ICO NEWSLETTER | AUGUST 2013 PAGE 1

NewsletterISSUE 6 AUGUST 2013

Welcome to this edition ofthe College Newsletter. I

am honored to address you forthe first time in my capacity asPresident of the College and tohave this opportunity to publiclythank Pat Logan for thecommitment she has given to theCollege over the past number ofyears, a hard act to follow indeed!

You will all be acutely aware ofthe growing demands andpressures on our health serviceand the College will continue toadvocate on behalf of our patientsand the specialty and highlightthe need for adequate resourcesto meet those demands. Recentmedia attention highlighted thefact that this is a specialty thatcontinues to expand to meetpatient needs and we mustcontinue to demand greaterattention in the health sector sothat we can meet those needs.

With best wishesMARIE HICKEY DWYER

Apublic information campaign topromote eye health awareness

and the significance lifestyle choiceshave on eye health was launched bythe College at our annual meeting inKillarney this year.

The ‘Your Sight,Our Vision’campaign includesan eye healthinformationbooklet aimed ateducating thepublic on theimportance ofearly diagnosisand treatmentof eyeconditions inorder topreventavoidablesight loss.

KerryFootballCaptain,EoinBrosnan lent hissupport to the initiative and took partin a photocall with Patricia Quinlan,Garry Treacy and Alison Blake, toannounce the booklet and to alsohighlight the public eye healthinformation event taking place in TheMalton during the conference week.

Speaking about the need to driveawareness Patricia Quinlan said, “Thebooklet is a tool that helps us relay themessage to the public that simplelifestyle changes can have a bigimpact, like giving up smoking,

eating a healthy diet,exercise andhavingregular eyeexams, oneye health.”

The bookletalso high lightsthe need forpeople in thehigher riskcategories,those with afamily history ofeye conditionsand the over 50’s,to have regulareye examinationsin order to catchearly symptomsand the importanceof seeing an eyedoctor if any

concerns arise.‘Your Sight, Our Vision’ is free to

the public and available to downloadby visiting www.eyedoctors.ie or hardcopies for surgeries and clinics can beordered by contacting the College.

Published byIrish College of Ophthalmologists121 St Stephen’s Green, Dublin 2. Tel 01 402 2777, Fax 01 402 2778ico@rcsi.ie · www.eyedoctors.ie

If you would like to make any suggestions forfuture issues of the College Newsleer pleasecontact Siobhan on 01 402 2777 or ico@rcsi.ie

Messagefrom the President

Dear Colleagues,

ICO Launch Public InformationEye Health Booklet

Your SightOur VisionEye Health:What you should know to help protect

your visionEye Check Guidelines • Healthy Diet & Lifestyle Tips •

Common Eye Conditions

www.eyedoctors.ie

Dr. Michael O’Rourke, eye doctorat the Royal Victoria Eye and Ear

Hospital, the Dublin Academic HealthCare Clinical Research Centre and TheConway Institute, St Vincent’sUniversity Hospital, UCD, is therecipient of the ICO Research Bursary2013.

Dr O’Rourke was announced asthe winner of the award, supported byNovartis, at the annual conference forhis project entitled ‘Acute AnteriorUveitis in an Irish Cohort: ClinicalCharacteristics and MolecularMechanisms’.

Explaining the research, DrO’Rourke said, “Anterior uveitis is arelatively common presentation to theophthalmologist. It is known to beassociated with systemic conditionsincluding spondyloarthritis, aninflammatory arthritis of the lowerback. In collaboration withrheumatology colleagues, this projectestablishes those patients attendingwith uveitis who may have anunderlying spondyloarthritis in aneffort to diagnose this earlier withimproved outcome for the patients.”

Dr O’Rourke continued, “From an

experimental point of view, thisproject is looking at the role ofepigenetics in the pathogenesis ofanterior uveitis. This will give usfurther understanding of the diseaseprocess itself with the aim ofexploring possible future therapeutictargets.”

The project is based within thewidely published rheumatologyresearch group at St Vincent’sHospital highlighting thecollaboration between ophthalmologyand rheumatology in common areas tobroaden research ideas. Provisionalresults of this project have beenpresented at national level to dateincluding this year’s ICO AnnualConference at which Dr O’Rourke wasawarded the ‘Barbra Knox Medal’ forbest paper presentation

Dr O’Rourke intends to present hisresearch at an international level,saying “The ICO Research Bursarywill allow for further expansion on theproject in terms of assisting withcontinuing medical research expenses.”

Dr O’Rourke will present anupdate on his research at the 2014Annual Conference.

ICO NEWSLETTER | AUGUST 2013PAGE 2

ICO/Novartis bursary winner EducationalBursary for EyeDoctorsThe ICO is delighted to announce

a new educational bursary foreye doctors.

The bursary, sponsored by MSDIreland Ltd, comprises two €3000prizes to support the recipients toattend a training course orinternational meeting with theoverall goal of benefiting bothpatients and the health service inIreland.

Speaking about the introductionof the new bursary, ICO CEOSiobhan Kelly, said: “In recognitionof the importance of continuousprofessional development and up-skilling by our eye doctors inpractice, the College is delighted toannounce this new bursary. TheCollege seeks to encourage andfacilitate further training at thehighest level for doctors specialisingin the field and to provide assistancein achieving this goal of eye careexcellence. On behalf of the College,I thank MSD Ireland for theirsupport and recognition of theimportant contribution this awardwill make.”

Michael Phelan, Business UnitDirector, MSD Ireland, said: “MSDare proud to partner with the IrishCollege of Ophthalmologist’s tosupport the education bursary. Webelieve by supporting education,patients will ultimately benefit. Thisopportunity is part of our on-goingcommitment to achieving improvedpatient experiences and quality oflife.”

The ICO is inviting interestedeye doctors to submit a 100 wordstatement to the College summar -ising how their chosen course ormeeting will benefit their patientsand the health service.

The closing date for applicationsis the 6th September. Applicantsmust include name, contact details,training and current post. Thebursary winners and presentation ofawards will take place at the MSDGlaucoma meeting in Galway on the27th & 28th September 2013.

The recipients will have theopportunity to write about theirtraining for inclusion in the ICOnewsletter.

Clodagh Brennock, Medical Science Liaison, Novartis, Michael O'Rourke, Winner of the ICOResearch Bursary, Paul O'Brien, Chair of the Scientific Committe and Patricia Logan.

NEXT YEAR’S MEETING –Suggestion for the programme?

Do you have a suggestion for next years meeting – please emailsiobhan.kelly@eyedoctors.ie before September 6th, 2013.

ICO NEWSLETTER | AUGUST 2013 PAGE 3

Strategic Framework Presentation at Leinster House

Facilitated by Deputy MaryMitchell O’Connor and chaired bySenator Martin Conway, represent -atives from the Coalition highlightedthe urgency of putting in place aNational Vision Strategy for eyehealth in order for the govern ment toaddress its commitment to the WHOobjectives of Vision 2020, to eradicatepreventable blindness by 2020.

The National Coalition for VisionHealth group was convened by theNCBI and Fighting Blindness andincludes representatives from vision-related advocacy organisations andhealthcare services. The group formedto review the future of eye health inIreland and is calling on theGovernment to implement a numberof specific recommendations focusedon eliminating avoidable sight loss.

David Keegan presented acomprehensive overview of the Costof Blindness and Sight Loss studiesand stressed the long-term economicand social benefits of the governmenttaking action on this urgent issue.David acknowledged that whileattempts are being made to improveeye health services, such as the roll-out of the HSE's diabetic retinopathy

screening programme, thesedevelopments are long overdue andgreater commitment to funding andthe provision of eye health services isrequired in order to tackle thegrowing incidence of sight loss in theIrish demographic.

Other representatives from theICO at the meeting included PatriciaLogan, Mark Cahill, Maureen Hillaryand Siobhan Kelly. Paul Moriarty,Clinical Lead for the Eye CareProgramme was also in attendance.

A number of TD’s, Senators andpolitical advisors attended thepresentation, including Deputy RoisinShortall, Deputy Robert Dowds,Deputy Denis Naughten, Senator CaitKeane, Senator Trevor O’Clochartaighand Senator Kathleen Zappone. Thepresentation was followed by a seriesof questions from the politicianspresent to the panel and affordedfurther opportunity forrepresentatives from the mainstakeholder groups to convey to thegovernment the importance ofprompt implementation of the HSENational Clinical Programme for EyeCare, with adequate funding.

Senator Conway shared a

commitment he had received from theMinister for Health, Dr James Reilly,to meet with the Coalition to discussthe main findings of the report overthe coming weeks. Senator Conway,who is visually impaired, spoke of hispersonal wish to see the issuesaddressed by government as a matterof urgency and priority in order toachieve a better future for eye careprovision in Ireland.

Senator Trevor O’Clochartaighexpressed his support for theimplementation of a Vision HealthStrategy by conveying the followingmessage to The Seanad, calling for adebate in the early autumn:

“I congratulate Senator MartinConway, who chaired a veryimportant presentation in the AVroom on the strategic frameworkfor vision health. This showed weare heading into a major dilemmaas regards the number of peoplewho will need support because offailing vision. I refer to the costthat may be incurred by the Stateand how that may be alleviated,with lives made much better, byimplementing a strategy soonerrather than later. I call for debate inthe early autumn on the area of thestrategic framework for visionhealth, which would save the Statemoney and do a lot of good forpeople who have visualimpairment.”

One hundred days after the initial launch of the StrategicFramework for Vision Health Report took place in the RHA

Dublin, the expert group which form the National Coalitionpresented the main findings to members of the Oireachtas inLeinster House on the 16th July.

ICO NEWSLETTER | AUGUST 2013PAGE 4

AREDS2: what does it mean for eye care?

In 2001, the landmark Age-RelatedEye Disease Study (AREDS),

conducted by the National EyeInstitute, provided level 1 evidencethat supplementation with aformulation of dietary antioxidantsand zinc, which included vitamin C500mg, vitamin E 400 IU, ß-carotene15mg, zinc 80mg and copper 2mg, butwhich was devoid of the macularcarotenoids, was associated with a27% risk reduction for visual loss anda 25% risk reduction for diseaseprogression in patients with at leastintermediate AMD. The AREDS,therefore, furnished the scientific andmedical communities with proof ofprinciple that supplemental dietaryantioxidants are of benefit in AMD,and somewhat paradoxically,generated interest in the role thatmacular pigment might play, given itsexquisite biological relevance to thetissue affected by this condition.

The AREDS2 report has recentlybeen published, with importantimplications for those afflicted withearly stage AMD. In summary,AREDS2 recruited 4,203 volunteerswith the non-advanced form of AMD,into a five-year study. All patientsreceived the AREDS1 formulation, or

variations thereof, with either placebo(treatment one), macular pigmentsconstituent carotenoids (lutein andzeaxanthin [L+Z]; treatment two),omega-3 fatty acids (docosahexanoicacid and eicosapentaenoic acid[DHA+EPA]; treatment three) or withL, Z and omega-3 fatty acids(treatment four). Dietary habits werealso assessed for each patient.

The ‘primary’ analysisThe AREDS2 report distinguishesbetween ‘primary’ and ‘secondary’analyses of the study data. In theprimary analysis, the placebo group(treatment group one) consisted of1,695 eyes of 1,012 patients whoreceived some variation of the originalAREDS1 formulation, but noadditional treatment (no L or Z, oromega 3). The other three treatmentgroups also received an originalAREDS1 formulation, but in additionreceived either L+Z (1,714 eyes, 1044patients), DHA+EPA (1753 eyes, 1068patients) or L+Z+DHA+EPA (1754eyes, 1,079 patients). Allocation totreatment groups was random, exceptthat some patients (mostly at theirown request) were allocated to aspecific AREDS1 formulation.

The purpose of the primaryanalysis was to decide which, if any, ofthe three treatments led to improvedAMD outcomes (reduced progressionof AMD), compared with the reference(placebo) group. “Improved”outcomes in the primary analysis wereassessed by length of time beforeprogression to advanced AMD.

The analysis revealed a 10% lowerrisk of progression to advanced AMDfor the L+Z only group comparedwith the reference subgroup, but thisdifference in risk was not statisticallysignificant. This was also the case fortreatment group four (11% reductionin risk of progression, but notstatistically significant), the othergroup to receive L+Z. The reduction inrisk for treatment group three, notreceiving any L or Z, was only 3%.

It is worth reiterating here that thecontrol group in this study is not atrue placebo group, but rather a groupreceiving some form of AREDS1supplement. Therefore, it would beincorrect to conclude from this studythat none of the three treatments isshown to reduce risk of progression toadvanced AMD. Such an analysiswould not have been possible withthis study, as no subject received atrue placebo. The correct conclusionfrom this primary analysis is that,controlling for baseline AMD status,none of the treatments (two, three andfour) were shown to significantlyreduce the risk of AMD progressionrelative to the group who received theAREDS1 supplement only (treatmentone).

The ‘secondary’ analysesThe primary analysis described abovewas supplemented in AREDS2 with asecondary analysis, where treatmentand control groups were re-defined asfollows: treatment group = L+Z andL+Z+DHA+EPA groups, combined(3,451 eyes) and a control group = allother patients (3,440 eyes). Thus the

John Nolan, Stephen Beatty and Jim Stack discuss the results of the AREDS2 study and what itmeans for the future of eye care.

SPECIAL REPORT

control group now consists of patientswho did not receive supplementalL+Z at all; it includes the placebogroup from the primary study but alsopatients who received DHA+EPA only.

Therefore, all patientssupplemented with L+Z werecompared with all other patients(those not supplemented with L+Z)with respect to progression toadvanced AMD.

The crucial difference, statistically,between this secondary analysis andthe primary analysis, is that only twogroups are now being compared andhence there are far more patients/eyesin each group. The actual reduction inrisk for L+Z patients (9%) is similar tothe reduction in the primary analysis(10%-11%), but (because of the largersample sizes) this reduction is nowstatistically significant. Based onstatistical significance, the conclusionfrom the study is now that supplem -ent ing with L+Z does indeed reducethe risk of progression to advancedAMD compared to not supplementingwith these macular pigments.

The evidence is even strongerwhen dietary intake of patients isincluded in the analysis. Quintilegroups were formed on the basis ofdietary intake of L+Z. Quintile groupone, therefore, consists of patients inthe lowest 20% when rankedaccording to dietary intake of thesecarotenoids (median = 696 µg/1000Kcal per day). In this group, therisk for progression is 26% lower forthe L+Z treatment group than theplacebo group.

This represents quite robust

evidence that L+Z supplementationreduces the risk of progression toadvanced AMD for patients with lowdietary intake of these carotenoids. Inthe manuscript of the AREDS2 paper,it is stated that similar results wereobtained when tertiles were usedinstead of quintiles to define thesubgroups. Thus, the study evidenceis that the lowest third of patients,based on dietary intake of L+Z willhave a reduced risk of progression toadvanced AMD when supplementedwith L+Z.

Patients supplemented with L+Z,

but who did not receive ß-carotene,were 18% less likely than patientsreceiving placebo to progress toadvanced AMD, supportingsupplementation of L+Z in theabsence of ß-carotene.

ConclusionAs a result of AREDS2, the eye careprofessional is now furnished withfirm evidence that patients withestablished non-advanced AMD willbenefit from supplementation withbroad spectrum antioxidants thatinclude the constituents of macularpigment, and that the formulationshould not contain ß-carotene oromega-3 fatty acids.

ICO NEWSLETTER | AUGUST 2013 PAGE 5

AREDS2: (Continued)

AREDS2 summaryThere are many important results emanating from AREDS2. The list belowsummarizes the main findings from the study:

1. There was no statisticallysignificant benefit (reduction inrisk of progression to advancedAMD) for any of the treatmentstwo to four compared to placebo(treatment one)

2. A statistically significant reductionof 9% in risk of progression toadvanced AMD was observed forpatients receiving lutein andzeaxanthin when compared withpatients not receiving thesemacular pigments

3. Participants with the lowestdietary intake of lutein andzeaxanthin showed a statisticallysignificant reduction of 26% in riskof progression to advanced AMD,when compared with patients notreceiving lutein and zeaxanthin

4. A statistically significant reductionof 18% in risk of progression toadvanced AMD was found forpatients receiving lutein andzeaxanthin in the absence of beta-carotene, when compared withpatients receiving an AREDSformulation with beta-carotene(and not receiving lutein andzeaxanthin)

5. A statistically significant reduction

of 26% in risk of profound visualloss (i.e. neovascular AMD) wasfound for patients receiving luteinand zeaxanthin (plus an AREDSformulation) in the absence ofbeta-carotene, when comparedwith patients receiving an AREDSformulation with beta-carotene(and not receiving lutein andzeaxanthin)

6. Beta-carotene was associated withpoor absorption of lutein andzeaxanthin, with consequentiallyreduced serum bioavailability ofthese carotenoids

7. The inclusion of beta-carotene inthe formulation was associatedwith increased risk of lung canceramongst current and past smokers

8. There was no evidence thatsupplementation with omega-3fatty acids was of benefit in any ofthe analyses reported in this study

9. Supplementation with omega-3fatty acids or beta carotene had nostatistically significant effect onvisual acuity

10. Supplementation with lutein andzeaxanthin, omega-3 fatty acids orbeta carotene had no statisticallysignificant effect on mortality.

About the authors: John Nolan, Stephen Beatty and Jim Stack are all members of theMacular Pigment Research Group based at the Vision Research Center at the WaterfordInstitute of Technology in Ireland.

SPECIAL REPORT

ICO NEWSLETTER | AUGUST 2013PAGE 6

Over 170 delegates from theIrish and International

ophthalmic communityattended the Irish College ofOphthalmologists AnnualMeeting in The Malton Hotel,Killarney from the 29th to the31st May this year to hearabout the latest developmentsin the field.

Pictured at the AnnualMooney Lecture and GalaDinner were:

Conference 2013 – Malton

Seated from left, Deepti Thacoor, Olya Pokronskaya, Fiona McDonnell and Emily Hughes. At back,Aine Ni Mhealoid, Evelyn O'Neill, Debbie Wallace, Sara McNally, Sarah Moran and Ruth Tevlin.

Hayder Dyer, Belfast and Edel LambournBelfast.

Michael and Cathy Bradbury USA. Ted and Elizabeth Kennelly, Killarney.

Deepti Thacoor, Galway and George Vartsakis,Galway.

Tom and Norma O'Regan, Tralee. Max and Evelyn Graham, Dublin.

ICO NEWSLETTER | AUGUST 2013 PAGE 7

Hotel Killarney 29-31 May

Patricia Logan; Gordon Plant, Mooney Lecturer and Marie Hickey-Dwyer, newly elected President, ICO.

Sandra Fiorentini, Dublin; Dharm Pandeya, Dublin; Tim Sullivan,Australia and Tahira Saad, Dublin.

Mike Burdon, Bermingham; Chris Hammond, London and Ian Flitcroft,Dublin.

Marie Houlihan, Mullingar; Tim Carpenter, Dublin and CatherineMcCrann, Limerick.

John Houlihan, Mullingar and Ann McCarthy,Fermoy.

Lisa McAnena, Galway; Mairide McGuire,Boyle and Sorcha Ni Dhubhghaill, Dublin.

Mark and Patrice James, Cork.

ICO NEWSLETTER | AUGUST 2013PAGE 8

Eye Health in General Practice

An eye care information event forcolleagues in general practice

was held on the eve of the annualconference in Killarney. The Collegeliaised with the ICGP to inform theirmembers of the event and circulatedan information flyer to all doctors inKillarney and surrounding areainviting them to attend.

Darragh O’Doherty, TimothyHorgan, David Wallace, and JohnTraynor made up the expert panel onbehalf of the ICO and focuseddiscussions on the most common eyeconditions GPs come across in theirpractices.

The College was delighted withthe strong turn out by local doctorsand the positive feedback on the

topics covered, which included recentadvances in management of retinalvascular conditions, ocular surfacedisease, common eyelid lesions andcommon eye conditions presenting tothe general practise. The ICO is a CPDAwarding Body and the event wasaccredited for CPD points.

The College recognises the crucialrole GP’s in the community play tothe appropriate referral of medical eyeconditions for specialist care andplans to continue to work with theICGP on future eye health inform -ation events. The eye care booklet isbeing distributed to GP surgeries. Theevent was a new initiative at thisyear’s Conference and thanks to allthose who participated.

Niamh Connolly, NCBI; Patricia Logan,President, ICO; Lean Kennedy and her dog‘Murphy’, Irish Guide Dogs for the Blind;Victoria Elliott, IGD and Geraldine O'Neill,Child Vision.

Eugene Mathews, WMO Health; John Traynor and Pat Buckley, WMOHealth.

Gary Stack, Killarney; Patricia Logan, Outgoing President, ICO andPatricia Mangan, Killarney.

Sarah O'Neill, Killarney; Marta Czerner, Listowel and Kate Arthurs,Tralee.

Darragh O'Doherty, Tim Horgan, Patricia Logan, President, ICO, DavidWallace, Tralee and John Traynor.

ICO NEWSLETTER | AUGUST 2013 PAGE 9

MontgomeryLecture 2013

Dr Nancy Newman will givethis year’s Montgomery

Lecture on Friday December 6th inthe RCSI. Nancy is LeoDelle JolleyChair of Ophthalmology at EmoryUniversity School of Medicine. Shealso holds the positions ofprofessor of Ophthalmology andNeurology, and instructor inNeurological Surgery at EmoryUniversity School of Medicine andis a lecturer at Harvard MedicalSchool.

Nancy has more than 350publications, including scientificarticles, book chapters and books,including the primary textbook inneuro-ophthalmology, Walsh &Hoyt’s Clinical Neuro-Ophthalmology, 5th and 6theditions. She is co-author, withValérie Biousse, of the textbook,Neuro-Ophthalmology Illustrated(Thieme), published in 2009.

Nancy has lectured widelythroughout the world and isknown for her innovative teachingstyle. She sees both adults andchildren with neuro-ophthalmologic problems, such asoptic nerve disorders, visual fielddefects and disorders of ocularmotility. Her main researchinterests include disorders of theoptic nerve and mitochondrialdiseases.

Nancy Newman

Report on UEMS Section ofOphthalmology Plenary SessionSofia June 2013 –Alison Blake

The 67th Plenary Session of theUEMS Section of Ophthalmology

was held in Sofia, Bulgaria 15th-16thJune 2012.

The Union of European MedicalSpecialists is an EU wide represent -ative body liaising with the EUCommission divided into sections byspecialty. UEMS represents over 1.6million medical specialists in all thedifferent specialties. It also has stronglinks and relations with EuropeanInstitutions (Commission andParliament), the other independentEuropean Medical Organisations andthe European Medical / ScientificSocieties.

The UEMS has 39 SpecialistSections, which represent independ -ently recognised specialties. Theyeach created a European Board as asubgroup, in conjunction with therelevant European Society, with aview to defining European standardsof medical education and training.They also contribute to the work ofMultidisciplinary Joint Committees(MJC) which address fields of amultidisciplinary nature. The Sectionof Ophthalmology encompasses theEuropean Board of Ophthalmologywhich offers the EBO Diploma.

The current President (4 year term)is Constantino Bianchi from Italy,General Secretary Guy Aflalo (France)and Treasurer Eija Vesti from Finland.

Elections were held at the meetingfor President Elect, Assistant GeneralSecretary and General Secretary.

Dr Hank Bonnemaijer (TheNetherlands) was elected President

Elect. He will become President in2015. De Guy Aflalo (France)continues as General Secretary and DrDenise Curtin (Ireland) becomesAssistant General Secretary, a postheld by Mr John Nolan in the past.

Several countries expressedinterest in hosting future meetings.Malta will host the next meeting in2014, Croatia in 2015, and Dublin willwelcome our European neighbours in2016. As the Irish representative Ipresented Dublin as potential futurelocation with an attractive slide showand the members are looking forwardto visiting Ireland.

The Section of Ophthalmologyaccredits E learning programmes:reviewers are scarce and more arerequired, each one hour programmetakes about two and a half hours toreview. Irish Trainers and EBODexaminers are encouraged to partakein this activity.

Accounts of the UEMS OphthalmicSection will be held as a sub-account ofthe UEMS Brussels account in future.

Standardisation of specialisation isrequired by EU directive, the length oftime is currently 4 years. A survey ofEuropean countries done betweenmembers recently shows that thislength varies from 4 to 5 years, withsome countries including a mandatorytime of up to one year in areas ofMedicine outside Ophthalmology.

The President has one more yearremaining in his term. The 2014Plenary Session will be in Valletta,Malta

New Council membersThe new members joining Council term were announced at the AGM. Alison Blake, Iain Harrison and Yvonne Delaneywill join the College’sgoverning body for a three year term which runs from 2013-2016. Pat Loganwelcomed the new Council members on board and thanked the outgoingmembers, Noel Horgan, David Keegan, Catherine McCrann and GarryTeacy.

ICO NEWSLETTER | AUGUST 2013PAGE 10

Mobility is Critical for Persons withVision Loss according to IGDB Study

Over a third of older people withvision loss never go out

independently in their local area,according to a report published in2012 by Irish Guide Dogs for the Blind(IGDB) and NCBI. The reportillustrates reduced mobility greatlyaffects quality of life and limitsopportunities for social participationamong persons who are blind or haveimpaired vision.

The study, which focused on asignificant sample of personsregistered blind in Ireland, found thatover a quarter of younger persons willnot go out in their local area withoutassistance from a sighted person.Over half of those who participated inthe study expressed having difficultygetting around in their local area.

Despite being legally blind, themajority of people who contributed tothe study have not undertaken anyformal mobility training.

What is Mobility Training?According to the the Irish Guide

Dogs for the Blind, Mobility trainingcommonly means learning to travelthrough the environment with the aidof a guide dog or long-cane.

Guide dogs help their owner toavoid obstacles in the streetenvironment and they warn theirowner when hazards, such as stairsand road works, are approaching. Thelong-cane enables persons to detectobstacles and changes in groundsurfaces, such as kerbs and ramps.

Formal mobility training goesbeyond simply teaching an individualhow to handle a guide dog or long-cane effectively as a mobility aid.Persons with vision loss also learnexcellent direction-finding andproblem-solving skills.

The Benefits of MobilityTraining:

Irish Guide Dogs for the Blind isworking hard to create betterawareness of the benefits of formaltraining for persons who are blind orhave impaired vision. Professional

mobility training benefits personscoming to terms with vision loss as itenhances their health and emotionalwell-being. Persons also gain greateropportunities to travel, work andsocialise.

Padraig Mallon. Chief Executive ofIGDB, says “Respondents to thisstudy said they didn’t take upmobility training because theymanage with the help of a sightedguide yet only 6% of those who usethis technique described theirperception of their mobility as “verywell”. We want to ensure that peopleare not just ‘managing’ to get by, butare enabled to be as independent asthey can be, given their personalcircumstances and the level ofsupport that is available to them.”

Irish Guide Dogs for the Blindprovides a comprehensive set ofservices which includes mobilitytraining and independent living skills.When ophthalmologists refer patientswith considerable vision loss to IrishGuide Dogs for the Blind, the patientmay discuss their options and makean informed decision as to whichservices may best meet their needs.

Keep an Eye onthe Ball for AMDThis year’s AMD Awareness Week

is running from 23 - 29 Septemberto promote early detection of the signsof Age-related Macular Degeneratio,the most common cause of registeredblindness in Ireland.

The ICO is working with NCBI,Fighting Blindness, the AOI toincrease public awareness of AMDand to highlight the importance ofregular testing to identify early signsof the condition.

AMD is the most common cause ofregistered blindness in Ireland andthe principal cause of sight loss forpeople over the age of 50 in theWestern world, affecting one in tenpeople in that age bracket.

This year’s campaign has asporting focus and is encouragingpeople over the age of 50 to “Keep aneye on the ball for AMD” with regulareye checks and by maintaining ahealthy lifestyle.

Throughout AMD AwarenessWeek, free testing will be carried outat a range of participating independ -ent opticians and by eye doctorsacross the country and the mobiletesting unit will be on the road visitthe following venues in Dublin,Galway, Limerick, Cork andWaterford. Information about AMDand the free testing locations isavailable for the public to view onwww.amd.ie

As in previous years individualstested who are deemed to requirefurther medical examination arereferred on to a list of participatingeye doctors. Please let the Collegeknow by August 30th if you wish tobe included in the list of eye doctorsavailable to test and/or see referrals.

RTE's Mary Kennedy is joined by AMD patientHilda Barrett launch AMD Awareness Week.

ICO NEWSLETTER | AUGUST 2013 PAGE 11

Launch of the Model of Care for Acute Surgery andthe National Policy and Procedure for Safe Surgery

The National Clinical Programmein Surgery (NCPS) is a joint initiativebetween the HSE Clinical Strategyand Programmes Directorate, andRoyal College of Surgeons in Ireland.

According to Minister for Health,Dr James Reilly, the Model of Care forElective Surgery, published by NCPSin 2011, is an example of theimportance of collaboration betweenthe HSE and training bodies to ensurethe successful roll out of the clinicalprogrammes. The model has alreadyhad a significant positive impact onthe efficient delivery of surgical careto patients in Ireland.

The Model of Care for AcuteSurgery has been developed giventhat up to 60% of the workundertaken in many surgicaldepartments is on patients requiringacute surgical care. These patients arefrequently the sickest, are elderly andhave co-morbidities with often resultin poorer outcomes.

Minister Reilly, stated, “In recenttimes there has been an 18% reduction

in the health budget with a 10%reduction in health service staff.Despite this there has been a 2.5%increase in activity and a 5%reduction in bed days”

The Model of Care for AcuteSurgery sets out the principles andstrategies necessary to ensure theprovision of high-quality acute carefor surgical patients in Ireland.Adherence to these principles,strategies and underlying criticalconsiderations are to ensure thatpatients experience access to high-quality surgical care throughoptimum resource utilisation.

Speaking at the launch, ProfessorPatrick J. Broe, President of RCSI saidthat ‘emergency surgery has to datebeen the poor relation of electivesurgery and unfortunately, inter -nationally, outcomes continue to be acause of concern. The launch of theModel of Care for Acute Surgery istestament to the determination ofRCSI and HSE to improve the safetyand quality of care for surgical

patients presenting in the emergencyor acute setting’.

Also speaking at the launch, MrTony O’Brien, CEO / Director GeneralDesignate of the Health ServiceExecutive (HSE), said that ‘Theadoption of global best practiceprinciples in surgical care, patientsafety, change management andbusiness process re-engineering willbe the keys to success as we worktogether to deliver the much neededchange and reform that our healthservice requires’. He continued bysaying that he ‘hopes the principlescontained in the document will guideall hospitals and groups of hospitalsin their efforts to provide the best carepossible for their patients’.

The President of the College ofAnaesthetists of Ireland (CAI), DrEllen O’Sullivan, who also spokeduring the event congratulated theNational Clinical Programme inSurgery for their achievements andhighlighted the need for continuedteam working and broad stakeholderengagement.

The Model of Care for AcuteSurgery and the National Policy andProcedure for Safe Surgery isavailable for download atwww.hse.ie/surgery or atwww.rcsi.ie/ncps

The Minister for Health, Dr James Reilly TD officially launched theModel of Care for Acute Surgery and the National Policy and

Procedure for Safe Surgery at the Royal College of Surgeons inIreland on the 17th July.

Pictured (left-right), Prof Patrick Broe, Consultant Surgeon, Beaumont Hospital, RCSI President;Minister for Health, Dr James Reilly TD; Martin Varley, CEO, Irish Hospital ConsultantsAssociation (IHCA); Áine Carroll, National Director, Clinical Strategy and Programmes, HSE; MrKen Mealy, Joint Lead, NCPS & Consultant General Surgeon; Professor Frank Keane, formerPresident of RCSI, Joint, Lead National Clinical Programme in Surgery (NCPS) and Mr TonyO’Brien, CEO/Director General Designate of the Health Service Executive (HSE).

Dr James Reilly TD, Minister for Health.

Phot

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ICO NEWSLETTER | AUGUST 2013PAGE 12

The inaugural Eye Triduathalon was held

in glorious sunshine inthe beautifulsurroundings of thelakes in Killarney. Thethree leg team racebegan with a 3km run,followed by a 20kmcycle and finishing upwith a 5km run. Congratulations to all

who took part and aspecial thanks to DaraKilmartin and DavidWallace for organisingthe event.

New arrival!

Welcome to babyCaoimhe Connellsafely arrived onJune 18th.

Congratulationsto mum EvelynO’Neill and dadPaul Connell.

Eye tri duathalon

ICO Golf Classic

John Walsh, Edward Dervan and John Doris pictured at the ICO GolfClassic in Killarney, congratulations to winner Iain Harrisson.

New President ElectEarlier this year College President Pat Loganwrote tothe members inviting nominations for the incomingPresident Elect. Pat was delighted to announce at theAGM that the nomination of Billy Power as PresidentElect was confirmed by Council. Billy has a two year runin as President Elect and will Preside over the Collegefor two years commencing at the Annual Conference in2015.

Upcoming Meetings and CoursesSep 5th: Pathology exam preparation

course, RVEEH, Dublin

Sep 12th & 13th: International PaediatricMeeting, Croke Park, Dublin

Sep 24th: Anaesthesia Course, RVEEH,Dublin

Sep 27th: Refraction Course, RVEEH,Dublin

Sep 27th & 28th: Glaucoma Meeting, Galway

Oct 10th: Retina Meeting, Adare

Oct 25th & 26th: International AMD Meeting,Convention Centre, Dublin