Jolie Higazi

Jolie is the Content Specialist for Ophthalmology Times. She can be reached at jolie.higazi@advanstar.com.

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	Glaucoma Research Foundation’s annual Glaucoma 360 unites clinical, industry, funding, and FDA leaders to discuss innovative research and advances in glaucoma treatment.  The event spans 3 days with the Glaucoma 360 Annual Gala, New Horizons Forum, Glaucoma Symposium CME, and Optometric Glaucoma Symposium.

	Preceding the Glaucoma 360 Annual Gala is an always much anticipated “silent auction,” though the hall is far from silent as industry and clinical leaders mingle at this Glaucoma-specific meeting in San Francisco. 

		Attendees bid on dozens of gift, travel, and other exotic packages displayed.

			7 nights at The Verandah Resort and Spa, Antigua

			Signed David West Golden State Warriors Jersey

			Pier 39 Family Fun Pack in San Francisco

			Geneology Certificate: 2 hours of professional family history research

	Professional classical musicians serenade the attendees as they enjoy the reception.

	Numerous paintings draw the attendees’ focus as they walk from the reception to the Gala hall.

	During the live auction, Liam Mayclem ramps up the audience and explains each of the prizes, including home plate tickets to a San Francisco Giants game, a journey to Japan for 2, and a San Diego getaway for 2.

	Many auction items have fierce competition, with all the proceeds benefiting the Glaucoma Research Foundation’s education, research, and support programs. To date, the Gala has raised over $5 million.

		Eugene de Juan, Jr., MD, was awarded the Catalyst Award, the Glaucoma Research Foundation's highest honor.

		“Dr. de Juan is an extraordinary physician and teacher, as well as a successful entrepreneur,” said Thomas M. Brunner, president and chief executive officer of the Glaucoma Research Foundation. “He has dedicated his career to the development of new and innovative technologies to preserve vision. GRF is thrilled to have this opportunity to recognize Gene for his many contributions to medicine and improving the lives of patients with blinding eye diseases.”

	Attendees enjoy a multiple course meal while dining with leading ophthalmologists, scientists, and industry members.

	For his research efforts to better understand the molecular pathways that are responsible for axonal degeneration in glaucoma, Richard Libby, PhD, was awarded the 2017 Shaffer Prize for Research during Thursday night’s Glaucoma 360 annual Gala. 

Rochester University researcher awarded 2017 Shaffer Prize

is the official media sponsor of Glaucoma 360. To receive live updates from the meeting, readers can follow on social media (

		Andrew Iwach, MD, (above) and Adrienne Graves, PhD, are the Glaucoma 360 co-chairs.

Articles

See the highlights and program overview from the Glaucoma Research Foundation's 2017 Glaucoma 360!

What you missed at Glaucoma 360 this year

	Ophthalmologists know how to watch an eclipse safely, but how will ophthalmologists around the country be participating in and observing the event?

	[For 5 tips on the specifics of safe eclipse viewing, take a look at

 Top 5 ways to help your patients safely view the solar eclipse

	“I will be speaking at a meeting in Toronto on the date of the solar eclipse, but I intend to view the eclipse with my daughter that afternoon,” said Andrew Lee, MD, Blanton Eye Institute, Houston Methodist Hospital, Houston, and a member of 

	“I once traveled to Aruba to see the eclipse as part of a medical meeting," Dr. Lee said. "One of the most memorable and fascinating aspects of the eclipse was that songbirds and other animals initially fell silent during the eclipse, and then a cacophony of confused and loud sounds followed as the birds, cats, and dogs reacted to the false dawn.”

 in Jacksonville, FL, about best practices for watching the eclipse. Though that conversation was geared towards the public, Dr. Gulani has a special message for his fellow ophthalmologists.

	“Savor this moment as a unique event to take life in a higher perspective,” he said.

	At Dr. Gulani’s practice, Gulani Vision Institute, patients fly in for surgery from around the world. He instructed his staff not to book any patients on the day of the eclipse.

	“It’s a once in a lifetime event,” Dr. Gulani said. “We sometimes need to slow down and remember how small and insignificant we are.”

	He considers it a natural phenomenon not to be missed, and noted he may go to South Carolina or Nashville to see the eclipse in totality.

	For people in areas where the eclipse will be visible in its totality, snake-like images called shadow or light bands may appear on the ground directly before and/or after totality.

 what causes these snake-like images, scientists consider them to be wavy lines of alternating light and dark moving in parallel patterns.

	"Who better to understand [this]? What an opportunity!” Dr. Gulani said. “Being ophthalmologists where vision is so important-what a spectrum!”

	An event such as this puts things in perspective, he continued, whether they be discussions about IOL choices, LASIK techniques, or complaints about traffic, technology, or life in general.

	“Sit down, smile, and realize, ‘I am nothing,’” he said.

	“The eclipse goes right over our cabin in Wyoming so I will have a big family crew there viewing the event,” said Randall Olson, MD, chairman, Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City. He also is an associate medical editor on the 

	Dr. Olson needed to purchase his solar eclipse glasses twice after he received an 

	“They were the most common ones that Amazon had been selling,” he said. “The new ones are from our local planetarium and were rechecked and found to be good.”

	“I am doing a road trip with my son to see the eclipse in Oregon,” said Uday Devgan, MD, FACS, FRCS, Devgan Eye Surgery, Los Angeles. "We are already on our way and we're hoping for clear skies and light traffic."

	“Safety is key and we have appropriate eye protection,” said Dr. Devgan, who is a member of the 

 Editorial Advisory Board. “We will be using commercial grade welding glasses with a shade 14 rating (note that the typical welding glasses in shade 5, 10, or 11 are insufficient to provide the appropriate protection for eclipse viewing). Solar retinopathy can be very damaging to the retina, particularly the fovea. While there are cheaper alternatives made using cardboard frames and Mylar plastic, I'd rather be on the safe side.

	“I've been telling my patients that even in Los Angeles, they will be able to see a partial eclipse (with proper eye protection), but it won't be the same as being in the path of totality!” he said.

	“I will try to run out in between patients to see it! Also…the [American Academy of Ophthalmology] sent along these cute solar glasses-so I will wear those for sure!” said Jesse Berry, MD, assistant professor of clinical ophthalmology, assistant director of ocular oncology at Children's Hospital Los Angeles, associate residency program director for Los Angeles County and University of Southern California Medical Center.

	“I plan on being on the Oregon coast that day and driving up to Newport or Depoe Bay early in the morning if traffic permits," said Richard S. Hoffman, MD. "I have my ISO 12312-2 solar glasses and plan on looking at the eclipse intermittently if weather permits.  I may even take a boat ride out of shore so that I can be one of the first people to see it in the country.

	"I tell my patients to make sure they are using ISO-approved glasses, but to play it safe, don’t stare at the eclipse for the full time," said Dr. Hoffman, clinical associate professor of ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, and a member of 

	"The totality event is the real special part of the eclipse so they should only stare for prolonged periods during that portion just in case they got bogus or defective glasses,” he said.

	“Mondays are my scheduled surgery days so I will be operating during the day of the solar eclipse," said Joshua Mali, MD, The Eye Associates, Sarasota, FL. "However, I may try to enjoy this amazing natural phenomenon in between surgical cases. If I finish my cases early, I will view the solar eclipse with my wife, Yasmin.

	"Naturally as a retinal surgeon, I have received many inquiries regarding optimal viewing tips for the solar eclipse from family, friends, patients, and media outlets," Dr. Mali said. "It is a pleasure educating people on all the safety aspects in order for everyone to enjoy this wonderful event!”

	The scientific community seems to be split on whether eye protection is needed for dogs during an eclipse. Some say the animals may be spooked by the sudden dawn, but unlike people, probably won’t be staring directly at the sun.

	Others say it’s better to play it safe and either keep dogs inside with blinds closed or to attempt to fit approved ISO 12312-2 glasses on them.

	“If the dog were to look at [the eclipse] directly, then it may pose a risk, especially during a partial eclipse,” Dr. Mali said.

Even the partial eclipse is worth watching

	“I am not traveling to see totality," said Joel S. Schuman, MD, FACS.

	"I will have to make do with the partial eclipse I can see in NYC," said Dr. Schuman, professor and chairman, Department of Ophthalmology, NYU Langone Medical Center, NY, and a member of the 

	"I will wear eclipse glasses that meet the safety standard ISO 12312-2," he said. "If I were in the band of totality, I could look at the sun when fully covered by the disc of the moon, with only the corona visible, without safety glasses, but as soon as the diamond ring appears, I would have to put the safety glasses back on."

	“I’m watching it and I’m following AAO recommendations: 

How to Experience the Great American Solar Eclipse Without Damaging Your Vision

,” said Robert K. Maloney, MD, MA(Oxon), Maloney Vision Institute, Los Angeles, and an associate medical editor of the 

Top 5 ways to help your patients safely view the solar eclipse

Learn How to Photograph an Eclipse Without Damaging Your Eyes or Your Camera

Reputable Vendors of Solar Filters & Viewers

Ophthalmologists all know how to safely watch an eclipse, but how will ophthalmologists around the country be participating in and observing the event?

How will ophthalmologists watch the eclipse?

Why the election was decided by ophthalmologists

Why Trump and Clinton would be terrible patients

See what eye exams may be composed of in a few years.

What is the future of eye exams?

	Patients with a contact lens lost in the eye are not a rare occurrence for ophthalmologists. However, 27 lenses at the same time may be another story!

	The case of a 67-year-old female who had 27 disposable contacts in her right eye discovered just prior to cataract surgery was recently published in the 

. The patient had not complained about any severe eye discomfort.

	Seventeen of the lenses formed together in a blue mass, which Dr. Richard Crombie, a consultant anesthetist at the Solihull Hospital, United Kingdom, discovered while he was preparing the eye for surgery. The other 10 lenses were found during an additional examination.

	Dr. Crombie noticed the blue mass under the upper eyelid while applying the anesthetic, said Dr. Rupal Morjaria, an ophthalmic specialist trainee and lead author of the paper.

	“It’s important to stress that people should realize that contact lenses are prescribed medical devices and need to be treated with respect,” said Thomas Steinemann, MD, clinical spokesperson for the American Academy of Ophthalmology (AAO), and professor of ophthalmology, Case Western Reserve University, Cleveland. “If you do that and you take care of your eyes, you’re not going to get into trouble.”

	The patient in this case had been wearing contact lenses for over 35 years. When she tried to remove a lens from her eye and couldn’t find it, she assumed she dropped it and would put in another lens.

	After removal of the lenses, the cataract surgery was postponed for two weeks.

	“This is an opportunity to examine [patients’] own habits about how they wear and care for their contact lenses,” Dr. Steinemann said. “Properly done, contact lenses are a great way of correcting vision.”

	Though 27 contact lenses may be a record for lenses stuck in an eye, it is not rare for a lens to be lost in the eye, said Kevin Hinshaw, MD, Eye Specialists of West County, St. Louis. “I don’t think it’s terribly uncommon,” Dr. Hinshaw added, “but you shouldn’t be finding that out on the [operating] table.”

	Multiple low power lenses are more likely to go unnoticed, he pointed out.

	Every year, Dr. Hinshaw said a few of his patients will present with a full or a fragment lens lost in the eye. The difficult ones to find are single lenses that roll up like a cigar, which is quite painful, he said.

	However, one of Dr. Hinshaw’s patients had five lenses lost in the eye. In cases like these, “(the patients) don’t realize they’ve become blinded in one eye.”

	In the case of the patient with 27 lenses, Dr. Hinshaw said part of the reason she could have not been in severe discomfort is because contact lenses today are advanced. “We’re in the era of 100% oxygen permeable lenses,” he added. “These lenses are transparent to oxygen…and don’t impede the oxygen getting the cornea.”

	While contact lens wearers do not need to be fearful of this sort of occurrence, Dr. Hinshaw said it raises awareness of it happening. When in doubt of whether a lens should be removed, patients are reminded to see their eye care provider.

	In terms of why this patient was not discovered until preop, Dr. Hinshaw said a standard ophthalmic exam would have revealed the lenses or at least raised the question.

	Surgeons also should not accept mucus in the eye, or dried mucus in the corner of the eye, as a normal occurrence, he advised.  “It’s a defense mechanism to coat the lens-mucus doesn’t just show up for no reason,” Dr. Hinshaw added.

	In cases where Dr. Hinshaw suspected a lost contact lens in the eye and could not find it, he will use a Desmarres lid retractor, put fluorescein in the eye, and have the patient look down.

	If a patient comes in with discomfort, saying the lens fell out, there is still reason to suspect a lost lens or lens fragment in the eye, then conduct a thorough examination.

	“Don’t take their word for it,” he said.

	Dr. Steinemann explained that continued contact lens wear over time can cause eyes to become less sensitive, and it is possible the discomfort from the clumped lenses was confused with dry eye symptoms in this U.K. case. An earlier visit to an eye care specialist could have detected this issue sooner.

	Dr. Steinemann pointed out that contact lens wearers should see an eye care provider annually.

	“Contact lenses-even in the best of circumstances in patients with a lot of lens wear experience-can cause chronic changes that need to be monitored,” Dr. Steinemann said.

	Physicians should treat patient calls with a higher level of suspicion if they know the patient has a history with contact lens-related complaints.

	“Contact lenses are a wonderful way to correct vision, but safe is relative,” he said. “It is largely dependent on the wearer taking ownership in proper care. There’s no such thing as absolute safety.”

	Consistent reminders for patients, such as not to sleep with their contacts and know when to discard lenses, are key.  “Follow the rules of the road,” Dr. Steinemann said. “There’s a reason why those guidelines are established.”

	Neither Dr. Steinemann nor Dr. Hinshaw had any financial interests to disclose pertaining to this subject matter.

Patients with a contact lens lost in the eye are not a rare occurrence for ophthalmologists. However, 27 lenses at the same time may be another story! Another ophthalmologist shares his experience with a case involving 5 lenses within a patient's eye.

Author | Jolie Higazi

Articles

How will ophthalmologists watch the eclipse?

What is the future of eye exams?

Contacts lost in eye not such a rare thing-but 27?

What you missed at Glaucoma 360 this year