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Proteomics is the study of total expressed proteins of genome in certain cell, tissue or organ. It is the frontier of the research in life science in the new century, and the core of functional genomics. Proteomics provides a new way to study ocular cell behaviors and the mechanisms of ocular disease. Here we reviewed the applications of proteomics in ophthalmology.
The delivery of health care services in America today utilizes a variety of approaches based on many economic, political and social factors. The current health care system is coming under significant review and criticism. Many options are being considered and recommended. This paper addresses possible changes in the delivery of eye care, specifically the relationship between the professions of optometry and ophthalmology, that may be needed in the future.
A system was set up to store images in the digital format; such system is a structural teleconference unit with comprehensive research, practical and educational performance capabilities, which is promising in sense of promoting the telemedicine in ophthalmology and which is accessible to broad circles of practitioners. The system, little dependable on a computer power, is assembled on the basis of "Pentium 1 (MMX)". The obtained digital image with a resolution of 600 x 800 dots is sufficient for a qualitative photo-documentation.
The phenomenon of the magnetic resonance and methods of its representation are described. A standard technique of spin echo used in ophthalmology is presented.
Change in the optometric profession is inevitable. Persuasive economic factors will play a great role in shaping the future of optometry and ophthalmology. Optometry is in a position now and into the future to leverage its great strengths to benefit the public in a cost conscious manner.
The article presents the state of medical knowledge in ancient Greece. Sacred medicine related to the cult of Asclepius and the origin of secular medicine is described. Ophthalmological aspects concerning the anatomy of the eye, diagnosis and treatment of ocular diseases are emphasized.
Operations of the anterior segment of the eye are dominant in ophthalmic surgery. It is a lesser known fact that these are the most common elective surgical procedures of all. There has been a dramatic change of anaesthetic practice for ophthalmic surgery over the last twelve years. LA is the anaesthetic of choice nowadays unless contraindicated. These changes were brought about due to the fact that anaesthetists initially became involved and then took over the performance of LA in ophthalmology. Peribulbar technique was introduced in 1986 as a safer alternative to retrobulbar anaesthesia. The needle tip is placed outside the muscle cone (in the peribulbar space). Adequate eyelid blockade and good hypotony of the eye is achieved. Perforation of the eyebulb is extremely rare complication. Sub-Tenon's anaesthesia is a new method of direct infiltration of local anaesthetic into sub-Tenon's space using a blunt cannula. Sub Tenon blocks avoid blind sharp needle penetration into space of the orbit. Although still a relatively new technique, sub-Tenon's anaesthesia is becoming increasingly popular. Day care intraocular surgery under local anaesthetic is the option of choice. Patients are admitted, operated on and discharged within few hours.
The article presents the life and work of an outstanding physician of ancient Greece--Hippocrates of Kos (460-370 B.C.). He is known as the father of medicine, because of his achievements in laying the foundations of medical knowledge and ethical aspects of medical profession, which is outlined in the article. A particular attention is given to ophthalmologic aspects of his work found in various Corpus Hippocraticum treaties. His views on the anatomy of the eye are presented as well. Reconstruction of the eye according to Hippocrates and Aristotle is included in the article. It also presents the International Foundation of Hippocrates of Kos.
The paper is dedicated to a small enterprise functioning in the field of medical engineering, i.e. the "Neuron" research-and-production Co. (Ufa), which has been designing and assembling the therapeutic outfit for ophthalmology.
The virtual ophthalmic clinic has been developed to provide an interactive learning platform within the correspondence courses of the Virtual University of Bavaria. It presents clinical case examples from ophthalmology. Basic concepts are a case-based learning dialogue (didactics), peer reviewing (quality), role-based access (organization) and thin web clients (availability). The following requirements had to be fulfilled: Best possible accessibility for students, authors and reviewers; learning control function; comfortable management. The application architecture is based on a relational data base, a ColdFusion (Allaire, Newton, MA, USA) web application server, a standard web server. So far, the application was used in four terms of the virtual university.
GOAL: To make the reader familiar with the term evidence based medicine (EBM), to explain the principle of cost-effectiveness analysis (price-profit), and to show its usefulness to compare the effectiveness of different medical procedures. METHOD: Based on few examples, in this article the relevance and calculation of important parameters of cost-effectiveness analysis (CE), as utility value (UV), quality adjusted life years (QALY) is explained. In addition, calculation of UV and QALY for the cataract surgery, including its complications, is provided. RESULTS: According to this method, laser photocoagulation and cryocoagulation of the early stages of retinopathy of prematurity, treatment of amblyopia, cataract surgery of one or both eyes, from the vitreoretinal procedures the early vitrectomy in cases of hemophtalmus in proliferative diabetic retinopathy or grid laser photocoagulation in diabetic macular edema or worsening of the visual acuity due to the branch retinal vein occlusion belong to highly effective procedures. On the other hand, to the procedures with low cost effectiveness belongs the treating of the central retinal artery occlusion with anterior chamber paracentesis, as well as with CO2 inhalation, or photodynamic therapy in choroidal neovascularization in age-related macular degeneration with visual acuity of the better eye 20/200. CONCLUSION: Cost-effectiveness analysis is a new perspective method evaluating successfulness of medical procedure comparing the final effect with the financial costs. In evaluation of effectiveness of individual procedures, three main aspects are considered: subjective feeling of influence of the disease on the patient's life, objective results of clinical examination and financial costs of the procedure. According to this method, the cataract surgery, as well as procedures in the pediatric ophthalmology belong to the most effective surgical methods.
German law abides anyone reponsible for the damage he or she has caused to another person's property or corporal integrity. This includes all medical costs directed towards the restitution of health as well as economical damage in direct consequence of the corporal damage. An ophthalmological expert is to state his opinion therefore in accordance with the specific conditions of every individual case and not just according to general charts. Financial compensation is only granted for the actual results of damage inquestion. Prior damage and disability have to be remarked but not to justify a financial compensation. The question of smart-money is dealt with in Part II.
The development of medicine owes a lot to Galen of Pergamum (Asia Minor) who lived around 130-200 AD. He was of Greek origin and he wrote his works only in Greek. However, he lived and worked mostly in Italy. He studied both medicine and philosophy. When he came to Rome in 162 he was quickly recognised as a talented physician due to his unusual medical skills. He even became a physician at the Emperor's court. Apart from being an outstanding physician, he had a great knowledge of medicines and ways of their production. Being familiar with various philosophical doctrines, in particular with Hippocrates' thoughts, as well as the views of Plato, Aristotle and the Stoics, Galen developed his general theory of body functioning. It was only after his death that his works attracted more general attention. Both theoretical developments and his works on various ailments were first recognised in the Arabic world. It was only this fact that resulted in his works being gradually translated from Arabic into Latin and published in Europe where they grew important among European university circles. The article outlines ophthalmologic aspects included in Galen's works. The accuracy of descriptions of eye diseases and elements of descriptions of particular cases are underlined. It is concluded that the knowledge of symptoms of certain diseases followed from clinical observations, as well as from experiments on animals.
The Dutch Society of Ophthalmology (NOG) has developed an evidence-based guideline for the referral of visually impaired people for rehabilitation and support. Referral for rehabilitation and support must be preceded by diagnosis and treatment. Consultation of an ophthalmologist is essential. Information about the disease should be given to the patient orally as well as in writing. The ophthalmologist brings up the possibility of rehabilitation in the presence of a visual acuity < 0.5 and/or visual field of < 30 degrees in the better eye and a well-defined request for help. Visually impaired patients with a relatively simple request for help are referred to a specialised optometrist whenever possible. Visually impaired patients with more complex requests for help are referred to a multidisciplinary (regional or national) rehabilitation centre for people with a visual handicap. Visually impaired and blind patients are informed about the existence of patient organisations. Referral for rehabilitation is done by means of a structured letter with all relevant information. A copy of this letter should be sent to the family physician and all other attending physicians.
The Edinburgh Medical School occupies a unique position in the history of medicine. It gave the three famous clinicians and scientists, who significantly developed the fundamentals of neuro-ophthalmology: Sir Charles Bell, Douglas Argyll Robertson and Harry Moss Traquair.
The article presents the state of development of medicine and ophthalmology in Byzantium in the period between the 4th and the 7th century. It discusses the life and work of Oribasius, Alexander of Tralles, Aëtius from Amida and Paullus from Aegina. It underlines the contribution of Oribasius into the dissemination of knowledge of Galen's works. It was this physician and Alexander of Tralles as well as Aëtius from Amida that did not recommend the surgical treatment of cataract (e.g. hypochyma). Paullus from Aegina was an exception in this respect as he provided a detailed description of couching of cataractous lens (e.g. hypochyma). His description is more detailed and precise than the one provided 600 years earllier by Celsus.
Ophthalmology Services were observed during the two week period July 4th through 16th, 1991 in Magadan in the Soviet Far East. The range of diabetic eye disease appears to be similar to that observed in the West. Major requirements for education (both patient and physician, stressing the importance of controlling blood glucose and its relationship to diabetic eye disease) and inexpensive reliable diagnostic and therapeutic equipment were identified. Substantial benefits can be achieved by supplementing the current medical infra-structure. Continued medical education through exchange of information remains a primary objective.
Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.