SIT BACK, RELAX, ENJOY THE SHOW AND SEE YOU NEXT YEAR

                                         by Leigh Spielberg

A large conference is sort of like the Olympic Village that’s always built in the Olympics’ host city. 

It contains a collection of like-minded individuals which,when the hotels are included, are separated from the rest of the population, separated from friends and family, essentially separated from the rest of the world.

There are shiny facilities, food & drinks and support staff for the doctors, who are only expected to expend their energies on ophthalmology and nothing else.

People come from all over the world and do so voluntarily. They give their best performance, one for which they have worked long and hard to perfect.

This year’s London multi-conference was quite a bit larger than the 2014 Olympic Village in Sochi. With more than 14,000 delegates attending EURETINA, ESCRS, EUCORNEA, the WSPOS sub-specialty day and ESCRS  Glaucoma Day,  it was nearly twice as large as Sochi’s village, which was attended by “only” 6,000 athletes.

Fortunately, we as ophthalmologists can continue doing what we do until longafter the current crop of Olympic athletes have retired, so I think we have the better end of this comparison.

Real life

I occasionally find it somewhat tricky to return to “real life” after being away from home for a while, whether I’ve been on vacation or at a conference. 

It’s not only the foreign environment, the unusual daily activities and the removal  from all that is familiar makes for an occasionally awkward transition back to normalcy. 

It is also, and primarily, the total immersion into the world of
ophthalmology that takes a day or two to snap out of.

However, it all pays off when I return to the clinic and begin to apply the things I have learned over the past few days. 

Colleagues are interested in hearing about what I heard, new discussions are initiated and vague plans are made to attend
next year, not only to step out of the clinic routine for a few days but to have time to focus on thinking about ophthalmology and learning what others have discovered, rather than simply doing what one already knows.

In my opinion, technological advances have brought about the biggest changes between recent conferences and those of the past. 

The ESCRS and EURETINA conference apps made it quite a bit easier this year to navigate the sessions. WhatsApp has made it simple to find colleagues and friends without paying exorbitant roaming fees for text messages.

The vibe at a conference this big is one of great energy. Most of that energy is good: “Great, I’m going to an interesting session. So nice to see you again, when was the last time, three years ago? How is your practice going?”

But some of it is nervous energy: “I’m late! I forgot to plan ahead and now I’m missing all the best sessions! I’m worried about my presentation! I hope they don’t ask me too many difficult questions!”

Ach, sit back, relax and enjoy the show. See you next year!

A BEAUTIFUL VISION

For many patients a hospital clinic can be a cold forbidding place. But this doesn't always have to be the case.

In the June Cover Story of EuroTimes, our Contributing Editor Howard Larkin , who is based in Chicago, interviewed a number of ophthalmologists and architects in the US and Europe.

They have decided that as the patient is the customer, and not the doctor, their clinics should be designed to make their patients comfortable and to alleviate their anxieties.

The spectacular image above is the exterior of the the seven-story Eye Tower of the University Eye Clinic Maastricht in The Netherlands. The Eye Tower has drawn rave reviews from patients, doctors, researchers and students alike, says Rudy MMA Nuijts MD, PhD, who heads the cornea service and refractive surgery at the  clinic, and Carroll Webers, MD, PhD, chairman of the department. Its sleek façade and welcoming interior also have been celebrated in high-profile architecture and art digests.

Most important, the University Eye Clinic Maastricht is enabling a steady increase in patient and procedure volume, they said. With the ageing of the population the department expects more demand for everything from diabetes and age-related retinal services to glaucoma, cornea, cataract and refractive procedures, not to mention routine primary eye care.

Clinic volume already exceeds the capacity of the department’s previous cramped quarters, and is on track to achieve a major increase over the next few years, they said. Most patients are still from The Netherlands, but they expect cross-border business may pick up as demand grows.

*Read the full story at http://www.eurotimes.org/cover-news.asp?id=3589 and see the image gallery at http://www.eurotimes.org/gallery.asp?id=72157635068524134

  Dr Nuijts and Dr Webers will be talking about their clinic at the ESCRS Practice Development Programme on Sunday 6 October at the XXXI Congress of the ESCRS in Amsterdam, Holland.
See http://www.escrs.org/amsterdam2013/programme/practice-development.asp

WONDERFUL COPENHAGEN

“Wonderful, wonderful Copenhagen
Friendly old girl of a town
'Neath her tavern light
On this merry night
Let us clink and drink one down”

For those delegates old enough to remember, the city of Copenhagen has been immortalised in Danny Kaye’s song from the 1952 musical“Hans Christian Anderson”.

It’s a beautiful song and it captures the spirit of this wonderful city, the venue for the 2013 European Society of Ophthalmology Congress.

As SOE president Stefan Seregard points out this year’s Congress presents an excellent scientific programme in close collaboration with the European subspecialty, research and educational organisations in ophthalmology.

An outstanding set of invited speakers, including internationally renowned keynote lecturers Roger Hitchings, Tony Moore and Greg Hageman will address pertinent issues and update delegates on the current approaches to clinical problems.

The SOE Congress continues to grow in popularity and this year’s meeting has representatives from 96 different countries.  

 EuroTimes, the official news magazine of the European Society of Cataract and Refractive Surgeons, is produci ng a newspaper capturing  the meeting highlights on Sunday June 9 and Monday June 10.

 The newspaper is free to all delegates and will be distributed at the Bella  Centre. You can also see the latest breaking news from the meeting at www.eurotimes.org

GROUND CONTROL TO MAJOR CHRIS

By Colin Kerr, Executive Editor, EuroTimes

If you were a teenager growing up in the 1960’s, David Bowie’s “Space Oddity”, released in 1969, would have been part of the soundtrack of your life.

Space travel defined that decade in the same way that the internet defines the times we live in today.

I’d recommend that anyone who loves m music and literature should listen carefully to Bowie’s lyrics and then read “The Right Stuff” by Tom Wolfe, one of the great American novels about the pioneers who put man on the moon (also listen to “Man on the Moon “by REM for a more whimsical insight into the great adventure ).

It started on April 12, 1961 when Yuriy Gagarin, an army major in the Soviet Union remained in orbit for 1 hour and 48 minutes, proving that human beings can survive in space.
http://www.spacechronology.com/1960s.html#ixzz2TA3bOjQJ

For most children and young boys of my generation, the pinnacle of the space age was reached on July 16, 1969 when the American astronauts Neil Armstrong and Buzz Aldrin safely landed on the moon, while Michael Collins orbited around it. Their space ship Apollo 11 spent 21 hours and 31 minutes on its surface and returned safely back to Earth.

So where do we go from here?  Commander Chris Hadfield has posted a cover version of Space Oddity, recorded 230 miles above the earth on his last day in charge of the international space station.

Only the great, great songs can bring tears to your eyes, and Hadfield’s version of the Bowie classic is one of them.

The lyrics have been reworked slightly but Hadfield has stayed true to the original and made it even better with a really stunning video.

Welcome home Chris, on behalf of all the ophthalmologists in the world who dare to go where no man or woman has gone before.

THE WHOLE EARTH CATALOGUE

By Colin Kerr, Executive Editor, EuroTimes

I keep returning to The Observer newspaper to read some of the best and incisive writing in the English language.

The cover story in the paper's review section looks at The Whole Earth Catalog and the visionary work of Stewart Brand.

The article features an interview with Brand by Carole Cadwallader whose breathtaking range of ideas has influenced generations of scientists, futurists, architects, storytellers, photographers, inventors and inventors including Steve Jobs.

Brand is now 74 but as Cadwallader points out he is still fit and active and brimming over with new ideas and insights into the way the world has changed and is changing.

Read the full interview at http://www.guardian.co.uk/books/2013/may/05/stewart-brand-whole-earth-catalog

ARE UNIVERSITY LECTURES DOOMED?

Jimmy Wales, the founder of Wikipedia, recently suggested that online courses herald the end of traditional lectures.

In an excellent article in The Observer newspaper, Philip Henshaw, novelist and professor of creative writing at the University of Bath-Spa, UK and John Mullan, writer and professor of English at University College London, went head to head and argued the case for and against.

Henshaw argues: "Since I took to lecturing myself, I generally approached it as cabaret. You and I have stood together and yammered in front of silent audiences of sighing Germans. Since nobody much walked out, we believed ourselves to be extraordinarily fascinating. This discovery for academics is thrilling, and so there is an incentive to hang on to the hour-long lecture. But, realistically, if one wanted to teach anyone anything, I think one should make them participate, interrupt, ask questions, disagree, talk back, and that's the alternative route I've taken. There are probably a dozen lecturers  in this country so brilliant you don't want to do anything but listen to them for an hour. The rest of them should approach learning as an exchange with students."

According to Mullan, this approach is flawed. "Participation, interruption, disagreement – all those student responses you celebrate are virtuous, of course, so you have class or seminar teaching, where they are part of the deal. But sometimes the students want to know what the academic knows," he says.

"Learning shouldn't all be exchanging thoughts with students (and in the sciences and quantitative subjects it often cannot be this). The students can find it frustrating (as they tell us) when they have to spend their time listening to the least informed but most opinionated fellow student in the room."

http://www.guardian.co.uk/commentisfree/2013/may/05/debate-university-lectures-doomed-philip-hensher-john-mullan

So does this logic apply for ophthalmology students? I'd welcome your comments so let me know your views.

Colin Kerr

Social Media - You Can't Have It All

Colin Kerr


Executive Editor, EuroTimes



I've just returned from the Media Future conference in Dun Laoghaire, Dublin, where I hoped to finally unlock the Pandora's Box that holds the answers to my quest for a Social and Digital Media strategy.


 I've been working on this project for the last ten years and still haven't found what I'm looking for. But hope springs eternal and maybe today is the day I will discover my inner New Media Guru.


 Of course, it isn't as easy as that. I met a colleague from a former life yesterday and asked him what he was doing, meaning what line of work he was in. 'I'm just trying to find what this stuff is all about," he replied.


 By 'this stuff' he meant New Media. Like me, he is a dinosaur of the golden age of newspapers and magazines when journalists pounded the keys of their manual typewriter, erased their mistakes with Tippex and kept copies of their articles with carbon sheets imposed on a second sheet of paper.



We carried out our research in a tiny little room known as The Librarybwhere we would spend hours poring over old newspaper cuttings neatly filed in small cardboard folders.


 Thank heaven for Google and the other search engines that have reduced the research timespan from hours to minutes. Thanks also to Bill Gates, Steve Jobs and the other visionaries who have developed the new technologies that have opened up a brave new media world.


 And hopefully today I too will find what all this "stuff" is about. 

ASCRS WELCOMES BO PHILIPSON AS HONOURED GUEST

Major honour for former programme chairman of ESCRS

By Howard Larkin in Chicago 

In recognition of his prominent role advancing cataract and refractive surgery in Sweden and Europe, incoming ASCRS President David Chang MD welcomed Bo T Philipson MD PhD, Stockholm, Sweden, as an honored guest at this year’s ASCRS Symposium.

“Dr Philipson also played a key role in development of the first OVD as well as heparin-coated IOLs, and the Technis diffractive multifocal IOL,” Dr Chang said.

Dr Chang also noted Dr Philipson’s service as a leader, founder and programme chair of the ESCRS, his extensive lecturing and surgery in more than 20 countries, his leadership of the ophthalmology department at Sweden’s prestigious Karolinska Institute and his founding of the Ögonklinik, now Sweden’s largest private eye clinic. “He has educated a generation of Swedish cataract surgeons and led the efforts to adopt phaco emulsification, intraocular lens implantation and corneal refractive surgery in his home country.”

Accepting the honor, Dr Philipson expressed his gratitude for the opportunities he had to improve ocular surgery and those who supported his efforts. “I am very fortunate to be of the group to have experienced the evolution of cataract and refractive surgery from intracapsular surgery to the modern very advanced surgery. It’s been very fascinating. This shift of surgical technique and the improvement of outcome have been made possible by the excellent teaching facilities that ASCRS and ESCRS have provided to us.”

Noting that he has attended almost all ESCRS and many ASCRS programs over the years, Dr Philipson thanked several American colleagues with whom he has studied and worked over the years, and whose ideas he shared in Europe. “Bob Sinskey was really my first mentor, and I visited him many, many times. Howard Fine was a fantastic teacher, and I had the possibility to work with and learn from Doug Koch, Steve Obstbaum and Dick Lindstrom. Jack Holladay and Jay McDonald, and I am very sorry we miss David Apple and Charlie Kelman. They taught us a lot.”

TEACHING IS EVERYTHING

Jack Holladay inducted into ASCRS Ophthalmology Hall of Fame in emotional ceremony

By Howard Larkin in Chicago

Internationally known for his pioneering work in optics, including brightness acuity tester for assessing the impact of glare on vision and widely used IOL power calculation formulae, Jack T Holladay MD MSEE FACS, was inducted into ASCRS’ Ophthalmology Hall of Fame. In an emotional address to the opening session of the ASCRS Symposium, Dr Holladay thanked colleagues for their support following high-risk aortic surgery in 2010, and cited his teaching experiences as among the most rewarding of his life.

Dr Holladay has contributed immensely to improving the understanding of optics in ophthalmology, including glare testing, interpretation of corneal topography and the nature of astigmatism, said Douglas Koch MD, Houston, US. His IOL consultant power calculation software that takes into account factors such as corneal transplants and refractive surgery have improved vision outcomes for cataract patients around the world.

Dr Holladay spoke from the perspective of one who came close to death. His operation to correct an aortic aneurysm involved lowering his body temperature enough for him to survive cutting off blood flow to his brain for about 20 minutes during the procedure, followed by an eight-day coma, he said.

“I had a one in 10,000 chance of survival. The intensive cardiologist just happened to be walking down the hall and the only surgeon in Houston who could do the procedure was doing heart surgery upstairs,” said Dr Holladay. Though he is still a Clinical Professor at Baylor College of Medicine, he no longer sees patients. Holding back tears, he haltingly recounted the support he received from his family during his eight-day coma, and the hundreds of messages from colleagues and students around the world.

“After 37 years in ophthalmology I had to retire because I wasn’t quite the same after the operation. Looking back, the things I think about are not the patents, not the papers, none of those things, really. It’s the teaching,” Dr Holladay said. In 40 years of teaching, as an engineer before he completed his medical training and as a physician, Dr Holladay estimates he has taught more than 10,000 ophthalmologists in optics.

Dr Holladay added: “I wanted to create for them the same excitement I had about the optics of the eye that is such a miracle; get them to understand this miraculous device that allows us to interact with the world. Every day we perform a miracle on patients by restoring their vision. Within a few hours they can go from complete blindness to vision that is almost perfect. Most important, I am grateful for all the friends I have around the world in ophthalmology. I say to you thank you, thank you so much.”

Embracing Dr Holladay at the podium, ASCRS Foundation Chair Richard Lindstrom MD, Minneapolis, Minnesota, US, shared the warm feelings Dr Holladay expressed. “He is a friend, colleague and a true giant in the field. His tenacity, commitment and sheer brilliance have given us some of the greatest advances in all of ophthalmology.”

A new dawn for ophthalmology in the Middle East and North Africa

"This region (the Middle East and North Africa) is the cradle of civilisation as well as the origin of  mankind. It is here that human civilisation started 6,000 years ago."

With these words Dr Adbulaziz Al Rahji sent out a message to the 10,000 delegates from 136 countries attending the World Ophthalmology Congress 2012 in Abu Dhabi, that ophthalmology has to look to a global audience if it is to develop.

This is the first time that the WOC had visited the MENA region and Dr Al Rahji and his colleagues will be hoping that it will not be too long before it returns.

At a spectacular opening ceremony in the Abu Dhabi National Exhibition Centre (ADNEC), Dr Al Rahji, said that ophthalmogists in the region had a past that they were proud of and a bright future that had brought them to WOC 2012.

They had come together to focus on science, he said, and to work together to improve the quality of life of their patients. Many individuals, he said, had worked together to make sure that the delegates attending the Congress would leave the meeting with greater scientific knowledge and a positive cultural experience.

EuroTimes talked to Dr Al Rahji, president of WOC 2012, on the day before the close of the meeting on Monday February 20 and he said that the feedback that they had received from delegates had been very positive. "We are happy that we managed to provide a high quality scientific programme with a good meeting facility, " he said. "One of our main aims was to give delegates a flavour of the culture of the region, so the congress has been scientifically enriching and also socially rewarding."

As one congress ends, the work begins on another. The venue for WOC 2014 is Tokyo, Japan.

Prague hosts 16th ESCRS Winter Meeting

The 16th ESCRS Winter Meeting in Prague hasd continued the improvements made in both the format and content of the recent meetings held in Budapest in 2010 and Istanbul in 2011.

“The first winter meetings held in the late 1990s were almost entirely dedicated to refractive surgery,” he said, “and the main autumn meeting was predominantly a cataract meeting. In recent years, the thrust of the winter meeting has evolved and I think it has evolved very much for the better,” said ESCRS President Dr Peter Barry.

Dr Barry (pictured above with Pavel Studeny, the ESCRS Board member from the Czech Republic pointed out that the society had made a commitment to hold the winter meetings in emerging European countries that in the past might not have had the opportunity to host major international meetings. “The winter meeting now has a similar format to the main summer meeting in terms of symposia, free papers, instructional courses and wet labs,” he said. “It might be somewhat more didactic than the main meeting but it also has innovative components similar to our main meeting.”

Dr Barry said the ESCRS was also very grateful that the international industry had continued to support the winter meeting to ensure that there was a lively trade exhibition at the meeting.

“The meeting is becoming more important in its own right,” he said, “and it is providing excellent opportunities for local ophthalmologists for practising and training. We  also introduced lower registration fees for delegates from the countries close to Prague so that it is more economic and convenient for them to attend the meeting.”

An indication of the success of this initiative is the fact that more than 100 delegates from the Czech Republic  attended this year's meeting in Prague, compared to seven  attendees from that country  in 2011.

Strawberry Visual Fields Forever

In the wake of the untimely death of Apple computer founder Steve Jobs, Dale K Heuer MD, chairman and professor of ophthalmology at the Medical College of Wisconsin, Milwaukee, US, reported  on some of the firm’s contributions to medicine as well as a real breakthrough for ophthalmologists – the recent availability of classic Beatles songs on iTunes. Glaucoma specialists’ favorites include “Trabby Road,” “Strawberry Visual Fields Forever” and “Blue Eyes Yellow Submarine.”

Dr Heuer, speaking at the recent meeting of the American Academy of Ophthalmololgy in Orlando, Florida ended his tribute with a rendition of the immortal “Yesterday”:

Yesterday.

Loss of vision seemed so far away

Then I had trabeculecto-may

Oh, how I long for Yesterday.

Suddenly

My vision’s half of what it used to be

There’s a shadow hanging over me

Oh vision loss came suddenly.

Why I needed more flow

I don’t know

She wouldn’t ne say

My field had something wrong

Now I long for yesterday.

Yesterday

Faking drops was such an easy game to play

Now my vision has all gone away.

Oh how I long for yesterday

It's all about the data for ophthalmologists

AAO is looking to national outcomes registries to defend the specialty from marauding insurance companies, politicians and optometrists.

“It’s all about the data,” AAO Executive Vice President and CEO David W Parke III MD told several thousand attendees of the opening session of this year’s annual meeting.

AAO has taken several steps to generate better information to document the complexity and value of care ophthalmologists provide. These include developing new ICD-9 diagnosis codes that more precisely describe ocular conditions, which were implemented by the Medicare program this year. Continued development of AAO’s Preferred Practice Patterns is also essential because they incorporate evidence-based care processes, said AAO President Richard L Abbott MD (pictured above)

 “Using clinical practice guidelines is not the same as ‘cookbook medicine,” he said. Rather, guidelines, including the AAO PPPs, provide a general pattern of practice which physicians must apply to individual patients using their professional judgment, clinical intuition and unique training. He pointed to the AAO’s analysis of the impact second-eye cataract surgery on patients’ quality of life, which led to a favorable national coverage decision, as an example of how good data can demonstrate the quality and value of the services ophthalmologists provide.

Dr Parke noted that other specialties in the US, notably cardiovascular surgeons, have successfully used national registries not only to improve care but to advocate for adequate reimbursement for services. This is a key issue for both preserving payments in the national Medicare system for older Americans, but also in private insurance companies. Many already profile physicians based on claims data, which do not take into account issues such as the difficulty of treating patients with advanced disease, multiple co-morbidities and other complications. As a result, some insurers have unilaterally lowered ophthalmology payments to levels reflecting uncomplicated routine care. Some states have even expanded the scope of practice for optometrists to include surgical procedures for which they are not trained.

Capturing the true level of service provided by individual ophthalmologists and the specialty as whole requires a national ophthalmology database that covers all subspecialties AAO President-Elect Ruth Williams said. Through its Hoskins research center, AAO is developing a guidelines-based database in collaboration with other ophthalmology societies.

Dr Williams envisions that the database will be linked to electronic medical records in ophthalmologists’ offices. These systems will also allow the integration of independent ophthalmic practices with larger risk-bearing delivery systems promoted by the US health reform bill passed last year, as well as by private insurance firms.

Steve Jobs RIP

To some ophthalmologists, the name Steve Jobs won't mean a  lot. He died today aged 56 with pancreatic cancer.


So why should eye surgeons, or indeed any other health professionals, remember him?

Older ophthalmologists may find it hard to adapt to the new world order which has seen Apple's and Jobs's iPhones and iPads transform the way that we create and share information. But for young opthalmologists in training today, I would suspect that these products have become essential tools of their trade.


Recent research carried out by EuroTimes has shown that the majority of ophthalmologists still prefer to get the latest news on ophthalmology from the printed magazine. But there is a growing number of ophthalmologists  who are looking to Apps or other  applications, not only to share information, but also to help them in their day to day work.

Of course it should be pointed out that Steve Jobs alone wasn't responsible for this technological revolution,  but he became a cheerleader for a new generation that wanted and continues to want to look at new ways of seeing, hearing and speaking.

The Apple website http://www.apple.com simply states: "Apple has lost a visionary and creative genius and the world has lost an amazing human being. "


Steve Jobs, rest in peace.

Vienna or Bust

By Howard Larkin

Evidence of its imperial past, as well as the outsize personalities of its rulers, artists and warriors is never more than a short walk away in this eminently walk-able city of Vienna, site of the XXIX Congress of the ESCRS. There’s something for every interest. But watch out for horse-drawn fiacres on the narrow cobblestone lanes of the ancient city center.

Rising dramatically from the tunnel-like strasses of the city center is the Gothic cathedral Stephansdom. It’s hard to miss the gigantic Habsburg coat of arms emblazoned in green, white, red and black tiles on the roof. The foundations of this house of worship date back to the 12^th Century. Since then friezes, frescos, alcoves, alters, pulpits, sarcophagi, and entire naves and towers have been added by a succession of patrons.

Many commemorate triumphs over evil in scenes mirroring Christ’s triumph over death in the resurrection. The Pulpit of Johannes Capistrano outside features a cherubim-bedecked gilt sunburst glorifying the enraptured Franciscan warrior standing over a writhing Turk. Nearby, a pious couple kneel beneath the risen Christ astride writhing demons. Inside, the master designer Pilgram looks out over his work, tools in hand.

Marble portraits of Kaisers past, including Mathias, Maximilian, Leopold I and Karls II & IV, along with Marie Antoinette, look over the crowds at the Kunsthistorisches Museum. Oil portratins and allegorical paintings by Reubens, Cranach the Edler, Rembrandt and more line the walls. The triumph of good over evil resonates throughout, from the allegorical Theseus defeating a centaur to the mythical St. George slaying the dragon to the literal Judith with the head of Holoferens.

On the campus of the University of Vienna, the Pathologisch-Anatomisches Museum chronicles the history of medicine. Samples of tubercular organs, venereal diseases and some of the oldest hip prostheses are on display. Domiciled in the former home of the psychiatric ward of the General Hospital, the barred windows and thick stone walls give further testimony to how far medicine has advanced in the past century.

And there’s Mozart and Strauss and Harry Lime. Get out and see it. Just a short walk.

There's eight days to go before the XXIX ESCRS Congress in Venice, Austria. Visit this blog for the latest news and views on this excitng event.

Ophthalmology - the next generation

Helen Tynan,  Head of Human Resources for Google Ireland  spoke recently at a "Commmerce and Cornflakes" breakfast , organised by the National College of Ireland and sponsored by cereal manufacturers Kellogs.

Ms Tynan told attendees at the breakfast that Google as a company has its pluses and minuses but there were things that worked for them that could be transferred to other companies.

What she didn't say, but what is true, that there are things that work for Google that could also work for ophthalmologists, particularly in the way they run and manage their practices.

 To get inside the mindsite of  Gen Y workers she asked the audience to think of teenagers aged 16 and 17 and young adults in the early 20s.

“They don’t sit, they land, they sprawl. When you are talking to them they are texting at the same time or checking their Facebook status or surfing the net. When they’re watching TV they have their laptops and they’re surfing at the same time. ake that and think about trying to put those people into a workforce and getting the best out of that generation.”

Google, said Ms Tynan, is a young company entering its teenage years and has grown up with Gen Y and the majority of its employees and managers are Gen Y so they don’t have the same challenges of assimilating this new generation of employees as older more established companies. Google was not set up as a traditional company and was never intended to become one.

So how does this philosophy transfer to the Google workforce. A typical Google workplace would include laptops everywhere,foosball, pool tables, volleyball courts, assorted video games, pianos, ping pong tables, and gyms that offer yoga and dance classes. Healthy lunches and dinners are provided for all staff at a variety of cafés. and break rooms are packed with a variety of snacks and soft drinks to keep Googlers going.

http://www.google.com/about/corporate/company/culture.html

But, said Ms Tynan, it’s not just fun for fun’s sake, it’s fun because it works and it encourages people to collaborate, get together and share ideas.

“It’s not all about beanbags and foosbol tables They work and they work fantastically well in a culture that has evolved around them,” she said. “Our intellectual property is our employees and from the very beginning part of the culture of Google was to take care of employees and to reward them for innovation and creativity.”

One area of particular interest, she said, is that in Google employees are allowed to spend 20 per cent of their time working on projects outside of their core working task. This is usually Google related which encourages them to come up with ideas for new products or improvements in existing products.

Gmail  was one of successful products to come out of this 20 per cent model.

Google spends a lot of its time on the hiring process and most employees will go through four or five interviews before they are recruited. They hire very bright people, said Ms Tynan, and provide them with an infrastructure to get the best out of them. “We don’t have a lot of formalities or policies. We try to let people get on with their jobs, improve their jobs and come up with new ideas. Every day we try to see what people are capable of and it’s amazing what people can do if you stay out of their way.”

So how can this translate to other companies? They should take risks with their employees and  not become overreliant on policies and procedures.  “Give employees freedom and give them trust and if it’s abused handle the cases individually . What we sometimes do in human resources is to legislate for five per cent of abuse rather than the 95 per cent of people who can be trusted.”

Good recruitment is also essential. “If you hold tough and hire the best people for your company and your culture you will reap the benefits of it,” said Ms Tynan. “This is not about academic brilliance, this is about someone who is going to demonstrate the values that are important to your culture and your team.” Even if you are desparate to fill a vacancy, she said, don’t hire someone who is not good enough and hold out for the best candidate for the job.

Openness is also important, she said, and staff should be briefed and consulted as often as possible and if they ask questions they are answered. “If you work for Google, you are trusted with information,” she said. “Confidential information is shared extensively internally.”

Focus on the future of ophthalmology in ancient Japan

Sean Henahan has just returned from Kyoto where more than 500 cornea specialists from throughout Asia and beyond gathered for the 2nd Asia Cornea Society Biennial Scientific Meeting.

Japan's ancient capital, showing its best autumn colour, served as backdrop for the conference, the theme of which was An Enlightening Focus on the Future.

"For 40 years, not much was happening in cornea, there was PK and that was about it. But now it has become one of the most exciting fields in ophthalmology. We are seeing a major paradigm shift over the past few years. The rationale for creating the society was to provide opportunities for networking among the Asian countries and the international societies, and to allow for networking, education and research,"  Donald Tan MD, president of the Asia Cornea Society, told EuroTimes.

The meeting served as an occasion for the announcement of two major initiatives by the Asia Cornea Society. The first of these is the creation of Association of Eye Banks of Asia (AEBA). The concept of this programme is to create standards for the collection, preparation, storage and delivery of donor corneas throughout Asia. The first phase, now under way, involves revamping the Sri Lanka Eye Bank, historically one of the leading centres in Asia.

"Asia has the highest rate of corneal blindness in the world. So we are taking a problem solving approach to this. That is the rationale for the AEBA. The ultimate goal is to create high quality local eye banks that are able to procure local donors and make corneas available locally, and eventually to be able to export any excess tissue."

The second initiative announced at the conference was Asian Cornea Society Infectious Cornea disease Study (ACSICS). The one-year prospective observational study will involve 11 sites in eight countries. These will document the extent and impact of keratitis in the region. Researchers aim to learn more about risk factors, aetiology, regional characteristics, antibiotic resistance etc. This will ultimately allow for the creation of meaningful practice guidelines, Dr Tan said.

The four-day meeting served up everything from essential basic research to the latest therapeutic strategies for the full spectrum of corneal disease.

Cornea specialists were probably the first to use stem cells therapeutically, by way of cell transplantation for ocular surface reconstruction. There have been considerable advances in that field, with major contributions from Japanese investigators. Attendees heard about current efforts to use cell sheet transplantation. In addition to cultivated limbal epithelial transplantation, researchers are now using cultivated oral mucosal epithelial cells, autologous nasal mucosal cells, and even ear perichondrium cells for ocular surface reconstruction.

Keratoconus continues to be a bread and butter issue for cornea specialists. Joseph Colin MD, Bordeaux, France, presented the latest findings on treating the disease with Intacs, and collagen cross-linking, alone and in combination.

Contact lens related ocular infection also continues to be a problem. Prof John Dart of Moorfields Eye Hospital in London presented a  large-scale epidemiological study of contact lens related keratitis. The largest study of its kind, it details differences in rates of Acanthamoeba keratitis, which is almost unheard of in continental Europe, but is an ongoing problem in England. More than 90 per cent of cases of contact lens related keratitis could be prevented with proper patient education and hygiene, he reported.

Conference delegates also got an update on corneal and lenticular refractive surgery. Hiroko Bissen-Miyajima MD, Tokyo, Japan discussed LASIK enhancement in patients who have received multifocal IOLs. She also presented information on new IOLs available for microincision cataract surgery.

The genetics of corneal dystrophies was another topic of interest, with considerable advances in screening for these disorders. Akira Murakami MD described early work using a hydrogel contact lens as a device for single gene transfer. He reported early success in animal work delivering a gene via a special contact lens a single gene disease. This approach also has broader potential for treatment of various corneal disorders, he noted.

Look for comprehensive coverage from the conference in upcoming issues of EuroTimes.

EuroTimes wins design award

Paddy Dunne, senior designer, EuroTimes, has won the Designer of the Year (Business Magazines) award 2010.

The judges of the award presented by Magazines Ireland said they saw evidence of major design innovation and excellence with a refreshing new look for the magazine following its redesign earlier this year.

"I believe the rebranded issue of EuroTimes vastly improves on the previous template," said Paddy in his submission for the award.

"Reader feedback on our new look has been very positive. With every issue since June 2010, we strive to make further improvements giving our readers a much more satisfying reading experience. This rebrand has given our product a massive reinvigoration and it is for these reasons that I believe EuroTimes eligible for Best Designer in B2B."

After accepting his award Paddy also paid tribute to EuroTimes assistant designer Janice Robb who played a major factor in the 2010 redesign.

Colin Kerr, executive editor, EuroTimes, said that winning the award was a major recognition for the magazine.

"This was very much a team effort and I would also like to thank the editorial and marketing team at EuroTimes and our international Editorial Board headed by Dr Emanuel Rosen, chairman of the ESCRS Publications Committee," he said.

For more information visit http://www.ppa.ie

ESCRS symposium on emerging lenticular options at AAO/ISRS refractive subspecialty day

Light-adjustable lenses that may be used to achieve emmetropia in post-LASIK cataract patients or increase binocular depth of field through selective manipulation of asphericity in mini-monovision were among the growing list of lenticular refractive options presented at the ESCRS symposium at the 2010 AAO annual meeting refractive subspecialty day sponsored by the International Society of Refractive surgery.

As in laser vision correction, a slight negative asphericity in the eye targeted for near in mini-monovision also has been shown to increase depth of field in pseudophakic patients, noted Jose Guell MD, Barcelona, Spain. “It can be a very useful tool for presbypoia improvement,” he said.

However, there are important limitations in applying it for IOLs, Dr Guell said. The tolerance for spherical aberration is limited to about 0.2 microns and achieving this level of precision can be difficult. For one, the degree of asphericity is related to the degree of residual astigmatism, so an accurate spherocylindrical correction is essential. The effects of lens decentration, tilt or rotation also affects asphericity and other higher order aberrations, and small lens movements could increase aberrations beyond the tolerable range.

Light-adjustable lens may be one way to address these issues, Dr Guell suggested. The power and asphericity of the lens can be adjusted after surgery. Laser corneal enhancements are another option and may be possible in conjunction with light-adjustable lenses, he added.

In a study presented by Roberto Bellucci MD, Verona, Italy, 20 eyes implanted with light-adjustable lenses were found to have higher levels of spherical aberration, resulting in their aberration-derived Strehl rations being similar to those seen in spherical monofocal lenses. He believes the increased asphericity, which averaged 0.118 +/- 0.044 microns for the eye, was most likely due to the reshaping of the lens with ultraviolet pulses after surgery. This resulted in a myopic shift of about 0.9 dioptre with an increase in pupil size from 4 mm to 6 mm.

However, and somewhat unexpectedly, the light-adjustable lenses did not result in higher levels of coma or other asymmetrical aberrations, Dr Bellucci noted. “From a clinical point of view all our patients were satisfied and reported good uncorrected vision. It can be postulated that the increased depth of focus involved with the high spherical aberration played an important role in this satisfaction.”

A study of 26 eyes implanted with the Crystalens HD accommodative IOL by Ioannis Pallikaris MD PHD, Crete, Greece, (pictured above with the other ESCRS presenters) found that the lenses produced a good range of vision even when implanted in the sulcus. Mean uncorrected distance vision improved from 0.41 +/- 0.21 to 0.70 +/- 0.19 on a decimal scale, and corrected vision improved from 0.66 to 0.87. At intermediate distances 80 per cent of patients achieved J1 and at near 70 per cent were J3 or better. The three patients with sulcus-implanted lenses also demonstrated accommodation, Prof Pallikaris said.

Joaquim Neto Murta MD, Coimba, Portugal, presented results on a new rotationally nonsymmetrical multifocal lens without Fresnel lines. The pupil independent lens has an aspheric asymmetrical distance zone combined with a sector near zone with a +3.0 add to minimize light loss and light sensations. The lenses provided adequate vision, were stable and provided good contrast sensitivity, he said.

Also presenting were Oliver Findl MD, Vienna, Austria, on add-on lenses to correct residual sphere and cylinder error and Beatrice Cochener MD, Brest, France on refinements in toric implantation. She emphasised the importance of meticulous technique, including removing all viscoelastic from the chamber, to help minimize lens rotation after surgery.