The honorary lectures are among the highlights of AAO 2023, and there are nine of them on Sunday. These informative presentations by leaders in their field are easy to fit into your schedule, as they are usually between 14 and 35 minutes long. Sunday’s honorary lecturers preview their presentations below.
REFRACTION
Whitney G. Sampson Lecture: Violet Light Hypothesis for the Control of Myopia Progression
Presented by Kazuo Tsubota, MD
When: Sunday, 8:50-9:10 a.m., during Sym33, Current Approaches to Myopia Control (8:00-9:15 a.m.)
Where: West 3018
“Myopia is a leading cause of blindness in Asia, and the prevalence of myopia has been increasing worldwide. It is becoming clear that an indoor lifestyle causes myopia in children. Why? We have found that a certain wavelength of sunlight, from 360 to 400 nm (violet light), which is abundant outdoors but nonexistent indoors, is essential for the prevention of myopia through the nonvisual photoreceptor OPN5. This lecture will discuss the research, proposed mechanism, and possible clinical applications related to this finding.”
—Kazuo Tsubota, MD
Current Approaches to Myopia Control (8:00-9:15 a.m.) is cosponsored by the Eye and Contact Lens Association.
NEURO-OPHTHALMOLOGY
William F. Hoyt Lecture: Optic Neuritis and Multiple Sclerosis: Friend or Foe?
Presented by Steven L. Galetta, MD
When: Sunday, 10:41-10:59 a.m., during Sym32, Cataract Surgery and Neuro-Ophthalmology: Optimizing Outcomes (9:45-11:00 a.m.)
Where: West 3018
“The entity of optic neuritis has had a notable journey over the last 150 years. Originally, its discovery as a distinct entity would suggest the presence of an infection, most notably syphilis. Its relationship to multiple sclerosis (MS) has been debated, with some early authors declaring that there was no relationship. The Optic Neuritis Treatment Trial brought optic neuritis to the forefront of our field by defining its clinical characteristics and emphasizing the importance of brain MRI in determining future risk of MS. This talk will examine the history of our understanding of optic neuritis and highlight the last two decades of advances in its diagnosis and treatment. In many ways, the entity of optic neuritis has been kicked to the curb, since the MS diagnostic criteria have largely focused on brain MRI findings that do not include the optic nerve. We will explore new evidence to support including the optic nerve as the fifth lesion site in the next version of the McDonald diagnostic criteria for MS, while emphasizing that new technologies do not eliminate the need to understand the clinical hallmarks of this important ophthalmological entity.”
—Steven L. Galetta, MD
Cataract Surgery and Neuro-Ophthalmology: Optimizing Outcomes (9:45-11:00 a.m.) is cosponsored by the North American Neuro-Ophthalmology Society.
GLAUCOMA
Robert N. Shaffer Lecture: Expanding the Reach of Glaucoma Care: Out-of-Office Testing and Telemedicine
Presented by L. Jay Katz, MD
When: Sunday, 10:45-11:00 a.m., during Sym29, Glaucoma Care for All: Opportunities and Pitfalls of Artificial Intelligence (9:45-11:00 a.m.)
Where: West 2005
“The rapid rise of technology has presented the opportunity to expand and improve the detection and timely care of glaucoma patients outside the limited resources of the ophthalmology office. Now, those individuals who are at high risk for glaucoma may be identified in primary care physician offices, senior centers, and pharmacies with navigation toward proper care. Other branches of medicine have adopted routine home testing of blood pressure, cardiac rhythm, and serum glucose. With early asymptomatic stages of glaucoma, home monitoring with tonometry may alert patients and physicians that there is inadequate intraocular pressure control. Home perimetry is also starting to be utilized, with optic nerve photography/imaging on the horizon.
“The benefits of incorporating these approaches include earlier detection and identification of glaucoma patients, allowing for a better prognosis, alleviating the burdens imposed on doctors’ offices with the increasing prevalence of glaucoma in our aging population, and easing the challenges for patients and their families in keeping office appointments. Sophisticated data collection and analysis promise to ease the acceptance and trust by physicians who make the critical clinical decisions.”
—L. Jay Katz, MD
Glaucoma Care for All: Opportunities and Pitfalls of Artificial Intelligence (9:45-11:00 a.m.) is cosponsored by Prevent Blindness.
UVEITIS AND IMMUNOLOGY
C. Stephen and Frances Foster Lecture on Uveitis and Immunology: A Delicate Balance: Autoimmunity’s Ying and Yang
Presented by Jose S. Pulido, MD, MS
When: Sunday, 11:35 a.m.-noon, during Sym34, C. Stephen and Frances Foster Lecture on Uveitis and Immunology (11:30 a.m.-12:30 p.m.)
Where: West 2002
The C. Stephen and Frances Foster Lecture on Uveitis and Immunology recognizes the groundbreaking work of C. Stephen Foster, MD, FACS, FACR, founder and president of Massachusetts Eye and Research Institution. Each year, the Foster Lecture is presented by an eminent authority on a clinical, research, or therapeutic subject related to ocular inflammatory disease. This year’s speaker is Jose S. Pulido, MD, MS, director of the Henry and Corrine Bower Memorial Laboratories for Translational Medicine at the Vickie and Jack Farber Vision Research Center at Wills Eye Hospital in Philadelphia.
ORGANIZED MEDICINE
Parker Heath Lecture: Physician Leadership in Designing the Digital Tools of the Future
Presented by Jesse M. Ehrenfeld, MD, MPH
When: Sunday, 12:08-12:23 p.m., during Sym38, Innovations in Ophthalmology From Around the World (11:30 a.m.-12:45 p.m.)
Where: West 2005
At a moment that is both an exciting time and a challenging time in the new digital world in medicine, AMA President Jesse M. Ehrenfeld, MD, MPH, takes a broad look at digital health trends, including AI, highlights some of the ways physicians are actively involved in the creation of new tech innovations in medicine, and helps answer an essential question: what really matters for patients and doctors in this new era of digital health?
“It’s impossible to predict exactly how—and how many—of the digital tools in use today will truly transform how we care for patients. But what we do know is that, from the American Medical Association’s perspective, physicians have a critical role to play in this endeavor and that without our knowledge, our expertise, and our guidance, most digital health innovations will fail in their most basic task of streamlining our workflow and improving patient outcomes.”
—Jesse M. Ehrenfeld, MD, MPH
PEDIATRIC OPHTHALMOLOGY
Marshall M. Parks Lecture: Child Development Informs Pediatric Eye Disease
Presented by William V. Good, MD
When: Sunday, 2:53-3:13 p.m., during Sym44, Adult Strabismus for the Comprehensive Ophthalmologist (2:00-3:15 p.m.)
Where: West 2005
“In children, the brain and eyes undergo remarkable development beginning in the first trimester and ending well after birth. The mature brain looks and functions very differently from the developing one. For example, the premature brain, with its blood supply partially derived from the germinal matrix, gradually begins to derive its blood supply from the more mature large cerebral vessels. A damaging event that occurs prenatally can have a different clinical appearance from one that occurs several years after birth. Although conventional disease models in ophthalmology consider the time of onset of a disease, these models often do not consider that the brain and eyes may differ significantly, both anatomically and functionally, at different times in the child’s life.
“The result is that a damaging event (e.g., vascular, traumatic) that occurs at a particular pre- or postnatal age may have widely different results from the same event occurring a few months or years later. Understanding the timing of disease occurrence may have ramifications for diagnosis, clinical significance, and management of various diseases. Several hypothetical clinical examples are offered in which an identical injury occurred at different times in a fetus’ or child’s life that could lead to important and different clinical interpretations and treatment.”
—William V. Good, MD
OCULOPLASTICS
Wendell L. Hughes Lecture: Orbital Fat: Friend or Foe?
Presented by Geoffrey E. Rose, DSc, FRCS, FRCOpht
When: Sunday, 2:01-2:21 p.m., during Sym46, Pearls and Perspectives From Influencers in the Field of Oculofacial Plastic Surgery (2:00-3:15 p.m.)
Where: West 2002
“Orbital fat is often regarded as a nuisance that intrudes annoyingly during various ophthalmic procedures—whether vitreoretinal, glaucoma, oculoplastic, or, in particular, repair of fractures and deep orbital surgery. In these circumstances, the fat appears to be a ‘foe.’ Problems encountered during orbital reconstruction will be discussed in detail, with particular stress being placed on the nature and avoidance of the ‘Cactus syndrome,’ even with placement of large spherical orbital implants.
“Fat is the major component of a normal orbit, and without it, the structures cannot function properly: here the fat is quite clearly a ‘friend.’ Loss of fat may lead to impairment of optic nerve function or ocular motility—as with cicatricial orbital inflammations or adhesion syndromes after trauma. Symptoms can also arise when fat loss leads to ‘bridging’ of the eyelids away from the enophthalmic globe.
“Perhaps the most important function of orbital fat is as a fluid buffer between normal orbital structures, without which the structures can have only little relative movement. Clinical examples of adhesion syndromes due to damaged orbital fat will be shown, together with examples of how to deal surgically with some cases of severe ocular impairment after suboptimal repair of orbital fractures.”
—Geoffrey E. Rose, DSc, FRCS, FRCOpht
REFRACTIVE SURGERY
Barraquer Lecture: Guided by the Light With a Little Help From My Refractive Friends
Presented by Roberto Pineda II, MD
When: Sunday, 2:01-2:21 p.m., during Sym46, Pearls and Perspectives From Influencers in the Field of Oculofacial Plastic Surgery (2:00-3:15 p.m.)
Where: West 2002
“Corneal biomechanics has become a growing area of research to help understand the structure and physiological response of the cornea to underlying corneal disorders as well as to various surgical procedures. Understanding these biomechanical responses is particularly important in cornea-based refractive surgery, which has largely depended on corneal tomography to identify structural characteristics of biomechanical changes. However, measuring in vivo biomechanical changes and interpreting their results has proved to be challenging and complicated. One technique, Brillouin microscopy, which uses a shift in light frequency, has been able to measure regional biomechanical changes in corneal stiffening before and after laser vision correction. This technology has also been able to map regional corneal weakness in keratoconus and to measure the effect of corneal stiffening after corneal collagen crosslinking. Another exciting method being used to analyze in vivo corneal biomechanical changes is optical coherence elastography. This technology has also provided new insights into the cornea’s response under various biomechanical stressors. This lecture will highlight my experience with these technologies and their application to understanding corneal biomechanics.”
—Roberto Pineda II, MD
CORNEA
Castroviejo Lecture: Will Laser Surgery Play a Role in Keratoplasty?
Presented by Theo Seiler, MD, PhD
When: Sunday, 4:37-4:57 p.m., during Sym52, Laser Surgery and Imaging for Corneal Diseases: When and How. (3:45-5:00 p.m.)
Where: West 2002
“During the past 20 years the number of penetrating keratoplasty (PK) procedures has steadily decreased relative to lamellar keratoplasty surgeries. The greatest increase was reported in endothelial keratoplasty, mainly Descemet membrane endothelial keratoplasty (DMEK), now comprising up to 50% of all keratoplasties. Conversely, the value of deep anterior lamellar keratoplasty (DALK) is still being disputed, even though DALK offers theoretical advantages, for example, in endothelial survival.
“In this era of innovations, the value of lasers for keratoplasty has to be reevaluated. Without question, there is no need to use lasers in DMEK. Most DALKs are accomplished using the big bubble (BB) technique; however, the BBs are achieved in only 30% to 70%. To improve this success rate, the femtosecond laser can create a channel that ends 30 μm away from the Descemet membrane and is controlled by OCT. With this approach, the BB success rate can be increased to 70% to 90%.
“One of the major problems of PK is high postoperative astigmatism. Naumann and Seitz proposed a noncontact trephination method using the excimer laser that was improved during the subsequent 30 years. In contrast to other mechanical and laser techniques used for this process, the corneas are not deformed, which results in highly significant improvements, including better centration of the graft, less all-sutures-out astigmatism (2.8 vs. 5.7 D), and higher visual acuity. Similar results should be obtained using the femtosecond laser with liquid interfaces, because deformations of the recipient cornea are avoided with this technique as well.
“In summary, lasers will be used to make DALK surgery easier and more reliable, and noncontact laser techniques will definitively improve the outcome of PK and DALK.”
—Theo Seiler, MD, PhD
This content is excerpted from the Friday/Saturday and Sunday/Monday editions of AAO 2023 News, the newspaper distributed at the convention center.
Read more news about Subspecialty Day and AAO 2023.