Sunday, September 13, 2009

WCPOS and ESCRS bring the best people together in one room

This year’s ESCRS meeting in Barcelona offers an unprecedented opportunity for ophthalmologists from around the world to avail of interactive learning with their paediatric specialist colleagues. The meeting marks a first, collaboration with paediatric ophthalmology in the form of the first World Congress of Paediatric Ophthalmology and Strabismus (WCPOS).

This is a lively time in the field of paediatric ophthalmology, with important new studies in many key areas including genetics, strabismus, retina, cataract and refractive surgery. The WCPOS meeting highlights controversies and innovations in the field that will be of interest to specialists and general ophthalmologists alike.

“The idea of putting the best people together in one room to talk about paediatric ophthalmology was irresistible. This is the beginning of what we hope will be regular opportunities for people to get together and talk. By getting together we can communicate with each other, take the skills and techniques that the adult [ophthalmologists] have, and the information that the paediatric specialists have, put those together and end up with something even better,” David Granet MD, director of the Ratner Clinic, University of California, San Diego, and co-director of WCPOS, told EuroTimes.

Dr Ken Nischal, consultant ophthalmic surgeon at Great Ormond Street Hospital for Children and Moorfields Eye Hospital (Hon) and co-director of WCPOS concurred.

“We all have strengths in different areas. Refractive surgeons are very good at refractive surgery, but in the child, it’s the visual rehabilitation after the refractive surgery that contributes to the success of the operation that the refractive surgeon has performed,” said Dr Nischal. “By increasing communications or links with paediatric ophthalmologists, who are good at visual rehabilitation in children, the refractive surgeons can increase the outcome or success of their own procedures,” he said.

The WCPOS offers a full menu of scientific sessions, keynote lectures, instructional courses, and satellite symposia over its two-day run. While planning the programme Dr Granet and Dr Nischal were careful to invite speakers from around the world in order to provide the widest possible perspective on current issues in the field. As a result the conference, with registrations far exceeding expectations, should prove to be an excellent gauge of trends and current and future concerns in paediatric ophthalmology.

“We’re very excited by the level of freedom that the ESCRS has given us to be able to have controversies, case presentations and discussions - every manner of learning experience - at the conference. We’re giving moderators the freedom to run sessions the way they would want to experience them if they were in the audience. We’re going beyond the format of just getting up and talking at people for 10 minutes, we’re making it more dynamic and interactive. We have experts from every region moderating the sessions. What we are doing has never been done before,” noted Dr Granet.

Research papers and posters are only a small part of what’s on offer. In addition to hundreds of free papers, lectures and posters there are three simultaneous tracks of instructional courses each day. These cover all areas of the field, including strabismus techniques, controversies in nystagmus, amblyopia, genetic disease, uveitis and beyond. The meeting was organised so that common areas of interest wouldn't conflict in the schedule, allowing attendees to visit both lectures and courses of interest.

The duties of ‘adult’ ophthalmologists and paediatric specialists overlap in different ways in different parts of the world, creating some controversies. Those controversies were discussed on Saturday in a joint symposium of the ESCRS/WCPOS on Paediatric Cataract & Refractive Surgery.

“We wanted to get the best people from both worlds together. To me the controversy is not that controversial because the people who can do this are the ones who should be doing it. There is no doubt that the paediatric people know the paediatric side better and the cataract people know the cataract side better. But there is a way to communicate better, and that is what this is about. We might not talk so much about where we disagree or differ, but actually where we can get together. We want to find the common ground, and help each other develop the skills, so that the child ends up with the best possible care,” said Dr Granet.

One area that is of great interest to both paediatric and adult ophthalmologists is refractive surgery. Refractive surgery is still considered something of a taboo on the paediatric side of ophthalmology, but that is changing. For example, early clinical experience indicates that laser refractive surgery can be very useful in correcting higher order aberrations in children for whom no other options exist. Laser refractive surgery is also finding a place in the treatment of high refractive errors, amblyopia and anisometropia.

“We may wake up in 15 years and find that refractive surgery is the standard of care in paediatric ophthalmology. The problem is getting from where we are to where we need to go. We need to talk to refractive surgeons who are very comfortable with refractive surgery, and get them together with paediatric surgeons who are uncomfortable with refractive surgery. We’re worried about these kids who will have to live with this for 70 years. We are worried that once we open that door that there will be a stampede of parents running through the door who want their 11-year-old kids to get rid of their glasses for mild myopia. We want to avoid lasering anyone too frequently, too young and in the wrong settings,” emphasised Dr Granet.

* Dr Granet and Dr Nischal are pictured above at the opening ceremony of WCPOS

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