Biomedical subjects
C E Nielsen
Publications and source records attributed to C E Nielsen.
[Consultations in ophthalmological practice. A multi-practice study of referrals to private ophthalmologists in Denmark].
In Denmark the GPs act as gatekeepers for secondary health care services except for ophthalmologists and ear-nose-throat specialists. The aim of this study was to describe consultations and referral patterns to ophthalmologists in private practice in Denmark. Forty-four out of 143 practising ophthalmologists agreed to fill out a short questionnaire on a random sample of their patients. They recorded 1844 consultations. Forty percent of contacts were appointments arranged by the ophthalmologist, 35% were self-referred, 13% were referred by their GP and 12% by others. Cataract, glaucoma and refraction anomalies accounted for 51% of all diagnoses. The distribution of reasons for encounter and diagnoses among self-referred patients and patients referred by their GP does not argue in favour of a change from the present system with free self-referral to a system with gatekeeping by GPs.
[Vision care outside hospitals. Selected aspects].
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Amiodarone induced cornea verticillata.
Among 30 patients (17 men, 46-76 years and 13 women, 15-70 years), treated with the antiarrhythmic drug amiodarone, 21 patients (11 men and 10 women) developed bilateral cornea verticillata. Total doses up to 494 g had been given and the duration of therapy was up to 113 weeks. In 14 patients samples of 50 microliters tear fluid were analyzed for aminodarone. No amiodarone was present in the tears at low serum concentrations but a rapid increase in tear concentrations was seen at serum values above 1.2 micrograms/ml (P less than 0.001). The grade of cornea verticillata was significantly correlated to total dose as well as to duration of treatment (P less than or equal to 0.001). On the day of examination at the eye clinic there was no significant correlation between se-amiodarone, tear-amiodarone concentration and the grade of cornea verticillata. One patient complained of coloured haloes. None had decreased visual acuity, fundus changes, cataract, exophthalmus, increased intraocular pressure, abnormal colour vision, or abnormal central corneal thickness, which could be attributed to the treatment of amiodarone.
Stickler's syndrome.
During recent years a new syndrome involving degenerations of the corpus vitreum and retina, and dysplastic abnormities of the bones, Sticklers Syndrome, has been evaluated. The patients have a bad visual prognosis because of a tendency to often uncurable retinal detachment. Several patients have glaucoma simplex, but only few descriptions of the angles of the anterior chamber have been published. Two patients with typical malformations and abnormal angles of the anterior chamber are described. Gonoidysgenesis is assumed to be part of the syndrome, which seems to be more common than earlier assumed.
Lenticonus anterior and Alport's syndrome.
Six patients, from five families, five males and one female, suffering from lenticonus anterior are presented. Furthermore, all suffered from chronic nephritis and nerve deafness and must be considered cases of Alport's syndrome. As all cases with lenticonus anterior which have been published within the last 13 years likewise were affected with nerve deafness and/or chronic nephritis, the assumption is submitted that lenticonus anterior exists exclusively as a part of Alport's syndrome. It is pointed out that four patients had a weakened bilateral macula reflex with changes in pigmentation. Attention is drawn to the fact that patients with lenticonus anterior often have a cornea astigmatism of 2-3 D. A complete table of all reported patients with anterior lenticonus is presented.