In this issue

Update from COS President, Dr. François Codère and Executive Director/CEO, Jennifer Brunet-Colvey

As is so often the case, COS remains very busy and active. In this issue of Perspectives we call your attention to some of the many initiatives, activities and advancements on which COS and its members are working.


Update on the International Council of Ophthalmology
In his update, Dr. Rand Simpson, COS Liaison with the International Congress of Ophthalmology (ICO), highlights World Health Organization (WHO) findings on global visual impairment (based on 2008 data) that indicate significantly lower levels of blindness than expected. The new estimate represents a 13% decline in vision despite the fact that the over-50 population grew by 18% between 2004 and 2008.

Un-operated cataract remains the major cause of avoidable blindness and severe visual impairment in low and middle-income countries. The ICO has prepared a position and policy statement calling attention to the wide disparities in cataract services:

The next ICO and World Ophthalmology Congress meetings will be held as follows:

  • ICO General Assembly, February 16, 2012, Abu Dhabi, United Arab Emirates
  • WOC, February 16 to 20, 2012, Abu Dhabi, United Arab Emirates

Canadian Blood Services partnership
COS is working with Canadian Blood Services (CBS) on the design of an integrated interprovincial system for organ and tissue donation and transplantation in Canada. Dr. Guillermo Rocha is the Chair of the COS Eye Bank Committee and COS Liaison with CBS. He is also Chair of the Ocular Standards Subcommittee of the Canadian Standards Association (CSA).

CBS met with the federal, provincial and territorial Deputy Ministers of Health on December 9, 2010 and will meet with them again in June 2011. Final detailed recommendations, including costing and implementation plans, will be presented to the provinces and territories as part of the final report in June.

A subcommittee has been formed with representation from Cornea Group members. Special thanks to Drs. Jamie Bhamra, Steve Brodovsky, Paul Dubord, Martin McCarthy, Charlotte Wedge and Rusty Ritenour for agreeing to serve on this subcommittee.

CBS is currently assessing the financial impact that would result from increasing the number of available corneas for transplantation by 500.

CBS is hoping to provide an update to the COS Eye Bank Committee at the Annual Meeting in June.

Interprofessional collaboration in glaucoma care
In 2010, the Canadian Glaucoma Society (CGS) developed a proposed model for interprofessional collaboration in glaucoma care and asked COS to comment on the proposed model. The COS Board of Directors and the Council on Provincial Affairs (CPA) reviewed the proposed model in June 2010 at the COS meeting and decided it would be critical to seek input and feedback from comprehensive/general ophthalmologists across the country before endorsing the document. The COS Board met in late November 2010 to review those comments and feedback. The CPA has also reviewed the consolidated comments and recommended additional changes to the document. COS is in the process of consolidating these additional changes for the Canadian Glaucoma Society. This document will be reviewed and discussed by all parties at the June 2011 COS meeting.

Canadian Medical Association (CMA) Specialist Forum

  1. CMA Strategic Plan - At the January 2011 National Specialist Forum (SPF) meeting, Secretary General and CEO, Mr. Paul-Émile Cloutier, provided an update on the CMA's new 3- to 5-year Strategic Plan. He focused on two areas: CMA's strengthened commitment to community building and the goal of establishing the CMA as a trusted source of knowledge for practice.

    The CMA is working to strengthen its offering to affiliate and associate CEOs. During consultations with affiliate/associate societies, it was suggested a new forum be created for CEOs/EDs to discuss issues of mutual interest. Joining Mr. Cloutier on the drafting group are Alex Saunders from the CPA; Dawn Haworth of CASEM; Dr. André Lalonde of the FNSSC; Dr. Andrew Padmos of the Royal College; and Jennifer Brunet-Colvey of the COS.

    The CMA is developing its plans for Knowledge for Practice offerings. The CMA's goal is to be the go-to source for up-to-date information for doctors in Canada. Mr. Cloutier also highlighted several common challenges facing national medical organizations - the disengagement of the federal government, declining public trust in physicians and facilitating physician leadership - and expressed a desire to work together to address these challenges.

  2. Wait Time Alliance (WTA) - Under the leadership of COS Past-President, Dr. Lorne Bellan, the WTA released its 2010 Report Card in June, garnering considerable media attention. As well, the Canadian Association of Paediatric Surgeons (CAPS) has joined the WTA, becoming its 14th member.

    In the coming year the WTA will seek to appear before the parliamentary review of the 2004 Health Accord and will release another report card on wait times.

    Dr. Bellan will be stepping down as WTA Chair and will be replaced by Dr. Chris Simpson of the Canadian Cardiovascular Society (CCS). The CMA thanked Dr. Bellan for his excellent contributions as WTA chair, paying tribute to him in recognition of his work.

Residents' Program
COS' vision is to be a recognized leader in supporting residents' programs. In our ongoing efforts to increase the engagement of residents, COS has provided a range of services and support including:

  • appointing Dr. Stephanie Baxter from the COS Board to act as Liaison on Resident Affairs;
  • providing an annual stipend to allow the Executive Committee of the Resident Affairs Committee to meet in the fall during the Sally Letson meeting;
  • supporting the Halifax Ethics course for residents;
  • recruiting a member of the Executive of the Resident Affairs Committee (Dr. Dan Rootman) to serve on the Council on Continuing Professional Development (CPD) to ensure our Annual Meeting scientific program meets the needs of residents;
  • organizing a targeted residents' stream at our Annual Meeting and covering associated costs (speakers, room rental, food and beverage, AV equipment, etc.);
  • inviting a renowned keynote speaker from the American Academy of Ophthalmology (AAO) to present at this year's meeting in Vancouver;
  • ensuring residents' needs are heard at the Council on Provincial Affairs (CPA) by sending a member of the Executive of the Resident Affairs Committee to all CPA meetings (Dr. Kelly Schweitzer);
  • supporting the residents listserve, and monitoring and managing the database to allow residents to communicate with each other; and
  • providing start-up funding for the residents' website.

Residents recently created the Canadian Ophthalmological Residents Society (CORS). Residents are the future of the COS and we look forward to further engaging them in the work of COS as we feel it is important to secure their membership for years to come.

Update on Clinical Practice Guideline on Diabetic Retinopathy
Work on the Diabetic Retinopathy Clinical Practice Guideline is progressing. Dr. Walter Delpero, Chair of the Clinical Practice Guideline Committee, reports the committee met by conference call on November 17, 2010 under the leadership of Diabetic Retinopathy Committee Chair, Dr. Phil Hooper. Material was reviewed in January and the guideline will be published in late 2011 or early 2012.

COS recently formed a collaboration with the University of Ottawa, Office of CME and Academy for Innovation in Medical Education on a submission for a CIHR Meetings, Planning and Dissemination grant to establish and test a model for Clinical Practice Guideline dissemination and implementation. The grant will provide an opportunity to look at ways to address the barriers limiting the uptake of recommended best practices in clinical environments. This grant brings together Faculty of Medicine, divisions of Continuing Professional Development (CPD) and National Specialty Societies (NSSs) to look at how we can effectively achieve change in provider practices and practice patterns in the area of diabetic retinopathy screening within the Champlain Local Health Integration Network (LHIN) of Ontario.

Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) task force
The JCAHPO task force has completed its submission to the CJO. Dr. William Astle is the lead author on the paper entitled, A Survey on Allied Health Personnel in Canadian Ophthalmology: The Scalpel for Change, published in the February 2011 issue. The results of the study highlighted that training of qualified Ophthalmic Medical Personnel (OMP) is identified as a need by ophthalmologists. Dr. Sherif El-Defrawy, Chair of the JCAHPO task force, reports that next steps include:

  • increasing awareness of these results among ophthalmologists;
  • determining if current OMP training programs can meet Canadian ophthalmologist's needs and exploring program expansions if they cannot;
  • enhancing the ways by which ophthalmologists can seek OMPs for hire;

The task force will convene at the June COS meeting to outline next steps for each of these goals.


Dr. Andrew Budning, Chair of the Council on Provincial Affairs (CPA) draws attention to changes or proposed changes in regulations for optometry that concern patient safety. The most active include:

  • In British Columbia, the use of glaucoma medications is being actively addressed;
  • In Alberta, surgery for optometry has been proposed by optometry, refuted by ophthalmology and is currently not accepted by the government;
  • In Ontario, as of April 6, 2011, proposed therapeutics including glaucoma medications were accepted by the government.

Following their American colleagues, optometry continues to lobby government effectively. Intense lobbying by US optometrists has resulted in changes to legislation; surgical procedures are now allowed in Kentucky. The same is feared for Tennessee.

Despite our understanding to the contrary, "surgical optometry" is being presented to legislators as safe and in the interests of patients. We must all increase our involvement with our provincial and federal politicians to educate them about the risks to patients when treatments are performed without proper expertise.

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COS Lifetime Achievement Award 2012 Nominations

The Canadian Opthalmological Society (COS) introduced the Lifetime Achievement Award several years ago to honour members who have made significant contributions to eye and vision care during their lifelong career in medicine.

The COS is soliciting nominations from its membership for the 2012 COS Lifetime Achievement Award. Nominees must be COS members who have "made a sustained impact nationally and internationally to the growth of the profession and who have maintained the highest standards of patient care in their practice. Recipients of this award have also been strong and positive role models in the community and exemplary mentors and educators."

To submit a nomination please describe (in less than 500 words) how this person has:

  • Made an impact nationally and internationally on the growth of the profession
  • Maintained the highest standards of patient care in their practice
  • Been a positive role model in the community and an exemplary mentor and educator

Please submit your nominations in writing to [email protected] by August 31, 2011.

Lifetime Achievement Award recipients
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Membership news

Membership fees are now due! Any outstanding fees may be remitted by cheque through regular mail or online at through our secure server for the use of credit cards. You may also contact Rita Afeltra directly at 613-729-6779 Ext. 300 or by email at [email protected].

The 2011 COS Membership Directory will be mailed in late Spring.

Notice to membership: Annual General Meeting 2011
Notice is hereby given that the Annual Business Meeting of COS members will be held on Saturday, June 11th at 0700 in the Stanley Park Ballroom 3 of the Westin Bayshore, Vancouver, BC to approve audited financial statements, receive nominations for the Board of Directors, and consider any other business.

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Continuing Professional Development (CPD) Update

Changes to the Maintenance of Certification Program
The Royal College of Physicians and Surgeons of Canada (RCPSC) are proposing changes to the Maintenance of Certification (MOC) program. These changes are significant and will affect the way you can earn CPD credits.

The MOC program has now been simplified into 3 categories from the previous 6: Group Learning, Self-Learning and Assessment. The chart below provides some examples of learning activities for each category and the corresponding credit value:

A special Town Hall forum is scheduled as part of the upcoming COS annual meeting. Plan to attend and share your comments and questions. Dr. Jeff Plant, a Royal College CPD educator will be presenting the new MOC structure and demonstrating the MAINPORT platform.

Town Hall Forum: MOC Changes
Sunday June 12 0800-0830

For more information about the MOC changes, please visit the Royal College website.

COS annual meeting in Vancouver: Exceptional Speakers and Outstanding Sessions
As spring approaches, be sure to register for the upcoming COS Annual Meeting, June 9-12! Experience the Vancouver vibe - home to the 2010 Olympic and Paralympic Winter Games! We will welcome many of the top ophthalmologists from Canada and around the world to share the latest scientific information for several days of learning, networking, and celebrating achievements.

COS is proud to have a stellar list of speakers for this year's conference. The 2011 COS Lecturer will be Dr. Richard Abbott, President of the American Academy of Ophthalmology. Dr. Philip Rosenfeld will give the E.A. Baker Lecture, presenting an update on anti-VEGF therapy for neovascular AMD.

Visit the conference web site for a look at our confirmed speakers and the most recent program updates, including skills transfer courses!

Don't miss this great opportunity to hone your skills and intensify your learning by participating in a skills transfer course. Skills transfer courses are intended to provide intensive instruction leading to new knowledge and/or skills. These hands-on workshops offer instruction in surgical and diagnostic techniques, with supervision from an experienced facilitator and a low participant-to-instructor ratio.

Glaucoma: Thursday June 9, 0800-1100
New glaucoma procedures: Trabectome, I-Stent, Canaloplasty, Express Shunt Implantation

Cataract: Thursday June 9, 1300-1430 or 1500-1630
Hands-on with advanced surgical devices and instrumentation

Cornea: Thursday June 9, 1300-1600
Severe ocular surface disease: Diagnosis and management

Be sure to check the conference web site regularly for the most up-to-date information, including additional speakers, schedule updates, and online registration details if you have not already registered.

For more information about the COS annual meeting and other CPD opportunities, please contact Inika Anderson, Manager Continuing Professional Development [email protected]

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Canadian Journal of Ophthalmology April Issue Highlights

Long-term visual acuity and initial post-operative refractive error in pediatric pseudophakia
Evidence-based guidelines for the target initial pseudophakic refractive error in pediatric IOL implants are lacking. This study attempts to determine if initial pseudophakic refractive error influences long-term BCVA. The statistical analysis suggests that initial postoperative refractive error does influence BCVA in unilateral cases, and that those with low initial hyperopia have better long-term visual acuity.

Eye care utilization in Canada: disparity in the public funded health care system
This survey examines patterns of Canadian eye care utilization to identify determinants and barriers. A substantial proportion of people at high risk of vision loss do not access eye specialists. Attributable factors are likely incomplete government coverage, asymptomatic ocular diseases and lack of perceived benefits of eye care services.

Practice patterns of Canadian Ophthalmological Society (COS) members in cataract surgery - 2010 survey
The authors re-surveyed the members of the Canadian Ophthalmological Society in 2010. While the majority of practice patterns analyzed were unchanged between 2009 and 2010, there appears to be a change in the timing of preoperative NSAID drops, an increase in the use of one-piece hydrophobic acrylic, aspheric and blue blocking IOLs and in the use of the 4th generation fluoroquinolone antibiotic, gatifloxacin.

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Tribute to Dr. Howard N. Reed, Founding Editor of the Canadian Journal of Ophthalmology

The Canadian Journal of Ophthalmology pays tribute to its founding editor, Dr. Howard N. Reed, who passed away November 15, 2010 in his 97th year. Dr. Reed had a remarkable career in ophthalmology beginning in England during World War II, practicing in Tanzania and then in Canada where he founded the eye department of the Winnipeg Clinic in 1953. Dr. Reed served as ophthalmic surgeon at the Winnipeg General Hospital and the Children's Hospital of Winnipeg for 20 years. In 1967 he was appointed chief of the Eye Department at the Misericordia Hospital. Throughout his career, Dr. Reed wrote extensively on eye disease, including reports from Tanzania in the 1940s and from the Canadian Arctic in the 1950s. In 1960 he published a textbook The Essentials of Perimetry, which was reissued in 1972.

In January 1966 the COS launched the Canadian Journal of Ophthalmology (CJO), with Dr. Howard N. Reed as editor-in-chief. The quarterly CJO grew out of the annual Transactions of the Canadian Ophthalmological Society, published by the Canadian Ophthalmological Society from 1948 until 1965. Dr. Reed remained editor-in-chief of CJO until the mid-1970s.

As CJO celebrates its 45th anniversary, we honour the hard work of Dr. Reed and hope that the journal continues to uphold his vision.

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