a.m. to 12:15 p.m.) during the Tues- said Dr. Alward. the American Association for Pediatric challenges.” —L.B.P. day Symposium titled Business, Ethical, RESEARCH OPPORTUNITIES. Glaucoma Ophthalmology and Strabismus takes place and Medical-Legal Aspects of Treating remains a poorly understood disease. Dr. in the Thomas B. Murphy Ballroom 4. STRA ATSMA LECTURE Glaucoma Patients (10:45 a.m. to 12:15 Alward anticipated that “as we study its ABOUT THE LECTURE. Considerable Paul D. Langer, MD, will present Creating p.m.). This combined meeting with Prevent molecular underpinnings, we will develop progress has been made during the last Excellence in Resident Education (11:20 to Blindness America takes place in the Sydney an understanding of the basic pathophysi- two decades in improving the under- 11:40 a.m.) during the Tuesday Symposium J. Marcus Auditorium. ology of trabecular dysfunction and optic standing of retinal dystrophies as well as titled Maximizing Teaching and Learning ABOUT THE LECTURE. “Robert N. Shaffer nerve damage, which should lead to the genetic mechanisms involved in their With Modern Technology (10:15 to 11:45 was remarkably insightful in his predic- improved diagnostic methodologies and development. One a.m.). This combined meeting with the tion about the future of glaucoma genet- treatments.” of the most notable Association of University Professors of Oph- ics in 1965 when he delivered the Jackson CHALLENGES AHEAD. “One of the greatest milestones is the thalmology takes place in Room A411. Memorial Lecture titled ‘Genetics and the challenges in ophthalmology is the decline identification of a ABOUT THE LECTURE. The recent focus in Congenital Glaucomas,’” said Wallace L. of government research funding,” said Dr. number of genes resident education ensures that every M. Alward, MD, who will discuss the latest Alward. “This is making it more difficult associated with physician graduates with measured com- developments in the molecular genetics of for clinicians to be involved in research. early-onset child- petence in six different areas considered glaucoma in his lecture. As someone with minimal scientific train- hood retinal dystro- central to the practice of medicine. “Yet ABOUT THE SPEAKER. Dr. Alward is a pro- ing, I find the chance to be a part of cutting- phies such as this approach is not really adequate,” said fessor and vice chairman of ophthalmolo- edge science a thrill and have been fortu- Leber’s congenital Paul D. Langer, MD. “We must take our gy at the University of Iowa and service nate to work with a group of scientists amaurosis and X- approach to medical education to the next director of the glaucoma clinic, where who value a clinician’s input.” —L.B.P. We have a short- linked juvenile step: not just helping all residents meet a age of pediatric retinoschisis . Elias minimal level of competency but ensuring ophthalmologists, I. Traboulsi, MD, that the best residents reach their greatest says Dr. Traboulsi. FREE PROFESSIONAL FINANCIAL ADVICE will discuss these potential as well.” breakthroughs and Dr. Langer said, “Our best residents are W ant to plan for retirement? Design an estate plan? Whether you’re a seasoned explain “how general and pediatric oph- our future leaders. They are likely to be investor or a beginner, the Academy Foundation invites you to take advantage thalmologists can correctly diagnose these the ones making groundbreaking discov- of free financial planning services in Atlanta. diseases using clinical clues such as symp- eries, excelling in patient care and serving Book a private consultation. The Academy Foundation offers complimentary, 50- tom identification and retinal exam find- in leadership roles throughout ophthal- minute private consultations with financial and estate planning professionals from ings and how, once a clinical diagnosis is mology’s professional organizations. The Chepenik Financial, Mercer Advisors and Merrill Lynch. Appointments are required and made, they can proceed to the next step— future of our field depends on our giving begin on the hour. Consultations take place Sunday and Monday from 8 a.m. to 4 p.m. providing a molecular diagnosis and these talented residents as much attention and on Tuesday from 8 a.m. until noon. To check what times are still available, please determining what genes are involved.” as possible, mentoring their careers and visit Room A406–407. ABOUT THE SPEAKER. Dr. Traboulsi, who investing time in their development.” Attend a lunchtime session. The Academy Foundation also offers free lunchtime ses- is board-certified in both ophthalmology ABOUT THE SPEAKER. Dr. Langer has sions covering a range of financial planning topics. No appointment is needed, but you and medical genetics, is professor of oph- served as director of resident education are advised to arrive early as the sessions are popular and well-attended. The Estate thalmology, head of pediatric ophthalmol- at the Institute of Ophthalmology and Planning session is on Sunday at 12:45 p.m. and the Investment and Retirement Plan- ogy and adult strabismus and director of Visual Science (IOVS) at the New Jersey ning is on Monday at 12:45 p.m. Both session are in Room A316. the Center for Genetic Eye Diseases at Medical School since 1995. He also is 22 s u n d a y ● m o n d a y ● tuesd a y e d i t i o n