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Providing low vision rehabilitation services with occupational therapy and ophthalmology: a program description.

This article describes a low vision rehabilitation program operating within a hospital-based outpatient rehabilitation clinic. The program uses a team approach combining ophthalmology and occupational therapy services. Patients are referred to the program by their primary care physician for a low vision evaluation completed jointly by the ophthalmologist and occupational therapist. The ophthalmology portion of the evaluation includes assessment of visual acuity, contrast sensitivity function, and macular perimetry with a scanning laser ophthalmoscope. The occupational therapy evaluation focuses on assessing the functional limitations experienced by the patient due to the vision loss and determining how the patient is best able to use remaining vision to complete daily activities. Occupational therapy treatment emphasizes training the patient to use remaining vision as efficiently and effectively as possible to complete daily activities and includes training in use of optical devices. Because of the specialized nature of the service provided, additional postgraduate preparation is needed to enable occupational therapists to provide effective low vision rehabilitation.

Activities of Daily Living↗

The neuro-ophthalmologic examination.

Neurosurgical practice requires a solid foundation in the principles and interpretation of the neuro-ophthalmologic examination. In this article, the techniques used in the neuro-ophthalmologic examination to assess visual acuity, ocular motility, visual fields, the pupils, the eyelids, and the fundus are reviewed. An emphasis is placed on those techniques most relevant to neurosurgical practice.

Humans↗

Ophthalmology in Thailand 1997.

This article is a brief history of ophthalmology in Thailand after World War II and the National Programmes for the Prevention of Blindness in the past two decades from the late 1970's. Presentation illustrates the efforts of the eye sector in Thailand not only modernizing ophthalmology. However, eye care services in public places has also been made available to all assured with easy accessibility and acceptable quality. The National Blindness Prevention programmes have been forwarded through adoption of primary eye care approach integrating into the national health scheme of primary health care. Avoidable blindness once prevalent in 1980's, has been reduced from 1.1 per cent to 0.3 per cent in twenty years. Eye care networks that came into existence in that period covering the whole country are now once again under realignment for new challenges from unavoidable types of blindness.

Cataract↗

[The Institute of Tropical Ophthalmology of Africa].

The Tropical Ophthalmology Institute of Africa (TOIA) is an integral part of the OCCGE. Located in Bamako since 1953, the TOIA is operated jointly by the member states of the OCCGE, the French Cooperation Ministry, and the WHO for which it serves as a center for the prevention of blindness. In addition to providing eye care for the people of western Africa, the TOIA promotes clinical, epidemiologic, and surgical research and carries out health surveys in function of the needs of the member states of the OCCGE. The major purpose of the TOIA is to training doctors and ophthalmologic nurses as well as for cataract operators and eyeglasses technicians. At the center of a network dedicated to the fight against blindness, the range of action of the TOIA now reaches beyond the borders of the eight states in the OCCGE.

Academies and Institutes↗

Open drops in ophthalmology offices: expiration and contamination.

OBJECTIVE: To determine the relationship between eye drop use and contamination rate in ophthalmology offices. DESIGN: Following permission request, open bottles were examined and the nozzle tip and one drop of content was cultured on solid media. OUTCOME MEASURES: Drug category, volume, weight compared to full, clean legible label, expiration date; 2 or more bacterial colonies along the inoculation site. RESULTS: In 18 offices, of 1,485 open bottles (mean 12.2, range 4 to 23 per lane) on average 19.8% (range 0% to 88%) were expired (16.2 of 82.5 bottles per office). The frequency of occurrence (%) and expiration (%E) were 40.3% cycloplegics (19.4%E); 16.4% glaucoma (33.7%E); 10.8% anesthetics (8.8%E); and 4% steroids (8.8%E; or 42.2%E including one outlier). Most likely expired were glaucoma (P < 0.001); small 2-3 ml (P < 0.02), nearly empty (P < 0.05), or dirty (P < 0.001) bottles. Only one (5 ml cyclopentolate, not expired) grew a Micrococcus (0.07%). CONCLUSIONS: Drops in ophthalmology offices may be expired but are not contaminated.

Drug Contamination↗

[Diagnosis related groups and cost by service: an approach to analytic accounting in ophthalmology].

PURPOSE: To establish the annual cost of the Ophthalmology Service in < > Hospital, according to its admission activity. Our last objective is to publish the management terms in our ophthalmology specialty. METHODS: We have done a one year analytic study of 766 patients classified into Diagnosis Related Groups (DRGs) in relation to the annual cost of this activity in our service. RESULTS: We have determined the annual cost of our service as well as the DRGs of the studied sample. The most frequent DRG was number 39 (crystalline procedures), 65% of the sample. We have obtained an average stay lower than the national average stay in each group. CONCLUSIONS: At present, this systematic study and evaluation of annual cost in our specialty is a necessity because it permits a correct future planning by ordering the main objectives, a better use of resources and to know the impact of the service in the economy of the hospital. The modern hospital is a service company and not relating the assistential quality with the cost may cause a crisis of the Health National System.

Accounting↗

[Establishment, system, and action of ophthalmology department between 1945-1970 in Łódź].

Investigating history of establishment, system and action of Ophthalmology department, 25 years after the second World War has been an aim of this work. In this period this Department has been directed by prof. Janusz Sobański constantly. Between 1945-1950 Department had been functioned within the framework of University of Łódź, but in 1950 it went in to structure Academy of Łódź. Ophthalmology Department had been leading lively diagnostic, treatment, training, instructional, didactic, preventive, scientific, and researching actions. To sum up there were 19 doctors graduated and 85 doctors received specialization in field of eye diseases. Treatment of squinting, glaucoma, rheumatical eye diseases, disappearance of eye nerve and pigmental retina degeneration has been an object of research particularly.

Education, Medical↗

Best practice treatment algorithm for primary open-angle glaucoma: implications for U.S. ophthalmology practice.

The objective of this study was to develop a "best-practice" treatment algorithm for the management of primary open-angle glaucoma in patients receiving initial medical therapy, to serve as a consideration for future ophthalmology practice. For comparison, a baseline, "common-practice" treatment algorithm was also created that reflects current ophthalmology practice patterns. Survey instruments were developed based on a comprehensive review of relevant literature, along with input from a general ophthalmologist. A panel of eight ophthalmologists subspecialized in glaucoma management was surveyed. Consensus was achieved using a modified Delphi technique. A comparison of common- and best-practice treatment algorithms suggests that in contrast with expert opinion, nonselective beta blockers are currently used more often, and alpha-2 agonists less often, as first-line therapy for the treatment of primary open-angle glaucoma.

Adrenergic alpha-Agonists↗

[Modern ultrasound methods of examination in clinical ophthalmology. Background problems and future prospects].

Historic aspects of ultrasound diagnostics in ophthalmology are described. The technological development of ultrasound diagnostic systems and the clinical application of different ultrasound modes in examining the eye and its choroids are traced back. The efficiency of Doppler mapping in the mode of three-dimension reconstruction at examining the orbital vascular system is evaluated. An experience obtained at the Research Institute for Eye Disease of the Russian Academy of Medical Sciences and outlooks for the diagnostic usage of computer ultrasound in clinical ophthalmology and angiologia are presented.

Forecasting↗

Revolutionary changes in medicine and ophthalmology--the St. Louis, MO, effect: Homer G. Phillips Hospital and Dr. Howard Phillip venable.

PURPOSE: To provide information on the revolutionary changes in medicine, particularly on the development of African-Americans in ophthalmology, created by Homer G. Phillips Hospital in St. Louis and the late Dr. Howard Phillip Venable. METHODS: Very little has been written about Homer G. Phillips Hospital and Dr. H. Phillip Venable. Through personal interviews with physicians trained by Dr. Venable and literature review, I was able to obtain information on Homer G. Phillips Hospital and Dr. Venable's influence in breaking the color line in medicine and ophthalmology. RESULTS: Homer G. Phillips Hospital in St. Louis was a major teaching hospital for African-American doctors. Dr. Venable was one of a few African-American ophthalmologists in the 1940s. Dr. Venable then trained approximately 40 African-American ophthalmologists at Homer G. Phillips Hospital between 1943 to 1979, when the hospital closed. CONCLUSION: The ophthalmologists trained by Dr. Venable have gone forward to treat thousands of patients with blinding eye diseases such as glaucoma and diabetes, and to influence others to become ophthalmologists. Although the hospital has closed and Dr. Venable has passed away, their existence has reformed the medical treatment received by African-Americans and other people.

Black or African American↗

[Investigation of the status of ophthalmology in China].

OBJECTIVE: To identify the quantity, constitution, distribution, human resources, medical service, equipment utilization conditions of our ophthalmic organizations. METHODS: Adopt the ophthalmology status survey forms developed by the Department of Health Administration of Ministry of Health and Office of National Committee for Prevention of Blindness to investigate the registered medical treatment organizations in the whole mainland of China in 1996. The collected data were analyzed using SAS software. RESULTS: There were 4,151 ophthalmological organizations, 43,204 beds for ophthalmic patients, 22,577 eye doctors, and 16,448 ophthalmic nurses in China in 1996. 41.55% of eye doctors worked in the general hospitals above the county level. CONCLUSION: The distribution of ophthalmic organizations and human resource is uneven. It may be the main cause to restrict the activities for prevention of blindness in China.

Blindness↗

General medicine and ophthalmology: common interests.

A conference entitled 'General Medicine and Ophthalmology' was held at the Royal College of Physicians on 1 June, 1992. Eye diseases are frequently a manifestation of systemic conditions; it is therefore in the patient's best interest for ophthalmologists and physicians to co-operate in their management. Without such co-operation there is the risk that patients fall between stools and neither condition is adequately treated. Medical specialties in which eye conditions are particularly prominent include dermatology, endocrinology, neurology, rheumatology, and cardiovascular diseases. The advantages of joint clinics in medicine and ophthalmology were demonstrated by Professors Alex Crombie and Pat Kendall-Taylor for Graves' disease, by Mr Philip Murray and Dr David Young for uveitis, and by Professor Eva Kohner for diabetes. These included more expert assessments of patients leading to quicker and more complete diagnoses, earlier recognition of complications, and access to a wider range of investigations and treatments, opportunities for collaborative research, improved education for patients and doctors, increased patient convenience, and a stimulus for better control of factors which can worsen the disease.

Ambulatory Care Facilities↗

[Promoting the efficient functioning of an ophthalmologic hospital].

A model of hospital management, i.e. a state regional ophthalmologic clinic, was designed on the basis of the Republican Clinical Hospital for Ophthalmology of the Udmurt Ministry of Health. Apart from the basic typical elements, its structure comprises the research-and-production units (as finances sources) and investment technologies. Described in the paper are related components and an analysis of the medical-and-economic efficiency of using the above model.

Hospitals, Special↗

Pediatric ophthalmology and anesthesia pearls in the operating room.

Providing nursing care to pediatric patients is both challenging and rewarding. The pediatric ophthalmic caregiver must remain acutely aware of physiologic changes, which may be subtle. Though most pediatric procedures are performed by an anesthesiologist using general anesthesia, the ophthalmic nurse needs to remain vigilant. Problems that arise must be attended to within mere seconds. This paper discusses distraction techniques and gives an overview of the care provided to children under general anesthesia at a major pediatric specialty hospital. This paper relates one ophthalmic nurse's experiences in a hospital-based outpatient surgery center that employs 14 board-certified faculty pediatric anesthesiologists as well as rotational anesthesia residents in their first, second, third, and fellowship years. The outpatient center has five operating rooms, and the inpatient surgery area has 14 operating rooms. Nearly 800 pediatric ophthalmology procedures are done in the outpatient area each year; approximately 20 ophthalmology procedures are done at the inpatient surgery area annually.

Anesthesia↗

[Bibliometrical analysis of Medline publications in neuro-ophthalmology].

PURPOSE: To analyze the contents of international publications in neuro-ophthalmology during the past decade. METHODS: Medline was searched with the Internet provider PubMed in December 2003, using "eye disease" as the medical subject heading and "optic nerve", "visual pathway", "visual cortex", "ocular motility", and "pupil" as subhead terms for retrieving English-language neuro-ophthalmic articles that were published between 1993 and 2002. RESULTS: A total of 9,585 English-written original articles available for analysis were concerned with a wide range of basic and clinical neuro-ophthalmic subjects, the order of frequency being ocular motility (22.8%), optic nerve (17.2%), visual functions (17.2%), visual cortex (10.1%), retina (8.6%), ocular adnexa (5.9%), optic chiasm (5.8%), brainstem (3.1%), and pupil (3.0%). The major optic nerve disorders included demyelinated optic neuritis, Leber hereditary optic neuropathy, and ischemic optic neuropathy. The major ocular motility disorders were supranuclear palsy, progressive external ophthalmoplegia, and ocular motor nerve disease. The articles were contributed from 73 countries. The top 10 countries ranked by share were USA (40.4%), United Kingdom (10.2%), Japan (8.7 %), Germany (6.0%), Italy (4.0%), Canada (3.5%), France (3.5%), Australia (2.2%), Israel (1.8%), and Turkey (1.8%). Researchers with diverse specialties contributed to the neuro-ophthalmic publications, including ophthalmology (40.5%), neurology/neuroscience (21.7%), and neurosurgery (5.9%). CONCLUSIONS: Neuro-ophthalmic papers were interdisciplinary, contributed by researchers with diverse specialties, and published in a wide range of biomedical as well as neurological journals.

Bibliometrics↗

[Advances of the Chinese Journal of Ophthalmology with the times].

Since the first publication of the Chinese Journal of Ophthalmology on October 1st, 1950, following the establishment of the People's Republic of China, more than fifty years have already elapsed. The editors and publishers of the elder generation of this magazine have witnessed the hardships in starting publication, the disappointments of the discontinuation of publication during certain periods, as well as the great delight of restarting publication. Having entered the 21st century, editors and publishers of the new generation have made dramatic achievements by keeping up with the times and continuously seeking innovations. However all of these achievements have only turned out to be the past. There are even more challenges for moving ahead in the future. The Chinese Journal of Ophthalmology has noted its achievements on the one hand; while on the other hand, has analyzed the main existing problems of this magazine. Some feasible approaches to improve the magazine have been proposed and the direction in the following few years was ascertained. We will collaborate with Chinese ophthalmologists to work towards the continuous development of this magazine.

China↗

[Review and suggestions for the Chinese Journal of Ophthalmology at its 55th anniversary].

This article reviews the development of the Chinese Journal of Ophthalmology during the last 55 years, mainly focuses on the extraordinary achievements of this journal in this new century from a reader's perspective. Meanwhile, several existing problems have been pointed out, suggestions are given to the journal on promoting its strengths and correcting weaknesses in an attempt to improve the overall development of ophthalmology in China.

China↗

[Analysis of authors of articles published in Chinese Journal of Ophthalmology from 1995 to 2004].

OBJECTIVE: We aimed to analyze the authors, the organizations and regional distribution of these authors of Chinese Journal of Ophthalmology, and ascertain the core authors, core organizations and core regions. METHODS: Using quantitative analysis method, we analysed the authors, co-authors and the core authors of papers published between 1995 to 2004. Also, the distributions of districts and highly quantitative organization were determined statistically. RESULTS: There were 2143 articles published during the last ten years; 912 author had published only one paper, accounted for 70.59% of total first authors. There were 1853 articles with one or more co-authors, the cooperative rate and degree were 86.47% and 3.56, respectively. There were 290 papers with single author, which accounted for 13.53% of total papers. The number of papers from universities, institutes, affiliated hospitals and hospitals were 246 (11.48%), 176 (8.21%), 969 (45.22%) and 423 (19.74%), respectively. There were 82 core authors published 553 (25.81%) papers, while 20 highly-quantities organizations published 1016 (47.41%) papers. Core region was Beijing, which published 574 (26.78%) articles. CONCLUSIONS: Authors of the Chinese Journal of Ophthalmology have a wide distribution and highly cooperative rate. There are a group of active and talented core authors, who have a great influence on this journal.

Authorship↗