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November/December 2008

Everything’s So Different: Have I Been Asleep?
By Richard P. Mills, MD, MPH, Chief Medical Editor, EyeNet

Have you ever awakened in the morning and noticed that your world is suddenly changed? I’m not talking about personal challenges that affect only us and a few other people. I’m talking about that Rip Van Winkle feeling that makes you wonder if you have been sleeping longer than you had thought because the world and all the people in it are acting differently than you remember. Some of these changes occur suddenly, like those that followed Pearl Harbor or 9/11, but others have been happening for a while under the radar and then abruptly come to awareness. Examples for me include the computer revolution, e-mail communication and now the globalization of almost everything. Thomas Friedman in his best-seller The World Is Flat describes economic globalization in chilling detail.

So what relevance does this have for ophthalmology? Borrowing a page from Friedman, there is an extraordinary confluence of major trends that enables the global dissemination of ophthalmic knowledge. This will result in the reduction of worldwide blindness in a significant way. First, the World Health Organization Assembly passed a resolution in 2006 for the first time identifying prevention of avoidable blindness and visual impairment as an organizational priority. Such a resolution carries enormous weight with political and public health leaders worldwide. Second, the explosive growth of the Internet that doubled in the two years leading up to December 2007 means that 22 percent of the world’s population, 1.3 billion people, actually used the World Wide Web as of a year ago. Not only that, but the Internet has made it possible to deliver information at virtually no cost to the sender or receiver. The confluence of these trends means that it will soon be possible to export ophthalmic knowledge to the benefit of ophthalmologists worldwide. The Academy successfully launched the O.N.E. Network for members a year ago. Now it is poised to make it available to ophthalmologists around the world, providing access to the breadth of the Practicing Ophthalmologists Curriculum with a few keystrokes at a computer.

In the past, the Academy has done all it could to distribute print materials to training programs and ophthalmology societies in developing countries. Sadly, this effort has heretofore been limited by the cost of the materials and their distribution. Yet the Academy’s reputation as the worldwide leader in quality ophthalmic education is well burnished thanks to its Annual Meeting and other trusted products.

So, how would you feel if I told you that globalization of ophthalmic education can be accomplished without the expenditure of a single penny of domestic members’ dues or by incurring opportunity costs that would reduce the Academy’s domestic effectiveness in advocacy or education at home? And that it can be done without endangering the Academy’s intellectual property rights. And that it would be done using a collaborative model, with willing participation of the International Council of Ophthalmology and national ophthalmology societies and their members. If these criteria could be fulfilled, wouldn’t you be in favor of helping ophthalmologists in the developing world reduce the local burden of blindness?

In the future, Opinion will provide more detail about these possibilities. Stay on top of your EyeNet reading, and, who knows, maybe you won’t wake up someday wondering how American ophthalmology played a major role in reducing blindness worldwide.