Coding Corner: ICD10 Update on Myopic Degeneration

Yoshihiro Yonekawa Mass Eye & Ear / Boston Children's Hospital Eric Nudleman Shiley Eye Institute / UC San Diego Lejla Vajzovic Duke Eye Center / Duke University Yannek Liederman Illinois Eye and Ear Infirmary / University of Illinois Earlier this week, we had the opportunity to broadcast a live educational panel discussion at Alcon's headquarters. Eric, Lejla and Yoshi were the panelists, led by our fearless moderator Yannek. The four of us have worked together in various capacities for many years, so we were very excited when we heard of the lineup. Please note the disclosure that we were all functioning as consultants for Alcon, but the event, and this post, was/is for educational, and not promotional, purposes. Alcon's home base is located in Fort Worth, Texas. We all flew into the Dallas/Forth Worth International Airport, which is large American Airlines hub. Eric flew in from San Diego, Lejla from Durham, Yannek from Chicago, and Yoshi from Boston. IMG_5223 We were met in the baggage claim by a car service that brought us to the Fort Worth campus. Security was tight, and we presented our IDs from our cars at the gate when we entered the grounds. Upon arrival at the main building, we noted that many of the buildings had curved contours. IMG_5224 The meeting coordinator met us in the lobby, and guided us to the auditorium for the broadcast. Right outside of the auditorium, there was a campus model that showed that the buildings were built and arranged to represent an eye when looking from bird's-eye view. IMG_5226 We had lunch together with the organizers, who then took us on a nice campus tour. There were many eye-themed pieces of artwork throughout the campus. IMG_5228 The team introduced us to the new Alcon Experience Center where surgical courses and training sessions are held. There were many rooms, including a large wet lab with numerous benches. IMG_5230 IMG_5229 IMG_5241.jpg A new component of the training center was the virtual reality station. We were very impressed to say the least. As you can see in the photos below, there are sensors on top of the virtual reality pod that track the movement of your hands, so that you can interact with the virtual world also. IMG_5231 IMG_5232 This is the headpiece that is worn: IMG_5234.jpg Most of us experienced the eye anatomy module, where you are fully immersed in a 360-degree world, inside the eye. IMG_5235 The educational module takes you from the front to the back of the eye, with interactive segments where you can, for example, hold and move the layers of the cornea. You look up, and there is light entering from the pupil. You look sideways, and there is aqueous flowing through the trabecular meshwork. Then you dive into the posterior segment to play with the ciliary processes to learn about accommodation and interact with the retinal layers in your hands. IMG_5276.png IMG_5277 There was another module that teaches minimally invasive glaucoma surgery. We look forward to further developments of this futuristic teaching tool. We then returned to the auditorium. Miniature microphones were fixed onto our clothing, and it was time for the dress rehearsal. The main purpose of the dress rehearsal was to work with the production team to seamlessly coordinate the timing of starting various multimedia content. This was particularly important, as this program was a live broadcast with only one shot to get everything right. The producer sat right in front of us throughout the program, giving us important cues, especially to our moderator Dr. Liederman. image002 There were three large screens in front of us. One for the surgical videos, one that indicated what the camera was doing (for example, "wide angle" that showed all of us, versus "focus on speaker" where the camera was zoomed into the panelist who is speaking), and another that displayed the questions that were being asked by the viewers from home. After the dress rehearsal was the make up session. Yes, make up, as in powders, creams, and whatever else they needed to make us look presentable. That was an interesting experience. No photos here though! 2018.06.13_Broadcast 3.png The live broadcast started at 6:00PM central time. Viewers throughout the world logged in via a web link, and we had 90 fantastic minutes to discuss great cases. Yannek.png Broadcast Lejla 2 We covered various topics including diabetic tractional detachment, proliferative vitreoretinopathy, sutureless scleral fixation of IOLs, surgery in eyes with uveitis, heads up surgery, instrumentation, endoscopic surgery, and even pediatric surgery. Broadcast IOL Broadcast 1 Broadcast Endoscope Broadcast PVR We also fielded questions from retina gurus watching from home, including those from Steve Charles, Tim Murray, Jon Prenner, John Kitchens, and Al Franklin, and Nik London. Broadcast Eric 2018.06.13_Broadcast 1 Thanks to everyone for tuning in! For those of you who couldn't watch the webinar live, the recorded program can be accessed here: We certainly learned a lot from each other and had a wonderful time working with the large team from Alcon, the BMC/Avenue Live audiovisual crew, and the production team. IMG_5257.jpg