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At least 937 records · Page 52Linked to original sources
PubMed1996

The continuing impact of treatment of eye disease on optometric practice in Missouri.

BACKGROUND: This study is a follow-up to a study performed in 1991 to determine the continuing impact of the use by optometrists in Missouri of therapeutic agents (TPA) to treat eye diseases. METHODS: Sixty-four percent of the Missouri optometrists certified to use therapeutic pharmaceutical agents responded to a 1995 questionnaire. RESULTS: More than 90 percent of those responding prescribe all categories of topical agents, while oral agents are used at lower percentages. Almost two-thirds of optometrists are registered with the Drug Enforcement Administration to prescribe controlled substances. The median number of therapeutic prescriptions written per year was 240, an increase of 67 percent from the previous study. More than half of the respondents now receive in-office detailing by drug company representatives. A small percent of optometrists have hospital clinical privileges and about one-fourth have privileges in nursing homes. CONCLUSIONS: The percentage of TPA-certified optometrists residing and practicing in Missouri has risen from one-half to slightly more than three-fourths of practitioners in a 4-year time period. This increase, coupled with the demonstrated increase in therapeutic prescriptions written, enhanced exposure to in-office detailing, and recent amendment of the optometry law to include the management of glaucoma bodes well for the delivery of primary eye care to citizens of the state.

Drug Prescriptions↗
PubMed1997

Analysis of methods for predicting near-magnification power.

BACKGROUND: Data were analyzed from 25 consecutive patient visits to the Low Vision Rehabilitation Service at Southern College of Optometry, during which magnification for near was recommended. METHODS: Linear regressions with analysis of variances were calculated for the results obtained from four near-different near-magnification prediction-calculation methods to determine how accurately they predicted the final near recommended magnifications. A t-test was performed to look for mean differences between calculation methods. RESULTS: No significance was found between the means of three of the calculation methods; a significant difference was found for one. However, all four near-magnification calculation methods significantly predicted final near magnification. CONCLUSIONS: Low-vision rehabilitation clinicians may feel comfortable using any of the four near-magnification methods Choice of method may be a reflection of previous method usage by the clinician. Use of the Lighthouse Near Acuity Test Chart reduces the need to calculate the near-magnification power with which to begin near-magnification testing.

Adult↗
PubMed1997

Comparison of entrance requirements for health care professions.

OBJECTIVE: To compare U.S. chiropractic college admissions requirements with those of allopathy, osteopathy, optometry, podiatry and dentistry. DESIGN: Survey. PARTICIPANTS: The schools that participated in the comparison were selected based on their geographic location within the United States. The number of schools selected were 16 chiropractic college, 17 allopathic colleges, 16 osteopathic colleges, 16 optometric colleges, 7 podiatric colleges and 15 dental colleges. MAIN OUTCOME MEASURES: Information collected from the individual schools included: (a) minimum number of undergraduate semester hours (toward a bachelor's degree) that are required on entrance; (b) actual percentage of applicants with a 4-yr bachelor's degree on entrance; (c) minimum GPA required on entrance and (d) actual average GPA of applicants on entrance. RESULTS: Averages were computed for each outcome. Overall, allopathic averages were highest and chiropractic averages were lowest for each of the four outcome measures, with the other programs scoring at varying points in between. CONCLUSION: Successful completion of preprofessional requirements may be an indicator for success within a rigorous professional curriculum. These data reflect overall differences between health-care professions on a very few entrance criteria. Further investigation is needed to understand the long-term impact of these differences as well as the possible economic or political factors that may be influencing these results.

Chiropractic↗
PubMed1996

Role conflict and conflict of interest: a professional practice dilemma.

BACKGROUND: The structural nature of the optometric profession requires that the majority of optometrists act both as professional health care providers and as entrepreneurial business persons. Clients in turn act both as patients seeking professional health care and as consumers who need to purchase ophthalmic products. METHODS/RESULTS: The development of the current structural nature of optometry is examined, and the concomitant moral implications and responsibilities that emerge out of the role conflicts experienced by both practitioner and patient are explained. Inasmuch as the optometrist's relationship to the patient can at times be ambiguous, the optometrist can be put in a conflict-of-interest situation. CONCLUSIONS: It is the optometrist's moral responsibility to endeavor to avoid conflict-of-interest situations, or to clarify or change them when they occur.

Conflict of Interest↗
PubMed1977

Education for the optometric educator.

Optometric education is faced with the need for new thinking in developing and training educators and new methods of financing their education. Establishing of research faculty and the instituting of research in present schools of optometry must be given a high priority in the future of optometric education.

Faculty↗
PubMed1977

Prevention and enhancement: future needs.

The objective of prevention of eye and visual problems, and the objective of enhancement of vision performance are primary and most urgent for undergraduate, postgraduate and/or continuing optometric education. Prevention is something done before the need occurs. The concept of enhancement assumes performance far beyond so-called normals. The future needs of the public and the profession should determine the content and scope of optometric education pre and post graduation. Occupying the unique areas of prevention and enhancement can expand optometry's role, insure its continued growth and vital service to the public.

Optometry↗
PubMed1977

Sphygmomanometry.

Hypertension is a major health problem in America today, affecting one in every six adults. The problem is that one-third of those with the disease do not know it. Optometry's role as a primary provider of health care must include screening procedures (sphygmomanometry) for hypertension.

Adolescent↗
PubMed1998

Non-compliance in optometric practice.

The purposes of this paper is to explore how some of the recent and future changes relating to the optometric profession could affect non-compliant behaviour among patients. Non-compliance has been widely documented and discussed in numerous health care fields and is understood to be the responsibility of both the practitioner and patient working in a health care partnership. At least one third of patients have been reported to be non-compliant with health care recommendations which can result in the poor outcome of a treatment, secondary medical problems, dissatisfaction, frustration and the wasting of health resources. In recent years contact lens complications have been linked with non-compliant behaviour with contact lens care and maintenance regimens which has led to several media scares over contact lens related hygiene risks and has heightened interest in the issue of non-compliance in the field of optometry. Shared care schemes have already been adopted in some areas of the United Kingdom and if therapeutic pharmaceutical agents are introduced to the list of drugs permitted for use by optometrists in the future the issue of non-compliance will become even more poignant. Every optometrist needs to be aware of the high probability of non-compliant behaviour among patients, the consequences of this non-compliance and the steps that can be taken to enhance compliance in different areas of eye-care.

Contact Lenses↗
PubMed1998

The implementation of prompted retinal screening for diabetic eye disease by accredited optometrists in an inner-city district of North London: a quality of care study.

Diabetic retinopathy remains the most common cause of blindness in people of working age but the provision of high quality eye screening for diabetic patients is still erratic in many health districts in the UK. National consensus guidelines recommend comprehensive population coverage, high sensitivity (>80%), high specificity (>95%), agreed clinical criteria, referral procedures and centralized data collection to facilitate audit. This study looks at the effectiveness of implementing a prompted recall programme for retinal screening in an inner-city district of North London. The scheme uses trained, accredited optometrists to screen patients with diabetes who are looked after in the community by their general practitioner. During the first 17 months of the scheme, 63 optometrists attended training and gained accreditation. Of the 666 patients recruited, 645 were scheduled for screening and 536 (83%) attended. Fourteen per cent of patients screened were found to have background retinopathy and 2.3% sight-threatening eye disease. In two audits, carried out 15 months apart in a random sample of GP practices, the incidence of recorded dilated fundoscopy increased from 48% at baseline to 56%, an increase of 8% (95% CIs 2%-14%). For referable eye disease, the sensitivity of this screening technique was 100%, the specificity 94% (95% CIs 90%-98%), the positive predictive value 79% (95% CIs 72%-86%) and the negative predictive value 100%. The administrative cost per case screened was Pound Sterling 12.60 (excluding clinical costs and any additional optometry payment).

Diabetic Retinopathy↗
PubMed2002

Preparing psychologists to prescribe.

In this report, an investigation of the training received by professionals currently authorized to prescribe medications is considered as a step toward understanding what might be involved in preparing psychologists appropriately if prescription privileges for psychology were to be obtained. Information about admission and curriculum requirements was collected from medical schools, dental schools, physician assistant programs, nurse practitioner programs, and schools of optometry. Results suggest a high level of pharmacologically relevant coursework is required for admission to, and the completion of, programs that currently prepare their professionals to prescribe. It is argued that preparing psychologists to prescribe would likely entail similar training requirements in addition to, or instead of, those already in place, leaving clinical psychology dramatically and permanently altered.

Curriculum↗
PubMed1995

Is there a reduction in postural load when wearing progressive lenses during VDT work over a three-month period?

In an initial study, 18 VDT operators were found to have a higher muscle load in the neck/ shoulder region when using progressive lenses compared with single-vision lenses, while working on a VDT unit. For single-vision lenses, a higher flexion angle in the neck was also discovered. The present study investigates whether this higher muscle load is reduced when a progressive correction is worn for a three-month period. Adaptation in terms of reduced muscle load measured by electromyography (EMG) was not discovered. Head flexion angle was smaller when using progressive correction as compared with single-vision lenses. Some practical implications for occupational optometry are discussed.

Journal Article↗
PubMed2006

Reading performance of patients with uveitis-associated cystoid macular edema.

PURPOSE: To evaluate the extent of the visual impairment caused by uveitis-associated cystoid macular edema (CME) and compare the results with lesion size. DESIGN: Observational case series. METHODS: setting: Uveitis outpatient clinic of the Department of Ophthalmology and Optometry, Medical University of Vienna. patient population: CME was verified in 30 eyes of 30 consecutive uveitis patients with optical coherence tomography and lesion size was assessed with retinal thickness analyzer. main outcome measures: Distance visual acuity (VA) (measured with Early Treatment Diabetic Retinopathy Study charts), reading acuity, and reading speed (tested with Radner Reading Charts). Results were compared with nonaffected partner eyes. RESULTS: Distance VA was logMAR 0.22 +/- 0.15 in CME eyes vs -0.02 +/- 0.17 in healthy controls. Reading acuity was 75% of logMAR in CME eyes vs 92% of logMAR in control eyes (P = .01). The mean reading speed was 148.4 +/- 36.6 words per minute in patients with CME vs 168.9 +/- 36.3 in patients without CME (P = .04). Reading acuity correlated with both lesion size and distance VA (r = 0.61; P = .01 and r = 0.53; P = .028, respectively). Neither anatomical classification of uveitis nor gender or age had a significant influence on the evaluated parameters. CONCLUSIONS: Reading acuity and reading speed were considerably more impaired than distance visual acuity. The assessed parameters showed a better correlation to lesion size and seem to be a better reflection of macular dysfunction. Analyzing reading function is an important factor when following patients with CME and evaluating success of treatment modalities.

Adolescent↗
PubMed2004

Anterior chamber angle biometry with ultrasound biomicroscopy after diode laser thermal keratoplasty.

PURPOSE: To evaluate the effect of diode laser thermal keratoplasty (DTK) on the geometry of the anterior chamber angle with ultrasound biomicroscopy (UBM). SETTING: Department of Ophthalmology and Optometry, Paracelsus Private Medical University, Salzburg, Austria. METHODS: In 9 eyes, a Rodenstock DTK (ProLaser Medical Systems) was used to correct hyperopia (n = 6) or hyperopic astigmatism (n = 3). Hyperopia was treated with a single- or double-ring pattern and hyperopic astigmatism, with additional spots in each of the flat half meridians. Ultrasound biomicroscopy measurements of the chamber angle were obtained preoperatively and 3 months postoperatively using a Humphrey UBM 840 system with a 50 MHz transducer. Quantitative measurements were performed at 3-, 6-, 9-, and 12-o'clock positions using a standardized method. RESULTS: No statistically significant differences between the preoperative and postoperative chamber angle measurements were detected. CONCLUSIONS: The results of the UMB measurements were surprising given the flattening of the corneal periphery found by computerized topography, a finding that suggests narrowing of the chamber angle. Shortening of the corneal tissue may result in centripetal traction that affects the trabecular meshwork and results in a relative opening of the chamber angle structures.

Adult↗
PubMed2004

Accommodation measurements in a prepresbyopic and presbyopic population.

PURPOSE: To study the efficacy of several subjective and objective methods of accommodation measurement in normal prepresbyopic and presbyopic populations to identify appropriate methods for measuring the outcome of accommodative restorative procedures. SETTING: University of Houston, College of Optometry, Houston, Texas, USA. METHODS: Thirty-one normal subjects with a mean age of 43.7 years (range 31 to 53 years) participated. Accommodation was measured monocularly using 3 subjective approaches--the push-up test, minus lenses to blur, and a focometer--and 2 approaches measured with a Hartinger coincidence refractometer, in which accommodation was stimulated with minus lenses to blur and topical pilocarpine 6%. RESULTS: The push-up method overestimated accommodative amplitude relative to objective measures in 28 subjects. Two subjective methods, minus lenses to blur and the focometer, produced comparable results, but with lower amplitudes in younger subjects and higher amplitudes in older subjects compared with objective methods. Comparable results were obtained when accommodation was stimulated in 1 of 2 ways and measured with the Hartinger. Pilocarpine elicited stronger accommodative responses than distance blur for subjects with low accommodative amplitudes. Pilocarpine 6% produced stronger responses in subjects with light irides than in those with dark irides. CONCLUSIONS: Hartinger-measured accommodation provides more realistic measurement of accommodative amplitude than the subjective methods tested, especially in the presbyopic population. In presbyopic subjects, the subjective tests resulted in accommodative amplitudes up to 4.0 diopters greater than those measured with objective tests. Measurements of accommodative amplitude are best achieved with objective methods to stimulate and measure accommodation.

Accommodation, Ocular↗
PubMed2004

Evaluation of a satisfied bilateral scleral expansion band patient.

PURPOSE: To measure accommodation subjectively and objectively in a satisfied bilateral scleral expansion band patient. SETTING: University of Houston, College of Optometry, Houston, Texas, USA. METHODS: One bilateral scleral expansion patient (age 50 years), 9 age-matched normal presbyopic control subjects (age range 48 to 52 years), and 1 normal control subject (age 27 years) participated. The scleral expansion patient had a complete eye examination, corneal topography, and wavefront measurements 19 months postoperatively. Accommodation was measured subjectively with the push-up technique, minus to blur, and dioptric range of clear vision. Accommodation was determined objectively by measuring the accommodative responses to negative lenses and pilocarpine 6% with a Hartinger coincidence refractometer and to real targets with a dynamic infrared optometer. RESULTS: Distance and near acuity of 20/20 was achieved with +1.00 diopter (D) in the left eye, +0.50 D in the right eye, and a near add of +2.25 D. Corneal topography and ocular aberration measurements revealed no suggestion of optical multifocality. Subjective measurements resulted in accommodative amplitudes of 1.50 to 4.00 D, and objective measurements resulted in amplitudes of 0.25 to 1.33 D. The PowerRefractor showed an accommodative response of 0.50 D to stimuli of 1.00 to 4.00 D and strong pupillary constriction with accommodative effort compared with the control. CONCLUSIONS: No increase in accommodative amplitude above normal age-matched controls was found. Patient satisfaction may have come from the high expectations this patient had for a positive surgery outcome.

Accommodation, Ocular↗
PubMed2004

Effect of instrument rotation on handheld keratometry.

PURPOSE: To study the effect of instrument rotation on handheld automated keratometry. SETTING: Department of Optometry and Radiography, The Hong Kong Polytechnic University, Hong Kong SAR, China. METHODS: In 33 recruited subjects, corneal curvature in 1 eye (randomly selected) was measured using a Medmont topographic keratometer and a Nidek handheld keratometer. In handheld keratometry, measurements were obtained holding the instrument in the upright position and rotating it anticlockwise 5 degrees, 10 degrees, and 15 degrees and then clockwise 5 degrees, 10 degrees, and 15 degrees. The sequence of measurements was randomly assigned. The steepest and flattest corneal curvatures as well as the axis along the flattest meridian were compared in different conditions. The corneal power was converted to vector representation (M, J0, J45) for a second comparison. RESULTS: There was a significant difference in the steepest and flattest curvatures in different conditions (repeated-measures analysis of variation, P<.05). However, the mean difference between handheld and topographic keratometry was approximately 0.25 diopter (D) for the steepest curvature and 0.05 D for the flattest curvature regardless of the direction and amount of rotation. The intraclass correlation coefficients were nearly 1, which indicated good clinical reliability. The mean difference in axis determination followed the direction and amount of rotation. With vector representation, the difference between the devices increased with the amount of rotation, especially J0 and J45. CONCLUSIONS: Handheld keratometry was in agreement with topographic keratometry. However, practitioners should adjust the axis manually according to the direction and amount of rotation. The difference between handheld and topographic keratometry increased with the rotational effect, which was seen with vector representation. Practitioners are advised to use the handheld keratometer in the upright position.

Adult↗
PubMed2005

Hepatocyte growth factor and keratinocyte growth factor regulation of epithelial and stromal corneal wound healing.

PURPOSE: To investigate the effects of hepatocyte growth factor (HGF) and keratinocyte growth factor (KGF) on early wound healing in the corneal epithelium and stroma. SETTING: Cell and Molecular Biology Unit, Department of Optometry and Vision Sciences, Cardiff University, and the Cardiff Institute of Tissue Engineering and Repair, Cardiff, United Kingdom. METHODS: Corneal keratocyte cell cultures and wounded corneal organ cultures (both maintained in serum-free conditions) were treated with 0.1 to 100 ng/mL of HGF or KGF for up to 5 days. Cell cultures were assessed for proliferation, migration, and differentiation into myofibroblasts. Organ cultures were used to evaluate the effect of HGF and KGF on reepithelialization following a wound, epithelial morphology and stratification, keratocyte numbers directly beneath the wounded area, and differentiation into myofibroblasts. RESULTS: The 2 growth factors had opposite effects on the rate of reepithelialization, with HGF delaying and KGF accelerating epithelial coverage of the wound. Morphologic assessment showed that both growth factors affected the stratification and differentiation of the epithelium. Both factors stimulated proliferation of keratocytes in serum-free cell culture, although neither induced the appearance of myofibroblasts. This was in contrast to wounded organ cultures treated with 100 ng/mL HGF, in which large numbers of myofibroblasts were observed under the wound. Control corneas and those receiving KGF contained very few myofibroblasts. Keratocyte repopulation of the denuded area under the wound was enhanced in the presence of HGF but decreased in response to KGF. CONCLUSIONS: Hepatocyte growth factor and KGF appeared to have potent and often opposite effects on epithelial and stromal cells following a wound. Hepatocyte growth factor was more detrimental than KGF, resulting in an aberrant epithelium and mass differentiation of keratocytes into myofibroblasts. Inhibition of HGF may be an appropriate therapeutic intervention in the case of persistent epithelial defects and to prevent fibrosis following a corneal stromal wound such as can occur after refractive surgery.

Animals↗