131: Genetics workshop: Part 2. Genetic testing in ophthalmology: What is available, who should be tested, and who understands the results?

Abstracts Workshops 128 Electronic health records for pediatric ophthalmology: Practical comparison. Robert Arnold The selection of an electronic medical record system is a potentially 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 alter workflow. This workshop draws from a group of pediatric ophthalmologists 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. General 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 treatment 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 individual presenters, with varying levels of surgical experience, will be allowed a maximum of 5 minutes to present her or his favorite surgical tip(s). This workshop promises to be fast-paced, entertaining, and very informative. Unfinished presentations that are still in progress will be terminated at exactly 5 minutes to assure that this workshop 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 visa-vis associated orbital or eyelid surgery, and medical management, including advances in immune modulators, corticosteroids, and radiation therapy, will be covered. A how-to description of surgery designed 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 ipsilateral 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 pattern exotropia and torsional diplopia resulting from large inferior rectus 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 understanding 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-palpebral fissure with primary upper eyelid retraction. Learn important

Journal of AAPOS

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 ophthalmology 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 ophthalmologists 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, entropion, 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 movements, with or without blunt head trauma in children typically younger 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 ocular 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

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