A Pandemic Innovation: Student-Led Model to Increase Accessibility to Educational and Mentorship Opportunities.

The Canadian Ophthalmology Student Interest Group (COSIG) is the first national medical student-led specialty interest group in Canada. COSIG has run several initiatives aimed at increasing students' opportunities for ophthalmology exposure and learning, including a resident-medical student mentorship program, an annual 6-week introductory course, amongst other events, and webinars.

Perspectives on a virtual student-led research conference in ophthalmology.

We share our experience of organizing a one-day virtual educational event, the first Canadian national student ophthalmology conference, in response to the need for ophthalmology career exploration. The conference included mentorship with residents, research presentations, keynote speakers, and more. Following the event, students expressed some improvement in accessing ophthalmology mentorship and research opportunities, along with a modest enhancement in their understanding of the specialty. We provide insights into the organizational framework and quality improvement results, aiming to assist students in adapting similar events for various specialities.

Nous partageons notre expérience portant sur l'organisation d'un événement éducatif virtuel d'une journée: la première conférence nationale canadienne des étudiants en ophtalmologie. Cette initiative a été prise en réponse au besoin d'exploration des carrières en ophtalmologie. La conférence comprenait des séances de mentorat avec des résidents, des présentations de recherche, des conférenciers d'honneur, entre autres. Suite à cet événement, les étudiants ont exprimé une amélioration dans l'accès au mentorat et aux opportunités de recherche en ophtalmologie, ainsi qu'une modeste amélioration de leur compréhension de la spécialité. Nous offrons un aperçu du cadre organisationnel et des résultats de l'amélioration de la qualité, dans le but d'aider d'autres étudiants à organiser des événements similaires pour diverses spécialités.

Development of a Cloud-Based Clinical Decision Support System for Ophthalmology Triage Using Decision Tree Artificial Intelligence.

Purpose: Clinical decision support systems (CDSS) are an emerging frontier in teleophthalmology, drawing on heuristic decision making to augment processes such as triage and referral. We describe the development and implementation of a novel cloud-based decision tree CDSS for on-call ophthalmology consults. The objective was to standardize the triage and referral process while providing a more accurate provisional diagnosis and urgency. Design: Prospective comparative cohort study. Subjects: On-call referrals to a Canadian community ophthalmology clinic. Methods: A web-based decision tree algorithm was developed using current guidelines and expert opinion. The algorithm collected tailored information on the patient's ophthalmic concern, and outputted a provisional diagnosis and urgency before sending an electronic referral to the on-call ophthalmology clinic. Data were described using descriptive statistics. Spearman-rho correlations and Cohen's kappa coefficient were used to characterize the observed relationships. Post hoc analysis was conducted using analysis of contingency tables and adjusted residuals. Main Outcome Measures: Diagnostic category, provisional diagnosis, and urgency for the referring provider, CDSS, and ophthalmologist. Results: Ninety-six referrals were processed. Referring providers included medical doctors (76.0%, n = 73), optometrists (20.8%, n = 20), and nurse practitioners (3.1%, n = 3). The CDSS (κ = 0.5898; 95% confidence interval [CI], 0.4868-0.6928; P < 0.0001) performed equally well with 66.7% agreement in determining category when compared with referring providers (κ = 0.5880; 95% CI, 0.4798-0.6961; P < 0.0001). The CDSS (agreement = 53.1%; κ = 0.4999; 95% CI, 0.4021-0.5978; P < 0.0001) performed better than referring providers (agreement = 43.8%; κ = 0.4191; 95% CI, 0.3194-0.5188; P < 0.0001) in determining a diagnosis. The CDSS (ρ = 0.5014; 95% CI, 0.3092-0.6935; P < 0.0001) also performed better than referring providers (ρ = 0.4035; 95% CI, 0.2406-0.5665; P < 0.0001) in determining urgency. The CDSS assigned a lower level of urgency in 22 cases (22.9%) compared with referring providers in 6 cases (6.3%). Conclusions: To our knowledge, this is the first cloud-based CDSS in ophthalmology designed to augment the triage and referral process. The CDSS achieves a more accurate diagnosis and urgency, standardizes information collection, and overcomes antiquated paper-based consults. Future directions include developing a random forest model or integrating convolutional neural network-based machine learning to refine the speed and accuracy of triage and referral processes, with emphasis on increasing sensitivity of the CDSS.

Navigating Personal and Professional Development Through Social Media in Ophthalmology.

Background: Although social media use among physicians skyrocketed during the COVID-19 pandemic, its role for networking, mentorship, and support among ophthalmologists remains unknown. The objective of this study was to elucidate how ophthalmologists use social media for navigating challenges related to personal and professional development. Methods: This was a cross-sectional survey study conducted during the height of the COVID-19 pandemic. A 40-item questionnaire investigating the usage of social media was developed and distributed to active social media users in ophthalmology including trainees and practitioners from November 2020 to December 2020 via social media channels. Quantitative responses were analyzed using descriptive and basic statistics, while a thematic analysis was conducted to examine the qualitative responses. Results: One hundred and forty-nine respondents (67% women) completed the survey, with 56% of participants between the ages of 25-35 years old. Women were more likely to report experiencing workplace discrimination (p < 0.005) and work-life imbalance (p < 0.05) compared to men, and social media was found to be useful in addressing those challenges in addition to parenting and mentorship (p < 0.005 and p < 0.001, respectively). Compared to their older counterparts, younger ophthalmologists (<45 years old) cited more challenges with practice management (p < 0.005) and turned to social media for corresponding guidance (p < 0.05). Compared to late career ophthalmologists, trainees were more likely to report difficulties with career development (p < 0.05), practice management (p < 0.0001), and financial planning (p < 0.05), and found social media beneficial for learning financial literacy (p < 0.05). A qualitative analysis of the free-response texts found both positive and negative viewpoints of social media use in ophthalmology. Conclusion: Social media is an invaluable tool for enhancing professional and personal growth for ophthalmologists, particularly for women, trainees, and younger surgeons through education and community-building. Future directions include exploring how social media can be used to improve mentorship, outreach, and training in ophthalmology.

Research productivity and impact of Canadian academic ophthalmologists: trends in H-index, gender, subspecialty, and faculty appointment.

OBJECTIVE: H-index has historically functioned as a metric of academic success for acquisition of research grants, awards, and faculty appointments. Our objective was to characterize the landscape of Canadian academic ophthalmology on the basis of research productivity and impact-as measured by H-index-with gender, subspecialty, and faculty appointment. DESIGN: Cross-sectional study based on data abstracted from publicly available databases. PARTICIPANTS: Academic ophthalmologists from all schools in Canada with an ophthalmology residency program. METHODS: Academic ophthalmologists and their faculty appointments were identified from university websites. gender was determined from available provincial College of Physicians and Surgeons or ophthalmology society databases. H-indices were collected from Scopus and Web of Science. Descriptive, univariate, and multivariate statistics were used to analyze the relationship of H-index with gender, faculty appointment, and subspecialty. RESULTS: We included data from 696 academic ophthalmologists. The mean H-indices for lecturers and assistant, associate, and full professors were 4.0 (±5.6), 5.6 (±5.0), 8.8 (±6.3), and 15 (±12), respectively. H-index had a significant positive correlation with faculty appointment (0.521, 95% confidence interval 0.469-0.579, p = 1.77e-41). The mean H-index was 6.7 (±8.2) for women and 8.1(±8.4) for men (p = 0.0635). Women comprised 27% of faculty positions, and men were more likely to have a higher faculty appointment than women (p = 0.0073). The top subspecialties for underrepresentation of women were surgical retina, medical retina, and oculoplastics. CONCLUSIONS: Faculty appointments are associated with research productivity, as measured by H-index. There are significant gender disparities in faculty appointments and subspecialty representation. Future directions include exploring other contributory factors to success in academic ophthalmology.

Gender and editorship in oculoplastics societal publications.

PURPOSE: The editorship of medical journals is a leadership role that can affect recognition and career advancement. We determine the gender representation of the editorial boards of oculoplastic surgery journals in comparison to the proportion of women in oculoplastics societies. METHODS: The gender composition of the American, European and Asia-Pacific societies of oculoplastic and reconstructive surgery and the editorial boards of their respective society journals were determined with online searches in March 2021. Statistical tests for the equality of proportions were performed. RESULTS: Excluding 44 individuals with missing gender data, the three combined oculoplastics societies comprised 1,230 distinct members, with 29% women. The editorial review boards of the three official society publications comprised 59 medical editors, 22% of which were women. There was no statistically significant difference in the proportion of women editors versus women OPRS members (p = .201) but the study is underpowered to detect a 7% difference. A sensitivity analysis with the missing data did not alter the conclusions. The mean h-index/m-quotient of the women editors was 20.50/0.87 and for the men 21.05/0.84, with no statistically significant difference (p = .903/0.851). CONCLUSION: Women are underrepresented on the editorial boards of oculoplastic journals. Possible methods to improve gender balance include multicriteria objective decision-making criteria for editor nominations, mentoring peer reviewers that are women, and appointing a journal editor for equity, diversity and inclusion.

The Incidence of Sympathetic Ophthalmia After Trauma: A Meta-analysis.

PURPOSE: Sympathetic ophthalmia (SO) is a rare, bilateral panuveitis that occurs following open globe injury (OGI), with a variable incidence reported in the literature. Our objective was to determine the incidence proportion and incidence rate of SO following OGI to help guide shared physician-patient decision making. DESIGN: Systematic review and meta-analysis. METHODS: A systematic literature search was performed using the MEDLINE, EMBASE, and Cochrane databases from inception to November 2020 for population-based studies on OGI and SO in adults and children. Two reviewers independently screened search results. Random-effects meta-analyses were performed to calculate the incidence proportion and incidence rate. The Risk Of Bias In Non-Randomized Studies - of Interventions (ROBINS-I) tool was used to assess the risk of bias. The study was registered on PROSPERO CRD42020198920. RESULTS: A total of 24 studies were utilized in the meta-analyses. After OGI, the estimated overall incidence proportion of SO was 0.19% (95% CI 0.14%-0.24%) and the incidence rate of SO was 33 per 100,000 person-years, (95% CI 19.61-56.64) with I2 of 13% and 72%, respectively. CONCLUSIONS: SO after OGI is rare. The estimated incidence proportion and incidence rate are useful when counselling patients regarding management options after OGI. Further studies are needed to examine the influence of age, the extent and location of trauma, timing of repair, and prophylactic eye removal on the incidence of SO.