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AAO 2018: The Art and Science of Ophthalmology

October 18, 2018

By Angela Woodall, Healthcare and Environmental Reporter.

The theme of this year’s AAO conference – the event right now for all things ophthalmology — is Art + Science. The science part is obvious in that practice is based in science, and clinical trials provide the basis for breakthrough techniques and technologies. The connection between that work and art may seem less obvious yet the relationship reaches back to the early days of ophthalmology, pervading the way that ophthalmologists characterize the art of their work. As one practitioner put it during the lead up to the Oct. 27 start date of the AAO conference: “The art of ophthalmology is conveying to the patient their diagnosis and supporting them in a manner that makes them comfortable during a very stressful time.”

In the eyeglasses industry, it makes an impact on the bottom when the lines between Art and Science become blurred. Art, often, blurs those lines even further to surprise the eye. In his piece Room for one colour, presented in 2009 at the at 21st Century Museum of Contemporary Art in Japan, artist Olafur Eliasson played with the limits of color perception: Monofrequency lamps mounted to the ceiling of a white room emitted yellow light that reduced the viewers’ spectral range to yellow and black. In reaction to the yellow environment, viewers momentarily perceived a bluish afterimage after leaving the space.

The breadth of specializations under ophthalmology – from prescriptions for eyewear to complex microsurgery – provides ample material for interpretation. While for some the art of ophthalmology is in treating patients, in other cases the reference is to artwork, such as a watercolor featured in the initiative Project VISIONS. Rendered in blues, greens and reds, the balloon-like figures floating on the canvas are retinal ganglion cells, which play a key role in healthy eyesight as well as diseases that impair vision. The project was meant to take science out of the laboratory and make it more public facing. “People need a language that deciphers the intricacies of microscope imagery, and the language that is accessible to everyone is art,” as ophthalmology scholar Dorota Skowronska-Krawczyk and artist Eva Henry described their collaboration.

The VISIONS project and others like it also make a connection to the imaging technologies that are playing a key role in ophthalmology. Techniques like spectral-domain optical coherence tomography (SD-OCT) and adaptive optics scanning laser ophthalmoscope (AOSLO) have helped to revolutionize the understanding of optic nerve structure and function and have also contributed to gene-based diagnoses.

In addition the projects make discernible key research areas in ophthalmology. For example, the retinal ganglion cells depicted ethereally on canvas are responsible for sending signals to the brain to make sense of visual inputs. Their damage results in vision loss in glaucoma patients.  One of the most read articles on the AAO website is an announcement of the FDA decision to give fast track designationto a single-administration intravitreal gene therapy for wet advanced macular degeneration in which blood vessels grow under the retina.

Art and science can be seen from a remembrance written upon the death of British ophthalmologist A.S. Percival in 1936, whose work on the mathematics of optics furthered the field at a time when the primary tool for examining the retina was the ophthalmoscope. The obituary, “The Art and Science of Ophthalmology,” provides a glimpse into the ophthalmology of another time yet the sentiment remains salient despite the dated exclusion of women.

“The death of Dr. A. S. Percival suggests some observations on the relations of pure science to the art or applied science of ophthalmology,” the author wrote in the British Journal of Ophthalmology. “It is not given to everyone to attain a thorough grasp of the ‘purer’ sciences upon which his art is based, but few will deny that such knowledge makes a man a better worker, endows him with a pioneering spirit, and, not least, adds immeasurably to the interest and joy of his work.”

 

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