More than 900 delegates, predominantly ophthalmologists, from around Australia and New Zealand, attended the 43rd RANZCO, which offered a stimulating program of symposia and workshops as well as key addresses from leaders in the field.
When speaking of current research efforts into eye disease, Congress Chairman, Dr. Iain Dunlop said, “In eye medicine and surgery, all our efforts are targeted at individualised treatments arising from better diagnostic technologies and specifically tailored treatment programs. This will be the future for eye care. It’s especially important for patients with multiple interconnected eye and general diseases.”
However delegates heard that there are fundamental challenges that need to be addressed for the profession. One challenge described was the shortage of paediatric ophthalmologists. There are currently 4.23 million children under the age of 15 inAustralia– or 18.9 per cent ofAustralia’s total population. With a workforce equivalent to only 20.5 full-time paediatric ophthalmologists, that equates to one medical eye specialist for every 206,000 children – and the numbers are dwindling. As a result, it is hardly surprising that eye specialists acrossAustraliaandNew Zealandare struggling to meet the increasing eye care needs of premature babies and children.
Ultimately the paediatric ophthalmologist has to make the decisions regarding the management of the eyes. Therefore the workforce issues cannot be ignored
According to Professor Martin AM, paediatric ophthalmologist at the Sydney Children’s Hospitals Network (Westmead andRandwick), the workforce shortage has far-reaching ramifications. “Premature babies are at high risk of eye problems, particularly retinopathy of prematurity (ROP), and they can go blind without very close monitoring,” he said. “Research shows that some degree of retinopathy of prematurity occurs in 44 per cent of infants with a birth weight of 1,000-1,250g. However,ROPoccurs in 93 per cent of babies who weigh less than 750g at birth.
“As the number of paediatric ophthalmologists decline, we are reaching a crisis stage where some hospitals won’t be able to offer eye screening for babies who are at risk of developing ROP,” he added. “This is evident even in major cities, not just rural areas.”
Prof. Martin said that large-scale screening programs for pre-schoolers in New South Wales States have been enormously successful. “We welcome this because it makes a big difference to the child’s life if vision problems are detected early. It does put a strain on the workforce however.”
He said Federal and State Governments have been approached to work in partnership to overcome the shortage of training posts for paediatric ophthalmologists in public hospitals. The approach includes developing Fellowships in paediatric ophthalmology and Visiting Medical Officer VMO/Staff Specialists in paediatric ophthalmology.
Additionally, delegates heard, collaborations between ophthalmologists, general practitioners, orthoptists, optometrists, low vision services and ophthalmic nurses are necessary to address the increasing workload of diagnosing, treating and preventing vision loss in babies and children.
“Ultimately the paediatric ophthalmologist has to make the decisions regarding the management of the eyes. Therefore the workforce issues cannot be ignored,” said Prof. Martin.
In an insightful presentation delivered by Dr. Mitchell Lawlor, delegates heard that thirty per cent of families, who agree to donate the organs of a recently deceased family member, specifically refuse to donate corneas. They also heard that many individuals refuse corneal donation. Dr. Mitchell Lawlor said his research has revealed that of all the body’s organs, the eyes hold a powerful metaphorical place within our culture, religion and philosophy.
Glaucoma: Sneak Thief of Sight
RANZCO’s newly appointed Vice President forNew Zealand, Dr. Stephen Best, spoke of research currently underway which aims to predict people at high risk of glaucoma.
“While there are good guidelines for the treatment of glaucoma, a sub-set of people who are treated for glaucoma still lose their sight. Work is being done to try and predict which ones,” said Dr. Stephen Best. “We know some people have a genetic pre-disposition to more aggressive forms of glaucoma. More research is needed and testing needs to be done earlier, so the right treatment can help prevent blindness.”
A presentation on Macular Degeneration highlighted some of the risk factors including family history.
“If you have a parent or sibling with macular degeneration, your risk of developing this eye disease is significantly increased,” said Perth-based ophthalmologist, Dr. Jane Khan. “Conservative estimates indicate that the risk to siblings may be increased 10-fold… and the risk to children may be even higher.” These findings lend support to the concept of screening first-degree relatives. “It is generally recommended that those over 50 have a routine eye check every two years, but if a first-degree relative is affected by macular degeneration, these check-ups may need to be more frequent. We strongly encourage families to talk to each other about this,” said Dr. Khan.
Delegates also heard that alcohol can increase the risk of age-related macular degeneration (AMD) in middle-aged men and women. “A study of 20,963 Australians, who were followed from their 40s to mid-80s, found that drinking more than two standard drinks a day was associated with a 20 per cent increased chance of developing early-stageAMD,” says Dr. Madeleine Adams, of Melbourne. “All types of alcohol – wine, beer and spirits – increased the risk ofAMD.”
Blindness and Depression
In an insightful presentation, Perth-based ophthalmologist, Dr. Nigel Morlet revealed that people who are legally blind experience twice the rate of depression, 50 per cent more hospital stays, and are twice as likely to have periods of psychiatric care. “This is the first time the impact of blindness on health services utilisation has been quantified,” said Dr. Morlet.
“Half of the legally blind in Western Australiahave never visited the Association for the Blind for support and rehabilitation services. Information from this study will help guide better allocation of resources to support those blind in
In 2012 RANZCO will be held from 24 – 28 November. For information go to: http://ranzco2012.com.au/
|New Leaders Appointed|
Three new Fellows have been elected to RANZCO core leadership positions of College President, Vice President New Zealand, and Vice President Australia. Dr. Bill Glasson AO, from Queensland was announced as President; Associate Professor Mark Daniell from Centre for Eye Research (CERA) and University of Melbourne as Vice President of RANZCO Australia and Dr. Stephen Best from Auckland as Vice President of RANZCO New Zealand. The announcements were made at the Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) in November 2011.
RANZCO’s Chief Executive, Susi Tegen, welcomed the appointments: “The College has spent the past four years re-building the foundation and developing new strategies not only for ophthalmic education and training, but also in the international, rural, remote and indigenous eye-health arena. I look forward to working with the new leadership team in 2012.”
The election of two Vice Presidents to RANZCO for the first time will enable the various portfolios of College business to be shared, ensuring wider advocacy, communication. It will also ensure that the unique needs of each state and country can be better served.
Dr. Bill Glasson AO: President
Dr. Bill Glasson AO grew up on a
Dr. Glasson has held many College roles at State level, and for the past four years he served as RANZCO’s Vice President. His roles outside the College have included Chair of Cancer Australia, Chair of Queensland Clinical Senate, on the Board of Medical and Associated Professions Superannuation Fund, and advisor on health issues to the Northern Territory Intervention taskforce.
“The College has undergone huge transformations in structure and operations over the past two years,” said Dr Glasson. “Some of the challenges ahead will be around managing the ophthalmology workforce shortage, ensuring adequate training positions for ophthalmology, and maintaining productive relationships with government at all levels. The College has a strong focus on the continuing professional development of our members and engaging with, and promoting, eye health and training in neighbouring countries.”
Associate Professor Mark Daniell: Vice President
Mark Daniell is an Associate Professor at the Centre for Eye Research (CERA) and Head of Ophthalmology at the University of Melbourne. He also works in the Corneal Unit at the Royal Victorian Eye and Ear Hospital (RVEEH) and served as Head of the Corneal Unit at the Royal Melbourne Hospital. He has served as visiting ophthalmologist to rural and remote areas of Victoria for 10 years.
A/Prof. Daniell served on the Boards of RANZCO for five years and the Ophthalmic Research Institute of Australia for eight years. He was Chair of The Ophthalmic Research Institute of Australia (ORIA) for five years and an examiner for the RANZCO Advanced Clinical Examinations (RACE). He was Section Editor for the journal Clinical and Experimental Ophthalmology, Chair of the Corneal Special Interest Group and served as a member of the Medicare Schedule Review panel.
“The College has set in place some major changes in terms of its operations,” said A/Prof. Daniell. “Historically the College’s main focus was on qualification and education, as a professional standards body. I look forward to being part of the leadership team during RANZCO’s exciting transition towards greater external contribution. The College is refining its involvement in rural, remote and indigenous ophthalmology as well as overseas development – while at the same time not losing sight of maintaining high professional standards.”
Dr. Stephen Best: Vice President New Zealand
Dr. Stephen Best is a RANZCO Fellow from Auckland who has been involved in College activities as a basic sciences examiner for more than 10 years, and served on RANZCO’s Scientific Program Committee. He was on the executive of RANZCO’s New Zealand Branch before serving as the Chair of the Branch for two years. He has been a member of the College Board and Council since 2003.
In addition to College roles, Dr. Best has been involved in health workforce overviews, and New Zealand optometry and Combined Medical Colleges’ meetings.
“With recent changes in RANZCO’s structures, New Zealand has much more Australian NZ focus in the College operations,” said Dr. Best. “My role will include a continuing commitment to College activities, ensuring ophthalmology has a higher profile throughout New Zealand and Australia, refining guidelines and promoting multidisciplinary teams for eye health. One of our biggest challenges is to make sure the College functions well and continues to serve the community and our members – while at the same time forging strong national and international relationships, maintaining high practice standards, and assisting neighbouring countries with eye-health training and education.”