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At least 1,423 records · Page 79Linked to original sources
PubMed1975

An automatic objective optometer. Description and clinical evaluation.

Automatic objective optometers provide a possible alternative to conventional clinical methods of refracting the human eye. Quantitative evaluation of one of these instruments (Dioptron), including a comparison between optometer and subjective refractions, was undertaken to determine how automatic optometers may be utilized most effectively in clinical situations. The results show a high degree of instrument validity and reliability. The conclusion is that the Dioptron has substantial promise as a means of estimating ametropia-as a replacement for retinoscopy and for screening or monitoring ametropia. However, the use of this instrument as a substitute for subjective refraction procedures does not seem warranted at this time.

Adult↗
PubMed1991

Fever in the night.

Explore the source record for details and available documents.

Health Facility Merger↗
PubMed1993

The content and cost of cataract surgery.

Although more than 1 million cataract surgeries are performed annually in the United States, little is known about the frequency of use or cost of various services provided in connection with this procedure. To assess the frequency with which various ophthalmic, optometric, anesthesia, and medical services are provided in conjunction with cataract surgery and to estimate the cost to Medicare associated with those services, we analyzed 1985 through 1988 Medicare claims records of a nationally representative 5% sample of Medicare beneficiaries. The experience of 57,103 Medicare beneficiaries who underwent extracapsular cataract surgery in 1986 or 1987 that was not combined with another ophthalmologic procedure formed the basis of our analysis. Projections for current costs were performed using 1991 charges allowed by Medicare for physician services. We estimate that the median charge allowed by Medicare for a "typical" episode of cataract surgery in 1991 was approximately $2500. In addition to the $3.4 billion that Medicare spent in 1991 on such "typical" episodes, Medicare spent more than $39 million on miscellaneous "atypical" preoperative ophthalmologic tests, such as specular microscopy (14% of cases) and potential acuity testing (8% of cases), more than $7 million on postoperative ophthalmologic diagnostic tests, such as fluorescein angiography (3% of cases), and more than $18 million on perioperative medical services (most commonly electrocardiography and chest roentgenography). The major determinants of the cost to Medicare associated with cataract surgery are the rate of performance of cataract surgery and neodymium-YAG laser capsulotomy and the charges allowed for these procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Cataract Extraction↗
PubMed1996

Postoperative management of cataract surgery patients by ophthalmologists and optometrists.

OBJECTIVES: To assess the frequency and content of post-operative examinations by ophthalmologists and optometrists for cataract surgery patients without operative complications and to assess the referral patterns of optometrists when complications are identified. DESIGN: In 1992 we conducted a survey of randomly selected members of the American Academy of Ophthalmology and American Optometric Association. Responses were obtained from 538 (82%) of 655 eligible ophthalmologists and 130 (84%) of 154 eligible optometrists. RESULTS: Eighty-eight percent of responding ophthalmologists reported that patients had 4 or more visits within 4 months after surgery, 97% of ophthalmologists performed the first postoperative examination on their cataract surgery patients, and 60% of ophthalmologists reported that no other eye professional saw their patients postoperatively. Forty-six percent of responding optometrists participated in postoperative care of cataract surgery patients, and usually performed their first postoperative examination 7 days after surgery; 78% of these optometrists reported that they saw patients 3 or more times after surgery. Postoperatively, 83% of ophthalmologists and 75% of optometrists usually performed at least 1 dilated fundus examination, 87% of ophthalmologists and 47% of optometrists performed 4 or more slit-lamp examinations, 74% of ophthalmologists and 42% of optometrists performed 4 or more tonometry tests, and 83% of both groups performed 2 or more refractions. More than 80% of responding optometrists involved in postoperative care of cataract surgery patients immediately refer a patient to an ophthalmologist if there is evidence of acute glaucoma or an unexplained decrease in vision in the eye that was operated on. For less urgent complications, most optometrists promptly make a referral to an ophthalmologist. CONCLUSIONS: In 1992, a small percentage of ophthalmologists and optometrists were performing fewer follow-up examinations and tests for cataract patients than recommended by the American Academy of Ophthalmology. Not all optometrists immediately refer to an ophthalmologist any acute complication that they identify postoperatively.

Adult↗
PubMed1986

Controversial approaches to treating learning disabilities and attention deficit disorder.

It is estimated that between 3% and 7% of children and adolescents in this country--up to 4 million--are learning disabled. Of this group, about 20% also have attention deficit disorder. Many professionals in multiple disciplines have proposed treatment approaches. When research has been done to support the approach, the reports and data may be published in journals not normally read by the practicing physician. When research data are not available, the information may be in a popular book, newspapers, or lay magazines or on television. Thus, parents may know of ideas and suggestions before the professional in clinical practice. These acceptable and controversial approaches to treatment are reviewed. It is understandable that a parent would seek out improved ways of helping his or her child. I reviewed the significant literature in an effort to assist the practicing physician in providing appropriate parental guidance and clinical interventions.

Adolescent↗
PubMed1998

Current and projected workforce of nonphysician clinicians.

Nonphysician clinicians (NPCs) are becoming increasingly prominent as health care providers. This study examines 10 such disciplines: nurse practitioners (NPs), physician assistants (PAs), nurse-midwives, chiropractors, acupuncturists, naturopaths, optometrists, podiatrists, nurse anesthetists, and clinical nurse specialists. The aggregate number of NPCs graduating annually in these 10 disciplines doubled between 1992 and 1997, and a further increment of 20% is projected for 2001. Assuming that enrollments remain at the levels attained in 2001, NPC supply will grow from 228000 in 1995 to 384000 in 2005, and it will continue to expand at a similar rate thereafter. The greatest growth is projected among those NPCs who provide primary care services. Moreover, the greatest concentrations of both practicing NPCs and NPC training programs are in those states that already have the greatest abundance of physicians. On a per capita basis, the projected growth in NPC supply between 1995 and 2005 will be double that of physicians. Because of the existing training pipeline, it is probable that most of the growth projected for 2005 will occur. The further expansion of both NPC and physician supply thereafter warrants careful reconsideration.

Acupuncture Therapy↗
PubMed1977

Cancer and malpractice claims.

An analysis of 36 closed malpractice claims related to the diagnosis of cancer was conducted at a time when both subjects are receiving particular attention. Awareness of cancer statistics and the medicolegal literature is necessary. Factors related to the allegation of delay as well as the psychological aspects of cancer are presented. Suggestions for claims prevention have been delineated.

Adolescent↗
PubMed1977

Persistent cerebellar ataxia after exposure to toluene.

An optometrist and a glue sniffer exposed independently to toluene vapors developed cerebellar, pyramidal, and cognitive dysfunction. All deficits cleared completely in the former but persisted in the latter. The findings confirm a previous report of a toluene-induced neurological syndrome that is exclusively central, sparing peripheral nerves.

Adult↗
PubMed1985

Helping the aphakic neonate to see.

The treatment of the infant who is born with sensory deprivation amblyopia is one of the most difficult therapeutic problem sets facing the ophthalmologist today. This group of anomalies has many forms, the most common of which seems to be unilateral and bilateral cataracts. Substantial advances have been made, however, in many aspects of therapy for infants who have this set of problems. We have come to realize that it is essential to address these conditions at the first moment that is consistent with the safety of the child. New techniques in cataract extraction have reduced the time course of surgical treatment, reduced the frequency of secondary cataracts, and sustained the patency of the visual pathway. Unfortunately, practitioners who engage in the surgery may not have the back-up skills in advanced contact lens fitting, correction of aniseikonia, and, in some instances, the strabismological complications which are encountered. Further, improved means of assessment of visual acuity, binocular vision, and other visual characteristics of these infants are only in the developmental stages at this time. Thus, we propose to present the problem in an orderly manner. We shall first review the types of cases and problems. We will then discuss surgical techniques and the information which must be determined during examination under anesthesia (EUA) for the purposes of visual correction. We will then describe the designs of the spectacle lens and/or spectacle/contact lens combinations that are used to correct the resultant aniseikonia and anisometropia. We will address the approaches to patching and techniques on how to best achieve binocular vision in these patients. Separately, means and methods of assessment of vision by preferential looking, visual evoked response, optokinetic nystagmus, and tests of other visual functions will be explored. In summary, we will try to tie together the entire therapeutic regimen that can be used in the treatment of these patients.

Amblyopia↗