ICO News No17 Spr17 News No17... · 2017. 3. 10. · Chief Executive, Siobhan Kelly was presented...

The ICO Winter Meeting tookplace in Dublin on December1st, where members of the College

gathered to discuss future plans for

greater integration of community and

hospital eye care.

Discussions at the meetingincluded examination of overseasmodels of community ophthalmiccare. The ICO welcomed AndyCassels-Brown, ConsultantOphthalmic Surgeon and CommunityEye Health, Leeds Teaching Hospitals

Trust to share his experience of themodel in operation in Leeds and alsoof international ophthalmic models.

Opening proceedings, ICOPresident, Billy Power introducedguest speaker Aisling Heffernan,National Programme Manager,Primary Care Division, HSE whoprovided an update on the status ofthe Primary Eye Care Services ReviewGroup Report and outlined the corefunctions and objectives of the project.

ICO NEWSLETTER | SPRING 2017 PAGE 1

NewsletterISSUE 17 SPRING 2017

With best wishesProfessor Billy PoWer

Message from the President

Continued on page 2 ➥

Dear Colleagues,

It was great to meet withso many of you at theICO Winter Meeting lastDecember and again at the recentophthalmology parallel session at the RCSICharter Day where discussions werefocused on examining models of sharedcare and the very latest technologicaladvances in the speciality. I would like tothank Aisling Heffernan from the HSE forattending the Winter Meeting to updateour members on the status of the PrimaryEye Care Service Report and also to ourinvited guest speakers at the RCSI CharterDay. Reports on discussions from these keymeetings are contained in this latest editionof the newsletter.

I am equally enthused by the out -standing international and Irish expertswho will join us at The Slieve Russell Hotelfrom May 17th-19th for the ICO AnnualConference. We are delighted to welcomeProfessor Jonathon Crowston, the RinglandAnderson Professor of Ophthalmology atthe University of Melbourne who will givethis year’s Mooney Lecture. Prof Crowstonwill also contribute to a glaucomasymposium, joined by Professor AugustoAzuara Blanco from Queens UniversityBelfast and Mr Leon Au, Dual SpecialistOphthalmic Consultant from ManchesterRoyal Eye Hospital. A symposium on“New Developments in Ocular Imaging”will include a talk from Mr Pearse Keanefrom Moorfields London and Dr AlexShortt, Clinician-Scientist at the UCLInstitute of immunity and Transplantation.Sports psychologist and former rugbyplayer Stephen McIvor, will give a talktaking on and tackling challenges at the“Adapting for Change” symposium.

As my Presidency term draws to aclose, I would like to take this opportunityto sincerely thank all who contributed andsupported me in the role. It has been awonderful honour and I will continue tofocus on the issues of particular import -ance at this critical time for our specialityas Clinical Lead. My very best wishes tomy successor, Alison Blake, who I knowwill make an exemplary President.

Published byIrish College of Ophthalmologists121 St Stephen’s Green, Dublin 2. Tel 01 402 2777 · [email protected] www.eyedoctors.ie · t: @eyedoctorsirl

If you would like to make anysuggestions for future issues of theCollege Newsleer please contact Siobhan on [email protected]

ICO Winter Meeting 2016Integration of Community and Hospital Care

L-R: Guest speakers at the ICO Winter Meeting discussion on the integration of community andhospital care, Andy Cassels-Brown, Consultant Ophthalmic Surgeon and Community Eye Health,Leeds Teaching Hospitals Trust and Aisling Heffernan, National Programme Manager, PrimaryCare Division, HSE are pictured with Billy Power and Alison Blake.

Aisling confirmed the advancedstage of the Report, due for publica -tion in early 2017, along with the HSEModel of Eye Care Document fromthe National Clinical Programme inOphthalmology.

The ICO welcomed the news thatMinister for Health, Simon Harris hasassured of the Government’s commit -ment to prioritise and implement theReport recommendations and keysactions in 2017. Ms Heffernanconfirmed that the HSE 2017 serviceand operational plan will includespecific and measurable goals whichwill be continuously reviewed.

In her presentation, Ms Heffernanoutlined the likely key recommenda -tions and implementation plan, andthe proposed initial priorities for 2017,including an action plan to addressthe immediate primary care paediatriceye services issues in the Dublin area.She also put forward the likelychallenges and outlined the estimateplanning process for the PCESRGreport.

Since April 2016, the ReviewGroup have had regular meetingswith Department of Health to explorethe draft report in more detail, and todiscuss the development of a detailedimplementation plan, profiled across3 yrs, 5yrs and 10 yrs.

Ms Heffernan highlighted thatthere are many social factors to beexamined in terms of each communityhealth care organisation profile (socialdeprivation levels, medical care levelsetc.) on the workforce planning side –all of which was informing the HSEestimates process. She confirmed thathaving this additional documentationreally strengthened the HSE’s businesscase through the estimates process.

The Review team made theirpresentation to the National Directorfor Primary Care and Primary CareSenior Management team in December2016 and liaised with key stakeholdersthroughout the process to ensure allare informed and no unnecessarydelays ahead of Leadership approval.

Outlining what the likelyimplementation plan will look like,Ms Heffernan forecasted that thereport will be published in early 2017,

coinciding with the Model of Caredocument from the National ClinicalProgramme in Ophthalmology.

The implementation phase of keypriorities and main work of the reportwill be carried out in the first 4 years,but Ms Heffernan predicted that itwill realistically take 5-10 years beforeall elements of the programme areimplemented.

The other main priorities includethe recruitment of a dedicatedprogramme manager and a clinicallead to oversee the implementationprogramme nationally and ensureconsistency in services at each CHOthroughout the country.

There should also be an implem -entation steering group to support thework of the Programme Manager andClinical Lead as all groups will needto liaise closely with the NationalClinical Programme for Ophthalm -ology and on selecting the sites for theprimary eye care teams.

Support for the CHO’s to recruitadditional staff incrementally will alsobe prioritised.

Examples of other models ofprimary care initiatives approved forfunding and in early stagedevelopment were discussed duringthe meeting, including the CommunityIntervention Scheme which enables

Primary Care Eye Services

Review – Key Objectives

• Examine and document theprimary care eye servicescurrently provided to childrenand adults nationwide includingHSE directly provided servicesand contracted primary careservices

• Determine and document theneed of the population forprimary care eye services

• Review the current primary careeye services in terms of quality,safety and consistency andidentify issues for actions

• Set out a blueprint withrecommendations for thedelivery of primary care eyeservices which will ensure ahigh quality, safe and consistentservice for patients

• Put in place an action plan toaddress immediate primary carepaediatric eye services issues inthe Dublin area.

Likely Key Recommend -

ations from the Review• Establish primary care eye teams

staffed by community ophthal micphysicians, optometrists, orthopt -ists, nurses and technicians.

• Resource the team appropriatelywith the equipment and clinicalspace needed (aim is for patientsto be able to travel to multi-disciplinary teams with coreequipment in situ, as opposed tooutreach service clinics as muchas possible).

• Establish governance system –via lead medical post per CHO.

• Procure a national eye carepatient management system.

• Move as much care as possiblefor medical card patients fromthe acute to the primary caresetting.

• Review the COSS and COSMTS • Transfer of care for the over 8’s to

optometrists, as appropriate andas determined by the Commun -ity Ophthalmic Physician Lead inthe governing role.

Likely priorities for 2017 –

action plans• Recruit Programme Manager

and Clinical Lead,• Commence the review and

update the COSS and COSMTS • Complete procurement process

for an eye care patient manage -ment system – acute andprimary, allowing integrationbetween 2 setting

• Complete a procurementprocess for modern eye careequipment for all CHOs

• Agree CHO sites for primary careeye teams, clinical rooms, storagefacilities etc – Chief offices to beplanning ahead for that.

• Terms of reference priority foryear 1 will be recruiting addit -ional staff for paediatric servicesin Dublin south and DublinNorth – start straight away.

ICO NEWSLETTER | SPRING 2017PAGE 2

Continued from page 2


the patient to transition from acutehospital to their home as soon aspossible through the utilisation ofnursing services and support and alsothe GP Minor Surgeries project, ofwhich a trial of 22 practicesnationwide has been in operationthroughout 2016 and plans for furtherexpansion in 2017 and beyond.

Both are key examples of ensuringthe patient is looked after in theprimary care setting and notunnecessarily referred to the acutehospital setting. Other projectsunderway include increasing GPaccess to ultrasound services in orderto alleviate patient waiting lists. TheHSE trialled out-sourcing ofultrasound in the South and West in10 primary care centres. Urgent casesare seen within 5 working days andnon-urgent within 10 days. Datashows that 85% of referrals are beingkept out of the acute setting, thereforealleviating waiting list time. There areplans to expand the programmenationwide in 2017, where the optionfor hospitals to undertake an in-housemodel will be available with supportfrom the HSE while others will optionfor the outsourcing model. The HSEwill compare the results and look atthe long-term approach needed.

Actions from an approved reportfor audiology services in 2011 are inoperation and receiving on-goingfunding. Ms Heffernan said theaudiology model displays the needfor a medical clinical lead in thecommunity, and has been recognisedas what is required for theophthalmology model of care.

Ms Heffernan acknowledged howthe metrics for ophthalmologycommunity services have developedin the past 2 years and commendedthe work and support of Alison Blakeand her colleagues in this area.

During the Q&A session, the needfor the development of a robustelectronic patient record washighlighted. Integration of hospitaland community care will not bepossible without the implementationof an electronic health record.

The Hse 2017 service Plan which

was published after the Winter Meeting

prioritises the implementation of the

review recommendations in 2017.

Nurse administered botulinum toxin injectionclinic at Beaumont ophthalmology department

ICO CEO Siobhan Kelly isparticipating in a new HSEworking group to develop a strategy

for doctor’s health and wellbeing.The group is chaired by Dr Lynda

Sisson, Consultant in OccupationalMedicine and Clinical Lead forWorkplace Health and Wellbeing Unitof the HSE.

The process commenced in Januarythis year and consists of a coreWorking Group, and a number ofWorking Parties, to be established, asrequired, during the life of this Group.

Discussions at the inauguralmeeting of the group examined anumber of areas, including the broadaspirations for our doctors workingenvironments, the goals on whichprogress can be measured and theorganisation systems which existand/or are necessary to ensure theycan operate, build and maintain the keycapabilities of our medical workforce.

It is anticipated that the group willmeet on a monthly basis for the firsthalf of 2017 and a report publishedby Q3.

Chief Executive, Siobhan Kelly was presented with her M.Sc in Leadership from RCSI PresidentProf John Hyland and NUI Chancellor Dr Maurice Manning at the RCSI Conferral Ceremony in TheConvention Centre on November 17th 2016

ICO invited to participate inWorking Group to develop“Healthy Doctors Strategy”

The first nurse administeredbotulinum toxin injections weredelivered to patients of BeaumontHospital Neuro OphthalmologyDepartment in January.

Clinical nurse specialists, AshlingMcCourt and Elaine Brennan carriedout the injections under the super -vision of Consultant OphthalmicSurgeon, Ms Pat Logan and SpR MsCaroline Bailey. Ashling and Elainecompleted training courses inadministering the botulinum toxin

injections to patients in advance ofthe clinic start up and an approvedstandard operation procedure hasbeen drawn up.

The first session carried out underPat Logan’s supervision in Januarywas successful and met withapproval from all patients, who whenasked to participate in this innovationat the Beaumont OphthalmologyDepartment, were happy to consent.

On-going procedures andoutcomes are being audited.


New patient information leafletsand ICO guidelines on theconsent process were launched at theICO Winter Meeting.

The documents were developed bythe ICO Ethics and ProfessionalStandards Committee in recognition ofthe need to ensure greater support forpatients as they consider the benefitsand risks of a proposed procedure andequally to provide guidance to ICOmembers on best practice of the patientconsent process.

In her opening address at the ‘GoodPractice Guidelines for Patient Consentin Ophthalmology’ seminar, PatriciaQuinlan, Chair of the Ethics Committeecommented that the ICO takes its rolein patient advocacy very seriously andthe on-going work of the College hasincluded the development of our codeof ethical conduct, the guidelines onrefractive surgery and on advertisingregulation recommendations.

Patricia discussed that issues whichmust be addressed include the everrising indemnity costs, the high patientexpectation, the appalling trivialisationof surgical procedures that doctorscome face to face with on a daily basisand the increasing number ofmalpractice suits. Equally, the problemspatients’ face which can make it hard

for them to have a full understanding oftheir condition and the proposedtreatment were acknowledged,including overcrowding of clinics, lackof privacy and time.

Delegates were referred to thedefinition of consent in the HSENational Consent Policy document as“the giving of permission oragreement for intervention following aPROCESS of communication about theproposed intervention”, i.e. it’s not justa signature on a form.

The policy outlines that a patientmust have received sufficientinformation in a comprehensiblemanner about the nature, purposes,risk, benefits and merits to theintervention and mustn’t be actingunder duress and must have thecapacity to make the decision. TheAssisted Decision Making Act 2015was enacted to ensure a person whohas limited capacity to make aninformed decision can formallyappoint a family member or friend tohelp them through the process.

The important factors which enablea patient to reach an informed consentdecision include adequate time,providing the information in clear andaccessible way for the patient andhaving a relative present.

A patient must be told the diagnosisand prognosis, including anyuncertainties, the options, includingthe option not to treat, and the purposeof the procedure and what it willinvolve, the potential benefits and risksand the likelihood of success, and theoption of any alternative procedure.The patient needs to be warned if theirparticular circum stances could impacton their risk. They should be asked ifthey have understood the informationand questions should be answeredfully and honestly. The patient shouldbe given down time to consider theirdecision.

Patient Information Leaflets and Guidelines on theConsent Process launched at ICO Winter Meeting

(L-r) Angela Hughes, HSE, Patricia McGettrick, Billy Power, Louis Collum, Prof Freddie Wood,President of the Medical Council, Patricia Quinlan and Asim Sheikh, Barrister at Law.

Patricia Quinlan, Chair of the ICO Ethics Committee is pictured with Prof. Freddie Wood, Presidentof the Medical Council, Greg Price, Assistant National Director, Quality Improvement Division, HSEand Angela Hughes, Programme Manager, Clinical Director Programme, Quality ImprovementDivision and Programme Lead for Consent Policy and Quality and Patient Safety, HSE at the launchof new Patient Information Leaflets and Guidelines on the Consent Process in Ophthalmology at theICO Winter Meeting on Thursday, 1st December in The Gresham Hotel, Dublin.


The ICO patient informationleaflets continue to be a work inprogress and the College would like tothank members who have givenfeedback to date, an essential part ofthe process in ensuring the documentsinclude the most relevant andimportant facts for patients.

The leaflets and consent guidelinesare available to download in PDFformat on the ICO website and used inyour clinics or patients can be directedto the site. In order to ensure theinformation is accessible to all, thedocuments have also been produced inaudio and Clear Print format incollaboration with the NCBI.

Members can contact the officedirectly if they would like to arrange toorder printed copies. The first series ofleaflets explain to patients therecommended treatment for cataract,wet AMD, diabetic macular oedema,retinal vein occlusion, strabismus andglaucoma. The College plans to extendon this current list and would ask thatany member who feels they couldassist, to please contact the ICO officeor the Ethics Committee.

The ICO wish to thank andacknowledge the extensive work of theEthics Committee in preparing thedocuments and the invaluablecontribution made by Mr A Sheikh,Barrister-at-Law in developing theconsent guideline document, and ofour colleagues Kathryn McCreery andJeremy O Connor who researchedstatistics, devised, and provided uswith patient information leafletsrelative to their surgical sub-specialty.

Speaking at the launch, Greg Price,Assistance National Director of theQuality Improvement Division at theHSE commended the ICO on thepublication of the documents and said:“Person-centred care is about puttingthe patient, their family members andcarers at the heart of their treatmentand empowering them to be partnersin decision making. These informationleaflets published by the ICO willenable patients to understand theprocedure that they are undertaking,to seek further information if theyneed it and to make decisions that arebest for them.”

Professor Freddie Wood, Presidentof the Medical Council also attendedthe ICO Winter Meeting and expressedhis support of the work of the Collegein this regard.

National Advisory Council for Patient SafetyMinister for Health SimonHarris has announced theestablishment of a new National

Patient Safety Office (NPSO).

Speaking at the inauguralNational Patient Safety Conferencein Dublin Castle on December 8th,Minister Harris said, “The establish -ment of the National Patient SafetyOffice is a key milestone inproviding sustainable leadership forpatient safety policy and innovation.This Office will focus on patientsafety legislation; the establishmentof a national patient advocacyservice; introduction of a patientsafety surveillance system;extending the clinical effectivenessagenda; a national patientexperience survey; and the settingup a National Advisory Council forPatient Safety. Within theprogramme of legislation, we intend

to progress the licensing of ourpublic and private hospitals, theHealth Information and PatientSafety Bill and provisions for OpenDisclosure.”

Mr Harris said the role of theCouncil “will be to provide adviceand guidance to inform the policydirection for the Department ofHealth’s new National Patient SafetyOffice in its delivery of three corefunctions; patient safetysurveillance; patient advocacy; andbuilding further the work of theNational Clinical EffectivenessCommittee.”

The Minister will appointmembers to the Council in 2017 toguide the work of the Office. TheCouncil will have an independentchair, significant representation fromhealthcare leaders and frompatients.

As part of the European Tour,Orbis will be showcasing theworld’s only Flying Eye Hospital to

their Irish supporters at Dublin

Airport from 2-5 March 2017.

Orbis are holding a series of eventsduring the fourday programmeand plan towelcome over500 individualson board thespeciallydesigned and converted MD-10aircraft to learn more about it and thesight-saving work it enables. Theaircraft service is the result of aunique and lasting alliance forgedbetween the medical and aviationindustries to bring ophthalmictraining to communities through longterm partnerships with hospitals andeye care institutions, and through theonline learning platform, Cybersight.

Through these variety of toolsOrbis train and share resources withthe entire eye care team, from healthworkers in rural clinics to eyesurgeons in urban centres.

On Saturday 4 March 2017 (from1.30pm – 4pm)Orbis will host aspecial MedicalSector receptionfor 60 individuals.There will be achance for all

guests to join a fully guided tour ofthe aircraft and hear from the medicalteam involved in the operation of thisone of a kind hospital. You will alsohear from Irish members of the OrbisVolunteer Faculty, including DonalBrosnahan. You will also have theopportunity to view an exhibition onOrbis through the years.

for more information, visit orbis.org

website.

Orbis Flying Eye Hospital –Medical Sector Event


The focus of the first training day,attended by approx. 35 doctors, wason the use of intravitreal injections inAMD, and included lectures ondiagnosis and manage ment and apractical session on injectiontechnique. The meeting was chairedby Fiona Kearns.

Dara Kilmartin opened themeeting with a lecture on ‘OCT andFluorescein Angiography. He alsodiscussed the huge pressure on theretinal services on the managementand treatment of this condition andthe need for combined care withMedical Ophthalmologists.

Mairide McGuire gave a lecture on'When to cease treatment', followedby Sarah Gilmore who gave a lectureon 'Intravitreal injections – from doorto needle'. This was followed by apractical session on intravitrealinjections with work stations andsimulated with pigs eyes and needles.

This was the first study day with apractical element for medicalophthalmologists and chair FionaKearn's said members found this very

helpful, reporting that medicalophthalmologists as a group would bevery interested in being more activelyinvolved in the management andtreatment of their patients with AMD.

The ICO is conducting apreliminary survey around thecountry to check the feasibility of this,Further subspecialty training daysfocusing on OCT and an AMDworkshop day will take place in thecoming months. Details will becirculated to members in due course.

Medical OphthalmologySub-Specialty Training Day

ICO members pictured at the first in a series of sub-specialty training day for medical ophthalmology which took place on Friday, 27th January at theEducation and Conference Centre, Royal Victoria Eye and Ear Hospital in Dublin.

L-R: Fiona Kearns, Beaumont Hospital, Sarah Gilmore, Mater Misericordiae University Hospitaland Mairide McGuire, Sligo General Hospital, pictured at the first in a series of sub-specialtytraining day for medical ophthalmology which took place on Friday, 27th January at the Educationand Conference Centre, Royal Victoria Eye and Ear Hospital in Dublin.

The first in a series of subspecialty training days for medical ophthalmologytook take place on January 27th in the Education and Conference Centreat the Royal Victoria Eye and Ear Hospital.


The announcement was made at theICO Annual Winter Meeting.Elizabeth will start her fellowship atMacclesfield District General Hospitalin Cheshire this year to completetraining in ophthalmic plasticlacrimal, orbital and reconstructivesurgery.

Andrea is currently carrying out afellowship in medical retina atMoorfields Hospital in London.Speaking at the announcement, shesaid, “I am extremely grateful to theICO and Bayer for the fundingprovided which allows me to accessthis invaluable training opportunityin one of the world’s leading eyehospitals. I hope to bring the expertisegained to the Irish healthcare systemto benefit the large and growingpopulation of Irish patients affectedby retinal disorders.“

Andrea said the key objective ofthe fellowship is to move towardsbecoming competent to specialistlevel in the assessment, diagnosis,

treatment and follow-up of patientswith medical retina disease includingretinal vascular, genetic and uveiticdisorders. The fellowship offersexposure to novel retinal imagingtechniques, electro-diagnostics,research opportunities and extensiveteaching sessions under thesupervision of experts in the field.

Elizabeth McElnea’s chosenfellowship at Macclesfield DistrictGeneral Hospital in Cheshire willcommence in July 2017. TheFellowship also presents Elizabethwith the opportunity to attend multi-disciplinary meetings and teachingsessions in three further centres in theUnited Kingdom – the RoyalLiverpool Hospitals NHS Trust, TheCentral Manchester Foundation NHSTrust and The Christie Hospital aswell as the chance to produce a bodyof research work that adds to theevidence based practice of thisophthalmic surgery sub specialty.

The ICO would like to thank Bayer

for their support in facilitating thewinning ICO trainees to undertake anexceptional training opportunity intheir chosen overseas centres ofexcellence in the field ofophthalmology. We acknowledge thetremendous benefit this will have totheir training experience and in turnthe Irish health service.

Katy Carroll, Business UnitManager of Bayer Irelandcongratulated the recipients and said,“As this is the first year of the award,we look forward to hearing thewinners describe how this has helpedto develop their careers when theyreturn to Ireland so they can inspirefuture applicants.”

Winners of Bayer/ICO Clinical FellowshipAnnounced at Eye Doctors Annual Winter Meeting

The College is delighted to announce that senior trainees, ElizabethMcElnea and Andrea Ryan, have been awarded as joint winners of theinaugural Bayer/ICO Clinical Fellowship in Ophthalmology 2016/2017.

Winners of the inaugural Bayer/ICO Clinical Fellowship in Ophthalmology 2016/17, Andrea Ryan(centre) and Elizabeth McElnea (2nd from left), pictured with Yvonne Delaney, ICO Dean ofPostgraduate Education (far left), Katy Carroll, Business Unit Manager and Neil O’Connor,Product Manager, Specialty Medicine of Bayer Limited at the announcement which took placeduring the ICO Winter Meeting in the Gresham Hotel on December 1st

Ophthalmologywaiting lists to beamong the specialitiesprioritised in NTPF2017 Budget Plan

The National TreatmentPurchase Fund has confirmedthat ophthalmology is to be amongthe specialities prioritised forfunding in the NTPF budget planfor 2017 to tackle the longestwaiting public patients. Theannouncement was made duringthe launch of the NTPF Plan at ameeting of healthcare professionalsattended by Minister for HealthSimon Harris on January 19th.

The fund will initially targetresources on patients waiting over18 months, particularly for daycases and expects to beginarranging by April.

Tender documents were issuedto all private hospitals in Januarythat have expressed an interest inproviding treatment. This is thefirst time since 2011 that the NTPFhas been given the job of arrangingtreatment for patients.


Annual Montgo

Maeve Rhatigan with Rory Murphy and Barry Power.

Mr Frank Larkin, Consultant OphthalmicSurgeon, Moorfields Hospital, London.

Mr Andy Cassels-Brown, Leeds Teaching Hospitals Trust, Princeton Lee,Paul Moriarty

Kevin Kennelly with David Guildea and Yvonne Delaney. Alain Munier and Caitriona Munier.

Mr Frank Larkin, Consultant Ophthalmic Surgeon,Moorfields Hospital, London presented the AnnualMontgomery Lecture at Trinity Biomedical Science Institute,

Dublin on Thursday, December 1st, 2016.

Mr Larkin’s lecture entitled “Accepting the Unacceptable:Prevention and Treatment of Rejection of Donor Cornea”illustrated the varied appearances of corneal transplant

rejection, immune privilege of donor cornea and its erosion,

pathways to rejection, and the management of high rejection

risk patients in 2016. Mr Larkin undertakes or supervises over

150 transplants annually.


omery Lecture

Peter MacManus and Garry Treacy. Siobhan Kelly and Emily Hughes

Tim Fulcher, Frank Larkin, Paul O’Brien, Professor Martina Hennessy, School of Medicine, TrinityCollege Dublin, Billy Power and David Keegan.

Pat Logan and Gerry Fahy.

Alison Blake and Marie Hickey-Dwyer. Jeremy O’Connor and Louis Collum.


The Board has been given the task ofoverseeing the standard ofophthalmology training. The nationaldelegates of the Board includeclinicians and academicians withspecific ophthalmological skills,expertise and a broad geographicdistribution. Two delegates arenominated from each country of theEuropean Union, Norway andSwitzerland by the NationalOphthalmological Societies. TheUnion Européenne des MédecinsSpécialistes (UEMS) advises theEuropean Union on matters related tospecialised medicine and is thus thedirect link with the European offices.

The late Professor Peter Eustace(Chair) and Mr John Nolanrepresented Ireland at the inauguralmeeting of the Board.

The Education Committee is incharge of the European Boardexamination. At the third EBOmeeting in Rome in October 1993, theprinciple of the Europeanexamination was accepted.

The first EBO examination was

organised by Peter Eustace in Milan inJune 1995, with 45 candidates. Sincethen the examinations are held on ayearly basis in Paris, at the Palais desCongrès in Porte Maillot. The formatintroduced by Peter Eustace is still inoperation.

The Peter Eustace Medal wasestablished by unanimous decision ofGeneral Assembly of the EuropeanBoard of Ophthalmology in Tallinn on20th June 2010 as a mark ofappreciation for Peter’s outstandingcontribution to the Board.

The Peter Eustace Medal is givento an ophthalmologist who hasdevoted long term and exceptionalefforts towards upgrading educationin ophthalmology in Europe. In 2015,Professer Marie José Tassignon wasawarded the medal and in 2016, Dr.José Luis Menezo was the recipient.

A record-breaking 619 candidatesfrom 26 European countries took partin the European Board of Ophthalm -ology Diploma (EBOD) examinationin 2016. The EBOD examination isdesigned to assess the knowledge and

clinical skills requisite to the deliveryof the highest standards ofophthalmic care both in hospitals andin independent clinical practices. Theexam helps to harmonise andcompare ophthalmology trainingprogrammes throughout the EU.

The European Board ofOphthalmology was recognised bythe American Academy ofOphthalmology for its strong andsustained partnership with theAcademy in developing and formallyendorsing the Basic and ClinicalScience Course for use in Europe, andfor the EBO’s success as a certifyingbody. The Special Recognition awardwas accepted on behalf of the EBO atthe opening session of the 2016 AAOAnnual Meeting in Chicago, USA byEBO President, Dr. Peter J Ringens,from The Netherlands. Presenting theaward were AAO President DrWilliam L Rich and AAO ChiefExecutive Officer Dr. David W Parke.The Special Recognition Award ispresented to an individual ororganisation for outstanding servicein a specific effort or cause thatimproves the quality of eye care.

The European Board ofOphthalmology Diploma is the exitappraisal for the Specialty Training inOphthalmology programme inIreland. Trainees must be in their 4thyear of training and have passed theMRCSI to be eligible to sit theexamination.

Successful candidates are awardedthe EBO diploma and when they are

EBO Report

Alison Blake pictured at the 71st PlenaryAssembly of the U.E.M.S Section ofOphthalmology/EBO, RCSI, Dublin, in June2016.

Prof Michelle McNicholas pictured with Gerry O’Connor and his wife Edel and Anne Hylandpictured at the 71st Plenary Assembly of the U.E.M.S. Section of Ophthalmology/EBO, RCSI,Dublin, in June 2016.

The European Board of Ophthalmology (EBO) was founded in 1992. It isthe permanent working group of the Ophthalmology SubspecialtySection of the European Union of Medical Specialists (UEMS).


Aine Ní Mhealoid and Denise Curtin pictured at the EBO Exam in Paris, May 2016.

John Nolan pictured with Dr Hanne Olsen,Denmark and Dr Jean Paul Dernouschamps,Belgium at the UEMS/EBO meeting in Dublin,June 2016.

Marie Hickey Dwyer pictured with Dr.Gordana Sunaric Mégevand, Switzerland, andDr Catherine Creuzet Garcher, France, at theUEMS/EBO meeting in Dublin, June 2016.

Professor Peter Ringens, Kamel Khalid, Denise Curtin, Daniel Coakley, Samla Babiker, Helen Ntomchukwu, Marie Hickey Dwyer, Aine Ni Mhealoid,Professor Edourdo Midena pictured at the EBO Exam in Paris, May 2016.

eligible to be included on theSpecialist Register as Ophthalmol -ogists in Ireland they are awarded thetitle of FEBO (Fellow of the EuropeanBoard of Ophthalmologists).

Examiners from Ireland travelannually to Paris for the oral EBOexamination.

Marie Hickey Dwyer hasexamined 19 times in Paris. Marieholds the national record foroutstanding support to the EBOexamination.

Gerry O’Connor has completed hissecond term as national delegate andexaminer. The ICO acknowledges theunique contribution of Mr O’Connorand thank him sincerely for hiscommitment to Education andtraining.

In June 2016 the UEMS/EBO AGMwas held in Dublin. Nationaldelegates Alison Blake, Denise Curtinand Gerry O’Connor providedinvaluable input to the organisation ofthis meeting. The ICO providedexcellent support for the event.

The Minister for Health SimonHarris attended the dinner held at theRCSI on June 11th 2016. Other notabledelegates included Billy Power,President ICO, Professor JohnHyland, President RCSI, John Duddy,President IMO, Professor PeterRingens, President EBO, and Dr.Hank Bonnemaier President UEMS.John Nolan and Aoife Doyle, pastnational delegates also attended.


We look forward to welcomingglaucoma expert Prof JonathanCrowston, the Ringland AndersonProfessor of Ophthalmology,University of Melbourne andManaging Director of the Centre forEye Research Australia (CERA) whowill give this year’s Mooney Lectureand will also contribute to a glaucomasymposium.

Jonathon is a practising glaucomaspecialist clinician at the RoyalVictorian Eye and Ear Hospital. Hetrained at Moorfields Eye Hospital,London and was awarded a PhD forwork on ocular fibrosis at the Instituteof Ophthalmology, University CollegeLondon in 2000. He subsequentlycompleted Glaucoma Fellowships atthe University of Sydney and UC SanDiego where he then joined theglaucoma faculty, prior to moving toAustralia in 2006.

Jonathan’s multi award winningresearch is focussed on understandingwhy ageing predisposes to opticnerve disease and in particularfocussing on neuroplasticity and thepotential for retinal ganglion cellrecovery. He serves as a director on anumber of boards including CERA,ORIA, World Glaucoma Association,CERA Technologies Pty Ltd, Et alResearch Pty Ltd, Oculo and Sight for

All. He is the recipient of the 2016Peter Watson Medal from CambridgeOphthalmology Society and theinaugural recipient of 2016 ARVODavid L Epstein Award recognisingoutstanding research in Glaucomaand for mentoring young clinicalinvestigators.

The ICO also looks forward towelcoming Professor Augusto AzuaraBlanco from Queens University Belfastand Mr Leon Au, Dual SpecialistOphthalmic Consultant fromManchester Royal Eye Hospital topresent at the glaucoma symposium.

Augusto has focused much of hisacademic career and research expertisein trying to improve patient care andinvestigating the efficacy, efficiencyand safety of new develop ments foreye diseases, including intervention,diagnostic tests and models of eyecare. He is the chief Investigator of aninternational multi-centre RCTcomparing primary lens extractionversus laser iridotomy in patients withangle-closure glaucoma and an UK-based multi-centre diagnostic studyevaluating automated imagingtechnologies in glaucoma.

Leon Au’s major areas of expertiseare glaucoma, cornea related problems,external eye disease and cataract. Heis considered one of the internationalleaders in innovative MinimallyInvasive Glaucoma Surgery (MIGS)and conducts clinical trials in many ofthese new technologies.

A symposium on “New Develop -ments in Ocular Imaging” will alsofeature at this year’s ICO Conferenceand will include a talk from Mr PearseKeane, Consultant Ophthalmologistat Moorfields Hospital London.Pearse specialises in appliedophthalmic research, with a particularinterest in retinal imaging and newtechnologies and was listed 4th in theOphthalmology Power List of 2015.He carried out OCT research with theoriginal inventors of the technology at

the Doheny Eye Institute, US. Hiswork focuses on late stage develop -ment, clinical testing and translationof new imaging technologies intoclinical practice, and the novelapplication of these devices for thegeneration and validation of anatomicbiomarkers, for use in trials and inroutine clinical practice. In January2015 he was awarded a “ClinicianScientist” award from the NationalInstitute of Health Research (NIHR) –the first ophthalmologist in the UK toreceive the award – and his remit is toexplore the potential of new medicaltechnologies and innovation in thetreatment of visual impairment andblindness, with a particular focus onophthalmic imaging. Keane predictsthat increased miniaturisation of OCTdevices and their use to performcomprehensive, automated eye examswill transform ophthalmology.

Pearse will speak about theexciting and innovative collaborationbetween Moorfields Hospital andGoogle DeepMind during his talk atthe ICO Annual Conference.

Dr Alex Shortt, Wellcome TrustFellow and Clinician-Scientist, UCLInstitute of immunity and Trans -plantation will also present at theimaging symposium on the latestdevelopments and technologies inanterior segment imaging.

Alex is a clinician scientist who has

ICO Annual Conference 2017

Prof Jonathan Crowston, the RinglandAnderson Professor of Ophthalmology,University of Melbourne and ManagingDirector of the Centre for Eye ResearchAustralia (CERA).

Pearse A. Keane, Consultant Ophthalmologist,Moorfields Eye Hospital, London and an NIHRClinician Scientist, based at the Institute ofOphthalmology, University College London(UCL),

The 2017 ICO Annual Conference will be held in the Slieve RussellHotel, Cavan from the 17-19th May.

undertaken joint academic andclinical training in ophthalmologythrough the NIHR’s IntegratedAcademic Training programme.Having been awarded his PhD in 2009he then completed an NIHR ClinicalLectureship at the NIHR BiomedicalResearch Centre at Moorfields and theUCL Institute of Ophthalmologyfollowed by two cornea and externaldisease fellowships at Moorfields EyeHospital. Over the past 10 years,Alex’s research has focused on thedevelopment of cell therapies forcorneal and conjunctival disease. Heis about to commence a prestigious4-year Wellcome Trust ClinicianScientist Award investigating theresponse of the recipient’s immunesystem to engrafted stem cells.

The College is delighted towelcome Hadas Levy, Psychologistfrom the Royal College of PhysiciansIreland to speak at the ‘Adapting forChange’ symposium.

Hadas is an expert on doctors’health and wellbeing and will talkabout doctors developing resilienceand dealing with burnout (how torecognise and guard against it),negotiating skills and how toinfluence people. Hadas will be joinedby sports psychologist and formerrugby player Stephen McIvor whowill discuss taking on and tackling thechallenge and opportunity for changeand aiming for progress.

Other guest lecturers at this year’sICO Annual Conference will includeProfessor of Ophthalmology andNeuro-ophthalmologist in Andara,

Turkey, Pinar Aydin O’Dwyer whowill give a talk entitled ‘Ophthalm -ology in Art’.

Pinar will explore visual artcompositions and the manydiagnostic procedures and diseaseswhich have been observed andexpressed by artists, illustrating whatthey have experienced and whatmoved their artistic instinct.

Amongst those tests are visual lossoptic neuritis, visual field examin -ation, including the Amsler chart,examination of functional visual loss,and some eye movementexaminations can also be observed invisual art works. Endocrinologicaldiseases causing ophthalmic complic -ations have also been a subject forpainters as well as other congenitaland acquired diseases, and infra andsupra nuclear eye movementdisorders. While painters painted“patients”, they also painted throughtheir own eye diseases.

Looking at these paintings welearn that the artists were not onlygood observers, but also had a veryunique approach to the patients withpathologies.


AAO ONE NetworkGlobal DirectoryService The ICO would like to remindour members of the resourcesavailable to you through the AAO

ONE Network. The recent updates

include member access to a greater

extent of new content, such as a

library of 3,500 free clinical

images, basic skills courses, master

class videos and self-assessments

At AAO 2016 in Chicago, a newdirectory called the GlobalDirectory of Training Opportunitieswas launched. It serves as aclearinghouse for what the AAOhope will be all ophthalmic trainingopportunities open to ophthalm -ologists outside of the UnitedStates. The directory was created inresponse to requests received fromyoung ophthalmologists seekinginformation about observership andfellowship opportunities.

The directory can be searched bysubspecialty and region of theworld and includes contactinformation, should you want topursue a training opportunity and aspace for public comments.

We also encourage members tolist a training opportunity if yourinstitution or practice wishes to beincluded in this comprehensivedirectory.

Enter the 2017 International

EyeWiki Ophthalmologists

ContestEyeWiki, the AAO eye encyclo -

pedia written by ophthalmologists,is an excellent authoringopportunity for ophthalmologistsworldwide.

To enter the 2017 InternationalEyeWiki Ophthalmologists Contest,you must be the sole author of yourarticle, it must be wholly originalwork, and must be added toEyeWiki by June 1, 2017.

Instructions for entry areavailable on the ICO website underour members section or visit theAAO website www.aao.org

Professor Augusto Azuara Blanco from QueensUniversity Belfast

Dr Alex Shortt, Wellcome Trust IntermediateFellow and Clinician-Scientist, UCL Instituteof immunity and Transplantation.

Abstract Submission – ICO

Annual Conference 2017The submission of abstracts is nowinvited for the ICO AnnualConference 2017. Closing date is Monday, 20th March.

Abstract form is available todownload and further details atwww.eyedoctors.ie


The session entitled ‘The use ofmodern technology to deliver better eye

care’, explored cutting edge technologyinfluencing the delivery of eye care andincluded presentations from DavidKeegan and Colm O’Brien, MaterMisericordiae University Hospital,Dublin; Professor Roshini Saunders,NHS Fife’s Queen Margaret Hospital,Dunfermline, Scotland; Professor JulieSilvestri, Royal Victoria Hospital,Belfast; and Conor Murphy and PaulKenna, Royal Victoria Eye and EarHospital in Dublin.

In his presentation, David Keegandiscussed the latest figures andprojections in relation to patients inIreland with retinal disease, the evergrowing demands on the intra vitrealinjection service and explored both theexisting and potential surround ing thegreater use of integrated technology inthe delivery of eye care services.

David discussed the innovationsaround new therapies and treatmentsfor the three main areas of retinaldisease, and how we can deliver alinked up system where patients or agroup of patients can be appraised andthe right treatment selected for them.The significance of the use of Optimizein the National Diabetic Screening

Service was highlighted, an integratedbig data system which helps to look atevolving patterns and trends andprovides real time results and vision onthis, all underpinned by qualitystandards and treatment practiceguidelines.

David explained that there are keycriteria for diagnosing and definingDiabetic Retinopathy and that this iswhat lends diabetes to photographicgrading, trained graders andautomated grading systems, in so far aspatients can be diagnosed and referredappropriately. It is estimated thataround 10,000 diabetics requiretreatment at the 8 national treatmentcentres. These patients have beenfiltered from approx. 93,000 patientswho attend the screening centres (122locations) across Ireland. The first runof predictions on the impact of theservice on the health service indicatedthat with full penetration, 11,000-11,5000 injections would be requiredand 30,000 outpatient visits. Whenadded to the 45,000 annual visits forAMD, it shows the scale of servicerequired and why it is currentlyoverburdened and struggling. Thesignificant knock on costs to the healthservice as a result of these patients

being more likely to fracture a hip,suffer from depression and earlieradmission to nursing homes was alsohighlighted. The Cost of BlindnessReport demonstrates the costs inrelation to all these factors and quiteclearly indicates that with a propersystem in place, significant savings canbe generated.

David also discussed how theadvances in imaging technology takingplace alongside technologicaladvances, from wider field imagingand metabolic imaging, to new OCTimaging techniques and OCTangiography (computer based), isallowing information to be fed intoother programmes and automatedresults given. This is helping in thediagnosis and follow ups with patientsand assisting in driving treatmentdecisions. David said the diabeticscreening programme managementteam is excited to be getting its ownadaptive optics system shortly (coneand rod imaging at the back of the eye)which will be very important from agene therapy aspect and which canshow for example the drop off in conesin patients with Achromatopsia.

The need for an integrated ITsystem in ophthalmic service for thefuture was stressed, which, through theinterpretation of images with newimaging technology, will provide realtime results, service appraisal andallow for effective healthcare planning.

Examples of the latest in modernhealthcare technology and softwarewere given, including the NHSpartnership with Google Deepmind touse machine learning in their fightagainst sight loss in the UK and the useof IBM Watson technology in cancercare centres in the US. Plans for IBMWatson software to be integrated andaid clinical decision making in the newnational children’s hospital in Irelandare currently being explored. Davidraised the point that the entire Irishhealth sector needs an integrated ITsystem and that legislation should beenacted in advance of the contracttendering process to ensure the mostinnovative, sustainable and viablecontract is secured.

RCSI Charter Day – Ophthalmology Session

Yvonne Delaney, Mr Andy Cassels-Brown, Leeds Teaching Hospitals and Professor RoshiniSaunders, NHS Fife’s Queen Margaret Hospital, Dunfermline, Scotland pictured at theophthalmology session, RCSI Charter Day on Friday, 10th February.

Aparallel session on ophthalmology featured at this year’s RCSIAnnual Charter Day Meeting on Friday, 10th February.


Colm O’Brien’s presentationexamined the evolving trends in thedelivery of glaucoma services inIreland, the rates of progression of thedisease and innovative ways to enablethe increasingly high volume ofpatients to be seen in a model of sharedcare. There are 55,000 outpatient visitscurrently envisaged for 2021 forpatients with glaucoma. Only 2% ofthese will require surgical treatment.

A common disease with aprevalence of 2% in the over 40population (increases to 5% in 60+),Colm stressed that this is a substantialnumber of glaucoma patients in agrowing population and an issue forIreland in terms of how we can sustaincare in a model which currently has alow number of people to look afterthese patients. The majority of patientspresent at pre or early stage glaucoma.A previous audit in the UK showedthat 25% of all eye hospital visits wasfocused around glaucoma in one formor another and the great majority ofthese patients have stable disease witha low risk of progression but whorequire on-going managementtreatment. Colm said it is the patientswith advanced disease at diagnosiswhich are at the highest risk ofblindness and who specialists need tobe concerned about and be able to seein clinics. He said the hospital basedglaucoma specialist should be lookingafter patients with poorly controlledeye pressure and those with advanceddisease and routine, low risk stablecases and suspects (family history etc)managed in a model of shared carevirtual clinic, which is properly

resourced and monitored either in thecommunity or hospital setting.

Results from a shared care, virtualmonitoring clinic system in operation inthe Welsh model of eye care service atOphthalmic Diagnosis and Treatment s(ODTC) for the last number of yearsshows that the system is extremelyeffective and that patient knowledge oftheir condition improved due to greaterone-to-one care with the same team.Virtual monitoring by the consultant ofnew patients coming in and returns andfollow up patients at the ODTC is thekey to the whole process, which allfeeds back into the central hub. Thescheme is supported by the NHS.

A nurse-led, shared care virtualclinic was set up by Colm at the MaterHospital over the last number of years.Patients (stable and repeat) wereidentified as suitable for the study andinvited to attend. They received anumber of tests by the nurse with casenotes then reviewed by Colm withinthe following days. If there was anychange in the treatment or monitoringrequired, the nurse would follow upwith the patient and inform them oftheir care plan. Of the initial 100patients involved in the study, Colmhighlighted that the good real data wasthat treatment was only adjusted in sixpatients in that period; five of themwere referred back to the main clinicfor further assessment. The realchallenge he said was the culturechange for the patient but also for thedoctor, and how a patient likes thereassurance of face to face access withtheir doctor. However the trial resultsshowed that patients were satisfied

knowing their cases were beingmonitored by the Consultant andpleased that usual waiting times offour hours in a clinic had been reducedas a result of the scheme trial.

The rationale for the introduction ofa Glaucoma Referral RefinementScheme (GRRS) in Ireland for newreferral patients was presented duringthe talk. Results from an Irish researchstudy of 223 new patients referred bycommunity optometrists to the GRRscheme showed that only 28% weretransferred to ophthalmology on firstvisit, thus releasing hospital clinic slotsby reducing false positive referrals(vital to improving services). Initialtests were carried out on referredpatients by an orthoptist in theNational Optometry Centre, andrealistically, Colm said, to a greaterdegree than is often possible in theoverburdened hospital clinic. Data waslooked at on a weekly basis by Colm ina virtual clinic, much of it screen basedand decisions made. Colm O'Brienhighlighted that the GRRS allows forthe effective transfer of care back to thecommunity for the majority of patientsand allows for the utilisation ofoptometric expertise in monitoring ofsuspects.

Professor Roshini Saunders fromScotland and Professor Julie Silvestrifrom Belfast spoke at the meetingabout models of e-referrals and tele-ophthalmology. Professor Saunders

Billy Power, President, ICO Colm O'Brien, Mater Misericordiae UniversityHospital

Conor C. Murphy, Royal Victoria Eye and EarHospital, who gave a talk on Innovations andStem Cells in Ocular Surface Reconstructionand Corneal Transplantation at theophthalmology session, RCSI Charter Day onFriday, 10th February.

Continued on page 16 ➥


discussed the results of a pilot studycarried out in 2007 in Fife’sDunfermline involving 350 consecutivereferrals with digital images throughthe NHS e-referral system. The systemfacilitated a 24hr turnaround of imagereview, with 35% of patients receivingan e-diagnosis. Professor Saunders saidthat the pilot proved to be clinicallysafe and allowed for the most effectiveand appropriate use of resources,providing compelling evidence forregional roll out. She stressed that thepower and benefit of OCT imaging tothe ophthalmic specialty isimmeasurable.

Prof Julie Silvestri, NationalDirector for Ophthalmology inNorthern Ireland, also spoke on howretinal imaging has transformed eyecare services and that electronic carerecording has been revolutionary tohealthcare delivery in NorthernIreland. Among some of the benefitshighlighted in an analysis of theNIECR were reduced human error risk,more informed decision making, aspeedier patient journey and reducedduplication of images.

Following her appointment asClinical Director in 2014 and review ofthe extensive waiting times forophthalmology, Professor Silvestriinitiated a pilot nurse-led imagingreview clinic initiative for 125 of herpatients who were waiting two yearsfor their follow up appointments. Theclinic was a new departure from thenormal service also in that it would runwithout a Consultant. All patients wereinformed by letter of this and told thatthe images would be reviewed by theConsultant in a virtual clinic. One ofProf. Silvestri’s key aims in carrying outthe pilot was to assess whether thissystem would assist in decisionmaking. Of the 125 patients invited toattend 86 agreed. Following imaging,Prof. Silvestri reviewed the scans andwrote to the patient,cc’ing GP. Thedischarge rate from the scheme was at50% which Prof. Silvestri said she couldnever have achieved in face to faceconsultations and in terms of efficiencyand cost saving, it allowed her toreview 40-45 patient cases as opposedto the 15 patients she might manage tosee in a normal clinic. Getting through

the backlog of review patients in a moreefficient and timely manner alsoresulted in 11% being recognised asneeding urgent review. There wassignificant patient satisfaction with thesystem. The pilot was also made easierdue to the NIECR allowing the patient’sfull medical history in all specialties tobe visible at a glance.

Imaging clinics are in operation inNorthern Ireland at present but there ishuge demand for a greater servicedelivery and currently a backlog exists,Prof. Silvestri stressed. She said ‘LiveImaging’ clinicsare hugely efficient andoffer great patient satisfaction. Patientsare scanned and the Consultant is onsite reading the images and determin -ing whether the patient should stay tohave their injection that same day,performed by a trained nursepractitioner, or whether the patient cango home and given their nextappointment. Prof. Silvestri stressedthat this saves a lot of unnecessaryadditional admin and mostimportantly the patient is treated ifnecessary and doesn’t have to worryabout injection delays. Since theintroduction of these clinics, injectionshave grown from 3,000 to 9,000 a year,without any increase in medicalmanpower necessary as nursepractitioners have been trained to carryout injections.

Prof. Silvestri said that if we are tomanage the ever increasing demand forservices due to our ageing populationand new time sensitive treatments, thatis essential to embrace technology andgreater healthcare partnerships toallow for a more efficient and reliableservice.

The parallel ophthalmology sessionalso included a fascinating presentationon innovations and stem Cells in ocularsurface reconstruction and Corneal

Transplantation by Conor Murphy,Royal Victoria Eye and Ear Hospital, inwhich Murphy referenced thesignificance of the first limbal stem celltransplantation carried out in Irelandby Billy Power in 2016.

This was followed by an equallyenlightening talk by Paul Kenna onGene Therapy applied to Eye Disease,which highlighted the outstandingpace of progress being made in geneticresearch and knowledge of genescausing inherited retinal disease since

the first identification of rhodopsin in1989. There are currently 17 activeclinical trials of genetic eye diseaseunderway, including trials for patientswith Stargardt’s disease, UsherSyndrome, LCA and RP. Knowledge ofthe causative gene(s) (genetic linkage,next generation sequencing (NGS) etc)is showing that gene replacement willbe the approved treatment forinherited retinal degenerationconditions in the future, includingtreatment for Leber CongenitalAmaurosis (LCA), a most challengingcondition to try and treat. SPK-RPE65will be the first approved gene therapyfor IRD following outcomes frommultiple human clinical trials whichshow that it has not only stoppedprogression of the condition but canlead to an improvement in visualfunction. Paul highlighted the work ofFighting Blindness and the Target 5000project which aims to provide geneticdiagnosis for Irish patients andcompare patient suitability forpotential participation in clinical trials.He said human clinical trials willincrease in number in the near future,making genetic diagnosis moreimportant. Suppression and replace -ment are also being developed as agene therapy for rhodopsin linkedautosomal dominant RetinitisPigmentosa.

In the afternoon 'Hot Topics' sessionof the Charter Day, ICO President BillyPower spoke on New frontiers inophthalmology – from stem cells to

teleophthalmology.

David Keegan, Mater Misericordiae UniversityHospital, who gave a talk on What is Changingin the Delivery of Services for Retinal Diseaseat the ophthalmology session, RCSI CharterDay on Friday, 10th February.

Continued from page 15

ICO News No17 Spr17 News No17... · 2017. 3. 10. · Chief Executive, Siobhan Kelly was presented...

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