The world of ocular surface health has lately sprawled, owing to a rapid, radical revolution in understanding and practice. How did we get there as a field and, more importantly, how can you get there as a clinician, and keep up?
In the last year alone, we’ve seen several completely new and different therapeutic approaches emerge, swiftly spilling over from the nebula of research into real-life practice. Think molecular resonance; thermal pulsation, now both handheld and stationary and heating from the inside or the outside of the lid; intense pulsed light; thermo-mechanical ablation; nasal sprays; unpreserved artificial tear solutions; and novel drug delivery mechanisms for new and old formulations alike. Even the staunchest cynics can’t scoff at the advent of radically new approaches. And we’re just scratching the surface (pun intended, sorry), given the products still making their way through the development pipeline.
Likewise, fresh diagnostic devices for identifying and classifying dry eye disease are also riding the bandwagon of technological innovation, with advancing imaging capabilities and powerful data processing taking advantage of the unparalleled accessibility to the ocular surface. Anterior segment OCT, meibography, (applied) corneal topography, osmolarity testing, thermography, interferometry, infrared imaging, fluorophotometry, inflammatory biomarker testing and others supply a wealth of new tear film and ocular surface parameters, helping illuminate the mysteries of dry eye. And we’re still in the awkward early days of artificial intelligence, machine learning, neural networks and deep learning.
Progress in the multifactorial nature of OSD
These advances have spurred, and largely been spurred by, an unprecedented breadth of scientific research. The ripples of the Tear Film and Ocular Surface Society’s second dry eye workshop (TFOS DEWS II) report in 2017 continues to shake up the clinical and scientific world, while the ongoing TFOS Lifestyle Epidemic Workshop promises another wave of insight into our practices to improve patients’ lives. This virtuous cycle of knowledge and technology may ultimately be the key to tackling the vicious cycle of ocular surface disease.
Annoyingly, access to such innovation is not distributed evenly across the world. Some are early adopters, like the US, while others often must wait on the side-lines, like New Zealand. There’s little that those eager to get their hands on the latest technology can do to bypass regulatory and corporate hurdles, except wait – and learn. But there’s value in watching the progress of (and learnings from) others and being able to hit the ground running once approvals and supply chains open up.
The local professional press (hat tip to NZ Optics too) does a fantastic job at covering the latest from across the pond(s) in a timely fashion, but nothing beats hearing directly from those who have used, or even created the latest tools. Anyone who has ever been to an international conference knows what a firehouse of learning it can be. This collision of science, academia, clinical and industry for a brief stint each year is unparalleled for sharing and acquiring knowledge, especially in times of growth, as seen in ocular surface health currently.
Expanding OSD learning opportunities
For New Zealanders who have not experienced an international conference ‘in the flesh’, given the last years of restrictions and the financial and time costs of international travel, there is now hope and options. One might be this year’s British Contact Lens Association (BCLA) conference in Birmingham, UK, which runs from 11-12 June in a hybrid format, with highly competitive attendance rates, especially for online attendance (www.bcla.org.uk). It’s an opportunity for OSL team members and interested readers to familiarise ourselves with the latest trends in ocular surface health and hear from some of the leading voices about recent, current and upcoming developments.
In a two-part lecture, starting and closing the conference, the last 10 years and the upcoming 10 years of OSD clinical practice will be put into perspective by luminary professors James Wolffsohn, Lyndon Jones, Philip Morgan and Shehzad Naroo. Though predicting the future is a troublesome undertaking (as we’ve seen) this year’s programme will showcase the latest in contact lens trends, myopia management, digital eyestrain and young patients. It’s also a great opportunity to sign up for a BCLA Dry Eye Certificate* and/or a BCLA Myopia Management Certificate, to improve clinical skills and acquire expert knowledge, something a few New Zealanders have already taken advantage of. Course takers stand to gain CPD points and obtain a certificate which will inch them closer towards obtaining a coveted BCLA fellowship. Anyone interested in completing a BCLA module or with questions about pursuing a fellowship is welcome to contact BCLA’s global ambassador for New Zealand, Professor Jennifer Craig at the University of Auckland, for further advice and guidance.
Though slow in patients’ perception, and fast for clinicians striving to keep up with the latest science and tech, progress is real and fast in the OSD world. But the learning curve is not insurmountable; online conferences provide a truly global opportunity for participation which can help you get there.
Dr Alex Müntz is a post-doctoral research fellow, with a background in optometry and vision science, working in the Ocular Surface Laboratory at the University of Auckland.