Day 2 :
Keynote Forum
J.F. Thomas
University of Buraimi, Oman
Keynote: Emerging trends in optometry in the Gulf of Oman and MENA Regions
Time : 10:00
Biography:
J F Thomas completed his PhD from the Manipal University, India. He was awarded the Late Dr. T.M. A. Pai Fellowship to pursue his PhD. He holds other Post-graduate degrees in Hospital and Health Systems Management, Philosophy and a second degree in Medical Record Science. He is the Dean of the College of Health Sciences, University of Buraimi in Oman. He is a PhD Thesis Adjudicator and Master’s Thesis Guide. He is an external reviewer for the Oman Academic Accreditation Authority. His publications include 5 textbooks for Distance Education Programs. His invention of a Low Cost IV Trainer is under Patent consideration.
Abstract:
Optometry remains in its early stages of development in the Gulf of Oman and MENA regions although it started in Sudan as early as in the year 1954. In Oman the first batch of students graduated in 2015 from the only Optometry program available in the country. Visual impairment and preventable blindness affect large populations in these regions. While there is a need to maintain a primary care focus in professional optometry education there is also a need to consider diverse career pathways to ensure sustainable employment of qualified optometry graduates. Tradition, socio-cultural factors, technology, knowledge gaps, and economic factors and the like influence employment. For instance mostly women students join optometry programs in these regions. But due to socio cultural factors and tradition women graduates are most unlikely to leave their country of origin for work. Graduates tend to choose government employment over entrepreneurial initiatives. Technology and allied knowledge gaps between the developing and developed nations grow ever wider escalating overdependence on the developed nations. Overdependence promotes mediocrity in professional education as it confuses imitation with replication. It also overburdens already struggling economies due to high cost of imports. Due to these contextual constraints early steps are being taken to ensure closer contextual relevance of curricula while maintaining global orientation. This presentation aims to outline the paradigm shift taking place in the design of Optometry curricula in the Gulf of Oman and MENA regions with a special focus on Optometry in Oman, and Sudan.
- Special Session on : Retinopathy of Prematurity - What’s new about the pathogenesis and treatment?
Session Introduction
Huseyin Yetik
Istanbul University, Turkey
Title: Retinopathy of Prematurity - What’s new about the pathogenesis and treatment?
Biography:
Huseyin Yetik was graduated from Istanbul University in 1996 and completed his Ophthalmology Residency program in 2000 from Istanbul University, Cerrahpasa School of Medicine. He became an Associate Professor in 2006 and full Professor in 2014 in Cerrahpasa. He has worked in several governmental and private hospitals as Academician including Goztepe Educational Hospital, Zeynep-Kamil Educational Hospital, Yeditepe University School of Medicine; Memorial Health Group. He has also worked in Azerbaijan, Albania and Kazakhstan as Academician and Vitreoretinal Consultant. He is currently a Professor at Istanbul University, Cerrahpasa School of Medicine and Vitreoretinal Consultant and Chief of Ophthalmology Department of Surp Pirgic Armenian Foundation Hospital which is one of main Armenian Foundations in world as well as he is also a Chief Vitreoretinal Consultant Surgeon of 15 private hospitals in Istanbul, Turkey. He is a Member of American Academy of Ophthalmology, American Association of Retina Specialist, European Retina Society (EURETINA) and Turkish Ophthalmology Society.
Abstract:
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness in developing and developed countries. CRYO-ROP (Cryotherapy for ROP) and ETROP (Early Treatment of ROP) studies demonstrated various successful outcomes after peripheral thermoablation (cryo/laser) of avascular retina. Cryo-ablation was successful in 75% of the cases in the CRYO-ROP Study. After the cryo era, even with high success rates of up to 98% depending upon the severity of the disease, laser was not effective, particularly in zone I and aggressive posterior ROP (APROP) cases. Research data demonstrated the role of vascular endothelial growth factor (VEGF) in the pathogenesis of ROP and anti-VEGF treatments were developed as another therapeutic option. It seems that anti-VEGF treatment is about to become the gold standard in ROP management. Despite an ongoing debate about the possible systemic adverse effects, clinical practice of intravitreal anti-VEGF (bevacizumab) injection demonstrated a better systemic clinical course in all premature babies without any exception besides dramatically successful results for ROP. Those results were able to give some clue about a possible one pathogenic mechanism for all morbidities including intracranial hemorrhage and associated cerebral complications, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and ROP. Details of this possible pathogenesis will be discussed in this lecture.
- Track 5:Cornea & External Diseases
Track 6:Veterinary Ophthalmology
Track 7 :Ophthalmology Surgery
Location: 5
Chair
Huseyin Yetik
Istanbul University, Turkey
Session Introduction
Georgios Vakros
Royal Free Hospital, UK
Title: The role of anterior segment optical coherence tomography in corneal melting disorders
Biography:
Georgios Vakros has completed his Medical degree from the University of Aberdeen and Master of Science from the Institute of Ophthalmology, University College London, UK. He is currently a Resident in Ophthalmology, London, UK.
Abstract:
Detailed examination of the anterior segment of the eye is essential in ophthalmic practice with the use of the slit lamp and provides a vast amount of information. However, modern imaging techniques are allowing us to acquire even more information especially at microscopic level that we would not identify otherwise. Anterior Segment Optical Coherence Tomography (AS-OCT) is able to provide such details in microscopic level both quantitative and qualitative, especially in situations where changes occur slowly such as in case of corneal melt. We studies three patients who attended our clinic with corneal melts and we used a high-speed spectral domain AS-OCT (TOPCON OCT 2000 and RTVue®) to take cross-sectional images during the course of the treatment. The images obtained on each follow-up were compared and by measuring the corneal thickness we monitored the healing process. Once Seidel negative was observed, a bandage contact lens was placed as adjuvant to assist in corneal healing, with satisfactory resolution in all cases. We believe that AS-OCT is a valuable tool for the assessment of the healing process of corneal melt and it should be used routinely in similar cases.
Heba M. El Shouni
Khobar Government Hospital, Saudi Arabia
Title: Overview of recent trends in management of dry eye
Biography:
Heba M El Shouni has completed his PhD in 2008 from Cairo University and FRCS in Ophthalmology from Royal College of Physicians & Surgeons of Glasgow. She is the Coordinator of National Eye Health Program in Eastern Province in Ministry of Health, KSA and has been Reviewing & reediting recent recommendations for elimination of preventable blindness by 2020 according to WHO recommendations.
Abstract:
Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tears film instability with potential damage to the ocular surface. Dry Eyes (Xerophthalmia) is one of the most common conditions in our modern times. Its prevalence as encountered in my Ophthalmology proactive in Khobar Specialist Clinics in KSA >70% of my patients. Due to hot & humid climate there, high prevalence of chronic diseases (Diabetes & hypertension, hypothyroidism), excess use of air conditioners, overuse of some drugs (antihistamics, contraceptive pills & antipsychotic) as well as over utilization. Thus, the development of new drug treatments for dry eye is important for both the dry eye patient and the ophthalmic industry. There are many drugs in development for the treatment of dry eye. A large number of these drugs are designed to target a specific cause of dry eye and some of these drugs will be approved for clinical use in the next 10 years. I will highlight available current options as well as future hope for all ongoing trials.
Alena Furdova
Comenius University, Slovak Republic
Title: Uveal melanoma treatment by linear accelerator stereotactic radiosurgery
Biography:
Alena Furdova has completed her PhD from Comenius University, Medical School in Bratislava, Slovak Republic. She is working as an Associate Professor at the Department of Ophthalmology, Comenius University, Medical School in Bratislava, Slovak Republic. She has published more than 50 papers in reputed journals and published two monographs on the theme of uveal melanoma.
Abstract:
Introduction: One step LINAC based stereotactic radio-surgery with a single dose 35.0Gy is one of treatment options to treat T1 to T3 stage posterior uveal melanoma and to preserve the eye globe. Multidisciplinary approach is necessary for indication, treatment and follow-up. Methods: Retrospective clinic-based study; clinical findings of patients with posterior uveal melanoma (choroid) in stage T1/T3 who underwent stereotactic radio-surgery (SRS) at LINAC in period 2001-2015 in Slovakia. Tumor stage, volume, maximum elevation, localization presence of secondary retinal detachment, general status, age, gender, the functional tests were taken into consideration. Immobilization of the affected eye was achieved by mechanical fixation to the stereotactic Leibinger frame. The stereotactic treatment planning scheme after fusion of CT and MRI was optimized according to the critical structures (lens, optic nerve, also lens and optic nerve at the contralateral side, chiasm). The best plan was applied for therapy at C LINAC accelerator. The planned therapeutic dose was 35.0Gy by 99 % of DVH (dose volume histogram). Results: In group of 170 patients with posterior uveal melanoma treated with SRS, patient age ranged from 25 to 81 years with a median of 54 years. Median tumor volume at baseline was 0.6 cm3 (with range from 0.2 to 1.3 cm3). Median of maximal dose applied was 49.0Gy (range from 37.0 to 52.0Gy). Conclusion: Follow up of the patient is necessary by an ophthalmologist to find out the changes in melanoma characteristics after SRS in long term interval after irradiation.
Huseyin Yetik
Istanbul University, Turkey
Title: Pediatric cataracts: Combined clear corneal and pars plicata approach
Biography:
Huseyin Yetik was graduated from Istanbul University in 1996 and completed his Ophthalmology Residency program in 2000 from Istanbul University, Cerrahpasa School of Medicine. He became an Associate Professor in 2006 and full Professor in 2014 in Cerrahpasa. He has worked in several governmental and private hospitals as Academician including Goztepe Educational Hospital, Zeynep-Kamil Educational Hospital, Yeditepe University School of Medicine; Memorial Health Group. He has also worked in Azerbaijan, Albania and Kazakhstan as Academician and Vitreoretinal Consultant. He is currently a Professor at Istanbul University, Cerrahpasa School of Medicine and Vitreoretinal Consultant and Chief of Ophthalmology Department of Surp Pirgic Armenian Foundation Hospital which is one of main Armenian Foundations in world as well as he is also a Chief Vitreoretinal Consultant Surgeon of 15 private hospitals in Istanbul, Turkey. He is a Member of American Academy of Ophthalmology, American Association of Retina Specialist, European Retina Society (EURETINA) and Turkish Ophthalmology Society.
Abstract:
Cataracts in childhood not only reduce vision but also interfere with normal visual development. The management is far more complex than in adults. The timing of surgery, the surgical technique, the choice of the aphakic correction and the amblyopia management are of utmost importance in achieving good and long-lasting results. Two main approaches exist for the removal of cataracts in children: The pars plana (plicata) approach and the clear corneal (limbal) approach. Both techniques have advantages and disadvantages. The pars plana (plicata) approach indicated mainly for neonates/infants less than 2 years of age. Particularly for those who have bilateral congenital cataracts for whom immediate IOL implantation is not intended. In clear corneal approach various techniques have been described for anterior capsulotomy, lens extraction, posterior capsulectomy and anterior vitrectomy; particularly for which immediate IOL implantation is intended. What if we use both techniques simultaneously and re-uniform a technique excluding most of the disadvantages and including most the advantages of both techniques? In this lecture possibility of this re-uniformed technique will be discussed.
S. Anoop
College of Veterinary and Animal Sciences, India
Title: Cholecyst derived collagen as an extracellular matrix scaffold graft for repairing large corneal defect (ulcer) in dog: A report of three cases
Biography:
S Anoop has completed his PhD in Canine Surgery with specialization in Ophthalmology from Kerala Veterinary and Animal Sciences University, India. He is presently working as an Assistant Professor of Surgery with Kerala Veterinary and Animal Sciences University. He has published more than 28 research papers in various journals and Principal Investigator of three research projects.
Abstract:
Contemporary Regenerative Medicine offers novel strategies for treating diseases through the use of cells and cell-seeded scaffolds of homogenic, allogenic or xenogenic origin. However, the use of xenogenic scaffolds as therapeutic graft is not new. This report documents three cases of large size corneal defects caused due to ulceration in Chinese Pug breed of dog. All the three animals had staphyloma as a complication of corneal ulcer. In all the cases, the corneal defect was surgically repaired by grafting with porcine cholecyst derived scaffold (CDS). The conventional surgical technique was adequate for grafting and retention of the scaffold in position. All the dogs responded well to the biomaterial-graft. CDS offered advantages in being inexpensive and technically straight forward. In the present study, the depth and extend of the lesion got reduced and became shallow by the 7th day and complete healing by 14th day. The grafting, as supported by results of clinical examination and fluoresceine-dye testing, caused healing with minimal vascularization. However, the graft has resulted in corneal pigmentation. The mechanism of graft-assisted healing was not clear but the observations suggested that the CDS has potential for clinical use as a corneal repair graft.
C.O. Oman Irabor
Hellyncom Eye Clinic, Nigeria
Title: Visualizing global advancements in ophthalmology via intergrated eye care
Biography:
C O Omon-Irabor has completed her Post-graduate study in Clinical Optometry (Low Vision) at Cardiff University Wales, UK. She is the Member of London College of Optometry and completed her MD from Hellyncom Eye Clinic Nigeria, Africa, Accredited Center, Nigeria Health Insurance Scheme (NHIS). She is a Secondary Health Care Provider for the Nigeria Defense Sector, Grassroots Community Primary Health Care Provider. She is the Author of the ‘Care of Eye” published in 2015 with many other publications in BEPCO (local journal). She is a pioneer Chairperson of Women Optometrist in Nigeria, Delta State and a two time Treasurer of the Nigeria Optometry Association (NOA), Delta state chapter.
Abstract:
This paper is on visualizing global advancement in ophthalmology via Integrated Eye Care. It thus draws substantially on review of secondary sources, archival material and some clinical experience. Review of extensive literature reveals considerable progress in ophthalmology via integrated care which all improved the management of the patient. Despite these, the deadline of ending avoidable blindness by 2020 cannot be achieved by ophthalmologist alone, for there is a need for synergy between the Ophthalmologist, the Optometrist and health care providers and medical professionals whose contributions are also important. The next section then deals with contributions of the optometrist, the practice of optometry in Nigeria and elsewhere, what integrated eye care is, the position of the optometrist in the recent advances in pre- and post-operative management of surgical cases, case of corneal transplants where patients are required to leave the same day of the procedure, and where Optometrist would play a unique role in post-operative management compared to leaving the patient to leave same day after the procedure without close monitoring. The concluding section looks at the global implication of advances made, and how the world is reacting to them and also the impact of the technological advancement in the practice of Ophthalmology and optometry, especially cornea transplant advanced cataract surgery techniques, improved accuracy in new glaucoma shunts, ocular imaging and implants for macular degeneration and Femtosecond laser for cataract surgery.
- Video Presentation
Session Introduction
Haci Koc
Inci Eye Hospital, Turkey
Title: Is prophylactic 360 degree laser photocoagulation necessary during vitrectomy for dropped nucleus?
Biography:
Haci is currently working as an at Inci Eye Hospital, Turkey
Abstract:
Purpose: We aimed to evaluate benefits of prophylactic 360 degree laser photocoagulation during vitrectomy for dropped nucleus. Materials & Methods: Medical records of the patients who underwent PPV due to the development of dropped nucleus after cataract surgery by phacoemulsification between 2003 and 2014 in three different centers were retrospectively reviewed. Results: The mean age of 79 patients with dropped nucleus enrolled in the study was 67.04±7.36 years (range, 51-82 years); 51.9% were female. Retinal tear was present before PPV in 5 of the patients. Proliferative vitreoretinopathy (PVR) was present in 6 of 9 patients with RD; 8 patients underwent PPV surgery for twice and 1 patient underwent PPV surgery for three times. We determined that proliferative membranes originated from prolifactic laser border in patients with PVR. Conclusions: We concluded that prophylactic 360 degree laser photocoagulation is not necessary during vitrectomy for dropped nucleus. Instead of this process, it should be paid attention for scanning the periphery of fundus for peripheral retinal breaks. If retinal breaks are encountered at that time retinal breaks should be surrounded by laser photocoagulation.
Muthuvenkatraman Ambika
Senior Consultant Optometrist, India
Title: Quality of life of patients using low vision aids
Biography:
She is currently working as Senior consultant optometrist in Chennai.She acted as in-charge for interns (Final year B.S Optometry students. She has been a FACULTY for Low vision aids, Visual Optics, Geriatric Optometry, and Pediatric Optometry.Dr.Ambika won prize for Best Performance in Low Vision Aids at SANKARA NARAYANAN
Abstract:
Purpose: The purpose of this study is to evaluate the quality of life of patients using low vision aids (LVA). Methods: Modified National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) to it local usage was administered to 22 first time LVA users. After 3 Months of their LVA usage, the same questionnaire was again administered. Since only near LVA is given for all our patients, the scores of the questions relating to the distance vision were not taken in to the analysis. The mean scores of each category in our questionnaire were compared between before and after LVA intervention using paired t test. And the effect size values were also determined. Results: The mean scores between before and after LVA intervention showed significant difference (p<0.001) in the categories General vision and near vision targeted questions. The mean scores of the category 1 well being, distress and dependency (1 WBDD) also showed a significant difference (p<0.002) between pre and post LVA interventions. The categories namely, general, systemic and ocular health, social functioning, role limitations, 2 well being, distress and dependency (2 WBDD) scores did not change significantly after low vision services. Conclusions: Low vision services are associated with high patient satisfaction. Near vision targeted questions were more sensitive than general health related questions. There was an improvement in the near functional status after low vision services. There was a marked improvement in the quality of life of patients who are less than fifty years of age when compared to that of the patients who are aged above 50 years because of other age related systemic ailments. Improvement in the near visual acuity was well related with the frequency of the use of LVA. Therefore low vision training and regular follow-ups play an important role in improving the quality of life.