Accreditation of our undergraduate and postgraduate medical education is a process that reinforces and enhances the quality of our medical education programs as well as assures the medical community and the public of the quality of education and its relevance to medical practice. It is one of the foundations of the quality of our healthcare in Canada. The RCPSC review of the DOVS post-graduate training program took place the last week of November and the first week of December. After meeting with our Department’s residents, faculty and admin staff and reviewing all documentation, the reviewers’ recommendations were full accreditation of our program with the regular follow-up in 8 years' time. This is the best possible result we could have obtained. First and foremost, a big congratulations goes to our Residency Program Director, John Lloyd, on such a stellar outcome. This is John’s second review during his tenure and the outcomes have been the best possible for both reviews. John, thank you for your leadership and dedication.
Congratulations also to the Residency Program Committee who oversee our training program. There is a lot of heart and soul that goes into this oversight. A big thank you to all our teachers without whom, this training program would not exist. An enormous thank you to Sandra Gauci, our Program Assistant. Sandra is indispensable to our program; our schedules, our communications, our examinations, and she serves as a compassionate listener for both our trainees and teachers! Of course, I also want to say thank you to our residents. Education is a two-way process and our residents not only facilitate our training program but often teach the teachers many things along the way.
In recognizing the importance of a review process to the integrity and quality of a teaching program, DOVS will be instituting a regular review of our fellowship programs as well which will begin in the new year. Please see our Fellowship Director, Nav Nijawan’s message in this newsletter.
I wish you and your loved ones the very best for the holidays. Let's look forward to a better 2021!
Sherif El-Defrawy, MD, PhD, FRCS(C)
Nanji Family Chair in Ophthalmology & Vision Sciences
Chair & Professor, Department of Ophthalmology & Vision Sciences
University of Toronto
U of T Researchers Identified Retinal Spheroids and Axon Pathology in Amyotrophic Lateral Sclerosis
With the support from the Henry S. Farrugia Ophthalmic Resesarch Fund and the Dan Sullivan Research Fund, Dr. Yeni Yucel, Dr. Neeru Gupta, along with Dr. Lorne Zinman, a neurologist at Sunnybrook Hospital and Associate Professor with the Department Medicine and students Kieran Sharma and Maryam Amin Mohammed Amin, identified Retinal Spheroids and Axon Pathology in Amyotrophic lateral sclerosis or ALS. They shared their discovery that individuals with ALS show tell-tale changes in the layers of their retinas — the membrane that lines the inner surface of the back of the eyeball in the most recent issue of Investigative Ophthalmology & Visual Science.
Health Canada has approved Luxturna (voretigene neparvovec), the first gene replacement therapy to receive regulatory approval in Canada. This therapy is indicated for the treatment of adult and pediatric patients with retinitis pigmentosa or Leber’s congenital amaurosis caused by confirmed biallelic RPE65 mutations and who have sufficient viable retinal cells. This is a onetime only treatment that can slow the progression of vision loss and may restore some vision. The therapy is not a cure but can improve vision and may slow the progression of vision loss.
Two centers in Canada will be providing this gene replacement therapy; Toronto and Montreal. The Hospital for Sick Children and Sunnybrook Health Sciences Center will be the sites in Toronto. Patients will be co-managed by the IRD specialists Elise Héon, Ajoy Vincent and Radha Kohly and the surgeons administering the treatment Peter Kertes and Rajeev Muni.
What we once thought was only science fiction is now a reality.
Congratulations to Drs. Heon, Vincent, Kertes, Muni, and Kohly! A special call out to Elise Heon for leading this amazing work!
Dr. Allan Slomovic receives Reviewer Recognition by Continuing Professional Development, Temerty Faculty of Medicine
Dr. Allan Slomovic (DOVS Vice Chair, Education & CPD Director), has received reviewer recognition by Continuing Professional Development, Temerty Faculty of Medicine in November 2020.
"Dr. Slomovic has been substantially involved in promoting high quality continuing professional development in the Department of Ophthalmology since his appointment as CPD Director. Also, he has evaluated a number of programs sponsored by the Department of Ophthalmology in the Temerty Faculty of Medicine through CPD’s current online review system that was launched at the end of 2019. Dr. Slomovic is highly regarded for insight, discerning comments, and timeliness in providing feedback."
- Dr. Suzan Schneeweiss, Associate Dean, Continuing Professional Development
Congratulations to Dr. Slomovic on his exceptional leadership and efforts in Continuing Professonal Development.
Fellowship Development Event
On October 15th, 2020, the first fellowship development event of the 2020-2021 academic year took place.
The event was well-attended by fellows, preceptors and DOVS department members who gathered together virtually, in light of the pandemic.
Fellowship Director, Dr. Navdeep Nijhawan and DOVS Chair Dr. Sherif El-Defrawy, welcomed guests and introductions were made by Chief Resident Parnian Arjmand.
Fellows participated in an enjoyable team-building exercise, telling us a bit about themselves and giving their thoughts on some of the weird and interesting things they’ve noticed about life in Toronto. Milk in bags, weak coffee, huge food portions and automatic apologies were just some of the quirks identified by the trainees.
Attendees were then treated to very informative and enjoyable talks by Dr. Ken Eng and Dr. Alan Berger. Dr. Eng gave a presentation on how to have a successful fellowship year: work-life balance; and Dr. Berger’s presentation entitled Fellowship pearls, addressed professionalism and building rapport with patients.
Thank you to all our speakers and attendees.
by: Dr. Navdeep Nijhawan, Fellowship Director
The University of Toronto Fellowship Training Program is the largest and most diverse one in the country offering 20 fellowships in tertiary care sub-specialty areas. Trainees from all corners of the globe pursue further education in our department because of the international reputation of our preceptors. These fellowships have largely operated independently with the majority of oversight coming from the fellowship committee.
Given the changing dynamics of how trainees and preceptors interact the fellowship committee has taken the initiative to carry out a systematic internal review of all of the DOVS fellowships.
With that in mind, all fellowship directors have been invited to fill out a survey asking pertinent questions regarding the organization and day to day workings of their fellowships. This will be followed by an interview in the new year with a fellowship review committee. The fellowship review committee will consist of members of the fellowship committee, Dr. Sherif El-Defrawy, Dr. Radha Kohly and second year fellows.
The objective of this exercise is to document the strengths of each fellowship, ensure the well being of preceptors and fellows, confirm that educational milestones are met and provide feedback on ways the fellowship can be improved. Moving forward we anticipate reviews will take place every three years.
We hope that the entire department will support this initiative so we can ensure that our fellowships remain current, cutting edge and world class.
If you have any questions please do not hesitate to contact Julie Thomson, Dr. Sherif El-Defrawy or myself.
Chief Residents 2020-2021
We are pleased to announce that Eli Kisilevsky and Jason Kwok are elected as Chief Residents for the
coming year. Congratulations to Eli and Jason, we look forward to working with you in 2021.
Dr. Myrna Lichter: Our Care of Vulnerable Populations
I want to thank Dr. El-Defrawy for the opportunity to engage our DOVS community in the Vulnerable Population current and future activities.
This is a project ongoing since 2013, and we have published work on vision testing addressing the needs of some patients living “rough”. Eye clinics have been held in many locations, including:
homeless adult shelters
Women’s shelters, including VAW shelters (Violence Against Women)
Out of the Cold sites - This project was cut short because of COVID, but hopefully will resume next fall.
We have not been idle during COVID, and Aman Sayal, one of my second year medical students and an MPH, has published two papers:
1. Attitudes of Canadian Ophthalmology Residents and Pre-clerkship Medical Students at an Ontario Medical School towards Homeless Individuals: A Cross Sectional Study.
Aman P. Sayal, Marko M. Popovic, Majd Mustafa, Stephen W. Hwang, Myrna Lichter. Ophthalmic Epidemiology Nov 2020
2. Visual Impairment and the Prevalence of Ocular Pathology in Homeless Children and Adults Globally: A systematic review.
Aman P. Sayal, Jacqueline Slomovic, Nishaant (Shaan) Bhambra, Marko M. Popovic, Myrna Lichter
Canadian Journal of Ophthalmology, Oct 21, 2020
Our residents are a most hard working and compassionate group, although likely with limited exposure to vulnerable populations. Further interaction with homeless patients outside of an emergency situation may bring greater awareness of the plight of the homeless. I have suggested that the residents may join me in a homeless shelter visit once COVID is over. This may stimulate a development of positive perspective for them, as we have found that many homeless patients in their own environment express much gratitude and appreciation.
During COVID, we launched an eye examinations project in Moss Park (tent city) spearheaded by a second year medical student. The project proved more difficult than anticipated. We had to transport and set up tents, equipment and a suitcase full of PPE. Then we had to screen each potential patient for COVID, excluding several who did not meet the criteria. The examinations were held in two tents, adjacent to the Sherbourne Health Bus, who provide medical and social support to neighbourhood residents. Because of delays in REB, we could not begin the project until September when the days were already becoming shorter.
Our future plans include submitting our paper on, the challenges and rewards of cataract surgery in homeless patients, with the recommendations and suggested protocols. I am fortunate to have a generous grant, allowing us to subsidize patients who do not have OHIP. Thank you to Dr. Clara Chan who has been assisting my medical student, Verina Hanna, with the guidelines.
We are embarking on two First Nations initiatives:
A study on the Indigenous homeless in shelters and drop ins in Toronto and Hamilton. This has been recommended for approval by the REB. The start of this project is dependent upon when we can re-enter shelters.
The second project spearheaded by Helen Dimaras and masters’ student, Justin Kritzinger, will investigate vision testing for urban Indigenous children and youth.
We will continue our Out of the Cold clinics which reopen at the end of 2021. We will also continue to hold general eye clinics in between research projects. With the purchase of a portable fundus camera we are now able to incorporate fundus photography in our work and this is in partnership with the Ontario Telemedicine Network - Teleophthamology Service.
Our group will be part of a COS workshop this year, focussing on migrant/homeless and Indigenous groups. It should prove to be an excellent learning opportunity, especially around Indigenous eye health. The focus will be on educating ourselves to better service this community.
I have the pleasure of mentoring a young Indigenous medical student who has expressed an interest in ophthalmology as a career and is assisting with some of our projects. I am aware some residents are already reaching out to her. If anyone wishes to offer her research/observerships, it would be really appreciated. She is a very bright young woman with a potential to be the first indigenous ophthalmologist in Canada. I am trying very hard not to put too much pressure on her.
I know that many of you would love to help, and if you are interested in any of these projects, or any other local projects, please be in touch with me. Thank you all.
U of T’s Temerty Faculty of Medicine launches new Temerty Centre for AI Research and Education in Medicine
Group photo of the T-CAIREM team Top row: Anna Goldenberg, Muhammad Mamdani, Vinyas Harish • Centre row: Mjaye Mazwi, Laura Rosella, Alistair Johnson • Bottom row: Sean Hill, Felipe Morgado, Zoryana Salo.
Professor Muhammad Mamdani has been appointed the Director of T-CAIREM for a five-year term. “Toronto is uniquely positioned to lead globally in artificial intelligence in healthcare,” says Mamdani. “Our expertise in medicine and allied health sciences, computer science, statistics, mathematics, and engineering is among the best in the world. The goal of T-CAIREM is to create a forum that brings together this multidisciplinary expertise so members can share their experiences and collaborate through common interests and a cutting-edge data and compute environment that will transform healthcare in innovative and exciting ways.”
T-CAIREM’s work will focus on three pillars: Research, Education, and Data Infrastructure. The centre brings together some of North America’s brightest researchers, including:
• Research co-leads: Professor Anna Goldenberg (Computer Science/SickKids) and Professor Mjaye Mazwi (Pediatrics/SickKids)
• Education lead: Professor Laura Rosella (DLSPH) and learner co-leads Vinyas Harish (MD/PhD student) and Felipe Morgado (MD/PhD student)
• Infrastructure co-leads: Professor Sean Hill (Psychiatry/CAMH) and Dr. Alistair Johnson (Computer Science/SickKids).
The T-CAIREM team is launching several initiatives this month for students in undergraduate, graduate and professional programs. The Trainee Rounds, aimed at graduate students across faculties as well as MD students, will give selected students the opportunity to showcase their work to leaders in the AI and healthcare research communities. In addition, a Summer Research Studentship Program will pair undergraduate and medical students with a U of T faculty supervisor to explore AI in medicine.
Congratulations to Dr. Joseph Weinstock on his retirement. Dr. Weinstock has been a distinguished and most important part of the Department of Ophthalmology & Vision Sciences at the University of Toronto for 45 years. As an excellent teacher he has contributed significantly to our residents’ education for which he will be long remembered. Equally important is his longstanding delivery of patient care from which our trainees have benefitted enormously.
Dr. Weinstock was awarded the Eye Physicians and Surgeons of Ontario Lifetime Achievement Award in 2018 for his distinguished career of service to the specialty of ophthalmology.
The Department of Ophthalmology & Vision Sciences wholeheartedly wish him health and happiness in his retirement.
Honours, Awards & Grants
Dr. Molly Shoichet receives Gerhard Herzberg Canada Gold Medal for Science and Engineering
Photo by Sylvie Li/NSERC/CRSNG
Professor Molly Shoichet of the Faculty of Applied Science & Engineering, a world-leading researcher in tissue engineering, has received the Gerhard Herzberg Canada Gold Medal for Science and Engineering – Canada’s most prestigious award for science and engineering research.
Dr. Yeni Yucel receives the People's Choice Award for Principal Investigator
Congratulations to Dr. Yeni Yucel, who receives the People's Choice Award for Principal Investigator at the 10th Annual iBest (Institute of Biomedical Engineering, Science & Technology) Symposium on November 20, 2020.
Dr. Raymond Stein receives Statemanship Award by the International Joint Commission on Allied Health Personnel in Ophthalmology
The International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO), St Paul, Minnesota, awarded Dr Raymond Stein the Statesmanship Award at the annual meeting on November 14, 2020. This is awarded to one individual each year as voted on by Past Presidents and the Board of Directors in recognition of leadership and commitment to international education in Ophthalmology and allied ophthalmic personnel.
Tina Felfeli (PGY-2) recognized among Ophthalmology Times® Top 5 of Research Scholar Honoree Program
Ophthalmology Times® recently announced the top five winners of their annual Research Scholar Honoree Program. This program provides a unique opportunity for fellows/residents to share notable research and challenging cases with their peers and mentors.
Tina Felfeli, M.D., of the University of Toronto was recognized among the top five honorees of the program, earning 4th place with her presented research, “Significance of Early Outer Retinal Findings on En Face and Cross-Sectional Optical Coherence Tomography Imaging of Eyes With Macula-Off Rhegmatogenous Retinal Detachment”. Felfeli’s research will be published on ophthalmologytimes.com and featured in print through an upcoming edition of Ophthalmology Times®.
Appointed to the Royal College of Physicians and Surgeons of Canada Strategic Advisory Group, November 2020
Eye and Brain expert on Human Physiology Panel of European Space Agency Roadmap (since October 2020).
Invited Lectures and Visiting Professorships
Felfeli T, Canizares M, Jin YP, Buys YM: Comparison of practice patterns amongst ophthalmologists and other practitioners. American Academy of Ophthalmology 2020 Annual Meeting, November 13-15, 2020, Las Vegas, Nevada. (Meeting Presentation)
Buys YM: Navigating the road to retirement. Canadian Ophthalmological Society Wellness Webinar Series. November 17, 2020, Ottawa, Ontario. (Organizer and Panelist)
Buys YM: Is your patient's position affecting their glaucoma? Dr Steele Perkins Lecture. Insight on eyesight in the Bahamas. Research Day 2020. November 26, 2020, Bahamas. (International Invited Guest Speaker)
Adaptations to Monocularity and Low Vision: Some Practical Lessons from Science [Invited Address, One Retinoblastoma World Virtual Conference, September, 2020].
Seeing With One Eye: A brief summary of adaptation to the loss of one eye. Monograph for the Canadian Retinoblastoma Society, August, 2020 (Development of Education Materials).
Giant Cell Arteritis: Diagnostic Testing and Risk Calculator. Presentation for the International Joint Commission on Allied Health Personnel in Ophthalmology Annual Meeting, (moved online Nov 7, 2020 for originally planned Las Vegas, NV meeting in conjunction with AAO. https://www.youtube.com/watch?v=QHIVM-kS4Kc
Mexican Retina Association Annual Meeting, October 2020 (Invited International Speaker)
Macular Hole Hydrodissection
Combined Vitrectomy and Scleral buckling surgery
Preoperative Pneumatic Retinopexy as an Adjunct for Pars Plana Vitrectomy
Scleral Needling for sclerotomy closure
Dealing with unexpected inferior pathology during vitrectomy for RRD, University of Calgary, Grand Rounds. October 21, 2020 (Invited Lecture)
Dislocated Iris prosthesis and IOL repair, Retina Case Conference Canada. November 21, 2020 (Best Presentation)
University of Alberta, Department of Ophthalmology Clinical Rounds. Presenter: K Mireskandari. October 2020 (Visiting Professor)
Ophthalmic Findings and Controversies in THI-CM. Canadian Symposium on Advanced Practices in Child Maltreatment. Virtual Meeting, Calgary, Alberta, Canada. Presenter: K Mireskandari. December 2020 (Invited Speaker)
Not as superficial as you think: Corneal diagnoses not to miss. Presented at iRounds, a session for Danish Ophthalmologists. Virtual via Copenhagen, Denmark. November 11, 2020. (Invited Speaker)
Pearl Jam: “Virtual Tour”. American Academy of Ophthalmology Annual Meeting. Virtual. November 13-15, 2020. (Invited Speaker)
Online Rounds Schedule and Events
Date: December 17, 2020 Cornea Rounds
Topic: The Recurrent Iris Cyst and Post-Traumatic Anterior Segment Reconstruction
Speaker: Dr. Sara Al Shaker
Date: December 18, 2020 Grand Rounds
Topic: Resident Education: Past, Present & Future Speaker: Dr. John Lloyd
Date: January 8, 2021
NO Grand Rounds / VPP Rounds
Date: January 15, 2021 VPP Rounds
Speaker: Dr. Shawn Lin
Date: January 22, 2021 Grand Rounds
Speaker: Dr. Nupura Bakshi
Date: January 29, 2021 Grand Rounds
Speaker: Dr. Wendy Hatch
Date: February 5, 2021 VPP Rounds
Speaker: Dr. Stephanie Watson
Date: February 12, 2021 Grand Rounds
Speaker: Dr. Joshua Teichman
Date: February 19, 2021 Grand Rounds
Speaker: Dr. Kamiar Mireskandari
Date: February 26, 2021 Grand Rounds
Speaker: Dr. David Wong
Date: March 5, 2021 Grand Rounds
Speaker: Dr. Hatem Krema
Date: March 12, 2021 Grand Rounds
Topic: Global Health
Speaker: Dr. Helen DImaras
Deng SX, Kruse F, Gomes JAP, Chan CC, Daya S, Dana R, Figueiredo FC, Kinoshita S, Rama P, Sangwan V, Slomovic AR, Tan D; and the International Limbal Stem Cell Deficiency Working Group. Global Consensus on the Management of Limbal Stem Cell Deficiency. Cornea. 2020 Oct;39(10):1291-1302. doi: 10.1097/ICO.0000000000002358.PMID: 32639314
Pereira A, Somani S, Tam ES, Chiu H, Maini R. Comparison of surgically induced astigmatism and corneal morphological features between femtosecond laser and manual clear corneal incisions. Journal of Refractive Surgery 2020;35(12):796-802.
Pereira A, Zhang A, Maralani P, Sundaram ANE. Acute orbital myositis preceding vesicular rash eruption in the setting of herpes zoster ophthalmicus. Canadian Journal of Ophthalmology 2020;55(3):107-109.
U Elbaz, H Strungaru, K Mireskandari, D Stephens, A Ali. Long Term Visual Outcomes and Clinical Course of Patients With Peters Anomaly. Cornea. 2020 Nov 4. doi: 10.1097/ICO.0000000000002577. Online ahead of print. PMID: 33156080.
Yuen D, Kaba Q, Tam E, Somani S. Reply. Ophthalmol Glaucoma. 2020 Nov 7:S2589-4196(20)30269-6. doi: 10.1016/j.ogla.2020.10.006. Online ahead of print.PMID: 33172769
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