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SCIENTIFIC HIGHLIGHTS OF ATLANTA 2008 EyeNet MAGAZINE Sunday, Monday & Tuesday
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Academy News from AAO 2008 Atlanta

Nov 18, 2014

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Page 1: Academy News from AAO 2008 Atlanta

S C I E N T I F I C H I G H L I G H T S O F A T L A N T A 2 0 0 8EyeNet

M A G A Z I N E

Sunday, Monday & Tuesday

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IN THIS ISSUE:

In this second edition of

Atlanta’s Academy News,

meet the Opening Session’s

Keynote Speaker, glimpse highlights of the Best of

Show Videos, and learn about Atlanta’s renowned

Carter Center.

A chat with the Keynote Speaker . . . . . . . 4–6

The Carter Center saves vision . . . . . . . . .9–10

Best of Show videos . . . . . . . . . . . . . . .11–12

Make coding easy (or easier) . . . . . . . . . . . .13

See the Museum of Vision exhibits . . . . . . .15

San Francisco in 2009 . . . . . . . . . . . . . . . .16

Volunteer abroad with your colleagues . . . . .17

TABLE OF CONTENTS FROM THE EDITOR

Welcome toAtlanta. Thisyear’s Joint Meeting is spon-sored by theAcademy and ourcolleagues fromthe EuropeanSociety of Oph-thalmology, andthat internationalspirit is reflected in the depth andbreadth of the presentations. Amongthe many excellent Symposia to whichthe EyeNet team is looking forward:

Sunday, from 3:45 to 5:15 p.m.—“Infectious Disasters: Are We SeeingFewer or Are We Treating Better?”

Monday, from 3:30 to 5 p.m.—“Warand Terror-Related Injuries: From Triageto Management to Rehabilitation.”

Monday, from 4:15 to 5:35 p.m.—“Around the World in 80 Minutes: Inter-national Symposium on Devices forComplicated Cataract Cases.” (This isjust one offering from the all-dayCataract Monday program.)

Tuesday, from 10:45 a.m. to 12:15p.m.—“Business, Ethical and Medical-Legal Aspects of Treating GlaucomaPatients.”

Beyond taking in these presenta-tions, enjoy your stay in Atlanta, andmake sure to meet new colleagues fromaround the world.

Richard P. Mills, MD, MPHChief Medical Editor, EyeNet Magazine

The Academy Seniors Special Meetingand Reception takes place on Mondayfrom 2:30 to 5 p.m. in Room B406.Archivist Ted Ryan will present theKeynote Speech, “10 Things YouMight Not Know About Coca-Cola.”Nancy J. Newman, MD, will present“Mitochondrial Disease: It’s Not AllYour Mother’s Fault.” This supersedesthe agenda published in October’sEyeNet.

C O R R E C T I O N

ON THE COVERPenetrating Keratoplasty

Photo by Marshall E. Tyler, CRA, FOPS

Wake Forest University Eye Center

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KEYNOTE SPEAKER

As president of the Institute of Medi-cine (IOM) of the National Acade-mies, Harvey V. Fineberg, MD, PhD,

has a job with mind-boggling scope. Anyattempt at encapsulation seems to do hiswork an injustice. He and the IOM tackle

any and all primary problems that appearon the U.S. health agenda. Provost of Har-vard University from 1997 to 2001, deanof the Harvard School of Public Healthfor 13 years and recipient of five honorarydegrees, Dr. Fineberg brings a wealth of

knowledge and experience to this her-culean task.

Keynote Speaker at this year’s JointMeeting, Dr. Fineberg has special interestsin public health practice, the evaluation ofdiagnostic and screening tests and the eth-ical and social implications of new med-ical technologies. He is coauthor of threebooks, Clinical Decision Analysis, Innova-tors in Physician Education and The Epi-demic That Never Was, the last of whichanalyzes the controversial 1976 federalimmunization program against swine flu.

Dr. Fineberg’s address to the Academyis titled “Seeing the Future of HealthCare,” and it will describe some of the keyforces that will affect medical practiceover the next 10 years. Rather than bepassive participants, Dr. Fineburg said,ophthalmologists and other physicianshave an opportunity to reexamine andreinforce their professional roles and toshape the future of health care.

The IOM is one of four organizationsof the National Academies—which alsoinclude the National Research Council,the National Academy of Engineering andthe National Academy of Sciences—thatare authorized by charter of the U.S. Con-gress. Operating independently of govern-ment, the IOM is a private organizationcreated in 1970 for the purpose of advis-ing policy makers, health care profession-als and the public on topics as wide-rang-ing as vaccine safety, health care delivery,nutritional standards and cancer preven-tion and management.

“Everything from the quality, safetyand cost of health care; the availability of health insurance; the issues that fosterscientific progress; the conflicts of interestamong professionals in their roles as teach-ers, caregivers and researchers; to child-hood obesity and global health,” said Dr.Fineberg, “all of these are on our agenda.”And each year the IOM produces dozensof reports to contribute to informed deci-sion making. A sampling of this year’sincludes reports on the topics of emer-gency preparedness, foodborne diseaseand genomic innovations in health andmedicine.

SHEDDING LIGHT ON MEDICAL ERRORS Among the IOM initiatives with the biggestimpact was one leading to the publicationof the report To Err Is Human: Building aSafer Health System (1999). This unsettlingreport revealed that close to 100,000 U.S.patients die annually from hospital errors—more than die from motor vehicle acci-

dents, breast canceror AIDS.1

Unmasking theforces of legislation,regulation andmarket activity thatinfluence quality of care, the reportgreatly increasedpublic awarenessand led to the con-vening of a WhiteHouse conferenceby President Clin-ton and the appro-priation of fundsby Congress to theAgency for Health-care Research andQuality.

Where medicinehad failed in the matter of hospital errors,said Dr. Fineberg, was by asking thewrong questions—who was at fault, ratherthan what system had created the condi-tions that enabled errors. In contrast, afocus on the forest, not just the trees, isemblematic of the work of the IOM,which followed up with its blueprint foraddressing the problem: Crossing theQuality Chasm: A New Health System forthe 21st Century (2001). Since its publica-tion, said Dr. Fineberg, some progress hasbeen made at improving systems andtracking prescriptions, but errors are stilla significant problem. He said that tech-nology could play a much greater role inreducing transcription and dispensingerrors. Computerized order entry, auto-mated pharmacy packaging, individualdosing and labeling, and bar-coding arejust a few examples of ways to reduceerror.

THE EXPANDING ROLE OF TECHNOLOGYDr. Fineberg is a measured proponent ofnew technologies. He points, for instance,to bipartisan agreement in Congress aboutthe need for better information technolo-gy investment. (In the case of IT, however,cultural resistance—getting doctors toembrace new technology—can be one ofthe biggest stumbling blocks.)

Overall, Dr. Fineberg considers tech-nology to be the proverbial two-edgedsword. “I think that our challenge is bothto encourage creative and innovativeadvances that solve real health problemsand to discourage marginally or negatively

THE INSTITUTE OF MEDICINE’S HARVEY V. FINEBERG, MD, PHD: ADVANCING THE NATION’S HEALTH AGENDA

Seeing the Trees and the Forestby annie stuart, contributing writer

Keynote Speaker, continued on page 6

This publication was printed in advance of the Joint Meeting. Check the TicketSales area in Hall A-2 for cancellations or changes in meeting times.

T I M E C H A N G E S & C A N C E L L A T I O N S

DR. FINEBERG givesthe KeynoteAddress from 9:08to 9:28 a.m. dur-ing the OpeningSession, whichtakes place from8:30 to 10, thismorning (Sunday)in Hall A-3 Ses-sion Room.

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useful applications of technology,” he said.“Technology is the pathway to progressand at the same time it is a very substan-tial source of the high cost of health carein the United States.”

He added that a variety of incentivesencourage overuse. It can be easier to ordertests than to take a thorough history. Thereis pressure from patients to use what’s avail-able. And currently, the more diagnostictests and technology that physicians use,the greater their reimbursement. A smarterway, he said, would be to pay for bothvalue and efficiency, encouraging evi-dence-based guidance for optimal use of technology.

HEALTH CARE REFORM IMMINENT?While leading the world in health careexpenditures, the United States is the onlywealthy, industrialized nation that doesnot ensure coverage for all citizens. In areview of the hidden costs of uninsurance,the IOM found that if the 45 millionuninsured U.S. citizens were to be covered,the cost of insuring them would be faroutweighed by the potential economicgain of better health outcomes from unin-terrupted coverage—an estimated $65 to

$130 billion each year.2 IOM’s subsequent2004 recommendations called for univer-sal, continuous and affordable health carefor all individuals and families.

Dr. Fineberg called the current deficien-cies in health coverage a travesty, withprogress largely stalled by a political stale-mate between two entrenched camps—those who favor a single-payer, govern-ment-run program and those who opposeexpansion of government programs. Thepresidential candidates comprise a thirdgroup and suggest building on our cur-rent system through mandates or incen-tives, or a mix of the two.

Despite the historical failures, Dr. Fine-berg is optimistic. “I believe that we’re inthe strongest position of any time in thepast decade to see genuine health reform,”he said. “All other industrialized countries—with widely disparate systems of govern-ment, patterns of social interaction, andlevels of capitalism or socialism—havesolved this problem. So, I have no doubtthe United States can do it, too.”

While pointing to a need for a distinctlyU.S. solution, Dr. Fineberg said there aremany lessons to learn from other countries.“You can see how Germany, for example,has worked out a system of insurance thatinvolves multiple participants, not simply

a single-payer system,” he said. “You cansee in places like France how access to ser-vices is very widely distributed in both thecities and throughout the smaller townsand villages. You can see in Scandinaviaexamples of integration of medical ser-vices with public health systems. We canbenefit from looking at a variety of othercountries and adapting to our particularneeds what works and avoiding the thingsthat haven’t worked very well.”

PRESSING PUBLIC HEALTH ISSUESDr. Fineberg said the principal driver forU.S. public health challenges is the demo-graphic and epidemiological transitiongenerated by the aging of the population.Though small in numbers, the fastest-growing segment of the population is overage 100. Despite healthy older populations,the total burden of chronic disease willrise dramatically due to huge numbers ofpeople living longer. “It means also thatfeatures of behavior that are conducive tochronic diseases like obesity and diabetes,to pick prominent examples, are especiallyproblematic,” he said. “It means that wehave to organize our health services tomeet the needs of people in their homesas well as in our clinics. It means we needto organize services that actually deliverthe care and the prevention that olderAmericans require.”

Using cancer care as an example, Dr.Fineberg described the implications of thefact that cancer is increasingly changinginto a manageable, chronic condition.“One of the key implications is that weneed to adopt a strategy of cancer care forthe whole patient,” he said. “We have tolook at advancing science, at treatmentand at better statistical and epidemiologicanalyses about what works and what thecauses are. But we need to do it with aframing that is healing in its intent andlooks to care for patients in the home aswell as in the hospital and as humanbeings, not merely as clinical material.”

Solving the challenges of health carefor the elderly, while not neglecting theneeds of children and other segments ofthe population, he said, will require a 21stcentury set of strategies to establish thepreventive and curative services that anaging and growing population is going torequire.

Mobilizing families, schools and healthcare providers—not to mention food pur-veyors, city designers, manufacturers andrestaurant owners—will be required tosolve problems like childhood obesity andthe remaining one in five adults who stillsmokes in this country, said Dr. Fineberg,who added that it’s sometimes said thatthe hardest problems often require thesoftest science. “And that’s why it’s very

important, in dealing with population-level health problems, to be open to solu-tions that are both medical and publichealth–oriented in character.”

GLOBAL HEALTH AND BIOTERRORISMWith the anthrax story back in the newsearlier this year, Dr. Fineberg reflected on the risks of bioterrorism. Thoughbioterrorism is a serious threat, he cou-pled it with natural biological threats—pandemics and other manifestations ofnatural diseases—observing that naturecan be the worst terrorist of all.

“From the point of view of nationalpreparedness, we are better prepared thanwe were five or even three years ago,” saidDr. Fineberg. “This recent investigation of the anthrax episode is a good exampleof where advancing science enabled thedetailed location or identification of theparticular anthrax strain. That wasn’t pos-sible earlier, so there is progress. At thesame time, the surveillance systems in theworld are still very much less than wewant, particularly in some parts of theworld where the natural disease problemsmay occur earliest.”

Advancing global health is a matter ofenlightened self-interest for the UnitedStates, he said, especially since borders arebecoming less of a barrier to the spread ofdisease. A global economy means people,goods, food—every imaginable form ofanimal and plant—are coming from allcorners of the world. “We cannot assureand protect the health of the Americanpeople unless we have done more to pro-tect the health of people everywhere,” saidDr. Fineberg. “And we need to have sys-tems of cooperation in everything fromsurveillance for potential outbreaks ofinfluenza, for example, to the manage-ment of ill travelers who may be movingfrom one place to another across interna-tional borders.”

Because health represents an interna-tional common aspiration, he added,advancing global health has indirect bene-fits for the U.S. public as well. “The degreeto which we can exert our soft powerthrough science and health is the degreeto which America’s strength and projectionin the world will have benefits in a widearray of interests, from our national secu-rity to our commercial success to ourdesire to promote good government anddemocratic principles around the world,”said Dr. Fineberg. “So America has manyinterests in global health—both for ourown health and for our national interests.”

1 National Academies Press Web site. www.nap.

edu/catalog.php?record_id=9728#description.

2 Institute of Medicine Web site. www.iom.

edu/CMS/3809/4660/12313.aspx.

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KEYNOTE SPEAKER

Keynote Speaker, continued from page 4

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 theglobal burden of eye disease. (Event Code 457, $35.)

G L O B A L E Y E M . D . S

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NOTABLE HONORS

The Academy’s 2008 president, DavidW. Parke II, MD, has extended aninvitation to three individuals who

have made significant contributions toophthalmology and the Academy to be his Guests of Honor at this year’s JointMeeting. He also is pleased to announcethe recipient of this year’s DistinguishedService Award. These honorees and othersare recognized during the Opening Ses-sion, which takes place Sunday from 8:30to 10 a.m. in the Hall A-3 Session Room.

THREE GUESTS OF HONORTHOMAS M. AABERG SR., MD, MSPH,FACSThe Academy is pleased to recognize Dr.Aaberg Sr. as a Guest of Honor for hiscontributions to ophthalmology as anoutstanding contributor to the art and sci-ence of vitreoretinal disease and surgeryand as a superb teacher and role model.

A graduate of Dartmouth College, Dr.Aaberg received his medical degree fromHarvard Medical School and completedhis residency in ophthalmology at theMassachusetts Eye and Ear Infirmary. Hethen worked in the U.S. Public Health Ser-vice for two years and graduated from theUniversity of Oklahoma with a Master ofScience in Public Health before starting an 18-month fellowship in retinal diseaseand surgery at Bascom Palmer Eye Insti-tute. While in Miami, he collaborated withRobert Machemer in developing a primatemodel to study the histopathology of reti-nal detachment and giant retinal tears.They also worked together in developingearly instrumentation and techniques forvitreous surgery. Upon completing his fel-lowship, Dr. Aaberg became assistant pro-fessor of ophthalmology and director ofthe retina service at the Medical College of Wisconsin, remaining on the faculty fornearly 18 years. Under his direction, theMilwaukee vitreoretinal fellowship train-ing program became one of the top-ratedprograms in the country, with graduatesof the program directing vitreoretinal sec-tions and departments nationwide.

In 1988, Dr. Aaberg was appointedchairman of ophthalmology at EmoryUniversity School of Medicine, as well asPhinizy Calhoun Sr. Professor of Ophthal-mology and director of the Emory EyeCenter. He built on the work of his prede-cessors to develop the Emory departmentof ophthalmology into a nationally respect-ed and highly ranked program in clinicalophthalmology, with an extensive scientif-ic faculty. He has personally been involvedin the training of 62 vitreoretinal fellowswho are in academic or private practicethroughout the United States and Canada.These fellows revere him for his kindness,clinical acumen, skill as a surgical instruc-tor and unwavering concern for patients.

Dr. Aaberg was senior associate editorof the American Journal of Ophthalmologyfrom 1982 to 2002 and is past president ofthe Macula Society and of the Associationof University Professors of Ophthalmology.He is a member or past member of theAmerican Ophthalmological Society,American Board of Ophthalmology, Asso-ciation for Research in Vision and Oph-thalmology, American Medical Association,American Eye Study Club, Pan-AmericanOphthalmological Society, Club JulesGonin, Retina Society and American Soci-ety of Retina Specialists.

The focus of Dr. Aaberg’s surgical andresearch activities has been the manage-ment of complicated retinal detachmentand diabetic retinopathy, but he also has astrong interest in medical retinal disorders.His main career interest, however, has beenteaching. He has been honored with clini-cal teaching awards from residents at theMedical College of Wisconsin and at EmoryUniversity School of Medicine, where in2006 the annual clinical teaching awardwas named the Thomas M. Aaberg Sr.,MD, Clinical Teaching Award.

The Academy expresses its admirationand gratitude for Dr. Aaberg’s many con-tributions to ophthalmology and wel-comes him as a Guest of Honor in 2008.

DOUGLAS D. KOCH , MDDr. Koch is honored by the Academy forhis contributions to ophthalmology as amentor, investigator and clinician. Hiscolleagues hold him in the highest esteemfor his professional leadership and hispersonal traits of humanism, humilityand integrity.

Dr. Koch was born and raised in PortHuron, Mich., and graduated from Har-vard Medical School in 1977. He complet-ed residency training in ophthalmology atthe Cullen Eye Institute, Baylor College ofMedicine, in 1981. He completed fellow-ship training in refractive and cataractsurgery at Moorfields Eye Hospital and inthe United States under the guidance ofDavid McIntyre, James Rowsey and Clif-ford Terry.

In 1982, Dr. Koch joined the depart-ment of ophthalmology at the Cullen EyeInstitute, Baylor College of Medicine. Hewas promoted to associate professor in1991 and to full professor in 1998. In 1999,he received the Allen, Mosbacher and LawChair in Ophthalmology. He served asdirector of residency training from 1992to 1996.

Dr. Koch’s clinical and research inter-ests are in cataract and refractive surgery.His primary areas of interest have includ-ed astigmatism analysis and management,corneal topography, wavefront technology,surgical techniques, prevention of compli-cations, intraocular lens calculations and

surgical instrument design. His engagingstyle, command of the literature and prag-matic approach to complex clinical prob-lems have made him an extraordinaryteacher and role model.

Dr. Koch was associate editor of theJournal of Cataract and Refractive Surgeryfrom 1994 to 2001 and co-chief editorfrom 2001 to 2007. He is a past presidentof the American Society of Cataract andRefractive Surgery and of the InternationalIntraocular Implant Club. He is now amember of both the council of the Ameri-can Ophthalmological Society and theexecutive committee of the AmericanSociety of Cataract and Refractive Surgery.

Dr. Koch combines expertise in medi-cine with expertise in music. He playstrumpet in both the Houston Brass Bandand a brass choir. Dr. Koch is president ofthe Bach Society of Christ the King Luther-an Church in Houston and a member ofthe boards of the Houston Brass Band andthe Holocaust Museum in Houston.

Dr. Koch is honored today for his dedi-cation to our specialty. It is with pride andpleasure that the Academy welcomes Dr.Koch as a 2008 Guest of Honor.

DAVID W. PARKE SR . , MDThe Academy is proud of the accomplish-ments of Dr. Parke Sr. and is delighted towelcome him as a 2008 Guest of Honor.His dedication to education and advocacyhas benefited not just his patients but allof ophthalmology.

Dr. Parke received his medical degreefrom College of Medicine, Ohio StateUniversity and his residency in ophthal-mology from the Wilmer Institute, JohnsHopkins Hospitals. His fellowship in ophthalmic pathology was at the ArmedForces Institute of Pathology in Washing-ton, D.C. He served as chief of ophthal-mology at Meriden-Wallingford Hospital(now MidState Medical Center) for 27years, was chief of medical staff there as well, and later served as an elected regu-lar member of its board of directors.While a consultant in ophthalmology at Gaylord Rehabilitation Hospital, Dr.Parke cofounded its closed head trauma

unit. He maintained an active compre-hensive ophthalmology practice until1988.

In a brief “retirement,” he retrained inlow vision and has since devoted his life to promoting low vision rehabilitation.He is serving now as associate clinical pro-fessor at Yale University and as director oflow vision rehabilitation at both Yale EyeCenter and Masonicare.

Dr. Parke’s incisive analytical abilityand strong organizational skills havemade him a popular choice for leadershipin every organization to which he hasbelonged, and his involvement in orga-nized ophthalmology has been extraordi-nary. He has been an active member of theAcademy for more than 50 years and hasgreatly enriched the Academy with hisknowledge and guidance through com-mittee service on the Academy’s Council,Committee on National GovernmentalRelations, Academy Seniors (formerly theSenior Ophthalmologist Interest Group)and Committee on State Affairs (which hechaired for six years). He is currently edi-tor of Scope, an Academy quarterly forsenior ophthalmologists.

At the state level, Dr. Parke has servedseveral terms as president of the Con-necticut Society of Eye Physicians as wellas 10 years as chairman of the Committeeon Legislation for the Connecticut StateMedical Society. He is a member or pastmember of the editorial board of Con-necticut Medicine, the executive commit-tee and ophthalmology advisor of LionsLow Vision Centers of Connecticut, theboard of Connecticut Lions Eye ResearchFoundation and the Committee on Accessto Care of Uninsured and Underinsured,State of Connecticut.

Dr. Parke’s career reflects his involve-ment and generosity in volunteering histime and talents to the development oforganized ophthalmology. He has been atireless champion of low vision patients inConnecticut and throughout the country.Through the Lions and Masonic organiza-tions, he has helped develop low visionclinics in Connecticut and has kept a reg-ular schedule as a volunteer, providing his

SPECIAL AWARDS

The Academy Recognizes Contributions in the Field

HONOREES. The 2008 President’s Guests of Honor are Dr. Aaberg Sr., Dr. Koch andDr. Parke Sr. This year’s Distinguished Service Award goes to the Knights TemplarEye Foundation.

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expertise in directing many of these clin-ics. He also serves as a consultant on lowvision to several national organizations.

Dr. Parke continues to play an activerole in teaching and serving the commu-nity and almost never refuses an opportu-nity to speak on behalf of low vision reha-bilitation, medical professionalism oraccess to care for the uninsured.

The Academy is pleased to acknowledgeDr. Parke’s many contributions and wel-come him as a Guest of Honor.

DISTINGUISHED SERVICE AWARDKNIGHTS TEMPLAR EYE FOUNDATIONThe Academy recognizes the KnightsTemplar Eye Foundation as the recipientof the Distinguished Service Award for itscontributions to the prevention of blind-ness through its innovative foundationservices available to patients and ophthal-mologists.

The Knights Templar Eye Foundation,the major charity of the Grand Encamp-ment of Knights Templar of the United

States of America, was chartered in 1956in Maryland with the ultimate goal of pre-venting blindness. Its mission is to pro-vide assistance to those who need sight-saving surgical treatment. Assistance isprovided without regard to race, color,creed, age, sex or national origin to thosewho are unable to pay or who do notreceive adequate assistance from govern-ment or other agencies. The foundationalso provides funds to support promisingvision research projects.

The Knights Templar is part of theMasonic Fraternity, with membersthroughout the United States and manyother countries. It has been funded byannual assessments from the members of the Knights Templar, donations by theindividual Knights Templar, local fund-raising efforts by the Knights Templar,estates, trusts and insurance policies, andsome grants from charitable foundations.

Since its inception, the Eye Foundationhas handled in excess of 84,000 patientcases and disbursed more than $104 mil-lion to health care providers. Patient casesare sponsored by the local volunteerKnights Templar organizations. Seventy-five percent of all foundation expendi-tures are paid to health care providers,13 percent fund vision research, and only12 percent support administrative andprinting expenses. Together with ophthal-mologists, hospitals and other health careprofessionals, the Eye Foundation contin-ues to provide critical assistance in theprevention of blindness.

The Knights Templar Eye Foundationresearch grant program has a particularfocus on pediatric ophthalmology. To date,the Eye Foundation has awarded in excessof $10 million to young investigators forboth clinical and basic research to impactthe care of infants and children.

The Knights Templar Eye Foundationalso supports America’s seniors as a co-sponsor with the Foundation of the Amer-ican Academy of Ophthalmology in itsEyeCare America–Seniors EyeCare Pro-gram.

The Academy is honored to present theDistinguished Service Award to the KnightsTemplar Eye Foundation. This award paystribute to the foundation’s boundless con-tributions to ophthalmology and to itsadvocacy on behalf of patients worldwide.

8 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

Follow your ethical compass to thesesessions. Each offers one hour of ethics-specific CME credit.

Everyday Ethics: Practical Case StudiesFrom the Ethics Committee FilesEvent Code 195, $35, Sunday, 11:30a.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 3p.m.

Breakfast With the Experts—InternationalOphthalmology and Codes of EthicsEvent Code B111, $40, Sunday, 7:30 to8:30 a.m.

Breakfast With the Experts—MarketingYour Practice EthicallyEvent Code B282, $40, Monday, 7:30to 8:30 a.m.

Breakfast With the Experts—Expert Wit-ness Testimony: What You Should Know Event Code B474, $40, Tuesday, 7:30to 8:30 a.m.

E T H I C S C O U R S E S

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CARTER CENTER

Founded in 1982 by former PresidentJimmy Carter and his wife, Rosalynn, TheCarter Center, in partnership with EmoryUniversity, nurtures no small goals. Itsmission is defined by a “fundamentalcommitment to human rights and thealleviation of human suffering,” and“seeks to prevent and resolve conflicts,enhance freedom and democracy, andimprove health.”

Although that task might seem Sisyph-ean at times, The Carter Center has beensuccessful at identifying and interveningin many health problems that are not onlytreatable but also preventable—and doingso among some of the poorest people ofAsia, Africa and Latin America. Seventynations around the world have benefitedfrom Carter Center initiatives.

Projects to fight trachoma and oncho-cerciasis, diseases that have stolen the sightof nearly 8 million people and visited havocon communities where they’re endemic,

are examples of The Carter Center’s work.Here is a brief report on progress TheCenter has made, in alliance with otherorganizations, in battling these diseases.

TRACHOMA: The Leading InfectiousCause of BlindnessAn infection caused by the bacteriumChlamydia trachomatis, trachoma affectsmore than 80 million people in 56 coun-tries. “Trachoma was a major problem in Europe and here in the U.S. until the1950s when it disappeared in the face ofimproved hygiene and sanitation,” saidPaul Emerson, PhD, director of The CarterCenter’s Trachoma Control Program. Butin addition to the millions affected byactive trachoma, another 500 million inthe developing world are living at risk ofcontracting trachoma. The Carter Center’spresent goal is not to eradicate the diseasecompletely but to eliminate blinding tra-choma, the late stage of the disease.

STAGES OF TRACHOMA. Infection with C. trachomatis may be mild and resolvewithin weeks. However, sometimes itleads to severe inflammation, causingpain, photophobia and a white, waterydischarge. Repeated reinfection forms anetwork of scars that contract, shorteningthe palpebral conjunctiva. Over time, theeyelid turns inward, transforming once pro-tective eyelashes into lacerating “thorns.”The result is trichiasis—or, as the Ethiopi-ans say, “hair in the eye.” Some pluck theireyelashes to relieve the pain, but the respiteis brief since bristly lashes quickly regrow.And because they are stubble, they don’tbend easily, and abrade the cornea.

Women are around three times as likelyas men to develop trichiasis. “It’s generallybelieved that children are the reservoir,”said Dr. Emerson. “Because of their role ascaregivers—particularly sharing a bed withyoung kids who have trachoma—womenget more frequent, repeated infections andmore scarring.” Disabling pain makes itdifficult to work and perform householdchores—cooking over fires, collecting waterin the sun, farming in dry, dusty environ-ments. This magnifies the disease’s annualeconomic impact, estimated at $2.9 billion.

“Blindness in trachoma is caused by acombination of physical damage to thecornea from aberrant lashes and infectionby many other opportunistic pathogensbecause the corneal epithelium is compro-mised by the scratching,” said Dr. Emerson.Sight can only be restored by corneal trans-plants—virtually unheard of in the devel-oping world.

A “SAFE” APPROACH. Fortunately, a strat-egy developed by the World Health Orga-nization and adopted by countries in whichthe disease is endemic is helping to elimi-nate blinding trachoma. Implemented byThe Carter Center and its partners, thestrategy involves a four-pronged approach:surgery, antibiotics, facial cleanliness andenvironmental improvements, or “SAFE.”Dr. Emerson says the approach has beenparticularly successful in Ethiopia. AndGhana may become the first country insub-Saharan Africa to apply for WHOcertification showing it has eliminatedblinding trachoma. Following are somedetails of the rationale behind SAFE.

BLINDING DISEASE UNDER SIEGE. Four years in the

White House and a Nobel Peace Prize were not enough for Jimmy Carter and

his wife, Rosalynn. Now they are working to eliminate preventable blindness

around the world.

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ATLANTA’S CARTER CENTER

From U.S. president to Nobellaureate to elder statesman,Jimmy Carter has been trying to reverse the inter-national tragedies of poverty, war and disease.

in the Poorest of the Poor

Saving Sight

Above, a man in Ethiopia blinded by onchocerciasis (river blindness). Merck has donatedits microfilarcidal drug ivermectin for the treatment and prevention of river blindnesssince 1987. Right, to relieve the suffering and the risk of blindness associated with tra-choma, fairly simple lid surgery can be performed in the community or at rural healthcenters.

by annie stuart, contributing writer

Page 10: Academy News from AAO 2008 Atlanta

� Surgery. Although surgery can’t undocorneal damage, it can relieve pain andstop further injury. Requiring little train-ing and only $10 in materials, a 15-minuteoperation can be performed by ophthal-mic nurses or trained health workers, saidDr. Emerson. After injecting the eyelid withlocal anesthetic and positioning a retrac-tor, the health worker makes a small inci-sion along the tarsal conjunctiva at the lidmargin. The side of the lid fringed witheyelashes is lifted outward; then the twosides are stitched together in the outfrac-tured position. This relieves tension onthe damaged eyelid and prevents eyelashesfrom scraping the cornea.� Antibiotics. With the help of the Lions

Clubs International Foundation, millionsof doses of azithromycin (Zithromax),which is manufactured by Pfizer, havebeen distributed to trachoma-affectedcommunities. All told, Pfizer has donatedaround 135 million doses.� Facial cleanliness. Discharge from eyesand noses attracts flies, which can transmitthe infection, and wiping or rubbing faceswith infected hands or materials can alsoquickly transmit the disease. Therefore,an essential part of the SAFE campaign ispromotion of cleanliness.� Environmental improvements. Amongother changes, construction of pit toiletsis essential to eliminate Musca sorbens, afly that breeds in human feces and swarmsaround eyes and noses, feeding on mois-ture and infecting eyelids and then trans-mitting the infection. Reducing the vector’sbreeding ground could stem the tide oftrachoma. In early 2002, The Carter Centerbegan training masons, providing materi-als and supervising the construction ofhousehold latrines. With sanitation anational priority and the infrastructure in place to deliver behavior change andhygiene promotion, Ethiopia increasedlatrine coverage on a district level from 4to 60 percent within just a couple of years,said Dr. Emerson. There and elsewhere,women have taken the lead, helping buildhundreds of thousands of latrines.� Added benefits. Although difficult tomeasure, the collateral benefits of SAFEare many, said Dr. Emerson. “It is not onlytaking care of trachoma, it’s like a guerillaaction for development—freeing commu-nities from a number of neglected tropicaldiseases,” he said.“I think the future is verybright for a world free of blinding tra-choma, provided we can keep the pressureon and continue delivering the programs.”

ONCHOCERCIASIS: Blindness by aThousand BitesOnchocerciasis, also called river blindness,

is spread through the bites of another flyspecies, Simulium damnosum. The fly is a host for Onchocerca volvulus, a parasitethat takes up residence under the skin forseven to 15 years. The females can producethousands of offspring (microfilariae),which migrate to the upper layer of skin,where they cause intense itching whenthey die. These tiny parasites also canmigrate into the eye, causing inflamma-tion, irritation and diminished vision.

PATHOLOGY FROM PESTS. “The microfilariaecause an immune response in the eye,which leads to an opaque cornea,” said Dr. Emerson. The second leading cause ofinfectious blindness, onchocerciasis resultsfrom not just one but hundreds—some-times thousands—of bites by infectedflies. Named for the fast-flowing streamswhere the black flies breed, river blindnesshas infected 17.7 million people world-wide, visually impairing a half-millionand blinding more than a quarter million.Endemic in 37 countries—mostly in Africa—river blindness has forced farmers toabandon fertile bottomlands.

In the 1980s, Merck developed a micro-filarcidal drug, ivermectin (Mectizan), andbegan donating it free for treatment andprevention of river blindness in 1987—foras long as is needed. The Carter CenterRiver Blindness Program has assisted inadministering more than 100 million treat-ments in both Africa and the Americas.

REALISTIC GOAL SETTING. In Africa, where

90 million are at risk, the goal is control of onchocerciasis through annual drugadministration of ivermectin. In theAmericas, where about 500,000 people areat risk in six countries, the goal is moreambitious: The Carter Center is leading amultinational partnership, which includesLions Clubs, to completely eliminate thedisease by administering ivermectin everysix months. No new cases of blindness fromthe disease have surfaced in the Americassince 1995.“It looks like blinding onchocer-ciasis is history in the Americas now,”said Dr. Emerson. “And with a concertedand continuous effort, particularly in theAmazon region of Venezuela, transmissioncan be halted.” The goal is to declare thedisease in Latin America eradicated by2012—and that appears to be right onschedule, said Dr. Emerson.

For more information on The Carter Center,

visit www.cartercenter.org.

10 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

CARTER CENTER

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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 andeventually leading to irreversible blindness. Above right, trained examiners assess eyelidsto determine the grade of trachoma.

Above, a Sudanese girl takes a dose ofbanana-flavored azithromycin, donated byPfizer, to protect herself from the bacteriumthat causes trachoma. Young children carrythe highest burden of active infection andannual mass distribution of antibiotics is recommended for communities wheremore than 10 percent of young childrensuffer from the disease.

Above, health workers in Latin Americadistribute ivermectin in a campaign toeradicate onchocerciasis.

VOLUNTEERWant to help provide eye care in devel-oping nations? See page 17 for a list ofevents and other resources.

Page 11: Academy News from AAO 2008 Atlanta

e y e n e t ’ s a c a d e m y n e w s 11

SilverScreen

CATARACTScleral Fixation Without Conjunctival Dissection(V4; 10 minutes)In this film, Hoffman and colleagues showhow a new technique for scleral fixationutilizes a scleral pocket originating from aclear corneal incision. Conjunctival dissection, scleral cautery

and sutured wound closure are eliminated

and suture knots are safely covered withthe roof of the scleral pocket.■ Theater screening times: Sunday—4:06p.m.; Monday—4:51 p.m. and Best of Showscreening (see intro).

Capsular Tension Ring Complications and Fish-Tail Technique for Stress-FreeInsertion(V11; 11 minutes)

In this film, Angunawela and colleaguespresent a new fish-tail technique for theinsertion of a capsular tension ring in thesituation of capsular instability arisingfrom zonular insufficiency. Insertion of a capsular tension ring can

at times be difficult and give rise to furthercomplications. The fish-tail techniqueallows placement of the tension ring without the need for dialing or injection,thereby avoiding further tangential stresseson the zonules. ■ Theater screening times: Sunday—10:42a.m.; Monday—9:27 a.m. and Best of Showscreening (see intro); Tuesday—10:13 a.m.

Understanding the Dropped Nucleus(V1; 10 minutes)It is well-known that the dropped nucleusis a serious complication of contemporarycataract surgery. In this video, Osher and colleagues

review a cadaver eye study designed tounderstand why the nucleus drops. Fac-tors evaluated include gravity, high infu-sion pressure, turbulence, pressure gradi-ent, excessive manipulation, machineparameters and the role of the vitreous,among others.

■ Theater screening times: Sunday—3:36p.m.; Monday—4:21 p.m. and Best of Showscreening (see intro).

CORNEAEndothelial Keratoplasty: Please Don’t Fold(V14; 10 minutes)The current method of donor insertion inDescemet’s stripping automated endothe -lial keratoplasty requires folding andunfolding donor tissue, which damagesendothelium. In this short video, Tan and colleagues

present a pull-through, gliding techniquethat is less traumatic to endothelium andreduces primary graft failure rates. This method utilizes a purpose-designed

microforceps, which is employed to pull apreviously dissected graft into the anteriorchamber over a viscoelastic-coated IOLglide. As a result, their experiences with pri-

mary graft failures have decreased from 20 to 1.7 percent, and endothelial countshave improved.■ Theater screening times: Sunday—11:15 a.m.; Monday—10 a.m. and Best of Show screening (see intro); Tuesday—10:46 a.m.

BEST VIDEOS

ATTEND THE “BEST OF SHOW VIDEO AWARDS” CEREMONY.The highlight of this year’s video program will be the Best of Show awards

ceremony. It takes place in the Video Theater on Monday at 12:15 p.m., and

will be followed by a special screening of the seven Best of Show videos.

Video Theater hours. It will be open Sunday from 10 a.m. to 5 p.m., Mon -day from 9 a.m. to 5 p.m. and Tuesday from 9 a.m. to 3 p.m. Check yourFinal Program (page 281) for a full schedule of all 39 films.

Where is the Video Theater? It is located in Hall A-3.

Videos on Demand. Watch what you want, when you want. Look for the monitors that are located in Halls A-2 and B-5. You can search the videoprogram by subspecialty, video title, video number or key word.

SURGEONS OF THE

Cataract: Video V4 Cataract: Video V11 Cataract: Video V1 Cornea: Video V14

This year, seven videos from four subspecialties were chosen as “Best of Show” and will be honoredat Monday’s awards ceremony. The full video programfeatures 39 short films from nine subspecialties.Glaucoma:

Video V23

Page 12: Academy News from AAO 2008 Atlanta

12 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

Deep Anterior Lamellar Keratoplasty Using the “Big-Bubble Technique” inHurler-Scheie Syndrome(V19; 11 minutes)In this film, Sharma and colleagues per-form deep anterior lamellar keratoplastyusing the big-bubble technique bilaterallyin a patient with Hurler-Scheie syndrome. Because of the sparing of Descemet’s

membrane and a decreased chance of glau -coma, deep anterior lamellar keratoplastyis one of the safest options in cases of

Hurler-Scheie syndrome. The big-bubbletechnique includes a 7.5-mm trephinationat a depth of 300 µm and a 27-gauge needleused to inject an air bubble between Des -cemet’s membrane and the host cornealstroma. After the debulking of the anteriortwo-thirds of the corneal stroma, anopening is created in the stromal tissue. Following air egression from the inci-

sion site, viscoelastic is then injected in thesupernumerary space above the membranealong with quadrantic splitting and exci-

sion of the stromal layers. Finally, a 0.5-mm oversized donor lenticule is secured.At three years, the patient’s best correctedvisual acuity was 20/40 in both eyes.■ Theater screening times: Sunday—noon;Monday—10:45 a.m. and Best of Showscreening (see intro); Tuesday—11:31 a.m.

GLAUCOMALate Secondary Angle-Closure GlaucomaFollowing DSEK and Its Management(V23; 10 minutes)Basak and colleagues demonstrate aunique late complication of Descemet’sstripping endothelial keratoplasty. Fiveout of 104 patients presented with acutepain and visual loss in the operated eyethree to 18 weeks after the procedure.There was 360-degree adhesion betweendonor lenticular edge and the iris in allcases, causing secondary angle-closureglaucoma. Endothelial cell density wasmeasured after controlling the IOP. Sim-ple mechanical separation of the irido-donor lenticular adhesion was performedwith Sinsky’s hook in two cases where theendothelial cell density was good. Donorreplacement was done in three caseswhere the density was poor.■ Theater screening times: Sunday—12:45 p.m.; Monday—11:30 a.m. and Bestof Show screening (see intro); Tuesday—12:16 p.m.

PEDIATRICSThe Surgical Correction of the PalpebralFissure Narrowing and the Vertical Devia-tion on Adduction in Duane Syndrome(V30; 11 minutes)In this film, Lee and colleagues introducea new technique of correcting specificcharacteristics in Duane syndrome that is an efficient and less-invasive procedurefor improving ocular alignment. Theyreport two type 1 Duane syndromepatients with upshoot or downshoot onadduction. The lateral rectus muscle wasdisinserted and reattached to the adjacentposterior tenon. The patients were treatedwith partial tendon transposition of thevertical rectus muscles augmented withFoster fixation.Lateral rectus posterior tenon fixation

markedly reduced co-contraction andglobe retraction. Palpebral fissure widenedon adduction. Also, all patients demon-strated a marked decrease in the upshootor downshoot and improvement ofabduction after surgery. ■ Theater screening times: Sunday—1:53p.m.; Monday—2:38 p.m. and Best of Showscreening (see intro); Tuesday—1:24 p.m.

B E S T V I D E O S

Cornea: Video V19

Pediatrics: Video V30

Page 13: Academy News from AAO 2008 Atlanta

QUICKER CODING. With detailed con-tent on each CPT code that relates to oph-thalmology, Coding Coach is the mostcomprehensive reference available. The2009 edition will be available as both abook and a CD-ROM.

EVERYTHING AT A GLANCE. To illustratehow Coding Coach will help your practiceto code more accurately and efficiently,consider CPT codes 65780 to 65782 (see sample page). On one page, you haveeight key sets of information at your finger-tips:

For each procedure, CodingCoach lists two numbers in the

relative value units (RVU) column—onefor when the procedure is performed in theoffice; the other for when it is performedin a facility. This enables you to verifywhether there is a site-of-service differen-tial where you may be paid a higher amountin your office than when the procedure isperformed in the hospital. And when youperform different procedures in the sameoperative setting, the codes with the high-est RVUs should be listed first—and Cod-ing Coach provides an easy way to seewhich code that would be.

(Note: the RVUs listed here are reprint-ed from the 2008 Coding Coach. Thosevalues may change in 2009.)

Coding Coachlists the global

surgical period for both Medicare and pri-vate payers. Note that while Medicare rec-ognizes a minor surgical period of one or10 days, private payers recognize a 0-, 10-or 15-day global period. For major sur-geries, Medicare recognizes a 90-day glob-al period, while private payers recognize a 45-, 90- or 120-day global period.

The final columnunder each code

indicates whether or not an assistant atsurgery may be a covered benefit.

The Correct Coding Initia-tive (CCI) edits are codes

that have been deemed not separatelypayable when performed in the sameoperative session. If you overlook thesebundling edits and submit two claims thatare mutually exclusive, the carrier will paythe primary code. In the case of compre-hensive codes, the insurance company willpay for the lesser dollar amount of the twobilled codes. By listing the CCI edits foreach procedure, Coding Coach helps youto avoid making these mistakes.

For each code,Coding Coach pro-

vides the AMA’s official description, alongwith a layperson’s definition.

Each of the codingexperts who contrib-

uted to Coding Coach has at least 18 yearsof experience in the field. The “CodingClues” section allows you to tap their dis-tilled wisdom.

For such petite codes—just two digits long—

modifiers can cause big problems. Thetrouble is that there are dozens to choosefrom, and the wrong choice can lead todenied claims, lost reimbursement and, inthe worst cases, an audit. By listing whichmodifiers apply to a particular procedure,Coding Coach allows you to apply themwith confidence.

To ensure that you are paid for a

procedure, you must record a symptom,diagnosis or complaint that provides justification for performance of that pro-cedure.

For each CPT code, Coding Coach liststhe ICD-9 codes that would establish this“medical necessity.”

HOW TO BUY IT. Visit the Academy ResourceCenter (Booth #3532) to place an advanceorder for next year’s Coding Coach. As abook (Product #012354) or a CD-ROM(#012355), it costs $195 for members;$263 for nonmembers. Or buy bothtogether and get a 30 percent discount(#012356) at $275 for members and $368for nonmembers. This product is expect-ed to ship by Jan. 31.

e y e n e t ’ s a c a d e m y n e w s 13

2009 CODING COACH

A handy reference to improve coding accuracy

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.

Code This Case features examples of sur-gical cases and provides the appropriateCPT, ICD-9 andHCPCS coding for surgeons, aswell as coding for ambulatory surgical centers. It also providesexamples of oper-ative reports thatwill be instructivefor the young ophthalmologist. Code ThisCase (Product #012357) costs $145 formembers and $175 for nonmembers.

S u r g i c a l C o d i n g

3 Assistant at Surgery

5 Defining the Code

4 CCI Edits

2 Global Surgical Period

1 RVUs

6 Coding Clues

8 Diagnosis Codes

7 Modifiers

Speed-UpYour Coding

1 2 3

4

57

8

6

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e y e n e t ’ s a c a d e m y n e w s 15

(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) SELFTESTING OPTOMETER, 1880. This box contains several sets of lenses on a rotatingwheel. A person would look through the oculars and turn the wheel to determinewhich lenses improved their eyesight. (3) PERFECSCOPE, 1900. This scope was likelya 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 nodto Victorian aesthetics. (4) TILLYER TRIAL LENS SET, CIRCA 1900. This Victorian triallens set features an unusual painted lid. (5) OPHTHALMOSCOPE, CIRCA 1950. Duringthe early 20th century, the design world became obsessed with the pared-down sim-plicity of International Style. Its clean lines have inspired product design everydecade since. (6) REALIST PROJECTOR MODEL 81, CIRCA 1950. This visual acuity chartprojector exemplifies the Streamlining movement, popular from 1934 to 1959. Thisaesthetic became design shorthand for fast, modern and cool.

2

4

6

The Academy Foundation’sMuseum of Vision (Hall B-4,Booth #3440) explores the cross-

roads of art and medicine with “Eye See-ing Eye: Art and Ophthalmology.” As pro-fessionals devoted to vision and theprevention of blindness, many ophthal-mologists have a special affinity toward

the visual medium of art. Not surpris-ingly, artistic movements have signifi-cantly influenced the design of diagnosticand surgical instruments.

The museum has therefore created anexhibit specifically devoted to ophthal-mology and vision. Enjoy a sample ofthese artistically created artifacts below.

THE MUSEUM

ART AND OPHTHALMOLOGY

Eye Seeing Eyeby jenny benjamin, museum director

1

3

5

Page 16: Academy News from AAO 2008 Atlanta

16 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

From its Victorian homes to its eth-nic neighborhoods to its sweepingvistas of the Pacific Ocean, San

Francisco is a treasure trove of sights andsounds. For decades, the city’s mixture oftemperate climate, cultural diversity andnatural beauty has made it one of the toptourist attractions in the United States.

As host to the 2009 Joint Meeting ofthe Academy and the Pan-American Asso-ciation of Ophthalmology, San Franciscooffers something for every visitor. Withsuch a diverse array of attractions, it canbe overwhelming to select a few sites tosee during your downtime or after meet-ing hours. EyeNet spoke to city residentsRichard L. Abbott, MD, and Susan H.Day, MD, to get the inside scoop on thebest places to spend time in San Francisco.

FERRY BUILDING MARKETPLACE. Uniquesights and cuisine await at the Ferry Build-ing. On Saturday morning, the market-place is host to a farmers’ market thatoffers certified organic produce and flow-ers, as well as regional artisan specialtiessuch as breads, cheeses and jams. Insidethe Ferry Building is the Nave, an impres-sive indoor street that showcases a rangeof food and wine specialty shops sellingeverything from gourmet teas to gelato, aswell as several top-of-the-line restaurants.“It’s such a fun scene,” said Dr. Day. “Theproduce is amazing, and the specialty shopsare extraordinary. It’s also a great place topeople watch.” The building’s beautifulclock tower has come to define the SanFrancisco waterfront. Jetting 240 feet intothe sky, the tower was part of the FerryBuilding’s original 1898 design and wasintended to be a beacon to those whotraveled to the city by water. For more infor-mation, visit www.ferrybuildingmarketplace.com.

CRISSY FIELD AND THE GOLDEN GATEBRIDGE. The restored Crissy Field, a uniqueand lovely park near the Golden GateBridge, features a flat, hard-packed prom-enade perfect for walking or biking, as wellas a beach in the midst of the city. Thewaves deposit crab shells, jellyfish andpebbles to examine, and there are drift-wood “seats” for picnics and shorelinecontemplation. East Beach is one of themost popular and challenging windsurf-ing and parasailing sites in the world. “Ifyou’re a jogger, there’s no better or morebeautiful place than Crissy Field,” notedDr. Day. You also can rent a bike on near-by Lombard Street to view Crissy Field aswell as the streets and Victorian houses ofnearby Russian Hill.

Another treat is to take a long walk orbike ride along the waterfront, past a wild-life preserve and windsurfers, and end upjust beneath San Francisco’s architectural

wonder, the Golden Gate Bridge. For moreinformation, visit www.crissyfield.org.

NEIGHBORHOODS OF SAN FRANCISCO. Oneof the sheer joys of visiting San Franciscois walking the hills of the city and viewingthe sights and scenes of its ethnic neighbor-hoods.“At the top of every hill is a wonder-ful vista,” said Dr. Day. “Walking throughthe city is a great way to view the bay, theparks and the urban beauty of this city.”However, be sure to bring comfortablewalking shoes, Dr. Day cautioned. Someof the neighborhoods that Dr. Abbottlikes to visit are North Beach, which is theItalian section of the city, famed for itscoffee shops and neighborhood bakeries,and Chinatown, where tourists and citydwellers alike sample the wares of neigh-borhood merchants, including clothing,jewelry, produce and fresh fish. Dr. Dayrecommends a walk down Stockton Streetin Chinatown, where the locals shop. “Itwill transport you to China itself,” shesaid.

Another wonderful neighborhood isthe Mission district, the Hispanic neigh-borhood that surrounds the historicalMission Dolores, founded in 1776. Theoldest intact building in San Francisco,the beautiful mission is still a lively parishand “gives you a view of California’s earlydays and the Spanish influence that was soimportant here,” said Dr. Abbott. SanFrancisco City Guides offer free walkingtours of many neighborhoods, rangingfrom Chinatown to North Beach to NobHill, as well as the Ferry Building. For

more information, visit www.sfcityguides.org.

THE MARIN HEADLANDS. The attractionsof the Marin Headlands include vast num-bers of hiking trails, beautiful beaches, the150-year-old Point Bonita lighthouse andpanoramic views of the coast and the city—all only a 20-minute drive from SanFrancisco. “There are several hikes aroundthe Marin Headlands that are amazing,”said Dr. Abbott. “You can hike to an oldWorld War II gun installation and see vis-tas that are fabulous. The Tennessee Valleyhike is also wonderful!” The TennesseeValley Trail goes 1.7 miles down to theTennessee Beach, and there are also hikesfor the more adventurous to the hills above.After spending time in the Headlands,you can finish your day with dinner at a

restaurant in picturesque Sausalito, hometo San Francisco’s houseboat community,or Dr. Abbott’s personal favorite—down-town Mill Valley. “It’s a well-kept secretwith charming shops and terrific restau-rants, all at the foot of Mount Tamalpais.”This 2,571-foot peak—replete with oakwoodlands, redwood groves and sweepingviews of the surrounding hills and cities—is well worth an outing as well. For moreinformation, visit www.nps.gov/goga/marin-headlands.htm and www.parks.ca.gov.

Dr. Abbott is a health science clinical profes-

sor of ophthalmology at the University of Cal-

ifornia, San Francisco. Dr. Day is chairwoman

and program director of ophthalmology at the

California Pacific Medical Center.

2009 PREVIEW

NEXT YEAR THE CITY BY THE BAY PLAYS HOST

Two Local Ophthalmologists on the Sights of San Franciscoby barbara boughton, contributing writer

SAN FRANCISCO IS A WORLD-RENOWNED TOURIST DESTINATION. Discover the city’s mix of historic landmarks, cosmopolitan cultureand eclectic cuisine when you visit for next year’s Joint Meeting.

The Joint Meeting of the Academy and thePan-American Association of Ophthalmol-ogy will take place in San Francisco,Oct. 24 to 27. It will be preceded bySubspecialty Day, Oct. 23 and 24. Asinformation on the programs for the

Joint Meeting and Subspecialty Day becomes available, it will be published in EyeNetMagazine and on the Academy’s Web site (www.aao.org/2009).

This is only the beginning of things to do while you are in San Francisco. Explore YerbaBuena Gardens, a five-acre park of trees, waterfalls and public art (www.yerbabuena gardens.com). Immerse yourself in the infamy of Alcatraz Island (www.alcatrazcruises.com). View the wide-ranging art collections of the Museum of Modern Art (www.sfmoma.org), the de Young Museum (www.famsf.org/deyoung) and the Legion of Honor (www.famsf.org/legion). For city information, visit San Francisco’s official visitor site at www.onlyinsanfrancisco.com.

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e y e n e t ’ s a c a d e m y n e w s 17

Ever thought of volunteering in devel-oping countries? If you don’t knowhow to get started, the Joint Meeting

is a great place to learn how you can help.ENJOY DEBATES AND DISCUSSIONS AT MON-

DAY’S INTERNATIONAL FORUM. You may findyourself reappraising your thoughts oneye care in developing countries.

In one debate—“Something Is BetterThan Nothing, or Is It?”—MohammedBabar Quereshi, MD, (Pakistan) and PetjaVassileva, MD, PhD, (Bulgaria) will discussthe donation of equipment.

A second debate—“Fee for Service, Yesor No?”—will feature R. D. Thulasiraj,MBA, (India) and Amel Meddeb-Ouer-tani, MD (Tunisia) discussing how tofund eye care.

And in the third debate—“Is the GrassGreener 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 Mondayfrom 8:30 to 11 a.m. in Room B406.

ATTEND AN INSTRUCTION COURSE. Ticketsare available at Ticket Sales in Hall A-2.■ Development of a ComprehensiveHigh-Quality, Sustainable, Rural EyeCare Model in a Developing Country.Learn how institutes in India have usedmanagement principles to develop effec-tive systems and to improve networkingand outreach activities. The goal: financialself-sustainability. (Instruction Course#262; Sunday from 4:30 to 5:30 p.m.; $35.)■ Eyes of Africa. Review ocular pathologyrarely seen in North America, includinganthrax, 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 theorganizations 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 4:30to 5:30 p.m.; $35.)

VISIT THE SCIENTIFIC POSTERS. Two areon display on Sunday—Trachoma Elimi-nation: Solving the Latrine Problem inNomadic Tribes (#PO136) and Risk Fac-tors for Microsporidial Keratoconjunc-tivitis in the Tropics: A Case Series(#PO137). You can talk to the authors onSunday from 12:30 to 2 p.m. in Hall B-5.

Two more Scientific Posters will be ondisplay on Monday and Tuesday—Triam-cinolone-Assisted Needling: A SimpleProcedure to Tackle Posterior CapsularOpacity (#PO429) and Seven-Year Inci-dence of Postoperative Bacterial Endoph-thalmitis in a Costa Rican Teaching Hos-pital (#PO430). You can talk to theauthors on Monday from 11 a.m. to 12:30p.m. in Hall B-5.

BROWSE THE INFORMATIONAL POSTERS.Many of these are presented by organiza-

tions that are seeking volunteers to servethe visually impaired worldwide. Theseare located in Hall B-5.

GO ONLINE FOR THE EYECARE VOLUNTEERREGISTRY. Developed by the Academy’sFoundation, this service will help you to

find a volunteer site in a developing coun-try. Visit www.eyecarevolunteer.org.

BUY THE VOLUNTEER’S HANDBOOK. EyeCare in Developing Nations describes inpractical detail best practices to prevent,treat and surgically correct the major

causes of blindness in developing coun-tries.

To see a sample copy, visit the Acad-emy Bookshelf display at the AcademyResource Center (Hall B-4, Booth #3532),where it also is available for purchase.

HOW TO BE AN INTERNATIONAL VOLUNTEER

Get Tips and Learn Skills for Overseas Service

VOLUNTEER

Page 18: Academy News from AAO 2008 Atlanta

18 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

As the voice of ophthalmology inWashington, D.C., the Academy hasrealized many successes during the

year. These triumphs include equity foreye visit codes resulting in a $154 millionincrease for ophthalmology, significant

expansion of the number of services thatcan be performed (and reimbursed) inambulatory surgical centers and, mostnotably, halting a 10.6 percent Medicarepayment cut last summer and a 5.5 per-cent cut slated for January 2009. Advocat-

ing on behalf of patients and ophthalmol-ogy does make a difference, as proven bythe participation of the Academy’s mem-bers and the leadership of the Academy’sHealth Policy Committee.

Over a two-month period, more than

4,000 ophthalmologists e-mailed andcountless others called their senators, urg-ing them to vote for legislation that wouldstop the devastating physician paymentcuts. In addition, many of the Academy’scongressional advocates used their long-standing relationships with key senatorsto persuade them to override PresidentBush’s veto and vote in favor of physiciansand Medicare beneficiaries. While passageof the new Medicare law guarantees 18months of relative stability for Medicarephysician payments, all physicians arethreatened with additional cuts in January2010. Those 18 months buy time to workwith Congress to develop a plan to replacethe sustainable growth rate (SGR) formu-la for determining physician Medicarepayments. The Academy, the AmericanCollege of Surgeons and other surgicalspecialties have begun discussions aboutnew approaches.

Besides replacing the SGR, other chal-lenges exist for ophthalmology. Come andhear leaders discuss these issues duringthe following free sessions:■ PHYSICIAN PROFILING AND ACCOUNTABILITYExamine profiling and other physicianaccountability initiatives tied to payment,including the outlook for CMS’ MedicarePhysician Quality Reporting Initiative andPhysician Web Compare plan. A newMedicare e-prescribing incentive bonuswill also be highlighted.Monday, 12:15 to 1:45 p.m.Event Code Spe28Room A412■ SURGERY BY SURGEONS FORUMAttend this segment of the Fall CouncilMeeting to learn how scope of practicebattles on both state and federal levels areaffecting all ophthalmologists’ ability todeliver quality eye care.Sunday, 11:30 a.m. to 1 p.m.Event Code Spe14Omni Hotel at CNN Center, Grand Ball-room E■ A GUIDE TO OPHTHALMIC DRUG AND DEVICE EVALUATIONExperts from the FDA will provide anoverview of the ophthalmic device anddrug approval processes. A question-and-answer session will follow.Sunday, 12:45 to 1:45 p.m.Event Code Spe18Room A401■ COMBAT-RELATED RESEARCH OPPORTUNI-TIES IN THE DEPARTMENT OF DEFENSE ANDTHE DEPARTMENT OF VETERANS AFFAIRSExplore combat-related eye and visionresearch opportunities available in theDepartment of Defense and the Depart-ment of Veterans Affairs. There will be aspecial focus on the visual challenges oftraumatic brain injury.Monday, 12:15 to 1:45 p.m.Event Code Spe30Room A401

CODING AND REIMBURSEMENT

Ophthalmologists and Medicare Victories

ADVOCACY

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e y e n e t ’ s a c a d e m y n e w s 19

HONORARY LECTURES

Some of the symposia during the JointMeeting include lectures named forthe profession’s seminal figures.

Catch up on the latest developments inophthalmology while honoring some ofthe most respected names in medicine.

The Monday and Tuesday lectures arehighlighted below, along with backgroundinformation on the speakers and theirthoughts on what lies ahead. Lectures tak-ing place on Sunday were previewed in theFriday/Saturday Academy News.

PARKER HEATH LECTURENancy Nielsen, MD, PhD, will present TheAMA Plan for Health System Reform: TheFuture for Ophthalmologists (9:45 to 9:58a.m.) during the Monday Symposium titledHealth System Reform: Paths and Oppor-tunities for Ophthalmology (8:30 to 10a.m.). This combined meeting with the AMAOphthalmology Section Council takes placein the Thomas B. Murphy Ballroom 4.Note: This lecture was prerecorded and willbe presented on DVD.

ABOUT THE LECTURE. “Rising health carecosts have brought the medical field underattack in recent decades, and most will

agree that the Unit-ed States health caresystem is in need ofa change,” saidNancy Nielsen, MD,PhD. In her lecture,she will outline howthese issues shouldbe approached bythe medical com-munity. “We need toprovide health carefor the uninsured,and the AmericanMedical Associa-tion’s plan is merely

a starting point. There are professionaland ethical challenges ahead for all of usthat must be approached thoughtfully.”

ABOUT THE SPEAKER. Dr. Nielsen is thecurrent president of the AMA, as well assenior associate dean for medical education

at the University of Buffalo. In addition to serving on the Institute of Medicine’sRoundtable on Evidence-Based Medicine,Dr. Nielsen represents the AMA on manyquality-related initiatives, including the National Quality Forum, the AMA

Physician Consortium for PerformanceImprove ment, the Ambulatory CareQuality Alliance and the Quality AllianceSteering Committee. She has collaboratedon the formulation of policy positions fordebates about the diagnosis and treatment

TEN LEADERS IN THE FIELD

Honor Some of Ophthalmology’s Great NamesBY LESLIE BURLING-PHILLIPS AND LORI BAKER SCHENA, CONTRIBUTING WRITERS

The U.S. healthcare system is inneed of change,says AMA PresidentDr. Nielsen.

In 2008, the focus of the Academy’sEyeSmart campaign has been the impor-tance of wearing protective eyewear tohelp prevent eye injuries. Learn more inAtlanta about the new recommendationfor wearing proper eye protection aroundthe 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 forthe first time or ordering additionalmaterials will receive a free pair ofANSI-approved protective eyewear. Formore information on EyeSmart, visitwww.aao.org/eyesmartcampaign.

G E T E Y E S M A R T

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20 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

HONORARY LECTURES

of depression, alcoholism among women,Alzheimer’s disease, priorities in clinicalpreventive services, colorectal cancerscreening, asthma control, the nicotinecontent of cigarettes and others.

CHALLENGES AHEAD. Two of the greatestchallenges ahead for health care are “design -ing a health care program for the unin-sured and financing it,” said Dr. Nielsen.“For example, some are in favor of a single-payer system and others are not. I will dis-cuss the pros and cons of each perspectiveas well as the challenges of meeting theneeds of two distinct populations—those who have insurance through theiremployers and those who do not. Weshould learn from other countries butfashion a uniquely American solution.”

—L.B.P.

Z IMMERMAN LECTURERalph C. Eagle Jr., MD, will present Retino -blastoma: New Developments (9:25 to 9:58 a.m.) during the Monday Symposiumtitled Relevance of Clinical and Pathologi-cal Stag ing of Benign and Malignant Ophthalmic Tumors for the PracticingOphthalmologist (8:30 to 10 a.m.). Thiscombined meeting with the AmericanAssoc iation of Ophthalmic Pathologiststakes place in Room A412.

ABOUT THE LECTURE. Ralph C. Eagle Jr., MD, will discuss a retrospectivehistopathologic review of approximately400 enucleated eyes from retinoblastomapatients who werecared for by the ocular oncology service at the WillsEye Institute—astudy designed toassess the incidenceof high-risk histo -pathologic featuresin a large urbanocular referral cen-ter. “It is currentlybelieved that benignretinal tumors withphoto receptor dif-ferentiation calledretinomas or retinocytomas may undergomalignant transformation into retinoblas-toma,” said Dr. Eagle, who also plans todetermine how many retinoblastomascontain residual foci of these presumedprecursor lesions.

ABOUT THE SPEAKER. Dr. Eagle is theNoel T. and Sara L. Simmonds Professorof Ophthalmic Pathology at Wills EyeInstitute and director of pathology. He haswritten more than 350 articles and bookchapters and given more than 430 lecturesabout ocular pathology and retinoblas-toma. He is also the author of Eye Patholo-gy: An Atlas and Basic Text. Dr. Eagle’sresearch interests include the morpholog-ical characterization of ocular neoplasmsand other ocular and adnexal diseases,using light and electron microscopy andspecial modalities such as immunohisto-chemistry.

RESEARCH OPPORTUNITIES. “Retinoblas-

toma is one of the great success stories inhuman cancer, with survival rates approach -ing 100 percent,” said Dr. Eagle. “Chemo -therapy saves lives when it is administeredto patients who are at high risk for metas-tasis—those with histopathologic markerssuch as retrolaminar invasion of the opticnerve and extensive choroidal invasion.How ever, the importance of other putativerisk factors such as anterior chamber inva -sion and infiltration of the iris stroma andtrabecular meshwork is less certain andneeds further exploration. The Children’sOncology Group is now conducting achemotherapeutic study that is evaluatingprognostic factors in a prospective fashion.”

—L.B.P.

WILL IAM F. HOYT LECTUREPeter J. Savino, MD, will present Evaluationof the Retinal Nerve Fiber Layer: Descrip-tive or Predictive (11:43 a.m. to 12:08 p.m.)during the Monday Symposium titled TopFive to Stay Alive: Five Neuro-Ophthal-mology Pearls and Pitfalls for the General-ist (10:15 a.m. to 12:15 p.m.). This com-bined meeting with the North AmericanNeuro-Ophthalmology Society takes placein the Sydney J. Marcus Auditorium.

ABOUT THE LECTURE. The utility of visual -izing the retinal nerve fiber layer in neuro-ophthalmologic disease—“an importantobservation made by William Hoyt,” saidPeter J. Savino, MD—and the developmentof modern equipment that enables us toimage this area will be addressed in thislecture. Dr. Savino will also discuss theclinical application of these instrumentsin neuro-ophthalmologic disorders.

ABOUT THE SPEAKER. Dr. Savino, whospecializes in optic neuropathies, is a pro-fessor of ophthalmology, neurology andneurosurgery at Thomas Jefferson Univer-sity and director of the neuro-ophthalmol -ogy service at Wills Eye Institute. He is acontributing author of a few textbooks:Neuro-Ophthalmology: Color Atlas andSynopsis of Clinical Ophthalmology andClinical Decisions in Neuro-Ophthalmology.Besides writing more than 300 scientificarticles, chapters, reviews, abstracts andposters, Dr. Savino has served as a journalreviewer for 16 scientific publicationsincluding the American Journal of Oph-thalmology and Ophthalmology.

RESEARCH OPPORTUNITIES. “The mostpromising areas inneuro-ophthalmol-ogy research relateto optic neuritis andother nondemyeli-nating optic neu-ropathies,” said Dr.Savino, who alsopointed out otherareas with consider-able potential such aschronic neurode-generative diseases.

CHALLENGESAHEAD. “Physiciansare spending muchof their valuable

time fulfilling unproductive mandatesdesigned by bureaucrats who are largelyfrom nonmedical backgrounds andunderstand little about the science and thepractice of medicine,” said Dr. Savino.“The greatest challenges for ophthalmolo-gy are the roadblocks and unnecessarybureaucratic activity imposed by the gov-ernment, managed care organizations andinsurance companies, which have sappedmuch of the time and enthusiasm frommany ophthalmologists.” —L.B.P.

KELMAN LECTURERichard L. Lindstrom, MD, will presentCataract Surgery in the Glaucoma Patient(11:37 a.m. to noon) during the Mondaysession titled Spotlight on Cataract Surgery:Cataract Complications—Video CaseStudies: Why? What Now? How? (8:15 a.m.to noon). This meeting takes place in theThomas B. Murphy Ballroom 1–3.

ABOUT THE LECTURE. Glaucoma is acommon comorbidity in patients withcataract, second only to age-related macu-lar degeneration—“a key statistic forcomprehensive ophthalmologists,” saidRichard L. Lindstrom, MD, founder, Min-nesota Eye Consultants, a private practicein Bloomington, Minn.

“Ten years ago, we would routinely doa combined procedure—phacoemulsifica-tion with a trabeculectomy—for thesepatients,” Dr. Lindstrom explained. “How-ever, with advances in phacoemulsification,including clear corneal incisions and theadvent of better medications to controlglaucoma, we now believe most of thesepatients are best treated with cataractsurgery alone.”

He pointed to new data indicating thatsimple cataract surgery provides significantreductions in IOP, with the IOP reductionproportional to the preoperative IOP. “Wereviewed a series of 588 eyes and found that

people who had high pressures between22 and 29 mmHg experienced an averagereduction of 7 mmHg following cataractsurgery, with those having lower pressuresexperiencing a proportionate reduction.”1

ABOUT THE SPEAKER. Dr. Lindstrom’sbackground is well-tailored to this topic.He completed his fellowship training incornea at the University of Minnesota,and was a Heed Fel-low in glaucoma atUniversity Hospitalin Salt Lake City,Utah, before spend-ing 10 years on thefull-time faculty atthe University ofMinnesota and 20years at MinnesotaEye Consultants. Heserved as presidentof the AmericanSociety of Cataractand Refractive Sur-geons in 2007.

RESEARCH OPPORTUNITIES. Dr. Lind-strom noted that with advances in micro -incision surgery, ophthalmologists canbecome more aggressive with refractivelens exchange in glaucoma patients whoare poor medication compliers or who are not responding to other surgicalapproaches. “On the other side of theargument, improvements in glaucomasurgery are making filtering techniquesless invasive as well,” he said.

CHALLENGES AHEAD. “Though our tech-nical capabilities are expanding exponen-tially in what we can do for people, whowill pay for this care?” Dr. Lindstromasked. He said the field is headed for the“perfect storm,” a burgeoning senior pop-ulation in which people over age 65 use 10times as much eye care as those under 65while the number of ophthalmologists is

Simple cataractsurgery providessignificant reduc-tions in IOP, saysDr. Lindstrom.

Optic neuritis andother nondemyeli-nating optic neu-ropathies arepromising areas ofresearch, says Dr.Savino.

Retinomas orretino cytomas maytransform intoretinoblastoma,says Dr. Eagle. Beginning in January, physicians can earn up to a 2 percent bonus for e-prescrib-

ing plus up to an additional 2 percent bonus for participating in the PhysiciansQuality Reporting Initiative (PQRI). Find out more at these free sessions:

Introduction to E-Prescribing: Improving the Safety and Efficiency of Medication Management This session will review what e-prescribing is and how to implement it. An Academyrepresentative will be on hand to discuss the Medicare incentive program, and anadministrator will share her experience with e-prescribing. Event Code Spe54, Sunday 1:15 to 1:45 p.m.Room A412

PQRI Implementation: The Nuts and Bolts of 2009 ReportingThis session will address all quality-reporting measures affecting ophthalmology, as wellas step-by-step practical implementation, CMS 1500 form examples and tips from suc-cessful reporting practices.Event Code Spe47, Sunday, 12:30 to 1 p.m.Room A412

Physician Profiling and AccountabilityThis session will cover profiling and other physician accountability initiatives tied topayment, including the outlook of CMS’ Medicare Physician Quality Reporting Initiativeand Physician Web Compare plan.Event Code Spe28, Monday, 12:15 to 1:45 p.m.Room A412

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

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slowly shrinking. “We must become muchmore efficient in the next 15 years.”

—L.B.S.

1 Poley, B. J. et al. J Cataract Refract Surg 2008;

34:735–742.

WENDELL HUGHES LECTUREGeorge B. Bartley, MD, will present Fromthe Operating Room to the Board Room:An Oculoplastic Surgeon’s Perspective onHealth Care in America (3:03 to 3:23 p.m.)during the Monday Symposium titled NewTechnologies in Oculofacial Diagnosis andTreatment (2 to 3:30 p.m.). This combinedmeeting with the American Society of Oph-thalmic Plastic and Reconstructive Surgerytakes place in the Sydney J. Marcus Audito-rium.

ABOUT THE LECTURE. “Taking care ofpatients and serving their needs is whyeach of us went into medicine,” said GeorgeB. Bartley, MD, who will share his thoughtsabout the current and future environment

of health care in the United States. ABOUT THE SPEAKER. Dr. Bartley is the

Louis J. and Evelyn Krueger Professor ofOphthalmology at the Mayo Clinic, wherehe is also the CEO of Mayo’s Florida oper-ations and the Mayo Clinic’s vice presidentfor quality—a position entailing the over-sight of about two dozen medical centers.“My current responsibilities are far fromthe familiar territo-ry of the orbit, eye-lids and lacrimaldrainage system thatwas the focus of thefirst 20 years of mycareer, but the expe-rience has given mea different perspec-tive to apply to theissues confrontingophthalmology,”said Dr. Bartley, whohas authored orcoauthored more

than 200 publications. Dr. Bartley is alsothe former editor-in-chief ofOphthalmicPlastic and Reconstructive Surgery; hasserved on the editorial boards ofOphthal-mology, the American Journal of Ophthal-mology and the Archives of Ophthalmolo-gy; and is a former director of theAmerican Board of Ophthalmology.

CHALLENGES AHEAD. “We are on a mar-velous frontier of medicine today, but wehave extraordinary challenges,” said Dr.Bartley. He offered the following analogywhen asked about the future of medicine:“In biology, form follows function. Inbusiness, function follows finance. Theimplication for medicine is that we arewhere we are and we’re headed wherewe’re headed, in large part because of theway health care is financed.” —L.B.P.

HELEN KELLER OCULAR TRAUMALECTURED. Jackson Coleman, MD, will presentImaging and Innovation in the Evolutionof Ocular Trauma Management (4:39 to4:59 p.m.) during the Monday Symposiumtitled War and Terror-Related Eye Injuries:From Triage to Management to Rehabili-tation (3:30 to 5 p.m.). This combinedmeeting with the American Society of Ocu-lar Trauma takes place in Room A411.

ABOUT THE LECTURE. Imaging and itssynthesis with surgical innovations usedto treat and manage ocular trauma will bethe focus of this lecture, said D. JacksonColeman, MD, referring to a quote attrib-uted to Sigmund Freud to summarize histheme: “Once you understand the prob-lem, you can deal with it.”

ABOUT THE SPEAKER. Dr. Coleman is avitreoretinal surgical specialist who hasbeen treating oculartrauma for 40 yearsand using ultra-sound and otherimaging techniquesfor evaluating ocu-lar trauma for morethan 30 years. He isthe John MiltonMcLean Professor of Ophthalmologyat Weill Cornell Med -ical College and haswritten more than500 peer-reviewedpapers, abstractsand book chapters.His textbook Ultrasonography of the Eyeand Orbit is in its second edition.

His work in the development of ultra-sound technologies led to a collaborationwith Frederic L. Lizzi, EngScD, in whichthey developed the first commercially avail -able B-scan ultrasound equipment forocular use. He has garnered more than adozen patents for his inventions, whichinclude an ultrasonically vibrated surgicalknife and an ultrasound system for cornealbiometry.

Dr. Coleman also established the Mar-garet M. Dyson Vision Research Instituteat Weill Cornell Medical College, where

ongoing research is conducted to deter-mine the causes of and possible therapiesfor age-related macular degeneration.Ultra sound imaging of the retina andchoroid are also a focus of study.

CHALLENGES AHEAD. “The continuedresearch of imaging techniques, both opti-cal and acoustic, is imperative in ophthal-mology,” said Dr. Coleman, who added,“Imaging modalities are expensive andmay only be available in limited centers,however. This presents a challenge in manycommunities. Dramatically reduced com-pensation for difficult and expensive pro-cedures, lack of access to emergency treat-ment and the increased elucidation ofhealing mechanisms are also hurdles thatmust be overcome.” —L.B.P.

CASTROVIE JO MEDAL LECTUREShigeru Kinoshita, MD, PhD, will presentTherapeutic Modalities for Ocular SurfaceDisorders (9:20 to 9:45 a.m.) during theTuesday Symposium titled CommonlyMissed Diagnoses Seen by a Corneal Spe-cialist (8:30 to 10:30 a.m.). This combinedmeeting with the Cornea Society and theEuropean Cornea Club takes place in theSydney J. Marcus Auditorium.

ABOUT THE LECTURE. While a cure forsevere ocular surface disease has yet to bediscovered, researchers continue to devel-op innovative medical and surgical treat-ment approaches. Shigeru Kinoshita, MD,PhD, will discuss his latest work, includingtransplantation of cultivated mucosalepithelial stem cells for ocular surfacereconstruction, and the use of immuno-suppressive agents and keratoepithelio-plasty with or without tectonic lamellarkeratoplasty to treat peripheral cornealulcers.

Dr. Kinoshita and colleagues also havemade progress in understanding Stevens-Johnson syndrome and toxic epidermalnecrolysis, a type of hypersensitivity reac-tion that occurs in response to medications,infections or illness.

ABOUT THE SPEAKER. Dr. Kinoshita hasserved as professor and chairman of oph-thalmology at the Kyoto Prefectural Uni-versity of Medicine since 1992. He is alsochief of the Kyoto Prefectural UniversityHospital. Over the past 30 years, Dr. Kino -shita has focused his work on ocular sur-face wound healing,ocular surface innateimmunity and ocu-lar surface recon-struction. In theearly 1980s at Har-vard Medical School,Dr. Kinoshita helpedestablish the con-cept of centripetalmovement ofcorneal epitheliumand the importanceof the limbal epi the -lium. These findingshave contributed tothe development ofthe corneal stem cell

e y e n e t ’ s a c a d e m y n e w s 21

HONORARY LECTURES

In business, func-tion followsfinance, says Dr.Bartley.

The continuedresearch of imag-ing techniques isimperative, saysDr. Coleman.

Regenerative med-icine and advancedlaser technologymay help revolu-tionize treatmentof corneal disease,says Dr. Kinoshita.

Casebeer AwardGraham D. Barrett, MD (Australia)

The Casebeer Award recognizes anindividual for his or her outstanding con-tributions to refractive surgery throughnontraditional research and developmentactivities.

Lans Distinguished AwardRonald R. Krueger, MD (United States)

The Lans Distinguished Award isnamed in honor of Leedert J. Lans, MD, ayoung, innovative researcher who definedthe basics of refractive surgery by workingto improve the techniques used to correctastigmatism.

The award is given to an individual whohas made innovative contributions in thefield of refractive surgery.

Kritzinger Memorial AwardGustavo E. Tamayo, MD (Colombia)

The Kritzinger Memorial Award wasestablished to honor the accomplishmentsof Michiel Kritzinger, MD.

Each year, a recipient is chosen whoembodies the clinical, educational andinvestigative qualities of Dr. Kritzinger toadvance the international practice ofrefractive surgery.

Lifetime Achievement AwardStephen L. Trokel, MD (United States)

The Life Achievement Award honors anISRS/AAO member who has made signifi-cant and internationally recognized contri-butions to the advancement of refractivesurgery during his or her career.

17th Annual Richard C. Troutman MD DSC(HON) $5,000 PrizeJosé Luis Rodriguez-Prats, MD (Spain)

The Troutman Prize recognizes the sci-entific merit of a young author publishingin the Journal of Refractive Surgery andincludes a $5,000 honorarium from theTroutman Endowment.

2009 Barraquer Lecture and AwardJorge L. Alió, MD, PhD (Spain)

The José I. Barraquer Award honors aphysician who has made outstanding con-tributions in the field of refractive surgeryduring his or her career, exemplifying thecharacter and scientific dedication of JoseI. Barraquer, MD. This year’s award winnerwill present the Barraquer Lecture duringnext year’s Joint Meeting.

Founders’ AwardJack T. Holladay, MD (United States)

The Founders’ Award recognizes thevision and spirit of the society’s foundersby honoring an individual who has madeextraordinary contributions to the growthand advancement of the society and itsmission.

2008 ISRS/AAO Presidential AwardJosé L. Güell, MD (Spain)Ana Maria Torres (Colombia)

This year’s ISRS/AAO PresidentialAward is being given to Dr. Güell in recog-nition of his important contributions torefractive surgery and his position as aleader in the field and to Ms. Torres inrecognition of her dedication to refractivesurgery and the society.

To join ISRS/AAO, visit the Member Ser-vices desk at the Academy’s ResourceCenter (Booth #3532) where you can pickup an application form. You can also visitwww.isrs.org.

S O C I E T Y R E P O R T

Congratulations to this year’s ISRS/AAO award recipients. The nine individuals belowwere honored during Friday’s ISRS/AAO Gala Dinner and Dance for their contribu-tions to the profession.

Page 22: Academy News from AAO 2008 Atlanta

theory by Tuen-Tien Sun.Dr. Kinoshita served as the former pres -

ident of the Japanese Society of Cataractand Refractive Surgery. He is the ARVOTrustee of the Cornea Section and servesas the associate editor of InvestigativeOphthalmology & Visual Science.

RESEARCH OPPORTUNITIES. “Stevens-Johnson syndrome is rare, yet the infor-mation gained from studying this diseasecan be applied to other more commondisorders,” Dr. Kinoshita said. “I liken it toinvesting in the development of advancedtechnology for Indy and Formula Onecars. Eventually, this technology can beused to increase the performance of regu-lar cars.”

CHALLENGES AHEAD. “In the near future,regenerative medicine and advanced lasertechnology, including femtosecondlaser–assisted keratoplasty, are positionedto revolutionize the treatment of cornealdiseases, and that is quite exciting.”

—L.B.S.

MARSHALL M . PARKS MEMORIALLECTUREElias I. Traboulsi, MD, will present MakingSense of Early Onset Childhood RetinalDystrophies (11:17 to 11:43 a.m.) duringthe Tuesday Symposium titled GeneticBasis of Pediatric Eye Diseases (10:15 to11:45 a.m.). This combined meeting withthe American Association for PediatricOphthalmology and Strabismus takes placein the Thomas B. Murphy Ballroom 4.

ABOUT THE LECTURE. Considerableprogress has been made during the lasttwo decades in improving the under-standing of retinal dystrophies as well asthe genetic mechanisms involved in their

development. Oneof the most notablemilestones is theidentification of anumber of genesassociated withearly-onset child-hood retinal dystro-phies such asLeber’s congenitalamaurosis and X-linked juvenileretinoschisis . EliasI. Traboulsi, MD,will discuss thesebreakthroughs and

explain “how general and pediatric oph-thalmologists can correctly diagnose thesediseases using clinical clues such as symp-tom identification and retinal exam find-ings and how, once a clinical diagnosis ismade, they can proceed to the next step—providing a molecular diagnosis anddetermining what genes are involved.”

ABOUT THE SPEAKER. Dr. Traboulsi, whois board-certified in both ophthalmologyand medical genetics, is professor of oph-thalmology, head of pediatric ophthal mol -ogy and adult strabismus and director ofthe Center for Genetic Eye Diseases at

Cole Eye Institute. He holds editorial posi-tions at Ophthalmic Genetics and theAmerican Journal of Ophthalmology andhas published nearly 300 articles, bookchapters, professional correspondenceand multimedia presentations. He hasalso written four books, including GeneticDiseases of the Eye and A Compendium ofInherited Disorders and the Eye.

Dr. Traboulsi trained with Marshall M.Parks at the Children’s National MedicalCenter in Washington, D.C. “He was mymentor and role model and is one of thetrue icons, not only in pediatric ophthal-mology but in ophthalmology in general,”said Dr. Traboulsi.

CHALLENGES AHEAD. “One of the chal-lenges in pediatric ophthalmology isattracting new graduates,” said Dr. Tra-boulsi. “We have a shortage of pediatricophthalmologists for a variety of reasons.For some, other specialties are attractivebecause they are more lucrative, technicallychallenging or better advertised, for exam-ple. And the results of treatment in pedi-atric ophthalmology often take years tosee as opposed to immediate visionimprovement that can be achieved inother specialties. Fortunately, those whoare attracted to the subspecialty comewith a genuine love of children and adesire to take care of them. That’s whatkeeps us going irrespective of all the otherchallenges.” —L.B.P.

STRAATSMA LECTUREPaul D. Langer, MD, will present CreatingExcellence in Resident Education (11:20 to11:40 a.m.) during the Tuesday Symposiumtitled Maximizing Teaching and LearningWith Modern Technology (10:15 to 11:45a.m.). This combined meeting with theAssociation of University Professors of Oph-thalmology takes place in Room A411.

ABOUT THE LECTURE. The recent focus inresident education ensures that everyphysician graduates with measured com-petence in six different areas consideredcentral to the practice of medicine. “Yetthis approach is not really adequate,” saidPaul D. Langer, MD. “We must take ourapproach to medical education to the nextstep: not just helping all residents meet aminimal level of competency but ensuringthat the best residents reach their greatestpotential as well.”

Dr. Langer said, “Our best residents areour future leaders. They are likely to bethe ones making groundbreaking discov-eries, excelling in patient care and servingin leadership roles throughout ophthal-mology’s professional organizations. Thefuture of our field depends on our givingthese talented residents as much attentionas possible, mentoring their careers andinvesting time in their development.”

ABOUT THE SPEAKER. Dr. Langer hasserved as director of resident education at the Institute of Ophthalmology andVisual Science (IOVS) at the New JerseyMedical School since 1995. He also is

director of ophthalmic plastic, recon-structive and orbital surgery at IOVS. In2007 he received the American Academyof Ophthalmology’s Secretariat Award.

RESEARCH OPPORTUNITIES. “The greatestresearch opportunities in graduate med-ical education lie in surgical simulation,which gives residents the ability to prac-tice surgery in a virtual reality setting,” Dr.Langer noted. “This technology is anal -ogous to a flight simulator. We can exposeresidents to both common surgical maneu -vers and rare complications a multitude oftimes, and they can learn to respond with-out the need to operate on a human eye. Itwill be the most important change in thetraining of surgeons since the apprenticesystem was developed more than 100years ago. This field will provide manyopportunities for research as we studyhow to implement this groundbreakingtechnology on a day-to-day basis.”

CHALLENGES AHEAD. “Our most impor-tant challenge will be to continue toattract the best and brightest medical stu-dents into our field. The future of ourfield and our patients depends on it.”

—L.B.S.

ROBERT N. SHAFFER LECTUREWallace L. M. Alward, MD, will presentThe Molecular Genetics of Glaucoma(11:50 a.m. to 12:15 p.m.) during the Tues-day Symposium titled Business, Ethical,and Medical-Legal Aspects of TreatingGlaucoma Patients (10:45 a.m. to 12:15p.m.). This combined meeting with PreventBlindness America takes place in the SydneyJ. Marcus Auditorium.

ABOUT THE LECTURE. “Robert N. Shafferwas remarkably insightful in his predic-tion about the future of glaucoma genet-ics in 1965 when he delivered the JacksonMemorial Lecture titled ‘Genetics and theCongenital Glaucomas,’” said Wallace L.M. Alward, MD, who will discuss the latestdevelopments in the molecular genetics ofglaucoma in his lecture.

ABOUT THE SPEAKER. Dr. Alward is a pro-fessor and vice chairman of ophthalmolo-gy at the University of Iowa and servicedirector of the glaucoma clinic, where

his current research projects include theevaluation of families with inherited glaucomas, comparison of glaucoma sur-gical techniques, evaluation of pigmen-tary glaucoma and advanced methods ofcombined cataract and glaucoma surgery.

He has written two books as well asmore than 200 peer-reviewed papers,chapters and abstracts and developedGonioscopy.org, an online tutorial thatteaches basic and advanced gonioscopytechniques using videography.

Dr. Alward’s research has garnered 12 domestic and international patents. “I have been fortu-nate to work with agroup of brilliantmolecular geneti-cists. Our researchled to the first genet-ic linkage for open-angle glaucoma(GLC1A). We thendemonstrated thatthis area contained agene called myocilinand that mutationsin this gene causedglaucoma. We alsoidentified genes forAxenfeld-Rieger syndrome and continueto search for other disease-causing genes,”said Dr. Alward.

RESEARCH OPPORTUNITIES. Glaucomaremains a poorly understood disease. Dr.Alward anticipated that “as we study itsmolecular underpinnings, we will developan understanding of the basic pathophysi-ology of trabecular dysfunction and opticnerve damage, which should lead toimproved diagnostic methodologies andtreatments.”

CHALLENGES AHEAD. “One of the greatestchallenges in ophthalmology is the declineof government research funding,” said Dr.Alward. “This is making it more difficultfor clinicians to be involved in research. As someone with minimal scientific train-ing, I find the chance to be a part of cutting-edge science a thrill and have been fortu-nate to work with a group of scientistswho value a clinician’s input.” —L.B.P.

22 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

HONORARY LECTURES

A great challengeis the decline ingovernmentresearch funding,says Dr. Alward.

We have a short-age of pediatricophthalmologists,says Dr. Traboulsi.

Want to plan for retirement? Design an estate plan? Whether you’re a seasonedinvestor or a beginner, the Academy Foundation invites you to take advantageof free financial planning services in Atlanta.

Book a private consultation. The Academy Foundation offers complimentary, 50-minute private consultations with financial and estate planning professionals fromChepenik Financial, Mercer Advisors and Merrill Lynch. Appointments are required andbegin on the hour. Consultations take place Sunday and Monday from 8 a.m. to 4 p.m.and on Tuesday from 8 a.m. until noon. To check what times are still available, pleasevisit Room A406–407.

Attend a lunchtime session. The Academy Foundation also offers free lunchtime ses-sions covering a range of financial planning topics. No appointment is needed, but youare advised to arrive early as the sessions are popular and well-attended. The EstatePlanning session is on Sunday at 12:45 p.m. and the Investment and Retirement Plan-ning is on Monday at 12:45 p.m. Both session are in Room A316.

F R E E P R O F E S S I O N A L F I N A N C I A L A D V I C E

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