Biomedical subjects
Publications and source records attributed to D K Talley.
Current ophthalmic laser treatment can be described on the basis of its effect on tissue. Laser variables such as wavelength, spot size, power, and mode of delivery are all controllable, but are dependent on the transparency, pigmentation, and water content of the tissue involved. This discussion introduces the clinician to these variables, while describing specific laser-tissue interactions.
The majority of complications associated with laser procedures can be minimized or avoided through proper technique. The astute clinician is aware of all potential complications and is prepared to manage any undesired effects promptly and correctly. This review discusses how to minimize the risk of significant complications and describes the appropriate treatment protocols for complications associated with specific anterior segment laser procedures.
Management of open-angle glaucoma is complex and consists of medications, laser therapy, and conventional surgery. Laser therapy is a vital component of management, with the most common procedure being a trabeculoplasty, which reduces intraocular pressure by increasing aqueous outflow. This review discusses the indications, contraindications, and specific techniques for laser trabeculoplasty. The use of holmium sclerostomy is also discussed. With recent advances in laser and fiberoptic technology, sclerostomy is proving to be a simpler procedure than conventional filtering surgery, while providing comparable effectiveness.
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Traumatic anterior uveitis is a common result of ocular contusion. Patients require careful evaluation to determine the degree of injury and the risk of further complications. This discussion updates the practitioner on the pathophysiology, diagnosis, and treatment of anterior uveitis secondary to a nonpenetrating ocular injury.
In many cases, anterior uveitis is not an isolated ocular entity but the harbinger of systemic disease. The diagnosis of an underlying disease is confirmed through laboratory testing and physical examination. Rather than ordering a broad spectrum of unnecessary tests, the clinician must correlate the patient's history with symptoms and physical signs to tailor laboratory testing to the individual. Subsequent co-management of the patient with an internist or appropriate specialist ensures that total patient care, ocular and systemic, will be achieved. This discussion addresses when and what laboratory testing to order in anterior uveitis cases with specific attention to why each auxilliary test is appropriate.
This observational study investigated the ability of three current brands of spherical soft contact lenses to correct or "mask" low amounts of refractive astigmatism. The lens brands were worn by 16 subjects having at least 0.50 D, but not more than 1.00 D, of refractive astigmatism. Spherocylindrical refraction over the soft lenses was used to determine the amount of astigmatism that was masked by the lenses. Results showed that the wearing of spherical soft contact lenses, such as those used in this study, cannot be expected to predictably mask astigmatism.
A worldwide survey of active duty military optometrists (Air Force, Army and Navy) was conducted in the spring of 1987. The survey response rate was 79%. Statistically significant differences (alpha = 0.01) in their roles, activities and attitudes are presented and discussed. Significant interservice differences were found in: types of duties, profession/status of immediate supervisors, work assignments, frequency and types of patient encounters, awareness of therapeutic drug policies, access to specific clinical instruments, and frequency of routine clinical tests. Attitude and opinion tabulations suggest an overall satisfaction with professional experiences and interprofessional working relationships. However, there was a common perception that optometrists did not receive appropriate promotional consideration or career opportunities within this multidisciplinary setting. Implications of survey results for non-military multidisciplinary health care institutions are also discussed.