THROUGH THE LOOKING GLASS

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January 25–27, 2013

Sheraton New Orleans Hotel

62nd Annual Symposium

THROUGH THE LOOKING GLASS

ADVENTURES IN GLAUCOMA, NEURO-OPHTHALMOLOGY AND CATARACT

New Orleans Academy

of Ophthalmology

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January 25–27, 2013

Sheraton New Orleans Hotel

Program Committee Chair

Jonathan D. Nussdorf, M.D.

Program Committee

Marie Acierno, M.D.

Ramesh Ayyala, M.D.

Owen J. LaCour, M.D.

Educational Objectives

Upon completion of this program, participants should be able to:

n Assess and rank risk factors for the development and progression of glaucoma

n Assess patient risk factors that lead to high complication rates in cataract surgery

n Assess surgical options for co-existing glaucoma and cataracts and plan effective

course of treatment

n Describe variables associated with improved patient adherence to glaucoma

treatment plans

n Enhance clinical decision making skills with the neuro-ophthalmologic patient

n Formulate an approach for patients who require pars plana vitrectomy during

cataract surgery

n Formulate appropriate patient selection criteria for various glaucoma

treatment plans

n Interpret data from recent randomized glaucoma studies (ABC, ABV, OHT, TVT Studies)

n Manage complications in cataract surgery, including vitreous loss and retained lens material

n Properly diagnose and manage the various non-glaucomatous optic neuropathies–

specifically those related to infectious, genetic and systemic diseases

n Provide adequate informed consent (options, risks and benefits, and expectations of

surgery) so that patients can make educated decisions regarding their care

n Recognize and provide appropriate management for various glaucoma

post-surgical complications

n Review new imaging and psychophysical tools for detection and monitoring

progression of glaucoma

n Review patient selection to enhance outcomes for refractive intraocular lens choices

n Review the different medical & surgical treatment options for non-arteritic ischemic

optic neuropathies (NAION)

n Summarize the side effects and complications associated with the use of glaucoma

medications

Accreditation

The New Orleans Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical

education for physicians.

Designation

The New Orleans Academy of Ophthalmology designates this educational activity for a maximum of 20.25 AMA PRA Category 1 Credits™. Physicians should only claim credits commensurate with the extent of their participation in the activity.

Needs Assessment

Early detection and treatment of glaucoma are vitally important for reducing the burden of blindness and its economic impact on society. A large number of major clinical trials have taken place over the last few years — and the information gleaned from these trials will enhance our understanding of the risk factors and treatment strategies at various stages of the disease. Optic neuropathy is a frequent cause of vision loss encountered by an ophthalmologist. Critical action is needed as the signs of optic neuropathy can be varied and difficult to pinpoint– ischemia, trauma, nutritional, and hereditary factors are just a few of the many causative factors. As the population ages, the incidence of cataract also increases. New techniques for cataract surgery complications are changing the standard of care in the aging eye. Comprehensive ophthalmologists and subspecialists need to be updated on the recent clinical trials, new techniques and treatments that impact the standard of care in glaucoma, neuro-ophthalmology and cataracts.

Purpose

The focus of this meeting will be to update the general ophthalmologist as well as the glaucoma and anterior segment specialist and neuro-ophthalmologist on the latest in diagnosis, medical management, preoperative evaluation, surgical techniques, clinical outcomes, and postoperative complications management in the fields of glaucoma, anterior segment and neuro-ophthalmology, as well as research on future developments in these disciplines.

New Orleans Academy of Ophthalmology

62nd Annual Symposium

Marilu O’Byrne, M.D.

Pulin Shah, M.D.

Jayne Weiss, M.D.

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Lisa Brothers Arbisser, M.D. Clinical Associate Professor University of Utah

John A. Moran Eye Center Bettendorf, IA

Riva Lee Asbell, AB, CO

Clinical Assistant Professor of Surgery UMDNJ-Robert Wood Johnson Medical School

New Brunswick, NJ

Donald L. Budenz, M.D., M.P.H. Professor and Director

of Ophthalmology

University of North Carolina Chapel Hill, NC

Jeffery Daigrepont, EFMP

Senior Vice President, Coker Group Alpharetta, GA

Robert D. Fechtner, M.D. Professor & Director of the Glaucoma Division

Institute of Ophthalmology and Visual Science

New Jersey Medical School Newark, NJ

Steven J. Gedde, M.D.

Associate Professor of Ophthalmology Director of Resident Training

Bascom Palmer Eye Institute Miami, FL

Andrew Lee, M.D.

Professor of Ophthalmology, Neurology, and Neurosurgery Weill Cornell Medical College Houston, TX

Nick Mamalis, M.D.

Director of the Intermountain Ocular Research Center Private Practice

Salt Lake City, UT

Cynthia Mattox, M.D., F.A.C.S. Associate Professor and Vice-Chair Department of Ophthalmology Tufts University School of Medicine Boston, MA

Joseph D. Rizzo, M.D.

Associate Professor of Ophthalmology Harvard Medical School

Massachusetts Eye and Ear Infirmary Boston, MA

Alfredo A. Sadun, M.D., Ph.D. Professor of Ophthalmology and Neurological Surgery

Director of Neuro-Ophthalmology Service University of Southern California

Doheny Eye Institute Los Angeles, CA

Kuldev Singh, M.D., M.P.H. Professor of Ophthalmology Director of Glaucoma Service

Stanford University School of Medicine Palo Alto, CA

Faculty

The New Orleans Academy of Ophthalmology relies upon invited speakers at all sponsored continuing

medical education activities to provide information objectively and free from bias or conflict of interest. In accordance with ACCME and institutional guidelines pertaining to potential conflicts of interest, the fac-ulty for this continuing medical education activity have been asked to complete facfac-ulty disclosure forms. In the event that some invited speakers indicate that they have a relationship which, in the context of the subject of their invited presentation, could be perceived as a potential conflict of interest, they have agreed to disclose such a relationship, but do not consider that it will influence their presentation. The intention is to provide full disclosure of any potential conflict of interest, real or perceived, which is related to a specific event.

Friday, January 25, 2012

7:00–7:45 AM Registration and Continental Breakfast

7:55–8:00 AM President’s Remarks–Nancy J. Wagner, M.D.

Session I

Glaucoma

8:00–8:20 AM Use of Tube Shunts in the Surgical Management of

Glaucoma Surgery Steven Gedde, MD

8:20–8:40 AM The Big Tube Studies: ABC and ABV

Donald Budenz, MD

8:40–9:00 AM Results from the Tubes versus Trabeculectomy

(TVT) Study Steven Gedde, MD

9:00–9:20 AM Glaucoma Surgcial Pearls

Robert Fechtner, MD

9:20–9:50 AM Roundtable: Is Trabeculectomy Still our Best Option?

Moderator: Robert Fechtner, MD

Panel: Donald Budenz, MD; Steven Gedde, MD

9:50 -10:05 AM Q & A

10:05 -10:45 AM Break and Visit Exhibits

Session II

Neuro: Mitochrondrial Optic Neuropathies

10:45 -11:00 AM New Insights from Brazil on LHON

Alfredo Sadun, MD

11:00 -11:30 AM An Epidemic of Optic Neuropathy: Cuba, Castro

and Converting Sugar to Rum Alfredo Sadun, MD

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11:30-11:45 AM Mitochondrial Optic Neuropathies:

When to Think about Leber? Andrew Lee, MD

11:45–12:00 PM Mitochrondrial Optic Neuropathies:

Why Antibiotics Can Blind You Alfredo Sadun, MD

12:00–12:15 PM Q&A

12:15 -1:30 PM Lunch and Visit Exhibits

Session III

Neuro-Ophthalmology

1:30 -1:45 PM Less Common Optic Neuropathies

Joseph Rizzo, MD

1:45–2:00 PM Syphilis: The Great Masquerader

of Neuro-Ophthalmology Andrew Lee, MD

2:00–2:15 PM Diagnosis and Management

of Transient Monocular Blindness Joseph Rizzo, MD

2:15–2:30 PM Optic Atrophy: When to Worry, When to Wait,

When to Work Up Andrew Lee, MD

2:30–3:00 PM Roundtable–Practical Neuro-Ophthalmology:

Ask the Consultants

Moderator: Marie D. Acierno, MD

Panel: Andrew Lee MD, Joseph Rizzo MD, Alfredo Sadun, MD

3:00–3:15 PM Q & A

3:15–3:40 PM Break and Visit Exhibits

Session IV

Anterior Segment

3:40–3:55 PM Posterior Polar Cataract

Lisa Arbisser, MD

3:55–4:10 PM Management of Weak Zonules

Lisa Arbisser, MD

4:10–4:25 PM Prevention of Posterior Capsule Opacification (PCO)

Nick Mamalis, MD

4:25–4:40 PM Accommodating IOL Update

Nick Mamalis, MD

4:40–4:55 PM Refractive Cataract Surgery and

Rapid Visual Rehabilitation Lisa Arbisser, MD

4:55–5:10 PM Q & A

5:15- 6:15 PM Workshop — Chart Documentation and Coding

for Cataract & YAG Procedures: 1-2-3 GO! Riva Lee Asbell, AB, CO

Workshop — Neuro-Ophthalmology: What’s Wrong with this Test?

Speaker: TBD

5:15–8:00 PM

President’s Wine and Cheese Reception

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11:00–11:15 AM The Fallacy of the One Eye Trial Robert Fechtner, MD

11:15–11:30 AM Why Generic? Why Not?

Robert Fechtner, MD

11:30–12:15 AM Keynote Lecture: Healthcare and Politics Update

Cynthia Mattox, MD

12:15–12:30 PM Q & A

12:30–1:35 PM Lunch and Visit Exhibits

Session VII

Glaucoma

1:35–1:55 PM Landmark Glaucoma Trials: What We Have and

Have Not Learned, Randomized Clinical Trials, Part I Kuldev Singh, MD

1:55–2:15 PM Landmark Glaucoma Trials: What We Have and

Have Not Learned, Part 2 Kuldev Singh, MD

2:15–2:35 PM Assessing Risk of Glaucoma in Ocular Hypertensive:

The OHT Study Donald Budenz, MD

2:35–2:50 PM What Have Glaucoma Clinical Trials Taught Us

About Medical Therapy? Robert Fechtner, MD

2:50–3:20 PM Roundtable–Pearls from the Randomized Clinical Trials

Moderator: Steven Gedde, MD Panel: Donald Budenz, MD;

Robert Fechtner MD; Kuldev Singh, MD

3:20–3:35 PM Q & A

3:35–4:00 PM Break and Visit Exhibits

Saturday January 26, 2013

7:50–8:00 AM President’s Remarks

Session V

Glaucoma

8:00–8:20 AM Applying Risk Factors for Glaucoma in Clinical Practice

Robert Fechtner, MD

8:20–8:40 AM Should Writing a Target IOP in the Medical Record

Be Necessary for Glaucoma Practice? Kuldev Singh, MD

8:40–9:00 AM Green and Red Disease: Pitfalls of Glaucoma Diagnosis

Using OCT

Donald Budenz, MD

9:00–9:20 AM Pearls and Pitfalls of Visual Field Use in

Glaucoma Diagnosis and Progression Donald Budenz, MD

9:20–9:40 AM How to Detect Progression

Robert Fechtner, MD

9:40–9:55 AM Q&A

9:55–10:30 AM Break and Visit Exhibits

Session VI

Glaucoma Non-surgical Approaches

10:30–10:45 AM Ocular Surface Disease and Glaucoma Treatment

Robert Fechtner, MD

10:45–11:00 AM Practical Guide for MDs: Using Glaucoma Medications

and Recognizing Adverse Effects

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9:00–9:15 AM Managing Co-existing Cataract and Glaucoma—Decision-making

Cynthia Mattox, MD

9:15–9:30 AM Complicatons of Trabeculectomy:

Prevention and Management Steven Gedde, MD

9:30–9:45 AM Managing the Post-op Trabeculectomy Bleb–

When and How to Intervene to Ensure Success Cynthia Mattox, MD

9:45–10:00 AM Q&A

10:00–10:15 AM Break

Session X

Anterior Segment

10:15–10:30 AM Tackling the Brunescent Cataract with Grace and Style

Lisa Arbisser, MD

10:30–10:45 AM Cataract Surgery in Pseudoexfoliation Patients

Nick Mamalis, MD

10:45–11:00 AM Intraoperative Floppy Iris Syndrome (IFIS)

Nick Mamalis, MD

11:00–11:30 AM Pars Plana Anterior Vitrectomy for the Cataract Surgeon

Lisa Arbisser, MD

11:30–12:00 PM Roundtable: TBA

Moderator: Lisa Arbisser Panel: Drs. Mamalis and Mattox

12:00–12:15 PM Q & A

12:15–12:20 PM Closing

Every effort has been made to present the program as accurately as possible from information available at the time of printing. The New Orleans Academy of Ophthalmology reserves the right to make changes to the program.

Session VIII

Neuro-Ophthalmology

4:00–4:15 PM Controversies in Neuro-Ophthalmology

Andrew Lee, MD

4:15–4:45 PM Status of the Field of Visual Prosthetics

Joseph Rizzo, MD

4:45–5:00 PM NAION Treatment: Is There Any Treatment?

Alfredo Sadun, MD/Andrew Lee, MD

5:00–5:15 PM Q&A

5:15–6:15 PM Workshop — Meaningful Use II and Surviving

an MU Audit Jeffery Daigrepont

Workshop — Comprehensive Strategy for the Unplanned Vitrectomy

Lisa Arbisser, MD

Sunday January 27, 2013

8:25–8:30 AM President’s Remarks — Nancy J. Wagner, MD

Session IX

Glaucoma

8:30–8:45 AM Selective Laser Trabeculoplasty

Steven Gedde, MD

8:45–9:00 AM Timely Cataract Surgery for Optimal Glaucoma

Management Kuldev Singh, MD

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Hotel Accommodations

Sheraton New Orleans Hotel

500 Canal Street • New Orleans, LA 70130

(504)-525-2500 • (888)-627-7033

A block of rooms have been reserved for registrants at the special rate of $219.00. To make your hotel reservations, call the Sheraton and mention the New Orleans Academy of Ophthalmology. The Sheraton may charge an early departure fee if your scheduled length of stay changes, so please inform the hotel prior to arrival on any change in departure date. After

December 21, 2012, reservations will be on a space available basis. Please make your reservations well in advance, as this is prime Mardi Gras season and the Su-perbowl will be held in New Orleans the following weekend. There will be limited room availability after December 21, 2012.

Registration information

The physician registration fee of $495.00 includes all course materials and refresh-ments. The deadline for the early registration fee is December 28, 2012. After De-cember 28, the fee is $595.00. The registration fee of $125.00 is for the allied health professional whose physician is NOT a NOAO member. The registration fee of $25.00 is for allied health professionals whose physician is a NOAO member. These fees include all course materials and refreshments. There is no charge for residents if letter from chief of service accompanies the reservation form.

The 2nd Annual Technicians’ Conference will be held on Friday, January 25, 2013. Separate registration for this important conference is available on-line at www. noao.org. More information for the technicians’ conference to follow soon in a separate mailer.

If you do not receive a confirmation of registration or you have any questions regarding this conference, please contact the Academy office at 504-861-2550.

Cancellation policy

Cancellation requests must be made in writing via e-mail, facsimile or by mail. A cancellation fee of $50.00 will be assessed if request is postmarked by December 28, 2012. After December 28, the cancellation fee is $150.00. Please enclose a copy of your confirmation slip with your notice of cancellation. Note: No refunds will be made once the meeting begins.

Workshop Registration Information

The following workshops are available at no charge to attendees of the 2013 Annual Symposium:

Chart Documentation and Coding for Cataract & YAG Procedures: 1-2-3 GO! Instructor: Riva Lee Asbell, AB, CO

Friday, January 25, 5:15–6:15 PM

It would seem that coding for cataract surgery is a straightforward affair – not so at all. With the ever rapid changing technologies like the use of the YAG laser, accurate coding for these procedures has become more difficult. This workshop explores qualifications for Complex versus Complicated Cataract Extraction, documentation of ADL (Activities of Daily Living) and the new guidelines for using femtosecond laser with cataract surgery along with suggestions on best practice procedures for navigating these coding complexities.

Neuro-Ophthalmology: What’s Wrong with this Test? Instructor: TBD

Friday, January 25, 5:15 –6:15 PM

What are the best tests to help make the diagnoses that are not so clear? If you have ques-tions like these, this workshop will help to answer them: Normal ESR, Normal Biopsy... and my patient is still blind and has a headache; VEP: Do I dare with non-organic visual loss? Thin RNFL and it’s not glaucoma; It’s the macular- Do I need a mfERG?

Meaningful Use — Stage II and Surviving an MU Audit Instructor: Jeffery Daigrepont

Saturday, January 26, 5:15–6:15 PM

Proposed requirements for Stage 2 Meaningful Use have been released – are you ready? And now CMS has begun conducting audits to determine compliance with meaningful use program reporting rules. If your office has collected or is in the pro-cess of collecting meaningful use payments, your hard work may be rewarded with an audit! This session will provide you with expert guidance on the both the impending changes in meaningful use and step-by-step instruction on preparing for an audit. Comprehensive Strategy for the Unplanned Vitrectomy

Instructor: Lisa Arbisser, MD Saturday, January 26, 5:15–6:15 PM

Dealing with capsule ruptures and vitreous presentation is one aspect of anterior segment surgery that the average cataract surgeon dreads. This workshop will present a systematic approach for successfully avoiding intra-op and post-op reti-nal traction and providing excellent chances for optimal outcomes.

Please register in advance for the following workshops: Chart Documentation and Coding, Neuro-Ophthalmology, E.H.R. Conversions and Vitrectomy. There are limited seats available.

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New Orleans & Activity Information

All of the Big Easy’s spectacular sights are still available and open to the public. Now’s the time to re-acquaint yourselves with the city you fell in love with. New to the city? Then check out some of the sights listed below.

Registration Form

Through The Looking Glass

Adventures In Glaucoma, Neuro-Ophthalmology And Cataract

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(check only one per day) — Included with registration fee

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Chart Documentation and Coding for Cataract & YAG Procedures: 1-2-3 GO! Friday, January 25, 5:15–6:15 PM

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Neuro-Ophthalmology: What’s Wrong with this Test? Friday, January 25, 5:15–6:15 PM

*New! Reserve ticket now for optional sit-down lunches

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Friday, January 25, 12:15 pm

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Saturday, January 26, 12:30 pm

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New Orleans Academy of Ophthalmology, 7733 Maple Street, New Orleans, LA 70118 504-861-2550 504-861-2549 fax Register on-line at www.noao.org

The French Quarter: This 12-block area, also

called the Vieux Carré (Old Square), is the heart of the city and borders the Mississippi River. The narrow streets of two-and three-story French and Spanish inspired buildings have a unique look. If historic sites interest you, see the Gallier House Museum (www. gnofn.org/~hggh), the Hermann-Grima House (www.gnofn.org/~hggh), the Old Ursuline Convent, and the Beauregard-Keyes House (504-523-7257). You’ll find everything from fabulous jazz and five-star restaurants to strip clubs on world-famous Bourbon Street.

Cities of the Dead: A high water table and

an elevation below sea level resulted in the practice of building aboveground tombs. There are 42 cemeteries in the metropolitan New Orleans area. Metairie, the most beau-tiful, and St. Louis Number One, the oldest, are worth a visit. Tour companies such as Save Our Cemeteries (504-525-3377) and Haunted History Tours

(504-861-2727) offer guided tours.

Plantations and Historic Homes: The Garden

District, minutes from the French Quarter, features many stately man-sions, including the pristine post-Civil War Van Benthuysen-Elms Mansion and Gardens (504-895-5493, www.elmsmansion.com). The Longue Vue House (504-488-5488,

www.longuevue.com) in

Old Metairie is a spectacular 45-room man-sion designed in a Classical Revival style.

By Land or by River: For a different view of

the Mardi Gras City, take a riverboat cruise on the Mississippi River. Sightsee by day or go on a dinner jazz cruise. The Cajun Queen Riverboat (504-523-0814, www.newor-leanspaddlewheels.com), the Steamboat Natchez (504-586-8777,

www.steamboatnatchez.com) and the John James Audubon Riverboat

(504-586-8777, www.aquariumzoocruise. com) all accept passengers. For

landlub-bers, the Riverfront streetcars are a great and economical way to sightsee.

For Families: The Crescent City boasts

one of the top 5 Aquariums and Zoos in the in the United States. The

Audubon Aquarium of the Americas (504-581-4629, www.auduboninstitute.

org) features the largest collection of sharks and jellyfish and a rare white

alligator. Located next to the French Quarter and beautiful Woldenberg

Park, the Aquarium is sure to please young and old alike. The Audubon Zoo (504-212-5452, www.auduboninstitute.org) has more than 2,000 animals in their natural habitat settings, including the Louisiana Swamp.