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At least 433 records · Page 24Linked to original sources
PubMed2003

Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment.

PURPOSE: To determine the feasibility of screening for depression, dementia, and functional impairment in an ophthalmology outpatient clinic. DESIGN: Prospective pilot survey study. PARTICIPANTS: Fifty consecutive ophthalmology clinic outpatients. METHODS: Consecutive patients more than 64 years of age with visits to the comprehensive eye clinic and the neuroophthalmology clinic at the University of Iowa were assessed. Suitable subjects were asked to complete a short questionnaire on instrumental activities of daily living, to answer a single question on depression, and to complete a clock drawing task in the office waiting room or examination room. RESULTS: The 50 questionnaires reviewed showed that most respondents were functional (94%) in instrumental activities of daily living, had normal clock drawing results (80%), and were not depressed (80%). A significant minority, however, were identified by the screening to have functional impairment (6%), abnormal clock drawing results (20%), or depression (20%), and these patients were offered geriatric assessment. The tests were rapid (fewer than 5 minutes to perform) and easy to administer. CONCLUSIONS: Screening for geriatric syndromes in the eye clinic was rapid, easy to perform, and detected a significant number of patients with functional disability, depression, and possible dementia.

Activities of Daily Living↗
PubMed1978

Elective subjects for medical students preparing for a career in ophthalmology.

Questionnaires asking for information as to what medical school electives should be taken by a student contemplating a career in ophthalmology were sent to 280 practicing ophthalmologists. Seventy-two replies were received and indicated that a medical school background in neurosciences, ophthalmology, anesthesiology, otolaryngology, dermatology, and infectious disease are believed to be most important.

Education, Medical, Undergraduate↗
PubMed1981

Microcomputer applications in clinical ophthalmology.

An Apple II computer was programmed for use as a clinical tool in ophthalmology. Currently, eleven distinct programs compose the Ophthalmology Program Library (OPL). These are used in diagnostic and therapeutic situations and are based on equations in physiologic optics. Problems in intraocular lens power calculation, astigmatism control, and spectacle over-refraction with spherocylinder addition (among others) are discussed. To demonstrate the usability of such a system, programs concerned with postcataract extraction astigmatism are discussed in depth. Practicing ophthalmologists should find this system of clinical value.

Computers↗
PubMed1983

Posterior chamber intraocular lens implantation by ophthalmology residents. A prospective study of cataract surgery.

The UCLA Cataract Surgery Study Group evaluated extracapsular cataract extraction with posterior chamber intraocular lens implantation (ECCE-posterior chamber IOL) performed by eight senior ophthalmology residents with faculty supervision and five faculty ophthalmologists experienced in intraocular lens surgery. The first 18 consecutive ECCE-posterior chamber IOL operations performed by each resident and faculty surgeon after July 1, 1981, were analyzed. All 234 operations and follow-up conformed to a predetermined protocol. Resident surgery achieved 20/40 or better final visual acuity in 88% of eyes; faculty surgery achieved 20/40 or better in 89%. Excluding cases with macular degeneration or other pre-existing eye disease, resident surgery achieved 20/40 or better final visual acuity in 95% of eyes; faculty surgery achieved 20/40 or better in 96%. There was no statistically significant difference between the results of resident surgery and faculty surgery. With supervision, ophthalmology residents achieved results generally equivalent to results obtained by experienced ophthalmic surgeons.

Aged↗
PubMed1988

Teaching ophthalmology residents about rehabilitation.

Ophthalmology is a medical specialty which deals with large numbers of patients who have irreversible impairments. A survey of all ophthalmology residency programs in the United States found that most programs require that residents receive training in low vision aids and devices, but they do not require training in seven other topics concerning the rehabilitation of visually impaired and blind patients. Those programs that do offer training in rehabilitation rely heavily on clinical training. Since practicing ophthalmologists themselves have an incomplete knowledge of the rehabilitation system, it is unlikely that the clinical model will provide residents with sufficient information about rehabilitation. Ophthalmologists need formal training about the rehabilitation process in order to ensure that their patients receive adequate referrals.

Blindness↗
PubMed1997

The utility of culturing corneal ulcers in a tertiary referral center versus a general ophthalmology clinic.

OBJECTIVE: The purpose of the study is to compare the utility of culturing corneal ulcers in a tertiary referral clinic and a general ophthalmology clinic. DESIGN: A retrospective review of medical and microbiologic records was performed. PARTICIPANTS: One hundred fifty-seven patients with corneal ulcers were included in the study. Eighty-two ulcers were treated in the referral clinic and 75 ulcers were treated in the general ophthalmology clinic. MAIN OUTCOME MEASURES: The authors determined the percentage of corneal ulcers in each clinical setting that failed to respond to empiric therapy and required a culture-directed change in treatment. RESULTS: One hundred fifty-seven ulcers were included. Eight (10%) of the 82 patients treated in the Cornea Clinic had treatment altered based on culture and sensitivity results. All 75 patients in the general clinic responded to empiric antibiotics, such that culture data never were required for modification of therapy (0%, P = 0.007). In contrast to patients treated in the Cornea Clinic, patients treated in the general clinic had smaller, more peripheral ulcers, shorter duration of symptoms, and fewer risk factors for corneal ulceration other than contact lens wear. CONCLUSIONS: Cornea specialists, who are referred the most severe cases, should consider culturing most corneal ulcers. However, it appears reasonable for general ophthalmologists to use culturing more judiciously. Patients with significant corneal ulcers should be cultured regardless of the clinic to which they present. However, small, peripheral ulcers respond extremely well to current, broad-spectrum antibiotics. Close follow-up is mandatory to discover the rare patient who will not respond to empiric therapy.

Adolescent↗
PubMed2004

Painful ophthalmologic disorders and eye pain for the neurologist.

Neurologists should be aware of the following causes of eye pain: (1)ocular and orbital disorders with or without visible pathology of the eye (eg,redness, corneal opacity, or proptosis); (2) ophthalmologic syndromes associated with headache; and (3) headache syndromes associated with ophthalmologic findings.

Diagnosis, Differential↗
PubMed1984

Epidemic keratoconjunctivitis: report of an outbreak in an ophthalmology practice and recommendations for prevention.

In Fall 1981, an outbreak of acute infectious conjunctivitis with keratitis (EKC) occurred in patients who had visited a private ophthalmology clinic just prior to onset of illness. Among an estimated 2,200 patient visits to the office from August 10 to October 15, 1981 for problems unrelated to infectious conjunctivitis, 39 (1.8%) persons subsequently developed EKC. The median incubation period was 6.5 days (range, 1 to 14 days). A case-control study was done to identify risk factors associated with contracting EKC; patients with EKC were more likely than control patients to have been examined by one or the other of two of the four ophthalmologists at the clinic and to have undergone procedures such as tonometry or foreign body removal. Adenovirus was isolated from conjunctival swabs from four of five persons with conjunctivitis; three were type 8 and one was type 7. Recognition of the problem and improved handwashing practices were associated with terminating the outbreak. This outbreak illustrates the potential for transmission of adenovirus infection during the provision of eye care. Infection control practitioners should be familiar with measures for the prevention of such infections among ophthalmology patients.

Adenoviridae Infections↗
PubMed1988

The significance of ophthalmological symptoms in idiopathic blepharospasm.

Two hundred and seventy-two patients with idiopathic blepharospasm were reviewed to establish the role of local eye disease in their illness. The majority of patients (57%) had symptoms at the onset of their illness such as dryness of the eyes, grittiness, irritation or photophobia suggesting eye lid or ocular surface disease. Detailed ophthalmological examination at the time of presentation had been carried out in 170 of the 272 cases; 64% of these patients had ocular symptoms, and 40% had demonstrable ocular surface or eye lid pathology. Such pathology was usually bilateral, chronic and resistant to local treatment. Blepharospasm developed in these patients after a long latent period, often of many years. Unilateral pathology was acute, normally responded well to local treatment, but was followed by the development of bilateral blepharospasm usually within six months. Amongst all 272 patients, those without ocular symptoms at presentation rarely developed them subsequently; if they did, there were no abnormal signs. The data suggest that ophthalmological disorders may trigger idiopathic blepharospasm in a substantial proportion of cases predisposed to develop this condition.

Adolescent↗
PubMed1991

Ophthalmological screening for von Hippel-Lindau disease.

Forty seven individuals (from 16 kindreds) without prior evidence of retinal haemangiomas underwent full ophthalmological assessment as part of a comprehensive screening programme for Von Hippel-Lindau disease. Ten were known to be affected on the basis of non-ocular involvement and 37 were at 50% risk of having the abnormal gene. Seventeen angiomas were detected in 14 individuals (six affected patients and eight at risk relatives). Regular detailed ophthalmological assessment is important for all patients with von Hippel-Lindau disease and for relatives at risk of inheriting the abnormal gene.

Adult↗
PubMed1997

How effective is undergraduate and postgraduate teaching in ophthalmology?

PURPOSE: To gain an insight into the adequacy of ophthalmic medical education for doctors in the primary care setting. METHODS: A short forced-choice questionnaire was set to 150 randomly selected primary care practitioners in and around Bristol. Information was collected in relation to undergraduate and postgraduate ophthalmic education, ophthalmic confidence, facilities and understanding. RESULTS: One hundred and thirty-three primary care doctors replied to the questionnaire of whom 35% were fundholders and 47% in training practices. Only 22% of all respondents felt their undergraduate ophthalmic medical education to be adequate. However, 83% of the 86 primary care doctors who had attended postgraduate update courses in ophthalmology felt these to be adequate. Despite the availability of an ophthalmoscope and distance vision chart, only 56% felt confident with the ophthalmoscope and only 61% reported that their distance chart was set up in accord with manufacturer's instructions. Seventy-one per cent of respondents reported having access to dilating agents but only 61% felt confident using them. Understanding of two key ophthalmic terms was also poor. Despite the general satisfaction, attendance of postgraduate update courses did not appear to alter facilities, confidence or understanding. CONCLUSIONS: It is apparent that most primary care doctors view their undergraduate ophthalmic medical education as inadequate and this is reflected in their confidence and understanding. Postgraduate courses, although more favourably received, do not appear to after these findings. We strongly suggest, therefore that general ophthalmic education is aimed at teaching examination techniques and ophthalmological principles suitable for primary care practice.

Adult↗
PubMed2001

Improved student learning in ophthalmology with computer-aided instruction.

PURPOSE: Recent changes in the medical school curriculum and in teaching styles have stimulated the development of novel learning resources. We investigated the impact of computer-aided learning in the field of ophthalmology at a large Australian undergraduate medical school. METHODS: Clinical case studies describing common ophthalmic conditions were incorporated into a computing program which uses a problem-solving format. The program was made available to 85 medical students for a 2 week period. A control group of 20 medical students did not have access to this material. Acquisition of new knowledge was assessed as the improvement in score on a knowledge-based multiple-choice examination which students took both before and following the learning interval. RESULTS: Students in the control group showed no improvement over the test period, whilst the students who had access to the computer significantly increased their knowledge base, both for material provided on the program (p = 0.0001) and in related areas (p = 0.0015). CONCLUSIONS: Suitably constructed material on the computer is a useful aid in teaching ophthalmology to medical undergraduates. The material and the medium may also act as a stimulus for further learning.

Computer-Assisted Instruction↗
PubMed2005

Independent sector treatment centres (ISTCS): early experience from an ophthalmology perspective.

In 2001, the NHS plan concluded that there was a significant lack of capacity within current NHS structures to deliver adequate volumes of cataract surgery for England and Wales. The initial central 'solution' for this was to invite in overseas surgical teams to existing NHS centres for short-term surgical initiatives. However, with the advent of the Waiting, Booking and Choice Strategy, a target was set for treatment centers (TCs) to be carrying out an additional 250 000 inpatient/day-case episodes, across all specialties, by 2005. This paper outlines how these Ophthalmology TCs were commissioned, and some of the policy and medical agendas that surrounded their evolution. The concept of 'take or pay' contracts, which placed the onus on local Primary Care Trust organisations to provide the promised number of suitable cataract patients for the TCs, and the 'additionality' of medical and nursing staff are discussed. In September 2003, Netcare was awarded the contract to carry out 41 600 cataract procedures over a 5-year period in a mixture of mobile and fixed site units. Netcare's proposed patient care pathways are examined, as is the reality of its interaction with local Ophthalmology Departments and the response of the Royal College of Ophthalmologists to its standards of patient care. Although Netcare TCs may have contributed to reduced waiting times for cataract surgery in some districts, the quality of care provided by the Netcare TCs has yet to be established. There are ongoing concerns about both the continuity of care and the management of postoperative complications, as well as the economics of neighbouring NHS units.

Cataract Extraction↗
PubMed2001

Undergraduate ophthalmology education survey of New Zealand ophthalmologists, general practitioners and optometrists.

AIM: To determine what New Zealand ophthalmologists, general practitioners and optometrists consider important ophthalmic topic areas requiring emphasis in the medical undergraduate curriculum. METHOD: A total of 793 questionnaires related to the content and teaching of undergraduate ophthalmology were sent to ophthalmologists, general practitioners and optometrists. Results were analysed separately for the three respondent groups and as a whole. RESULTS: Four hundred and fourteen questionnaires were returned (52% return rate). Overall responses of the three participant groups were similar and agreed favourably with the current curriculum. The ability to measure visual acuity (97%) and pupillary reflexes (93%), perform ophthalmoscopy (92%), and assess visual fields (68%) were regarded as 'important or essential' by the majority of respondents. Only 53% of respondents consider the ability to diagnose chronic open angle glaucoma as important. The respondents stressed the importance of the diagnosis of predominantly anterior segment disease contrasting with the traditional bias towards the teaching of ophthalmoscopy and posterior segment disease. The majority of respondents stressed the importance of graduating medical students being able to treat bacterial and allergic conjunctivitis, styes, blepharitis, corneal abrasion, and corneal and conjunctival foreign bodies, areas present but not normally emphasized in current curricula. CONCLUSION: The findings of this study provided additional data to facilitate curriculum design and illustrated the value of an integrated problem-based learning approach in ophthalmology undergraduate teaching.

Clinical Competence↗
PubMed2000

Random comments: neurologists and neuro-ophthalmology; the "ocular motor" system; and update on ophthalmoplegic migraine.

In this brief commentary, I recount the entry of neurologists into the field of neuro-ophthalmology, which was previously regarded as exclusively within the purview of ophthalmology. I then quickly describe the difference between "oculomotor" and "ocular motor," before summarizing "ophthalmoplegic migraine," a rare condition with a rich history that engendered a heated debate among legendary neurological luminaries in 1946.

History, 20th Century↗
PubMed2004

[Presentation of visual acuity in ophthalmological publications].

BACKGROUND: Visual acuity is one of the most important functions of the visual system. Visual acuity is the basis of many decisions in clinical practice. The assessment of visual acuity is clearly defined (norm EN ISO 8596). In this study, the presentation of results of visual acuity assessments in the ophthalmological literature was analysed. MATERIALS AND METHODS: All the issues of the journals "Klinische Monatsblatter fur Augenheilkunde" and "Der Ophthalmologe" of the years 2002 and 2003 were reviewed especially concerning the procedure of visual acuity assessment, the scaling in the lower visual acuity range, axis scaling and the calculation of mean values of visual acuity. RESULTS: In total, 550 publications were reviewed. Of these papers, 207 contained at least one visual acuity value and 42 papers presented detailed data concerning either the change of visual acuity over a certain time interval, or mean values, or using charts. A linear scale was used in 9 of 28 papers with presentation of visual acuity measurements in a chart. Of 32 publications with visual acuity measurements less than 0.2, only 2 used a logarithmic scale in the lower visual acuity range, while in 14 papers, scaling was rather rough or not numeric (e. g., counting fingers). Sixteen papers used the units "finger counting" or "hand movements" to describe low visual acuities. The way of calculating mean values remained obscure in 36 papers. CONCLUSIONS: Regarding a correct assessment of visual acuity and the effect of therapy, the fundamental guidelines of visual acuity assessment and its correct presentation should be considered.

Humans↗
PubMed2006

[The German Ophthalmological Society (DOG) during the Period of National Socialism].

Sixty-one years after the end of the Hitler dictatorship, the history of the German Ophthalmological Society (DOG) has still hardly been investigated. According to different sources, especially the reports of the DOG congresses 1934, 1936, 1938, and 1940, the following picture can be drawn: 1. The seizure of power ("Machtergreifung") of Adolf Hitler was appreciated by most of the DOG members. 2. After a change of the constitution the DOG came under the control of the "Reichsinnenministerium". However, it escaped the egalitarianism ("Gleichschaltung") and remained relatively independent. 3. Approximately 40 % of the heads of the German university eye clinics who were the most influential DOG representatives were members of the national socialistic German working party (NSDAP). Almost all of these joined the party in 1933 or later. 4. Up to the last congress in Dresden, 1940, the DOG activities were quite extensive. After that time the activities strongly declined. 5. The "Law for the prevention of genetically disabled offspring" ("Gesetz zur Verhütung erbkranken Nachwuchses") from January 1st 1934 was intensely discussed by the DOG. Some prominent ophthalmologists and DOG members were at least in part responsible for the sterilisations because of "congenital blindness". However, as far as it is known, the DOG itself did not intervene directly concerning the practice of sterilisation. 6. Between 1932 and 1940, the DOG lost approximately 12 % of its members. Many of these stemmed from foreign countries, and many were German Jews. The latter left the DOG, as Walther Löhlein stated after the end of the war, "voluntarily". However, a main reason for leaving the DOG was very likely the feeling of being unwanted. The national socialism had several disastrous effects on ophthalmology. Although single DOG members participated in the excesses, the DOG as an organization was not directly involved. However, taking into consideration that more than 10 % of the members of the pre-Hitler era left their scientific society it is a matter of interpretation whether the DOG remained completely innocent between 1933 and 1945.

Eugenics↗
PubMed1998

[Teleconsultation network for ophthalmology--experiences and results].

MOTIVATION: Telemedical services for ophthalmology are developed within the OPHTEL project, which has been funded by the European Union and by the Bavarian government in the Bavaria-online initiative. METHODS: Seven private ophthalmologists, one university eye clinic, one clinical Diabetes center and an informatics research institute are connected within a teleconsultation network. Asynchronous (based on Internet E-Mail) and synchronous (based on ISDN-mediated videoconferencing tools) types of teleconsultations are realized. RESULTS: 86 teleconsultations (62 asynchronous, 23 synchronous) took place within the first 10 months. Complex and rare eye diseases as well as interdisciplinary questions (ophthalmology--diabetology) are the main area of medical communication interest. Legal and security problems are discussed. CONCLUSIONS: Telemedical services must be understood as a complete process of medical care on the basis of modern communication technologies, which influences also the management of this process.

Computer Communication Networks↗