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EDITORIAL
Year : 2012  |  Volume : 19  |  Issue : 1  |  Page : 2-3  

International Ophthalmology and the Implications for Progress


Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Date of Web Publication20-Jan-2012

Correspondence Address:
Peter J McDonnell
Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
USA
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DOI: 10.4103/0974-9233.92109

PMID: 22346108

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How to cite this article:
McDonnell PJ. International Ophthalmology and the Implications for Progress. Middle East Afr J Ophthalmol 2012;19:2-3

How to cite this URL:
McDonnell PJ. International Ophthalmology and the Implications for Progress. Middle East Afr J Ophthalmol [serial online] 2012 [cited 2014 Oct 2];19:2-3. Available from: http://www.meajo.org/text.asp?2012/19/1/2/92109

Recently, I attended a large national ophthalmology meeting in South America. At the meeting, I learned that a friend and ophthalmologist colleague of mine in this South American country had obtained promising results with a new corneal surgical procedure for the management of keratoconus. The procedure combines a laser treatment (pioneered by a colleague in the United States) with a corneal implant device (pioneered by an American and a European) and a cross-linking technology (developed by a European).

Certainly, we are now in an exciting time in ophthalmology, with more technologies and new therapies than ever to allow us to help our patients. But it is also clear that the rapid and accelerating pace of discovery in ophthalmology relates at least in part to the unprecedented dissemination of knowledge across national boundaries. This dissemination creates an opportunity for ophthalmologists in different countries on various continents to add their contributions, to use new technologies for different purposes based upon the local needs of their own populations, or to improve upon discoveries made on the other side of the world.

Our ability to learn so soon of advances made by our ophthalmologist colleagues in other parts of the world is a relatively recent phenomenon. Throughout most of mankind's history, isolated centers of learning and medical progress existed, and only a relatively few privileged physicians had the opportunity to travel and learn in other countries. At the time of the creation of the Wilmer Institute, in 1925, our founder, Dr. William Holland Wilmer, took a transatlantic cruise ship to Europe and spent six months visiting the major ophthalmic hospitals there. His goal was to learn all he could from what was then widely considered to be the leading centers of ophthalmic medicine in the world, and to use that information to help design his institute in my country. The first World Ophthalmology Congress was not held until 1857, and only 100 ophthalmologists from 24 countries attended.

Thankfully, today it is much easier to share information developed in one country with our ophthalmologist colleagues around the world. This World Ophthalmology Congress in Abu Dhabi, like the previous three meetings in Sao Paulo Brazil, Hong Kong China and Berlin Germany, represent a fantastic opportunity for us to learn from each other. Similarly, the internet has largely eliminated the excessive costs and other constraints on sharing new published information, surgical videos and other instructional materials. Eighty-five years ago, it was unusual for an ophthalmologist to travel to another country to study, but this year we will welcome over 100 students, scientists and visitors to the Wilmer Institute from many countries (Brazil, Canada, China, Germany, India, Iran, Japan, Mexico, Niger, Pakistan, Saudi Arabia, Turkey, Qatar, Venezuela and others). Similarly, faculty from my department are located in countries around the world (China, India, Tanzania, Saudi Arabia and others). We speak different languages, have unique customs and political systems, and our healthcare systems vary (government run, private, mixed), but we ophthalmologists are very much alike and face mostly the same challenges in the care of our patients.

The ability to work closely together across national boundaries is particularly exciting. Because of the different prevalences and spectrum of disease around the world, it is possible for us to accelerate the pace of scientific discovery when ophthalmologists from different countries lend their various expertise to study a common problem. For instance, the application of public health techniques and antibiotic therapy to the study of trachoma in regions of Africa is resulting in measurable advances to reduce and eventually eliminate that disease. Open angle glaucoma is easily studied in European-derived populations, while many of the most important studies of narrow angle glaucoma are being performed in Asia. Diabetic retinopathy has emerged as a worldwide epidemic, and ophthalmologists in many if not most countries are challenged with managing this disease in the population at a time when many governments are challenged to fund care for costly chronic illnesses like diabetes.

Keratoconus represents a particularly interesting condition for cornea specialists around the world. This non-inflammatory, progressive ectasia occurs in populations around the world, but the underlying pathogenesis remains a mystery. But keratoconus varies in important ways around the globe; in the United States, it largely impacts individuals in the third decade of life, while in Saudi Arabia it is a much more aggressive disease, progressing more rapidly and typically reaching the advanced stages about one decade earlier. Whether this observation is the result of environmental or genetic factors remains undetermined, but if we can discover the answer we will have an important clue to the underlying "cause" of keratoconus and be on the way to identifying a cure.

International efforts in ophthalmology, as exemplified by the World Ophthalmology Congress, the International Council of Ophthalmology and by institutions like my own are a relatively recent but extremely positive development in medicine. Combining our efforts to improve the education of young ophthalmologists, to improve the care of our patients and to accelerate scientific discovery, will benefit us all.



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