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RESEARCH PROFILE
Pediatric Screening and Eye Disease
DR CHRISTINE LAW
After receiving the Research Initiation Grant shortly before my maternity leave, my vision screening research has now taken o on multiple fronts. In order to fully understand the impact of vi- sion screening on the Canadian landscape, medical students Stephanie Cheon and Rachel Oh have been conducting system- atic reviews on the economic costs of universal pediatric vision screening programs and global vision screening guidelines, re- spectively. Stephanie will be presenting her results at the upcom- ing 2019 COS meeting, with a publication to follow.
In conjunction with the Kingston, Frontenac, Lennox and Adding- ton Public Health Unit, another medical student, Patrick Wang, will be analyzing local data on the follow-up rate and barriers to care following vision screening. On a larger scale, in conjunction with Dr Robert Campbell, we are examining rates of amblyopia detection and subsequent cost to the healthcare system using ICES data.
For the 2018-2019 academic year, both Drs Adrienne Duimering and Jessica Ruzicki have been working with me in conjunction with the Queen’s University Department of Computer Science and Centre for Advanced Computing, Johns Hopkins University Department of Engineering in Healthcare, and Dr Rylan Egan to investigate the role of machine learning in cataract surgery. Dr. Duimering is piloting the use of motion tracking during simulated cataract surgery using surgical instruments with 3D printed track- ers. By quantitatively analyzing the path length and time for sur- gical movements among trainees and experts, and then combin- ing these with analyses of the video recorded surgery with a validated rubric, the goal is to create a machine learning continual database that will provide real-time, quantitative, unbiased feed- back for trainees. Dr Ruzicki’s research expands on concept of cre- ating a deep learning database of cataract surgery but for real time surgeries performed in the operating room. She is collecting hundreds of videos from trainees and experts to be analyzed by machine learning with the purpose of creating a system in which individual cataract surgery videos, by novice and experts alike, can be inputted and evaluated for precise feedback. Both proj- ects are novel in ophthalmology and arti cial intelligence for the use of motion analysis technology and video recording analysis. Future work by Dr Duimering will aim to link the two platforms together to monitor the surgical skills progression of a trainee.
Above: Dr. Duimering practicing a simulated cataract removal while a motion capture camera (in foreground at right) records her movements.
Left: Dr Law and orthoptist Sarah Churchill perform an eye exam on a young patient.
Within the pediatric ophthalmology division, I continue to work with our orthoptists (Sarah Churchill and Lesley MacSween) to participate in research trials with the Pediatric Eye Disease Investi- gator Group (PEDIG), a collaborative network of over 300 pediatric ophthalmologists and pediatric optometrists in Canada, the Unit- ed States, and the United Kingdom. One of the recent studies we participated with involved investigating binocular treatment for amblyopia in children. As one of the co-authors, the results were recently published in Ophthalmology [2019 Mar;126(3):456-466]. We also continue to monitor patients previously enrolled in the intermittent exotropia study comparing bilateral lateral rectus re- cession or unilateral medial rectus resection and lateral rectus re- cession for long-term follow-up data.
Department of Ophthalmology | 7