[Epibulbar tumors. Clinical and histological aspects].
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The survey proposes the analysis of the Romanian implementation of the action: "Protocol for screening of diabetic retinopathy in Europe" (London, 1990). Based on the answers obtained after spreading a typical questionnaire, it was constated that the protocol's implementation was done in 9 sanitary profilated units and implied a percentage of patients less then 4%. Some of the difficulties mentioned were the insufficiency of (photocoagulation) devices, of funds and adequate (qualified) staff, and also the inertia of the old evidencing system.
The angiofluorographic surveys done on 46 patients with diabetes shows some particular modifications of the retinal vessels, from the foveolar, perifoveolar and parafoveolar areas. These modifications influence the values of the visual acuity; they are not connected in all cases with all the retinal vascular modifications.
The psychic ill man, no matter the gravity of the syndrome presented, is not undesirable and does not constitute a contraindication in ocular surgery. But in these situations a correct evaluation of the general and ocular state must be done, and also a correct premedication, a local or general on case good-conducted anesthesia and a close cooperation with the psychiatrist. Are discussed the problems of the little psychiatry which appear in the ocular interventions: senile psychosis, unorganical psychoses like ambulatory schizophrenia, maniacal-depress psychosis and paranoia decompensated by surgical act.
The general anesthesia is recommended in ocular surgical interventions on children or patients with psychical lability, anxiety and in general intervention on open globe. Before the intervention, a permanent contact between the ophthalmologist and the anesthesiologist is necessary, in order to manage the complexity of the case and to adopt a common attitude. The attitude which has to be taken to avoid the pre- and post-operational incidents is put into light.
It presents the indications and contraindications of general and local anesthesia in the patients with diabetic cataract. It insists about the criterion of preoperative clinical evaluation of the patients, about the different schemes used in those two type fact that every case must be individualised as for the indication for anesthesia. Also, it insists about the fact that it is necessary the collaboration between the ophthalmologist with diabetologist and anaesthesist, with a view to ensuring one operator gesture that establish the best, functional outcome.