Dr. Sherif El-Defrawy
Chair, Department of Ophthalmology & Vision Sciences
University of Toronto
The Eye Bank of Canada (Ontario division) (Eye Bank) shares a long history with DOVS. It originated in 1950 as the result of discussions between the COS and the CNIB regarding the need for an eye bank registry in Canada. COS organized an eye bank committee which met regularly with the CNIB to create a registry and the required regulatory framework. This reached fruition in 1955 with the Department of Ophthalmology at U of T establishing the Eye Bank, which was housed in the Banting Institute using a $500 donation from the CNIB.
At the Eye Bank’s inception, Hugh Ormsby, a University of Toronto ophthalmologist, was appointed as Medical Director and Prasanta Kumar Basu became its first Research Director, with Ann Wolf as the administrator. This proved to be a very worthy leadership team as the Eye Bank expanded continually over its first decade along with efforts to educate the public and medical personnel on the importance of eye donations. Ormsby obtained funding under Elliot, the Chair of the Department, to perform research into storage media, xenotransplantation and storage conditions. William Dixon took over leadership of the Eye Bank in 1978 and shared the position of Medical Director with David Rootman from 1996 until 2003. Dixon continues as the Medical Director, working alongside Charlotte Wedge, the assistant Medical Director and Linda Sharpen, the Eye Bank’s manager. Under their leadership the Eye Bank is now one of the largest in North America.
In 1967 the Eye Bank moved to 1 Spadina Avenue, where it remained until 2008 when it relocated to the CNIB building on Bayview. It was when the Eye Bank’s lease came up for renewal in 2013 that DOVS was in the midst of centralizing its administration at Kensington. With corneal surgery being performed at the Kensington Eye Institute and DOVS moving its administration there, it was a logical step to bring the Eye Bank to Kensington.
For some time, the University of Toronto had been uncomfortable with the liability that the eye bank brought to the institution. The Eye Bank was the only clinical entity under the University’s domain and for many years, the University searched to find new governance for it. With centralization of DOVS and vision health care at Kensington, it was apparent that the time was right to explore the opportunity for Kensington to assume custody of the Eye Bank, allowing the University to step away from the clinical liability. Discussions began in 2013 and resulted in a new agreement being signed in 2015 between Kensington and the MOHTLC, with U of T divesting from the Eye Bank.
The Eye Bank is now governed by a Governing Board chaired by Mark Richardson, a Toronto lawyer. The other members of the Board include David Rootman, Chief of the DOVS Cornea service; Bill Dixon, Medical Director of the Eye Bank and myself along with Mark Fava, a McMaster cornea specialist; Brian McFarlane, Kensington CEO and two laypeople, Beth Malcolm and Marie Rounding.
The Eye Bank has implemented many positive changes in the last two years, including computerization of processes and the precutting of corneal tissue. It has expanded its staff so that it will soon able to supply precut tissue throughout Ontario and enhance its quality assurance programs. Other plans are afoot, including the development of an Eye Bank technician teaching program. The Eye Bank of Canada (Ontario Division) is recognized as one of the significant eye banks worldwide, and strives to be the leader internationally.
Linda Sharpen & Dr. Charlotte Wedge
(Photo credit: Toronto Star)
Featured in this issue:
Spotlight on our Faculty
Focus on DOVS Docs
Dr. Calvin Breslin
Clinician Educator
Dr, Calvin Breslin
(Photo credit: Toronto Star)
Dr. Calvin Breslin graduated from the University of Toronto in 1974, went on to complete two Fellowships, one at Moorfields Eye Hospital (London, England) and one at the University of Florida in Gainesville. Returning to Toronto in 1976, Dr. Breslin joined DOVS, following a request to take on the position of “Coordinator” of the clinical and surgical years. He held this position until 1992 and assumed the title of Programme Director in 1988. The changes effected during his time as Programme Director were the foundation of today’s curriculum. Dr. Breslin’s contributions were recognized by the many awards he received, the Resident Teaching Award (in 1979, 1987, 1988, 1996 and 1999), the Silver Needle Award (1978 and 1981), and the Thimble in 1982. In addition to his teaching and surgical work, Dr. Breslin has been a tireless advocate for ophthalmology and for improvements to public health care, working with such organizations as COS, OMA, CPSO, and others. Dr. Breslin recently retired from surgery, but continues on with his strong ties to the eye care community.
As the first Programme Director, tell us about some of the ways you changed the residency experience. Is there something you are particularly proud of?
At the time of my joining DOVS, through 1973 to 1976, an issue had become apparent of a significant number of our residents not successfully completing their Royal College Exams. This caused great concern for the department. My responsibility was to identify the problem(s) and correct them. With help from a committed group of individuals we established a comprehensive lecture schedule. It ran over two years and incorporated the medical and surgical aspects of ophthalmology. A reading list appropriate to the Canadian experience was compiled. Oral and written multiple choice examinations were introduced and administered semi-annually. Small group teaching thrived. We gave residents appropriate feedback and remediation long before they attempted their RCPSC exams. I believed it was the responsibility of the Program Director to ensure our candidates had a reasonable chance of success on the RCPSC exams. Towards this end, we established a meaningful pass-fail system identifying any weak candidates. For the most part remediation solved these problems. In extremely rare instances residents were held back from writing their exams (if possible) or were asked to rethink their choice of a career in ophthalmology. Obviously this created some angst. Ensuring fairness and equality and applying departmental educational policies across the board was my goal. These alterations, coupled with changes mandated by the RCPSC, improved the educational experience for the residents and, more importantly, improved their success at the RCPS examinations.
What were some of the challenges facing Ophthalmology at that time you began your work with the OMA in 1984?
It was a tumultuous time for ophthalmology and my belief is that you have to be involved – to be there at the table -- to effect change. I became involved with the OMA Section on Ophthalmology in the 1980s, serving three terms as Section Chair (1984-1985, 1988-1990, and 1992-1994). The IOL add-on fee was being attacked by our colleagues at the OMA. We successfully defended the fee which basically stayed unchallenged until only recently. The OMA attempted to introduce a Relative Value Fee Schedule where the main determinant of a fee was the “time” component. Ophthalmology is time-efficient so this would have been disastrous. We successfully maintained the status quo. During my OMA tenure I was exposed to the COS as the Ontario representative to the Council on Provincial Affairs (1990-1995).
What was it like to chair the National Coalition on Vision Health? Did you have goals for the Coalition, and how did this impact public health policies?
The NCVH was a not-for-profit association of organizations established in 1998. It comprised a wide swath of the Canadian eye care universe and, as with any group that tries to be all things to all people, it became unwieldy. When I came on board, membership was reduced to six: FFB; CNIB; Vision Health Researcher of Canada; members of the ophthalmology, optometry and Opticianry communities. A newly-minted Mission Statement reflected our new direction, which became a Vision Plan for Canada. In 2008, by successfully lobbying the Federal Government, funding was obtained to conduct an environmental scan of vision care in Canada. Data was published the following year and used by the Health Professions Regulatory Advisory Council, for looking at the delivery of eye care in Ontario and scope of practice. Those results have since been quoted by the COS and CNIB in their study on vision care costs in Canada; and even as recently as 2013, in the Strategic Recommendations for Ophthalmology in Ontario. Unfortunately, as is the nature of coalitions, it eventually succumbed to internal differences and ultimately disbanded. I believe that it was a worthwhile endeavour for we brought vision care to the attention of many who would otherwise have been unaware of these issues; and more than that I enjoyed working with a lot of very engaged people.
You served on the Executive Committee of COS from 1999 until 2006 – what can you tell us about your work in that area?
I was invited to serve on the Executive Committee of the COS and was pleased to accept because it afforded me the opportunity to contribute at the National level. The Committee on Eye Care was not an onerous responsibility, not like CPD or the Council on Provincial Affairs. The position allowed me to do what I do best, i.e. express my opinion in an honest, straightforward and hopefully constructive way. I am a straight-shooter and call it like it is. I guess I sort of played Devil’s advocate.
How do you encourage today’s residents to become involved with the work of COS?
I tell residents that if they want to see change, not to sit around and complain: or expect someone else to do it. They need to get involved, and the best way to lead is through the COS. It’s unfortunate that only a small percentage of ophthalmologists actually join the COS. Being a member adds another voice, and broadens exposure to other community-minded associates.
Retiring from surgery, doesn’t mean retiring from ophthalmology does it, since here you are taking part in this year’s Walter Wright Day. What else are you planning to do?
Although I’ve given up surgery, I’m still working from my office. Since 2011 I have been a Physician Assessor for CPSO. Now, I am also a consultant ophthalmologist for WSIB, and provide independent medical opinion to insurers. In particular, they have a huge need for expert advice in the area of vision therapy, in relation to brain injuries caused by traffic accidents, concussions, etc.
With your long and successful career and your significant endeavours for Ophthalmology in Canada, what are you most proud of?
I would have to say my teaching and specifically my small group teaching. For most of my career I conducted resident small group teaching sessions in cornea for 1-2 hours before the start of my hospital Clinic. I believe I used what is called the Socratic Method. In fact my promotion to Full Professor (1992) was based on “Sustained Excellence in Teaching” which at that time was a new promotion track.
News
DOVS Resident Holiday Party December 18, 2015
Dr. David Yan's annual Resident Holiday Party was a resounding success. Everyone had a terrific time, and a novel way to appoint the new Chief Resident was discovered!
Upcoming Events
January / February / March 2016
January 5, 2016 The Contractual Aspects of Academic Health Research
Dr. Margaret H. Kerr
January 21, 2016
Research Seminar Series Refractive Errors
Drs. Elizabeth Irving / Raymond Stein
February 4, 2016
Journal Club
Review of the book "Waking up Blind"
Faculty Conference Room
February 3, 2016
CaRMS Interviews
February 18, 2016
Visiting Professors Rounds
Pediatrics
Dr. Federico G. Velez
March 4, 2016
Jack Crawford Day
The Hospital for Sick Children
March 5, 2016
Practical and Theoretical Ocular Ultrasonography
The Peter Gilgan Centre for Research and Learning
Start the New Year with some new information—that may help you to stay out of trouble!
KEI invites you to a presentation and question-and-answer session given by Margaret Kerr, B.A., LL.B., M.A., Ph.D., Barrister & Solicitor
This is a great opportunity to hear what KEI’s lawyer has to say about
what academic researchers should know before signing a research contract 5:45-6:45pm Tuesday, January 5th, 2016
Faculty Conference Centre, 45 Brunswick Avenue The Contractual Aspects of Academic Health Research Kick-off topics:
What is a contract?
Why should researchers care about contracts?
What rights and obligations does a research contract typically contain?
If a study goes wrong, will an insurer have your back?
And bring your own questions about research contracts!
Please join us for this informative talk.
MARGARET H. KERR, B.A., LL.B., M.A., Ph.D. is a member of the Ontario Bar and has specialized since 2001 in law related to research in clinical and/or academic settings. She has also practised in the fields of litigation (personal injury, corporate/commercial) and legal research. Her clients include hospitals, research institutes, physicians, contract research organizations, corporations, and the occasional pharmaceutical company. She is the co-author with JoAnn Kurtz of Legal Research: Step by Step (with Arlene Blatt), the Canadian Small Business Kit for Dummies, Wills and Estates for Canadians for Dummies, Canadian Tort Law in a Nutshell (with Laurence Olivo), Make It Legal: What Every Canadian Entrepreneur Needs to Know About the Law, and Buying, Owning and Selling a Home in Canada, among other books. Her doctorate is in Medieval Studies (legal history). For more information visit her website at www.mhkerrlaw.com.
Honours and Awards
Dean’s Honour Roll Luncheon Nov 16, 2015
Mrs. Laurie Squires, Dr. Gordon Squires, Zenny Gepilano, Heather Yearwood, Henry Farrugia, Rosemary Hodgins
Dean Trevor Young, Dr. Gordon Squires, Julie Lafford
Click on the image above to watch the video of the interview
Celebration of Brenda Gallie's Appointment to the Order of Canada
November 30, 2015
Dr. Brenda Gallie, Director of the Retinoblastoma Program at SickKids Hospital, Professor of Medical Biophysics, Molecular Genetics and Ophthalmology and Vision Science at the University of Toronto, staff in Ocular Oncology at Princess Margaret Cancer Centre, and a member of the affiliated faculty of Techna has received this honour “for her contributions to the prevention, diagnosis and treatment of retinoblastoma, a childhood eye cancer.” The prestigious appointment was announced on December 26, 2014 by His Excellency the Right Honourable David Johnston, Governor General of Canada.
The Order of Canada, one of our country’s highest civilian honours, was established in 1967, during Canada’s centennial year, to recognize outstanding achievement, dedication to the community and service to the nation. Over the last 45 years, more than 6,000 people from all sectors of society have been invested into the Order.
Recent Publications
Recent publications by DOVS Faculty, Staff, Residents and Fellows
October - November 2015
AlAli A, Bushehri A, Park JC, Krema H, Lam WC. Pimasertib and serious retinal detachments. Retin Cases Brief Rep. 2015 Oct 26. [Epub ahead of print]
Ali A, Subhi Y, Ringsted C, Konge L. Gender differences in the acquisition of surgical skills: a systematic review. Surg Endosc. 2015 Nov;29(11):3065-73. Epub 2015 Jan 29.
Astudillo PP, Cotesta M, Schofield J, Kraft S, Mireskandari K. The Effect of Achieving Immediate Target Angle on Success of Strabismus Surgery in Children. Am J Ophthalmol. 2015 Nov;160(5):913-8. Epub 2015 Jul 22.
Belliveau MJ, Odashiro AN, Harvey JT. Yellow-Orange Palpebral Spots. Ophthalmology. 2015 Oct;122(10):2139-2140.e1. Epub 2015 May 20.
Berlin MS, Rowe-Rendleman C, Ahmed I, Ross DT, Fujii A, Ouchi T, Quach C, Wood A, Ward CL. EP3/FP dual receptor agonist ONO-9054 administered morning or evening to patients with open-angle glaucoma or ocular hypertension: results of a randomised crossover study. Br J Ophthalmol. 2015 Oct 9. [Epub ahead of print]
Bourgault S, Baril C, Vincent A, Héon E, Ali A, MacDonald I, Lueder GT, Colleaux KM, Laliberté I. Retinal degeneration in autoimmune polyglandular syndrome type 1: a case series. Br J Ophthalmol. 2015 Nov;99(11):1536-42. Epub 2015 Apr 29.
Branfield Day L, Quammie C, Héon E, Bhan A, Batmanabane V, Dai T, Kamath BM. Liver anomalies as a phenotype parameter of Bardet-Biedl syndrome. Clin Genet. 2015 Nov 24. [Epub ahead of print]
Budenz DL, Feuer WJ, Barton K, Schiffman J, Costa VP, Godfrey DG, Buys YM; Ahmed Baerveldt Comparison Study Group. Postoperative Complications in the Ahmed Baerveldt Comparison Study during Five Years of Follow-up. Am J Ophthalmol. 2015 Nov 17. [Epub ahead of print]
Burnett HF, Lambley R, West SK, Ungar WJ, Mireskandari K. Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. Br J Ophthalmol. 2015 Nov;99(11):1565-70. Epub 2015 May 6.
Chan AT, Ulate R, Goldich Y, Rootman DS, Chan CC. Terrien Marginal Degeneration: Clinical Characteristics and Outcomes. Am J Ophthalmol. 2015 Nov;160(5):867-872.e1. Epub 2015 Jul 23.
Cheng RW, Yusof F, Tsui E, Jong M, Duffin J, Flanagan JG, Fisher JA, Hudson C. Relationship between Retinal Blood Flow and Arterial Oxygen. J Physiol. 2015 Nov 26. [Epub ahead of print]
Donnenfeld ED, Solomon KD, Voskanyan L, Chang DF, Samuelson TW, Ahmed II, Katz LJ. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma. Clin Ophthalmol. 2015 Nov 3;9:2057-2065. eCollection 2015.
Elbaz U, Mireskandari K, Kirwan C, Ali A. Validation of Corneal Endothelial Specular Microscopy in Children Under General Anesthesia. JAMA Ophthalmol. 2015 Oct 8:1-3. [Epub ahead of print]
Elbaz U, Mireskandari K, Shen C, Ali A. Cornea. 2015 Oct;34(10):e31-2.
Grzybowski A, Kuklo P, Pieczynski J, Beiko G. A review of preoperative manoeuvres for prophylaxis of endophthalmitis in intraocular surgery: topical application of antibiotics, disinfectants, or both? Curr Opin Ophthalmol. 2015 Nov 13. [Epub ahead of print]
Gupta RR, Choudhry N. Enhanced depth imaging spectral domain optical coherence tomography features of light chain deposition disease. Retin Cases Brief Rep. 2015 Fall;9(4):281-5.
Hynes MB, Bujak MC, Chérin E, Sade S, Foster FS. Design of a Subtarsal Ultrasonic Transducer for Mild Hyperthermia Treatment of Dry Eye Disease. Ultrasound Med Biol. 2015 Oct 23. [Epub ahead of print]
Lenassi E, Vincent A, Li Z, Saihan Z, Coffey AJ, Steele-Stallard HB, Moore AT, Steel KP, Luxon LM, Héon E, Bitner-Glindzicz M, Webster AR. A detailed clinical and molecular survey of subjects with nonsyndromic USH2A retinopathy reveals an allelic hierarchy of disease-causing variants. Eur J Hum Genet. 2015 Oct;23(10):1318-27. Epub 2015 Feb 4.
Lyttle DP, Johnson LN, Margolin EA, Madsen RW. Levodopa as a possible treatment of visual loss in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2015 Oct 20. [Epub ahead of print]
Matsushima H, Nagata M, Katsuki Y, Ota I, Miyake K, Beiko GH, Grzybowski A. Decreased visual acuity resulting from glistening and sub-surface nano-glistening formation in intraocular lenses: A retrospective analysis of 5 cases. Saudi J Ophthalmol. 2015 Oct-Dec;29(4):259-263. Epub 2015 Jul 29.
Mednick ZD, Cao K, Braga-Mele R. A survey for the need of translational aids among Canadian ophthalmologists. Can J Ophthalmol. 2015 Oct;50(5):388-92.
Merico D, Roifman M, Braunschweig U, Yuen RK, Alexandrova R, Bates A, Reid B, Nalpathamkalam T, Wang Z, Thiruvahindrapuram B, Gray P, Kakakios A, Peake J, Hogarth S, Manson D, Buncic R, Pereira SL, Herbrick JA, Blencowe BJ, Roifman CM, Scherer SW. Compound heterozygous mutations in the noncoding RNU4ATAC cause Roifman Syndrome by disrupting minor intron splicing. Nat Commun. 2015 Nov 2;6:8718.
Moro SS, Kelly KR, McKetton L, Gallie BL, Steeves JK. Evidence of multisensory plasticity: Asymmetrical medial geniculate body in people with one eye. Neuroimage Clin. 2015 Oct 9;9:513-8. eCollection 2015.
Ngo C, Smith D, Kraft SP. Reply. J AAPOS. 2015 Oct;19(5):490-1. No abstract available.
Shah M, Law G, Ahmed II. Glaucoma and cataract surgery: two roads merging into one. Curr Opin Ophthalmol. 2015 Nov 13. [Epub ahead of print]
Sharma A, Foster RS, Suh DW, Smith D, Kraft SP, Ali A. Idiopathic Enlargement of the Extraocular Muscles in Young Patients: A Case Series. Am J Ophthalmol. 2015 Nov 13. . [Epub ahead of print]
Sheybani A, Lenzhofer M, Hohensinn M, Reitsamer H, Ahmed II. Phacoemulsification combined with a new ab interno gel stent to treat open-angle glaucoma: Pilot study. J Cataract Refract Surg. 2015 Sep;41(9):1905-9. doi: 10.1016/j.jcrs.2015.01.019. Epub 2015 Oct 23.
Sheybani A, Dick B, Ahmed II. Early Clinical Results of a Novel Ab Interno Gel Stent for the Surgical Treatment of Open-angle Glaucoma. J Glaucoma. 2015 Nov 10. [Epub ahead of print]
Small KW, DeLuca AP, Whitmore SS, Rosenberg T, Silva-Garcia R, Udar N, Puech B, Garcia CA, Rice TA, Fishman GA, Héon E, Folk JC, Streb LM, Haas CM, Wiley LA, Scheetz TE, Fingert JH, Mullins RF, Tucker BA, Stone EM. North Carolina Macular Dystrophy Is Caused by Dysregulation of the Retinal Transcription Factor PRDM13. Ophthalmology. 2015 Oct 24. pii: S0161-6420(15)01153-7. [Epub ahead of print]
Szigiato AA, Trope GE, Jin Y, Buys YM. Trends in glaucoma surgical procedures in Ontario: 1992-2012. Can J Ophthalmol. 2015 Oct;50(5):338-44.
Tan W, Wright T, Rajendran D, Garcia-Sanchez Y, Finkelberg L, Kisilak M, Campbell M, Westall CA. Cone-Photoreceptor Density in Adolescents With Type 1 Diabetes. Invest Ophthalmol Vis Sci. 2015 Oct 1;56(11):6339-43.
Tayyari F, Khuu LA, Flanagan JG, Singer S, Brent MH, Hudson C. Retinal Blood Flow and Retinal Blood Oxygen Saturation in Mild to Moderate Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2015 Oct 1;56(11):6796-800.
Wagschal LD, Trope GE, Jinapriya D, Jin YP, Buys YM. Prospective Randomized Study Comparing Ex-PRESS to Trabeculectomy: 1-Year Results. J Glaucoma. 2015 Oct-Nov;24(8):624-9.
Yang Y, Trope GE, Buys YM, Badley EM, Gignac MA, Shen C, Jin YP. Glaucoma Severity and Participation in Diverse Social Roles: Does Visual Field Loss Matter? J Glaucoma. 2015 Nov 10. [Epub ahead of print]
