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Updates from AAOPT 2023: Day 3

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Michael Cooper, OD, FAAO, president of Visionary Medical Education, rounded out Day 3 of the American Academy of Optometry (AAOPT) annual meeting with a look at a few of his top sessions.

Let’s dive into your top sessions.

One of my favorite sessions today was a course called Corneal Injuries, Dystrophies, and Catastrophes: Using Anatomy to Improve Our Strategy, taught by Pierce Kenworthy, OD, FAAO, out of the Arizona College of Optometry.

He went through how the epithelial and stromal areas could be impacted by these specific areas of insult—whether it’s from a genetic condition like a dystrophy, from trauma, or, unfortunately, the byproduct of intraocular surgery.

[Dr. Kenworthy] covered how certain techniques could potentially be used, like Descemet stripping automated endothelial keratoplasty (DSAEK) or Descemet's membrane endothelial keratoplasty (DMEK) or some of the newer techniques like Descemetorhexis without endothelial keratoplasty (DWEK).

Give me an example.

For instance, anterior basement membrane dystrophy (ABMD) is relatively common but still has a genetic component, and it’s something we see on a regular basis.

He also mentioned contact lens-related issues and complications, which I think is important to never leave out of the conversation in these types of lectures.

And he discussed microbial keratitis, looking at bacteria and fungal keratitis, then diving into how to identify and treat.

And there’s another session to note, right?

Yup. This one ties into what I spoke about yesterday regarding certain diagnostics with optical coherence tomography (OCT), but this one dug a little deeper into the neurodegenerative portion of things.

The Role of Ocular Diagnostic Technology in Neurodegenerative Disease was co-lectured by Dr. Christopher Kuc, OD, FAAO, and Erin Draper, OD, FAAO.

We’re hearing more about people being diagnosed with conditions like Alzheimer’s disease, dementia, and Parkinson’s disease, even post-concussive conditions and complications afterward, and we’re seeing more and more of those cases in clinic.

Drs. Kuc and Draper looked through the different techniques that we have in practice, like optical coherence tomography (OCT), visual fields (VFs), and electroretinogram (ERG), to identify early-state conditions.

What do you mean by that?

By “early state," I mean the subclinical signs of the diseases that may not present immediately and overtly, but might show up in this microvascular environment that is the eye.

It’s imperative that optometrists, as primary eye care providers, can identify these diseases as early as possible for proper treatment.

That doesn’t mean we are necessarily going to treat them. But if we can identify them, we can then appropriately refer to a neuro-ophthalmologist or a neurologist for proper assessment, diagnosis, and treatment.

Those are definitely some significant topics.

They are, and ones that we don’t typically think about. We usually think of glaucoma, age-related macular degeneration (AMD), or geographic atrophy (GA).

In this instance, we’re looking at how the neurological impacts the eye. And this is something that we, as optometrists, can start doing because we can identify those pre-parametric changes.

It may not be classic glaucoma, but it could be one of a variety of field defects that can appear in this type of scan.

So, we have to question other disease states, complications, or anything else that could go along with special trauma.

Sounds like this could be the future of optometric focus.

Exactly. Looking to the future, something that I’ve talked about before is genetics and how that is going to inform us of the future of therapeutics.

While we’re probably not going to see significant product releases in the next 6 months, with enough investigations going on in this area, we will eventually see more of these investigative or experimental therapies become available to all clinicians.

Any specifics to keep in mind?

These companies are going to be aggressively investigating ways to treat rare diseases, particularly inherited retinal dystrophies (IRDs), not just to rehabilitate but potentially restore vision.

That sounds groundbreaking.

It is because it doesn’t really happen with the retina. Typically, when vision loss has occurred, it’s permanent, and there’s no way of getting it back.

If an individual has the potential for improved vision, that’s a major win. But to restore the anatomy? That’s a whole different ballgame.

With current retinal treatment, it’s more about maintaining vision and trying to halt the progression of vision loss. So, this is an entirely different avenue of treatment for individuals suffering from these diseases.

Let’s move on to hot topics.

What stuck out in the Exhibit Hall was the portability of certain technologies and devices.

Gone are the days of the large footprint. We talk about this continuously, but I think we’ll start seeing it more as technicians are empowered to operate these user-friendly devices.

Any specific examples?

Verséa Ophthalmics has a quantitative point-of-care (POC) testing platform for ocular surface disease (OSD) (see coverage on the July 2023 launch here).

Then there’s LumiThera, with the Total Immunoglobulin E (IgE). That’s going to have an impact beyond what's currently out there.

With tools like those, we can inform our patients of the numbers potentially associated with a disease to help them make a decision.

You can tie it back to what Eyes On Eyecare is doing with the Courses platform. You’re going to see more of these informational guides that inform people how not only to identify but also manage and treat.

The course that comes to mind is Dr. Hardeep Kataria’s, where she went through all these iterations of dry eye and MGD, so that practitioners, via this modular-based education, can understand how they’re able to treat and manage these cases through a very informative, easy, approachable style, where you can take what you’re learning here and apply it to clinic afterward.

Lastly, how’s the vibe in the Exhibit Hall?

Attendees are continuing to have informative, introspective conversations across the industry.

Conversations like, for example, how to learn more about Notal Vision and the ForeseeHome.

It wasn’t just attendees walking up to the booth and walking away; they were having meaningful discussions and gaining something from that experience.

That’s encouraging to hear, see, and feel because we want the industry and the practitioner to engage with each other at these meetings. That way, in the end, it helps the patient.

And the patient is the person in whom we’re invested the most.

The American Academy of Optometry (AAOPT) annual meeting is being held in New Orleans, Louisiana, October 11-14, 2023.