• Inspiring the Next Generation: Inaugural Global Ophthalmology Summit

    What started as a small annual retreat for global ophthalmology fellows has grown into an international conference for those passionate about tackling vision-related health disparities across the globe. 

    The inaugural Global Ophthalmology Summit took place in Park City, Utah from Aug. 12 to 13. Over 200 medical students, residents, fellows, public health specialists, nongovernmental organization representatives, industry representatives and leaders in global ophthalmology from several countries attended. The summit brought together a community that has helped shape global ophthalmology as a subspecialty. Here are a few highlights among many inspiring moments from the conference.

    As Global Ophthalmology Expands, So Does Need for Subspecialty Care

    Challenges in providing care in low-resource settings are unique and vary with each subspecialty. At the summit, leaders in each field joined to discuss these challenges and brainstorm solutions. Sessions dedicated to each subspecialty were co-sponsored by subspecialty societies and delved into the challenges specific to each field.

    The societies included American Association for Pediatric Ophthalmology and Strabismus, American Glaucoma Society, American Society of Retina Specialists, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, North American Neuro-Ophthalmology Society, American Uveitis Society, the Cornea Society and the International Society of Ocular Oncology,

    Diagnosing and treating glaucoma in low-resource settings differs drastically from addressing vision impairment and blindness due to cataracts. Cataracts can be diagnosed visually and may be treated with a one-time surgery. In contrast, glaucoma is a chronic disease that requires lifelong care. 

    How do you screen and diagnose patients? If resources are limited, which patients should be prioritized for treatment? How do you manage intraocular pressure when access to eye drops in the long term is not guaranteed? What are the risks and benefits of surgical management of glaucoma? How do you monitor for progression once treatment is initiated? In the glaucoma session a panel of experts shared their experiences in addressing these complex issues.

    In the Best Relationships, Both Sides Benefit

    More than ever, successful and sustainable global eye care requires reciprocal partnerships. The Vision 2020 Links program brings together hospitals and training institutions in low and middle income countries with training institutions in high income settings to develop partnerships that will improve education and patient outcomes at both institutions. Ciku Mathenge, MD, PhD,  from the Rwanda International Institute of Ophthalmology (RIIO) and John Anhalt, MD, from the Center for Academic Global Ophthalmology at Wills Eye Hospital shared their experiences in developing a strong partnership between their two institutions with support from the Links program. Global ophthalmology fellows from Wills Eye Hospital take on the role of both learner and educator during their time at RIIO, highlighting the reciprocal nature of the partnership. Drs. Mathenge’s and Anhalt’s shared experiences highlight the importance of identifying needs and opportunities of both institutions to foster lasting relationships.

    Resolving Complex Problems

    Tackling complex problems in global health requires innovative solutions. Artificial intelligence methods are making their way into every aspect of ophthalmology, and global ophthalmology is no exception. Gabriella Lanouette, a machine learning engineer at Orbis International, presented the organization’s work in developing a deep learning algorithm (Cybersight) to screen fundus images for diabetic retinopathy and provide clinical decision support and real time referral recommendations to patients. One of the challenges of screening in low resource environments is the shortage of experts to grade images which in turn leads to a delay in referral recommendations. 

    The Rwanda Artificial Intelligence for DiabEtic Retinopathy Screening (RAIDERS) randomized trial found that AI assessment of diabetic retinopathy with instant referral recommendations lead to an increase in referral adherence. Artificial intelligence-based tools will certainly be an important resource for eye care providers to keep up with an ever-increasing demand for eye care.

    Learning by Doing

    Though American residents graduate with the tools necessary to excel at phacoemulsification cataract surgery, they typically have much less exposure to manual small incision cataract surgery (MSICS). One of the benefits of manual small incision cataract surgery is the relatively low cost and resource use compared with phacoemulsification cataract surgery. One of the many highlights of the summit was an opportunity for trainees to learn how to perform manual small incision cataract surgery. Wet lab sessions sponsored by SEE international allowed trainees to gain hands-on experience performing manual small incision cataract surgery on cow eyes with guidance from expert surgeons.

    If you missed out on the 2022 Global Ophthalmology Summit, it isn’t too late to tune in. All sessions from the summit are recorded and available on the Academy’s website.

    Tomas Meijome, MD, MS About the author: Tomas Meijome, MD, MS, is a current Academic Global Ophthalmology Fellow at Wills Eye Hospital. He completed residency training at the University of Michigan Kellogg Eye Center.