Workshop 3

Mar 04, 2017 by AAPOS editor in  Workshop


How Recent Technology Should Change Your Practice Patterns

Yasmin Bradfield; Burt Kushner; Michael Struck; Melanie Schmitt

University of Wisconsin
Madison, Wisconsin

Purpose/Relevance:  Recent technology advances that affect clinical practice include extraocular muscle imaging, ophthalmic genetic testing, visual evoked potential testing, and binocular treatments for amblyopia.  Each technology will be presented with their benefits and pitfalls, practical use in a clinic setting, specific competing equipment will be discussed, and a conclusion whether the individual technology should be adopted in clinical practice today.
The diagnosis of the following clinical entities: glaucoma, anomalous or slipped extraocular muscles, extraocular muscle activity in thyroid disease, inherited ophthalmic diseases, and vision assessment in preverbal children using standard methods is challenging. In addition, current amblyopia treatments are not always effective in children.  Newer technologies may offer a clearer diagnosis.
With the advent of more sophisticated genetic testing, our knowledge regarding genotype-phenotype correlations in inherited ophthalmic conditions has broadened. Though this expanded knowledge comes with many advantages, it also carries its own challenges. Current trends in ophthalmic genetic testing with patient cases will be presented.

Target Audience:  Pediatric Ophthalmologists
General Ophthalmologists

Current Practice:  It is difficult to know with a variety of new technologies developing annually, which has the highest clinical utility with cost-effectiveness in a busy clinical practice.  In addition, the accessibility of such modern technologies is important for ease of use.  Ocular genetics testing is frequently performed, but analyzing the results with appropriate counseling is difficult for the pediatric ophthalmologist.

Best Practice:  New technologies which can offer more accurate clinical diagnoses will be presented.
Ocular genetics testing and result analysis, extraocular muscle imaging, visual evoked potential testing, and binocular amblyopia treatments will be discussed.
The benefits and downsides of each technology including cost, availability, ease of use will be presented.

Expected Outcomes:  Audience members will gain practical knowledge of new technologies to apply in their clinics, which equipment of specific technologies perform better, and benefits and downsides of each technology including cost, availability, ease of use.

Format:  Case presentations with audience quiz

Summary:  The workshop will cover the following:
1. Ocular genetics testing for variety of inherited eye diagnoses- where to get, costs, obstacles
2. Interpreting results of genetics testing
3. Use of imaging for strabismus
Inform radiology as to type of scan
Muscle heterotopia and anomalies
Lost, slipped muscles
Use of dynamic scans
Muscle edema in Graves
4. VEP for preverbal vision testing
5. New binocular therapies for amblyopia

References:  Hess RF, Thompson B. Amblyopia and the binocular approach to its therapy. Vision Res. 2015 Sep;114:4-16.
Birch EE, Li SL, Jost RM, Morale SE, De La Cruz A, Stager D Jr, Dao L, Stager DR Sr.
Binocular iPad treatment for amblyopia in preschool children. J AAPOS. 2015 Feb;19(1):6-11.
Shin A, Yoo L, Demer JL. Independent active contraction of extraocular muscle compartments.Invest Ophthalmol Vis Sci. 2014 Dec 11;56(1):199-206.

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