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At least 775 records · Page 43Linked to original sources
PubMed2003

[Current State of Corneal Pathology in Germany: Results of a Survey Conducted Among Members of the Cornea Section of the German Ophthalmological Society (DOG)].

BACKGROUND: The current situation of corneal pathology is widely unknown. Especially, there are no data available how corneal tissue is processed after penetrating keratoplasty. MATERIAL AND METHODS: In November 2002 a questionnaire with 15 questions was sent to all registered members of the cornea section of the German Ophthalmological Society (DOG) ( www.sektionkornea.org ) via email. Only one answer per eye clinic was allowed. RESULTS: Answers were obtained from 40 eye hospitals in which 3070 penetrating keratoplasties had been performed in 2001. 90 % of the surgeons believe that ophthalmopathological investigations of excised corneal specimens are always or at least in some cases important, and 80 % examine 75 to 100 % of all corneal buttons. However, the corneoscleral rim is investigated only exceptionally. 45 % of all corneal buttons are examined by a pathologist within the hospital while 33 % of the corneal specimens are investigated by an ophthalmopathologist in an ophthalmopathological laboratory. In most cases the hospital itself has to bear the cost. Clinics with a high number of corneal transplantations do not differ from the average regarding the fate of corneal buttons. Morphological investigations and publications concerning the cornea are more frequent when an ophthalmopathological laboratory is available in the hospital. CONCLUSIONS: For most eye hospitals performing keratoplasties, the histopathological examination of excised corneal buttons is very important. It is carried out to a large extent by pathologists, but specialised ophthalmopathological laboratories are consulted when a profound expertise is needed. Thus, this survey is an argument for the preservation of these laboratories too. Based on the obtained data and on several comments by the section members initiatives to intensify histopathological investigations of excised corneal specimens should be undertaken.

Attitude of Health Personnel↗
PubMed1982

[Ophthalmologic ultrasound diagnosis--current training programs in Germany, Austria, Switzerland].

In these three countries the application of diagnostic ultrasound in ophthalmology is restricted, with few exceptions, only to institutions having access to in-patients. This situation is based on the organization of medical care and does not depend on the technical evolution of the equipment. Consequently the annual rate of trainees in ophthalmic ultrasound is relatively low, but a comprehensive training programme is needed in this field. The requisite training subjects are described. They include a technical and a clinical programme for both pulse-echo (A, B, M, D mode) and Doppler techniques as applied for biometry as well as for tissue and vascular examination. Some data are given regarding training facilities, aids and courses in the three countries. The concept and organization of a 5-day course (Bonn/Würzburg Course, Directors: W. Buschmann/H.G. Trier) is described in greater detail. For ophthalmic ultrasonography, testing and calibration of system parameters both for equipment and transducers is necessary for obtaining reliable and reproducible results. Examples are given for the organization of technical training in the practical course. The 1981 guidelines of the "Kassenärztliche Bundesvereinigung", Cologne, are discussed. These regulations define minimum requirements for both ultrasonic training and equipment in the FRG. Finally, a few controversial aspects of the teaching (quality assurance, role of biometry) are mentioned.

Austria↗
PubMed1996

[Drug side-effects of the eye--a contribution to quality assurance in ophthalmology].

BACKGROUND: The aim of this research is to catalogue the increasing number of side effects of medications on the eyes and, by putting this catalogue into a data bank, to make it available for use in hospitals. Here a deliberate search is made for medications, which could possibly cause certain side effects as well as a list of possible undesired side effects caused by a certain group of medications analogous to the main groups in the so-called "Rote Liste". METHODS: With the use of the medical literature data bank MEDLINE (CD-ROM) and a search strategy suitable to the topic, German or English publications are included in the data bank, when dose, duration and method of application has been stated, and there had to be a definite or at least possible connection between the side effects observed and the substance causing the side effects. The relevant datas in each article, for example, details about the substance, its application, the publication reference, the individual side effects, categorized according to anatomical or functional aspects, and, if necessary, details about reversibility and therapy were registrated on the data bank. RESULTS: The most common side effects in systemic therapy relate to conjunctiva, cornea/sclera, retina as well as a large number of changes in vision. In external application the undesired side effects were also mainly on conjunctiva, cornea/sclera, as well as on eyelids, uvea, and changes in visual acuity. In medications taken externally ophthalmological side effects were most frequently caused by cytostatics, dermatics, corticoids and antibiotics. In the case of external application on the eye, by far the most undesired side effects were caused by glaucoma medications, followed by antibiotics, mydriatics and corticoids. CONCLUSION: In future, with the use of the data bank, it should be possible to quickly observe a relation between undesired side effects and medications which could possibly cause these side effects.

Adverse Drug Reaction Reporting Systems↗
PubMed1994

[Are graduate education requirements in ophthalmology in Germany compatible with European standards?].

The advanced training of medical specialists is determined by federal regulation called '(Muster) Weiterbildungs-Ordnung'. As education and cultural affairs are subject of federal sovereignty, that regulation of postgraduate training is to be determined by the minister for education and culture in each of those 16 german federal states. To get an utmost identical regulation for Germany the federal councils of physicians have handed over the task of evaluation and upgrading of that regulation to the Bundesärztekammer (BAK). The BAK designs the novel of postgraduated training regulations as a kind of frame-work for all federal councils. That frame-work is called exemplary regulation. On the level of each federal country only editorial changes are added or submitted. Federal regulation is proposed to each federal minister for educational affairs and turned into validity by federal law. The renewed regulation, dated by late summer 1992, prescribes a minimum duration of training for ophthalmology of 5 years, which can be done in any acknowledged institution (university eye hospital, county hospital, municipal hospital or office of any eye-doctor, acknowledged for medical training). Two years of those five years duration may even be done in the office of any physician, who got the right for medical training. In addition to the essential regulation of ophthalmic training there are supplementary demands for special knowledge and abilities which should be fulfilled by each applicant for a specialist's diploma. Those demands precisely prescribe the number and degree of difficulty of special medical procedures as well as the degree of responsibility of the trainee for his activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗
PubMed1993

[Reciprocal influence of jurisprudence and medicine in Switzerland, exemplified by ophthalmology].

Through judgements, the legal system influences medicine and insurance matters strongly, sometimes in a positive way, but sometimes by judgements, which seem to be wrong to the medical expert. Certain institutions lead to the effect that cases are being prevented from judgement by the court and by enactment. This has advantages and disadvantages. Two examples of judgements, having enacted new law are described: 1. The "Cataract Judgement" of the (Swiss) Federal Court of Insurances. This is a prime example of how to come to a correct conclusion without specific medical expertise, namely, that surgery of cataract is a measure for reintegration of the patient (in the sense of the Swiss Law of Invalidity). 2. The judgement of the (Swiss) Federal Court of Insurances, which states that glasses are an aid (in the sense of the Swiss Law of Invalidity), is a model to demonstrate the outcome, if the knowledge of experts is not requested. These facts call for better collaboration between law and medicine. Prevention of legal judgements, which would set precedents, enact new laws, is a disadvantage in points of dispute between patients and medical doctors which are settled outside the court with the guidance of expert opinions of the Swiss Federation of Medical doctors (FMH). The pioneering achievements of the Swiss Academy of Medical Sciences in stating ethical guidelines in delicate matters like organ transplantation, artificial insemination etc. is highly acknowledged, but has the disadvantage of delaying new laws. The Swiss medical doctor had to pass examinations regulated by federal law. There are no examinations after training in specialties, such as ophthalmology.(ABSTRACT TRUNCATED AT 250 WORDS)

Expert Testimony↗
PubMed1992

[Development and organization of a knowledge-based documentation system for ophthalmologic video documentation].

We introduce a system for documentation of ophthalmological video tapes. This system can be implemented without regarding the German data security law (Bundesdatenschutzgesetz), because the documentation of the patient identification and the video tape identification number is done manually and separated from the EDP-supported documentation of the video tape identification number and the contents of the tape. But the use of a controlled vocabulary framework for diagnosis and surgery can be considered as the main advantage of this system. This enables a complete and fast retrieval to all records containing the terms searched for. Our system provides additional space for non-standardized text-documentation, e.g. comments etc... The implemented search-editor allows a fast retrieval to all records by input of strings, which can be connected by boolean expressions.

Computer Security↗
PubMed1991

[Computer as replacement for the current medical record? Introduction of a pilot project of the St. Gallen ophthalmology clinic].

Computerized data processing is more and more used in hospitals and medical offices. There are no doubts about the usefulness of a computer for administrative tasks. At our Dept. of Ophthalmology we started a pilot project to enter the medical records into the computer. The pros and cons of such an information system are discussed. Entering medical records into the computer did not prove to be definite advantage for the physician.

Computer Systems↗
PubMed1984

[Surgeon and eye doctor Caspar Stromayr and the ophthalmological illustrations in his "Practica copiosa" (1559)].

In 1559 Caspar Stromayr wrote a richly illustrated book about hernias and their treatment. The manuscript also includes 3 chapters of a book on ophthalmological diseases which, however, was never published. In addition, it contains 6 separate watercolor illustrations of eye diseases, though without any explanatory texts. The authors attempt to interpret these first colored pictures of eye diseases.

Germany↗
PubMed1998

Statistical analysis of correlated binary data in ophthalmology: a weighted logistic regression approach.

Ophthalmological studies often deal with correlated binary outcome variables. We propose a weighted logistic regression method to account for the intraclass correlations between eyes. Using simulation studies, we compared this method with two standard logistic regression approaches: a) based on eyes as the unit of analysis and b) treating individuals classified as cases if at least one eye is affected. The considered approaches were evaluated in terms of type I error, power and estimation properties. The simulation results reveal that the subject-based approach can lead to substantial bias in regression coefficient estimates when the correlation between eyes is heterogeneous across groups or when it is low, and that power is directly affected by this bias. Furthermore, the standard eye-based approach, which ignores intrasubject correlations, leads to inflated type I error rates. The proposed weighted approach performed well in all of the situations considered. This is a simple method which can be implemented using any current statistical or epidemiological package that includes logistic regression analysis.

Aged↗
PubMed2006

Preseptal transconjunctival approach for orbital floor fracture repair: ophthalmologic results in 209 patients.

CONCLUSIONS: The transconjunctival approach to orbital floor fractures permits excellent exposure of the inferior orbit and provides a good surgical outcome, especially with regard to ocular motility. OBJECTIVE: Surgical access to orbital floor fractures can be accomplished via the transconjunctival approach. The majority of studies on this subject deal with surgical aspects and complications. The purpose of this study was to report the ophthalmologic outcome after transconjunctival orbital floor fracture repositioning in a significant number of patients. MATERIAL AND METHODS: In a retrospective study, the data of 209 patients with orbital floor fractures treated via the transconjunctival approach with (n=181) and without (n=28) lateral canthotomy were analyzed. RESULTS: The commonest cause of injury was forms of violence (32%). An isolated fracture of the orbital floor had occurred in 62 cases, while concomitant facial fractures were present in the remaining 147. A total of 24 patients (11%) had an exophthalmos and 13 (9%) an enophthalmos. Most patients (69%) complained of infraorbital dysesthesia. When elevating the eyeball, the majority of patients showed a marked or severe disturbance of ocular motility (53% in abduction; 51% in adduction) and diplopia (37% in abduction; 36% in adduction). Thirteen patients required repeat surgery. After a follow-up period of 2 years, infraorbital dysesthesia was observed in only three patients, one of whom presented with a considerable persistent enophthalmos of 4 mm, and only four patients had persistent reduced motility and diplopia.

Adolescent↗
PubMed2005

A modeled economic analysis of a digital tele-ophthalmology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy.

The objective of this study was to compare, using a 12-month time frame, the cost-effectiveness of a non-mydriatic digital tele-ophthalmology system (Joslin Vision Network) versus traditional clinic-based ophthalmoscopy examinations with pupil dilation to detect proliferative diabetic retinopathy and its consequences. Decision analysis techniques, including Monte Carlo simulation, were used to model the use of the Joslin Vision Network versus conventional clinic-based ophthalmoscopy among the entire diabetic populations served by the Indian Health Service, the Department of Veterans Affairs, and the active duty Department of Defense. The economic perspective analyzed was that of each federal agency. Data sources for costs and outcomes included the published literature, epidemiologic data, administrative data, market prices, and expert opinion. Outcome measures included the number of true positive cases of proliferative diabetic retinopathy detected, the number of patients treated with panretinal laser photocoagulation, and the number of cases of severe vision loss averted. In the base-case analyses, the Joslin Vision Network was the dominant strategy in all but two of the nine modeled scenarios, meaning that it was both less costly and more effective. In the active duty Department of Defense population, the Joslin Vision Network would be more effective but cost an extra 1,618 dollars per additional patient treated with panretinal laser photo-coagulation and an additional 13,748 dollars per severe vision loss event averted. Based on our economic model, the Joslin Vision Network has the potential to be more effective than clinic-based ophthalmoscopy for detecting proliferative diabetic retinopathy and averting cases of severe vision loss, and may do so at lower cost.

Cost-Benefit Analysis↗
PubMed2000

Collagen vascular diseases: cutaneous manifestations in ophthalmology.

PURPOSE: To describe the effects of collagen vascular diseases on the eyelids and periorbital tissues. METHODS: Retrospective review of dermatologic pathology slides at Massachusetts General Hospital and eye pathology slides at Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. RESULTS: A spectrum of dermatologic manifestations of collagen vascular diseases was observed, affecting the eyelids and periorbital region. CONCLUSIONS: Collagen vascular diseases may present complicated diagnostic and clinical challenges for the practicing ophthalmologist. Familiarity with the cutaneous periocular manifestations of these diseases may facilitate early recognition, diagnosis, and ophthalmologic intervention where necessary.

Collagen Diseases↗
PubMed1996

Pediatric ophthalmology.

In the recent pediatric ophthalmology and strabismus literature, there have been some important papers. Topics have included ocular outcomes in children born before 32 weeks of gestation, a practical correlate of Teller visual acuities and visual behavior in a real environment in a severely handicapped child, and a debate on the indications and efficacy of population screening for amblyopia. New information on the creation of refractive errors by earlier eyelid closure than used previously and a new torsionometer represent new sensory information. New information about motor adaptations in strabismus includes a new evaluation of saccade disconjugacy in deep amblyopia and in anisometropia. Spasmus nutans may be a long-term rather than a self-limiting disease, and the debate on neuroimaging in this condition has been evaluated. A subtle predictor of outcome in the surgical treatment of partially accommodative esotropia is presented, as well as an important case report on the treatment of a metabolic cause of strabismus in chronic progressive external ophthalmoplegia with coenzyme Q10. Finally, some information is presented on the treatment of hereditary retinal dystrophies with nonautologous retinal pigment epithelial cell transplants to the subretinal space of the dystrophic retina-the first experimental model of a successful biologic treatment of which I am aware and a possible indicator of future trends in human disease.

Child↗
PubMed1998

Topical nonsteroidal anti-inflammatory agents in ophthalmology.

Nonsteroidal anti-inflammatory agents or NSAIDs are potent inhibitors of prostaglandin synthesis. As such, they have found many useful roles in ophthalmology. NSAIDs are approved by the FDA to prevent intraoperative miosis during cataract surgery, reduce postoperative inflammation following cataract surgery, and control symptoms of allergic conjunctivitis and pain following refractive surgery. In addition, they have been shown to be effective in preventing cystoid macular edema following cataract surgery or treating cystoid macular edema once it occurs.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Neuro-ophthalmology of movement disorders.

Movement disorders are a diverse group of neurologic disorders that share in common the frequent development of clinical abnormalities in ocular motility or visual perception. This article reviews the recent literature pertaining to the neuro-ophthalmologic advances in the basal ganglia disorders (Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, multiple system atrophy, and Huntington disease), the spinocerebellar ataxias and episodic ataxias, amyotrophic lateral sclerosis, benign essential blepharospasm, hemifacial spasm, and Tourette syndrome.

Humans↗
PubMed2002

False and non-localizing signs in neuro-ophthalmology.

The absolute reliance on abnormal neuro-ophthalmologic findings as signposts for particular lesions of the neuraxis must be tempered by a working knowledge of false and nonlocalizing signs and symptoms. Transient monocular visual loss or complex visual hallucinations may lead to neuroanatomic ambiguity, and elevated intracranial pressure is not the most common cause of swollen optic disks in late life. Sixth nerve palsy associated with increased intracranial pressure is possibly the best-known false localizing sign, but other ocular motility disturbances (divergence paresis, convergence insufficiency, and skew deviation) also elude localization. Lastly, the localizing pitfalls of anisocoria--Horner and Raeder syndromes, physiologic anisocoria, pupil-involving third nerve palsy, and benign pupillary dilation--are discussed.

Brain Diseases↗