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PubMed1996

[Resources on the Internet in Ophthalmology].

BACKGROUND: In the age of information, the Internet became a powerful, fast and international information resource. The ease with which individuals can access the Internet and with which institutions can make information available explains its exponential growth in the past few years. It is our purpose to provide ophthalmologists with new opportunities and to explore the potential and different functions for the information superhighway with a focus on information resources available to the ophthalmologist like the World Wide Web. RESULTS: By using the computer programme Netscape one can send or obtain reports or images, consult colleagues, perform a literature search, take part in an ophthalmological congress or discussion- and newsgroup, get information about past and ongoing ophthalmological events or, moreover, achieve product and company information. CONCLUSIONS: The Internet transformed the way we view and use information by a dramatic expansion of the ways ophthalmologists interact with their colleagues. Thereby, the use of the Internet and its vast resources will greatly improve the quality of patient care.

Computer Communication Networks↗

PubMed1993

[Developments in ophthalmologic electrophysiology].

During the last years electrophysiology in ophthalmology has been facilitated to a big extent by computerized methods. Thus it has become a suitable method for an increasing number of relevant diagnostic problems. To make comparisons between test results of different diagnostic places easier an international standard concerning the methodology of the electroretinogram (ERG) has been elaborated by the "International Society of Clinical Electrophysiology in Vision" (ISCEV). Aim of the present article is to give a short description of the ERG-standard and to review recent developments in clinical electrophysiology in ophthalmology (ca. since 1989).

Adult↗

PubMed1988

[Carl Ferdinand von Graefe (1787-1840) and his relevance to ophthalmology].

This paper gives a short biography of Carl Ferdinand von Graefe, father of the most famous German oculist Albrecht von Graefe (1828-1870). On the occasion of his 200th birthday his work, in particular in the field of ophthalmology (cataract operations, prescription formulae, and therapeutic procedures, publications) is given due recognition. Although C.F. von Graefe was first and foremost a surgeon and the creator of plastic surgery of the face, he may also be considered one of the pioneers of ophthalmology, which, in the first third of the last century, had not yet achieved the status of an independent specialty.

Germany↗

PubMed1986

[Johannes Kepler's contributions to ophthalmologic optics].

Until the beginning of the 17th century it was held that an image is formed in the eye on the anterior surface of the crystalline lens. Ophthalmological optics as a scientific discipline only began with a discovery made by Johannes Kepler. Without performing new experiments, and solely by application of the laws of light refraction, he analyzed the path of light through the eye and demonstrated that an image is formed on the retina and that it is inverted. Acceptance of this discovery was impeded by contemporary prejudices which could imagine nothing but an upright image in the eye, even though this attitude could not explain certain phenomena. Kepler's discovery of the path of light in the eye made it possible to explain the following physical phenomena: central visual acuity, visual field, dark adaptation, and errors of refraction. Physiological diplopia and the mechanism of accommodation were discovered later. The law stating that the intensity of light decreases with the square of distance was also formulated by Johannes Kepler; this law, too, could only be demonstrated after the path of light through the eye had been discovered. In recent years the Keplerian telescope has assumed a practical significance in ophthalmological optics. As a reading aid for individuals with impaired vision it offers a significantly higher magnification than any other optical visual aid.

Germany↗

PubMed1983

[Teaching and learning in ophthalmology].

The acoustic era is being transformed ever more rapidly into the audiovisual era. This development is also having an increasing effect on training methods in medicine. In ophthalmological training especially, "teaching to see" plays a decisive role. Every newcomer to the specialty first has to learn how to "see" correctly, to judge three-dimensional relationships. The dynamic processes in the retinal and choroidal circulation can easily be demonstrated to students and young ophthalmologists by fluorescein angiography and TV fundus photography. This study illustrates the importance of space and time and shows how they can be integrated into ophthalmological training.

Humans↗

PubMed1981

[Comments on a hitherto unknown ophthalmological monograph by Jacob Rüff (ca 1500-1558)].

Jacob Rüff challenges the representatives of academic medicine in a hitherto unknown and incomplete latin manuscript to oppose the decline in ophthalmology. This manuscript is the rough draft of an ophthalmological text-book of early modern times, never published but written at least 25 years before Bartisch's "Augentrost". It comprises traditional knowledge, the author's own discoveries, 85 prescriptions and 50 pen-and-ink drawings showing the anatomy of the eye and ophthalmo-surgical instruments.

History, 16th Century↗

PubMed1980

[An ophthalmological cautery (author's transl)].

A microcautery specially developed for ophthalmological procedures--in contrast to the cauteries commonly used in ophthalmology--is described. It is a foot-operated unit controlled by the surgeon or his assistant. The power settings for the cautery tip are designed to permit easy selection of optimum current flow. The pre-selected cautery temperature is not affected by switching on and off or by the cautery tip becoming red-hot. There is a continuous audible signal as long as power is reaching the cautery tip. The device has been in use for three years without giving trouble.

Electrocoagulation↗

PubMed2002

The monthly variation in acute anterior uveitis in a community-based ophthalmology practice.

BACKGROUND: A significant increase in the number of episodes of acute anterior uveitis was found in December for two consecutive years at a community-based ophthalmology practice. PURPOSE: To evaluate the monthly variation in episodes of acute anterior uveitis (AAU). METHODS: The charts of all patients with AAU in a practice within a community-based multispecialty ophthalmology group in Albuquerque, New Mexico, were reviewed. Seventy-seven patients with acute, self limited, nontraumatic, unilateral, nongranulomatous anterior uveitis over a two-year period were identified. RESULTS: Ninety-four episodes of AAU occurred in 77 patients (42 men, 35 women). The median number of episodes of AAU was three episodes per month (range: 0-14 episodes/month). An increased number of episodes was found in December of both years (11 in December 1996 [p < 0.01] and 14 in December 1997 [p < 0.003]). Smaller clusters of AAU were seen in other months, but did not reach statistical significance. CONCLUSIONS: The presence of a seasonal variation in the number of episodes of AAU suggests that environmental factors are important. A search for such factors that increase the risk of AAU during selected periods may be useful for a better understanding of disease pathogenesis.

Acute Disease↗

PubMed2001

Photodynamic therapy with verteporfin: a new treatment in ophthalmology.

Photodynamic therapy (PDT) with verteporfin is a new treatment modality in ophthalmology that has previously shown its effectiveness in treatment of a variety of neoplastic pathologies. In this therapeutic approach, the photosensitizer verteporfin is activated by non-thermal laser light to obtain closure of neovascular structures. Preclinical and clinical studies have indicated that PDT is a safe, selective, and effective treatment for choroidal neovascularization in age-related macular degeneration. No significant damage to the neurosensory retina was found, which explains why PDT does not cause loss of visual acuity and may be used in a larger population than laser photocoagulation. This review summarizes the mechanisms of action of PDT, and the results of preclinical and clinical studies in ophthalmology.

Choroidal Neovascularization↗

PubMed1996

'Identities ascertained': British ophthalmology in the first half of the nineteenth century.

The paper takes its cue from the work on specialization and American ophthalmology by George Rosen (1944). Where Rosen's account was inspired by sociology, this paper gives a non-teleological account of medical specialization through a cultural history of ophthalmology. The cultural nature of the ophthalmic epidemics motivated practitioners to study the eye in earnest. These practitioners had to surmount obstacles intrinsic to the medical culture: the division between physicians and surgeons, hostility to specialisms, and the association with quackery. Practitioners justified their interests through the management of history, the association with philanthropy, and the construction of a father-figure. New interest in the eye was partly legitimated by the use of existing discourses, both philosophical and religious, that offered practitioners motivating languages to describe their practice. Specialization was effected through varying combinations of elements: emotional and intellectual investment in the eye, the advocacy of further research, and the explicit prosecution of specialties. The process depended upon generalist enthusiasm for the eye, and specialists' championing of generalist medicine. Specialization is a continual cultural process in a constant balancing act with the generalist tendency in medicine.

History, 19th Century↗

PubMed2000

Neuro-ophthalmology of the phacomatoses.

The phacomatoses are a group of disorders that feature multiple hamartomas of the central and peripheral nervous system, eye, skin, and viscera. Most of these disorders have a well-defined Mendelian pattern of inheritance because of a mutation in a single gene which has been identified. In other instances, no clear patterns of inheritance or genetic susceptibility have been recognized. The combination of ocular and central nervous system manifestations in patients with phacomatoses makes neuro-ophthalmologic evaluation particularly important in diagnosis and management. This review provides an overview of the phacomatoses with emphasis on recent reports of significance to neuro-ophthalmology.

Diagnosis, Differential↗

PubMed2003

A survey of patterns of physician hygiene in ophthalmology clinic patient encounters.

PURPOSE: This study examined physician hygiene patterns in the eye clinic of a major medical center to assess compliance with recommended practice patterns to avoid nosocomial infection during patient encounters. METHODS: One hundred ophthalmology resident-patient encounters were observed anonymously by the authors. Examining physicians were evaluated in handwashing between patients, cleaning and disinfecting of tonometer tips after each use, and recapping of diagnostic drop bottles after each use. RESULTS: Physicians washed their hands 74% of the time between patient encounters. The surfaces of tonometer tips were disinfected with an alcohol pad 100% of the time. Diagnostic drop bottles were recapped 57% of the time after each use. CONCLUSIONS: There is ample clinical evidence in the ophthalmic literature that practitioners' hands and tonometer tips can be vectors for transmission of nosocomial infection and that vigorous handwashing and disinfection of instruments can decrease the rates of transmission. Sometimes, however, physicians neglect to follow these simple and effective steps. We suggest posting visual educational materials in examination rooms as a reminder to ophthalmology residents and clinic personnel to adhere to these precautions, benefiting doctors and patients.

Ambulatory Care Facilities↗

PubMed2004

Pediatric neuro-ophthalmology.

PURPOSE OF REVIEW: This review will update the ophthalmologist on recent developments in pediatric neuro-ophthalmology. RECENT FINDINGS: Research into the genetics of congenital strabismus syndromes has brought new insights into the development of the ocular motor system. There is also new literature on childhood ocular myasthenia gravis and childhood neurosarcoidosis. The results of three different surgical treatments for congenital nystagmus are described. Reviews on cortical visual impairment, dyslexia, Aicardi syndrome, and neuronal ceroid lipofuscinosis are presented. SUMMARY: Pediatric neuro-ophthalmology is a diverse and challenging field. As we strive to provide excellent care to these patients, we will use the results of basic science, genetic, and neurobiological research.

Child↗

PubMed2006

Legislative issues facing pediatric ophthalmology in 2006.

PURPOSE OF REVIEW: There has been a surge in legislative activity concerning children's vision in recent years. This review will summarize and compare newly enacted state statutes and review legislation that has been introduced at both the state and federal level. Detailed reference sites are provided and may be a useful resource for those involved in legislative advocacy. RECENT FINDINGS: The legislative arena has often mirrored the disparate views of ophthalmology and optometry regarding the most appropriate methods for identifying vision problems in young children. While state legislation mandating comprehensive eye examinations for all asymptomatic and risk free children was passed in Kentucky in 2000, no other state since has successfully enacted and implemented similar legislation. In contrast, numerous states, have enacted mandatory preschool vision screening legislation. Federal legislation, introduced separately by ophthalmology and optometry, would provide funds for uninsured children's eye exams, but the two bills have important differences in eligibility requirements. Issues such as eye safety and retinoblastoma detection have also been addressed through the legislative process. SUMMARY: There has been a myriad of state and federal legislative activity in the area of children's vision. The momentum is likely to continue as additional states file new legislation.

Child↗

PubMed1982

The diploma of Ophthalmology, University of Melbourne. Its rise and fall.

The diploma of Ophthalmology of the University of Melbourne was the first Australian specialist qualification for ophthalmologists. Between 1934 and 1979, 100 were awarded. Many of the Diplomates became senior consultant ophthalmologists and held high office in Australian ophthalmological societies. The University Diplomas of Melbourne, Sydney and Queensland formed an academic base which provided experience in administration, teaching and examining, making possible the formation of the Royal Australian College of Ophthalmologists. The Fellowship examination of the College (FRACO), controlled by ophthalmologists from all States, became the entry to the college and has superseded the University Diplomas.

Australia↗

PubMed1988

Who remembers the first professor of ophthalmology?

The cradle of modern ophthalmology was the Joseph's Academy which still stands in Vienna's ninth district. History records some famous names from the academic lineage which flourished there in the nineteenth century, but few people have heard of Joseph Barth, who became the first professor of ophthalmology in 1773. A biography of Joseph Barth is presented.

Austria↗

PubMed1992

Ophthalmology in the undergraduate curriculum. A review in Queensland.

Three hundred and sixty-nine postal questionnaires related to the content and teaching of the undergraduate medical course were sent to Queensland city and provincial ophthalmologists, general practitioners, physicians and surgeons. The return rate was 53%. The views of the four groups were similar in most respects. The majority of respondents thought that ophthalmology should be taught as a separate course. They stated visits to operating theatre and eye casualty unit should be included in the course. Ophthalmologists and general practitioners stated the course should be longer, physicians thought it should remain the same length and surgeons felt less time should be dedicated to the teaching of ophthalmology. Topic areas regarded as essential were the acute care areas: trauma; glaucoma; infection; use of an ophthalmoscope; acute visual loss; and red eye. Squint was also regarded as an essential area by ophthalmologists.

Curriculum↗

PubMed2000

Diclofenac and flurbiprofen with or without clonidine for postoperative analgesia in children undergoing elective ophthalmological surgery.

We conducted a prospective, randomized study to compare the efficacy of preoperative diclofenac, flurbiprofen, and clonidine, given alone, as well as the combination of diclofenac and clonidine, and flurbiprofen and clonidine in controlling postoperative pain in 125 children. The patients (ASA I, 2-12 years) undergoing elective ophthalmological surgery were allocated to one of five groups: rectal diclofenac 2 mg.kg(-1) following oral placebo premedication, i. v. flurbiprofen 1 mg.kg(-1) following placebo premedication, oral clonidine premedication, rectal diclofenac 2 mg.kg(-1) following clonidine, and i.v. flurbiprofen 1 mg.kg(-1) following clonidine. The children received clonidine (4 microg.kg(-1)) or placebo 105 min before anaesthesia. Diclofenac or flurbiprofen was given immediately after induction of anaesthesia. Anaesthesia was induced and maintained with sevoflurane and nitrous oxide in oxygen. Postoperative pain was assessed by a blinded observer using a modified objective pain scale (OPS). No opioids were administered throughout the study. Rectal diclofenac 2 mg.kg(-1) i.v. flurbiprofen 1 mg.kg(-1), oral clonidine 4 microg.kg(-1) provided similar OPS scores and requirement for supplementary analgesics during 12 h after surgery. Combination of oral clonidine and one of these nonsteroidal analgesics minimized postoperative pain. Our findings suggest that this combined regimen may be a promising prophylactic approach to postoperative pain control in children undergoing ophthalmological surgery.

Administration, Oral↗