Patients' Day at Madrid Ocular Surface Symposium (Apr 1)

[Rebecca Petris]

The eighth Congress of the International Society of Dakryology and Dry Eye (held April 1-3 in Madrid) is holding a one-day course for dry eye patients on Friday April 1st, covering the different causes of dry eye and the treatments available. Scientific presentations will be taking place on the 2nd/3rd.

More information here. (Look for the red arrow and click on the graphic.)

Cindy and I will both be there, and are very much looking forward to the event and meeting other patients. If you're considering going, feel free to drop us a line.

[dianat]

I had a feeling you ladies were planning to attend. If I though I'd walk away with something useful with which to help myself, I'd go. Since I likely won't go (lest I drag my three-year-old with me) I'd love to know what is discussed. What do you expect to hear? Thanks to this site (or at least its counterpart) I'm interested in serum drops and nerve growth hormone.

[Rebecca Petris]

I had a feeling you ladies were planning to attend. If I though I'd walk away with something useful with which to help myself, I'd go. Since I likely won't go (lest I drag my three-year-old with me) I'd love to know what is discussed. What do you expect to hear? Thanks to this site (or at least its counterpart) I'm interested in serum drops and nerve growth hormone.

I should have mentioned: We will of course be reporting back EVERYTHING of interest that we can learn from the presentations and from doctors we meet there.

If you go to the link here and click on the icon below the arrow, then click on "Oral and Video Presentations", you'll see the topics for the scientific presentations. To tell the truth I've been going flat out the last few months and haven't gone to any special trouble to learn what's going on on the patients day but this is a good reminder that I should! And come to think of it I'll post the scientific presentations in this thread.

I'm dragging my two-and-a-half year old with me so if you decided to go they'd each have company. Not that I'm recommending going that far. Long way to go for a one-day session.

I just got a tip yesterday about a terrific recent study published (German, I think?) about autologous serum. I will post it when I get the reference. Something to keep in mind - even though the clinical study we were trying to arrange for post LASIK patients did not work out because of expensive FDA requirements, any doctor can prepare and prescribe autologous serum without being subject to those requirements, so it basically boils down to finding a doctor willing to do it.

[Rebecca Petris]

FRIDAY 1st APRIL

09:30 Introduction of speakers and presentation of schedule
09:40 Ducasse A, Laboriusse M, Delattre JF. (France).
Arterial vascularisation of the lacrimal gland.
09:47 Sánchez Tomero MC. (Spain).
Special study of mucin, lysozime, and fibronectin.
09:54 Paulsen F, Fabian A, Ehrich D, Sel S, Recker K, Kindler C, Schaudig U. (Germany).
Mucins and TFF-peptides are a major components of dacryoliths.
10:01 Paulsen F, Jansen A, Woon CW, Mergler S, Podolsky D, Barker N, Recker K, Kindler C, Pleyer U, Varoga D. (Germany).
TFF-peptides accelerate healing of wounded cornea.
10:08 Dicussion
10:15 Holly FJ. (USA).
Tear film formation, stability, and rupture. Presentation with video.
10:22 Dogru M, MD, Goto E, Kojima T, Ishida R, Kaido M, Megumi S, Tsubota K. (Japan).
Kinetic analyses of the ocular surface and tear functions.
10:29 Németh J, Hagyo K, Erdélyi B, Csakany B. (Hungary).
Effects of tear film build-up and break-up on the total refraction of the eye.
10:36 Erdélyi B, Kraak R, Guthoff R, Németh J. (Hungary).
Confocal microscopy of the corneal epithelium in dry eye patients.
10:43 Discussion
11:00 Coffee break and Visit of Posters
11:20 Nepp J, Linzmayer L, Schild G, Schauersberger J, Sibylla RM, Wedrich A. (Austria).
Psychic influence in dry eye symptoms.
11:27 Fernández-Velázquez F. (Spain).
The McMonnies Questionnaire is more helpful than the OSDI Test as part of the prefitting protocol in irregular corneas.
11:34 Rodríguez A. (Spain).
Study to evaluate goblet cell populations in pre and post laser assisted in situ keratomileusis (LASIK) patients.
11:41 Rodríguez Amador S. (Venezuela).
Dry eye post lasik.
11:48 Gilbard PG, Miljanovich B, Trivedi KA, Dana R, Buring J, Schaumberg DA. (USA).
Dietary omega-3 fatty acid intake and risk of clinically diagnosed dry eye syndrome in women.
11:55 Discussion
12:15 Inauguration
12:30 Tiffany JM, Lachowicz SS. (UK).
Evaporation rates from cornea and sclera.
12:45 Van Setten, G. (Sweden).
The contact lens in the medium of tears: effects and interaction with cytokines in eyes with tear deficiency. A model.
13:00 Holly FJ. (USA).
The dry eye.
13:20 Official picture to be taken on the façade of the Congress Palace
13:30 Lunch in the Congress Palace and Visit of Posters
15:30 Raus P. (Belgium).
Transplantation of labial salivary glands to conjunctiva in cases of severe dry eyes.
15:37 Sieg P, Hakim SG, Jacobsen HC. (Germany).
Microsurgical submandibular gland transfer in the treatment of severe keratoconjunctivitis sicca. A 10 years experience.
15:44 Soriano HM. (Argentina).
Transplant of accessory salivary glands for the treatment of severe dry eye
15:51 García-Delpech S, De Andrés J, Udaondo P, Serrano M, Díaz-Llopis M, Salom D, García Pous M, Amselem L, Pérez A, Hernández M. (Spain).
Bilateral programmable infusion pumps implanted in CREST syndrome
15:58 Murube J, Sales M, J , Arnalich F. (Spain).
Punctum patch with autologous lid skin
16:05 Discussion
16:12 Ugurbas SH, Alpay A, Kargi, S, Özcan, E, Güney, T. (Turkey).
Effect of posterior approach ptosis surgery on tear production
16:19 Arrieta B, Ducasse C, Salduna D, Picco A. (Argentina).
Ocular manifestations of cutaneous rosacea.
16:26 Ducasse A, Merol JC, Bekoin F. (France).
Acute dacryocystitis: Epidemiology, evolution and treatment.
16:33 Rahimi A, Tabatabai Z, Rajabi MT, Sadeghi A, Kasai A. (Iran).
Bloody discharge due to iatrogenic metallic foreing body in the lacrimal sac.
16:40 Discussion
17:00 Departure of buses for city tour
20:00 Buffet



SATURDAY 2nd APRIL

09:30 Lemp MA (USA).
A new nanoliter tear osmometer for the clinical diagnosis of Dry Eye.
09:37 Shalaby O (Egypt).
Management of different types of corneal perforations.
09:44 Rivas L, López-García S, Corredera E. (Spain)
Transplantation of amniotic membrane combines with limbal allograft in patients with aniridia.
09:51 Bonci P, Bonci P, Lia A (Italy).
Suspension made with amniotic membranE: Clinical trial.
09:58 Spinelli D,Gambaro S, Spinelli A (Italy).
Amniotic Membrane Transplantation in Ocular Surface Reconstruction.
10:05 Hincapié J, Biancciotto C, Méndez MC, Saornil MA, Blanco G. (Spain).
Amniotic membrane for ocular surface reconstruction after surgical escision of conjunctival tumors.
10:12 Funk M, Nepp J, Mitterbauer M, Greinix H, Wedrich A. (Austria).
Keratoconjunctivitis sicca after allogeneic haematopietic stem cell transplantation.
10:19 Discussion
10:30 Tseng SCG. (USA).
Limbal stem cell transplantation.
11:05 Coffee break and Visit of Posters
11:20 Goffi V. (Italy).
Lacrimal drainage system endoscopy: our technique and results.
11:27 Spinelli, D, Gambaro S (Itaky).
Update on lacrimal endoscopy.
11:34 Hincapié J, Bianciotto C, Méndez MC, Blanco G. (Spain).
Surgical management of canaliculitis.
11:41 Rahimi A,Linardos B, Beigi B. (Iran).
The efficacy of mini monoka silicone tube for treatment of punctal phimosis and associated canalicular stenosis.
11:48 Tabatabai Z, Sadeghi A, Sarvarian A, Kasaei A, Rahimi A. (Iran).
Repair of canalicular laceration with silicone intubation.
11:55 Shalaby O. (Egypt).
Evaluation of the recanalization technique in different types of canalicular obstructions.
12:02 Cervenka S. (Czech Republic).
Bicanalicular intubation for congenital nasolacrimal duct obstruction.
12:09 Rahimi A, Tabatabai Z, Khatami M, Kasai A, Sadeghi A. (Iran).
Results of silicone intubations in acquired nasolacrimal duct obstruction.
12:16 Discussion
12:30 Dogru M, Stern M, Smith J,Foulks G, Bron A, Pflugfelder P, Lemp M, Tsubota K, and the 2004 Dry Eye Workshop. (DEWS) Committee Member. (Japan, USA, UK, et al.).
Changing perspectives in the definition and diagnosis of dry eye. The tentative recommendation of the 2004 Dry Eye WorkShop (DEWS) meeting.
12:45 Lemp MA. (USA).
What causes ocular surface damage in dry eye?
13:00 Lunch and Visit of Posters
15:00 Rahimi A, Kasai A, Sadeghi A, Ghahreman M, Tabatabai Z. (Iran).
Mechanical endonasal DCR in nasolacrimal duct obstruction. Results.
15:07 Blanco Mateos G, Bianciotto C, Hincapié J, Santos J. (Spain).
Endonasal endoscopicv dacryocystorhinostomy (DCR) with mitomycin C and endonasal tube
15:14 Javate R. (Philippines).
Efficacy of endoscopic radiofrequency-assisted dacryoplasty versus standard external DCR among patients with complete primary acquired nasolacrimal duct obstruction.
15:21 Gómez Fernández T, Zaragoza Casares P, Zato Gómez de Liaño MA. (Spain).
Endonasal DCR.
15:28 Sellares Fabres MT, Maeso Riera J. (Spain).
Endolaser transcanalicular DCR: indications and results
15:35 Sellares Fabres MT, Maeso Riera J. (Spain).
Endolaser transcanalicular DCR after previous techniques failure: initial results.
15:42 Maeso Riera J, Sellares Fabrés MT. (Spain).
Endolaser transcanalicular DCR: why can it fail and how to avoid it.
15:49 Wannerbroucq S. (Spain).
DRC Endoscope Assisted According to JM Piffaretti.
15:56 Vilaplana i Blanch A, Ciprés MC, Blasco PL, Fernández A, Díaz J, Dod CW, Moreno MC, Alemany A. (Spain).
Reintervention of DCR.
16:03 Discussion
17:00 General Assembly of the ISD&DE
17:30 End



SUNDAY 3rd APRIL

CONFERENCE ROOM "A"

09:30 Merayo-Lloves J, Sued J, Escribano N. (Spain).
Laboratory tests in ocular surface diseases (Course. Level:Basic-Intermediate)
10:30 Video presentations
Alañón FJ, Alañón MA, Martínez Fernández A, Cárdenas Lara M. (Spain). (Video). Advanced techniques in transcanalicular laser assisted DCR.
Alañón FJ. (Spain). (Video). Virtual transcanalicular laser-assisted DCR.
Holly FJ. (USA). (Video) Mechanism of lid lubrication.
Holly FJ. (USA) (Video). Tear film formation, stability, and rupture.
Holly FJ. (USA). (Video). Kinetic model of the Schirmer-Holly lacrimation test.
Holly FJ. (USA). (Video). Management of epithelial adhesive failure by osmotic flow.
Weil Schneider D. (Argentina). (Video). Conjunctivorhinostomy (CR) with Jones tubes. Classic approach.
Weil Schneider D. (Argentina). (Video). Dacryocystorhinostomy (DCR). External approach.
11:18 Kaynak-Hekimhan P, Faruk Yilmaz Ö. (Turkey).
Ho:YAG laser lacrymal by-pass surgery with PVP coated silicone tubes.
11:25 Kominek P, Cervenka S, Matousek P. (Czek Republic).
Conjunctivocystorhinostomy. Analysis of 100 cases.
11:32 Murube J.
Other system than Jones tubes when natural lacrimal pathways can not be repermeabilized.
11:39 Zaragoza P Sr, Zaragoza P Jr (Spain).
Endonasal Dacryocystorhinostomy.
11:46 Murube J, Morum M, Sales M.
New surgical technique to treat the conjunctivochalatic LIPCOFs.
11:53 Discussion
12:00 Höh H.
Lid-parallel conjunctival folds (LIPCOF) are a definite sign of dry eye

[dianat]

If I really truly thought as a patient that I would figure out something at this conference that could make my life better, I would go. I'm sure my Kate would enjoy you little one as well. Still, I'd really need to be talked in to this. Financially, it's feasible. Spain would be really neat. But does it make sense for me right now??

[Rebecca Petris]

If I really truly thought as a patient that I would figure out something at this conference that could make my life better, I would go. I'm sure my Kate would enjoy you little one as well. Still, I'd really need to be talked in to this. Financially, it's feasible. Spain would be really neat. But does it make sense for me right now??

Wish I knew the answer to this! I just don't. That's a toughie.

[dianat]

Rebecca,

I'm looking at day one of the symposium and I just don't see how exactly it is geared toward the "patient". Am I misunderstanding something here? It looks to me like Friday's schedule that you've posted isn't the schedule for patients and treatments. The first discussion refers to "arterial vascularisation of the lacrimal gland". Is there a schedule for the patient forum?

Thanks so much, by the way, for your email reply to me. I only "stuck it to you" because I truly don't know what step to take. I'll take some time and respond some time tomorrow.

Diana

[Cindy]

I see a lot on Friday's schedule that interests me (thanks for posting this, Rebecca):

10:15 Holly FJ. (USA).
Tear film formation, stability, and rupture. Presentation with video.

10:36 Erdélyi B, Kraak R, Guthoff R, Németh J. (Hungary).
Confocal microscopy of the corneal epithelium in dry eye patients.

11:20 Nepp J, Linzmayer L, Schild G, Schauersberger J, Sibylla RM, Wedrich A. (Austria).
Psychic influence in dry eye symptoms.

11:27 Fernández-Velázquez F. (Spain).
The McMonnies Questionnaire is more helpful than the OSDI Test as part of the prefitting protocol in irregular corneas.

11:41 Rodríguez Amador S. (Venezuela).
Dry eye post lasik.

11:48 Gilbard PG, Miljanovich B, Trivedi KA, Dana R, Buring J, Schaumberg DA. (USA).
Dietary omega-3 fatty acid intake and risk of clinically diagnosed dry eye syndrome in women.

13:00 Holly FJ. (USA).
The dry eye.

15:37 Sieg P, Hakim SG, Jacobsen HC. (Germany).
Microsurgical submandibular gland transfer in the treatment of severe keratoconjunctivitis sicca. A 10 years experience.

15:44 Soriano HM. (Argentina).
Transplant of accessory salivary glands for the treatment of severe dry eye

15:58 Murube J, Sales M, J , Arnalich F. (Spain).
Punctum patch with autologous lid skin

16:19 Arrieta B, Ducasse C, Salduna D, Picco A. (Argentina).
Ocular manifestations of cutaneous rosacea.

17:00 Departure of buses for city tour
20:00 Buffet

[Rebecca Petris]

Rebecca,

Is there a schedule for the patient forum?

Yes! The patient part is occurring in parallel. (We may be doing a little jumping back and forth!) Sorry about that. Here is the patient day schedule:

1st April, Friday

09:00-09:30 AM Registration
09:30-09:45 AM Inauguration
09:45-10:00 AM Presentation and Program Dr. MURUBE
10:00-10:15 AM Cause: Age Related Dry Eye Dr. MATEOS
10:15-10:30 AM Cause: Hormonal Dry Eye Dr. ZARAGOZA Sr.
10:30-10:45 AM Cause: Pharmacologic Dry Eye Dr. BENÍTEZ DEL CASTILLO
10:45-11:00 AM Cause: Autoimmune Dry Eye Dr. BENÍTEZ DEL CASTILLO
11:00-11:15 AM Cause: Hyponutritional Dry Eye Dr. GILBARD
11:15-11:30 AM Cause: Dysgenic Dry Eye Dr. MURUBE
11:30-11:45 AM Cause: Inflammatory Dry Eye Dr. ZARAGOZA Jr.
11:45-12:00 AM Cause: Traumatic Dry Eye Dr. GOMEZ FERNANDEZ
12:00-12:15 AM Cause: Neurodeprivative Dry Eye Dr. MERAYO
12:15-12:30 AM Cause: Tantalic Dry Eye Dr. SANZ

Lunch

03:00-03:15 PM Clinics: Dry Eye Grade 1 Dr. MURUBE
03:15-03:30 PM Clinics: Dry Eye Grade 2 Dr. SANZ
03:30-03:45 PM Clinics: Dry Eye Grade 3 Dr. ROJO

03:45-04:00 PM Diagnosis: Anamnesis Dr. RODRÍGUEZ ARES
04:00-04:15 PM Diagnosis: Office Examination Dr. MONTERO
04:15-04:30 PM Diagnosis: Laboratory Examination Dr. RIVAS

04:30-04:45 PM Treatment: Environmental Dr. MATEOS
04:45-05:00 PM Treatment: Medical: Lacrimal Substitutives Dr. HOLLY
05:00-05:15 PM Treatment: Medical: Others Dr. HERRERAS
05:15-05:30 PM Treatment: Surgical Dr. ROJO

[dianat]

Rebecca,

Do you know what the "clinics" and "diagnosis" sessions mean here? Sorry I keep at it here, but I really want to understand this patient part of the symposium. Perhaps your're just guessing like I am. Still, it is pretty unlikely I would go, but nothing is out of the question for. I am rather addicted to understanding more about our dry eye issues and do find it interesting.

[Rebecca Petris]

Diana,

I think they're just distinguishing categories of topics, i.e. clinics = clinical findings during basic examination when a patient presents with thus-and-such severity, diagnosis = specific diagnostic tests they're using in clinic or lab.

Dr. Holly may be able to tell us more about this.

[dianat]

Thanks. Heck, I'm just trying to make sense of it all. But I'm just not in a good place to make that trip even if I thought it worth my while.

[Rebecca Petris]

I should have thought of that part. I don't think you really want to do two transatlantic flights in that condition. Very tough on the eyes, especially the overnight flight east (waking up to erosions...). Don't worry, we will glean as much as we possibly can to share afterwards.

[dianat]

My eyes could handle the trip, though I'll admit it would be tough, but this psyche of mine. Not doing so great.

[rhohltjr]

Yes! The patient part is occurring in parallel. (We may be doing a little jumping back and forth!) Sorry about that. Here is the patient day schedule:
1st April, Friday
09:00-09:30 AM Registration
....
09:45-10:00 AM Presentation and Program Dr. MURUBE
10:00-10:15 AM Cause: Age Related Dry Eye Dr. MATEOS
...........
12:00-12:15 AM Cause: Neurodeprivative Dry Eye Dr. MERAYO
.....
05:15-05:30 PM Treatment: Surgical Dr. ROJO

Hope you two learn a lot and come back with good news for all of us.
Before you leave for your whirlwind tour, I am hoping you will let us know there are at least some samples of those drops available. Things are at least feeling a little more hopefull for the future in my opinion.

[Rebecca Petris]

Just a quick note about Madrid:

I was not able to attend because of a family emergency, so unfortunately I won't be able to report back firsthand. However, Cindy is there right now and attended the patients session (which was, er, all in Spanish) today. I'm hoping the organisers will help us get copies of some of the (English!!) scientific presentations from the rest of the conference this weekend. At any rate, I'll report back both here and in our upcoming newsletter any and all useful highlights of the conference that we glean.

[Cindy]

Hola! from Madrid! And that about sums up my working Spanish vocabulary. My son accompanied me and we attended the patient sessions today. There were over 60 patient attendees and at least twelve plus lectures. One thing is for sure...the discomfort of dry eye patients transcends language barriers. The blinking, eye rubbing, sunglass-wearing patients were the same as I see among my friends here in the U.S. Some of the Q & A sessions were spirited and passionate. And in Spanish, all the more emphatic!! There were two women in particular that I tried reasonably successfully to speak with. Dry eye is a universal language. They loved my goggles.

I have enjoyed seeing the enthusiastic doctors and have loved making new acquaintances.

Adios for now,

[dianat]

Cindy,

I'm excited that you've gotten to take a trip with your son. That sounds nice to me. I hope you manage to bring home some ideas for us, or some news of new treatments. Enjoy the rest of your trip. I'm sure there's a lot to see.

Can't wait to hear more.

Diana

[Cindy]

THE MADRID TRIPLE CLASSIFICATION OF DRY EYE

MURUBE J, BENÍTEZ DEL CASTILLO JM, CHENZHUO L, BERTA A, ROLANDO M
http://www.oftalmo.com/seo/2003/11nov03/04.htm

The Madrid Triple Classification of Dry Eye provided the outline for the presentations for the patient sessions in Madrid.

Excerpts:
DRY EYE DISEASES TRIPLE CLASSIFICATION

Knowledge of Dry Eye, which is a condition in phase of discovery, will be greatly increased during the 21st century. At present there is not even a practical clinical classification of its many different varieties. It is evident that an etiological, histopathological and clinical classification is necessary for the treatment and management of any dry eye disease.

It is for this reason that, in the 14th congress of the Societas Ophthalmologica Europaea (Madrid, 11 June 2003), a multicentric study developed a practical classification of patients with ocular surface dryness. Any clinical diagnosis of dry eye is classified by three parameters:

A. Etiology.

B. Histopathology.

C. Clinical Severity.

A. Etiological classification

The more than 100 different etiologic types of dry eye can be grouped in a decalogue of 10 families: 1. age related, 2. hormonal, 3. pharmacologic, 4. immunopathic, 5. hyponutritional, 6. dysgenetic, 7. inflammatory, 8. traumatic, 9. neurodeprivative, and 10. tantalic. The first five etiologic families of this classification generally and simultaneously affect many exocrine systems (lacrimal, salivary, tracheo-bronchial, etc). The second five families usually affect only the eyes or may even be limited to a single eye or a single type of dacryogland (aqueous, lipid, mucinic) (table I).

B. Histopathological or «ALMEN» classification

The lacrimal system is one of the most complicated exocrinic systems, comparable to the gastric and intestinal ones. The three basic types of dacryoglands, i.e. aqueous (main and accessory lacrimal glands), lipid (Meibomian, Zeis, and to less extent Moll glands) and mucinic (goblet cells, epithelium), and the corneal epithelium have an interrelated function. Many etiologies of dry eye simultaneously produce dryness in other exocrinic glands of the body. Therefore, the etiologic classification must be completed with the expression of the affected dacryoglands, as this will enable the clinical symptoms to be interpreted, and will orientate the treatment.

This is summarized with the acronym ALMEN, where the A stands for «aquodeficiency», the L for «lipodeficiency», the M for «mucodeficiency», the E for «epitheliopathy», and the N, for «Non ocular exocrine deficiencies» (table II).

C. Clinical severity classification

The severity of dry eyes can be expressed in five grades: subclinical, mild, moderate, severe and disabling (table III):

Admittedly, some of the terminology is over my head but what is clear is that proper diagnosis by doctors in clinical practice and successful treatment of patient symptoms is accomplished through thorough investigation of many variables.

The doctor sessions were a sharing of vast research, techniques and studies that assess dry eye causes, classifications, diagnoses and treatments as mentioned earlier in this thread.

[Cindy]

Dr. Gilbard, of Advaced Vision Research and creator of TheraTears, chaired a portion of the patient session and also gave a presentation. His presentation, "Hyponutritional Dry Eye" (a condensed version given the 15 minute limit), is available here: http://www.dryeyeinfo.org/Dry_Eye_In_Depth.htm

It is also available in Spanish http://www.ojoseco.us/ He gave his patient presentation in Spanish and did an admirable job answering patient questions in Spanish.