— General Meeting & Lab Information —

Please be sure to RSVP for the Friday Opening Session, Friday Welcome Dinner, and Saturday Breakfast Symposia when registering for Eye Trauma 2024.

Cancellation Policy: Refunds are made upon written request and by approval of the Executive Committee only and must be received by May 1, 2024 and a 30% handling fee will apply against the refund. No refunds will be given after May 1, 2024 (NO EXCEPTIONS).

Lab & Opening Session | Friday

Houston Methodist | MITIE Lab

Lab: 11:00 AM – 6:00 PM

Opening Session: 6:30 – 8:00 PM

Controversial Cases, includes Tex Mex Welcome Dinner.

Join us! Open to all Eye Trauma 2024 attendees.

CLICK HERE TO RSVP

Introduction:

The American Society of Ophthalmic Trauma (ASOT) Annual Meeting will host its inaugural Damage Control Ophthalmic Trauma surgical wet lab on May 17^th, 2024, at the Houston Methodist Institute for Technology, Innovation and Education (MITIE Lab) in Houston, Texas.

The goal of this 6-hour course is to improve patient outcomes by presenting current concepts of emergency treatment of ocular and adnexal injuries.

The learner will understand the arc of diagnosis, medical management, microsurgical stabilization, and reconstruction/rehabilitation of the injured eye and gain the knowledge and surgical skills to confidently initiate damage control procedures.

Capacity: 32 residents/fellows/practicing ophthalmologists

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Assessment Structure:

Medical and surgical eye trauma training is limited (1) despite ~2.5 million eye injuries occurring in the United States each year (2). Perceived preparedness in ocular trauma may be gained through structured curriculum and expert discussion (1). Participants in the American Society of Ophthalmic Trauma Lab Day will gain instruction in the surgical management of eye trauma using the prinicples of damage-control ophthalmology, a concept of approaching each eye trauma with the goial of the stabilizing the situation to maximize the chances of vision preservation. Lab-day participants will complete a pre-workshop survey asking each to rate their comfort with eye trauma on Likert scale and asking each to complete knowledge-based questions on surgical principles in damage-control ophthalmology. Participants will then receive a basic lecture on damage-control ophthalmology surgical principles, will practice surgical techniques of damage control ophthalmology in small groups of 4 with an expert instructor on wet lab models of common eye injuries, and finally complete a post-intervention survey. Analysis of the pre- and post-intervention surveys will be used to assess the utility of the course and ways to improve eye trauma education in the future.

References:

Zafar S, Chen X, Woreta F, Sikder S. Self-perceived preparedness and competence among ophthalmology residents for open globe repair. Clin Ophthalmol. 2019 Jul 16;13:1273-1278.
https://hcup-us.ahrq.gov/reports/statbriefs/sb112.jsp#:~:text=Each%20year%20more%20than%202.5,or%20all%20of%20their%20vision, last accessed February 15, 2024. Original reference publication for the data is no longer available.

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Faculty List:

Boonkit Purt, MD | Grayson Armstrong, MD | Amy Coburn, MD

Grant Justin, MD | Barton Blackorby, MD | Ankoor Shah, MD

Fasika Woreta, MD | Charles Soparker, MD | Imtiaz Chaudry, MD

Rupesh Agrawal, MD | Richard Blanch, MD | Robb Mazzoli, MD

Masih Ahmed, MD | Nicholas Scoville, MD

Course Overview:

The course will be divided into 3 segments –

1. Lecture:
• Concepts and Principles of Damage Control Ophthalmology
• History, examination, diagnostic testing of the injured eye
• Preop stabilization; surgical planning including anesthesia; infection control; medical management; surgical prep and exposure
• Timing of intervention
• Consent
• Documentation
• Communication, including telemedicine for consultation and triage

2. Surgical Skills Transfer Wet Lab: with 3 laboratory experience stations (details below)
• Open Globe
• Oculoplastics/Adnexal injury
• Traumatic cataract/ Anterior segment injury
• In the wet lab, students will develop and execute an appropriate repair strategy under direct supervision by faculty mentors, with emphasis on:
– Tissue handling
– Instrument and suture choice and handling

3. “Choose your Own Adventure” will expand opportunities to explore additional tools and skills used in damage control and reconstruction through interactive exhibits by leading industry partners
• B-scan ultrasonography
• Surgical equipment including phacoemulsification and vitrectomy systems, alternative surgical instrumentation, suture material, indirect ophthalmoscopes, intraocular lenses, surgical loupes, 3D slit lamp imaging for teleophthalmology; eye models for additional surgical practice; amniotic membrane and contact lens applications for trauma

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Prerequisites:

Completion of Internship, current Ophthalmology Resident, or Ophthalmology Residency Graduate.

No CME will be offered for the wet lab component of the Annual Meeting.

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Needs Assessment:

Ocular trauma is common in all age groups, occurring in both military and civilian settings, including sports, the workplace, and at home. While all ophthalmologists will encounter eye trauma, most train and practice outside a level 1 trauma center, therefore have limited experience with evolving management paradigms. Because any part of the eye can be injured, treatment crosses multiple ophthalmic subspecialties, and may require action within minutes to hours to save the eye. This course provides ophthalmologists with an innovative and collaborative educational opportunity to master the knowledge and surgical skills to preserve ocular structure and function in an emergency. Personalized instruction with a low ratio of students to faculty provides attendees the benefit of one-on-one training with assessment of individual strengths.

Corneoscleral open globe repair – learners will:

- Gain knowledge and experience taking a history of and managing repair of eye injuries involving the cornea, limbus and sclera
- Become competent at repair of open-globe injury and understand common complications of open-globe injury.
- Manage/repair corneal lacerations, limbal and scleral lacerations, hyphema, and endophthalmitis
- Skills: suture simple and complex corneal, limbal, scleral lacerations; peritomy with relaxing incision; muscle isolation and repair; manage uveal prolapse; vitreous prolapse; irrigate liquid hyphema, tap/culture/inject; glue; discuss timing of potential vitrectomy, removal of intraocular foreign bodies

Oculoplastics/Adnexa – learners will:

- Gain knowledge and experience taking a history of eye injuries involving the eyelids, lacrimal system, and bony orbit.
- Evaluate and repair marginal eyelid lacerations, treat orbital compartment syndrome, and canalicular lacerations.
- Discuss the indications for and perform an enucleation.
- Discuss indications and timing for orbital fracture repair
- Skills: exploration to identify structures; debridement; full-thickness lid marginal laceration repair; reapproximating tarsal plate; reapproximating levator to tarsus; eyelid septal defects; brief teaching of canalicular exploration and repair; tarsorrhaphy; lateral canthotomy/cantholysis for orbital compartment syndrome; enucleation
- Emphasis on anatomic structures; closure in layers; ideal would construction

Traumatic cataract/anterior segment injury – learners will:

- Gain knowledge and experience taking a history of eye injuries involving complex crystalline lens trauma scenarios with emphasis on capsular integrity, zonular stability, vitreous prolapse and iris injury.
- Gain proficiency in understanding and practicing lensectomy and be introduced to various intraocular lens implantation techniques in a traumatized eye
- Skills: lensectomy; anterior vitrectomy; paracentesis; trypan blue and triamcinolone staining; vitrector for removal of clotted hyphema; managing iris prolapse; faculty introduction to capsular tension ring; capsular ring segments; sulcus IOL; ACIOL, IOL fixation without capsular support