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Do You See What I See - Optometry Decoded


President's Week Cruise
  Saturday, February 16 – Saturday, February 23, 2019

 7-Night - Eastern Caribbean Cruise


 

RCCL’s  Grand
Symphony of the Seas


 

Do You See What I See - Optometry Decoded

 

presented by

 

Blair Lonsberry, MS, OD, MEd., FAAO*

  

Patients’ present with a myriad of concerns and a corresponding variety of clinical signs and symptoms. This creates a unique puzzle, which the clinician has to try and decode to provide appropriate clinical care. In this interactive case-based presentation, the audience will work through key characteristics to look for in diagnosing patients with glaucoma and anterior/posterior segment disease. Emphasis will be placed on the use of the latest imaging equipment to diagnose and manage patients and the latest treatment and management options will be discussed.  In particular, with ever expanding scopes of practice, oral medications will be discussed as part of the treatment options.

 

 

 

 

TOPICS TO BE COVERED:

 

Imaging Interpretation for the Comprehensive Eye Care Professional

Course Description:

The following interactive course will focus on OCT interpretation using clinical cases. It will provide an overview of interpretation and diagnostics in retina and glaucoma management using OCT and perimetry. Structure and function will be discussed in detail.

 

Course Learning Objectives:

Course Objectives:

Upon completion of this course the participant will understand the challenges of diagnosing glaucoma and a variety of retinal conditions.

 

Upon completion of this course the participant will be able to understand the basic principles of neuroretinal imaging technology specifically spectral domain OCT

 

Upon completion of this course the participant will be able to recognize the signs and symptoms of a patient undergoing hydroxychloroquine toxicity and the importance of OCT technology and perimetry in management.

Upon completion of this course the participant will be able to recognize the signs and symptoms of a patient with glaucoma and the importance of OCT technology and perimetry in diagnosis and management.

  

Outline:

Challenges in glaucoma:

      - risk factors

      - structural changes in early disease

      - monitoring treatment/management and progression

- Structural and functional relationship in glaucoma with disease progression

- Clinical exam of optic nerve

- Importance of automated nerve fiber examination

 

OCT:

-          time domain (Stratus)

-          spectral domain technology

-          RNFL thickness analysis

-          progression analysis

-          the role of  macular thickness mapping

-          clinical examples including retinal images

Review of the new hydroxychloroquine screening guidlines

 

 

Lab Testing: The Basics:   

The following interactive presentation will explore the various lab testing used in the diagnosis of systemic conditions that have associated manifestations in the eye and ocular structures.  Common ocular conditions and the associated systemic diseases will be reviewed with an emphasis on what tests should be ordered and what the optometric physician should know once the results are back.

 

Learning Objectives:

 

-          Upon completion of this course the attendee will know the specific diagnostic 
     criteria and testing for a patient suspected of rheumatoid arthritis  

-          Upon completion of this course the attendee will know the specific diagnostic
     criteria and testing for a patient suspected of lupus

-          Upon completion of this course the attendee will know the specific diagnostic
     criteria and testing for a patient suspected of a HLA B27 condition

 

 

Legends of the Posterior Segment:

Optometric physicians are typically comfortable in the diagnosis and treatment of anterior segment conditions.  However, the posterior segment is often viewed with less confidence.  The following presentation will utilize the latest in interactive technology to review a variety of common posterior segment conditions in a case based format. 

 

Objectives:

 

Upon completion of this course the participant will be able to diagnosis and manage a patient with diabetes and diabetic retinopathy

 

Upon completion of this course the participant will be able to differentiate between common posterior segment tumors and what appropriate treatment options are available.

 

Upon completion of this course the participant will be able to incorporate the latest screening protocols for hydroxychloroquine for their patients

 

Upon completion of this course the participant will be able to diagnosis and manage of common retinal vasculature disorders including branch retinal and central retinal artery occlusion.

 

Upon completion of this course the participant will be able to recognize the key differentials in a patient suffering from an acute onset painless loss of vision including retinal artery and vein occlusions and make appropriate management referrals utilizing the latest clinical research such as the BRAVO and CRUISE studies.

 

Upon completion of this course the participant will be able to diagnosis and manage a patient presenting with a central serous choroidopathy.

 

  

Outline:

1.      Diabetes and diabetic retinopathy

a.       Review of types of diabetes

b.       Criteria for diagnosis

c.       Recommendations for control

d.       Common ocular complications associated with diabetes

e.       Diabetic retinopathy

f.        Treatment options for diabetic retinopathy

2.       Malignant melanoma vs metastatic carcinoma

a.       Review of the key characteristics between the two types of tumors

b.       Diagnostic criteria

c.       Ocular manifestations

d.      Treatment options

3.      Hydroxychloroquine retinopathy

a.      Systemic conditions requiring use of hydroxychloroquine

b.      Ocular manifestations of toxicity

c.       New screening guidelines for patients on medication

4.      Review of common retinal vascular disorders

a.       Review of CRAO, BRAO, BRVO and CRVO

b.      Key characteristics in differential diagnosis

c.       Systemic associations

d.      New guidelines for the treatment of the various conditions e.g. BRAVO and
   CRUISE studies

 

 

 

Oral Pharmaceuticals in Anterior Segment Disease

This interactive course examines the use of oral pharmaceuticals in the treatment/management of a variety of anterior segment diseases. Topical areas include HSV keratitis, herpes zoster ophthalmicus, bacterial/allergic conjunctivitis, lid/periocular tissues, uveitis and dry eye disease/Sjogrens.

 

Learning Objectives:

-          Upon completion of this course the attendee will know the diagnostic criteria
     for HSV keratitis and the appropriate oral and topical treatments

-          Upon completion of this course the attendee will know diagnostic criteria for
     herpes zoster ophthalmicus and the appropriate oral and topical treatments

-          Upon completion of this course the attendee will know the diagnostic criteria
     for lid/periocular tissue disease (e.g. hordeola, preseptal cellulitis) and
     appropriate oral treatments

-          Upon completion of this course the attendee will know the diagnostic criteria
     for allergic and bacterial conjunctivitis and appropriate oral and topical
     treatments

-          Upon completion of this course the attendee will know the diagnostic criteria
     for blepharitis and meibomian gland dysfunction and appropriate oral and
     topical treatments

-          Upon completion of this course the attendee will know the diagnostic criteria
     for dry eye disease and importance of ruling out Sjogrens disease and
     appropriate oral and topical treatments

-          Upon completion of this course the attendee will know the diagnostic criteria
     for a patient suffering from a uveitis and the treatment including topical and
     oral medications.

 

Outline:

1.  Herpes Simplex virus keratitis: (10 minutes)

            - patient case outlining the presenting signs and symptoms

            - etiology of HSV keratitis

            - pathophysiology of HSV keratitis

            - current treatment options (oral and topical) and the “controversy” over oral prophylactic
              treatment

 

2.  Herpes zoster ophthalmicus: (10 minutes)

            - patient case outlining the presenting signs and symptoms

            - etiology of herpes zoster

            - pathophysiology of herpes zoster

            - current treatment options (oral) for the management of the outbreak and pain management and
              the “controversy” over the shingles vaccination

 

3.  Hyperacute conjunctivitis: (10 minutes)

            - patient case outlining the presenting signs and symptoms

            - etiology of hyperacute conjunctivitis including chlamydia and gonorrhea

            - pathophysiology of hyperacute conjunctivitis and the underlying conditions

            - current treatment options (oral) for the management of chlamydia and gonorrhea with a review of
              the importance of obtaining diagnostic testing and reporting

 

4.  Allergies and allergic conjunctivitis: (10 minutes)

            - etiology of allergies and allergic conjunctivitis

            - pathophysiology including common signs and symptoms and outlining the allergic cascade

            - current treatment options (oral and topical) for the management of systemic allergies and
              allergic conjunctivitis

 

5.  Periocular infections: (15 minutes)

            - patient case outlining the presenting signs and symptoms of a patient with a preseptal cellulitis,
              hordeola, dacrocystitis

            - etiology of the various periocular infections

            - pathophysiology of the various periocular infections

            - current treatment options (oral) for the management of the various periocular infections including
              the use of oral penicillins, cephalosporins, tetracyclines and sulfa’s

 

6.  Blepharitis and meibomian gland dysfunction: (10 minutes)

            - patient case outlining the presenting signs and symptoms of a patient with blepharitis/MGD

            - etiology of blepharitis/MGD

            - pathophysiology of blepharitis/MGD

            - current treatment options (oral and topical) for the management of these conditions including the
              use of oral doxycycline

 

7.  Uveitis: (20 minutes)

            - patient case outlining the presenting signs and symptoms of a patient undergoing an acute iritis

            - etiology of uveitis

            - pathophysiology of uveitis and the different types of uveitis (anterior, posterior and pan)

            - current treatment options (oral and topical) for the management of uveitis and the importance of
              lab testing to determine underlying etiology

 

8.  Dry eye syndrome: (15 minutes)

            - patient case outlining the presenting signs and symptoms of a patient with dry eye disease

            - etiology of dry eye disease and particular emphasis on Sjogrens and the new diagnostic criteria
              for Sjogrens

            - pathophysiology of dry eye disease and Sjogrens

            - current treatment options (oral and topical) for the management of dry eye disease and
              particular emphasis on differentiating patients with underlying Sjogrens disease, the appropriate
              lab testing and management options.

 

 

 

The Secondary Glaucomas:

The secondary glaucomas are a varied group of conditions that are often asymptomatic and challenging to diagnose, manage and treat. The following interactive presentation will explore the development of glaucoma with a secondary cause and the latest treatment/management options.

 

Learning Objectives:

-          Upon completion of this course the participant will be able to understand
     what constitutes a secondary glaucoma

-          Upon completion of this course the participant will be able to recognize a
     patient suffering from
neovascular glaucoma and the appropriate treatment
     and management strategies.

-          Upon completion of this course the participant will be able to recognize a
     patient suffering from
pigment dispersion syndrome and the potential
     development of glaucoma and review the appropriate treatment and
     management strategies

-          Upon completion of this course the participant will be able to recognize a
     patient suffering from
pseudoexfoliation syndrome and the potential
     development of glaucoma and review the appropriate treatment and
     management strategies

-          Upon completion of this course the participant will be able to recognize a
     patient suffering from
lens induced glaucomas including phacomorphic and
     phacolytic, their diagnosis, treatment and management

 

Outline:

What is secondary glaucoma

            - etiology of the secondary glaucomas

 

Neovascular glaucoma (NVG):

            - case of a patient presenting with neovascular glaucoma including signs and symptoms

            - signs of NVG:

                        - iris neovascularization

                        - synechiae development

            - etiology of NVG

                        - link between VEGF and NVG

            - NVG management

                        - surgical management including PRP, anti-VEGF

                        - management of elevated IOP including surgical interventions

 

Pigment dispersion syndrome/glaucoma (PDS/PDG):

            - case of a patient presenting with PDS including signs and symptoms

            - signs of PDS:

                        - krukenberg spindle

                        - TI defects

            - etiology and common demographics of PDS and PDG

            - PDG management

                        - management of elevated IOP including surgical interventions

 

Pseudoexfoliation syndrome/glaucoma (PXS/PXG):

            - case of a patient presenting with PXS glaucoma including signs and symptoms

            - signs of PXS/PXG:

                        - triple ring sign

                        - dandruff material

            - etiology and demographics of patients with PXS/PXG

            - link of PXS/PXG and alzheimers disease

            - PXG management

                        - management of elevated IOP including surgical interventions

            - increased risk of complications secondary to cataract surgery

 

Lens induced glaucomas:

            - case of a patient presenting with phacomorphic glaucoma including signs and symptoms

            - types of lens induced glaucomas including phacomorphic/phacolytic and lens particle

            - signs of lens induced glaucoma:

            - etiology of phacomorphic/phacolytic glaucoma

            - clinical management

                        - surgical management including importance of cataract surgery

                        - management of elevated IOP including surgical interventions

 

Angle recession glaucoma:

            - case of a patient presenting with angle recession glaucoma including signs and symptoms

            - signs of angle recession:

                        - gonioscopy

            - etiology of angle recession glaucoma

                        - link between trauma and angle recession

                        - importance of extent of damage and timing of damage

            - angle recession glaucoma management

                        - management of elevated IOP including surgical interventions

 

 

Diagnosing and Managing Ocular Emergencies and Urgencies

Course Description:

Utilizing the latest in interactive technology, this course will review the various presentations of ocular urgencies and emergencies; focusing on triaging, case history and key points in diagnosing various emergent conditions.  Up to date treatment and management plans will be discussed in detail, focusing on current therapeutic intervention.

 

Learning Objectives:

 

Upon completion of this course the participant will be able to triage a patient as a potential emergency utilizing specific case history questions and understanding of what constitutes an emergency.

 

Upon completion of this course the participant will be able to recognize the signs and symptoms of a patient experiencing an acute onset red eye and be able to diagnosis the various types of red eye such viral conjunctivitis and be able to prescribe appropriate treatment and management.

 

Upon completion of this course the participant will be able to recognize the signs and symptoms of a patient experiencing an acute onset uveitis, be able to order appropriate lab testing to assess for a systemic cause and prescribe appropriate treatment and management options.

 

Upon completion of this course the participant will be able to recognize the signs and symptoms of a patient experiencing a transient ischemic attack and understand the appropriate recommendations for management.

 

Upon completion of this course the participant will be able to triage a patient experiencing flashes of light and floaters, potential diagnoses and appropriate treatment and management options.

 

Upon completion of this course the participant will be able to triage a patient experiencing sudden loss of vision and be able to differentiate the possible etiologies and be able to recommend appropriate treatment and management options.

 

 

Outline:

What constitutes an ocular emergency?

            - what questions to ask

            - common types of emergencies

            - general patient assessment (e.g. mini mental)

 

Sudden loss of vision

            - case presentation of a patient who presents with an acute loss of vision in one eye

            - potential differentials of an acute loss of vision with no pain e.g. vein occlusion, artery occlusion

            - appropriate diagnostic testing required

            - etiologies of sudden loss of vision and associated systemic conditions

            - treatment and management options with potential visual outcomes

 

Acute onset red eye:

            - case presentation of a patient who presents with an acute onset of a red eye

            - review of the potential differentials of an acute onset red eye

            - appropriate diagnostic testing required to differentiate different types of red eye

            - etiologies of the various types of acute onset red eye

            - treatment and management options for the various acute onset red eyes, including any oral
             and topical treatments

 

Uveitis:

            - case presentation of a patient presenting with an acute uveitis

            - review of the different types of uveitis and associated signs and symptoms

            - etiologies of uveitis including systemic associations

            - treatment of uveitis including topical and oral medications

            - review of appropriate lab testing for determining underlying etiology

 

Flashes and Floaters:

            - case presentation of a patient who presents with acute onset of flashes and floaters

            - potential differentials of a patient presenting with flashes and floaters and questions that need to
              be asked

            - etiologies of the differentials of flashes and floaters including PVD, retinal tears

            - appropriate work up and recommendations

            - important patient education and follow up recommendations

 

Transient Ischemic Attack

            - what is the difference between a TIA versus a TMB (transient monocular blindness)

            - what are the presenting signs and symptoms of a TIA

            - review of the potential etiologies of a TIA

            - risks of a stroke associated with a TIA versus a TMB

            - appropriate medical referral for a patient experiencing a TIA

 

 

Eyelid Lesions

Patients’ present with a variety of lumps and bumps associated with the ocular and periocular tissues.  This interactive presentation will review the various periocular lesions focusing on differentiating the benign from the malignant, the various differentials and current treatment/management options.

 

Learning Objectives:

-          differentiating a benign vs malignant lesion

-          review of the benign lid lesions

o   different types

o   diagnostic criteria

o   differentials

o   treatment/management options

-          review of the common malignant lid lesions

o   different types

o   diagnostic criteria

o   differentials

o   treatment/management options

 

 

 

The Latest in Corneal Dystrophies and Degenerations: 

The ever-expanding scope of therapeutic privileges for optometrists has made the diagnosis and treatment of anterior segment diseases a crucial aspect of clinical practice. This interactive course will examine the various forms of corneal dystrophies and degenerations focusing on patient symptoms, diagnostic criteria, affects on vision, and the most current management and treatment options with an emphasis on co-managing surgical patients.

 

Objectives:

- Upon completion of this course the participant will be familiar with the diagnostic criteria and presentation of the most common corneal dystrophies (e.g. basement membrane dystrophies (with RCE), stromal dystrophies (Granular/Macular), endothelial dystrophies (Fuchs))

- Upon completion of this course the participant will be familiar with the latest treatment options for the most common corneal dystrophies with a particular emphasis in surgical treatment and co-management of these patients. (e.g. DALK, DSEK, stromal puncture)

- Upon completion of this course the participant will be familiar with the diagnostic criteria and presentation of the most common corneal degenerations and the potential treatment/management options including surgical options (e.g. keratoconus, e.g. DALK, collagen cross-linking)

         

Outline:

- defining dystrophies and their importance to the optometric physician

- review of the latest information on corneal dystrophies:

          - basement membrane dystrophies

                   - etiology and patient demographics

                   - tools for diagnosis

- associated RCE’s

- latest treatments including topical, oral and surgical

- discussion on the important considerations when co-managing surgical patients

- stromal dystrophies

- granular/macular/lattice

- etiology and patient demographics

- tools for diagnosis

- latest treatments including DALK (video of surgery) and PK

- discussion on the important considerations when co-managing surgical patients

- endothelial dystrophies

- Fuchs

          - etiology and patient demographics

          - tools for diagnosis

          - latest treatment options including DSEK (video of surgery)

- discussion on the important considerations when co-managing surgical patients

 

- review of the latest information on corneal degenerations

- e.g. keratoconus

          - etiology and patient demographics

          - tools for diagnosis

          - latest treatment options including DALK, collagen cross linking

          - discussion on the important considerations when co-managing surgical patients

 

 

 

Ocular Manifestations in Autoimmune Disease: 

Patient's present with an array of systemic disorders. The autoimmune disorders are a varied group of conditions that provide a difficult challenge for both patient and clinician. This interactive presentation will focus on the ocular complications associated with autoimmune disorders, including diagnosis, management and treatment.

 

Objectives:

 

At the conclusion of this presentation, participants will be able to describe the diagnostic criteria and treatment of rheumatoid arthritis as well as the ocular complications associated with rheumatoid arthritis including current treatment regimen

 

At the conclusion of this presentation, participants will be able to describe the screening guidelines for patients taking hydroxychloroquine

 

 

At the conclusion of this presentation, participants will be able to describe the diagnostic criteria and treatment of systemic lupus erythmatosis as well as the ocular complications associated with systemic lupus erythmatosis including current treatment regimens.

 

At the conclusion of this presentation, participants will be able to describe the diagnostic criteria and treatment of Sjogrens Syndrome as well as the ocular complications associated with Sjogrens Syndrome including current treatment regimens.

 

 

At the conclusion of this presentation, participants will be able to describe the diagnostic criteria and treatment of patients with HLA-B27 related autoimmune conditions as well as the ocular complications associated with the HLA-B27 conditions and current treatment regimens

 

Outline:

Learning Objective 1

Rheumatoid Arthritis:

          - case

          - RA definition

          - RA etiology

          - RA pathophysiology

          - RA diagnostic criteria

          - RA lab testing

          - RA treatment and management

          - review of plaquenil screening guidelines

          - RA ocular manifestations

 

Subject 2:

Lupus:

          - case

          - Lupus definition

          - lupus etiology

          - Lupus epidemiology

          - Lupus pathophysiology

          - Lupus diagnostic criteria

          - Lupus lab testing

          - Lupus treatment and management

          - Lupus ocular manifestations

 

Subject 3:

Sjogrens

          - case

          - Sjogrens definition

          - Sjogrens etiology

          - Sjogrens epidemiology

          - Sjogrens pathophysiology

          - Sjogrens diagnostic criteria: review of the new criteria

          - Sjogrens lab testing

          - Sjogrens treatment and management

 

Subject 4:

HLA-B27:

          - case

          - 5 main HLA-B27 conditions

          - review of the various HLA-B27 etiologies

          - review of the various HLA-B27 pathophysiologies

          - review of the various HLA-B27 diagnostic criteria

          - review of the various HLA-B27 lab testing

          - review of the various HLA-B27 treatment and management options

 

 

 

Simplifying Systemic Antibiotics

Course Description:

Optometrists are familiar with the use of topical antibiotics in the treatment of ocular conditions. However, optometrists often hesitate in the use of systemic antibiotics in treatment protocols. Utilizing the latest in interactive technology, this course will review the major groups of antibiotics, their modes of action and their systemic indications in infection management.

Special emphasis will be placed on the current use of systemic antibiotics in the treatment of ocular disease conditions.

 

Learning Objectives:

- upon the completion of the course the attendee will understand the basic principles of antimicrobials including the importance of resistance development

- upon the completion of the course the attendee will be familiar with the major group of antibiotics, their mode of therapeutic action, specific representatives from each group and their appropriate dosing

- upon the completion of the course the attendee will be familiar with the individual groups of antibiotics and their systemic indication for use

- upon the completion of the course the attendee will be familiar with the individual groups of antibiotics and their ocular indication for use

- upon the completion of the course the attendee will be familiar with the complications associated with antibiotic use

- upon the completion of the course the attendee will be familiar with the ocular side effects of systemic administration of antibiotics

 

Systemic Antibiotics Outline:

-          review of the basics to antimicrobial therapy

o   e.g. antimicrobial spectrum of activity, resistance, patient factors

-          review of the various groups of antibiotics and their therapeutic use both systemically and ocularly

o   Inhibitors of cell wall synthesis

§  B-lactam antibiotics

§  Cephalosporins

§  Vancomycin/bacitracin

o   Inhibitors of protein synthesis

§  tetracyclines,

§  aminoglycosides,

§  macrolides,

§  chloramphenicol

o   inhibitors of nucleic acid synthesis

§  fluoroquinolone

o   inhibitors of metabolism

§  sulfa

§  trimethoprim

§  bactrim

o   inhibitors of cell membrane function

§  isoniazid

-          specific examples of ocular conditions will be given for each of the various groups with clinically relevant dosing

o   therapeutic spectrum, dosing and side effects will be discussed

 

Partial CV: 

Dr. Lonsberry is the Clinic Director for the Portland Vision Center associated with Pacific University in Portland, Oregon.  He supervises students during their Primary Care and Ocular Disease clinics and teaches the Applied Ocular Therapeutics Class and the Patient Care Classes.
For complete CV:
Click here

 

This program is presented in partnership with the
New Jersey Society of Optometric Physicians

Dr. Travel Seminars, LLC is a COPE Approved CE Provider

This course is approved for 16 CE

 

Seminar Fee*

Optometrists
Opticians

$695
$495

Students, Residents, and Office Personnel:

$145

GROUPS:

Please call

  * Discounted fees apply when purchased in conjunction with the cruise, if purchased separately, please add $400

 

   
 



    
Course given during days at sea

 

 

 

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Seminar: There is a $100 cancellation penalty for any course when made greater than 3 weeks prior to the seminar. If a

If a cancellation is made within the 3 weeks prior to the course, no refund will be granted.