Global Pediatric Ophthalmology Congress June 06-07, 2016 London, UK

Biography:

Bruna Ventura graduated from the Medical School of the University of Pernambuco and completed her residency training at the Altino Ventura Foundation, both in Recife, Brazil. Did a postdoctoral fellowship in cataract and refractive surgery at the Baylor College of Medicine, in Houston, USA. Obtained her Master Degree from the Federal University of Alagoas, in Maceio, Brazil, and is currently working on her PhD Degree. Is Head of the Cataract Department of the Altino Ventura Foundation. She has published more than 25 papers in reputed journals, written several book chapters, and serves as an editorial board member of two ophthalmologic journals.

Abstract:

The Zika virus (ZIKV) is a neurotropic flavivirus. It was first identified in a rhesus monkey in 1947, and first isolated in humans from Uganda a year later. However, only in 2007, a ZIKV outbreak was reported outside of Africa. This outbreak was characterized by rash, conjunctivitis and arthralgia. Another ZIKV epidemic occurred in the French Polynesia in 2013 and 2014. In April 2015, the first ZIKV autochthone transmission was confirmed in Brazil, followed by an epidemic scenario in the country. It is estimated that more than one million Brazilians have had ZIKV infection since then, reflecting the virus’ capacity to cause large-scale outbreaks where the vector is present. After the Brazilian ZIKV outbreak, an unexpected 20-fold increase of microcephaly in newborns was identified, with approximately 3,174 new suspect cases until January 2016. For the first time in history, this malformation has been associated with ZIKV intra-uterus infection. Since other vertically transmitted diseases can cause ocular alterations, ZIKV may also affect the eye. Literature is scarce regarding the ophthalmologic findings of infants with clinical diagnosis of ZIKV-related microcephaly. The Altino Ventura Foundation is a tertiary reference center in Ophthalmology in Recife, Pernambuco, Brazil, and has a Rehabilitation Center for patients with multiple disabilities. Since Pernambuco is one of the states with the highest prevalence of ZIKV-related microcephaly, several patients received ophthalmologic care at the Foundation. Thus, we have assessed the ocular findings of infants born with microcephaly during the Brazilian ZIKV epidemic.

Biography:

Jasmine H Francis MD is an attending surgeon on the Ophthalmic Oncology Service at Memorial Sloan Kettering Cancer Center, which has one of the highest volume retinoblastoma centers in the world lead by Dr. David H. Abramson MD. She has published more than 40 papers in peer-reviewed journals predominantly on the subject of retinoblastoma. She was voted one of the top 40 under 40 eye doctors by The Ophthalmologist.

Abstract:

Up until a decade ago, there was inadequate treatment for vitroeus seeds in retinobalstoma and most of these eyes came to enucleation. However, with the increased use of both intra-arterial and intra-vitreal chemotherapy, the ocular survival rate for these eye is now greater than 95%. As we salvage more of these eyes, our understanding of vitreous seeds has also improved greatly. Our group has previously proposed a classification system for vitreous seeds, which predicts response to and drug requirements for intra-vitreal melphalan. Furthermore, there are particular tumor, eye and patient characteristics that also correspond with the vitreous seeds classification. We, our recent advancements over the past decade and particularly the last two years, not only has our treatment of vitreous seeds in retinoblastoma greatly improved, but so has our understanding of this disease entity.

Biography:

Dr. Lieberman received her medical training at SUNY Downstate in New York, where she also completed her ophthalmology residency. She then went on to complete a 2 year surgical retina fellowship at Mount Sinai Medical Center, in New York. She is the Director of Medical Retina Services for the Queens Hospital Network, an HHC affiliate. She has published extensively, participated in clinical trials and is involved in the training of ophthalmology residents in the HHC and at Mt. Sinai Medical Center.

Abstract:

Bevacizumab (Avastin®, Genentech, San Francisco, Ca) is a recombinant humanized monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A). It has been used successfully in the treatment of macular degeneration, diabetic macular edema and proliferative retinopathy and other retinal vascular diseases. It has been shown to be effective and safe in the treatment of specific stages of retinopathy of prematurity (ROP). The purpose of this talk is to compare and contrast intra-vitreal injection of bevacizumab with laser treatment, the current standard of care of care, and discuss the evolving treatment options in this disease. A number of multi center based studies will be discussed, including Early Treatment for Retinopathy of Prematurity (ETROP) and Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of Prematurity [BEAT-ROP], as well as a recent meta analysis on the subject. In addition, our personal experience over a number of years at 2 large centers in New York will be included. Treatment algorithms will be included.

Biography:

Pedro Mattar MD is a Consultant of Pediatric Ophthalmology at Strabismus Division at King Khaled Eye Specialist Hospital in Saudi Arabia. He is a Pediatric Ophthalmology Fellow at University of Colorado, Denver, USA. He completed Ophthalmology course from A.V.A.O, Venezuela and Medicine from Universidad Central de Venezuela. His associations include, American Association of Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Venezuelan Society Ophthalmology, Pan American Association of Ophthalmology, Latin-American Pediatric Ophthalmology Society and Pan American Society of Retinopathy of Prematurity.

Abstract:

Retinopathy of prematurity (ROP) in Venezuela has become the first cause of childhood blindness because of the high incidence of preterm births and poor oxygen control in the neonatal units. Venezuelan screening guidelines are: Infants < or = 1750 grs and < or = 35 weeks of gestation. The first exam should be done on the fourth week of life. Treatment follows the CRYO-ROP and ET-ROP criteria. Diode laser photo-ablation and anti-VEGF intra-vitreal injections are the treatments of choice in ROP. Variation in anesthesia, the risk of neurodevelopmental disorders associated with general anesthesia in small babies and developmental changes in preterm infants in responses to pain has been reported. A total of 103 babies with ROP who received Diode Laser Photocoagulation (93 patients) and intra-vitreal injections of anti-VEGF (10 patients) under topical anesthesia and suction of a pacifier with fructose were evaluate under the Premature Infant Pain Profile (PIPP). In the Laser group 64% presented moderate pain and 36% minimal pain. In the intra-vitreal injection groups all of then presented minimal pain. Topical anesthesia with no sedation and suction of a pacifier with fructose is a safe and effective anesthetic technique for treatment in infants with ROP.

Biography:

Coming soon

Abstract:

Purpose: To study prevalence, pattern and associated comorbidities of ROP in high risk neonates in India. To study efficacy of internationally used online monitoring system called WINROP developed by Sahlgrenska Center for Pediatric Ophthalmology Research; Sweden, in Indian population. Methods: Retrospective analysis of 665 high risk neonates for ROP who were screened at Vanivilas Hospital during study periodbetween 02/01/14 to 25/04/15 was done.Study conductedaccording to guidelines issued by American Academy Of Pediatrics (AAP) 2011 .The inclusion criteria was infants withBW less than 1500 g or GA 30 weeks or less, infants with BWbetween 1500 and 2000 g or GA more than 30 weeks with anunstable clinical course that was considered to place them at high risk for ROP. Same babies were also analyzed by WINROP software. Inthis study, the simplified version of WINROP analysis withpostnatal weight gain alone was used. For analysis, infants were classified into 2 groups: No alarm group: unlikely to develop ROP and infants not satisfying inclusion criteria. Alarm group: at risk for developing ROP Results: Among 611 babies screened by American Academy of Pediatrics guidelines 2011, Non pre threshold ROP developedin 35 babies (58.3%),Type 1 ROP in 22 babies (36.6%)and type 2ROP in 2 babies (3.3%).Single baby developed type 1 ROP in right eye and non Pre-threshold ROP in left eye. Among 60 ROP neonates, Respiratory Distress Syndrome (p-value=0.0001) diagnosed in 35, Anemia of prematurity (p-value=0.001) diagnosed in 13, malnutrition (p-value=0.0001) diagnosed in 16 neonates. Among the 60 ROP neonates, 9 underwent blood transfusion (p-value=0.0001). Pregnancy Induced Hypertension was significant maternal co-morbidity in ROP neonates. Hypoxic Ischemic Encephalopathy, Late Onset Sepsis, Pre-Mature Rupture of Membranes and Birth Asphyxia, Intra Uterine Growth Retardation, Patent Ductus Arteriosus and Hydrocephalus were found insignificant co-morbidities. In WINROP assessment, among 611 babies only 30 received alarm. 26 babies fell in low risk alarm group and 14 babies in high risk alarm group. Among High Risk Alarm group, 3 received alarm on week 30, 8recivedalaram on week 31 and 3 received on week 32. Conclusion: Prevalence of ROP in our study according to AAP guidelines (9.8%) was lower than range reported in other developing countries. Malnutrition, Respiratory Distress, Blood Transfusion and Anemia of Prematurity were significant co-morbidities in Indian ROP neonates. WINROP software could detect only half the ROP babies, hence can only be used as accessory tool but not as alternative for ROP screening in Indian babies.

Biography:

Pavel Pochop has completed his PhD in the year 2012 and in the year 2015 he became Associate Professor at Charles University in Prague. He has published more than 20 papers in reputed journals not only in Czech Republic, but also in other European countries and in United States.

Abstract:

Background: Treatment of retinal capillary hemangioma (RCH) can be complicated. Choice of treatment depends on tumor size, tumor location and any associated findings. Treatment of RCH using infrared laser is a very recent treatment option. Aim: Presentation of RCH treatment results using infrared laser from the Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine of Charles University and Motol University Hospital (1998-2014). Design: Non-comparative, prospective, interventional case series. Participants: The treatment and follow-up of eight eyes (eleven tumors of different size and localization) in six patients (four children) with RCH. Methods: Infrared diode laser was used at 810 nm and power between 200 and 1100mW with a beam diameter of 2 mm (indirect ophthalmoscope, +28 D or +40 D lens) or 0.5 mm-3 mm (slit-lamp) depending on the diameter of the hemangioma, with 1 minute of exposure time. Results: We achieved complete destruction of the tumor with flat chorioatrophic scar in all cases. Only one tumor regrowth was observed and another treatment in this case was necessary. There was one serious complication, total retinal detachment, causing deterioration in visual acuity. Other complications like haze and bleeding were transient. Final visual acuity ranged from 20/20 to counting fingers at 2 feet. Conclusions: Infrared laser can be considered an acceptable therapeutic option for RCH especially for centrally localized lesions. We believe that the role of this therapy will increase in the future.

Biography:

Huseyin Yetik graduated from Istanbul University Istanbul School of Medicine in 1996 and completed his ophthalmology residency program in 2000 in Istanbul University Cerrahpasa School of Medicine. He became Associate Professorship in 2006 and full professor in 2014 in Cerrahpasa. He worked in several governmental and private hospitals as academician including Goztepe Educational Hospital, Zeynep-Kamil Educational Hospital, Yeditepe University School of Medicine, Memorial Health Group. He worked in Azerbaijan, Albania, Kazakhstan as academican and vitreoretinal consultant. He is still professor in Istanbul University Cerrahpasa School of Medicine and vitreoretinal consultant and chief of ophthalmology department of Surp Pırgic Armenian Foundation Hospital which is the one of main Armenian Foundations in world as well as he is still chief vitreoretinal consultant surgeon of 15 private hospitals in Istanbul, Turkey. He is a member of American Academy of Ophthalmology, American Association of Retina Specialist, European Retina Society (EURETINA) and Turkish Ophthalmology Society.

Abstract:

Retinopathy of prematurity (ROP) is a leading cause of child- hood blindness in developing and developed countries. CRYO-ROP (Cryotherapy for ROP) and ETROP (Early Treatment of ROP) studies demonstrated various successful outcomes after peripheral thermoablation (cryo/laser) of avascular retina. Cryo-ablation was successful in 75 % of the cases in the CRYO-ROP Study. After the cryo era, even with high success rates of up to 98 % depending upon the severity of the disease, laser was not effective, particularly in zone I and aggressive posterior ROP (APROP) cases. Research data demonstrated the role of vascular endothelial growth factor (VEGF) in the pathogenesis of ROP, and anti-VEGF treatments were developed as another therapeutic option. It seems that anti-VEGF treatment is about to become the gold standard in ROP management. Despite an ongoing debate about the possible systemic adverse effects, clinical practice of intravitreal anti-VEGF (bevacizumab) injection demonstrated a better systemic clinical course in all premature babies without any exception besides dramatically successful results for ROP. Those results were able to give some clue about a possible one pathogenic mechanism for all morbidities including intracranial hemorrhage and associated cerebral complications, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and ROP. Details of this possible pathogenesis will be discussed in this lecture.

Biography:

Abstract:

Background: Current techniques used in strabismus surgery are associated with a considerable injury caused to eye tissues. Thus the development of alternative tissue-sparing techniques is very much relevant. Here we present a minimal invasive surgery technique that involves the use of high-frequency radio-wave knife to cut eye tissues. Our study demonstrated that the use of this technique decreases the post-operative edema, hyperemia and scarring processes and reduces patients’ overall rehabilitation time. Introduction: Minimal invasive surgery technique is attracting increasingly more attention in strabismus surgery. An injury caused to ocular muscles is a result of manipulations on connective and covering tissues of the eye. These manipulations lead to post-operative edema and tissue scarring. A complete uncovering of the muscle tissue and its surgical detachment from the sclera cause a vascularization disorder not only in the muscle itself but also in the vascular pools of the corresponding ciliary arteries. Thus, the development of tissue preserving and minimal invasive surgery techniques is very much relevant. We have developed a technique that uses high-frequency radio-wave knife, which allows to preserve the eye’s covering tissues and vessels, significantly reduce the injury caused to muscle during surgery and dose the surgery with maximal accuracy. An increase in precision of strabismus surgery is also achieved by using a mathematical model for esotropia surgery dosage that we have developed. This model was presented by our group at ESA 2011 and AAPOS 2012 and includes 4 anthropometric parameters of patients’ eyes needed for the dosage: strabismus angle, refractive error, axial length and inter-pupillary distance. Methods: A retrospective study was conducted on almost 2500 patients. 1500 patients were treated with conventional surgery method and 1000 patients - with our minimal invasive surgery technique. Two groups were compared by the following criteria: Conjunctival and eyelid edema, hyperemia and post-operative rehabilitation time. We used a high frequency 10 micronradio-wave knife to cut through covering and muscle tissues of the eye. The use of this knife allows making very precise cuts, coagulating the vessels and sterilizing the wound at the same time. Vessel coagulation with radio-wave knife reduces the hemorrhage and reduces the soaking of tissues with blood. The cut is made in such a way that connective tissues covering muscles are preserved, which allows minimizing the scarring process. In our surgeries we use vicryl 7/0 and a silicon protector on a hook for extra tissue preservation. The strengthening of the muscle is achieved by tucking the muscle, without excising it from the eyeball, preserving vessels, nerves and connective tissues of the muscle. The sutures are passed through the muscle and the sclera in such a way that the tuck is equally distributed under the muscle. While conducting a strengthening surgery we also suggest using a fixating suture, which will help sink the tuck beneath the muscle. Results: Our proposed method allows reducing post-operative tissue edema and hyperemia in more than 95% of cases. Also, we reduced the rehabilitation time to up to 7 days in 60% of cases and in 30% of cases patients were able to attend school after 3 days. Discussion: Overall this investigation has demonstrated that a significant reduction in hyperemia and tissue edema post-operatively can be achieved with our minimal invasive surgery technique. Additionally, the rehabilitation time was reduced significantly, while the scarring process was reduced to minimum and the vessels were preserved. Additional steps should be taken to help reduce the post-operative tissue injury and increase surgery precision even further.

Biography:

Sorath Noorani Siddiqui is an Associate Professor of Ophthalmology, a consultant pediatric ophthalmologist and the chief of the department of Pediatric Ophthalmology, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan Institute of Ophthalmology. She did her fellowship in general ophthalmology from the College of physicians and Surgeons Pakistan. She also earned her second fellowship in Pediatric Ophthalmology from McGill University, Canada. She is the Director of the Pediatric Ophthalmology fellowship program accredited by the College of Physicians and Surgeons Pakistan. She has published more than 28 papers in reputed journals and serves as a Member of the Editorial Board of reputed journals. She received a bronze medal in medical college. She also received a gold medal for the best paper presentation in the Ophthalmology Society of Pakistan meeting in 2014. Ophthalmology Society of Pakistan has awarded her gold medal for her professional achievements. The medal was awarded at the national meeting of the ophthalmology society of Pakistan on 4th December 2015 at Lahore Pakistan.

Abstract:

Retinoblastoma is a global problem affecting many children worldwide. It is the most common intraocular malignancy in children and leads to death if not treated. In high income countries, the goal of treatment is eye and vision preservation while lifesaving is the main goal in low income countries. There are obvious differences in globe survival between developed and developing countries. The most important factor responsible for this difference is the late presentation of the disease/delay in diagnosis in developing countries. At our tertiary eye care center, 217 eyes of 158 children were diagnosed with retinoblastoma in the last four years. Group-A was 0.9%, group-B 16.1%, group-C 4.1%, group-D 9.2% and group E in 70% eyes at first presentation. Globe salvage was not possible in 165 (76.03%) out of 217 eyes due to advanced disease at the time of first presentation. In our set up, reasons for delay in diagnosis are the unavailability of a screening program and health insurance facilities, lack of awareness, refusal for treatment due to greater trust on alternative medicines and spiritual therapies, socioeconomic factors, and the unavailability of treatment facilities close to home and long journeys .In developed countries , besides a good health care system, the modern technique of intra-arterial chemotherapy has resulted in an improved globe survival in children with advanced intraocular involvement. Enucleation is still widely performed in developing countries due to late presentation and the unavailability of intra-arterial chemotherapy. More children could be cured globally by increasing the capacity for the modern technique of intra-arterial chemotherapy in developing countries.

Biography:

Caroline Mvilongo Tsimi has completed MD degree from Yaounde faculty of Medicine and Biomedical Sciences. She is an Ophthalmologist at Yaounde Central Hospital and has published some papers in reputed journals.

Abstract:

Introduction: Retinoblastoma is an embryonal tumor of neuroectodermal origin, highly malignant affecting the young child and the infant. It is bilateral in 40% of cases. We report 2 clinical cases of bilateral retinoblastoma with extra-retinal diffusion which is a poor prognosis factor. Case 1: DW, 20 months brought in our ophthalmology service in 2009 with a tumor of the left eye since one month with a past history of leucocoria since birth. At the ophthalmology exam, he was classified at stage V of Reese- Ellsworth for the contro-lateral right eye and orbital extension of the left eye. He has been enucleated for the left eye and received 3 doses of chemotherapy. The patient was lost of view 2 months after the surgery. Case 2: H O, 3 years centrafican refugee referred in our ophthalmology service on June 2015 for the care of a tumor of the right eye since 3 months. She had a leucocoria in the right eye since one year; with past history of 1st degree consanguinity. The ophthalmology exam showed a great tumor with necrosis and inflammation of the right eye. At the left eye, sub-retinal mass with retinal detachment stage-V of Reese- Ellsworth, she has received neoadjuvant chemotherapy and exenteration of the right eye. She died few hours after the surgery. These 2 cases have been seen late in an appropriate ophthalmology unit. The prognosis was poor because of the extra retinal diffusion of the tumor.

Biography:

Farzana Afzal is the Lecturer at Faculty of Medicine at AIMST University, Malaysia. She accomplished F.C.P.S (Fellow of College of Physicians and Surgeons, Bangladesh) and M.C.P.S (Member of College of Physicians and Surgeons, Bangladesh) in Ophthalmology as well as she has 4 years professional training on phthalmology. Furthermore, she also passed Basic Science, Theoretical Optics & Refraction and Clinical Science Examination under International Council of Ophthalmology (ICO), London, UK. In addition, She has more than 5 years teaching experiences. It is noted that she completed Basic degree (M.B.B.S) from Bangladesh Medical College under Dhaka University, Bangladesh. She also registered with Bangladesh Medical and Dental Council (BMDC) as Medical Practitioner since November 2008. She joined many international and local conferences/seminars; however, she published 8 research papers at international conference proceedings and reputed journals. Recently, she published two books from LAP, Germany. Her research interests are Cataract, Refraction, UVEA, etc. She is the member of International Council of Ophthalmology (ICO), Ophthalmological Society of Bangladesh (OSB), Malaysian Society of Ophthalmology (MSO), Asia-Pacific Association of Cataract & Refractive Surgeons (APACRS), and so on.

Abstract:

Purpose: This is a comparative study that illustrates the management of childhood cataract and compares the post-operative complication and visual outcome between aphakic and pseudophakic patient group. Materials & Method: It consists of primary and secondary data which was experimented on 250 eyes with cataract of 160 children in Bangladesh within the period of January 2012 to January 2014. In patients up to 8 years, irrigation and aspiration, including primary posterior capsular rhexis with anterior vitrectomy were done. However, after 8 years, I/A were done without PPC and AV. Consequently, all were evaluated and followed up for 1 year. Result: The most common postoperative complication is posterior capsular opacity which was observed in 22 (49%) pseudophakic eye below 1 year and 30 (25%) pseudophakic eye after 1 year of age. The final visual acuity of 82% bilateral and 53% unilateral pseudophakic patient reached 6/60 or better whereas only 50% of bilateral and 32% unilateral aphakic patient’s visual acuity reached to the same level with spectacle or contact lens correction. Conclusion: Primary intraocular lens implantation after childhood cataract surgery definitely results in better visual acuity compared to aphakia. Nevertheless, careful planning and improved technique must be taken to implant IOL especially in younger children because younger eyes are more prone to have serious postoperative complication requiring reoperation. Furthermore, proper postoperative care and regular follow-up are also significant part of childhood cataract management. This paper would unlock further frontiers for prospective researchers in this area and contribute to eradicate the curse of childhood blindness from all over the world.

Biography:

Lisa Brothers Arbisser, MD teaches cataract and anterior segment surgery worldwide and is a Princeton University graduate. She is an adjunct Associate Professor at University of Utah Moran Eye Center. She authors, edits and reviews textbook chapters, journal articles and the American Academy online news network, Focal Points and has two regular journal columns. Her residency at the University of Iowa Hospitals and Clinics prepared her to specialize in refractive and complex cataract surgery, both adult and pediatric. She has been for years on the Best Doctors list nationally, was voted to the top 50 opinion leaders in cataract and refractive surgery by the readership of Cataract and Refractive Surgery Today (CRST), and was chosen as one of the 250 leading innovators in the field of premium IOL implant surgery by the editors of Premier Surgeon. She serves on the editorial board of CRST and Eye World and pens a quarterly column for each. She serves on the cataract committee for the AAO Online and Education Network and is the cataract editor for Focal Points.

Abstract:

For over a decade the state of the art pediatric cataract surgery has required vitrectorrhexis and anterior vitrectomy to avoid opacification of the visual axis. This paper will explain the rationale and methods for planned posterior capsulotomy with posterior optic capture into Berger’s space without vitrectomy in the pediatric eye as originally described as far back as 1991. This paper will contend that advantages include not only a zero rate of visual axis opacity due to proliferation of lens epithelial cells but a quieter eye without lens epithelial cell transformation and metaplasia which cause lens decentration, phimosis and whitening of the anterior capsule. There is potential for reducing the incidence of subsequent congenital cataract glaucoma and retinal tears and detachment which may follow when the trabecular meshwork is not burdened with elements of vitreous and the vitreous base is stabilized by the posterior placement of the lens without violating the posterior segment’s integrity. Additionally the bag and sulcus remains available for secondary refractive implantation later in life. The recent infant aphakia trial’s complications seen with pseudophakia are not unlike complications seen in adult eyes whose surgery is complicated by vitreous loss. The author has 5 years’ experience with this technique with excellent outcomes. Rabbit studies will be underway; an excellent model for pediatric cataract.This paper will describe the literature documenting safety. Surgical methods of accomplishing this goal, even for the low volume surgeon, with modalities not in common use today will be described.

Biography:

Bruna Ventura graduated from the Medical School of the University of Pernambuco and completed her residency training at the Altino Ventura Foundation, both in Recife, Brazil. Did a postdoctoral fellowship in cataract and refractive surgery at the Baylor College of Medicine, in Houston, USA. Obtained her Master Degree from the Federal University of Alagoas, in Maceio, Brazil, and is currently working on her PhD Degree. Is Head of the Cataract Department of the Altino Ventura Foundation. She has published more than 25 papers in reputed journals, written several book chapters, and serves as an editorial board member of two ophthalmologic journals.

Abstract:

The Zika virus (ZIKV) is a neurotropic flavivirus. It was first identified in a rhesus monkey in 1947, and first isolated in humans from Uganda a year later. However, only in 2007, a ZIKV outbreak was reported outside of Africa. This outbreak was characterized by rash, conjunctivitis and arthralgia. Another ZIKV epidemic occurred in the French Polynesia in 2013 and 2014. In April 2015, the first ZIKV autochthone transmission was confirmed in Brazil, followed by an epidemic scenario in the country. It is estimated that more than one million Brazilians have had ZIKV infection since then, reflecting the virus’ capacity to cause large-scale outbreaks where the vector is present. After the Brazilian ZIKV outbreak, an unexpected 20-fold increase of microcephaly in newborns was identified, with approximately 3,174 new suspect cases until January 2016. For the first time in history, this malformation has been associated with ZIKV intra-uterus infection. Since other vertically transmitted diseases can cause ocular alterations, ZIKV may also affect the eye. Literature is scarce regarding the ophthalmologic findings of infants with clinical diagnosis of ZIKV-related microcephaly. The Altino Ventura Foundation is a tertiary reference center in Ophthalmology in Recife, Pernambuco, Brazil, and has a Rehabilitation Center for patients with multiple disabilities. Since Pernambuco is one of the states with the highest prevalence of ZIKV-related microcephaly, several patients received ophthalmologic care at the Foundation. Thus, we have assessed the ocular findings of infants born with microcephaly during the Brazilian ZIKV epidemic.

Biography:

Janardan Kumar, PhD is a Professor of microbiology and chemistry at Becker College. He served as a chair of natural science department from 2011-2014. Prior to joining to Becker College, while a research associate/Assistant Professor at Duke University, he first proposed at the ARVO international conference, Fort Lauderdale, (1999) that the Rho-GTPase activation mediated through LPA and thrombin perfusion caused increase outflow resistance in porcine eyes. In 2001 while at Duke University he filed for intellectual property in the US on RGD-containing peptides as safe therapeutic alternatives for glaucoma therapy. The same molecule has been filed for patent in Japan, with additional international applications to follow.

Abstract:

The emerging evidence on Rho-GTPase studies in the field of glaucoma research has reinforced a growing understanding of the molecular mechanism(s) of aqueous humor outflow resistance and provided new drug targets for glaucoma therapy. Several laboratories including our research team suggested that the increased outflow facility was as a result of the cellular contractions in outflow pathway cells. Even perfusion of thrombin with impurities in porcine eyes, initially misled us to a conclusion that the Rho-GTPase activation with thrombin leading to cellular contraction might increase the outflow facility. Furthermore, investigation of pure thrombin and lysophosphatidic acid (LPA) perfusion in porcine eyes led us to conclude that Rho-GTPase activation, in fact, decreased the outflow facility. A number of studies have focused on to the regulation of outflow, however, very little is known about the regulation of fluid dynamics in the eye and the role of outflow pathway cells for maintaining aqueous humor outflow resistance. The simple reason is that the physiologically compromised fluid dynamics measuring device at constant pressure and the fluid medium for perfusion, similar to the aqueous humor, are not fully developed. Hence, measurement of the fluid dynamics at constant pressure is warranted to determine if aqueous flow is continuous or discontinuous and could be directly correlated with the function of outflow pathway cells. Moreover, we hypothesize that the measurements of LPA and/or thrombin in the aqueous humor of glaucomatous eyes might provide a rationale to the pathophysiology of glaucoma. We anticipate that this new knowledge will ultimately lead to the development of new therapeutic alternatives in the management of glaucoma.

Biography:

Samantha Harding was a chemist, polymer scientist and journalist before entering medicine. She was a resident and fellow at Great Ormond Street Hospital, London where she developed her interest in pediatric ophthalmology. She was the first in the history of the American Association of Pediatric Ophthalmology and Strabismus to win best of show twice as first author for posters in 2008 and 2011 and was the first to publish a series of pediatric deep anterior lamellar keratoplasty cases with Ken Nischal. She is a fellow of the Royal College of Ophthalmologists.

Abstract:

The diagnosis of papilloedema can be elusive at the best of times but in children it can present particular challenges. Children are often sent to the eye clinic because "blurry disc margins" are visualised on direct ophthalmoscopy or retinal photography but these can represent normal structural variants. Ultrasound can be helpful, quickly distinguishing an obvious drusen and autofluorescence and enhanced depth imaging can be helpful in a buried druse. Can electrophysiology also be of assistance? This talk will look at some of the challenges diagnosis of true papilloedema can present and clinical and imaging modalities that can assist in making a diagnosis of swelling of the optic nerve head due to raised intracranial pressure.

Biography:

Celso Cunha has completed his specialization at the age of 27 at Hospital Regional – Santa Catarina - Brazil. He is a member of the Refraction Department SOBLEC – Brazil, and a Medical consultant for Hoya Vision Care. He has published more than 10 papers which were published in Brazilian journals and Meetings. He is a new member of the editorial national board of Arquivos Brasileiros de Oftalmologia and Revista Brasileira de Oftalmologia.

Abstract:

PURPOSE: To compare the efficacy of 0.025% atropine eye drop in children for the control of myopia with and without photosensitive lens. METHODS: This was a prospective study of sixty children, aged 6 to 12, with spherical equivalent refractive error of -1.00 to -6.00 diopters (D) and astigmatism of -1.00 D or smaller. Children were randomly assigned into two groups in a 1:1 ratio of either anti-reflective coating lens (group 1) or photosensitive lens (group 2). Both groups used 0.025% atropine, once-nightly dosing to both eyes for 1 year. Cycloplegic refraction, axial length, and keratometry were noted at the baseline and 1 year later. In terms of corneal topography, only regular astigmatism was accepted. Student's t test was used to compare the two groups. RESULTS: The age mean and SD for the two groups were 8.2 +/- 1.7 and 8.3 +/- 1.7 years; the initial refractive errors were -3.63 +/- 1.21 D and -3.60 +/- 1.38 D in groups 1 and 2, respectively. Myopic progression was significantly less (P = 0.0007) in group 1 (-0.19 +/- 0.14 D) than in group 2 (-0.32 +/- 0.13 D). Axial length increase was also significantly smaller (P = 0.001) in group 1(0.11 +/- 0.08 mm) than in group 2 (0.21 +/- 0.11 mm). There were no significant statistical differences in relation to keratometry between groups. CONCLUSION: Topical 0.025% atropine eye drops is more effective without photosensitive lens for retarding myopic progression in moderate myopia. However, it is necessary the usage of multilayer anti-refrective coating lens for preventing glare. Furthermore, a larger scale randomized controlled study with longer follow-up seems warranted.

Biography:

Anna Laura Giacomin has completed her Medical degree in 1986 at the Padua University. She has joined as the Ophthalmological Specialist at the Padua University in 1991. In 1996, she joined in the Ophthalmology Unit of the Camposampiero PD Civil Hospital, responsible for the Ophthalmoplastic Service. She has obtained Homeopathy clinic course and in 2011, Master 2° level in Ophthalmoplastic Surgery from Naples Federico II University. From 2005, she is a full Member of the European Society of Ophthalmic Plastic and Reconstructive Surgery.

Abstract:

Infective and inflammatory eyelid disorders (blepharitis, chalazion, allergy, viral infections) have a frequent manifestation in pediatry. Usually they are treated with therapeutic local procedures to resolve itching and ocular reddish to reduce the risk of bacterial infection due to a minor control of the hygiene in this age. If the pathology has recurring aspects, or has an aesthetic expression, other examinations are performed to place the problem in a general health contest. In fact disorders of immune system are revealed in eyelid disorders, in particular in mucous membrane immune system (lung, intestine, liver). The environment, nutrition and of family life style, play an important rule in eyelid disorders. Prophylaxis, conventional and unconventional therapies (homeopathy) are proposed to prevent chronicity, avoid lid surgery and reduce the risk of sight problem due to corneal damage.

Biography:

Daniel Valverde presently working as a Faculty of Medical Sciences at University of Guayaquil. Being Specialist in Retina Medicinal – Ocular Nutrition - Low Vision – Pediatric Vision - Public Health - Community Development Projects in Public Health.

Abstract:

If the immature immune system entirely in the patient newborn, receiving no maternal colostrum either by birth not to end, or not to receive the colostrum any case, that patient with immature immune system. It presents pictures hyperactivity, allergies and recurring weakness in their health. Many signs and symptoms in ametropia suffered by the infant patient, one in hyperopic pictures are more noticeable than in other ametropia are sharpened. Cellular reprogramming with the help of strengthened transfer factors help these sharp pictures disappear and allow the patient's immune system to work more efficiently, overcoming not only the pathologies that arise but also the visual system. With our team for over four years valuing these types of cases concluded in the advantage provided by having the optimization of the immune system in the pediatric patient suffering from ametropia.

Biography:

Sevinj Salmanova has completed her PhD from Azerbaijan State Medical University. She is chief of Pediatric Department at National Center of Ophthalmology. She has published more than 25 papers in reputed journals.

Abstract:

To trace the state of adrenergic-cholinergic relationship in the recovery stage of sensomnestic and pupil-accommodative mechanisms 2000 children suffered from pre-, perinatal encephalopathy aged 3-12 months and further in ages 1-3 years, followed by catamnesis 5-7 years old were examined. The state of sensomnestic indicators was assessed by the adequacy of fixation of visual attention, by flash visual evoked potential and the reaction of "assimilation" of photostimulation rhythm in the EEG. They were grouped by diagnosis of neonatologists; pre-, perinatal encephalopathy (PPE) – 1000 children, perinatal acute cerebrovascular stroke (PACVS) - 400 children, perinatal toxic-hypoxic encephalopathy - 600 children. We found that 85% of children with PACVS and 50% of children with PPE in the early neonatal period have marked catecholamine excite dumping syndrome. We have had a direct positive correlation between this syndrome and the duration of unstable fixation of visual attention in children with PACVS and with PPE, examined of a periods of life up to 3 and 3-6 months, even – up to 1st year. In more than one third of these children up to age of 1 year, there was a tendency to strengthen of dysregulation of the visual analyzer vascular providing mechanisms, related to cholinergic irritation. However, we have worked out the treatment plan, including Prednisolone 1 mg - in the morning, 2 ml of Bio-Ritmo – in the afternoon, Vasobral 10 mg - in the evening, Semax - 1 drop in each nostril (1 time a day) carry through 3 weeks, minimizes the risk of exacerbation of the consequences of catecholamine excite dumping syndrome.

Biography:

Caroline Mvilongo Tsimi has completed MD degree from Yaounde faculty of Medicine and biomedical sciences. She is an ophthalmologist at Yaounde Central Hospital and has published some papers in reputed journals.

Abstract:

The management of strabismus in Cameroon is not well developed and the average age of first consultation is beyond the age amblyopia reversal. It is with the aim of improving strabismus management that we undertook this prospective and descriptive study which spanned 11 months. The objective was to describe amblyopia in patients with comitant strabismus at their first visit. Data collected included the age at the first visit, past history, refractive error, the characteristics of strabismus, amblyopia and strabismus-associated factors.Forty patients were included amongst whom there were 21 females and 19 males. The mean age was 5.5±4.6 years, with extremes of 3 months and 24 years. The hospital prevalence of amblyopia was 1.02%. Esotropia was the most common form of strabismus in 52.5 % of cases. In 37.5% of cases, the onset of strabismus was before the age of six months. Amblyopia was present in 63.7% of cases. It was classified as severe in 29.41% of cases, moderate in 21.57% of cases, and mild in 49.02% of cases. Head tilt was present in 27.5% of cases and nystagmus in 25% of cases. In conclusion, the prevalence of amblyopia is high in our milieu with a higher prevalence amongst esotropic patients. The management of strabismus relies on the wearing of the full cycloplegic correction and requires the full cooperation of the parents.

Biography:

Jagmohan Dyal Singh is completing his BS in Biochemistry, Genetics and Molecular Biology (Major) and Applied Mathematics (Minor) through National Credit Policy of ACE (American Council of Education). He himself is suffering from amblyopia comorbid with Refractive Squint and had diplopia when reading through a book. He corrected his visual handicap by designing a special type of spectacles which gave him the power to read and eventually complete his education, which he had left for 12 years. After he corrected his disorder he continued his education in Biochemistry, Genetics and Molecular Biology (Major) and Applied Mathematics (Minor).

Abstract:

“Lazy Eye” syndrome or Amblyopia is a common phenomenon scattered throughout the human population. It is estimated that around 5% of the human population suffers from this syndrome along with diplopia and refractive squint present in many or rather most of the cases. It is quite possible that other animal species that depend on stereoscopic vision for their survival are also prone to this condition in the same frequency as the human population. During prehistoric and ancient times, this condition did not interfere with human survival and this is the reason of its prevalence among the human population even in the present times. As it is present among 5% of the human population, it is no doubt a genetic condition. It has presented itself in individuals that have a genetic history of this condition in the maternal or paternal lineages. This condition is a major liability for the sufferer in the modern world. During ancient times, when man started as a hunter-gatherer and until the human world did not depend on the written word this condition was a benign syndrome, possibly without any competitive disadvantage. That is the reason this condition has survived into the modern world. In the modern world, the major disadvantage is in field of academics. Children suffering from this condition are at a disadvantage due to their inability to study like other normal children, due to this condition. In the amblyopic patients, having diplopia and refractive squint near stereoscopic vision is disrupted during reading and other near vision activities. Two different images that are created in the visual cortices do not overlap. Special glasses can be utilized to fuse two different images that do not overlap, into an image that overlaps and soothes the patient while reading and other near vision activities. These glasses force the visual cortices to fuse the two different images into one which otherwise is impossible and makes amblyopia comorbid with refractive squint a difficult malady to correct with present treatment options. These glasses are based on the neurobiology of vision. How stereoscopic vision is processed by the brain and the understanding of underlying cause that produces this deficit in the brain of individuals afflicted with this disorder is also conceptualised in this treatment option. Why 3D Optics is helpful in correcting this disorder in the brain is also hypothesized in the paper. These glasses should only be used for near vision activities like reading through a book but not for reading through a computer screen or watching television, as no diplopia is present when words or visuals are seen on an illuminated background, although amblyopic patients who suffer headache while using a computer shall benefit immensely from this procedure. This method will correct the visual deficit and convergence insufficiency with 100% positive results and shall improve the academic capabilities of children suffering from amblyopia and refractive squint who complain of diplopia and headache while reading. These glasses shall also correct the binocular acuity of individuals suffering from amblyopia. This shall be done by breaking the suppression of visual signals sent by the amblyopic eye to the brain. Prolonged use of these glasses shall train the brain to make use of signals and images created in both the visual cortices into one. The brain shall be forced to utilize visual signals from both the eyes due to its neurophysiology.

Biography:

Coming soon

Abstract:

The incidence of uveitis in children (between 4-7/100,000/year) is lower than that of adults, but it is more likely to cause vision impairment. Unlike adults, the onset is mostly insidious in normal looking white eyes, whilst slowly allowing inflammation to damage the structures of the eyes until vision is compromised, often permanently. In the developed economies the proportion of infectious cases is declining but idiopathic uveitis stubbornly persists. Screening of children at high risk, such as those with arthritis, allows earlier treatment, which can save vision. However treatment with steroids topically, regionally or systemically leads to delayed causes of vision loss that may not be manifested until late adolescence or even adulthood. Promptly initiating steroid sparing immunomodulatory therapy can avoid these problems, but management is complicated potentially dangerous and is independent of the status of any systemic condition and uveitis often smoulders on long after the arthritis has completely resolved. Use of biological agents is effective but is expensive and needs to be prolonged increasing the risk of systemic side effects, including cancer. The challenges of early diagnosis, appropriate referral and control of inflammation are ever present and despite best modern care children still lose vision in one or both eyes as a consequence of uveitis.

Biography:

Chris D Kalogeropoulos is the Professor of Ophthalmology in School of Health Sciences, University of Ioannina, Greece. He obtained Diploma of Medicine at University of Patras, Greece in 1983 and PhD in Ophthalmology, School of Medicine; University of Ioannina, Greece in 1991. He worked as a Research Associate (Ocular Inflammations), Lecturer and recently, Professor in Ophthalmology at University of Ioannina. He was also a Research Fellow at University Eye Clinic of Geneva, Switzerland. He also served as a President of the Hellenic Society for the Study of Ocular Inflammations and Infections. He is the Head of Ocular Inflammation Service at University Hospital of Ioannina, with over than 100 publications in International and Greek scientific journals and invited speaker in Hellenic and International Ophthalmological Congresses.

Abstract:

Vernal keratoconjunctivitis (VKC) is a very important allergic eye disease in children, especially in boys, potentially sight threatening in some cases. VKC is usually characterized by seasonal exacerbation and resolves by puberty. The disease has a geographical variation (increased incidence in hot-dry areas). The onset presents between 3 to 5 years (in early childhood). There are two main clinical types: palpebral and limbal. The complications of VKC include loss of vision, corneal scarring, keratoconus, limbal stem cell deficiency, steroid induced cataract and glaucoma and behavior alterations. Antistamines, mast cell stabilizers and topical steroid constitute the classic treatment. However, recently topical cyclosporine-A is a new approach to the treatment of VKC. Injection of sub-tarsal short and long-acting steroids can be used. Surgically, cryoablation and/or surgery of tarsal cobblestones and amniotic membrane transplantation are also performed. A new grading system of VKC based on the seventy of the disease has been proposed and different treatment options are oriented according to the clinical grade of VKC. The goal regarding the management of VKC is to prevent severe complications before puberty since afterwards a remission of the disease is observed. Therefore, grading of VKC is useful for clinicians and researches to classify disease activity and to establish an agreement for treatments.

Biography:

Arturo Maldonado-Junyent is a Medical doctor and surgeon, graduated from the National University of Cordoba, Argentina, specialist and master in ophthalmology. He is head of the anterior segment department of the Clinica de Ojos Maldonado Bas in Córdoba, Argentina. He is also Assistant Professor of the Postgraduate specialization in Ophthalmology in the Catholic University of Córdoba and Director of the Postgraduate in Ophthalmology of the Ophthalmology Society of Córdoba, Argentina.

Abstract:

Penetrating keratoplasty is rarely used in children due to the high rate of rejection. But manual lamellar keratoplasty requires a level of surgical skill that limits its performance. And the visual results in conventional femtosecond assisted lamellar keratoplasty are not good. In order to solve this, we have developed a hybrid lamellar keratoplasty technique with high replicability, since its performance is almost entirely automated, thus guaranteeing a significant percentage of surgery completion. It is named FEHLK (Femto Excimer Hybrid Lamellar Keratoplasty). Indications: This technique is indicated for any corneal pathology in which the endothelium is unharmed, including keratoconus, superficial and deep corneal opacities and scars. Technique: This involves making a lamellar cut with a femtosecond laser, with the lamellar keratoplasty program, without completing the central three millimeters, which will later be dissected manually. This makes possible an interface zone in the visual axis of much higher quality than that made by the femtosecond laser. We then make a photoablation with an excimer laser to regularize further the surface of the corneal bed. Finally, the donor tissue is sutured. Conclusion: With this technique, we can make a reproducible lamellar keratoplasty in children and adults with a very low complication rate, which allows us to maintain the endothelium and extend the life of the graft and decrease rejection, achieving better visual results. This is the best option for pediatric patients.

Biography:

Professor Mohamed Mostafa Kamel Diab has completed his Ph.D. at age of 29 years from Ain Shams University and postdoctoral studies from Ain shams university school of medicine Cairo Egypt. He is professor of ophthalmology Ain shams university Cairo Egypt and consultant ophthalmology Magrabi hospital KSA. He has published 16 international papers in reputed ophthalmology journals.

Abstract:

Introduction: Dissociated vertical deviation (DVD) is a poorly understood vertical deviation which may remain latent (compensated) or manifest (decompensated). The deviation may be symmetrical or asymmetrical Objective: we compare 3 different surgical approaches in patients with DVD without IO over-action. Methods: This is prospective study include 48 consecutive patients with dissociated vertical deviation without inferior oblique overaction subdivided into three groups, 16 patients each Group I patients was subjected to bilateral inferior rectus tucking (plication), and Group II patients were subjected to combined bilateral superior rectus recession and Faden procedure (posterior fixation), lastly Group III bilateral superior rectus recession is the procedure for management. Results: It was found that DVD had significantly improved in all cases of group inferior rectus tucking with correct11±3pd of vertical deviation and 4±2pd of asymmetry with exception one patient needed retucking of unilateral IR for residual manifest DVD. GroupSR Faden procedure revealed moderately improved DVD with correct 9±2pd of vertical deviation 2±2pd of asymmetry with 4 patients needed resection of unilateral IR for residual manifest DVD. Group SR recession corrected to10±3pd of vertical deviation and 3±1pd of asymmetry. Conclusion: Various treatment modalities as a primary procedure for management of dissociated vertical deviation without inferior oblique overaction revealed still superior rectus recession combined with faden procedure is the best line of treatment nevertheless inferior rectus tucking procedure is safe easy respectable substitute, further studies is recommended in this field.

Biography:

Divya Vakharia completed her graduation in medicine (MBBS) from Mahatma Gandhi Missions Medical College, Mumbai, India from Maharashtra University of Health Sciences, Nashik, India. She is specializing in Ophthalmology from Smt. Kashibai Navale Medical College and General Hospital, Pune, India. She started her specialization in August 2013. She has published 3 papers and presented 10 papers at both national and international conferences.

Abstract:

The study was conducted on cases in children coming to outpatient department of Ophthalmology in Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India from August 2014 to November 2015. After taking the consent from the legal guardians, history was taken and comprehensive ophthalmic examination as carried out in view of detecting amblyopia ( best corrected visual acuity is 6/12 or worse without the presence of any pathological cause). Mann Whitney U-Value two tailed hypothesis was applied for statistical analysis. 60 cases were included in the study. 3 cases (5%) had bilateral amblyopia, of which 2 cases were females and one case was male. 12 cases (20%) had unilateral amblyopia. Total incidence of unilateral and bilateral amblyopia was 25%. 10 cases (8 cases with unilateral amblyopia and 2 cases with bilateral amblyopia) had visual acuity less than 6/60 which accounts for 16.67% cases of amblyopia. Unilateral or Bilateral amblyopia was not found to be statistically different in males and females in pediatric age group. In this study the incidence, of associated amblyopia was 25% cases (unilateral amblyopia-20% and bilateral-5%). In this study, the incidence of amblyopia was found to be 25% and it was not found significantly different by age in males and females.

Biography:

Frank Sandi is an eye doctor with passion of serving pediatric eye health in Tanzania. After his residence in Ophthalmology at KCMC, now he is the head of Ophthalmology services at the new University of Dodoma where he has a major role of establishing eye care services. Despite all the setbacks in health systems in developing countries, he is setting up eye care services for the central zone which is inhabited by 8 million people but with no pediatric eye care services. So he knows the global pediatric ophthalmology challenges better as is in the process of establishing eye care services in Tanzania.

Abstract:

Of recently, Pediatric Ophthalmology is a growing field as new advances and techniques are progressively discovered with regard to childhood blindness and its management. Most developed countries are at better position of offering comprehensive pediatric eye care services but in most of the developing countries this field is lagging behind and is given less attention despite the significant impact of blind years in children. Most of the blindness and visual impairment in children in developing countries are either preventable or treatable such as vitamin A deficiency, congenital cataract, corneal opacities, Retinoblastoma, trauma, congenital glaucoma etc. These are the majority of cases seen in developing countries. Despite these challenges in provisional of quality pediatric eye care there is a huge opportunity for government of developing countries to wake up and take pediatric blindness seriously by having a strategic document to increase human resource and develop pediatric eye care centers within each province/region and later on to trickle down to community level. This can be done in collaboration with development partners and other stakeholders in eye care industry such as sight savers, HKI and others. In Tanzania for example there are only three centers which offer pediatric eye care services which are not evenly distributed. This is very few for a country of approximately 50 million populations. This is an unacceptable ratio of pediatric eye care facilities. This will need advocacy and political will to change the current situation given the high demand of pediatric eye care services within the country.

Biography:

Ahmed Fahmi completed his MD at University of Khartoum in Sudan. He joined London School of Hygiene and Tropical Medicine where he got an MSc in Community Eye Health. He goes certified in Pediatric Ophthalmology training at CCBRT - Tanzania with Richard Bowman. He established the pediatric ophthalmology unit of the main ophthalmic service provider in Khartoum -Sudan. The unit provided medical and surgical training for residents and young ophthalmologists in pediatric ophthalmology.

Abstract:

Background: The objective of this study was to evaluate the outcome of surgery and the factors affecting it in children with primary childhood glaucoma attending Makka Eye Complex in Riyadh, Khartoum in the period from January 2011 to June 2012. Methodology: This is a prospective, descriptive, hospital based study. A total of 32 patients were involved after confirming the diagnosis of PCG. Preoperative data including IOP, corneal diameter and clarity, CD ratio and refraction were considered. The eyes were classified as having mild, moderate or severe disease based on intraocular pressure, corneal diameter and corneal clarity. Main outcome measures were postoperative intraocular pressures, corneal diameter, corneal clarity, bleb characteristics, surgical success, and complications. Complete surgical success was defined as a postoperative intraocular pressure of ≤21 mm Hg without additional medical or surgical therapy, and with stabilization of corneal diameter and CD ratio. Success was considered qualified when anti-glaucoma drugs were needed to maintain these criteria. Failure was defined as IOP greater than 21 mmHg or the occurrence of sight-threatening complications, or the need for additional surgery. Results: A total of 60 eyes of 32 patients were included in the study. Twenty one (65.6%) of the patients was males. Mean age at presentation was 17.7±30.6 months (range 0.25-120 months). Mean duration of the disease was 14±24.7 months (range 0.25–96 months). Twenty nine infants (91%) had bilateral disease. Mean duration of follow-up was 9.48 ±3.7 months (range 6–21months). Surgeries performed were combined trabeulotomy-trabeculectomy, augmented trabeculectomy and goniotomy. Mean preoperative and postoperative IOP were 23.1 and 14.9 mmHg respectively, with a mean reduction of 8.2 mmHg (P-value 0.00). The mean preoperative horizontal corneal diameter was 12.7±1.2 mm. Corneal-oedema was present in 93.3% of eyes preoperatively. Postoperatively no oedema was found in 68% of eyes. Complete success was obtained in 60% of the study population and qualified success in 18%, while 22% of the study population was considered as failures. Six eyes required secondary surgical intervention and 22 were on antiglaucoma medication at the last follow-up. There were no major postoperative complications apart from phthisis bulbi which developed in one eye. Risk factors of surgical failure were early age of presentation, short duration of disease, severe disease and severe corneal oedema. Conclusion: The overall surgical success of primary congenital glaucoma was 78%. Age of presentation, duration of disease, severity and corneal clarity significantly affect the surgical outcome.

Biography:

Gustavo Amorim Novais is a cornea specialist in Rio de Janeiro, Brazil and has pursuit the highest level of training in the world’s best ophthalmology hospitals such as Bascom Palmer Eye Institute (Miami, USA), Massachusetts Eye and Ear Infirmary- Harvard (Boston, USA), McGill University (Montreal, Canada). He is now in-charge of the cornea and external disease at Federal University of Rio de Janeiro State- UNI-RIO and is also a board member of the PanCornea and Brazilian Ophthalmology societies.

Abstract:

Ocular allergic disease is very frequent among pediatric population worldwide and can vary from simple and mild seasonal to sight threatening vernal disease. Early diagnosis and adequate treatment is crucial to prevent more severe complications related, specially, from vernal and atopic variants. This presentation is intended to cover basic and advance aspects of allergic eye disease, management of complications and new treatment options.

Biography:

Abstract:

Introduction: Resilience of the amblyopia to its treatment in children with astigmatism necessitates a further study of the features of this disease. The purpose of the investigation is to study the specificity of the responseof the cerebral cortex and the mechanisms of the perceiving disorders in children with astigmatism. Methods: We used VEP generated in response to a reversion of black and white stripes with rectangular illumination profile to study cerebral cortex response. The size of rectangular stripes corresponded to maximally corrected visual acuity under the condition of full optical correction. The peculiarity of this technique is that the stripes are dimensionally oriented in the direction of the main astigmatism meridians of the amblyopic eye. Amplitude P100, which was obtained in main meridians, was investigated and compared. Visual acuity was investigated in main meridians. Correlation between amplitude P100 and visual acuity in similar meridians was analyzed. Results: We noted a significant difference in amplitude P100 when the reversible stripes were localized in main meridians. This meridional asymmetry correlates with different visual acuity, obtained in different meridians. The difference in amplitude P100 in meridians doesn't depend on the type and the extent of astigmatism. Discussion: We have obtained a particular response from the cerebral cortex in patients with astigmatism. This allows to suggest that amblyopia in patients with astigmatism develops in a specific manner - afferent signals from retina cells, sending information about dimensional localization, are perceived by the cortex unequally. So, information coming from the receptive field of the meridian which has preferred optics (with focus located closer to retina) is perceived better. We have also discovered that the type of astigmatism significantly influences the mechanism and the extent of amblyopia development. It was also noted that meridional asymmetry appears in patients even with insignificant level of astigmatism (1.5 dptr and more). Conclusion: Information obtained allows for more in-depth appreciation of the mechanism of the amblyopia development in patients with astigmatism. This circumstance makes possible to develop new, more effective ways of amblyopia treatment in patients with astigmatism. It also allows identifying a new criterion for the successful amblyopia treatment in patients with astigmatism - an absence of meridional asymmetry when conducting VEP using method described above.

Biography:

Rakshya Panta Sitoula completed MD Ophthalmology from Institute of Medicine, Kathmandu, Nepal in 2008. She did two years long “Anterior Segment Fellowship” from Biratnagar Eye Hospital, Nepal (2010 - 2012) and ICO fellowship in Glaucoma from New York Eye and Ear Infirmary, USA (2013). Presently, she is Head of Department of Glaucoma at Biratnagar Eye Hospital, Nepal and is actively involved in clinical work. She has surgeries nearing 25,000 to her credit. She is also an Assistant Professor of Ophthalmology at National Academy of Medical Sciences and is involved in teaching and training the residents and the fellows. She is actively involved in research. She was awarded “Travel Grant” to present her paper titled “Lens induced glaucoma: A hospital based clinico-epidemiological study” at World Glaucoma Congress 2015 (Hong Kong). She also has a number of papers published in peer-reviewed journals.

Abstract:

Primary congenital glaucoma is a specific term referring to eyes that have isolated mal-development of trabecular meshwork without other ocular anomalies or diseases that can raise IOP. It has an incidence of approximately 1 in 10,000 live births. Though a rare entity it poses a major challenge in management in developing countries. We prospectively looked at case series of 11 patients with primary congenital glaucoma that presented to Biratnagar Eye Hospital (Nepal) from November 2014 to October 2015. All patients underwent examination under anesthesia. On the basis of corneal diameter, IOP, CDR who met the criteria, were subjected to combined trabeculotomy with trabeculectomy (19 eyes of 11 patients). We operated these patients in as low cost as NPR 1200 which is equivalent to approximately 10 Euro. There were 11 patients (6 males and 5 females); mean age of first consultation was 10.73.8 months. Eight patients had bilateral involvement and 3 had unilateral involvement. Mean vertical corneal diameter was 12.8 1mm and horizontal corneal diameter 13.51 mm. The mean IOP was 45  8 mm of Hg. The surgical intervention led to clearance of corneal haziness, symptomatically relieved children and enhanced functional results; however the most important challenges in our scenario were late presentation with advanced disease. The reason for so being the financial constrains, geographic barrier and lack of awareness about the treatment.

Biography:

Ahmed A K El-Massry, MD, is the Professor of Ophthalmology at Faculty of Medicine, Alexandria University, Egypt and Wilmer Eye Institute, Johns Hopkins University Baltimore Maryland. He served as the Technical Director of Ophthalmology Department, Alexandria University from 2006-2010. He is the Vice Manager of Alex Eye Center from 2011 till present. He is the Member of the American Academy of Ophthalmology, (AAO) for 30 years, American Society of Cataract and Refractive Surgery, (ASCRS) for 25 years, international Society of Refractive Surgery (ISRS), Egyptian Society of Ophthalmology (ESO) for 30 years. He is the member of the board Delta Ophthalmology Society (DOS) (25 years), member of the Board of (ESOIRS) Egyptian Society of Cataract and Refractive Surgery and performing life surgery for 29 years in the ESOIRS meetings. He is the Reviewer of the Journal of Refractive Surgery, Sudanese Journal of Ophthalmology and the Continuous Committee for promotion of Assistant Professors and Professors in Egypt. He published more than 30 papers in reputable journals.

Abstract:

Anisometropic Amblyopia is one of the frequent causes of lifelong unilateral visual impairment in children. It is well known that Anisometropic Hyperopia is the most common type of Amblypia followed by aniso- astigmatism followed by anisometropic Myopia. Since 1992 LVC (laser Vision Correction) was done to anisometropic Myopic children with long term follow up of Regression, decentration and Ectasia proving it was not the optimum treatment for this situation. Phakic IOLs were studied since 2002 with fair results at that time. The aim of this prospective, non-randomized, non-comparative interventional study is to assess the two years follow up of Insertion of Collamar Co-Polymer intraocular lenses (ICL) in Anisometropic Myopic Children. Twelve eyes of 12 children with myopic anisometropia more than five diopters in children aged 4-14 years, with myopic anisometropia, had ICL implantation in the posterior chamber after full preoperative assessment, Visual acuity, anterior segment OCT, endothelial cell count and posterior segment evaluation were done. Improvement of visual acuity with more than three Snellen’s lines, Occlusion therapy was done to all cases after surgery.

Biography:

Elvan Yalçın has completed her Ph.D. at the age of 25 years from Hacettepe University and Postdoctoral studies from Ankara University School of Medicine. İnternational scholar certificate From Wills eye hospital in 2013. She is the Director of World eye hospital-Etiler branch which is an eye hospital. She has published more 21 papers in reputed and national journals.

Abstract:

I attempted to evaluate the efficacy of perceptual vision (neural vision) therapy in enhancing best-corrected visual acuity (BCVA) and contrast sensitivity function (CSF) in amblyopic patients.Amblyopia is the most frequent cause of reduced vision (unilateral or bilateral) in children, and is demonstrated by deficiencies such as loss of Snellen and grating acuity.The perceptual learning therapy program (RevitalVision LLC, Lawrence, KS, USA) is a noninvasive, software-based, patient-specific, interactive perceptual learning tool based on visual stimulation. It facilitates neural connections at the cortical level through a computerized visual training regimen using Gabor patches to improve contrast sensitivity and visual acuity.14,16–19 This treatment approach aims to reduce the noise activity of single cells, thereby increasing the signal strength and readapting the cortex to higher contrast sensitivity and visual acuity levels. The term “perceptual learning” describes a process whereby practicing certain visual tasks leads to an improvement in visual performance. Visual performance can be improved with repetitive practice on specific controlled visual tasks. These repetitive tasks initiate neural modifications that can lead to improvement in neuronal efficiency. Such neural modifications indicate the presence of brain plasticity.

Biography:

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Abstract:

Purpose: Post-traumatic endophthalmitis is a rare but serious complication of open global injury (OGI), representing a major turning point for the children’s visual prognosis. We aim to identify the epidemiology, etiology, culture results; anatomic outcomes and to report the experiences and skills of 23-gauge pars plana vitrectomy (PPV) in pediatric post-traumatic endophthalmitis in rural China over a 6-year period. Methods: One hundred and seven eyes of 107 consecutive patients aged below 15 who were diagnosed as post-traumatic endophthalmitis between September 2009 and October 2015 were included in this retrospective study. All patients were undergone combined PPV and silicone oil tamponade. We extracted the following parameters: age, gender, wound anatomy, intraocular foreign body (IOFB) characteristics, initial and final best corrected visual acuity (BCVA), anatomically reattachment. The VA were predicted using the ocular trauma score (OTS), and the predictions were compared with the BCVA using Fisher’s tests (SPSS version 17.0). Results: Seventy patients (65.42%) were male while thirty-seven (34.58%) were female, average age was 7.84 ±2.31 years, and mean follow-up was 13.31±3.15 months. The top three causes of injuries were: metallic substances (22.43%), scissors (16.82%) and firework (15.89%). Zone 1 injuries presented 14.02% (15/107) of the cases, and zone 2 and 3 presented 64.49% (69/107) and 21.50% (23/107), respectively. Lens trauma was noted in 53 (49.53%) eyes. An overall significant difference was observed among groups OST-1 (P=0.001) and OST-2 (P=0.012). Total retinal attachment was achieved in 99 of 107 eyes (92.52%) undergoing repair. Conclusions: If endophthalmitis is associated, surgery is urgent. The use of PPV combined silicone oil tamponade dramatically improved the prognosis of VA. However, prevention is always better than cure. Increasing awareness of the serious nature of endophthalmitis will help to develop a comprehensive plan for educating both parents and children to minimize preventable pediatric OGI.

Biography:

Olga Alvarez-Bulnes has completed her PhD from Universitat Autònoma de Barcelona and a Pediatric Ophthalmology Fellowship at Great Ormond Street Hospital. She is Pediatric Ophthamologist at Fundació Hospital de nens de Barcelona.

Abstract:

Introduction: Gestational diabetes mellitus (GDM) develops in 1-3% of pregnancies. GDM is associated with adverse health outcomes for both mother and newborns. Regarding, children born from a GDM pregnancy, there is association to disturbances of intrauterine growth, congenital anomalies (cardiovascular congenital abnormalities, isolated renal a/dysgenesis, obstructive defects of the urinary tracts, cryptorchidism, shoulder dystocia, esophageal atresia) as well as post-natal neurobehavioral disorders. But after a search through PubMed, we only found one work on how GDM could affect the eyes of these children. Ricci et al., describe changes in the iris vessels and stroma that resolved spontaneously within 2weeks.
Methods: We conducted an observational study among children who attended the outpatients’ ophthalmology clinic in our hospital from January 2011 to December 2015. We divide the study patients into three groups: A (GDM controlled with diet), B (GDM controlled with insulin), C (control, no GDM). We review the notes collecting information on refraction, ophthalmologic pathology and/or congenital ocular malformations.
Results: So far, we have collected date from 217 children (planning to reach about 350 by the end of December). Partial results show similar results in strabismus rate among the three groups. But there seems to be an increase in the rate of ametropia in those children born to a GDM mother, who controlled glycemia with diet and there is an increase in the rate of amblyopia in both diet and insulin treated patients compared to control group.
Conclusion: These results would show a need to refer children born to GDM pregnancies to the ophthalmology department as ametropia and amblyopia can interfere normal acquisition of fine skills as well as academic achievements and can also easily be treated and corrected if detected.

Biography:

Enrique Suarez graduated as Medical Doctor from Universidad de Los Andes. He obtained Internship and Ophthalmology Residency at Military Hospital (Caracas, Venezuela) and Cornea, External Diseases and Anterior Segment Fellowship with Dr. Herbert Kaufman at Louisiana State University (USA). He is the Head of Cornea Division at Military Hospital, Director of Cataract and Refractive Surgery & Clinic Ophthalmology Service at Centro Medico Docente La Trinidad Private Foundation (Caracas, Venezuela) for 20 years. Currently, he is the Senior Academic Consultant at King Khaled Eye Specialists Hospital (Riyadh, Saudi Arabia). He has over 40 publications in his credit and presented 450 lectures in international meetings. He also serves as the Board of Directors of International Ophthalmological Societies and Editorial Board Member of Ophthalmological Journals.

Abstract:

The major concerns in pediatric keratoconus comprise of the accelerated progression of the disease in the pediatric age group and management of co-morbidities such as allergic or vernal kerato-conjuntivitis. In Saudi Arabia, adverse environmental conditions, hereditary factors and consanguinity contribute frequently to visual impairment in pediatric patients due to Corneal Ectasia. The traditional treatment alternatives of visual rehabilitation such as spectacles, contacts lenses and keratoplasty (lamellar or penetrating) are more difficult to achieve in pediatric cases. Corneal collagen crosslinking (CXL) has been successfully utilized for more than a decade in adult patients halting or slowing the progression of the disease and more recently in pediatric keratoconus. It seems quite reasonable to treat not only eyes that demonstrate rapidly progressive keratoconus with corneal collagen crosslinking, but also those pediatric or adolescent eyes without documented progression of keratoconus before the disease potentially worsens. If longer-term follow-up demonstrates continued efficacy and more important, continued safety of this procedure, treating eyes with keratoconus before evidence of definite progression might become the standard of care.

Biography:

Arturo Maldonado-Junyent is a Medical doctor and surgeon, graduated from the National University of Cordoba, Argentina, specialist and master in ophthalmology. He is head of the anterior segment department of the Clinica de Ojos Maldonado Bas in Córdoba, Argentina. He is also Assistant Professor of the Postgraduate specialization in Ophthalmology in the Catholic University of Córdoba and Director of the Postgraduate in Ophthalmology of the Ophthalmology Society of Córdoba, Argentina.

Abstract:

Introduction: This paper analyzes the options of early or late cataract surgery in children with the implantation of different types of intraocular lenses. Development: Because the change of the ocular structure produces very significant variations in the child’s refraction, especially in the first 3 years of life, we analyzed the options of cataract surgery with primary intraocular lens implants. Among the alternatives we used, according to the patient's age, the piggy back lens implant technique, which allows us to later remove one of the lenses when the child has passed the stage of greater refractive changes, is our choice in children under one year of age. Then we can use monofocal lenses in children between one and three years of age, and multifocal lenses in those over three years. In both cases, the lens is implanted in the capsular bag. Conclusion: We believe the primary implantation of the intraocular lens important in order to decrease the degree of amblyopia. Depending on the different lens options, a better forecast can be achieved for refraction in adulthood, with consequent better quality of life.

Biography:

Professor Mohamed Mostafa Kamel Diab has completed his Ph.D. at age of 29 years from Ain Shams University and postdoctoral studies from Ain shams university school of medicine Cairo Egypt. He is professor of ophthalmology Ain shams university Cairo Egypt and consultant ophthalmology Magrabi hospital KSA. He has published 16 international papers in reputed ophthalmology journals.

Abstract:

Purpose: Based on Herring's law of equal innervations to the yoke muscles, this study aims at comparing the anatomical outcome following sound eye surgery versus amblyopic eye surgery for correction of unilateral sensory strabismus in adult patients. Patients & Methods: A prospective study that included 148 adult patients with unilateral sensory strabismus (50 prism Diopters) and amblyopia. Patients were randomly allocated between two groups: Group-A included patients subjected to surgery in the sound eye only, and group B included patients subjected to surgery in amblyopic eye only. Patients were followed-up for at least 6 months to detect the anatomical success rate as well as any residual, consecutive or recurrent strabismus. Results: After a mean follow up period of 7.68±1.93 months in group A, 61 patients (82.4%) had orthotropia, two patients (2.7%) had residual strabismus, 8 patients (10.8%) showed consecutive overcorrection, and three patients (4.1%) had recurrent strabismus. In group B and after a mean follow-up period of 7.24±1.72 months, 49 patients (66.2%) had orthotropia, 3 patients (4.1%) had residual strabismus, 9 patients (12.2%) had consecutive overcorrection, and lastly thirteen patients (17.6%) had recurrent strabismus. The differences between the results of both groups were statistically significant (p<0.05) only in the patients who achieved orthotropia and those with recurrent strabismus. Conclusion: For unilateral sensory strabismus and amblyopia in adults, sound eye surgery could give a higher success rate with a lower chance for recurrence at six months, as compared to amblyopic eye surgery.

Biography:

Pedro Mattar MD is a Consultant of Pediatric Ophthalmology at Strabismus Division at King Khaled Eye Specialist Hospital in Saudi Arabia. He is a Pediatric Ophthalmology Fellow at University of Colorado, Denver, USA. He completed Ophthalmology course from A.V.A.O, Venezuela and Medicine from Universidad Central de Venezuela. His associations include, American Association of Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Venezuelan Society Ophthalmology, Pan American Association of Ophthalmology, Latin-American Pediatric Ophthalmology Society and Pan American Society of Retinopathy of Prematurity.

Abstract:

Pediatric cataracts are one of the most important causes of preventable and treatable blindness in children. The eye of the child is not a small adult eye; it is in constant growing, has the risk of amblyopia and has an aggressive inflammation response to any surgical intervention. We present in videos, different tips to avoid and to treat complications during pediatric cataract surgery.

Biography:

Aygun Nabiyeva is a Pediatric Ophthalmologist at Briz-L Eye Clinic in Baku, Azerbaijan. She graduated as Medical Doctor from Azerbaijan Medical University and completed her Internship at National Eye Center (Baku, Azerbaijan). She is a member of Turkish Ophthalmology Society (TOS). She previously presented in National Congresses of TOS and participated in American Academy of Ophthalmology as Rotary Guest.

Abstract:

Congenital cataract is one of the major causes of visual deprivation in pediatric population due to factors like need of early surgery, risk of amblyopia development, demanding surgical skills due to small dimension of infant eye with a small capsular bag, decreased scleral rigidity. Both surgical aphakia and cataract are equally amblyogenic if not corrected in time. Various modalities like spectacle, contact lens, and primary IOL implantation are available for correction of aphasia. Nowadays primary IOL implantation has been widely used with favorable results in children older than two years; however, there are problems such as difficulty in selecting the appropriate dioptric power of the IOL, due to early phase of rapid eye growth in children less than 2 year. Also, current theoretical and regression intraocular lens power prediction formulas are largely based on adult eyes at axial lengths, anterior chamber depth, and keratometric values much different than those seen in infants. The small dimension of infant eye, and increased tissue reactivity leading to excessive postoperative inflammation make IOL implantation technically more difficult in these patients. With the invent of microsurgical techniques, instrumentation and increasing evidence of successful primary intraocular lens implantation in first two years of life, this appears to be new ray of hope in patients with congenital cataract. The aim of the present study was to evaluate outcome of primary IOL implantation in the first 2 years of life.

Biography:

Marcelo C Ventura was graduated from the Medical School of the University of Pernambuco, in Recife, Brazil and completed his Residency training at the Santa Casa de Misericórdiain São Paulo, Brazil. He has completed his Fellowship training in Retina and Cataract Surgery at the University of Puerto Rico. He has also obtained his Master and PhD degrees at the Federal University of São Paulo. He is the Co-Founder and CEO of the Altino Ventura Foundation and Co-Founder and Member of the Board of Directors of the HOPE Hospital, both in Recife, Brazil. He is also the past President of the Latin American Society of Cataract and Refractive Surgeons and of the Brazilian Cataract Society.

Abstract:

Congenital cataract is an important cause of reversible blindness in childhood. Early diagnosis and surgery, adequate refractive error correction, and aggressive amblyopia management improve these patients’ visual prognosis. However, early cataract surgery is associated with greater risk of complications, possibly due to the enhanced inflammatory response and the more reactive vitreous face in children. The use of corticosteroids for modulating postoperative ocular inflammation was established decades ago. Topical and systemic corticosteroid administration results in effective intraocular concentrations. However, they do not maintain long adequate concentrations of the drug in the aqueous humor, which is compensated by frequent doses in the postoperative period. This, in turn, increases the risk of adverse events. Moreover, caregivers do not always adhere to the instructions for administering drugs postoperatively, a scenario favoring complications that may compromise the visual prognosis. In contrast, intraocular injection of corticosteroid delivers an adequate and sustained quantity of the drug to the target tissue. Triamcinolone acetonide is a deposit corticosteroid with low water solubility, which contributes to its prolonged action. It has been increasingly used in ophthalmology as a vitreous dye in children and adults, as well as to modulate intraocular inflammation after phacoemulsification in adults. However, its use is not exempt of risks. Thus, we conducted a series of studies to investigate and compare the use of intracameral triamcinolone at the end of the procedure versus the conventional use of postoperative oral prednisolone for modulating intraocular inflammation in children that undergo congenital cataract surgery younger than 2 years of age.

Biography:

Marcelo C Ventura was graduated from the Medical School of the University of Pernambuco, in Recife, Brazil and completed his Residency training at the Santa Casa de Misericórdiain São Paulo, Brazil. He has completed his Fellowship training in Retina and Cataract Surgery at the University of Puerto Rico. He has also obtained his Master and PhD degrees at the Federal University of São Paulo. He is the Co-Founder and CEO of the Altino Ventura Foundation and Co-Founder and Member of the Board of Directors of the HOPE Hospital, both in Recife, Brazil. He is also the past President of the Latin American Society of Cataract and Refractive Surgeons and of the Brazilian Cataract Society.

Abstract:

Ectopialentis encompasses any displacement or mal-position of the crystalline lens irrespective of the cause or association. Lens subluxation can be congenital, acquired or due to developmental conditions, such as Marfan syndrome. The surgical management of ectopialentis is a challenging situation. The Ventura technique involves inserting an endocapsular tension ring and partly amputating one of the intraocular lens’ (IOL) haptics in order for the IOL’s optic to be centered in the visual axis after lens placement in the bag, without stressing the residual zonules. In the postoperative follow-up, minimal phacoiridodonesis is seen and the lens optic maintains centered in the visual axis. The use of the femtosecond laser associated with the Ventura technique facilitates the confection of the capsulotomy and enables the surgeon to decrease the residual astigmatism by making relaxing incisions.

Biography:

Amrita Verma completed her graduation (MBBS) and post-graduation (MS- ophthalmology) from Himalayan Institute of Medical Sciences, Dehradun, India. She then went on to do her fellowship in vitreo-retina from Dr Nagpal’s retina foundation. Her FICO training is from LMU University, Munich, Germany. She has presented papers in a number of conferences and has international publications to her credit. She is actively involved in ophthalmic social services. She is an accomplished retinal surgeon and is presently a consultant for vitreo-retina services.

Abstract:

The rhegmatogenous retinal detachments in the pediatric age group is uncommon with an annual incidence of 0.38–0.69 per 100,000, making up only 0.5–8% of all retinal detachments. The median ages of presentation reported are 9–13 years of age. The aetiologies encompass trauma, idiopathic, inherited syndromes associated with high myopia and abnormal vitreous, atopic dermatitis, congenital and developmental abnormalities, retinal vascular diseases and intraocular inflammation. A complete ophthalmic evaluation is preferably done under anesthesia. Full systemic workup by a pediatrician is also often required. The surgery for pediatric detachments is challenging. The rate of retinal reattachment with single intervention is considerably low at 50–80%. Visual outcomes are also worse in children with most series showing only 30–40% of patients reaching a final acuity of 20/200–20/400. Patients with congenital and developmental abnormalities have worse anatomical and functional outcomes than patients who had no predisposing factor or high myopia. Other risk factors for poor outcome are macular involvement, the presence of PVR, the presence of giant retinal tear, and inability to determine pre-operative acuity. Multiple surgeries are often required. Especially in younger children the importance of refraction and amblyopia therapy cannot be over emphasized. While visual outcomes are poor compared to the adult population, the high rate of bilateral detachments, as well as, the importance of even low levels of vision in these patients mean that the repair of these detachments pose unique challenges to the surgeon and the family.

Biography:

Mario Audie Sasongko earned his Medical degree in Atma Jaya University in Jakarta and finished his Ophthalmology training in Philippines in 2015. Currently, he is working at International SOS Jakarta while preparing to continue his study. Fueled by the growing need of quality eye care for children, he intends to pursue a fellowship in pediatric Ophthalmology.

Abstract:

Objective: To preform a cost benefit analysis of the retinopathy of prematurity (ROP) screening done in the setting of an urban tertiary hospital in comparison to a hypothetical screening based on the Philippine Retinopathy of Prematurity screening guidelines. Methods: The direct cost of ROP screening and treatment was determined by reviewing data retrospectively from infants admitted in Neonatal Intensive Care Unit (NICU) of the Makati Medical Center (MMC). The indirect cost of severe visual impairment was estimated from currently published Philippine economic data. Progression probabilities were estimated based on MMC census and previously published literature. Results: Retinopathy of prematurity screening was found to be cost beneficial with a benefit cost ratio of 38.58. The net benefit, which is the difference of benefit and cost, is estimated at PHP 583,952 (USD 13,166). Conclusion: Screening for retinopathy of prematurity is cost beneficial despite the wide criterion, high costs incurred, and in the setting of an urban tertiary hospital where financing is largely out-of-pocket.

Biography:

Akanksha Prasad has completed her medical training from B.P. Koirala Institute of Health Sciences and Ophthalmology residency at Icare Hospital (National Board of Examinations, New Delhi). She was selected for the prestigious ARVO Developing Country fellowship in 2015. She is a lifetime member of Association of Research and Vision in Ophthalmology (USA). She is interested in eye research and deeply motivated to improve the quality of life of pediatric population in her region.

Abstract:

PURPOSE: To know acceptance of low vision devices (LVD), taking into account the patient’s adjustment to vision loss. METHODS: In our prospective study, 100 low vision patients including children were assessed at a tertiary eye hospital. The prescription and acceptance of LVD were done for distance and near. RESULTS: Retinal disorders comprised the most common cause affecting 61 patients (61%). Distance vision improved by refractive correction in 48 patients (48%).Out of total 44 patients prescribed LVD for distance, 19 patients (19%) were prescribed handheld telescope. 34 patients (34%) prescribed LVD for near improved to 0.8 M. Another 28 patients (28%) improved to 1 M while 10 patients (10%) improved to 1.6 M. Overall 42 patients (42%) were prescribed Spectacle magnifiers of various powers for near vision. Difference in visual acuity before and after LVD for near was significant (Z=8.658, p=0.00). Overall 72 patients (84.7%) had good acceptance, with low vision device prescribed for near as it improved reading/writing skills.10 patients (11.8%) had moderate acceptance while another 3 patients (3.5%) had poor acceptance. CONCLUSION: It was noted that an accurate refraction can help the patient to improve reading skills for day to day work. We also concluded that even though telescopes are absolute vision enhancers, many patients did not purchase LVD prescribed due to cost factor and cosmesis. Thus, we can conclude that majority of children with low vision had good acceptance of the LVD prescribed as it improved reading and writing skills. Low vision is an important socio-economic burden in this region.

Biography:

Muhammad Irfan Karamat, has completed his MBBS from King Edward medical University. He did FCPS (College Of Physicians and Surgeons Of Pakistan) and MRCS (Royal College Of Edinburgh) in age of 30 years. Currently he is doing fellowship in Vitreo-retina from King Edward Medical University. He has published 1 paper in PJO and presented a case in WOC 2012 in Dubai.

Abstract:

A 12 year old male with marfanoid features (Picture 1) presented in our Out patient clinic with painless decreased vision in both eyes. His past ocular history revealed retinal detachment in left eye 5 years ago for which he under went scleral buckling.There is no history of recent trauma or systemic association. Occular examination showed that best corrected visual acuity was 6/60 and 6/36 in right and left eye respecitvely. Intra Ocular Pressure was 10 and 12mmHg. Patient was having corneal diameters of 15mm and 16mm and axial length of 32.4 and 32.6mm. There was dislocation of nucleus in the vitrous cavity bilaterally. Both pupil were constricted,irregular and they could not be dilated with medication. Anterior chamber was deep and quiet. Iris was atrophic and tremulous (picture 2). Fundal examination through the undilated pupil showed a retinal detachment involving the macula in the right eye and a sclearl band intruding into the globe superonasally with adhesions at the sight of band intrusion (Picture 3,4). B- scan revealed an intact, quite globe with band intrusion superiorly and dropped nucleus in the vitreous cavity in left eye. Patient’s systemic evalution was done to rule out any association. General physical examination showed that patient was tall, and thin with significantelly broad horizantal arm span (Picture 1). Homocystein levels were within normal limits.There was no arotic disection or M.V prolapse on chest X ray and Echocardiography. He underwent right eye scleral buckling along with dropped nucleus removal and pars plana vitrectomy. Laser was applied to the retina at 1st post operative week. We did not plan any surgery for left eye as the eye was quite and chances of globe rupture were very high. Patient was advised a close follow up for both eyes. He developed silicon oil induced raised intra-ocular pressure in right eye which was managed conservatively. After 5 years of follow up, patient again developed retinal detachment in left eye for which he under went vitrectomy with oil without cutting the intruded band.currently,(8 weeks since surgery) his retina is attached.

Biography:

Shu Yi has completed her Master’s degree in Ophthalmology from Chong Qing Medical University, China. She is an attending Doctor of the People’s Hospital of Chong Qing China, who is interested in control of myopia for children. She has published almost 6 papers in international and Chinese journals. She had studied for 3 months in the department of ophthalmology, the affiliated hospital of Rostock university, Germany, in 2015.

Abstract:

Purpose: To evaluate the efficacy of topical atropine 1% in promoting unaided visual acuity, reducing myopia, and slowing the progression of ocular axial elongation in Chinese children with low myopia. Methods: Children with low myopia were randomly assigned to one of two groups, receiving either atropine 1% (treatment group) or placebo eyedrops (control group) once nightly for 1 year. After instillation of 3 drops of cyclopentolate 1%, unaided visual acuity, cycloplegic refraction, and ocular axial length were tested and recorded at baseline (2 weeks after atropine or vehicle eyedrops), 3 months, 6 months, 9 months and 1 year. Results: A total of 132 children 7-12 years of age with a refractive error of spherical equivalent -0.50 D to -2.00 D were included. After 1 year, the mean unaided visual acuity in the treatment group was 0.31±0.16 logMAR; in the control group, 0.66±0.15 logMAR, (P<0.0001). After treatment for 1 year, there was a decrease of 0.32±0.22 D from baseline in the treatment group and an increase of -0.85±0.31 D in the control group (P<0.0001). The axial elongation in the treatment group was -0.03±0.07 mm; in the control group, 0.32±0.15 mm (P<0.0001). Conclusions: In this study cohort, topical atropine1% reduced the degree of low myopia and slowed the progression of ocular axial elongation in children.