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Post-LASIK IOL calculations

Ms. PRK tells me she isn’t overly worried about her refractive outcome following cataract surgery. But, she’s also had previous refractive which certainly causes me to raise a red flag! This is a patient who clearly cares (or at least previously cared!) about refraction!

I’m reflecting on the Toronto Cataract Course 2019 that took place in March, where I had a wonderful time connecting with colleagues, learning new insights, and picking up pearls. The knowledge I gleaned at this meeting will definitely help me to optimize refractive results for my cataract patients.

In particular, we are all aware of the challenges in selecting intraocular lens (IOL) powers for post-refractive patients undergoing cataract surgery. Over the years, a number of different approaches to dealing with this challenge have been developed, but there is room for further improvement. The scope of this problem will only grow as we encounter more post-refractive patients requiring cataract surgery.

I would like to highlight two links that serve as the backbone of post-refractive IOL calculations in 2019. The first is the ASCRS post-refractive IOL calculator, and the second is Graham Barrett’s True K post-LASIK calculator. Armed with these two resources, I think many of us will be able to more effectively tackle these interesting cases going forward.

ASCRS post-refractive IOL calculator: http://iolcalc.ascrs.org/ – please be mindful to pick the appropriate previous refractive surgery along the top.

The Barrett True K calculator: http://www.apacrs.org/barrett_true_K_universal_2/. With this calculator, please be sure to select the appropriate previous refractive surgery from the drop down menu.

Recommended by Dr. Amandeep Rai
Amandeep Rai, MD, FRCSC
Practice Resource Centre Committee Member

Featured post

Finessing your Retinopathy of Prematurity (ROP) Skills

Just recently, an ophthalmology resident that was nearing the end of their pediatrics rotation said to me, “All the ROP babies we have screened together have no ROP or ROP not requiring treatment. I’m afraid that when I go into practice I might not be confident enough to call Type I ROP. What should I do?”. Initially my first obvious answer was to recommend what I did in residency – see more patients together and continuing to review the ROP criteria and standard photos. However, I then recalled a great online ROP case-based training tool that had become available when I was in fellowship, Retinopathy of Prematurity: Case-Based Training, available through the American Academy of Ophthalmology website.

This interactive tool provides 20 cases of varying severity including a tutorial, if needed, to review how to diagnosis and when to treat ROP. Each case provides the birth weight, gestational age, postmenstrual age, six standard ROP imaging views for each eye, and selections for your specific diagnosis and follow-up. Although it may sound straightforward, some of the cases really get you thinking about whether they truly meet the criteria for treatment based on the Early Treatment of ROP (ETROP) study. Some of the cases are so challenging that at the recent ROP Update Conference – which is an accredited biennial meeting of ROP gurus and neonatologist that I also highly recommend – the exact same images and criteria were shown to the attendees and they were asked to respond resulting in varying diagnoses and management plans. As such, the training tool is great for residents, fellows, and any comprehensive, pediatric, or retina specialist performing ROP screenings who want to ensure their skills are up to date.

You do not need an AAO account if you would like to access the education module for pure learning purposes. However, if you are wanting the self-assessment credits for the activity you will need to be an active member of the AAO.

Retinopathy of Prematurity: Case-Based Training, available through the American Academy of Ophthalmology website.

Recommended by Dr. Christine Law
Christine Law, MD, FRCSC
Practice Resource Centre Committee Member

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Straight from the Cutter’s Mouth: A Retina Podcast

I have a secret…I love listening to podcasts! There is something very relaxing to me about simply turning off a screen, slipping on some headphones and listening to someone tell a story. Whatever your interests may be, I would bet you that there is a podcast on it! I recently learned that you can also claim podcasts as a scanning activity under Section 2 MOC for 0.5 credit per podcast. Since claiming credits to listening to “Serial” or “Dr. Death” would probably raise some eyebrows at the Royal College, I decided to do a little digging for ophthalmology podcasts that I could get CME credits for.

A retina colleague of mine suggested “Straight from the Cutter’s Mouth: A Retina Podcast.” Through interviews and discussions with leading retina specialists, they cover a wide range of topics from practice management, career development, medical and surgical retina, and also have a regular journal club. You can access their podcasts from their main website, or through iTunes. You may find some episodes will be more or less relevant to you depending on your scope of practice.

Overall, I have found that it is pretty easy to scroll through the podcasts and get a sense of their relevance for me by their titles. I think anyone who practices surgical/medical retina or comprehensive ophthalmology will likely find a few episodes of interest. I recently listened to “Episode 64: Yag Laser for Floaters”, which was a great review of three papers recently published looking at the role of Yag Laser Vitreolysis in these cases. I probably would not have come across these papers otherwise.

So next time you are sitting in traffic on your way to work, why not play a podcast, learn something new and claim some MOC credits at the same time?

Recommended by Dr. Anu Mishra
Anu Mishra, MD, MSHPEd, FRCSC
Practice Resource Centre Committee Member

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Neuro-Ophthalmology Virtual Education Library

The Neuro-Ophthalmology Virtual Education Library (NOVEL) has been one of my favorite educational resources as a resident and still continues to be one that I go back to as part of my general practice. Neuro-ophthalmology cases can sometimes be hiding amongst blurry vision and glaucoma suspect referrals. They somehow always seem to find a way to sneak into my clinics! I do find it helpful to refresh myself on neuro topics from time to time and for me a video is worth 1000 words. NOVEL is an amazing open access, repository of digital materials that may be used for education and research purposes. This is a great place to access images and videos for presentations, review key neuro-ophthalmology concepts and also as a place to submit interesting cases.

Last month I was responsible for organizing an introduction to ophthalmology workshop for a group of med 2 students, and I ended up using several clinical examination videos to help highlight key exam techniques such as the pupillary exam and extra ocular motility testing. One of the other great features is being able to access all the presentations from the Annual North America Neuro-Ophthalmology Society (NANOS) meetings through the site. I recently came across this nice series of presentations from the 2016 meeting, that reviews OCT use in neuro-ophthalmology.

Reviewing these videos could easily could be made into a Section 2 MOC Personal Learning Project which would give you 2 credits per hour.

Check out NOVEL today!

Recommended by Dr. Anu Mishra
Anu Mishra, M.D., MSHPEd, FRCSC
Practice Resource Centre Committee Member

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CSI: Cataract Surgery Investigation

Symposium Resources

The COS is pleased to provide access to the presentations from the co-developed symposium presented at the 2018 COS Annual Meeting, CSI: Cataract Surgery Investigation. Dr. Ike Ahmed, along with a team of forensic ophthalmologist investigators, presented three different and engaging cases, unveiling clues to analyze the causes of poor outcomes in cataract surgery patients. They discussed tools and strategies to prevent these outcomes from occurring in future patients. Below, you will find video presentations and handouts on complicated cataract surgery.

CPD Credits
Scanning resources that are relevant to your professional practice by enhancing your awareness of new evidence, perspectives and findings can be claimed as Section 2: Self-Learning under Scanning in MAINPORT with the MOC Program of the Royal College of Physicians and Surgeons of Canada.

Episode 1: Residual Sphere
Join forensic expert Dr. Amandeep Rai on his investigation of a spherical refractive error after cataract surgery. Do you have what it takes to uncover the suspect in this refractive surprise?

Episode 2: Astigmatism Post Toric
Special Agent Dr. Rosa Braga-Mele tackles a complicated case of astigmatism post TORIC IOL implant. Can you catch the perpetrator?

Explore handouts related to this case file:
Download

Episode 3: The Miniature Ghost
Follow seasoned investigator Dr. Guillermo Rocha as he puts together clues to uncover the truth about an apparent ghost. What will you notice at the dysphotopsia crime scene?

Explore handouts related to this case file:Download

Episode 4: CSI Case Discussions
In the last episode of this season, members of the investigative team field questions and discuss their challenging cases, including the use of different formulas and calculations and the implementation of new technologies.

This symposium was co-developed with the Canadian Ophthalmological Society and Alcon in order to achieve scientific integrity, objectivity and balance.

This resource is only available in English.

Featured post

Practice Update: Eye Care

This month, I want to highlight a site that offers curated content in the eye care area, which I find useful within my practice as an ophthalmologist. PracticeUpdate is an Elsevier product which provides journal scans across both the ophthalmology and the optometry literature.

In addition, it provides commentary from key opinion leaders. While not all the content is relevant to all ophthalmologists, I find it gives me a good overview of what is current and allows me to select areas of interest to pursue further learning.

PracticeUpdate is commercially supported by online advertising, sponsorship, and educational grants, however claims that it ‘maintains the highest level of academic rigor, objectivity, and fair balance associated with all Elsevier products. No editorial content on the site is influenced in any way by commercial sponsors or content contributors.’

Another feature that may be useful is that you can also signup for journal scans in other areas such as neurology or diabetes care that may be of interest. By registering, you can customize options for what information you wish to have pushed out to you, how often, and in what areas.

The site is responsive for access from a variety of devices. Check it out at www.practiceupdate.com.

Recommended by Dr. Colin Mann
Chair, Practice Resource Centre

Featured post

EyeRounds.org

As a physician, I am always searching for the most current content I can reference quickly that will be most relevant to my practice and sub-specialties. For those that may not be familiar with it, EyeRounds.org is a content-rich site which is a service of the University of Iowa Department of Ophthalmology and Visual Sciences. It provides access to content in a variety of forms including case reports, tutorials, videos and an online searchable atlas.

The information presented is, in many cases, useful to both trainees as well as a review for practicing ophthalmologists. One area I found fun and engaging is the series of Photo Quizzes. These eclectic collections of pictures and photos provide a quick challenge to your general ophthalmology knowledge base.

The tutorials derive mainly from Grand Round presentations and while their usefulness to practicing ophthalmologists (vs trainees) varies, there are some excellent summaries which might be especially to community ophthalmologists who don’t have ready access to ophthalmology grand rounds in their area.

Explore the site at eyerounds.org for updated content.

I hope you find this website helpful for your practice.

Recommended by Dr. Colin Mann
Colin Mann, M.D.
Chair, Practice Resource Centre

Webinar: Turning Burnout into Joy

The webinar Turning Burnout into Joy will take place on Thursday, February 13, 2020 from 7:00 – 8:00 pm EST.

The Keynote Speaker for this event is:
Mamta Gautam, MD, MBA, FRCPC, CPE
Dept of Psychiatry, University of Ottawa
Psychiatrist, Psychosocial Oncology Program, The Ottawa Hospital
President and CEO, PEAK MD Inc.
Course Director, MOMENTUM® Leadership Retreat for Medical Women

Moderator:
Dr. Lisa Gould, ophthalmologist and Chair of the COS Physician Wellness Steering Committee

Webinar Overview

Stress is inherent in medicine and can lead to burnout. This presentation is designed to assist physicians in learning how to recognize the symptoms of burnout, and prevent burnout in themselves and their colleagues. The main causes of stress and drivers of burnout will be discussed, as well as the impact of burnout to the person and the system. We need to stop blaming doctors and see burnout prevention as a shared responsibility of both the individual physicians and the healthcare system. We will look at enhancing joy in our work, so we can maintain an intellectual, behavioural, and emotional commitment to meaningful and satisfying work. We will review the 5 C’s of Resilience to reinforce concrete and practical strategies that individuals can leverage to enhance resilience and maintain the joy in medicine.

Learning Objectives

By the end of this presentation, participants will be able to:

Define and recognize burnout, and appreciate the scope of the issue
Understand the drivers that lead to stress and burnout in physicians
Know the consequences of burnout to the person and the system
Implement personalized strategies to prevent burnout
Consider the responsibility of the organization or system in preventing burnout
Know the 5 C’s of Resilience, and identify strategies to enhance resilience and maintain the joy in medicine

This is the second webinar in the COS Physician Wellness Webinar Series. You can review the accredited webinar recording for Ergonomics and Mindfulness in the Operating Room… Providing care to your patients while avoiding becoming one.

CPD Credits

This webinar is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, and was approved by the Canadian Ophthalmological Society. You may claim a maximum of 1 hour.

Access Details

Registration for the webinar will open shortly. Should you have any questions email [email protected]

This program was delivered with financial support from an educational grant provided to the COS by the Canadian Medical Association, MD Financial Management and Scotiabank through the Affinity Agreement.

2020 Cataract Surgery: Telling it Like It Is

The aim with this meeting is to help every attendee leave this meeting feeling more confident about delivering the best possible surgical care. The first day and a half will be spent covering all the main subspecialty areas. The rest of the meeting will be a deep dive into the field of cataract surgery, covering what’s new in cataract surgery, new technology, managing technology, managing complications and IOL selection triumphs and tragedies. Customize your learning experience by choosing from 30 different hands-on wet lab courses.

Access Details

For more information visit the event website: https://www.healio.com/meeting/tellingitmeeting/home

Advanced Ophthalmologic Practice

Three decades of excellence in ophthalmology.

This year, the conference (January 10 – 11, 2020) boasts a large variety of wet and dry labs, video sessions and surgery battles to boost your anatomical and practical knowledge, as well as, AI, new technologies and product analysis sessions to stay up-to-date with innovations and advances.

AOP also aims to promote additional training, inter-generational exchanges and networking for Young Ophthalmologists and Young Orthoptists, with a program tailored to their needs, combining theory and surgical practice.

CPD Credits

The AOP Event is accredited by the European Accreditation Council for Continuing Medical Education to provide CME activity for medical specialists.

Access Details

For more information visit the event website: www.aopcongress.com

126e Congrès International de la SFO

The COS has been invited to present a special symposium as part of the 126^e Congrès international de la Société française d’ophtalmologie (SFO).

Access Details

Visit the website of the SFO for more information: https://www.sfo.asso.fr/actualites/congres-sfo-2020

CJO Lectureship series : Les traumatismes oculaires : une morbidité sournoise chez l’enfant

La prochaine conférence scientifique du département d’ophtalmologie de l’Université de Montréal aura lieu le mardi 14 janvier 2020 à 19h00.

Titre

CJO Lectureship series : Les traumatismes oculaires : une morbidité sournoise chez l’enfant : Drs Cyril Archambault & Nicole Fallaha, Université de Montréal.

La Société Canadienne d’Ophtalmologie et L’AMOQ en partenariat avec l’Université de Montréal vous présente cette conference (et webconférence).

Détails d’accés

Pour participer via le web (de la maison), lien web : https://zoom.us/j/332634315

Réunion # (Meeting ID) : 332 634 315
Pour obtenir l’attestation pour les crédits de formation continue vous devez :
Bien inscrire votre prénom et votre nom au moment de vous brancher pour que nous puissions vous reconnaître
Demeurer branché tout au long de la conférence et garder le système vidéo allumé
Remplir la fiche d’évaluation à la fin de la conférence (le lien est indiqué dans l’invitation ci-jointe).
Ne pas faire partie du corps professoral ou étudiant de l’université de montréal (dans ce dernier cas, il faut se rendre sur place, au chu ste-justine)
Pour les instructions concernant l’utilisation du logiciel, vous pouvez télécharger un court document en cliquant sur ce lien.

Lien pour l’évaluation : https://form.jotform.com/200059214418952

COS Council on CPD Meeting

Symposium Resources

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