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At least 775 records · Page 43Linked to original sources
PubMed1986

Objective and subjective measurement of tonic accommodation.

Measurements of tonic accommodation (TA) were made on 25 subjects using He-Ne laser optometry (HNL), infra-red optometry (IR) and near retinoscopy (NR) under darkroom conditions. All three techniques were shown to produce comparable mean estimates of TA (HNL: 1.10 D; IR: 1.15 D; NR: 1.07 D). Significant correlations were found between HNL and IR (r = 0.88, p less than 0.001) and between HNL and NR (r = 0.81. p less than 0.001). Control studies under cycloplegia indicate that the estimates are not seriously affected by fluctuations in accommodative state. These findings indicate that ophthalmic practitioners can gain access to refractive data that aids the clinical management of the "anomalous myopias" and asthenopia associated with VDU work.

Accommodation, Ocular↗
PubMed1979

Vision care for an underserved community.

In 1975, joint efforts of the Southern California College of Optometry, Los Angeles County Department of Health Services, and involved community organizations resulted in development of a unique pilot outreach project, funded primarily by HEW, bringing vision care to a highly underserved area while providing comprehensive, community-oriented clinical training for future doctors of optometry. This training of optometric students, as part of multidisciplinary health care teams in an area whose population might otherwise have no access to vision care services, may prove an influencing factor in future achievement of an equitable opportionment of healthcare specialists to underserved communities.

Ambulatory Care Facilities↗
PubMed1979

Industrial vision revisited.

With the Occupational Safety and Health Act of 1970 and other government agencies addressing the protection of employees from occupational hazards at their work place, there has been a reemphasis in the industrial eye care field. Industrial vision programs are reviewed and an overview of the Army's occupational vision program is presented. If optometry is to continue progress in this sphere of public health, optometrists must become more involved in and knowledgeable of the visual requirements of the local industrial community, and the profession should consider the establishment of a certification program for occupational doctors of optometry.

Military Medicine↗
PubMed1981

Part II. Diagnostic outcomes of optometric referrals in a VA medical center.

In a previous study, the authors examined the medical records of patients seen in the optometry clinic of the Birmingham Veterans Administration Medical Center (BVAMC) who were referred to other providers within the BVAMC for diagnosis and/or treatment of health problems outside the scope of optometric clinical privileges. The present study examined an equivalent number of medical records of patients who had been examined in the optometry clinic but were not referred to other health care providers within the BVAMC. By utilizing retrospective clinical judgment, the authors found that 3 of 266 patients (1.13 degrees) that were not referred probably should have been. None of the 3 patients had potentially sight or life threatening disorders. An algorithm for the methodology and case reports of the 3 patients are presented.

Eye Diseases↗
PubMed1995

Clinicolegal aspects of practice guidelines for pediatric eye and vision examination.

BACKGROUND: The American Optometric Association (AOA) recently joined a growing trend in the health care professions by adopting clinical practice guidelines. The goals of practice guidelines are to improve quality of care and to provide a more objective measure of standard of care for the legal system and the health insurance industry. Practice guidelines may eventually reduce the number and cost of malpractice actions. Historically, the standard of care for pediatric eye and vision examination has been the subject of controversy. Issues of disagreement include the amount of ocular health testing that should be performed and the determination of appropriate emphasis on functional vision. This paper summarizes the precedents that have established a legal standard of care for pediatric eye and vision examination. METHODS: A review of malpractice claims relevant to pediatric optometry was conducted. Public health policy, legal, and malpractice literature was also consulted for current views on practice guidelines. The recent AOA Optometric Clinical Practice Guidelines for Pediatric Eye and Vision Examination were compared to this review. RESULTS: Standards of care for pediatric eye examination should minimally include assessment of visual acuity, refractive error, binocular vision, functional vision, and eye health assessment including dilated funds examination with a binocular indirect ophthalmoscope. These standards are commensurate with the AOA Guidelines. CONCLUSIONS: The AOA Optometric Clinical Practice Guidelines for Pediatric Eye and Vision Examination is compared to the current standard of care for pediatric optometry. It is concluded that the Guidelines are appropriate. Optometrists should integrate these practices into patient care, and the optometric profession should seek to obtain wide spread acceptance of the Guidelines.

Adolescent↗
PubMed1995

A clinical trial of the SUN SK-2000 computer-assisted videokeratoscope.

A clinical trial was performed on 20 optometry students in order to evaluate the suitability of the SUN SK-2000 (SUN contact lens company, Japan) computer-assisted videokeratoscope for use in clinical practice. Suitability was assessed by observing three factors: the accuracy, repeatability and agreement for central mean corneal power (MCP) with a keratometer (Javal Schiotz). Measurements of eight peripheral points and the central radius of curvature were made on 20 optometry students and on an 8 mm calibration surface using the SUN SK-2000. The SUN SK-2000 accurately determined the 8 mm calibration surface (supplied by manufacturers) to be spherical (SD = +/- 0.013, P = 0.776). Careful alignment was found to be an important factor in determining the actual radius of the calibration sphere. Unfortunately, the system required measurements to be taken at a point which was not coincident with the line of sight. A simple improvement to this has been suggested. Readings were most repeatable for central corneal radii. Peripheral radii showed the most repeatability for the horizontal and inferior corneal radii. It has been suggested that the ocular adnexa may be a possible cause for the poor repeatability in the superior area of the cornea. The level of agreement between the Javal Schiotz keratometer and the SUN SK-2000 in terms of mean refractive error (MRE) was not found to be sufficient for the two instruments to be interchangeable (P = 0.011). The C0 and C45 components of corneal astigmatism were found to have little association with the keratometer.

Adolescent↗
PubMed1994

Co-management of patients with hypertension.

Information provided by doctors of optometry to the primary care providers of patients with hypertension provides one of the few objective means of assessing the status of these patients. The optometrist may also be the first to suspect primary or secondary hypertension in the course of a comprehensive eye examination. In this paper the pathophysiology of essential, malignant, and secondary hypertension is reviewed. The treatment and management of the systemic and ocular effects of hypertension are discussed along with the pivotal role that doctors of optometry play in co-managing patients with hypertension.

Humans↗
PubMed1994

Providing service and education through community outreach.

We have described several of the innovative ways in which the New England College of Optometry has addressed its goal of cultivating compassionate and ethical behavior in its students while providing them with unique educational opportunities. In these four projects the New England College of Optometry has taken its services to where those in need are located. All of these projects have received enthusiastic support from their host institutions and from the many clients and students who have benefited from their services.

Community Health Services↗
PubMed1994

Developing innovative programs for unique student populations.

BACKGROUND: Optometric education has been faced with ever-increasing expectations. These include the ability to educate students and practitioners to care for new patient populations, deal with more diverse and complex clinical problems, to be significant participants in the research community and to fulfill leadership positions within the profession. To fulfill this expectation, schools and colleges need to diversify their program offerings to attract and educate unique student populations who come from diverse backgrounds and bring a range of pre-existing knowledge and skills. RESULTS: This paper provides an overview of The New England College of Optometry's efforts in this area and two programs, the "Advanced Standing International Program" and the "Accelerated Doctor of Optometry Degree Program," are examined in detail. An emphasis is placed on outcomes assessment to ensure the programs are fulfilling their purpose and the results of a retrospective analysis of the two programs is provided.

Curriculum↗
PubMed1994

Measuring trends in optometric practice: a study in Oregon.

BACKGROUND: Considerable change has occurred in the United States, over the past several years, broadening the scope of optometry to include the treatment of ocular disease. This change has received a great deal of "press", however little has been done to measure actual trends occurring in the practice of optometry. A study was undertaken in 1991 to establish an accurate profile of optometric practice in the state of Oregon including trends over the past five years and those projected into the next five years. METHODS: A sampling of all optometrist (465) in the state was done early in 1991, query being made as to five years back (1986) and five years ahead (1996) relative to various practice characteristics. The return rate was 51%. RESULTS: It was found that general examinations, spectacles, and contact lenses are services offered by, essentially, every office. However, there is considerable variation, office-to-office, on all other services. Projections into the next five years forecast increased services in contact lenses, vision therapy, and the management/treatment of ocular disease. As to technology, trends indicate greater use of auto-refractors, auto-keratometers, automated visual fields, and binocular indirect opthalmoscopy. CONCLUSIONS: Optometrists in Oregon are optimistic on the projected growth of particular services. While this outlook seems to be based on an existing patient base in most areas of care, it appears to assume that projected treatment privileges will attract a new and expanded base of patients relative to ocular disease.

Humans↗
PubMed1994

Healthy People 2000--health promotion and disease prevention, a new opportunity for optometrists.

The Healthy People 2000 objectives represent a major opportunity for optometry to expand its scope of practice, enhance its quality of patient care, and become involved in making policies and programs that will directly affect the services and patient care it provides. If optometrists take advantage of this opportunity they will: 1. Increase the visibility of optometry and enhance our image as the primary eye and vision care provider. 2. Increase the number of patients seen by optometrists. 3. Expand the number of organizations, policy makers and third party providers who understand the services optometrists provide and their importance in achieving the Healthy People 2000 objectives. 4. Increase the number of referrals from nontraditional sources. 5. Enhance the overall health of their patients. 6. Be recognized as the leader of health promotion and disease prevention activities involving eye and vision care. The question is, "Will optometrists become involved and use this opportunity?" We must look back from the perspective of the year 2000 and be able to answer this question with a definite YES!

Health Promotion↗
PubMed1977

Vision care in Nicaragua.

In recent years an increasing number of professionals have become interested in providing health care to the people in under-privileged countries. Today, optometrists are serving these people through various organizations. This article relates the experiences of three University of Houston College of Optometry fourth year students during their volunteer optometric service in Nicaragua in the summer of 1975. Most colleges and schools of optometry have similar programs; however, only Ohio State University and the University of Houston participate in the Amigos de las Americas program. Participation in these and other similar activities by the profession is necessary to maintain good public health and develop better public relations.

Adolescent↗
PubMed1997

Use of the Ober2 Model B-1200 system for analysis of eye movements made during reading.

BACKGROUND: The Ober2 Model B-1200 system uses infrared reflections to record and analyze eye movements made during reading. The system's ability to analyze data from normal subjects and the reliability of the data produced by subjects who read standard paragraphs were investigated. METHODS: Forty-two optometry students and 20 junior high school students, all self-assessed normal readers, read five different Taylor test paragraphs during each of two sessions. Ober2 Model B-1200 analysis was attempted for each paragraph; when analysis was successful, grade-equivalent scores based on fixations, span of recognition, regressions, fixation duration, and reading rate were determined. RESULTS: The Ober2 Model B-1200 system was unsuccessful in analyzing data from 30% of the paragraph presentations; manual calibration procedures allowed no additional data analysis. Using mean grade-equivalent data from 16 optometry student subjects for whom all 10 paragraphs could be analyzed, significant differences were found between results for two of the test paragraphs. Split-half inter-session reliability coefficients for grade-equivalent data ranged from 0.84 to 0.95. No intra-session learning or fatigue effects on reading data were found. CONCLUSIONS: Although the Ober2 Model B-1200 potentially can provide valuable information on eye movements made during reading, problems exist with respect to its ability to analyze data. The analysis failures significantly limited the value of this system.

Adolescent↗
PubMed1998

Use of the Taylor Visagraph II system to evaluate eye movements made during reading.

BACKGROUND: The Taylor Visagraph II is a relatively new device designed to evaluate eye movements made during reading. It uses goggles with infrared optics to detect the eye movements and computer software to determine the number of fixations, regressions, and other characteristics of the eye movements. The system also calculates several scores, including a school-grade equivalent for the reader. METHODS: Fifty first-year optometry students served as subjects. Each read five standard Taylor Level 10 (College) paragraphs during each of two sessions while eye movements were assessed by the Visagraph II. RESULTS: The Visagraph II operated correctly for 498 of the 500 trials; operator error caused two malfunctions. Significant differences were found between scores from the first paragraph read and subsequent paragraphs. Nonlinear relationships were found between most of the variables, especially those that involved grade levels and spans of recognition. Also of interest was the wide range of reading eye-movement skills; several of the optometry students appeared to have skills that placed them at below fourth grade level. CONCLUSIONS: The Visagraph II performed properly over a large number of trials and produced data that seemed to be reliable indicators of reading skills. Paragraph-to-paragraph variations in mean scores suggest caution in interpretation of small changes in performance across paragraphs and the need for at least one practice trial before usable data are obtained.

Adult↗
PubMed1998

The burgeoning presbyopic population: an emerging 20th century phenomenon.

Improved social welfare in the wake of the 'industrial revolution' set in train in mid-18th century Britain an escalation in population numbers which has been sustained through to the end of the 20th century--and is projected to continue into the 21st century. However, within the total population envelope the percentage-contribution of certain age groupings shows a striking pattern when viewed across nearly five centuries. For 350 years, up to the end of the 19th century, the over--40 year old section of the population comprised a steady 25% of the total population count of England (latterly England and Wales): over the same period the 60-plus section contributed nearly 10% of the total. Throughout the ten decades of the 20th century these proportions have both increased, such that with the arrival of the next millennium a two-fold increase in the percentage-contribution of both age groups will have occurred: nearly one-half (over 24 million) of the population of England and Wales will be aged over 40, or more than one-fifth (around 11 million) will be aged over 60 years. This 'ageing' of the general population will have economic and socio-medical implications both at home and abroad, since this is a demographic trend which is present/projected in all countries of the European Union (as presently constituted). The future practise of optometry will certainly be touched by these changes. Naturally a potential increase in demand for presbyopic refractive corrections from the growing volume of aged 40-plus individuals is possible. However of greater significance is the certain increase in age-related oculo-visual problems arising from within the growing aged 60-plus population. Greater acknowledgement and utilisation of the optometrist's skills, currently being reappraised through the profession's participation in 'collaborative care' schemes, may indicate the direction in which optometry should move in the early 21st century to remain a valuable--and valued--health care profession.

Age Distribution↗
PubMed2006

Xerophthalmia secondary to alcohol-induced malnutrition.

BACKGROUND: Xerophthalmia refers to the ocular manifestations associated with vitamin A deficiency. Vitamin A deficiency can be caused by numerous disorders, including alcohol-induced malnutrition. The ocular manifestations of xerophthalmia include conjunctival and corneal xerosis (drying), keratomalacia (corneal necrosis/ulceration), nyctalopia (night blindness), and Bitot's spots (conjunctival lesions). CASE REPORT: A 47-year-old white male with complaints of dryness and difficulty seeing at night presented to our clinic for consultation from general medicine to rule out xerophthalmia. Laboratory testing and general medicine, psychiatry, and nutrition evaluations confirmed the systemic diagnosis of alcohol-induced malnutrition. He admits that his alcoholism was induced by depression. Confirmed associated disorders compounding the malnutrition include alcoholic cirrhosis, protein deficiency, and megaloblastic anemia. The patient had xerophthalmia diagnosed in the optometry clinic as a result of symptoms, slit lamp examination signs, and the associated disorders. The associated disorders were treated with systemic medications and vitamins. Ophthalmic treatment consisted of carboxymethylcellulose-based artificial tears. CONCLUSIONS: Although xerophthalmia and vitamin A deficiency are more common in underdeveloped countries, their presentation in the United States may be induced by conditions such as liver cirrhosis, malnutrition, and alcoholism. This report summarizes ocular manifestations of alcoholism and presents a case of xerophthalmia secondary to alcohol-induced malnutrition and the role of optometry in its treatment and management.

Alcoholism↗
PubMed2006

Reproducibility of ultrasound pachymetry using the Sonogage Corneo-Gage Plus 2.

PURPOSE: The aim of this study was to determine the reproducibility of measurements made using the Sonogage Corneo-Gage Plus 2 (Cleveland, Ohio) ultrasound pachymeter of total corneal and corneal epithelial thickness in 5 different regions of the cornea. METHODS: Twenty-seven subjects at the New England College of Optometry (NECO) and 20 subjects at the Southern College of Optometry (SCO) were enrolled in this study. Measurements were taken of the central cornea as well as the nasal and temporal regions of the midperipheral and peripheral regions of the right cornea of each subject. Identical measurements were again taken in these subjects 1 week later at approximately the same time of day. Within-subject variations were then assessed using paired t tests. RESULTS: The only significant measurement differences that were found between visits were for full corneal thickness at both the nasal and temporal midperipheral locations. The mean differences for these locations were 13.5 microm and 13.7 microm, respectively. CONCLUSIONS: Epithelial corneal thickness and central and peripheral total corneal thickness measurements using the Corneo-Gage Plus 2 pachymeter were reproducible; however, midperipheral total corneal thickness measurements showed poor reproducibility.

Cornea↗
PubMed2003

The impact of cataract surgery on depression among older adults.

CONTEXT: Aged-related cataract is the leading cause of vision impairment in the elderly. Elderly individuals with cataract not only suffer from the difficulties in daily activities, but also are more prone to depression. OBJECTIVE: To examine the impact of cataract surgery on depression among older adults. DESIGN: Longitudinal follow-up study. SETTING: Outpatient ophthalmology and optometry clinics in Birmingham, Alabama. PATIENTS: Potential subjects were identified through consecutive chart review of patients seen in 10 ophthalmology and 2 optometry clinics. Three groups of individuals were identified: cataract patients who underwent surgery, cataract patients who did not undergo surgery, and patients without cataract. MAIN OUTCOME MEASURE: Depressive symptoms as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS: There was no significant difference between the baseline and follow-up CES-D scores within each group. The unadjusted CES-D score changes did not differ significantly among the three groups. Adjustment for visual acuity and contrast sensitivity in the better and worse eyes, co-morbid conditions, age, gender, and education did not alter this pattern of results. CONCLUSIONS: Cataract surgery does not appear to have an effect on reducing depressive symptoms in elderly people.

Aged↗