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Heads Up! concussion: current trends in diagnosis and management
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Volume 21 Number 4 / August 2017
Workshops 160 What's new and important in pediatric ophthalmology and strabismus in 2017. Darron A. Bacal, Tina Rutar, Chryssa Adamopoulou, Leah Reznick, Erin Herlihy, Walker Motley, III, Hilda Capo, Emily McCourt, Wadih Zein, Leemor Rotberg, Elena Gianfermi—Professional Education Committee AAPOS Purpose/Relevance: The authors will investigate the literature for articles of interest to the subspecialty of Pediatric Ophthalmology & Strabismus for the time period March 2016-February 2017. Ophthalmic journals are stressed but journals from other specialties such as pediatrics, neurology, and comprehensive medicine will be included. Key findings will be summarized in the major topics, including, but not limited to vision screening, amblyopia, neuroophthalmology, retinopathy of prematurity, strabismus, cataract, glaucoma, genetics, retina, orbit, uveitis and practice management. The presentations will summarize and emphasize second-order analyses of the material. Target Audience: Pediatric ophthalmologists, ophthalmologists, and orthoptists who examine, diagnose, and treat children and adults with strabismus and other pediatric eye disorders. Current Practice: Pediatric Ophthalmology is a rapidly evolving subspecialty. It is difficult to remain current with all of the literature in the field. Best Practice: The authors will summarize, analyze, and present the most current and important information from more than 20 medical journals. This will allow the audience to have an overview of the most current and important literature. Expected Outcomes: The audience will understand the most current and critical published information in this subspecialty. Format: Didactic lecture. Summary: More than 20 medical journals will be reviewed for relevant new findings in the subspecialty of pediatric ophthalmology and strabismus from March 2016 to February 2017. The material presented will educate the target audience in new research and practice patterns. 161 Heads Up! concussion: current trends in diagnosis and management. Nancy M. Benegas, Gary S. Solomon, Allan K. Sills, Jennifer V. Werthe, Jeffrey D. Schall Purpose/Relevance: Extraocular motility abnormalities have been described in association with concussion and traumatic brain injury (TBI). The King Devick test has been validated for use in various concussion protocols and incorporates assessment of eye movement abnormalities into concussion and TBI diagnosis. This multidisciplinary workshop brings together international experts on King-Devick testing, NHL and NFL concussion protocols, anatomical injury from concussion and discusses return to function following a TBI. Target Audience: AAPOS membership: pediatric ophthalmologists and orthoptists. Current Practice: Many pediatric ophthalmologists have limited knowledge of how concussions are diagnosed, particularly by nonmedical providers on the sidelines of youth sporting events. Best Practice: Understand the role of the King-Devick test in concussion diagnosis, learn about concussion diagnosis and management from youth sports to professional football and hockey. Increase our knowledge base as a subspecialty concerning this important topic with overlaps to our field. Expected Outcomes: Improved knowledge and understanding of concussion diagnosis, managment, and public health implications of concussion. Increase our knowledge and awareness of our
role when patients present in our clinics with concussion diagnosis. Format: Primary author will moderate panel. Each expert will present a didactic lecture, with a Q&A session at the end. Summary: Use of the King-Devick Test to aid in diagnosing concussion will be presented with discussion of validated data. NFL and NHL concussion protocols will be discussed by a consultant for both leagues. The anatomical injuries and repercussions will be discussed by a neurosurgeon with an emphasis on concussion. 162 Guidelines for developing an exit strategy for withdrawal from practice and entering retirement. Albert W. Biglan, John D. Baker Purpose/Relevance: The thought of retirement may seem distant and frightening. This may foster an approach- avoidance conflict. Two members, one completely retired, the other, mostly retired, will share their experiences in making the transition from practice to retirement. Guidelines will be offered to those who are considering retirement. The presentation will cover abrupt, planned retirement and gradual phased out retirement. Target Audience: Members who are considering retirement and those approaching retirement age. Current Practice: Retirement from practice may be a frightening thought and may cause the member to put off important decisions. Best Practice: Members who are proactive can plan for an orderly withdrawal from practice and can enter retirement having a successful transition from one lifestyle to another. Expected Outcomes: Members will be presented issues to be considered, and to be addressed prior to their exit from practice. The retired life can be satisfying and meaningful when planned activities are chosen. With planning, resources can provide a secure, and satisfying lifestyle for the member and family to enjoy. Format: Power Point presentation with an open dialogue with the attendees. Summary: Members nearing retirement will be encouraged to plan for their retirement. An exit strategy for withdrawal from practice, either abruptly or gradually will be presented. Lifestyle changes and considerations during retirement will be covered. Finances of retirement will be discussed. 163 Abusive head trauma: primer and mock trial. Gil Binenbaum, Alex V. Levin, Steve E. Rubin, Brian J. Forbes Purpose/Relevance: Severe retinal hemorrhage (RH), folds, and retinoschisis are highly suggestive of abusive head trauma (AHT) in young children. Ophthalmologists may testify about the significance of these findings, yet be faced with alternative hypotheses proposed by defense teams in court. Ophthalmologists should be familiar with strengths and limitations of their own expertise, relevant literature, and the process and challenges of giving court testimony. Target Audience: Ophthalmologists who evaluate children for possible abuse and may be called to appear in court as witnesses. Current Practice: Physicians may face aggressive challenges by attorneys, who have manufactured a false controversy over the diagnosis of AHT in the media and courtroom and offer outlier theories as causes of ocular findings. As cases move into the judicial system, ophthalmologists may be confused, frustrated and uncomfortable. Best Practice: Ophthalmologists play an important role in protecting both children and caregivers by providing professional unbiased evidence-based court testimony.
Journal of AAPOS
Volume 21 Number 4 / August 2017
Workshops 160 What's new and important in pediatric ophthalmology and strabismus in 2017. Darron A. Bacal, Tina Rutar, Chryssa Adamopoulou, Leah Reznick, Erin Herlihy, Walker Motley, III, Hilda Capo, Emily McCourt, Wadih Zein, Leemor Rotberg, Elena Gianfermi—Professional Education Committee AAPOS Purpose/Relevance: The authors will investigate the literature for articles of interest to the subspecialty of Pediatric Ophthalmology & Strabismus for the time period March 2016-February 2017. Ophthalmic journals are stressed but journals from other specialties such as pediatrics, neurology, and comprehensive medicine will be included. Key findings will be summarized in the major topics, including, but not limited to vision screening, amblyopia, neuroophthalmology, retinopathy of prematurity, strabismus, cataract, glaucoma, genetics, retina, orbit, uveitis and practice management. The presentations will summarize and emphasize second-order analyses of the material. Target Audience: Pediatric ophthalmologists, ophthalmologists, and orthoptists who examine, diagnose, and treat children and adults with strabismus and other pediatric eye disorders. Current Practice: Pediatric Ophthalmology is a rapidly evolving subspecialty. It is difficult to remain current with all of the literature in the field. Best Practice: The authors will summarize, analyze, and present the most current and important information from more than 20 medical journals. This will allow the audience to have an overview of the most current and important literature. Expected Outcomes: The audience will understand the most current and critical published information in this subspecialty. Format: Didactic lecture. Summary: More than 20 medical journals will be reviewed for relevant new findings in the subspecialty of pediatric ophthalmology and strabismus from March 2016 to February 2017. The material presented will educate the target audience in new research and practice patterns. 161 Heads Up! concussion: current trends in diagnosis and management. Nancy M. Benegas, Gary S. Solomon, Allan K. Sills, Jennifer V. Werthe, Jeffrey D. Schall Purpose/Relevance: Extraocular motility abnormalities have been described in association with concussion and traumatic brain injury (TBI). The King Devick test has been validated for use in various concussion protocols and incorporates assessment of eye movement abnormalities into concussion and TBI diagnosis. This multidisciplinary workshop brings together international experts on King-Devick testing, NHL and NFL concussion protocols, anatomical injury from concussion and discusses return to function following a TBI. Target Audience: AAPOS membership: pediatric ophthalmologists and orthoptists. Current Practice: Many pediatric ophthalmologists have limited knowledge of how concussions are diagnosed, particularly by nonmedical providers on the sidelines of youth sporting events. Best Practice: Understand the role of the King-Devick test in concussion diagnosis, learn about concussion diagnosis and management from youth sports to professional football and hockey. Increase our knowledge base as a subspecialty concerning this important topic with overlaps to our field. Expected Outcomes: Improved knowledge and understanding of concussion diagnosis, managment, and public health implications of concussion. Increase our knowledge and awareness of our
role when patients present in our clinics with concussion diagnosis. Format: Primary author will moderate panel. Each expert will present a didactic lecture, with a Q&A session at the end. Summary: Use of the King-Devick Test to aid in diagnosing concussion will be presented with discussion of validated data. NFL and NHL concussion protocols will be discussed by a consultant for both leagues. The anatomical injuries and repercussions will be discussed by a neurosurgeon with an emphasis on concussion. 162 Guidelines for developing an exit strategy for withdrawal from practice and entering retirement. Albert W. Biglan, John D. Baker Purpose/Relevance: The thought of retirement may seem distant and frightening. This may foster an approach- avoidance conflict. Two members, one completely retired, the other, mostly retired, will share their experiences in making the transition from practice to retirement. Guidelines will be offered to those who are considering retirement. The presentation will cover abrupt, planned retirement and gradual phased out retirement. Target Audience: Members who are considering retirement and those approaching retirement age. Current Practice: Retirement from practice may be a frightening thought and may cause the member to put off important decisions. Best Practice: Members who are proactive can plan for an orderly withdrawal from practice and can enter retirement having a successful transition from one lifestyle to another. Expected Outcomes: Members will be presented issues to be considered, and to be addressed prior to their exit from practice. The retired life can be satisfying and meaningful when planned activities are chosen. With planning, resources can provide a secure, and satisfying lifestyle for the member and family to enjoy. Format: Power Point presentation with an open dialogue with the attendees. Summary: Members nearing retirement will be encouraged to plan for their retirement. An exit strategy for withdrawal from practice, either abruptly or gradually will be presented. Lifestyle changes and considerations during retirement will be covered. Finances of retirement will be discussed. 163 Abusive head trauma: primer and mock trial. Gil Binenbaum, Alex V. Levin, Steve E. Rubin, Brian J. Forbes Purpose/Relevance: Severe retinal hemorrhage (RH), folds, and retinoschisis are highly suggestive of abusive head trauma (AHT) in young children. Ophthalmologists may testify about the significance of these findings, yet be faced with alternative hypotheses proposed by defense teams in court. Ophthalmologists should be familiar with strengths and limitations of their own expertise, relevant literature, and the process and challenges of giving court testimony. Target Audience: Ophthalmologists who evaluate children for possible abuse and may be called to appear in court as witnesses. Current Practice: Physicians may face aggressive challenges by attorneys, who have manufactured a false controversy over the diagnosis of AHT in the media and courtroom and offer outlier theories as causes of ocular findings. As cases move into the judicial system, ophthalmologists may be confused, frustrated and uncomfortable. Best Practice: Ophthalmologists play an important role in protecting both children and caregivers by providing professional unbiased evidence-based court testimony.
Journal of AAPOS