Special report by: Ms Maggie O'Hara
Visiting Specialists
Dr. Mary A. O’Hara, M.D.
Professor, UC Davis Department of Ophthalmology and Vision Sciences
Associate Professor, Uniformed Services University of Health Sciences Department of Surgery
Director, UC Davis Eye Center (Pediatric Ophthalmology and Strabismus)
American Board of Ophthalmology
American Academy of Ophthalmology
American Academy of Pediatric Ophthalmology and Strabismus
Dr. Michael Pi, M.D.
Medical Director, Surgicare of Hawaii
American Board of Anesthesiologists
American Society of Anesthesiologists
Society of Pediatric Anesthesiology
Dr. Hai H. Tong, O.D.
Pediatric Optometrist, UC Davis Eye Center
Residency Instructor, UC Davis, Department of Ophthalmology;
Clinical optics, refraction, and binocularity
California State Board of Optometry License
American Academy of Optometry
Dr. Larisa M. Johnson-Tong, O.D., FAAO
Clinical Optometrist, UC Davis Eye Center
Residency Instructor, UC Davis, Department of Ophthalmology;
Clinical optics, refraction, and contact lens fitting
California State Board of Optometry License
American Academy of Optometry
*******
In June 2012, four American eye specialists traveled to
Vietnam for the 4th Joint Vietnamese American Ophthalmology
Symposium. This symposium focused on the specialty of pediatric ophthalmology,
and the American visitors were able to share their expertise on a variety of
subjects, such as diagnoses, surgical techniques, anesthesia, and optometry.
The experience was an opportunity for members of two cultures to collaborate
with and learn from each other while providing premiere eye care to local
patients and their families.
Wednesday, June 13, American Eye Center Viet Nam
Dr. Mary O’Hara, director of Pediatric Ophthalmology and Strabismus at the University California Davis Eye Center, saw four pediatric patients at the American Eye Center. This modern facility in Ho Chi Minh , directed by VAOS organizer Dr. Nam Tran Pham, provides a variety of ophthalmic services, such as children’s eye care, eyelid surgery, contact lenses and glasses, LASIK, and treatment for presbyopia, diabetic eye disease, and glaucoma.
Dr. Mary O’Hara, director of Pediatric Ophthalmology and Strabismus at the University California Davis Eye Center, saw four pediatric patients at the American Eye Center. This modern facility in Ho Chi Minh , directed by VAOS organizer Dr. Nam Tran Pham, provides a variety of ophthalmic services, such as children’s eye care, eyelid surgery, contact lenses and glasses, LASIK, and treatment for presbyopia, diabetic eye disease, and glaucoma.
Dr. O’Hara looked at a variety of patients with cases
including congenital cataracts and
Duane’s syndrome. Throughout each case, she offered advice to Dr. Pham and to
the parents about what the next steps in treatment should be.
Thursday, June 14: Ho Chi Minh City Eye Hospital
Dr. Nam Tran Pham, Dr. Mary O’Hara, Dr. Michael Pi, Dr. Hai Tong, and Dr. Larisa
Johnson-Tong visited the HCMC Eye Hospital for a full day of seeing young patients
and preparing for Friday’s surgeries. They were assisted by Ms. Ashley Le, a clinical nurse from Hawaii, and Ms. Maggie O'Hara.
In the afternoon, as Dr. Johnson-Tong and Dr. Tong met with
patients needing contact lens and other optometry care, Dr. O’Hara and Dr. Pi
were in the operating room looking at pediatric cases in preparation for the
surgeries scheduled for the next day. Each American doctor was surrounded by a
group of Vietnamese doctors, who eagerly asked questions and followed along as
the American visitors explained treatment options
The four cases were:
1. 3 year-old boy
Diagnosis: Double elevator palsy
Procedure: Transposition of left lateral rectus and medial rectus muscles
2. 6 year old girl
Diagnosis: Esotropia 35 PD, dissociated vertical deviation, Inferior oblique overaction
Procedure: Bilateral medial rectus recession 5mm, Bilateral anterior transposition of inferior oblique muscles
3. 13 year-old girl
Diagnosis: Dissociated vertical deviation both eyes
Procedure: Bilateral anterior transposition of inferior oblique muscles
4. 15 year-old girl
Diagnosis: Left superior oblique palsy with hypertropia 25 PD
Procedure: Right inferior rectus recession 5mm, Left inferior oblique recession
Diagnosis: Double elevator palsy
Procedure: Transposition of left lateral rectus and medial rectus muscles
2. 6 year old girl
Diagnosis: Esotropia 35 PD, dissociated vertical deviation, Inferior oblique overaction
Procedure: Bilateral medial rectus recession 5mm, Bilateral anterior transposition of inferior oblique muscles
3. 13 year-old girl
Diagnosis: Dissociated vertical deviation both eyes
Procedure: Bilateral anterior transposition of inferior oblique muscles
4. 15 year-old girl
Diagnosis: Left superior oblique palsy with hypertropia 25 PD
Procedure: Right inferior rectus recession 5mm, Left inferior oblique recession
Dr. Michael Pi worked closely with hospital anesthesiologists on Pediatric general anesthesia techniques.
Dr O'Hara also examined patients with Retinopathy of prematurity (ROP) and Retinoblastoma under anesthesia and provided consultation on their management with hospital doctors.
Dr. Tong worked with the Refractionists to teach techniques of refracting pediatric patients and demonstrate orthoptics training. The doctors in the Strabismus department were eager to learn Orthoptics as a new tool that had previously never been used here.
In the afternoon, Dr. Pi and Dr. O’Hara gave several
lectures to the hospital staffs. Dr. Pi started
with his lecture on “Anesthesia for Pediatric Ophthalmology Surgery,”
explaining some of the key physiologic differences between infants and adults,
and what those mean for anesthesiologists. Dr. O’Hara then described several
pediatric disorders, such as dissociated vertical deviation (DVD) and
congenital glaucoma, and offered advice for treatment.
Saturday, June 16: Ho Chi Minh City Eye Hospital and
Continental Saigon Hotel
Then, Vietnamese ophthalmologists gathered at the Hotel Continental in Ho Chi Minh City for the symposium conclusion. The symposium gathered the American visitors and at least 50 Vietnamese ophthalmologists for a program of lectures and case presentations.
Anatomy of Extraocular Muscles and Strabismus (Dr. O’Hara)
Case Presentation: Orthoptics (Dr. Yen)
Binocular Vision and Orthoptics (Dr. Tong)
Pediatric Ocular Tumors (Dr. O’Hara)
Pediatric Anesthesia for Eye Surgery (Dr. Pi)
Amblyopia: Current Therapies (Dr. Tong)
Pediatric Refractive Errors & Contact Lenses
(Dr. Johnson-Tong)
Case Presentation: Congenital Glaucoma (Dr. Tam)
Congenital Glaucoma (Dr. O’Hara)
Monday, June 17: Hue Central Hospital
After the symposium, Dr. O’Hara, Dr. Tong, and Dr. Johnson-Tong traveled more than 600 miles (about 1000 km) to Hue for similar outreach efforts. They saw patients and gave lectures to a smaller group of Vietnamese ophthalmologists at Hue Central Hospital.
After the symposium, Dr. O’Hara, Dr. Tong, and Dr. Johnson-Tong traveled more than 600 miles (about 1000 km) to Hue for similar outreach efforts. They saw patients and gave lectures to a smaller group of Vietnamese ophthalmologists at Hue Central Hospital.
Enthusiastic responses from VN doctors
Video clip of Vietnamese doctors' reaction to the symposium:
http://www.youtube.com/watch?v=7E-VIeCDWtc
Dr. Truyen , a pediatric ophthalmologist at the HCMC Eye Hospital, found the experience to be very fulfilling: “This symposium is very helpful so we can learn from simulations, diagnoses, and the technique being showed to you.” He said that vertical deviation surgery and interior transpositions were just some of the lessons he’s taken away from the symposium.
Video clip of Vietnamese doctors' reaction to the symposium:
http://www.youtube.com/watch?v=7E-VIeCDWtc
Dr. Truyen , a pediatric ophthalmologist at the HCMC Eye Hospital, found the experience to be very fulfilling: “This symposium is very helpful so we can learn from simulations, diagnoses, and the technique being showed to you.” He said that vertical deviation surgery and interior transpositions were just some of the lessons he’s taken away from the symposium.
“From now on, I will apply what’s learned,” he said.
Dr. Truyen also spoke
about the importance of the ability to speak English in the Vietnamese medical
world. “Many other doctors from other provinces come in here and we talk about
new techniques,” he said. “If you have English, you can learn fully anything
they teach.”
Dr. Hong Hanh, a strabismus specialist who assisted Dr.
O’Hara in the operating room and translated during the Friday lectures, also
appreciated the opportunity to meet with physicians from across the world.
“I like it. This is a very useful program,” she said. “We
can learn and interact. American doctors are very warmful and they help us a lot in
professional and surgical tips.” Dr. Hanh also gave a case presentation on
strabismus during the Saturday conference.
For Dr. Nguyen, those “tips” will benefit her patients for
years to come. in the past, her
strabismus surgeries have gotten too close
to the inferior rectus muscle, and so some patients’ eyes get stuck when they
look out and down after the surgery. She says she will remember Dr. O’Hara’s
advice during a strabismus case in the operating room, “Always have 2
millimeters away from the inferior rectus.”
The day after the strabismus surgery, Dr. Nguyen checked the
patient’s progress. “The eye movement is normal and I’m very happy with that,”
she said.
A rewarding experience for visiting American doctors
The experience took special meaning for Dr. Tong, who was born in Can Tho, Vietnam. In 1975, he moved to California; this symposium marked his second visit back to Vietnam. He was particularly moved by the resilience of the Vietnamese doctors and their ability to “do amazingly well with what they have,” even though that means lacking a number of equipment, such as contact lens supplies, adequate space for patients, and blood pressure monitors in the surgery recovery room.
The experience took special meaning for Dr. Tong, who was born in Can Tho, Vietnam. In 1975, he moved to California; this symposium marked his second visit back to Vietnam. He was particularly moved by the resilience of the Vietnamese doctors and their ability to “do amazingly well with what they have,” even though that means lacking a number of equipment, such as contact lens supplies, adequate space for patients, and blood pressure monitors in the surgery recovery room.
Dr. Pi agreed: “They do so much with so little.” He was also
impressed with the young patients themselves: “the kids are brave, very mature
for their age.” The older children simply walked into the operating room and
calmly lay down on the operating table.
Because of VAOS, Dr. Pi said that he was more interested in
the Hawaiian Eye Foundation, a VAOS sponsor.
