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PubMed1997

C.S. O'Brien: founder of the Department of Ophthalmology, the University of Iowa.

Cecil Starling O'Brien, M.D. (1889-1977), was the founder (1927) of the Department of Ophthalmology at the University of Iowa, and he is credited with the establishment of a strong department that has made many important contributions to ophthalmology. The surviving O'Brien residents were interviewed on videotape, and this article is a composite of their memories together with a brief biographical sketch of Dr. O'Brien.

Academic Medical Centers↗
PubMed2006

[Establishing ophthalmology in the research framework programs of the European Union].

The framework programmes (FP) of the European Commission have substantially contributed to the funding of research within the European countries. The contribution of the funding provided by the EU relative to the funding available on the national level has steadily increased. European ophthalmology and vision research has benefited from this support provided by the EU. This review introduces the European funding policies and the European Research Area (ERA) and provides a list of all projects in ophthalmology and vision research that have been funded within FP1 to FP6. As an example for new instruments within FP6, Integrated Projects, the EVI-GENORET project is introduced. Finally an outlook for FP7 is provided.

Biomedical Research↗
PubMed1997

[Prevalence of patients with diabetes mellitus without and with retinopathy in an ophthalmology practice].

OBJECTIVE: In a prospective study 10,000 consecutive patients were interviewed and examined in a German ophthalmology practice to evaluate the prevalence of diabetes mellitus and diabetic retinopathy. PATIENTS: Out of all patients 496 (4.96%) suffered from diabetes. In most patients (488:230 male, 258 female; mean age: 66 +/- 15 years) a clinical workup including demographic data and binocular ophthalmoscopy was performed. RESULTS: Diabetic retinopathy (DR) was present in 130 (26.6%) of the 488 diabetic patients. Subgroup analysis showed a higher prevalence of diabetic retinopathy in patients with insulin therapy (85 of 149; 57%) to those treated with oral antidiabetics (37 of 198; 19%) or diet only (8 of 141; 6%). The prevalence was significantly correlated with the duration of diabetes in the groups treated with insulin (P < 0.01) and with oral antidiabetic drugs (P < 0.001). Mild or moderate non-proliferative DR was found in 93 patients (19%), severe non-proliferative DR in 23 patients (4.7%) and proliferative DR in 14 of 488 patients (2.9%; 13 with insulin-dependent diabetes). Clinically significant diabetic macular edema was identified in 41 patients (8.4%). In 48 (9.8%) laser coagulation had already been performed: 13 cases with panretinal scatter, 18 with a focal coagulation, 17 cases with both. CONCLUSIONS: The prevalence of diabetes mellitus in a German ophthalmological referral practice is similar to the total prevalence in Germany (4.9%). Diabetic retinopathy was found in fewer patients than reported in the Wisconsin Epidemiologic Study and other recent studies in other countries. The data in this study showed that regular screening of all diabetic patients is mandatory.

Adolescent↗
PubMed2001

[Internet-based teaching and learning in ophthalmology].

The transmission of clinical knowledge occurs traditionally through lectures, theoretical and practical courses, bed-side teaching as well as case-oriented teaching in small groups. The realisation is, however often very laborious and problematical because of low resources. For these reasons the development of computer-based, and in particular internet-based tutorials have increased dramatically in recent years. Furthermore, the transmission of knowledge by means of internet-based tutorials offers several advantages. The content can be quickly updated and multimedia presentations are possible. The use of these sources is normally independent of time and location. The possibilities of internet-based teaching and learning are on-line lectures, case simulations and online quizes. At present, the number of ophthalmological applications on the internet is still restricted. Internet-based multimedial tutorials represent a meaningful supplement to traditional forms of teaching. Especially in ophthalmology, a visual presentation of details can be performed in an easier way via multimedial tools and the training is followed without causing stress for the patients.

Computer Graphics↗
PubMed2001

[Application of diagnosis related groups (DRGs) in ophthalmology in Germany].

Starting on 01.01.2003 the hospital reimbursement system in Germany will be transferred completely to a diagnosis-related groups (DRG) system based on the data of 2001. As the reimbursement system is of vital importance for the development of a speciality, current information is given about the impact of the new payment system on ophthalmology. The Australian AR-DRG system to be adopted in Germany distinguishes 20 DRGs for ophthalmology. The patients are grouped into the DRGs according to their principal diagnoses and comorbidities and the procedures coded by electronic data processing. Errors in coding and missing data may cause reductions in the hospital budget as do economically inhomogeneous DRGs. The tight timetable given by the legislation requires completion of determining DRG groups and weightings by 31.12.2001. However, important prerequisites such as the mapping tables of the Australian DRGs are still missing, which means that hospitals have to prepare for the new system like a pilot flying blind with no instruments.

Cost Control↗
PubMed2004

Serious eye and adnexal injuries from fireworks in Northern Ireland before and after lifting of the firework ban--an ophthalmology unit's experience.

BACKGROUND/AIMS: To report serious fireworks-related eye and adnexal injuries presenting to the Department of Ophthalmology in the Royal Victoria Hospital, Belfast. To assess the effect of lifting of the legislative ban on fireworks in Northern Ireland in 1996. METHOD: Twelve year retrospective review from 1990 to 2001 inclusive of all ocular and adnexal injuries from fireworks requiring hospitalisation to the ophthalmology department. RESULTS: Twenty three patients with 23 injured eyes were reported. Six were female. The mean age was 18 years (+/- 13 SD). Six patients presented between the years 1990 and 1995. The remaining 17 patients presented between 1996 and 2001. Nearly half of the patients required ophthalmic surgical procedures. Thirty-six percent of patients had a final visual acuity of 6/60 or less. Superficial trauma not requiring hospitalisation was not included. CONCLUSION: Removal of the legislative ban on fireworks in 1996 has had a significant effect on the incidence of eye injuries. These injuries are potentially preventable with stricter control on the availability of fireworks and a greater awareness of the ocular risks they pose.

Adolescent↗
PubMed1993

The history of ultrasound techniques in ophthalmology.

The history of 50 years of applications of ultrasound in ophthalmology is described. This period started in 1938 with a study of the possible effects of high intensity ultrasound on eyes. The measurement of biological effects for the assessment of potential hazards characterizes the first decades. More recently, the therapeutic use of ultrasound by hyperthermia has gained much interest in ophthalmology. Further topics are: the measurement of acoustic characteristics of ocular tissues; the biometry of the eye ball, the results of which are used to calculate the optical power of artificial lens implants; the development of diagnostic instruments in various parts of the world; and ultrasonic tissue characterization for the differential diagnosis of pathology. The final topic is concerned with some recent developments which present a look into the future.

Biometry↗
PubMed2026

Workforce Representation in Ophthalmology Oral Board Examiners and Examinees.

PURPOSE: To evaluate the characteristics of the American Board of Ophthalmology (ABO) oral board examiners and examinees as well as trends in examiner and examinee gender over time. DESIGN: Retrospective cohort study. SUBJECTS: ABO oral board examiners and examinees. METHODS: We utilized data from the American Board of Ophthalmology (ABO) and Association of American Medical Colleges (AAMC) to assess board examiner and examinee demographic characteristics from 2011 to 2024. Examiner characteristics included gender, years of experience, initial certification year and average examiner score. Examinee characteristics included gender, years since residency graduation and exam outcome (pass/fail). We utilized logistic regression to examine temporal trends in examiner and examinee gender from 2013 to 2024. MAIN OUTCOME MEASURES: Gender distribution of examiners and examinees. RESULTS: Overall, the proportion of women examiners increased over the study period. Notably, the most pronounced increase occurred following the transition from in-person to virtual oral board exam administration in 2020, rising from 31.3% (95% CI: 24.1%-38.4%) in 2019 to 49.1% (95% CI: 43.8%-54.4%) in 2024 (p < .001). The percentage of women examinees remained stable (41.7% [95% CI: 37.6%-45.8%] in 2019; 37.5% [95% CI: 33.0%-42.0%] in 2024, p-value: .019). CONCLUSIONS: The representation of women among the ABO oral board examiners has increased significantly following the transition to virtual exams while the proportion of examinees remained stable. Strategies to increase flexibility in scheduling exams may be beneficial in continuing to improve examiner representation.

Humans↗
PubMed2006

The American Association for Pediatric Ophthalmology and Strabismus workforce distribution project.

PURPOSE: To describe data sources and functional utility of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) workforce database and associated map files. METHODS: Population data from the 2000 U.S. Census and current listings from the AAPOS and American Academy of Ophthalmology (AAO) databases were organized to demonstrate and analyze practitioner-to-population relationships for metropolitan statistical areas nationwide. An interactive map was developed to provide an intuitive graphical display of the data. RESULTS: A total of 749 active AAPOS members were distributed in 154 of 280 defined metropolitan statistical areas. Within these areas, a 0- to 20-year age subgroup varied from 17.8% to 42.6%, with an average of 30.4%. The AAPOS member-to-million-person ratio varied from 1.3 to 27, with higher numbers generally representing regions with population bases inadequately defined by Census Bureau statistical area definitions. Ratios for a majority of larger, better-defined areas ranged from 3 to 4 AAPOS members per million persons. Sizable areas with no AAPOS member presence were identified and tabulated. AAO members with a specified pediatric practice focus who were not AAPOS members were identified in 103 areas, possibly influencing patient choices and practitioner referrals for these regions. CONCLUSIONS: The AAPOS workforce database and related interactive map display practitioner and population data that may assist physicians and planners in targeting practice development and identifying potentially underserved areas.

Databases, Factual↗
PubMed2005

Ophthalmology and vision science research. Part 1: Understanding and using journal impact factors and citation indices.

In an increasingly "publish or perish" clinical and academic environment, all clinicians and clinician-scientists involved in research must have a firm understanding of the measures commonly used to assess the quality of scientific journals and, by default, those extended to grade individual articles and authors. The publication of research is a vital part of clinical and experimental research, and citation analyses of research publications have increasingly been adopted as a means of assessing the apparent quality of journals and the research published therein. In the first of a series of articles for those embarking on ophthalmic and vision science research, this paper discusses the key features of citation analysis, concentrating on the 2004 Journal Citation Report figures for the field of ophthalmology that include 42 ophthalmology, vision science, physiological optics, and optometry journals. The Institute for Scientific Information (ISI) calculates a number of parameters including citation counts, Journal Impact Factor (JIF), Immediacy Index, and cited/citing half-life. This article discusses the methods of calculation and possible uses along with current controversies and potential abuses. The JIF and its relevance, potential bias, and limitations are discussed in depth as it has become the most widely used analysis of journal quality. The possible alternatives to ISI citation analysis are presented, and we conclude that citation analysis can be considered a reasonable measure of journal research quality only if used correctly.

Bibliometrics↗
PubMed2006

Approach to ophthalmologic emergencies.

This article presents evaluation and treatment approaches to ophthalmologic conditions that are likely to be encountered in a primary care office. These conditions can be organized by diagnostic category, symptoms, and location of complaint. By using one ora combination of these categories, the practitioner can provide appropriate, timely, and effective ophthalmologic evaluation and treatment. Acute conditions are categorized according to urgency of intervention.

Acute Disease↗
PubMed2006

Representation of ophthalmology concepts by electronic systems: intercoder agreement among physicians using controlled terminologies.

OBJECTIVE: To assess intercoder agreement for ophthalmology concepts by 3 physician coders using 5 controlled terminologies (International Classification of Diseases 9, Clinical Modification [ICD9CM]; Current Procedural Terminology, fourth edition; Logical Observation Identifiers, Names, and Codes [LOINC]; Systematized Nomenclature of Medicine, Clinical Terms [SNOMED-CT]; and Medical Entities Dictionary). DESIGN: Noncomparative case series. PARTICIPANTS: Five complete ophthalmology case presentations selected from a publicly available journal. METHODS: Each case was parsed into discrete concepts. Electronic or paper browsers were used independently by 3 physician coders to assign a code for every concept in each terminology. A match score representing adequacy of assignment for each concept was assigned on a 3-point scale (0, no match; 1, partial match; 2, complete match). For every concept, the level of intercoder agreement was determined by 2 methods: (1) based on exact code matching with assignment of complete agreement when all coders assigned the same code, partial agreement when 2 coders assigned the same code, and no agreement when all coders assigned different codes, and (2) based on manual review for semantic equivalence of all assigned codes by an independent ophthalmologist to classify intercoder agreement for each concept as complete agreement, partial agreement, or no agreement. Subsequently, intercoder agreement was calculated in the same manner for the subset of concepts judged to have adequate coverage by each terminology, based on receiving a match score of 2 by at least 2 of the 3 coders. MAIN OUTCOME MEASURES: Intercoder agreement in each controlled terminology: complete, partial, or none. RESULTS: Cases were parsed into 242 unique concepts. When all concepts were analyzed by manual review, the proportion of complete intercoder agreement ranged from 12% (LOINC) to 44% (SNOMED-CT), and the difference in intercoder agreement between LOINC and all other terminologies was statistically significant (P<0.004). When only concepts with adequate terminology were analyzed by manual review, the proportion of complete intercoder agreement ranged from 33% (LOINC) to 64% (ICD9CM), and there were no statistically significant differences in intercoder agreement among any pairs of terminologies. CONCLUSIONS: The level of intercoder agreement for ophthalmic concepts in existing controlled medical terminologies is imperfect. Intercoder reproducibility is essential for accurate and consistent electronic representation of medical data.

Decision Support Systems, Clinical↗
PubMedDate not supplied

The new competencies and their impact on resident training in ophthalmology.

Changes in the health care environment and the evolving needs of external stakeholders have created a demand for a new set of competencies in residency training. This article reviews the forces that have shaped the development of the new competencies; defines the specific Accreditation Council for Graduate Medical Education competencies; describes the tools that might be used to measure these competencies; introduces current concepts and terms in the field of post-graduate medical education; and summarizes an implementation plan for ophthalmology. Meeting the new Accreditation Council for Graduate Medical Education competencies will require the development of a toolbox for measurement outcomes and a reinvention of the residency training process in ophthalmology. A coordinated, thoughtful, and standardized effort will be required to meet the challenge.

Accreditation↗
PubMedDate not supplied

The amniotic membrane in ophthalmology.

The amniotic membrane is the innermost of the three layers forming the fetal membranes. It was first used in 1910 in skin transplantation. Thereafter it has been used in surgical procedures related to the genito-urinary tract, skin, brain, and head and neck, among others. The first documented ophthalmological application was in the 1940s when it was used in the treatment of ocular burns. Following initial reports, its use in ocular surgery abated until recently when it was re-discovered in the Soviet Union and South America. Its introduction to North America in the early 1990s heralded a massive surge in the ophthalmic applications of this membrane. The reintroduction of amniotic membrane in ophthalmic surgery holds great promise; however, although it has been shown to be a useful and viable alternative for some conditions, it is currently being used far in excess of its true useful potential. In many clinical situations it offers an alternative to existing management options without any distinct advantage over the others. Further studies will undoubtedly reveal the true potential of the membrane, its mechanism(s) of action, and the effective use of this tissue in ophthalmology.

Amnion↗
PubMed2006

Factors influencing career choice in ophthalmology.

BACKGROUND: To investigate the factors influencing choice of ophthalmology as a career in medicine. METHODS: Data were extracted from the 2004 National Physician Survey, a questionnaire distributed to all physicians across Canada. Data were categorized by medical discipline, and chi2 comparative analyses were done. RESULTS: Intellectual stimulation emerged as the most frequently cited factor influencing career choice for ophthalmologists and nonophthalmologists alike (81% and 79%, respectively). Compared with other physicians, ophthalmologists were significantly more likely to cite flexibility (58% vs. 42%, respectively), mentorship (42% vs. 31%, respectively), and earning potential (38% vs. 26%, respectively) as important factors (p<0.001). INTERPRETATION: Intellectual stimulation is the principal reason physicians pursue a career in ophthalmology. Ophthalmologists cite flexibility, mentorship, and earning potential as important factors more frequently than do physicians of other disciplines.

Attitude of Health Personnel↗
PubMed1987

Special diagnostic and therapeutic modalities in pediatric ophthalmology.

Ophthalmology is a specialty rich in instrumentation used for special diagnostic and therapeutic functions. Many of these special modalities are appropriate to pediatric ophthalmology, and this article discusses them in summary fashion for those who may wish to know about the procedures but who may not be involved directly in their use.

Child↗
PubMedDate not supplied

Neuroimaging contrast agents in ophthalmology.

Magnetic resonance (MR) imaging and computed tomography (CT) are routinely performed with the use of contrast materials in the diagnosis of neuro-ophthalmologic disease. Iodinated agents are commonly used in CT scanning and femoral contrast arteriography, and gadolinium is used in MR imaging. While contrast materials contribute greatly to diagnostic accuracy, they may also be responsible for adverse effects, ranging in severity from mild discomfort to death. The most frequent and severe side effects are associated with ionic iodinated contrast agents, while the rate of adverse reactions is less with use of nonionic iodinated contrast agents. Side effects and adverse reactions to gadolinium are uncommon, but they do occur. In neuro-ophthalmologic diagnosis, MR imaging is generally preferred over CT scanning, partly because of its greater ability to delineate soft tissue intracranial structures, but also because of the relative safety of gadolinium as a contrast agent. Properties of contrast agents are discussed in the context of specific imaging techniques and tissues investigated. Types and severity of adverse effects as well as risk factors for incurring such effects are summarized.

Contrast Media↗
PubMedDate not supplied

Manuel Straub and the Amsterdam School of Ophthalmology.

Manuel Straub was one of the forefathers of Dutch ophthalmology and is well known for his early work on phacogenic uveitis and refraction. In this historical account of the rise of ophthalmology in the Netherlands, the author traces Straub's significant role and reflects on how his own fate became inextricably linked with Straub and other illustrious Dutch ophthalmologists, such as W.P.C. Zeeman, Otto Roelofs, and Arend Hagedoorn.

History, 19th Century↗