Celine Dion at the Caesars Palace

AAO Day Three: It’s Over but Our Hearts Will Go On

The last day of any ophthalmological conference is always a bittersweet moment for the CAKE & PIE team. We don’t want the sessions and symposia, posters and presentations to end, but all good things must… you know the expression. Even a typhoon could not stop us this year, and after offering a few strong words, we on the Asia-Pacific Media MICE team ensured Storm Vamco went away to bother someone else.

So if you are feeling down in the dumps about the annual meeting of the American Academy of Ophthalmology (AAO 2020 Virtual) coming to an end (especially without having occurred physically), remember, the show must go on. Indeed near, far, wherever you are, I believe that the heart does go on…as will ophthalmology. The AAO really outdid itself with this year’s virtual event, and day three of the conference was perhaps the best yet.

The leadership of the AAO changed hands as President Dr. Anne Coleman passed the gavel of leadership to the incoming president, Dr. Tamara Fountain. Based in Chicago, Illinois, Dr. Fountain was praised by Dr. Coleman as a professional who is dedicated to the preservation of the AAO’s work and efficacy. In turn, Dr. Fountain spoke warmly of the friendship she enjoyed with Dr. Coleman, describing her as one of her role models.

AAO Day Three: It's Over but Our Hearts Will Go On
Ophthalmologist can learn a lot from pilots.

“My father was a pilot, and he told me that when struck by disaster the key thing was to keep the plane aloft. COVID-19 has marched across oceans and continents, we’ve had so much to adapt to,” Dr. Fountain said.

“If a pilot’s main focus is to keep the plane aloft, what should an ophthalmologist’s be? It is to take care of patients, and even though we were physically separated, we scrambled to protect sight. Access to telehealth helped, the airplane was stabilized, and the show goes on, even if it is in our living rooms,” Dr. Fountain said.

Check your mental health; it’s ok to not be okay

Day three took a broader view of ophthalmology in 2020, inspired by the coming together of the medical community in response to the coronavirus pandemic. There were two plenary sessions entitled Keep the Fire Lit: Strategies for Preventing Burnout, which focused on how to address the growing mental health crisis in the United States and beyond, which is spilling over into ophthalmology. Panelists, including two practice administrators as well as doctors, discussed how to create an emotionally intelligent workplace culture involving team dynamics designed to reduce stress.

Lean Scheduling & Practice Management Tips for COVID-19 took on a similar theme, and brought together a wide variety of practice staff and physicians. Organized as an open mic session, this allowed the moderators to take as many views into account as possible. The session was ably organized and led by member of the AAO board of directors Stephanie Collins Mangham, the COO of Austin Retina Associates.

Anyone working in ophthalmology will naturally prefer to focus on the practice of medicine. Sometimes however life and legality get in the way, which is what made Employment Law Basics for the Small Ophthalmology Practice so insightful, especially for those who are just starting out with their own clinics. While this session was designed for those working in the United States it also contained a number of excellent lessons for ophthalmologists around the world.

Stopping putting your fingers near your eyes!

AAO Day Three: It's Over but Our Hearts Will Go On
A problem as old as time itself.

The Effect of Eye Rubbing on Corneal Biomechanics was one of the CAKE & PIE team’s favorite posters of day three. A group of researchers led by Dr. Hormoz Abdshahzadeh were determined to evaluate the effect of eye rubbing on the corneal biomechanics in an ex vivo model of eye rubbing. As part of the study, thirty-three eyes were rubbed over their own eyelids in a specially developed eye-rubbing device.

Thirty-seven eyes served as the non-rub control group. E-modulus at the range of 1% and 5% of strain was 1.219 ± 0.284 and 1.218 ± 0.304 N/mm in the eye-rubbing group and the no-rub controls, respectively, and corneal stiffness was thus similar in both groups. The researchers concluded that the damage threshold level to induce biomechanical changes must be higher than 10,500 eye rubbing movements, suggesting that occasional eye rubbing should not impact corneal biomechanics.

Ophthalmology of tomorrow and the future of our industry has definitely been a theme of the AAO 2020 Virtual, so we would also like to showcase Vector Planning: The Next Generation of Astigmatism Treatment. This poster was a case study involving a 34-year-old male with post operative LASIK symptoms of glare, starbursts, halos, and reduced contrast sensitivity associated with 20/20 unaided visual acuity. Drs. Noel Alpins and George Stamatelatos wanted to examine the change from preoperative ocular residual astigmatism 0.99 D Ax 6 and left 1.24 D Ax 174 to postoperative 1.12 D @ 90 and in the left eye was 1.04 D @ 85.

I believe that the heart goes on

The doctors realized that vector planning would have reduced the postoperative corneal astigmatism to right 0.59 D @ 96 and left 0.74 D @ 84 by incorporating the corneal astigmatism into the treatment. They report that this would place further treatment outcomes at below the contrast sensitivity associated without any increase in refractive cylinder remaining. Watch this space, this could be a fantastic development in astigmatism treatment!

The final cherry on the top of day three was a performance by the internationally renowned magician Penn Jillette, a member of the legendary Las Vegas duo Penn & Teller. Jillette was invited to appear as part of the Michael F. Marmor Lecture in Ophthalmology and the Arts and shared some fantastic stories including about celebrities and public intellectuals. A fitting end to a Las Vegas conference.

So that was it, the AAO 2020 Virtual is over, but love can touch us one time and last for a lifetime, and never let go ’til we’re gone. Near, far, wherever you are, remember that CAKE & PIE will always bring you the best in ophthalmology globally. Until next time!

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