APACRS 2021 Daily News (Sunday, 1 August 2021)

The Present and Future: Medical Retina Ophthalmology care has become crucial in the past few years with outpatient activity greater than any other speciality in 2017. With 10 million patients per year, the healthcare system is drowning in the number of patients ophthalmologists need to see. With this burden, “patients can lose sight while waiting for their appointment,” says Pearse Keane, MD, UK. With artificial intelligence (AI) technology on the rise, ophthalmologists now face a multitude of ways to tackle the challenges of ophthal- mology care. Currently, Dr. Keane states that we lie in the “AI Chasm” on the timeline of AI development, meaning that “it’s one thing to have a cool demo of your product, but another thing to be scalable.” In other words, actual implementation is hard. However, many ophthalmology centers around the world have already begun implementing ways to include AI in practice through screening methods. Although digital technology faces significant barriers, Tien Wong, MD, PhD, Singapore, says, “we need to build trust from patients and physicians. Ultimately, we need to go through a process change,” and AI within the health- care system is implemented “not just through computer science and engineering.” Accessible screening tools have also played a huge role in patient care as lack of screening has been shown to decrease a patient’s visual acuity over time. One screening model for di- abetic retinopathy Gavin Tan MBBS, MMED(Ophth), FRCSEd, FAMS, PhD, Singapore, describes is through telemedicine screening. Using retina photography and remote non-physician graders who are trained to screen, the time and cost savings is apparent. Reports are sent back to clinics on the same day with approximately 90% of reports sent back in less than one hour. Accuracy in terms of sensitivity and specificity is very high as well, with sensitivity being at 95 to 96.45%. Self monitoring methods have also been studied. Through a mo- bile app alleye.io, Kelvin Teo, MD, Singapore, says that risky pa- tients can be monitored from home through 2 hyperacuity tests per week. Results are sent to SNEC immediately and patients are followed up if their reports cause concern. Choi Mun Chan, MD, Singapore, discussed a variety of retinal diseases including choroideremia and Leber’s congenital amau- rosis. With these diseases, Dr. Chan says that the eye represents an ideal target for gene and cell therapies and that “genetic testing may be a new standard of care.” Anna Tan Cheng Sim, MBBS, BSc, Mmed, FAMS, FRCSEd, Sin- gapore, discussed an intervention to increase patient education through a patient assessment quiz with a dedicated nurse coun- selor. With results of this intervention showing increased patient education, Dr. Sim says, “engaging and empowering patients and decision making is increasingly essential.” Another program that has been established is TAAP: translation- al asian age-related macular degeneration programme. Gemmy Cheung, MD, Singapore, anticipates that this program, designed to improve Asian age-related macular edema (AMD) through a multidisciplinary approach, can address the knowledge gaps and unmet clinical needs of Asian AMD patients. Vicki Drury, PhD, RN, RMHN, OND, Australia, spoke about how important it is to establish strong education and train- ing programs for the scope of nursing practice. She says, “At the end of the day, it’s about safe practice.” Poor edu- cation and a lack of sufficient knowledge can lead to mis- takes that are costly for people’s health. Pang Nguk Lan, RN, Singapore, discussed the boundaries of nursing prac- tice: it is important to protect the nurse and the public and they should work according to their optimum level of edu- cation, competence, and interest. In the last presentation, Ang Shin Yuh, Deputy Director of Singhealth stated that nurses do have the qualities to be an intrapreneur: one who creates and innovates at a large organization while learning new things at work. “I urge nurses to develop their ability to communicate ideas well,” she said, as this will lead nurses to be a strong advocate in the realm of healthcare. EWAP Daily News - 6