The latest edition offers a chance for ophthalmologists to step out of their lanes to learn from their cross-subspeciality peers. Insight was there to summarise the key takeaways.
Ophthalmology Updates! has once again lived up to its name – and then some, in 2025.
The ninth edition of the conference set new records, drawing more than 250 in-person delegates to Sydney’s Fullerton Hotel for two days of ophthalmic science, spirited debate and collegial connection on 30-31 August.
From fresh takes on intraocular lenses (IOLs) and emerging therapies for macular disease, to the event’s first-ever panel on pregnancy in ophthalmology and a searching discussion on professional ethics, the 2025 program demonstrated that it’s more than a forum for ophthalmologists to brush up on key issues affecting each subspecialty.
It’s also a space where clinical breakthroughs, practical dilemmas and broader questions of identity and integrity intersect.
The calibre of speakers reflected this ambition. Five international experts flew in from the US, UK, and New Zealand to share their latest research and experiences, while local leaders cut through the hype to inform colleagues on how the latest technologies are performing in the real world.
Event founder and convenor Professor Adrian Fung was proud to host his largest Ophthalmology Updates! yet, featuring the highest number of delegates and sponsors. Even the Sydney Marathon, held on the Sunday in the same area, couldn’t get in the way.
“This two-day meeting is designed so generalists and subspecialists can grasp what is changing outside their area of expertise, sharpening their referrals and diagnoses,” he said.
“We want delegates to gain both practical take-home insights and space for collegial exchange.”
Day 1 – IOLs, pregnancy and ethics
That intent – to deliver knowledge that could be translated into the clinic tomorrow – was captured from the outset with Dr Ben LaHood’s session.
The Adelaide cataract and refractive surgeon’s talk separated the signal from the noise around IOLs, ranging from monofocals and extended depth of focus (EDOF) lenses, to new multifocal options.
Starting with monofocals, he discussed how they were still the quiet achievers, with new data on Alcon’s Clareon showing excellent stability and even better-than-
expected intermediate vision.
“Intermediate vision was probably as good as a monofocal plus, and sometimes as good as some of the EDOFs out there,” he said.
He also discussed a common question among colleagues: what to do when very high-powered monofocals are required.
“Personally, I use a HumanOptics lens. It’s a simple monofocal that goes up to extremely high powers. You do sometimes wonder about the tolerance in creating a lens like that – what you’re really getting. But the advantage is you can still insert it through a standard 2.4 mm incision. It’s a nice lens to have in your kit.”
On EDOFs, he pointed to Johnson & Johnson MedTech’s TECNIS PureSee as a go-to during the past year.
“It’s given really good visual acuity – 20/20 unaided distance and nearly 20/20 unaided intermediate,” he said.
“It’s been reliable, with a consistent range and very few outliers. Probably the biggest thing is there haven’t been a lot of dysphotopsias, and the refractive accuracy has been excellent, with about 95% of my patients within 0.50 D. It seems to tolerate small amounts of residual astigmatism very well.”
He also noted interest in Rayner’s RayOne EMV lens, which the company developed with Professor Graham Barrett and applies positive rather than negative spherical aberration. “I don’t think it gets quite as much depth as PureSee or Vivity, but the distance acuity has been good, with minimal dysphotopsias,” he added.
Dr LaHood also covered advances in multifocal and full range of vision IOLs, and highlighted the much-discussed Rayner Galaxy spiral design that’s showing promise, with adaptation and patient counselling remain key.
Refractive outcomes have been strong, with nearly 90% of his patients landing within 0.50 D.
“Out of 50 patients, five have described halos at night, but none have found them disabling,” he said. “Even patients who work underground in mines have been very happy with their night vision.”
On the horizon, he said lenses like Alcon PanOptix Pro and Hoya’s Gemetric design could soon broaden surgeons’ options even further in Australia.
Later on day one, Associate Health Sciences Professor Jay Sridhar from Los Angeles had some intriguing insights into diabetic macular edema (DME) treatment. He described how US retinal specialists tend to use less steroids than ex-US counterparts, and there was discussion of the best treatment regimen to use (monthly vs. treat and extend vs. PRN [as needed]).
Intravitreal anti-VEGF remains the gold standard, with bevacizumab and aflibercept the most commonly used worldwide, but he highlighted research reminding ophthalmologists that long-term outcomes converge, regardless of starting agent.
On the issue of next-generation agents, A/Prof Sridhar pointed to higher-dose aflibercept and faricimab showing the ability to extend intervals safely without sacrificing outcomes, which could reduce treatment burden significantly.
And even further on the horizon, he pointed to gene therapy, port delivery systems, tyrosine kinase inhibitors (TKIs), senescence inhibitors and systemic diabetes breakthroughs (e.g. GLP-1 agonists) that may change the diabetic eyecare landscape – but cost and access will be the ultimate limiting factors.
Then, he ventured into the controversy around photobiomodulation for intermediate dry age-related macular degeneration. This therapy is now Food and Drug Administration (FDA)-authorised in the US and uses low level light to stimulate cellular function to promote healing, at the mitochondrial level.
Treatment is “intensive”, with nine sessions over three to four weeks, and two to three treatment cycles per year.
Presenting a study that met the primary endpoint with efficacy, A/Prof Sridhar said: “At month 21, patients in the photobiomodulation group tended to gain about six letters, and a mean gain of 5.6 letters was maintained in month 24 when you compare it to the sham group.
“There were also no significant safety events.”
But despite positive outcomes, scepticism remains due to small sample sizes and potential placebo effects. Ethical concerns about cost, the number of treatments required and treatment administration by non-physicians were also discussed.
“There’s also growing interest in many other conditions (DME and high myopia), so I don’t think it’s going be the last we hear about it, even if it never takes off in dry AMD, but of course, we need continued research to standardise and adopt this more broadly.”
Among the most talked-about sessions was the first-ever Pregnancy & Ophthalmology panel, where seven speakers tackled challenging scenarios across subspecialties.
The discussion explored issues related to pregnancy, including worsening of disease in areas like diabetic retinopathy (DR), thyroid eye disease, and idiopathic intracranial hypertension (IIH), and the risks of treatment such as anti-VEGF therapy, glaucoma drops and surgery.
Key clinical takeaways included: anti-VEGF is not an absolute contraindication in pregnancy; DR does not necessarily improve postpartum; brimonidine (Alphagan) is the safest anti-glaucoma drug in pregnancy; pharmacological management of thyroid eye disease remains largely restricted to steroids; and women with IIH should focus on nutrient-rich rather than calorie-dense foods.
Another standout moment was the Bioethics in Ophthalmology session, led by Professor Ian Kerridge who is a haematologist/bone marrow transplant physician at Royal North Shore Hospital, Sydney, and Professor of Bioethics and Medicine at Sydney Health Ethics (SHE) at the University of Sydney.
The session explored areas like social media promotion and commercial interests and incentives. It also touched on the challenges of whistleblowing when practitioners become “complicit” after caring for patients from a poorly performing peer.
“It was an opportunity to reflect on why we became doctors in the first place,” Prof Fung said.
“[Prof Kerridge] expanded on the virtues of humility and sagacity, which are often overlooked by the more traditional ‘pillars’ of ethics. It was refreshing to have industry representatives (Alcon, Bayer and Roche) on the panel for their unique perspective too.”
Contributing to the panel itself, Prof Fung noted that often the challenge in medical practice is to “stay virtuous”, rather than learning it.
“If you look at many medical students or even people fresh out of high school, they genuinely try to do the right thing. But as we progress in our careers, challenges creep in – financial incentives, time pressures – and it becomes harder to hold on to those virtues, let alone learn them. Deep down, I think we do know what’s right and wrong, but staying true to that is the real test,” he said.
Prof Kerridge added: “There’s empirical research that bears this out. Serial testing during medical school shows first-year students are more ethically aware and sensitive than final-year students – and both groups score higher than junior medical officers further down the track.
“It’s a hard one to combat, because there is literature suggesting that the profession can maintain situations, or particular policies, that principally benefit the profession, rather than the community, and are often slow to act when they concerns about colleagues performance or personal behaviour.”
Dr LaHood, active on platforms such as LinkedIn like many other ophthalmologists, shared an interesting take on how ophthalmologists can toe a fine line that promotes one’s achievements in a healthy way.
“Personally, I try to do it with a bit of humour, and it’s usually a bit self-deprecating,” he said.
“It’s about being genuine and authentic, so if a patient comes to see me, they’ll see that same person. It’s not as though what I portray online is different to what you’ll see in real life. And I think that’s probably the biggest thing, is keeping that consistent.”
A dinner at Shellhouse rounded out the Saturday, where delegates enjoyed oysters, champagne and a live DJ.
Day 2 – Surgical retina,
glaucoma and more
Sunday’s program continued the momentum with a strong focus on emerging retinal therapies.
A/Prof Jay Sridhar was on stage again to present on methotrexate for proliferative vitreoretinopathy, while Dr Amy Cohn explored novel approaches to macular telangiectasia type II with ciliary neurotrophic factor (Encelto).
Dr Jennifer Fan Gaskin’s session on normal tension glaucoma was also well received. It tackled critical questions around what target intraocular pressure (IOP) and management should be considered in patients with IOPs that are already considered “low”, how to determine if there truly is progression, what lifestyle advice to consider, and when to request neuro-imaging.
International flavour
Event convenor Prof Fung was proud of the calibre of international speakers secured for this year’s conference.
Among them was Professor Richard Allen, from Baylor College of Medicine, Texas. He’s is famous for his OculoSurg video library of oculoplastics procedures, the largest such repository in the world and staple viewing for surgeons.
He spoke on teprotumumab, the first-in-class human monoclonal antibody used for treatment of active moderate to severe thyroid eye disease. It has recently been approved in Australia. However,
one side effect to look out for with this
treatment is hearing loss.
Associate Professor Simon Fung flew in from San Francisco and showed how corneal transplantation could be successfully performed in children, for challenging diseases such as Peters anomaly.
“All his surgery looked challenging but beautiful, with perfectly aligned sutures at the end of each case,” Prof Fung noted.
Dr Sui Wong from Moorfields Hospital, London, provided the latest updates on ocular myasthenia, and factors to look out for when screening for conversion to systemic myasthenia gravis.
“She also gave a refreshing talk on mindfulness for visual snow symptoms, and how clinical group therapy was transforming her practice,” Prof Fung added.
Looking ahead, Prof Fung confirmed that the 2026 event is already in planning.
“I expect the venue to be the same (Fullerton Hotel), but the date may change to September or October,” he said.
“We are already planning more exciting speakers – but if there is someone you think would be great, please reach out. Watch this space.”
