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Lessons learned from 25 years of pediatric ophthalmology & strabismus claims
e38 undertaken through systematic, standardised data collection. Early outcome data will be presented. Best Practice: The genetics of congenital cataract: new high throughput molecular technologies, including microarray technologies for autozygosity mapping and next generation sequencing promise to shed light on the breadth of the genetic causes, both syndromic and nonsyndromic. This will be illustrated using cases and examples. Management of aphakic and pseudophakic glaucoma: the rationale for different treatment modalities, their relative risks and benefits will be presented together with results from a UK tertiary hospital. IOLu2 study: 256 children under 2 years old undergoing surgery for congenital or infantile cataract have been recruited. IOL implantation was undertaken in the majority of children over 6 months old, but aphakia was the preferred option for younger children, due in part to the high frequency of other ocular anomalies. Overall primary IOL implantation conferred no visual benefit for those with unilateral cataract, but may be associated with better visual outcome following bilateral cataract surgery. During the first postoperative year 16% developed glaucoma. Age at surgery was the most significant factor. Refractive outcomes suggest there is a need for standardisation of refractive planning. Expected Outcomes: The genetics of congenital cataract: molecular analysis for congenital cataract facilitates the development of individualised care pathways and enables improved determination of diagnosis, familial risk and clinical outcomes. Management of aphakic and pseudophakic glaucoma: earlier intervention with surgical treatment modalities improves outcomes in aphakic and pseudophakic glaucoma. IOLu2 study: this unique inception cohort will provide information on longer term outcomes and their impact on the educational and personal development of children born with cataract. Format: Didactic lectures followed by panel discussion and audience participation. The workshop will close with case presentations illustrating management of challenging clinical scenarios. Summary: This workshop will provide a comprehensive update of recent advances in three important themes of congenital and childhood cataract management—genetics, aphakic/pseudophakic glaucoma, and the epidemiology and surgical management of children under 2 years of age.
135 Lessons learned from 25 years of pediatric ophthalmology & strabismus claims. Anne M. Menke, Robert Wiggins Purpose/Relevance: Physicians who provide care for pediatric ophthalmic conditions and strabismus are concerned about the risk of medical malpractice lawsuits. Target Audience: Eye surgeons who practice pediatric ophthalmology and perform strabismus surgery. Current Practice: While eager to implement loss prevention measures, these eye surgeons face multiple demands from regulatory, legal, and professional societies and may not know how best to focus their efforts on improving the quality of their care. Best Practice: This assessment of closed claims will identify practices that could lead to harm or liability and ways to decrease those risks. Expected Outcomes: Physicians who participate in this workshop will be able to assess their risk and chose loss prevention measures geared toward them. Format: Didactic lecture featuring claims data and case studies followed by question and answer period.
Volume 17 Number 1 / February 2013 Summary: Summarize material to be presented at the workshop : This workshop will present an analysis of 25 years of claims related to pediatric opthalmology and strabismus. Frequency, severity (money paid to settle), causes, and trends will be explained. Key lessons on how to improve patient safety and reduce the likelihood of successful claims will be shared.
136 Video demonstrations of classical or rare signs in pediatric ophthalmology and strabismus. Ken K. Nischal, Edward G. Buckley, David Plager, Edward Wilson, David Granet, Jane C. Edmond Purpose/Relevance: To demonstrate using high quality video, rare or classical clinical or surgical signs in pediatric ophthalmology and strabismus. Target Audience: Pediatric ophthalmologists, orthoptists, and training ophthalmologists. Current Practice: Many rare or classical signs are often described in textbooks but not always recorded in busy clinics. Equally some surgical signs are so rare that very few people get to see them. This workshop allows the audience to see videos of such signs with an explanation from the ophthalmologist who had recorded them. Best Practice: Many of the conditions shown in the video demonstartions are usually seen in tertiary and quarternary settings but may well present in the primary or secondary setting. Ideally all physicians would have access to such videos for contued medical education but these are not currently available at any one site. Expected Outcomes: This workshop should make the audience more confident in making diagnoses based on the signs shown. It should allow them to better formulate treatment plans based on the clinical signs. The surgical videos will allow the audience to see unusual procedures or signs so they are more familiar with them. Format: Six experienced authors will have 12 minutes each to present videos of surgical, and clinical signs of classical, or rare conditions. Each presenter will be quizzed by other panel members about differential diagnoses for clinical signs or alternative techniques for surgical videos. Some of these will be videos of oculo-palatal myoclonus, signs in pediatric myasthenia gravis, endoscopic evaluation of a failed Ahmed Tube, forced duction test of a lax superior oblique tendon, floppy iris syndrome in a child,eyemovents in a child diagnosed with neurological tics which were due to dry eye syndrome, goniotomy in aniridia, nystagmus of benign paroxysmal hemiplegia of childhood, paradoxical pupils, forced duction test to cure Brown syndrome and rupture of an inferior rectus muscle during strabismus surgery. Summary: Demonstration of classical or rare clincial signs and surgical techniques using high quality video and inter-panel debate.
137 Difficult problems—nonstrabismus. Ken K. Nischal, Elias Traboulsi, Lea Ann Lope, Federico Velez, Mary OHara Purpose/Relevance: The clinical range of what we as practitioners see is so varied that it is impossible for one person to have seen all the atypical presentations of common conditions and the typical presentations of rare conditions. This workshop allows us to share some of these cases with the audience. Target Audience: Pediatric ophthalmolohists, orthoptists, vision scientists and trainees. Current Practice: Current practice for each individual is comprised of a bulk of secondary clincial cases. Exposure to tertiary and quarternary cases is limited to those working a few academic centres
Journal of AAPOS
135 Lessons learned from 25 years of pediatric ophthalmology & strabismus claims. Anne M. Menke, Robert Wiggins Purpose/Relevance: Physicians who provide care for pediatric ophthalmic conditions and strabismus are concerned about the risk of medical malpractice lawsuits. Target Audience: Eye surgeons who practice pediatric ophthalmology and perform strabismus surgery. Current Practice: While eager to implement loss prevention measures, these eye surgeons face multiple demands from regulatory, legal, and professional societies and may not know how best to focus their efforts on improving the quality of their care. Best Practice: This assessment of closed claims will identify practices that could lead to harm or liability and ways to decrease those risks. Expected Outcomes: Physicians who participate in this workshop will be able to assess their risk and chose loss prevention measures geared toward them. Format: Didactic lecture featuring claims data and case studies followed by question and answer period.
Volume 17 Number 1 / February 2013 Summary: Summarize material to be presented at the workshop : This workshop will present an analysis of 25 years of claims related to pediatric opthalmology and strabismus. Frequency, severity (money paid to settle), causes, and trends will be explained. Key lessons on how to improve patient safety and reduce the likelihood of successful claims will be shared.
136 Video demonstrations of classical or rare signs in pediatric ophthalmology and strabismus. Ken K. Nischal, Edward G. Buckley, David Plager, Edward Wilson, David Granet, Jane C. Edmond Purpose/Relevance: To demonstrate using high quality video, rare or classical clinical or surgical signs in pediatric ophthalmology and strabismus. Target Audience: Pediatric ophthalmologists, orthoptists, and training ophthalmologists. Current Practice: Many rare or classical signs are often described in textbooks but not always recorded in busy clinics. Equally some surgical signs are so rare that very few people get to see them. This workshop allows the audience to see videos of such signs with an explanation from the ophthalmologist who had recorded them. Best Practice: Many of the conditions shown in the video demonstartions are usually seen in tertiary and quarternary settings but may well present in the primary or secondary setting. Ideally all physicians would have access to such videos for contued medical education but these are not currently available at any one site. Expected Outcomes: This workshop should make the audience more confident in making diagnoses based on the signs shown. It should allow them to better formulate treatment plans based on the clinical signs. The surgical videos will allow the audience to see unusual procedures or signs so they are more familiar with them. Format: Six experienced authors will have 12 minutes each to present videos of surgical, and clinical signs of classical, or rare conditions. Each presenter will be quizzed by other panel members about differential diagnoses for clinical signs or alternative techniques for surgical videos. Some of these will be videos of oculo-palatal myoclonus, signs in pediatric myasthenia gravis, endoscopic evaluation of a failed Ahmed Tube, forced duction test of a lax superior oblique tendon, floppy iris syndrome in a child,eyemovents in a child diagnosed with neurological tics which were due to dry eye syndrome, goniotomy in aniridia, nystagmus of benign paroxysmal hemiplegia of childhood, paradoxical pupils, forced duction test to cure Brown syndrome and rupture of an inferior rectus muscle during strabismus surgery. Summary: Demonstration of classical or rare clincial signs and surgical techniques using high quality video and inter-panel debate.
137 Difficult problems—nonstrabismus. Ken K. Nischal, Elias Traboulsi, Lea Ann Lope, Federico Velez, Mary OHara Purpose/Relevance: The clinical range of what we as practitioners see is so varied that it is impossible for one person to have seen all the atypical presentations of common conditions and the typical presentations of rare conditions. This workshop allows us to share some of these cases with the audience. Target Audience: Pediatric ophthalmolohists, orthoptists, vision scientists and trainees. Current Practice: Current practice for each individual is comprised of a bulk of secondary clincial cases. Exposure to tertiary and quarternary cases is limited to those working a few academic centres
Journal of AAPOS