EyeCon 2023 brings the fast pace of innovation to today’s ophthalmology practices

In December, The Ophthalmology Times EyeCon 2023 will gather the nation’s leading ophthalmologists to share new data and practical strategies that clinicians can apply in their practices. The conference will take place from December 1 to 2 at the Marriott Sanibel Harbour Resort and Spa in Fort Myers, Florida.

Cochair Peter J. McDonnell, MD, director of the Wilmer Eye Institute at The Johns Hopkins University School of Medicine in Baltimore, Maryland, recently spoke with Ophthalmology Times Group Editorial Director Sheryl Stevenson about what is unique at this year’s EyeCon 2023.

Video transcript

Editor’s note: This transcript has been edited for clarity.

Sheryl Stevenson: We're joined by Dr. Peter McDonnell, who is with Wilmer Eye Institute, and we're so delighted to have you join us again as co-chair of our EyeCon conference in December, in Sanibel, Florida.

I can't believe we're already talking about December and Florida in June and July, but no time like the present, right?

Peter J. McDonnell, MD: I've heard time flies, and that may be true.

Stevenson: We'd love to talk about this year's... looking ahead to this year's conference and what ophthalmologists should be really excited about or what you're most excited about in terms of some of the agenda?

McDonnell: The meeting is a great opportunity to get CME credits in one of the truly great settings.

One of the things that I always remember, particularly when my children were young, was feeling really guilty going to one of these meetings and taking time away from my family. But when I brought my family to a place like Sanibel Island for a meeting, I didn't have to feel guilty because they would have a great time during the day while I was in the sessions. Then we could get together in the evening and they could show me whatever shells they'd collected and tell me about all the fun things they'd done, swimming in the ocean or the pool or whatever. It's an opportunity for a guilt-free way to update.

There's so much innovation going on in ophthalmology that it's really it's impossible these days for anybody to read all the journals and see all the articles that are coming out. To have the opportunity to sit in a nice meeting, and with a very strong group of faculty, and have all the highlights in terms of innovation in our field presented and discussed about how to integrate them into one's practice would be a very cost-effective use of time and a really good way to make sure we're updated on all the things that are becoming available to us.

Stevenson: Absolutely, you make some really great points there with that. In terms of focusing on some of the hot button topics, obviously, in ophthalmology right now. There's a lot going on with geographic atrophy. Do you want to talk a little about some of the events there?

Yeah, well, there's some big things, big FDA approvals that have recently occurred or will soon occur.

You mentioned geographic atrophy, and you're exactly right. It's somewhere about 8 million people worldwide, 1 million in the US, that are going to be candidates for this new treatment that involves intraocular injections to treat this disease that until today, or until the launch of this new product, essentially we've not had anything to offer these patients.

How are we going to treat? How we're going to take care of all these additional 1 million patients? How are we going to identify the patients that are the right, appropriate candidates for this treatment, educate them about their options, the costs, probably this is going to be a costly treatment. And then who's going to do all these injections and who's going to monitor these patients? And will it be retina specialists? Will it be comprehensive ophthalmologists? Will there be co-management with MDs and ODs to handle this enormous volume of patients?

Similarly, myopia... What could be a bigger public health impact than nearsightedness? And particularly in some subsets of our population, the prevalence of this problem has exploded. And so the recent FDA approval of devices for slowing the progression of myopia and the data suggesting that low-dose atropine can be very effective in reducing the magnitude of myopic progression in these young children means we're going to have to educate ourselves so we can educate our patients, or young patients and their families, about who's an appropriate candidate for some of these treatments for myopia.

It's interesting about 80% of the literature on therapies, clinical trials for myopic progression have been not in the ophthalmic literature but in the optometric literature. That's an area where I think many optometrists may be, how would you say, more up on the latest literature in this area than the typical ophthalmologists.

We want to make sure we're on the same page. Everybody's educated, and as patients come through our practices, many of which have both MDs and ODs in them, we're able to identify those individuals who may be appropriate candidates for these new treatments and plug them into whatever system we've created in our practice to deal with these patients.

I'm sure every ophthalmologist that's listening to us has had the experience of parents coming in with their child, saying, 'we will do anything, we will pay anything if you can help our child not to develop this severe myopia that we have.' The parents often feel guilty. They know that it's often hereditary. They feel guilty that they quote, 'gave it to their child.' And they're eager for their child to have a better quality of life by not having this myopia be too severe or too much of a problem for them. Hence, the interest in orthokeratology, which I think will be small compared to the interest in some of the newly available treatments, including atropine, for these patients.

I think it's a must for ophthalmologists to make sure they're up on the latest information when it comes to addressing progressive myopia in children. And that's something that'll come out of this meeting, and I'm very excited that people will leave and they will go back to their practices with that idea in mind [on] what to do for the coming new year on how to incorporate this into their practices.

I can't pick up a magazine or listen to the news these days without hearing about artificial intelligence. And there's all this new technology available in terms of home monitoring of diseases like glaucoma, where we can imagine that patients won't need to be filling up our offices anymore to come in for a quote 'routine' annual check of their visual field and their eye pressure to make sure to confirm that they're stable.

But in fact, through use of some of this technology and artificial intelligence to interpret the results, we will be seeing those patients who maybe are having progression of their myopia and need to see us ophthalmologists because they need treatment. Or maybe they've developed diabetic retinopathy, and that was detected with one of the FDA-approved camera, artificial intelligence, diabetic retinopathy detection instruments that are proven to be quite sensitive and specific in detecting diabetic retinopathy.

So we will be doing less of the what you might call regular annual checkups in diabetics, and instead we'll be seeing more of the patients that we know need some sort of treatment, because they develop some of the early signs of diabetic retinopathy.

Dry eye is another area condition just so prevalent. There have been some new recent approvals for dry eye. It pretty much used to be ointments and tears and then we had one FDA-approved medication for many, many years. Now we have an assortment of treatments that attempt to treat different forms or different kinds of dry eye, whether it's decreased tear production from inflammation, whether it's increased evaporation, whether it's eyelid margin disease contributing to the problem. We now have, as we would say, an armamentarium of potential treatments to help these patients who are often quite miserable.

You see some ophthalmologists or some practices that are dedicating themselves to the treatment of patients with dry eye, which would have been unheard of when I was a young ophthalmologist or resident. So many of these conditions so prevalent...myopia, macular degeneration, dry eye...pretty much an ophthalmologist could choose to specialize in each of those.

It's very important, I think, for the comprehensive ophthalmologist to be up to date in all of these areas and make informed decisions about which of these areas will be important parts of his or her practice.

Stevenson: You make you make a good point. I mean, there certainly have been a lot of changes through the years and you were talking about co-management. Just in terms of that, can you can you speak about that? I know there will be some joint sessions on the agenda at EyeCon regarding that as well.

McDonnell: Many practices these days incorporate both MDs and ODs to ensure efficient care delivery for their patients. Our goal is to make sure that patients who need treatment or need surgery or need to be seen get in and [if] they need surgery by their ophthalmologist are able to get that in a very timely manner. Often that means that there are certain things that perhaps the ophthalmologist in the practice does not need to do that his or her partnering optometrist, comanaging optometrist, can do some to some of that, and the ophthalmologist can do what all those years of training to become an ophthalmologist equip the ophthalmologist to do.

There just seem to be so many patients with the so-called demographic tidal wave of baby boomers in the United States, that, particularly when you think of adding 1 million patients with geographic atrophy into our busy clinics this year, I think the really thoughtful practices will figure out how to best make co-management an important part of how they are able to function well and get patients into the system in a very efficient manner. We will have a number of sessions that focus on this issue of co-managing.

I'm hopeful that ophthalmologists who have optometrists in their practices, they'll both want to come to attend the meeting and give careful thought to how are we going to screen all these potential patients for geographic atrophy treatment. Who's going to do that screening, who's going to identify the candidate patients who's going to educate them, etc, and figure out how to incorporate so many of these new treatments, therapies, and opportunities into the practice.

As I said, geographic atrophy, but again myopia is enormous. Who's going to be screening all these children? It's already clear in the United States, we have a extreme shortage of pediatric ophthalmologists in most counties in the United States. So who's going to do it? It's going to be presumably comprehensive ophthalmologists and optometrists. And they'll be wanting to figure out how to handle that, all of us, in our practices to address an enormous unmet need.

Stevenson: In terms of the conference itself, what makes it unique from other conferences? Or is there anything else in that aspect that you'd like to touch upon that we have not talked about yet?

McDonnell: Last week, one of my colleagues from another state called me, and he told me that he attended the meeting last year virtually. I said, What do you think of it? And he said, I thought it was great. It seemed every speaker had these pearls that I was able to use in my practice right away. And he just found it so helpful.

I love that response, because that was exactly what we've been hoping for with this meeting.

The speakers [are challenged] to please think about what pearls can they share to the practicing attendees based on their years of experience in their area that the attendees can bring back and use in their practice on Monday after the meeting. Add some new services to their practice, become more efficient at delivering care for certain patients. And specifically I've said if possible, I'd like them to come up with something that when the ophthalmologist goes back and uses it the next week he or she will have paid for the fee of attending the meeting. The meeting will pay for itself. That's exactly what we're hoping for.

Rather than some sort of vague review of the science, and don't get me wrong, I love science, but actually how the practical side of things... how this new information can be applied in our practices right away, not 10 years from now, but right away to better help our patients, help our practices run more smoothly and effectively help us serve more patients better, and recoup the investment that we put into bringing ourselves and maybe our families down to Sanibel Island to this beautiful environment for a couple of days of learning.

I hope most attendees feel that way that they come away with not only a better understanding of the current literature, etc, but actually a lot of pearls and how to use this...incorporate this information into the practices.

Stevenson: We certainly look forward to seeing you and the faculty there in early December down in Sanibel Island. Thank you again so much for your time today. Really appreciate it and we look forward to learning more in the coming weeks and months about the meeting.

McDonnell: Nice to speak with you, Sheryl.

To register for or learn more about The Ophthalmology Times EyeCon 2023, click here.