The Irish College of Ophthalmologists hosted their Annual Conference 2024 at the Knockranny House Hotel in Westport, Co Mayo from Wednesday 15th to Friday 17th May. Over 200 ophthalmologists gathered for the three-day scientific conference to hear the latest clinical and scientific developments in the speciality from eye experts at home and abroad.
Key symposia at this year’s conference focused on Vision and Strabismus, Orbit and Socket, and Sustainability in Ophthalmology.
Among the keynote guest speakers, the College was delighted to welcome Mr Ian Marsh, Consultant Ophthalmic Surgeon at the Liverpool University Hospital NHS Trust and Dr Arvind Chandna, Consultant Paediatric Ophthalmologist at Alder Hey Children’s Hospital, Liverpool and Senior Clinician Scientist at Smith Kettlewell Eye Research Institute, San Francisco to present at the Vision and Strabismus symposium, alongside Ms Kathryn McCreery, Consultant Ophthalmic Surgeon at Children’s Health Ireland at Crumlin Hospital.
In her talk, Ms McCreery discussed difficult paediatric ophthalmology and strabismus consultations including drop administration in children, evaluation of the child with autism and delivering bad news. The management of strabismus surgery complications and the informed consent process in paediatric and adult strabismus surgery was also discussed, with an emphasis on effective communication with children, their parents and adults in advance of undergoing strabismus surgery.
Mr Ian Marsh currently runs a comprehensive strabismus service mainly for adults but also including more complex children squint at Liverpool University Hospital NHS Trust in Liverpool and spoke to delegates about decoding the process of strabismus management. Recent developments have included the introduction of Bupivacaine injections to permanently straighten eyes, the use of inferior medial rectus plication in near exotropia and since the Covid pandemic, a regular video clinic and a monthly local anaesthetic squint list.
Dr Arvind Chandna delivered a comprehensive talk on Cerebral Visual Impairment and a structured approach to managing the condition beyond visual acuity.
Dr Chandna conducts research programmes dealing with significant gaps in clinical and scientific knowledge of common childhood eye conditions with poor management outcomes, investigating them in collaboration with SKERI’s vision scientists. His talk outlined this investigation of visual brain neuroscience and oculomotor behaviour using eye tracking, photorefraction, psychophysics and visually evoked brain potentials in childhood eye disease.
Mr Manoj Parulekar, Consultant Ophthalmic Surgeon at the Birmingham Women’s and Children’s NHS Foundation Trust and Oxford University Hospitals NHS Trust and Professor Geoffrey Rose, Consultant Orbital, Lacrimal and Plastic Reconstructive Surgeon at Moorfields Eye Hospital, London were guest speakers at the Orbit and Socket symposium. Mr Tim Fulcher, Consultant Ophthalmic Surgeon at the Mater Misericordiae University Hospital Dublin chaired and presented on the management of socket complications at this session.
Mr Parulekar outlined the clinical assessment, differential diagnosis and management of benign and malignant lesions of the paediatric orbit. He contributes to the paediatric ophthalmology service at the Birmingham Women’s and Children’s Hospital, the largest women’s and children’s hospitals in Europe, where he treats a wide range of childhood eye conditions including strabismus, paediatric cataracts and glaucoma, oculoplastics and neuro-ophthalmology, ocular oncology, and external eye diseases. He has special expertise in the treatment of eye cancers in children and is consultant ophthalmologist to the Birmingham National Retinoblastoma Unit, the largest nationally designated retinoblastoma center in the UK.
Mr Parulekar contributes to the ocular motility service (squints and complex eye movement disorders), and the neuro-ophthalmology service at the Oxford University Hospital where he provides a supra-regional service to Oxfordshire, Buckinghamshire, Berkshire and Wiltshire.
Prof Geoffrey E. Rose, Honorary Consultant Ophthalmic Surgeon, Moorfields Eye Hospital, and Senior Research Fellow of the Biomedical Research Centre at the Institute of Ophthalmology, London, gave a detailed presentation on ‘Managing the Removal of an Eye’ at the Orbit and Socket symposium. In his talk, he discussed the problems that can occur with socket management and the alternatives to eye removal, the patient consent process and challenges which can occur as a result of “over promise” by the physician. Prof Rose addressed the mechanics of eye removal and how to manage (largely by prevention) the volume deficiency that would otherwise arise from the removal of the globe.
It was a great honour for the College to invite Professor Rose to deliver the Annual Mooney Lecture at the 2024 ICO Conference, which he presented on the evening of Wednesday 15th May.
Prof Rose’s lecture entitled “Trends in rehabilitation of patients with thyroid eye disease” considered what thyroid eye disease means, in practical terms, to the patient and the mechanism of the disease in terms of the underlying inflammatory mechanism, and the biomechanics of the condition.
Prof Rose outlined the historical treatment of thyroid eye disease in patients, up to the modern day advances and the changes in treatment approaches. Four decades ago, changes in treatment were largely directed to improving surgical techniques to allow a better restoration of function and appearance, with less injury to neighbouring tissues. Early immunosuppressive regimes were based on various regimes for systemic corticosteroids, either oral or intravenous (and occasionally intraorbital administration). More recently, the immune response has been mollified with monoclonal antibodies directed against the inflammatory mediators or cells and over the last 20 years, it has been shown that changes in thyroid eye disease appear to be produced through an immune activation of the TSH-receptor and IGF1-receptors.
On the final day of the conference, a dedicated symposium on Sustainability in Ophthalmology welcomed experts from both home and overseas to share their knowledge on ways to minimise the carbon footprint of the speciality and plan for the future from both an environmental and sustainable practice perspective. Healthcare is a notable contributor to greenhouse gas emissions, accounting for an estimated 5% of total emissions globally. The ophthalmic field, like many others in healthcare, has a significant environmental footprint. From the disposal of single-use instruments to the energy consumption of diagnostic equipment, the impact is significant.
Miss Radhika Rampat, Consultant Ophthalmic Surgeon at the Royal Free London NHS Trust outlined the sustainability in the ophthalmology journey so far of the American European Congress Of Ophthalmic Surgery – Green Working Group, examining “How can I act locally and share globally”. She examined what has been achieved to date in eye clinics and theatres locally and internationally in the efforts to reduce the carbon footprint in the specialty. Miss Rampat is the co-chair of AECOS Green Working Group.
Ireland is among the major healthcare emitters per capita internationally. The ICO welcomed Dr Philip Crowley, National Director of Strategy and Research and HSE National Lead for Climate Change who spoke to delegates about the HSE Climate Action Strategy 2023-2050 being adopted to reduce emissions and protect population health in the Irish healthcare system.
The strategy is one of the first national health service climate strategies globally, and Dr Crowley outlined the progress on implementation of its target to achieve net-zero emissions for the HSE by 2050, the relevant actions for ophthalmology practice and the work to mobilise health service staff.
Dr Emilie Mahon, RCSI Ophthalmology Clinical Tutor at the Royal Victoria Eye and Ear Hospital, outlined the findings of her research on the ecological impact of phacoemulsification cataract surgery where she examined the single-use items consumption and the results concerning the carbon footprint of cataract surgery in the Eye and Ear Hospital.
Mr Arthur Cummings, Consultant Ophthalmologist at the Wellington Eye Clinic in Dublin looked at the practice side of sustainability in ophthalmology in light of the growing burden of ophthalmic needs building globally while the number of ophthalmologists is decreasing.
Mr Cummings highlighted the need for the specialty to become more efficient and effective while the shortage of ophthalmologists is addressed. His talk reviewed three areas that can help achieve greater efficacy and efficiency, namely system design, artificial intelligence and the role of the allied health professional team in leading to improvements in making ophthalmic practice sustainable.
Workshop sessions, paper and poster presentations and the European Society of Ophthalmology (SOE) Lecture 2024 presented by Mr Michéal O’Rourke, Royal Victoria Eye and Ear Hospital, St James’s Hospital and Children’s Health Ireland at Crumlin, Dublin on the topic of Paediatric Oculoplastics also featured on the three day conference programme.
The Barbara Knox Medal for Best Paper was awarded to Dr Shane O’Regan for his paper entitled “Eyes on Spina Bifida: A Two Decade Retrospective Exploration of Ophthalmic Manifestations in Paediatric Patients at Temple Street Children’s University Hospital, Dublin.”
The William Wilde Medal for Best Poster was awarded to Dr Patrick Murtagh for his poster “Uveal Melanoma Patients Treated with Iodine Plaque versus Ruthenium Plaque versus Proton Beam Radiation: A Ten-Year Review.”
Dr Murtagh was presented with his medal by Professor Brendan Kelly, Consultant Psychiatrist, Tallaght University Hospital, Dublin and Professor of Psychiatry at Trinity College Dublin who shared with the audience his insights on human behaviours and reactions to perceived challenges in his fascinating talk on “Pandemics in Ireland, and Lessons Learned from Covid (If Any)”
Prof Kelly’s recently published book ‘Resilience: Lessons from Sir William Wilde on Life After Covid’ reflects on the pandemic in Ireland and what we might learn as a society and as individuals from the experience.
The ICO announced the publication of its Annual Report for 2023 at the conference in Westport. The ICO is a registered Irish charity. The organisation is committed to the advancement and improvement of eye health and patient safety and works to protect, enhance and promote the highest standards in the delivery of eye care
The Annual Report 2023 outlines the activities undertaken by the College and finances for that year.
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