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2 of the Most Interesting and Important Sessions at AAO 2021

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As this year’s AAO annual meeting in New Orleans winds down, I cannot help but to compare and contrast this year’s meeting to the many meetings that preceded these unprecedented times. Strangely, the lower number of attendees seemed to make the COVID-19 threat to me more real and slightly more ominous — not less. 

The meeting attendee social distancing options created some awkward but friendly encounters at the meeting and at the social events. The AAO ID badge sticker choices (e.g., “smile and wave,” “elbow bumps,” or “high fives and handshakes”) did not seem to help dissuade the occasional well-intentioned hug or extended hand. The on-site meeting precautions (including a vaccine verification requirement) seemed to be taken in stride by most participants and I suspect that some of these changes will become permanent even as the pandemic recedes to endemic. 

Some of the meeting sessions seemed undersubscribed but other course offerings and SubDay sessions actually appeared (at least to my eye) to be more populated than in prior years. Perhaps this was due to reduced course and activity “competition” for attendees’ time created by the shift to “on demand” and “virtual only” content. A few courses were canceled. 

As is the case everywhere, some hospitality based industries have taken longer to rebound and the taxicab versus ride hailing services (Uber/Lyft) battle created a shortage of transportation options at the airport as well as surge pricing and limited availability to and from some peak social and dining venues. During the meeting, there were a few speaker substitutions (some very late) that required quick action and flexibility on the parts of session moderators and some late line-up changes seemed to be relatively common. The exhibit floor seemed relatively quieter to me, but sales appeared to be brisk and enthusiastic perhaps related to pent up demand during the pandemic.

The two most important and interesting sessions at this year’s AAO annual meeting for neuro-ophthalmology content that strongly impacts a comprehensive ophthalmology audience were the Hoyt Lecture, delivered by my good friend, colleague, and neuro-op hero, Valerie Biousse, MD and the Neuro-ophthalmology SubDay symposium on transient monocular visual loss (TMVL). Dr. Biousse’s talk on the management of acute retinal ischemia emphasized that we eyeMDs should “BE FAST” with stroke recognition (Balance, Eye, Face, Arm, and Speech are Time). In addition, ophthalmologists should recognize, triage, and refer any “stroke of the eye” to a stroke center to see a stroke neurologist for a stroke work-up (e.g., CT and MRI of head, cardiac evaluation and vascular imaging). The importance of timing was emphasized and “Time is Brain but Time is also Eye”. This paradigm shift in the rapid evaluation of TMVL is evidence based, timely, topical, and critical for preventing new and potentially life-threatening strokes in patients with TMVL. The outdated and linguistically mismatched term, “amaurosis fugax” (Greek amaurosis for blindness and Latin fugax meaning fleeting) is less precise and less helpful than the more accurate terms TMVL or transient bilateral visual loss (TBVL). 

COVID19 has impacted every part of our lives both inside and outside of the eye clinic. This AAO Annual Meeting was strange and surreal but also our first step back toward our new “normal.” I for one am glad that I attended in person and I greatly appreciated all of the health precautions that were taken to ensure a safe and healthy environment for on site attendees. For my wife, Hilary Beaver, MD, also an ophthalmologist who chose not to attend in-person, the Academy made many adjustments and accommodations for a remote audience with high quality livestream, on demand, and other hybrid options.

As I write this piece heading home from the AAO meeting, I am reminded of the Roman saying: “Per angusta ad augusta” (i.e., “through difficulties to honors”). I hope to see you all in person at the 2022 AAO Annual Meeting in Chicago, IL.

Dr. Lee reports no conflicts of interest.

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