Video Content for Patient Education

In this study, patients newly diagnosed with nAMD will be randomized into two groups. Half of the patients will watch a video with information about their disease and the other half will receive information from the ophthalmologist as usual without watching the video. The effectiveness of the video will be tested with a knowledge assessment form and patient information satisfaction questionnaire

Impact of Slit Lamp Design on Eye Care Provider Ergonomics

Ophthalmologists experience high rates of work-related musculoskeletal (muscle and bone) disorders as a result of poor postures over long periods of time. This study seeks to assess the posture of eye care providers when using a standard slit lamp compared to the posture when using a slit lamp microscope with adjustable oculars. Studying the differences in postures while using different equipment may help identify poor postures that currently exist. Additionally, the findings of this study may help improve the design of future equipment which may reduce the risk of work-related musculoskeletal disorders. This is a prospective study of eye care providers at the Ivey Eye Institute, St. Joseph’s Hospital. The postures of eye care providers will be assessed while using the traditional slit lamp and the slit lamp with adjustable oculars

CRISPR: On the road to restoring sight to the blind

CRISPR-Cas9 is a novel gene-editing tool that promised to revolutionize our ability to treat genetic conditions when first introduced. Today, it continues to fuel many areas of health research, ranging from cancers to sickle cell disease to Huntington’s disease.1–3 Vision science researchers immediately saw the potential of CRISPR, with some of the earliest experiments exploring CRISPR as a treatment option for inherited ocular disorders.4 Only a few years later, in March 2020, vision research was again at the forefront of this field.5 A CRISPR therapy was injected into the human body for the first time in an attempt to correct a vision threatening mutation.5 Inherited retinal diseases have traditionally presented therapeutic challenges, but CRISPR is now providing hope for a cure.</jats:p

Evaluating the Diagnostic Accuracy of a Novel Bayesian Decision-Making Algorithm for Vision Loss

The current diagnostic aids for acute vision loss are static flowcharts that do not provide dynamic, stepwise workups. We tested the diagnostic accuracy of a novel dynamic Bayesian algorithm for acute vision loss. Seventy-nine &ldquo;participants&rdquo; with acute vision loss in Windsor, Canada were assessed by an emergency medicine or primary care provider who completed a questionnaire about ocular symptoms/findings (without requiring fundoscopy). An ophthalmologist then attributed an independent &ldquo;gold-standard diagnosis&rdquo;. The algorithm employed questionnaire data to produce a differential diagnosis. The referrer diagnostic accuracy was 30.4%, while the algorithm&rsquo;s accuracy was 70.9%, increasing to 86.1% with the algorithm&rsquo;s top two diagnoses included and 88.6% with the top three included. In urgent cases of vision loss (n = 54), the referrer diagnostic accuracy was 38.9%, while the algorithm&rsquo;s top diagnosis was correct in 72.2% of cases, increasing to 85.2% (top two included) and 87.0% (top three included). The algorithm&rsquo;s sensitivity for urgent cases using the top diagnosis was 94.4% (95% CI: 85&ndash;99%), with a specificity of 76.0% (95% CI: 55&ndash;91%). This novel algorithm adjusts its workup at each step using clinical symptoms. In doing so, it successfully improves diagnostic accuracy for vision loss using clinical data collected by non-ophthalmologists

Challenges in transition to practice

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Outcomes of an Extended Treat-and-Extend Protocol for Neovascular Age-Related Macular Degeneration

Patients with nAMD undergoing anti-VEGF eye injections will be invited to take part in this study when their injection interval is being extended to 16 weeks. Data will be collected from the medical record from the time of first injection, the time at which the injection interval is extended to 16 weeks, and at timepoints 1 and 2 years later. Data to be collected includes: age, sex, anti-VEGF type, visual acuity, disease characteristics from OCT images, length of treatment and number of injections received, and final injection interval

CRISPR: On the road to restoring sight to the blind

CRISPR-Cas9 is a novel gene-editing tool that promised to revolutionize our ability to treat genetic conditions when first introduced. Today, it continues to fuel many areas of health research, ranging from cancers to sickle cell disease to Huntington’s disease.1–3 Vision science researchers immediately saw the potential of CRISPR, with some of the earliest experiments exploring CRISPR as a treatment option for inherited ocular disorders.4 Only a few years later, in March 2020, vision research was again at the forefront of this field.5 A CRISPR therapy was injected into the human body for the first time in an attempt to correct a vision threatening mutation.5 Inherited retinal diseases have traditionally presented therapeutic challenges, but CRISPR is now providing hope for a cure

The state of low vision care in Ontario

Viable, Healthy and Safe CommunitiesApproximately half a million Canadians live with vision loss significantly impacting their quality of life. The prevalence of vision loss is expected to increase by 30% in the next decade as Canada’s senior patient population continues to rapidly increase.1 This demographic shift is producing a mounting vision loss epidemic and a strain on available resources. Although vision rehabilitation services are available for these patients, limited research has been done to study how these services by ophthalmologists are being provided. In this retrospective population-based study, we analyzed the patterns of provision and utilization of vision rehabilitation services in Ontario between 2009 and 2015. Billing data for low vision services were received from the Ontario Health Insurance Plan Database. Patient demographics (age, sex, geographic distribution, number and type of visits) and service provider information (geographic location, number of years providing services, and number of services per year) were analyzed. The majority of patients that received vision rehabilitation services were females (61%) and over 60 years old (79%). While patient and provider geographic distributions overlapped in the areas with the largest patient populations, many regions lacked services. Over the period analyzed, the majority of patients (71%) made only one vision rehabilitation visit and a small subset of patients (11%) made more than two visits. Nine providers practiced low vision for seven years, while 43 provided services for only one year. In 2015, the most common diagnostic service provided to low vision patients was Optical Coherence Tomography of the retina and the most common therapeutic service was intravitreal for wet age-related macular degeneration. Although low vision services increased between 2009 and 2015, we estimate that 5% or less of patients with low vision accessed these services. There were inequities in ability to access care based on age, sex, and geographic location. Our findings are expected to help inform future healthcare policy decisions, especially as considerations are made to provide for our ageing population. Importantly, there is a significant need to increase number of providers, service locations, and access for patients. 1. CNIB - Fast Facts about Vision Loss. CNIB. http://www.cnib.ca/en/about/media/vision-loss/pages/default.aspx#canadians. Accessed August 26, 2017