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Editorial

Neuro-Ophthalmology Around the World

Golnik, Karl C. MD, MEd

Author Information
Journal of Neuro-Ophthalmology: December 2013 - Volume 33 - Issue 4 - p 319-321
doi: 10.1097/WON.0000000000000082
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The International Council of Ophthalmology

The North American Neuro-Ophthalmology Society (NANOS) recently has become a member of the International Council of Ophthalmology (ICO). The ICO collaborates with ophthalmic societies and other organizations to enhance ophthalmic education and improve access to the highest quality eye care in order to preserve, restore, and enhance vision for the people of the world. The ICO represents and serves more than 100 national ophthalmic associations and 30 multinational ophthalmology subspecialty organizations.

The ICO is working to build a “World Alliance for Sight” by leading, stimulating, and supporting the efforts of ophthalmologic societies, eye departments, and related organizations worldwide to enhance ophthalmic education and eye care.

The ICO's long history of providing ophthalmic education dates back to the first International Congress of Ophthalmology in 1857. Now called the World Ophthalmology Congress (WOC), the WOC is held every second year in a different region of the world. Member subspecialty societies are invited to participate in the development of the Scientific Program of the WOC.

The ICO leads and coordinates the efforts of international ophthalmology to increase support for eye care and prevention of vision loss worldwide. The ICO collaborates closely with the World Health Organization, the International Agency for the Prevention of Blindness, ophthalmologic organizations, and nongovernmental development agencies to support and implement initiatives like VISION 2020, the Global Initiative for the Elimination of Avoidable Blindness.

In an effort to internationally validate an ophthalmologist's level of knowledge, the ICO offers examinations for ophthalmologists in training and practice. Since first established in 1995, more than 20,000 candidates have taken the examinations. In 2012, there were 3,327 ICO examinations taken in 130 test centers in 70 countries. The ICO examinations also enable teachers and trainers to evaluate their trainees' performance by international standards.

One of the main efforts of the ICO is to improve the education of ophthalmologists. Since 2000, the ICO has awarded more than 600 fellowships, allowing promising young ophthalmologists from countries with an urgent need for modern eye care to bring acquired knowledge and skills back to their home country and take part in programs to preserve and restore vision. Working with committed partners, the ICO is improving the educational effectiveness of ophthalmology teachers by introducing them to principles of adult learning, curriculum development, teaching methods, and assessment tools. Collaborative efforts with member societies and other ophthalmologic organizations are creating beneficial educational opportunities and refining the most effective ways to teach residents, medical students, subspecialty fellows, practicing ophthalmologists, and allied eye care personnel.

In 2011, the ICO completed a revised ICO Residency Curriculum, working with more than 100 subspecialists from around the world, to offer an international consensus on what ophthalmology residents should be taught and provide a standardized content outline for ophthalmic training. Delivered online, it is intended to be translated and adapted, with the precise local detail for implementation left to each region's educators. The Curriculum can be accessed at www.icoph.org/refocusing_education/curricula.html

In 2012, the ICO initiated development of curricula for subspecialty fellowship training. The first 4 currently being drafted include Neuro-Ophthalmology, Cornea and External Diseases, Glaucoma, and Oculoplastic Surgery. Similar to the process for the ICO Residency Curriculum, the ICO involved the relevant member subspecialty societies in nominating a specialist to serve on these committees. To learn more about ICO programs, please visit http://icoph.org/downloads/2012Update-web.pdf

Regional and National Neuro-Ophthalmology Societies

Besides NANOS, there are a number of other supranational and national neuro-ophthalmology societies, and the ICO hopes that they will follow the lead of NANOS and join the ICO to collaborate and facilitate achieving the goals listed above. The largest of the supranational societies is the Asian Society of Neuro-Ophthalmology (ASNOS) with more than 1,000 members. Established in 2002, members represent China, India, Indonesia, Japan, Malaysia, Philippines, South Korea, Taiwan, and Thailand. Scientific meetings are held every 2 years. The seventh Congress occurred in Bali Indonesia in August 2013. Notably, it had a special session called “Walsh-in-Asia”, a clinicopathologic case presentation conference in the style of the Frank B. Walsh Society Meeting. The official journal of ASNOS is Shinkei Ganka (Asian section) and the official Web site is http://www.shinkeiganka.com/asnos/index.html.

The European Society of Neuro-Ophthalmology (EUNOS) was founded in 1993 and conducts biennial clinical and scientific meetings. Beginning in 2012, shorter “update” meetings will take place in the off years. EUNOS has a membership of approximately 85 members from 28 countries. The main aims of the Society are to extend the knowledge of neuro-ophthalmology by promoting cooperation and communication among clinical neuro-ophthalmologists and vision scientists within Europe; to support the development of clinical neuro-ophthalmology in Europe by establishing training standards and syllabi and promoting the education of trainees through teaching courses; and to promote clinical research in neuro-ophthalmology and represent neuro-ophthalmologists in relevant European medical forums. Further information is available at www.eunosweb.org.

In Latin America, the Club Latinoamèricano de Neuroftalmologìa (CLAN) was created in 1988. It initially was formed by a group of neurologists and ophthalmologists from Buenos Aires and Santiago. Membership now includes neuro-ophthalmologists from Argentina, Brazil, Chile, Columbia, Paraguay, Perú, Uruguay, Venezuela, and the United States. Scientific meetings have taken place once a year since 1988 to discuss trends and new developments between the members who also are active in national and international societies of neurology and ophthalmology. Members of CLAN also belong to supranational organizations, such as the ICO and the Pan American Association of Ophthalmology.

Other national neuro-ophthalmology societies including France, Israel, Australia/New Zealand, Japan, and South Korea have been described previously in this Journal (1–5).

The Neuro-Ophthalmology Society of the Philippines (NOSP) was founded in 2000 and is recognized by the Philippine Academy of Ophthalmology (PAO). The main objective of the society is to foster academic exchange and dissemination of knowledge in the realm of neuro-ophthalmology in the Philippines. This includes participation in the annual PAO Meeting by organizing instructional courses and basic course lectures being given by both invited international and local speakers and creation of a neuro-ophthalmology fellowship program. Currently, NOSP is creating a unique Philippine National Registry, ethambutol toxic optic neuropathy. This initiative is designed to provide awareness and gather information nationwide on ethambutol toxicity and describe its clinical profile in the country. The ultimate goal is to establish official treatment guidelines on monitoring the visual parameters of patients on anti-tuberculosis medication and to help reduce the frequency of ethambutol optic neuropathy in the Philippines.

Thus, supranational and national neuro-ophthalmology societies are flourishing around the world. They serve to enhance training and provide advocacy for their members, which ultimately leads to improved patient care. Hopefully, the ICO can facilitate collaboration, communication, and provide mechanisms for these societies to realize their goals.

REFERENCES

1. Tilikete C, Vighetto A. Neuro-ophthalmology in France. J Neuroophthalmol. 2013;33:e19–e20.
2. Huna-Baron R, Rath EZ. Neuro-ophthalmology in Israel. J Neuroophthalmol. 2013;33:e17–e18.
3. Lueck C, Williams IM. Neuro-ophthalmology “down under”. J Neuroophthalmol. 2013;33:e3–e4.
4. Kashii S. Neuro-ophthalmology in Japan. J Neuroophthalmol. 2013;33:e1–e2.
5. Kim SJ, Kim JS. Neuro-ophthalmology in Korea. J Neuroophthalmol. 2013;33:e8–e10.

Editor's Note: The Journal of Neuro-Ophthalmology and International Neuro-Ophthalmology

In his editorial, Dr. Golnik highlights the activities of neuro-ophthalmology around the world. The ICO is assuming an important role in facilitating and coordinating educational activities in ophthalmology, and an opportunity for neuro-ophthalmology to assert itself on the world stage.

In a similar fashion, the Journal of Neuro-Ophthalmology (JNO) serves as an important educational publication in neuro-ophthalmology throughout the world. Currently, 9 of our 26 editorial board members represent the international community. Sixty percent of our submissions come from outside North America. We have created a new section in the Journal entitled “Worldwide Neuro-Ophthalmology”, which features neuro-ophthalmology activities in specific parts of the world. In addition, in “Neuro-Ophthalmology News,” we feature major meetings and other educational events taking place internationally. Probably no one more than William Hoyt, MD, recognized the importance of international education and collaboration. Many of his former fellows practice throughout the world and are training the neuro-ophthalmologists of the future. The JNO is committed to recognize and promote international neuro-ophthalmology and looks forward to expanding this role in the years to come.

Lanning B. Kline, MD

Editor-in-Chief

© 2013 by North American Neuro-Ophthalmology Society