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ISSUE 5 | VOLUME 5 | 5th October 2016


Welcome to the fifth WSPOS newsletter of 2016.


We are delighted to announce our Newly Formed Ethics Bureau which will be chaired by Dr. Alex Levin. 

In addition to the above exciting announcement, we would like to present the third edition of our Country in Focus series, where we focus on Paediatric Ophthalmology practised in different countries around the world. 

This newsletter also contains the 3rd case of our Global Case Report Quiz  Here we have case reports from around the world in the form of a survey. Each of these cases will be stored on the education part of the website.


We would like to announce our Global Consult Bureau.


The WSPOS would like to introduce yet another novel Initiative, the WSPOS Connectivity Bureau.


We are also very happy to announce that the All India Orthoptic Society, Instituto De Microcirugía Ocular Fundación (IMO Foundation), and Algeria have joined us at WSPOS.


In addition to gearing up for all our International meetings, we are well advanced in our preparations for the 4th World Congress for Paediatric Ophthalmology & Strabismus, which is slated to take place in India, from the 1st - 3rd of December, 2017.  


Further information on this meeting and all of our activities are available on our website www.wspos.org. We will also be providing regular updates in future newsletters.


We would like to thank you again for your support of WSPOS. If you have any news that you would like included in our next newsletter, please contact us.



Dr. Ramesh Kekunnaya

Dr. Adedayo Adio

Dr. Muhammad Younis





Chief, Jasti V. Ramanamma Children’s Eye Care Center, Pediatric Ophthalmology, Strabismus & Neuro -ophthalmology, L. V. Prasad Eye Institute (LVPEI), Hyderabad, Telangana, India.


Consultant Pediatric   Ophthalmologist & Strabismologist, Children's eye clinic, Department of Ophthalmology, University of Port Harcourt teaching hospital, Rivers state, Nigeria; Volunteer Ophthalmologist, TLEC rehabilitation Center for the Blind, Port Harcourt, Nigeria


Consultant Ophthalmic Surgeon; Pediatric Ophthalmology & Adult Strabismus; Co-Chair : Eye Dept. Rafic Hariri University Hospital; Eye Dept. American University of Beirut, Medical Center; Eye Dept. Lebanese American University, University Medical Center, Beirut, Lebanon




We are very happy to announce our Newly Formed Ethics Bureau.

Dr. Alex Levin has graciously agreed to chair the WSPOS Ethics Bureau. We have selected ten members for our Ethics Bureau by combining Dr. Levin’s suggestions & the WSPOS Executive Bureau’s, in order to have as global a representation as possible. We have Dr. Mohamad Jaafar representing the North American region, Dr. Mario Zanolli representing the South American region, Dr. Wagih Aclimandos representing the region of Western Europe, Dr. Daniela-Eleonora Cioplean representing the region of Eastern Europe, Dr. Hana Leiba representing the North African region, Dr. Travis Pollock representing the region of South Africa, Dr. Arif Khan representing the Middle Eastern region, Dr. Meenakshi Swaminathan representing the region of Southeast Asia, Dr. Clement Tham representing the Far Eastern region & Dr. Glen Gole representing the Australasian region.

The Ethics Bureau will have the authority to review WSPOS activities regarding research and education.

Click here for more information about the Ethics Bureau members





Demographics : Nigeria, the 20th world largest economy is a democratic secular country which gained independence in 1960 from Great Britain. It is located in West Africa on the Gulf of Guinea along the Atlantic ocean coast line. One in every four Africans is a Nigerian therefore it is a very important African country with at least 8 cities having over a million population each (e.g. Lagos has 17 million, Port Harcourt 1.3 million in 2016, etc.)

Population : 188 million (2016) mostly heterogeneous people.50.6% are male

Percentage of population under 15 years : 41% are 15y and younger (2015)

Life expectancy : 46.8 years for males and 48.4 years for females

Birth rate : 40 births/1000 population

Infant mortality : 8.4 deaths/1000 births (2010)

Language : Over 500 languages though only about 250 are still being spoken.

Yoruba, Ibo and Hausa are the mainly spoken ones.

Official language : English

Education : Nigeria provides free, government-supported education, but attendance is not compulsory at any level, and certain groups, such as nomads and the handicapped, are under-served. Private education is also available to university level

Youth literacy rates : 72.79%

Registered doctors : 82,000 registered doctors with 4000/year more being produced

Number actually practicing : 40,000 (2016) others practicing abroad

Number of registered Ophthalmologists : 363 Ophthalmologists

Number of Pediatric ophthalmologists: 22 (1 to 8 Million population)


Health care system : The health workforce is concentrated in urban tertiary health facilities particularly in the southern parts. Policymakers are now focusing strongly on primary healthcare which is the frontline to address these gaps in the healthcare system, plagued by ‘brain drain’ of skilled doctors due to poor working conditions and few functional and modern equipment. National health insurance system is not very functional and effect not palpable due to poor stock of drugs and consumables. Government hospitals go on frequent strikes so most access private care during these periods. Training programs very actively going on at postgraduate level to stem the tide of efflux of doctors and to improve the quality of care. Two colleges available: the National Postgraduate and the West African College of surgeons. Examinations are held twice a year. The pediatric healthcare is generally improving in recent years with more and more preterm babies surviving with emergence and increasing numbers of ROP cases.


General eye care : Relatively few numbers of ophthalmologists with most older ones practicing general ophthalmology. There’s a concerted move now to subspecialize with only about 10% actually making any move to seek further training mostly available outside the country (generally expensive and distant from Nigeria) but nevertheless most aligning themselves with a subspecialty and annually attending national and regional meetings to improve practice.


Paediatric eye care : Very few ophthalmologists aspire to be paediatric ophthalmologists due to the poor remuneration and low perceived benefits but active interest being generated to increase the numbers by the umbrella body, The Nigerian Pediatric Ophthalmology and Strabismus Society (NIPOSS) which recently just had its yearly Subspecialty meeting with the Theme Management of Pediatric cataract and evaluation of Strabismus for 2016 on Wednesday, the 23rd of August 2016 in Port Harcourt, Rivers state, Nigeria. Well attended by renowned pediatric ophthalmologists and those in training both from all over the country and outside including Prof Marilyn Miller and Dr. Linda Lawrence in addition to Prof. Scott Lambert of the USA along with Dr. Ramesh Kekunnaya of Hyderabad, India.

Other notable speakers included the chairperson of NIPOSS Dr. Dupe Ademola-Popoola and Secretary of NIPOSS, Dr. Adedayo Adio and Prof. Ose Dawodu who is a past chairperson of NIPOSS.

Average Cost to patient of squint surgery under GA : 1500 dollars in private;120 dollars in government.

Average Cost to patient for pediatric cataract under GA per eye : 800 dollars in private and 100 dollars in government.


Major successes :

1) Improving numbers of those now getting interested in the subspecialty from the establishment of a coordinated multicenter time bound paediatric subspecialty training program with clear objectives a few years ago. This has significantly increased the numbers of trained personnel in recent years. Interest is now being shown in this program by neighbouring African countries.

2) Coordinated center for almost complete care of retinoblastoma in at least two tertiary centers. Heightened awareness programs going on to sensitize the populace in different parts of the country.

3) Moves being made to develop and enforce national vision screening guidelines.

4) Concerted efforts being made in at least three tertiary centers to develop an ROP screening program with two centers with an identifiable team in place.

5) Vibrant paediatric ophthalmology Society making active moves for partnership with stakeholders like OB-GYN, pediatric and community health colleagues to improve awareness of referral guidelines.

6) Renewed interest in the education and rehabilitation of the irreversibly blind.


Major challenges :

1) Unequal access to healthcare and poor access to rural areas located on desert and riverine areas. Most pediatric ophthalmologists are located in major tertiary centers with predominant locations in the middle belt and southern Nigeria. Very few in the northern parts.

2) Few fully trained paediatric ophthalmologists. Strabismus not as common but a lot of congenital and developmental cataracts.

3) Extremely poor funding for eye care in children with virtually none in certain regions. Most depend on private care with this sometimes superior to government care in certain regions making it out of reach to the common man. Only very few tertiary centers have vitrectomy machines.

4) No coordinated Nationwide eye screening going on in a sustainable manner. Few areas have a functional school eye screening program. Some efforts being made from one region to promote teacher-led screening to improve rapid coverage. Legislation not enforced.

5) There are very many optometrists but other allied eye care professionals virtually nonexistent. Currently an orthoptist is being trained in India to start training of others with faculty being drawn from the International Orthoptists federation and NIPOSS (local body of Paediatric Ophthalmologists). Very few low vision specialists- less than 5 in the whole country.

6) Rehabilitation and care of the severely visually impaired and the blind not given priority. Advocacy is going on in addition to awareness programs.





Population: 5,851,000 (around 2,000,000 immigrants from Syria , Palestine and Iraq)

Live births per year: 63,800

Percentage population under 15 years : 21%

Percentage population above 65 years : 9.9 %

Ophthalmologists : Around 330 ophthalmologists practicing in the country


Paediatric ophthalmologists and strabismologists : 15 in Lebanon with around 80% found in the capital Beirut. Most of them are attached to university hospitals in addition to private practice.


Health care system : In Lebanon two types of health care systems are present : private and public. The public system includes many third parties related to the government. There are many government hospitals spread nationwide with one tertiary university hospital (Rafic Hariri University Hospital) in the capital Beirut with a capacity of 400 beds. 6 university hospitals have residency program in ophthalmology but yet no structured fellowship program in the field of Paediatric ophthalmology and adult strabismus.


Consultation: ranging from 40 to 150 US dollars for a visit to see a Paediatric ophthalmologist

Strabismus surgery ranges from 200$ dollars in public set-ups to 1800$ and more in private set-ups.


Major successes :

Lebanon is a tertiary referral centre for many countries around in the region like Syria, Iraq and the gulf countries.

Tertiary referral Centre for retinoblastoma.

Awareness of screening in Paediatric population.


Major challenges :

Very few orthoptists (only 4) found all over Lebanon, working in private sector.

No structured coordinated screening program for Pediatric population.



Dr. Fernando Prieto Díaz, from La Plata & Buenos Aires, Argentina, has kindly sent on the Third case presentation. We would like to thank Dr. Dominique Bremond-Gignac for translating the case presentation to English. This case is about an 18 years-old male who presented with diplopia & vertical deviation and severe damage of inferior rectus muscle.


Dr. Fernando Prieto Díaz,

Director Medico del Intituto Oftalmológico Prieto-Diaz, La Plata-Argentina; Secretario General del Consejo Latinoamericano de Estrabismo-CLADE (2003-2010); Presidente del Centro Argentino de Estrabismo (2004-2006); Editor Jefe de REOP - Revista de Estrabismo & Oftalmología Pediátrica (Desde 2014)


We would like our members to select one of the options present at the end of the quiz. Please complete the survey and send it to us no later than Friday, 21st of November, 2016.


We will compile the responses we receive and include them along with the opinion of a few experts in an eblast to all our members soon.


Click here to view Global Case Report Quiz


We have also compiled our members’ responses received for the first case of our series. As promised we are even providing three Experts’ Opinions for the same.

Click here to view



We also have a ‘one-of-a-kind’ initiative; our Global Consult Bureau; for doctors to send in difficult cases to share with a global audience. This is a bureau headed by Dr. Kimberley Tan of Sydney. We have two Section heads; Dr. Fernando Prieto-Diaz from Argentina who will head the Strabismus section & Dr. Paolo Nucci from Italy who will head the Non-strabismus section. We intend having a Global pool of 48 experts with an equal representation from Paediatric as well as Adult Ophthalmologists (24 each).  The cases from our Global Case Report Quiz are sent to a few members of the Global Consult Bureau to comment on. It will be instructive to see different viewpoints from around the world.


If you would like to participate as a global consult expert, please Contact us. Send us your CV, no later than Friday, 21st of November, 2016.  We expect experts to have a minimum of 5 years’ experience as an attending or consultant.



We would like our members to send in their nominations to be a part of the exclusive, 1st-of-its-kind, WSPOS Connectivity Bureau. We are on the lookout for young social media aware ophthalmologists to post important news & / educational information on WSPOS Social Media handles like Facebook, Twitter, etc. Please Contact us.  Email us your nominations with a short bio of yourself no later than Friday, 21st of November, 2016. 


New Member Society & Chapter announcement

We are very happy to announce that the INSTITUTO DE MICROCIRUGÍA OCULAR FUNDACIÓN (IMO FOUNDATION), THE ALL INDIA ORTHOPTIC SOCIETY & ALGERIA have now joined us at WSPOS. While Algeria has become a chapter with web hosting by us, the All India Orthoptic Society & Instituto de Microcirugía Ocular Fundación (IMO Foundation) have joined us as member societies.



The WSPOS Sub-specialty day was held on Friday, 9th of September, 2016 at Bella Center, Copenhagen, Denmark. It was awarded 6 EACCME CME Credits. It preceded the XXXIV Congress of the European Society of Cataract & Refractive Surgeons (ESCRS) from 10th – 14th September, 2016. It was coordinated jointly by Drs. Bremond-Gignac, Yair Morad, Lotte Wielander and Nikolas Ziakas & had speakers from all around the world present at an extremely educative Sub-specialty day. There were a variety of topics on paediatric ophthalmology, strabismus and neuro-ophthalmology that encompassed sessions on pediatric cataract, myopia, ocular surface allergy, strabismus, ROP and vision screening, to name a few.


The highly informative program which ran from 8:30 am to 6:00 pm showcased topics like Current management of pediatric cataract including visual outcomes of secondary cataract implantation in children were discussed in addition to complications observed and protocols set up subsequently as a result to monitor them in the Paediatric cataract session, Recent developments in myopia control in addition to newer thoughts on its etiology were discussed. Evolution of Hypermetropia in the Refractive errors in children session, Management strategies for vernal and atopic conjunctivitis and other chronic conjunctival disease were discussed. Newer strategies like refractive surgeries and the rationale behind doing it in children in the Ocular surface allergy session, Strabismus syndromes along with acute acquired conditions, Outcomes in Oculocutaneous Albinism and rates of reoperation, Perspectives of strabismus care in West Africa, Endophthalmitis following squint surgery in the Strabismus session, were a few of the many topics discussed by eminent Paediatric Ophthalmologists & Strabismologists from all over the Globe. A large project called the EU screening was introduced. The vision screening protocol followed in Nigeria & West Africa was also discussed. Regular ROP screening was encouraged both in Nigeria and other developing countries where there is improving healthcare. Experiences in Sweden and Denmark were shared. Interesting videos on treatment of nystagmus and other accidents that can happen during surgical procedures were highlighted. Short presentations were also made on topics in genetics.


Here are some photographs of the same:


Clockwise from Top left : (1) Welcome favours for the participants (2) Dr. Beatrice Cochner’s talk (3) Dr. Ken Nischal’s talk (4) Dr. Sarah Otaibi’s talk (5) Dr. Richard Hertle’s talk (6) Dr. Preeti Patil-Chhablani’s talk (7) Drs. Adedayo Adio and Dominique Bremond-Gignac moderating a session in ocular surface allergy.

Click here to view the programme




We are busy preparing for our International Meetings in 2017 & will be providing regular updates in future newsletters.



We have received a list of member society meeting updates which are now listed on our website.

Click here to view



WCPOS III was held from the 4th - 6th of September, 2015 in Fira Gran Via, Barcelona, Spain. This World Congress was awarded 18 EACCME CME Credits & was attended by 1,236 delegates from 91 countries.


Here are some snapshots of the same :




Clockwise from Top left: (1) Dr. David Granet with JAM Session Speaker Dr. Fay Cruz, (2) Dr. Larry Able; ADS Session: Nystagmus Surgery; Beyond Visual Acuity & Face Turn: How Can We Better Assess Infantile Nystagmus, (3) Strabismus Workshop with Dr. Wilson (4) Mock Trial.


Click here to view the programme schedule


You can also view interviews of a few WCPOS III speakers conducted by Dr. David B Granet; kindly sponsored by the University of California, San Diego, USA.

Click here for more







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