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In view of the forthcoming universal mass health screening, considerations are given to some problems of supplying ophthalmologic services at various levels with medical engineering devices on the systemic and integrated basis.
From this intentionally brief discussion, it is easy to see that the computer has already made quite an impact on ophthalmology. It is with anticipation that we await the future.
Besides the compensation of the damage German Law includes also to compensate the noneconomical damage as pain, cosmetic or psychic damage etc. The ophthalmological expert is to state his opinion in accordance with individual consequences of the damage for the given person. He is not obliged to make proposition about the amount of financial compensation of smart-money because this point has to deal with other juridical circumstances of the specific conditions of every individual case.
Application of flexible light guides in ophthalmological devices and light sources permits to develop the tools for illumination of surgical field, transilluminators for eyes, combinations of instruments with tools for intraocular manipulations. An eye transilluminator has been produced and tested with a set of attachments comprising fiver-optic light-guiding elements. This instrument allows to reveal foreign particles in the eye's vitreous body and in the surrounding tissues, and to diagnose some pathological changes.
In the present study 46 patients with severe psoriasis maintained on long-term PUVA therapy have been followed up to 6 1/2 years after the initiation of treatment. Repeated ophthalmological examinations were performed in order to detect any early sign of lens changes. No ocular side effects attributed to the photochemotherapy were revealed during this period. Continued use of appropriate eye shielding is recommended and also routines to remind patients to actually wear their protective glasses.
In respect to the instrument practice the slit lamp holds an eminent place in ophthalmology. The 6th generation of slit lamps after Gullstrand is now presented as a new development. The slit lamp 30 SL/M has been designed as a basic instrument which can be used with accessories to measure characteristics of the eye and to document actual shapes. With that the increasing demand for quantity and objectivity has been answered.
In order to develop the structure of an automated control sub-system for the medical operational process "Ophthalmologic service" in an outpatient clinic the following approaches are used: functional, organizational, personnel, technological, and algorithmic.
Holmes' priority in establishing an extensive body of knowledge that defines much of neuro-ophthalmology is given. His original descriptions are reviewed and his findings reappraised in light of present-day knowledge.
Almost all ophthalmic services in southern Africa are located in large urban centres beyond the reach of many patients in isolated rural areas. The Bureau for the Prevention of Blindness organizes mobile eye-care teams which tour these areas to provide free ophthalmic therapy and surgery. The structure and aims of the mobile teams, with reference to a specific tour, are described; the problems encountered in providing rural ophthalmological services are discussed and some possible solutions proposed.
In looking to the future of optometry and ophthalmology, the author identifies four interacting components--the public, optometrists, ophthalmologists, and eye-health-care manpower, including opticians--which he evaluates. The interactions are discussed, and specific recommendations are made to improve relations between the two professions,
Cataract surgery with intraocular lens implantation (cataract-IOL surgery) performed by ophthalmology residents under supervision of experienced surgeons in 1974-1978 was analyzed. Retrospective evaluation of 32 cases noted patient age and sex distribution, preoperative ophthalmic examination findings, technique for cataract surgery with implantation of iris support intraocular lenses, postoperative complications, and visual acuity with best correction 30 months after surgery as well as on the last examination. Postoperative follow-up, ranging from one to 84 months, recorded a visual acuity with best correction of 20/40 or better in 87.5% of cases. Excluding two cases in which decreased visual acuity resulted from macular degeneration, visual acuity with best correction was 20/40 or better in 94% of cases.
Local and retrobulbar block anesthesia in combination with a brief span of amnesia - not general anesthesia -- produced by minute doses of four intravenous sedative drugs, has made it possible to perform ophthalmologic surgery without the memory of the pain of the retrobulbar block, followed by an ensuing quiescence augmented by behavioral modification for the duration of the operation. Patients are awake, rational, cooperative, calm and relaxed, and because of behavioral modification, are highly motivated to guarantee not only their own survival, but to feel a part of the team effort to preserve the integrity of their eye.
For the cases of normally- and binomially-distributed outcome variables, methods are presented for analyzing ophthalmologic data to which a person may have contributed two eyes worth of information, the values from the two eyes being highly correlated. A frequently-used method of analysis, where each eye is treated as an independent random variable, is shown to be invalid in the presence of intraclass correlation: it yields true p-values two to six times as large as nominal p-values when realistic assumptions are made about the degree of correlation between eyes. These results may be applicable to other medical specialties, such as otolaryngology, where highly-correlated replicate observations are obtained from individuals.
Report on the connection between ophthalmology and actual social medicine by means of 4 different investigations the results of which are stated.
A vacuum apparatus is offered for drying the surgery field during ophthalmological operations. In fact, this is an aspirator consisting of a vacuum source--vacuum pump, collecting cup and the patients' tube with a holder of suction tip (syringe needles). The pedal with a valved device is attached to control unsealing of the pneumosystem.
In the ophthalmological field, it is not always easy to adopt a primary prevention. Much more useful would be a secondary prevention program towards the affections at birth or those later developed that, if diagnosed and treated early, grant a normal visual development. Differentiated prevention can be carried out, according to various ages: at the tender age congenital glaucoma and cataract, strabism, ametropia, anisometropia (possible cause of amblyopia) have to be considered; in the adult-senile age must be prevented damages due to hypertension, diabetes, thrombosis, as well as cataract, glaucoma, uveitis, kerato-conjunctivitis and retinal detachment.
In cooperation with the C.H.U.-Lille (Eye Department) we set up an interregional and european project. We explain the possibilities and difficulties of remote diagnosis. The aim is to build up a network between different ophthalmological centers and so to give access to different centers of expertise to have a faster and more reliable diagnosis for the benefit of the patient.
The main objective of this first epidemiological ocular allergy survey was to precise the profile of patients with an ocular allergy, especially in terms of antecedents, clinical type and trigger or favourising factors, in order to better determine the evolution of the type of diagnosed allergy. This survey covered 399 sufferers drown from amongst general ophthalmologists patients consulting for ocular allergy. Three main points which came out of the survey were: - the chronic aspect of this pathology and the multiplicity of responsible allergens; - the almost permanent existence of conjunctival lesions (9 patients out of 10) and corneal epithelial disease (1 patient out of 3); - the need for an extremely rigourous and thorough questioning of the patient and a complete ophthalmologic examination covering not only the symptoms but equally the lesions of ocular allergy.