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Biomedical subjects

W Glasson

Publications and source records attributed to W Glasson.

5 recordsLinked to original sources

Royal Australian College of Ophthalmologists and Royal Australian College of General Practitioners National GP Eye Skills Workshops: colleges and divisions reskilling general practice.

PURPOSE: Little formal eye skills training has historically been available to Australian general practitioners at undergraduate or postgraduate levels. The development of the National GP Eye Skills Workshop was a joint initiatve of the Royal Australian Colleges of General Practice and Ophthalmology, to enhance the skills of Australian general practitioners in a range of important ocular examination and procedural areas. METHODS: Workshops were run in eight Queensland Divisions of General Practice in 1998. Between two and 10 local ophthalmologists in each divisional area were involved ether in the workshop programme or in the recruitment of patients for the patient assessment module. Workshops were run on weekends and included modules on vision testing and disease screening in children and adults, ophthalmoscopy, assessment for glaucoma and diabetic retinopathy, incision of chalazions, removal of corneal foreign bodies, ocular first aid, implementing eye assessment in busy general practice, and a patient assessment clinic. A questionnaire was administered which was comprised of sections relating to the format of the workshop, new skills and concepts learnt, learning exceptions, and perception of future ability to treat/scan/assess for eye conditions in general practice. The questionnaire was completed by 91% of participants. RESULTS: Participants strongly supported the impact of the workshop on their ability to detect and treat eye problems in their practices, and refer where appropriate to an ophthalmologist. They also rated highly all individual aspects of the programme in terms of impact on their delivery of general practitioner eye care. CONCLUSIONS: The results illustrate the comprehensive success of the workshop programme in format, content, relevance and delivery.

Adult↗

Prevention of visual loss. Screening in general practice.

BACKGROUND: Diseases such as primary open angle glaucoma, diabetes, strabismus and retinoblastoma have been found to have improved outcome by early investigations. Australian GPs are currently well placed to enhance their role in preventable blindness. OBJECTIVE: To identify key clinical target areas for the prevention of visual loss and discuss opportunities to address these in everyday general practice. DISCUSSION: Undertaking visual assessment in both children and adults can have benefits in reducing the incidence of preventable blindness in the community. Upskilling and having protocols to work to can enhance the GP's ability to offer this preventive service.

Adult↗

Assessing for glaucoma in general practice.

Examining patients appropriately for primary open angle glaucoma in the general practice setting has traditionally been extremely difficult. The authors review important issues in the early detection of primary open angle glaucoma and discuss new assessment tools to assist GPs in this area.

Acute Disease↗

Screening for glaucoma in a Brisbane general practice--the role of tonometry.

OBJECTIVES: (1) To pilot, and evaluate, a tonometry training intervention for general practitioners; (2) to evaluate the efficacy of three types of tonometer (Perkins, Schiotz and Tonopen) in the hands of these general practitioners; (3) to evaluate the predictive value of tonometry in screening for glaucoma in a general practice population; and (4) to evaluate the acceptability of tonometry to general practice patients. DESIGN: After being trained, three general practitioners recruited 73 of their patients over 50 years of age to attend for measurement of intraocular pressure by tonometry. Intraocular pressure was initially measured by an ophthalmologist using the Goldmann applanation tonometer, and then recorded in random order by GPs using three types of tonometer--the Perkins, Schiotz and Tonopen. SETTING: A group general practice in a middle-class suburb in southern Brisbane. OUTCOME MEASURES: (1) Comparison of measurements on the Perkins, Schiotz and Tonopen tonometers with that of the 'gold standard', the Goldmann Applanation tonometer; (2) prevalence of disc and perimetric abnormality suggestive of glaucoma among those patients with increased intraocular pressure; and (3) the acceptability of contact tonometry to general practice patients. RESULTS: There was considerable variability between intraocular values obtained across doctors and across instruments (6% to 95% of values within 4 mm of the 'gold standard'). The Schiotz tonometer provided the most uniform assessment of intraocular pressure across the groups. Nineteen of the 73 patients (26%) had intraocular pressures > or = 21 mmHg using the 'gold standard'. Of these, 18 were followed up with funduscopy, gonioscopy, repeat measurement of intraocular pressure and visual field assessment. Five had persistent elevations of intraocular pressure > or = 21 mmHg on subsequent assessment, and two had mild abnormalities of cup-disc ratio with normal fields on testing with Humphrey computerised perimetry. CONCLUSION: No one hand-held tonometer proved highly accurate in the hands of all three doctors. Even measured optimally, increased intraocular pressure alone was a poor predictor of glaucoma. Of the population screened, two patients (3%) showed evidence of mild cup-disc abnormality requiring follow-up.

Australia↗

Conjunctival and limbal tumours.

One hundred cases of histologically proven corneal and conjunctival tumours were extracted from the records at the Princess Alexandra Hospital and from the senior author's private practice in the last ten years. The tumours were analysed according to Duke-Elder's classification. There were 78 epithelial tumours, 15 pigmented naevi, four melanomas, two dermolipomas and one limbal dermoid. Fourteen of the 41 epithelial carcinomas were followed for three years or more. None of the 14 recurred.

Adult↗