EyeNet Magazine

Academy Notebook

What's Happening 

Physician Workloads

Although U.S. ophthalmologists are working slightly longer hours since 2003, how they spend their time has not changed much over the same time span. According to the biennial Academy membership survey,1 the average ophthalmologist worked 45.25 hours per week. That figure is up from 44.2 hours in the 2003 survey and 42.8 hours in the 2005 survey.

Physicians who indicated that their primary subspecialty was glaucoma worked the longest workweek with an average of 48.22 hours. Cataract/anterior segment doctors worked the shortest workweek at 44.06 hours. International ophthalmologists worked 47.03 hours on average, with doctors in the Middle East and North Africa maintaining a punishing 52.26 hours per week on average.

“Higher population-to-physician ratios in these areas may contribute to physicians working longer hours,” said Academy Secretary for Global Alliances Ronald E. Smith, MD. “In the United States where we have a lower population-to-physician ratio, many ophthalmologists are interested in seeing more patients.”

The survey also showed that the average U.S. ophthalmologist spent 67 percent of his or her time seeing patients in the office, 14 percent in surgery and hospital care, 12 percent in administrative duties, 5 percent in teaching and 2 percent in consulting. This distribution is essentially the same as it was in the data for 2003 and 2005.

By comparison, the 2007 survey showed that international ophthalmologists spent more time in surgery and less time seeing patients in the office. “This is probably due to the increased use of ancillary medical personnel in some countries,” said Academy Secretary for Member Services Ruth D. Williams, MD. “We also know from survey data that our international members tend to be more specialized than their U.S. counterparts with far fewer practicing comprehensive ophthalmology.”

1 This survey was sent to 2,200 U.S. practicing members, 854 of whom responded. The sampling error is +/– 3.4 percent. Separate surveys were sent to U.S. members-in-training and international members.


Academy Presence at the Chief Resident Leadership Forum

Academy president David W. Parke II, MD, will be a keynote speaker at the Chief Resident Leadership Forum, which celebrates its fifth anniversary early next month. The event is designed to provide newly selected chief residents with a cutting-edge curriculum and experiential leadership sessions that will prepare them for their forthcoming role as leaders.

Each year since the forum’s inception, the Academy’s president has played a key role, and this participation has influenced the forum’s evolution and helped solidify it as an important meeting for incoming chief residents.

As the forum’s fifth anni-versary approaches, a few of the Academy’s past presidents have these words to say about it.

Allan D. Jensen, MD (2004): “It was my pleasure to participate in the program during its infancy. I was im-pressed with the number of attendees and their enthusiasm and thirst for knowledge.”

Harry A. Zink, MD (2006): “The forum creates a unique opportunity for young resident leaders to meet, share ideas, work together and develop skills and resources to better handle the responsibilities facing them as chief residents. This group is made up of some very talented and dynamic physicians who will be tremendous assets to their profession. After spending some time with these young men and women, there is no doubt in my mind that ophthalmology still attracts the very best within medicine.”

C. P. Wilkinson, MD (2007): “It has been customary for Academy presidents to attend and be a keynote speaker at the annual Chief Resident Leadership Forum. My visit to the meeting in Dallas in 2007 was quite instructive, as I found the curriculum, lecture topics, speakers and enthusiasm of the resident participants to be excellent. Acquisition of leadership skills as well as organizational skills is an important segment of the overall education of our residents, and this meeting appeared to offer value in this regard.”

More than 150 chiefs have participated in the Chief Res-ident Leadership Forum since 2004. This year’s forum is from May 2 to 4 in Dallas. To register, call 800-771-6927.



Take Part in the Eye Injury Snapshot Project

Help put the focus on eye injuries by participating in the Eye Injury Snapshot Project.

Both the Academy and the American Society of Ocular Trauma urge all ophthalmologists, ophthalmology residents and emergency room physicians to report every eye injury treated during the week of May 11 to 18.

This is the fifth annual Eye Injury Snapshot, and the Academy is now combining this project with its EyeSmart campaign to launch a broad public awareness effort on eye injuries and eye safety. The campaign will launch in June with new research on the public’s understanding of eye injuries.

For more information, visit www.aao.org/snapshot. For additional details on EyeSmart, visit www.aao.org/eye smartcampaign.


Volunteer for an Academy Committee

In early summer, the Acad-emy president-elect and the committee chairs begin the process of identifying volunteer leaders to serve on Academy committees for the following year.

To review and select from the Academy’s committees and to submit personal information, visit www.aao.org and click “Member Services,” “Volunteer” and “Committees.”


Mark Your Calendars for Codequest

AAOE’s Codequest Ophthalmic Coding College is a one-day seminar to get you up to speed on state- and specialty-specific coding information. Learn about CPT, ICD-9, OIG investigations and more.

For a complete schedule, visit www.aao.org/codequest.


Ask the Ethicist: Drafting Guidelines for Clinical Practice

Q: I am a glaucoma specialist with consulting and research- funding relationships in the pharmaceuticals industry. I have been asked to participate in a panel of academic experts to draft guidelines for the medical treatment of glaucoma for an HMO. What are my ethical obligations regarding disclosure of my financial relationships with pharmaceutical manufacturers?

A: A central concept of modern medical ethics is that a physician’s recommendation for care should be made with the patient’s interests foremost in mind, without being compromised by self-interest, other obligations or loyalties. Good ethical practice and the Academy’s Code of Ethics require adequate management of conflicts of interest that could potentially alter unbiased clinical judgment in patient care. As articulated in Rule 15 of our Code of Ethics,1 this applies to counseling the individual patient, as well as communications to the public and to colleagues.

Clinical guidelines by their very nature potentially affect the care of many patients, especially if compliance with the recommendations is eventually required by HMOs or other health care entities as a condition of participation or reimbursement. Clearly, drafting clinical care guidelines is a very responsible activity that ideally should be based on the broadest possible foundation of unbiased medical evidence, without the influence of bias.

If a conflict arising from personal or institutional financial benefit from a relevant industry exists, that conflict must be disclosed to others on the panel and managed appropriately, ideally by recusal from all aspects of the panel discussion that could be affected. Under some conditions, any participation in such a panel may pose irreconcilable conflicts and may require that one decline participation.

Attention to the principles of disclosure and management of conflicts of interest will help assure that clinical guidelines are based on the best clinical and scientific evidence, without being tainted by biased personal opinion or commercial interests.

To submit a question, contact the Ethics Committee staff at ethics@aao.org.

1 www.aao.org/about/ethics/code_ethics.cfm.


Academy Store 

Customize Your Communication Materials

Personal-Eyes Printable Patient Handouts (#058030) features more than 200 patient education handouts explaining diseases, procedures, diagnostic tests and treatments. Spanish-language versions of some of the most frequently used handouts are also included. Personal-Eyes allows the user to change text and photos, increase font size, add maps and append illustrations or diagrams.

This product is Windows and Mac compatible and costs $220 for members and $286 for nonmembers.

For more information or to place an order, visit www.aao.org/store or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540.


New OTA: Orbital Radiation for Graves’ Ophthalmopathy

The Ophthalmic Technology Assessment of Orbital Radiation for Graves’ Ophthalmopathy (#112062), published in February’s Ophthalmology, surveys the literature reporting mixed benefits of radiation on extraocular motility, proptosis, eyelid retraction, soft tissue changes, patient function and quality of life. This product costs $11 for members and $16 for nonmembers.

To place an order, visit www.aao.org/store or phone the Academy Service Center at 866-561-8558 (toll-free in the United States) or 415-561-8540. OTAs can also be downloaded for free online. Visit www.aao.org/education and click “Practice Guidelines” and “Ophthalmic Technology Assessments.”


Meeting Matters 

Important Dates for the 2008 Joint Meeting

Don’t forget to mark your calendar for the Academy’s Joint Meeting with the European Society of Ophthalmology. Circle the following dates:

  • May 21: Advance programs mailed to Academy and AAOE members
  • June 25: Registration and housing open to Academy and AAOE members
  • July 9: Registration and housing open to nonmembers
  • Aug. 13: Early registration deadline
  • Nov. 7 to 8: Subspecialty Day meetings (Retina and Refractive Surgery)
  • Nov. 8: Subspecialty Day meetings (Cornea, Glaucoma, Pediatric Ophthalmology and Uveitis)
  • Nov. 8 to 11: Joint Meeting

For the most up-to-date meeting information, visit www.aao.org/2008.


International Attendees of the 2008 Joint Meeting

If you live outside the United States and plan to attend Subspecialty Day or the Joint Meeting in Atlanta, please note that, as of Jan. 31, citizens of Canada, Mexico and Bermuda who arrive in the United States by land or sea will be required to present valid photo identification and proof of citizenship. This is in addition to last year’s requirements for those traveling by air. In most cases, Canadians and Bermudans will not need a visa.

Other international citizens visiting the United States will require a visitor visa upon entry. Secure a visitor visa through the U.S. Department of State and apply early to avoid delays.

For more detailed visa information, for helpful links and to personalize a letter of invitation, visit www.aao.org/2008 and click “Hotels and Travel.”


Submit Abstracts for Papers, Posters and Videos by April 8

If you are interested in being a presenter at this year’s Joint Meeting, abstracts must be submitted online:

  • For papers, posters and videos, the online submitter closes on April 8.
  • For those submitting a video abstract, the deadline to submit the actual video is April 25.
  • Be sure to download guidelines before making your submission.

For more information visit www.aao.org/2008, click “Scientific Program” and “Presenter Central.” For further information, e-mail meetings@aao.org or phone 415-447-0343.


Hotel Function Space Requests for Atlanta

Would your alumni or specialty group like to meet during the Joint Meeting in At-lanta? If so, please note that hotel function space requests are now being accepted. As-signments are made on a first-come, first-served basis. The deadline is Oct. 24.

For details, including hotel options, approved meeting times and processing fees, visit www.aao.org/function_space.


ISRS/AAO Cancún Advance Registration Deadline Is April 16

The advance registration deadline for the ISRS/AAO Cancún meeting is April 16.

This year’s meeting, Re-fractive and Cataract Surgery: Today and Tomorrow, will take place May 29 to 31 at Fiesta Americana Grand Coral Beach in Cancún. Program Directors Ramon Naranjo-Tackman, MD, José Manuel Vargas, MD, and Steven E. Wilson, MD, are planning a program on the latest innovations in refractive and cataract surgery.

For more information on the ISRS/AAO Cancún meeting, visit www.isrs.org/cancun.


Academy Exhibit at ASCRS

If your plans take you to the American Society of Cataract and Refractive Surgery meeting April 5 to 8 in Chicago, be sure to stop by the Academy booth (#416) and see the latest products from the Academy.


Members At Large 


William F. Astle, MD, has been elected president of the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) and will serve in the position until Aug. 1, 2009. He is a fellow of the Royal College of Physicians and Surgeons of Canada and a diplomate of the American Board of Ophthalmology. Dr. Astle currently serves as director of pediatric ophthalmology and strabismus at Alberta Children’s Hospital in Calgary. He also is a professor of ophthalmology at the University of Calgary and a consulting ophthalmologist at Peter Lougheed and Foothills Provincial Hospitals in Calgary.

The board of directors of the Universidad Nacional Autónoma de México, the largest university in México, has designated Enrique L. Graue, MD, to be the dean of the school of medicine for the period from 2008 to 2012. The university’s Facultad de Medicina has more than 3,200 professors and 15,400 students. Dr. Graue is also past president of the Pan-American Association of Ophthalmology.


Who’s in the News

Charles S. Zwerling, MD, was interviewed by the Chicago Tribune for a Feb. 11 story on the FDA’s recent launching of studies to identify the safety and risks of the chemicals comprising tattoo and permanent makeup inks. “If you are concerned about public safety, we need rules and guidelines,” said Dr. Zwerling.



Gerard W. Crock, MD, Australia’s first professor of ophthalmology, died December 23. He was 78.

Dr. Crock’s appointment as Melbourne University’s Ringland Anderson professor of ophthalmology in 1963 was the first medical specialty chair in Australia and only the second chair in ophthalmology in the British Commonwealth. Afterward, he established the university’s department of ophthalmology and much of the Royal Victorian Eye and Ear Hospital.

In addition to helping develop microsutures, Dr. Crock assisted in a range of microsurgical inventions, including the Schultz-Crock binocular ophthalmoscope and a corneal cutter for precision cutting of the eyes of donors and recipients in corneal transplants. He also worked with indigenous eye care programs in aboriginal communities and was a founding member of Project Orbis, in which experts from Australia and the United States delivered training programs in China.


Washington Report

Military Eye Trauma Measure

A new eye trauma measure will improve tracking, treatment and follow-up for service members such as this young man, who sustained bilateral explosive globe ruptures from an improvised explosive device in Iraq.

Soldiers who sustain eye injuries while serving on active duty should see improvement in their medical care, thanks to a military eye trauma measure signed into law as part of the National Defense Authorization Bill. The legislation was passed by Congress shortly before Christmas, but the president took issue with an unrelated clause, which delayed the law’s passage until Jan. 28.

The bill, supported by many veterans’ services organizations as well as the Academy and the Blinded Veterans Association, marks an important step toward a more seamless transition in care between the Department of Defense and the Veterans Health Administration. Chief among the provisions is the creation of a Center of Excellence within the Department of Defense, which will improve tracking, diagnosis, treatment and follow-up for service members who sustain eye injuries.

“The collaboration and enthusiasm between military ophthalmology and the Veterans Health Administration in caring for our injured troops is already exceptional and gratifying,” said Robert A. Mazzoli, MD, consultant in ophthalmology to the Surgeon General of the Army. “This legislation will enhance that care and cooperation, so that we can continue providing the care that these heroes deserve, whether from this conflict or those yet to come.”

Under the legislation, ophthalmologists in the Department of Defense would be required to report surgeries and other procedures they perform within 30 days. This case information, including additional treatments and the eventual visual outcomes, would be accessible to both the ophthalmologists who provide initial treatment and those in the VA who may handle subsequent care of the patient. The registry would cover both eye injuries and blast injuries with visual symptoms.


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