128: Electronic health records for pediatric ophthalmology: Practical comparison
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Abstracts Workshops 128 Electronic health records for pediatric ophthalmology: Practical comparison. Robert Arnold The selection of an electronic medical record system is a poten- tially major perturbation in the practice of pediatric ophthalmology. Implementation is costly in terms of money, time, stress, and patient safety. Product advertisements and initial observations may poorly represent the potential of various software systems to eventually al- ter workflow. This workshop draws from a group of pediatric ophthal- mologists interested in electronic records who have communicated via group email. Using 3 typical anonymous case scenarios, from a typical simple new examination to a complex, reoperation return patient, the benefits and weaknesses of certain popular styles of electronic medical records will be compared and contrasted. Gen- eral warnings and recommendations, not for any particular software, will be given in conclusion. 129 Surgical secrets. David K. Coats, Scott E. Olitsky, Madhuri Chilakapati, Jane Edmond, Jim Ellis, Denise Hug, Malcom Mazow, Aaron Miller, Evelyn Paysse, David Plager, David Stager Sr., Donny Suh, Benjamin Ticho, Dan Weaver, Ken Wright The acquisition and enhancement of surgical skills in the treat- ment of strabismus is a lifelong journey. During the course of a career, each surgeon develops a range of surgical secrets to facilitate care. These secret personal techniques may make a difficult step easier, make surgery more efficient, make surgery safer, or may enhance outcomes. The purpose of this workshop is to reveal an assortment of these surgical secrets that both the novice and expert surgeon will find valuable. With a heavy emphasis on video presentations, 15 in- dividual presenters, with varying levels of surgical experience, will be allowed a maximum of 5 minutes to present her or his favorite sur- gical tip(s). This workshop promises to be fast-paced, entertaining, and very informative. Unfinished presentations that are still in prog- ress will be terminated at exactly 5 minutes to assure that this work- shop remains both dynamic and on schedule. 130 Managing Graves orbitopathy: Honing your skills to improve outcome. Linda R. Dagi, Alexandra T. Elliott, Oscar A. Cruz This workshop provides a practical approach to the management of Graves' orbitopathy with emphasis on the associated restrictive strabismus. Patient selection, timing of strabismus surgery vis- a-vis associated orbital or eyelid surgery, and medical management, including advances in immune modulators, corticosteroids, and radi- ation therapy, will be covered. A how-to description of surgery de- signed to resolve or equalize relative intereye restrictive strabismus covers the correlation between preoperative deviation, findings on forced ductions, and amount of surgical recession. The role of the ip- silateral antagonist, contralateral restrictive disease, and pearls and pitfalls associated with adjustable sutures will be addressed. This workshop will cover methods to avoid or manage sequential A pat- tern exotropia and torsional diplopia resulting from large inferior rec- tus and medial rectus recessions will be discussed. Techniques to manage lower lid retraction resulting from inferior rectus recession and the impact of lower lid retraction on an adjustable inferior rectus recession are noted. The workshop seeks to improve your under- standing of the impact of strabismus on lid height and your capacity to communicate with your colleagues in oculoplastic surgery. Don't confuse fixation duress and associated widening of the inter-palpe- bral fissure with primary upper eyelid retraction. Learn important details about bony versus fat decompression and the indications for each. Bony decompression, highly associated with post operative strabismus and diplopia, can often be avoided and your patient treated with fat decompression, a technique less likely to result in diplopia. Learn how children with Graves' differ from adults. Leave an expert! 131 Genetics workshop: Part 2. Genetic testing in ophthalmology: What is available, who should be tested, and who understands the results? Arlene V. Drack, Terri Young In the recent past, most ophthalmic genetic testing was research based. Testing was usually ordered for ''academic'' reasons, and it was understood that a result may not be found, or may take years to be reported. Testing also was free of charge. Today, fee-for-service (FFS) genetic testing is available for many eye diseases. Fees vary, as does the willingness of insurance companies to pay. Gene therapy is now in clinical trials for one genetic eye disorder and will likely be available for more soon, making a genetic diagnosis of more than academic interest. The availability of FFS genetic testing in ophthal- mology poses a challenge to clinicians. It is becoming standard of care to discuss availability of genetic testing with patients who have disorders such as Leber Congenital Amaurosis, Usher syndrome and retinitis pigmentosa. Opportunities may be missed for treatment, and for scholastic and reproductive planning, if a correct diagnosis is not made. Medicolegal issues may also arise. Yet most ophthalmolo- gists do not know which tests are available or how to obtain them. After completing this course, participants will be able to: Identify at least 3 common genetic eye diseases for which FFS genetic testing is available Access information on where testing is available, cost, and how to send a sample Read and understand a genetic test result Understand when to consult a geneticist or ophthalmic genetics specialist Discuss current clinical trials for genetic eye diseases. 132 Pediatric oculoplastics procedures. Forrest J. Ellis, Gregg Lueder, Robert Gold, David Plager Ophthalmic plastics and orbital conditions are common in the field of pediatric ophthalmology. The correction of these problems often involves surgery. This workshop reviews surgical techniques for common ophthalmic plastic procedures performed by the pediatric ophthalmologist. Covered topics will include congenital ptosis, entro- pion, ectropion, and congenital eyelid abnormalities; eyelid and canalicular lacerations; nasolacrimal probing, intubation, balloon catheter dilation, and dacryocystorhinostomy; excision of periocular lesions; and injection and surgical management of hemangiomas. This year's workshop will emphasize prevention and management of complications. The goal is for the participant to gain knowledge and comfort in selected surgical management of common pediatric ophthalmic plastic procedures. 133 Retinal hemorrhages are present—so what does it mean? Brian J. Forbes, Alex V. Levin, Steven E. Rubin Shaken baby syndrome/abusive head trauma in children refers to repetitive violent acceleration–deceleration head and neck move- ments, with or without blunt head trauma in children typically youn- ger than 3 years of age. It is characterized by a combination of fractures, intracranial hemorrhages, or intraocular hemorrhages with retinal hemorrhages being the most characteristic type of ocu- lar finding. Although the ophthalmologic examination is an important component in the evaluation of the young child whose injuries are suspicious for child abuse, one can not assume that the presence Journal of AAPOS e33
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Transcript of 128: Electronic health records for pediatric ophthalmology: Practical comparison
Abstracts
Workshops
128 Electronic health records for pediatric ophthalmology:Practical comparison. Robert Arnold
The selection of an electronic medical record system is a poten-tially major perturbation in the practice of pediatric ophthalmology.Implementation is costly in terms of money, time, stress, and patientsafety. Product advertisements and initial observations may poorlyrepresent the potential of various software systems to eventually al-ter workflow. This workshop draws from a group of pediatric ophthal-mologists interested in electronic records who have communicatedvia group email. Using 3 typical anonymous case scenarios, froma typical simple new examination to a complex, reoperation returnpatient, the benefits and weaknesses of certain popular styles ofelectronic medical records will be compared and contrasted. Gen-eral warnings and recommendations, not for any particular software,will be given in conclusion.
129 Surgical secrets. David K. Coats, Scott E. Olitsky, MadhuriChilakapati, Jane Edmond, Jim Ellis, Denise Hug, Malcom Mazow,Aaron Miller, Evelyn Paysse, David Plager, David Stager Sr., DonnySuh, Benjamin Ticho, Dan Weaver, Ken Wright
The acquisition and enhancement of surgical skills in the treat-ment of strabismus is a lifelong journey. During the course of a career,each surgeon develops a range of surgical secrets to facilitate care.These secret personal techniques may make a difficult step easier,make surgery more efficient, make surgery safer, or may enhanceoutcomes. The purpose of this workshop is to reveal an assortmentof these surgical secrets that both the novice and expert surgeon willfind valuable. With a heavy emphasis on video presentations, 15 in-dividual presenters, with varying levels of surgical experience, willbe allowed a maximum of 5 minutes to present her or his favorite sur-gical tip(s). This workshop promises to be fast-paced, entertaining,and very informative. Unfinished presentations that are still in prog-ress will be terminated at exactly 5 minutes to assure that this work-shop remains both dynamic and on schedule.
130 Managing Graves orbitopathy: Honing your skills to improveoutcome. Linda R. Dagi, Alexandra T. Elliott, Oscar A. Cruz
This workshop provides a practical approach to the managementof Graves' orbitopathy with emphasis on the associated restrictivestrabismus. Patient selection, timing of strabismus surgery vis-a-vis associated orbital or eyelid surgery, and medical management,including advances in immune modulators, corticosteroids, and radi-ation therapy, will be covered. A how-to description of surgery de-signed to resolve or equalize relative intereye restrictive strabismuscovers the correlation between preoperative deviation, findings onforced ductions, and amount of surgical recession. The role of the ip-silateral antagonist, contralateral restrictive disease, and pearls andpitfalls associated with adjustable sutures will be addressed. Thisworkshop will cover methods to avoid or manage sequential A pat-tern exotropia and torsional diplopia resulting from large inferior rec-tus and medial rectus recessions will be discussed. Techniques tomanage lower lid retraction resulting from inferior rectus recessionand the impact of lower lid retraction on an adjustable inferior rectusrecession are noted. The workshop seeks to improve your under-standing of the impact of strabismus on lid height and your capacityto communicate with your colleagues in oculoplastic surgery. Don'tconfuse fixation duress and associated widening of the inter-palpe-bral fissure with primary upper eyelid retraction. Learn important
Journal of AAPOS
details about bony versus fat decompression and the indicationsfor each. Bony decompression, highly associated with post operativestrabismus and diplopia, can often be avoided and your patienttreated with fat decompression, a technique less likely to result indiplopia. Learn how children with Graves' differ from adults. Leavean expert!
131 Genetics workshop: Part 2. Genetic testing in ophthalmology:What is available, who should be tested, and who understands theresults? Arlene V. Drack, Terri Young
In the recent past, most ophthalmic genetic testing was researchbased. Testing was usually ordered for ''academic'' reasons, and itwas understood that a result may not be found, or may take yearsto be reported. Testing also was free of charge. Today, fee-for-service(FFS) genetic testing is available for many eye diseases. Fees vary, asdoes the willingness of insurance companies to pay. Gene therapy isnow in clinical trials for one genetic eye disorder and will likely beavailable for more soon, making a genetic diagnosis of more thanacademic interest. The availability of FFS genetic testing in ophthal-mology poses a challenge to clinicians. It is becoming standard ofcare to discuss availability of genetic testing with patients whohave disorders such as Leber Congenital Amaurosis, Usher syndromeand retinitis pigmentosa. Opportunities may be missed for treatment,and for scholastic and reproductive planning, if a correct diagnosis isnot made. Medicolegal issues may also arise. Yet most ophthalmolo-gists do not know which tests are available or how to obtain them.After completing this course, participants will be able to: Identify atleast 3 common genetic eye diseases for which FFS genetic testingis available Access information on where testing is available, cost,and how to send a sample Read and understand a genetic test resultUnderstand when to consult a geneticist or ophthalmic geneticsspecialist Discuss current clinical trials for genetic eye diseases.
132 Pediatric oculoplastics procedures. Forrest J. Ellis, GreggLueder, Robert Gold, David Plager
Ophthalmic plastics and orbital conditions are common in the fieldof pediatric ophthalmology. The correction of these problems ofteninvolves surgery. This workshop reviews surgical techniques forcommon ophthalmic plastic procedures performed by the pediatricophthalmologist. Covered topics will include congenital ptosis, entro-pion, ectropion, and congenital eyelid abnormalities; eyelid andcanalicular lacerations; nasolacrimal probing, intubation, ballooncatheter dilation, and dacryocystorhinostomy; excision of periocularlesions; and injection and surgical management of hemangiomas.This year's workshop will emphasize prevention and managementof complications. The goal is for the participant to gain knowledgeand comfort in selected surgical management of common pediatricophthalmic plastic procedures.
133 Retinal hemorrhages are present—so what does it mean?Brian J. Forbes, Alex V. Levin, Steven E. Rubin
Shaken baby syndrome/abusive head trauma in children refers torepetitive violent acceleration–deceleration head and neck move-ments, with or without blunt head trauma in children typically youn-ger than 3 years of age. It is characterized by a combination offractures, intracranial hemorrhages, or intraocular hemorrhageswith retinal hemorrhages being the most characteristic type of ocu-lar finding. Although the ophthalmologic examination is an importantcomponent in the evaluation of the young child whose injuries aresuspicious for child abuse, one can not assume that the presence
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