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PubMed1997

The American Journal of Ophthalmology 1862-1864.

The American Journal of Ophthalmology was the first specialty periodical to be published in the Western hemisphere; the first issue appeared in New York City July 1862. Its editor and publisher was Julius Homberger, M.D., aged 22 years, who had emmigrated from Germany in January 1861. Six issues were published the first year and The Journal ceased publication after two issues in 1864. Possibly, the American Ophthalmological Society, the first national medical specialty society, was founded in 1864 in a reaction to Homberger, his journal, and his strong belief that specialists, but not other practitioners, should be permitted to advertise their skills. In 1866, Homberger submitted his resignation to the American Medical Association, which he had served a secretary of the Section on Surgery, 1864-1865. His resignation was refused and he was expelled from membership in 1868. He moved to New Orleans to practice ophthalmology in 1867, and died in 1872. The second series of The Journal began in St. Louis in 1884 with Adolf Alt, A graduate of Heidelberg University, who trained in ophthalmology in New York City, with Hermann Knapp, founder, editor, and publisher of the Archives of Ophthalmology. In 1918, the current third series of the American Journal of Ophthalmology, consolidated five ophthalmic publications, with Edward Jackson of Denver as editor.

History, 19th Century↗
PubMed1985

Survival with excellence: education and the future of ophthalmology. XLII Edward Jackson memorial lecture.

Health care and medicine are in tremendous flux. Survival of the specialty of ophthalmology in a traditional sense is in question. Positive adaptation to our new environment must occur. A central focus of ophthalmology has always been its commitment to excellence in education. Residency education in ophthalmology is at a high level. Far more random and non-individualized education characterizes continuing education in ophthalmology and all of medicine. The fundamental approach is to base our future on personal accountability and excellence in providing consummate care. I have proposed a more systematic, individually oriented approach to continuing education in ophthalmology. A combined effort by the American Academy of Ophthalmology with other ophthalmic organizations and the individual ophthalmologist would provide individual assessment and educational programs based on practice setting and clinical emphasis.

Education, Medical↗
PubMed1988

Edward Jackson, MD--a historical perspective of his contributions to refraction and to ophthalmology.

Edward Jackson died October 29, 1942, at 86 years of age. He served as president of the major national ophthalmologic organizations and was professor and chairman of the Department of Ophthalmology at the University of Colorado. He established the first graduate course for ophthalmologists, suggested the formation of the instruction courses of the American Academy of Ophthalmology, and was the principal founder of the American Board of Ophthalmology. He founded and edited the Yearbook of Ophthalmology and Ophthalmic Literature. In 1918, he became editor of the third series of the American Journal of Ophthalmology, which consolidated five ophthalmic periodicals. In 1885, he popularized retinoscopy in the United States and was mainly responsible for making it a practical refraction tool. Two years later, he described the cross cylinder to determine the presence or absence of astigmatism. In 1907, he described the use of the cross cylinder to refine the axis of a correcting cylinder in astigmatism. He lectured and wrote widely and published over 700 scientific articles, book chapters, and books.

History, 19th Century↗
PubMed1991

An ophthalmologist's definition of ophthalmology.

Ophthalmology has long been on the vanguard of medicine and innovation. Ophthalmologists have enjoyed high levels of satisfaction from restoring sight to patients. But the world as we know it has shifted, and now we are burdened by the pressures of modern medicine and a competitive marketplace. Ophthalmology should take the lead in medicine in learning how to weather these crises and how to emerge a revitalized specialty. It seems that the right choice for the specialty of ophthalmology is to reclaim our role as comprehensive providers of total eye care. Ophthalmologists can lead teams formed to provide comprehensive eye care. A dialogue on a consensus definition of the scope of ophthalmology should take place, involving all segments of the profession. Another dialogue that is critical to the future of the specialty is a deliberate examination of the issue of formal accreditation and/or certification of ophthalmologic subspecialties. Ophthalmology needs to define itself for the future.

Accreditation↗
PubMed1994

[Ophthalmology in Leipzig and Dresden 100 years ago].

BACKGROUND: Based on a rich ophthalmologic tradition in Saxony--for example Georg Bartisch (1536-1606) and his "ophthalmoduleia" furthermore the anatomist and surgeon of the university of Leipzig Justus Gottfried Guenz (1714-1754), working about the staphyloma and criticizing the notorious oculist John Taylor (1703-1772)--the situation at Dresden and Leipzig is described. The development was dynamical, scientifical and in the end independent of surgical specialty. Physiology (Purkinje, Helmholtz), obstetric (Credé) and other medical specialties had a great influence on the ophthalmology too. MATERIAL AND METHODS: The investigation predominantly is determined by the "Staatshandbuch für das Königreich Sachsen" and by the also important address-books of Dresden and Leipzig. In this material are to find the number of ophthalmologists, of clinics and practices as well as the kinds of work. RESULTS: The ophthalmology in Saxony 100 years ago, especially in the university of Leipzig and in the capital of this country, Dresden, may be mirror of the development in whole Germany. As well in the academic field as in the ophthalmology the specialty was very spreaded and accepted. CONCLUSIONS: In the focus of the ophthalmological picture the extent and the level or the quality of this medical specialty stands. We can say, that the oculists at that time are versed in concerning the operative and conservative therapy. The social welfare played a part in the supply of the blind and in the prescription of glasses. With reference to the chairs and many personalities Saxony was a centre of ophthalmology in Germany.

Germany↗
PubMedDate not supplied

Usefulness of systematic ophthalmologic investigations in neurofibromatosis 1: a cross-sectional study of 211 patients.

PURPOSE: To evaluate the usefulness of ophthalmologic examination for diagnosis and for detection of complications in adult patients with neurofibromatosis 1. METHODS: PATIENTS with at least one criterion of neurofibromatosis 1 (excluding ophthalmologic criteria) seen at a referral centre had a systematic ophthalmologic examination including best-corrected visual acuity, slit-lamp examination and dilated funduscopy. The ophthalmologist was unaware of all other anamnestic data. RESULTS PATIENTS: 211 patients with NF1 were included (mean age: 32 +/- 14 yr.). Ophthalmologic examination in neurofibromatosis 1 patients: Lisch nodules (n = 185) (87.7%); choroidal hamartomas (n = 61) (29%); enlarged corneal nerves (n = 1); 3 plexiform neurofibromas (n = 3); symptomatic optic pathway gliomas (n = 5). Diagnostic contribution of presence of Lisch nodules: 6 (3%) of 211 patients. Detection of complications: none. CONCLUSIONS: In adult patients with neurofibromatosis 1, the contribution of ophthalmologic examination to diagnosis and to the detection of complications is low. Ophthalmologic examination should be performed in patients for whom questioning and clinical examination failed to give evidence of NF1 or to determine the NF subtypes.

Adolescent↗
PubMed2001

The opportunity for international ophthalmology in treating blindness.

As our worldview has become more pervasive, there has been a maturation of various international ophthalmological organizations. They have created several new initiatives that have the potential to dramatically affect preventable and treatable blindness, worldwide. The first international ophthalmological organization (the International Council of Ophthalmology, established in 1927) evolved from the longest continuously held medical meeting in the world (the International Congress of Ophthalmology, first held in 1857). Subsequently, a number of supranational and international organizations have been created, and these groups are beginning to communicate with each other and with national ophthalmological societies in joint planning. The international nongovernmental organizations, lay ophthalmic international organizations (e.g., International Agency for the Prevention of Blindness), and the World Health Organization have recently joined to create a proposal called Vision 2020: The Right to Sight. The International Council in partnership with Academia Ophthalmolgica Internationalis has created a parallel and complementary plan, Vision for the Future. The potential to alleviate or prevent blindness in over 150 million people requires our attention. Understanding the seemingly complex interrelationships of these many organizations--often unfamiliar to American ophthalmology--is important for the uniquely strong ophthalmic organizations in the United States. American involvement can make a difference. This presentation describes the background, relationships, and present plans, which, if implemented, will have a tremendous impact on treatable and preventable blindness and the level and quality of ophthalmic services throughout the world.

Blindness↗
PubMed2004

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.

PURPOSE: To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. METHODS: Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances. RESULTS: A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY. CONCLUSIONS: The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.

Cost-Benefit Analysis↗
PubMed2004

Community ophthalmology in the Indian perspective.

Community ophthalmology is as important as practice of clinical ophthalmology. Community ophthalmology deals the part of ophthalmology which is meant for identifying common causes of ocular morbidity in different regions, assessing the needs of the population, selecting appropriate intervention strategies, planning education programmes and analysing the utilisation patterns. Community ophthalmology denotes the use of appropriate strategies to reduce the burden of eye diseases in the community and the consequences of ocular ill health, while striving to ensure the best possible ocular health status for a major proportion of the community. Community-based services do not mean that institutional care is being downgraded. Institutions will always be central to the success of community-directed programme. The rational for practising community ophthalmology has been pointed in the text portion.

Community Health Services↗
PubMed2006

[Citation characterization of the ophthalmological journals in Chinese in 2001].

OBJECTIVE: To investigate the utilization and the requirement of literatures by the researchers through analyzing and valuing citation of the ophthalmological journals in Chinese. METHODS: There were 13 journals, of which five were core journals, to publish the results of primary study in ophthalmology in 2001. The citation amount and type, language category, self-citing rate of 13 journals were calculated. Meanwhile, the time distribution of citation, the Price index, the half-citing life and the cited situation of 5 core ophthalmological journals were investigated. RESULTS: In 2001, total amount of citations of 13 journals were 16,429. The mean citations per article were 5.13, and the mean citation rate 77.42%, self-citing rate 23.49%, other-citing rate 76.51%. The major language of citation was English (59.17%), and the major citation was from journals (89.25%). In 5 core ophthalmological journals, the time distribution of foreign language and Chinese references ranked at highest was the fourth and third year, respectively, after they were published. The total Price index of citations was 35.22%, the half-citing life of the Chinese and English references was 5.12 and 7.52 years, respectively. CONCLUSIONS: The main citations of 13 ophthalmological journals came from the English journals. There was a short half-citing life for Chinese literatures. Cited-papers in Chinese were mainly from five core ophthalmological journals.

Bibliometrics↗
PubMed1989

The Tenth Frederick H. Verhoeff lecture. What else did 1864 contribute to ophthalmology?

In summary we can say that the AOS was founded at a time when ophthalmology established itself as an independent scientific medical specialty. A hundred years earlier, in 1750, ophthalmology became an independent surgical specialty when Jacques Daviel of Marseille had begun extracting a cataract instead of merely couching or dislocating the lens. Now in the middle of the 19th century a new era dawned on the ophthalmic horizon. An era which Julius Hirschberg calls "the reform of ophthalmology." It was effected mainly by a group of unusual, gifted and genial scholars. Hermann v. Helmholtz, who not only invented the ophthalmoscope, but established with his handbook physiologic optics as an advanced, sophisticated branch of optics and mathematics; F.C. Donders, who put refraction, refractive errors and accommodation on a sound scientific footing, the great A. v. Graefe, who contributed so much to the concept and treatment of glaucoma, to strabismus, to various diseases of the fundus, to neuro-ophthalmology and to many other fields and finally William Bowman, the great investigator, clinician and surgeon. It was during this time of reform, of fermentation, of maturation, that a group of farsighted American ophthalmologists decided to establish a society to further the aims and objectives of our specialty in America. The time was right; the effort succeeded and our society developed into one of the decisive forces of American ophthalmology. I hope that my address has met the objectives which I had outlined earlier: To present and illuminate the circumstances and external conditions which were effective in 1864 when our society was founded. At the same time I hope I have done justice to the memory of this outstanding American ophthalmologist, Frederick Verhoeff, who contributed so much to the American Ophthalmological Society. On this the quasquicentennial jubilee of the AOS we find the Society healthy and flourishing. May it continue as an association of the most prominent and most promising American ophthalmologists who consider the practice of our specialty a scholarly profession and not a mercenary trade. I can only conclude with wishing the AOS a happy birthday, many successful returns, ad multos annos!

England↗
PubMed1986

Ophthalmology training in US family practice residencies.

Training in office ophthalmology is important in family practice residencies, especially because ophthalmology problems are common in family practice and only one quarter of medical students take structured ophthalmology clerkships in US medical schools. A joint committee of the American Academy of Family Physicians (AAFP) and the American Academy of Ophthalmology (AAO) has developed for family practice residents a core curriculum in ophthalmology listing essential cognitive knowledge and psychomotor skills. A national study on the extent and type of training currently available in US family practice residencies was performed. Based on a response rate of 82 percent, structured ophthalmology training experiences are provided on a required basis by 93 percent of the programs. Of these, 63 percent offer block rotations normally of two or four weeks' duration. Although a majority of the cognitive areas and psychomotor skills recommended by the AAFP-AAO joint committee are likely to be covered in existing family practice residencies, gaps identified in both categories call for closer attention to improving the learning experiences of residents in this field.

Curriculum↗
PubMed1993

A brief review of the development of ophthalmology in Croatia.

Autochtonous folk medicine practice in Croatia was mostly based on the use of herbs in the treatment of eye diseases. The first document on the presence of medical activity was one in which the Republic of Venice gave Draga Slava permission to practice medicine in 1330. The 19th century was the turning-point for the development of ophthalmology in Croatia. The basis for well-organized clinical, preventive and social ophthalmological care was established. The Cathedra for Ophthalmology was founded in 1920 and its first head was Albert Botteri, who was along with Nizetić, Spanić, Gradilicić and Meixner, the most prominent ophthalmologist in the first half of the century. Zvonimir Pavisić and Kresimir Cupak were the leading persons in Croatian ophthalmology in the second half of the century. Croatian ophthalmologists were organized in the Section for Ophthalmology as the part of the Medical Association of Croatia from 1926 up to 1992, when the Section changed its name to the Croatian Ophthalmological Society, with more than 250 members. Inspite of the difficulties, Croatian ophthalmologists tend to use almost all modern diagnostic and therapeutic methods in use in the world.

Croatia↗
PubMed1995

Short-wavelength automated perimetry in neuro-ophthalmologic disorders.

OBJECTIVE: To evaluate the efficacy of short-wavelength automated perimetry (SWAP) in the assessment of patients with neuro-ophthalmologic disorders, especially optic neuropathies. METHODS: A modified Humphrey field analyzer was used to perform standard automated perimetry and SWAP, a technique that isolates the activity of short-wavelength-sensitive ("blue") mechanisms. Forty patients (80 eyes) were evaluated by SWAP and standard automated perimetry. Thirteen patients (26 eyes) had recovered from optic neuritis and/or multiple sclerosis, 15 (30 eyes) were in various stages of treatment for pseudotumor cerebri, and 12 (24 eyes) had other miscellaneous neuro-ophthalmologic conditions. Six additional patients (12 eyes) with neuro-ophthalmologic conditions were tested twice on different days during a 2-week period, with the order of SWAP and standard perimetric testing being reversed on the second day. RESULTS: Of the 80 eyes tested, 38 (48%) had SWAP visual fields that were worse than standard automated perimetry results; 29 (36%) showed no difference between standard and SWAP visual fields; and 13 (16%) had standard automated perimetry results that were worse than SWAP visual fields. Of the 26 eyes in patients with optic neuritis and/or multiple sclerosis, 15 (58%) had SWAP results that were worse than standard visual fields. Ten (33%) of the 30 eyes with pseudotumor cerebri had SWAP results worse than standard automated perimetry results, and 13 (54%) of 24 eyes with miscellaneous neuro-ophthalmologic conditions had SWAP results worse than standard automated perimetry results. For the 12 eyes undergoing repeated testing, SWAP visual fields were worse when they were performed last, perhaps indicating that some fatigue effect was present. This was observed for standard visual fields as well, but to a smaller extent. CONCLUSIONS: Preliminary findings suggest that SWAP may be useful in detecting certain neuro-ophthalmologic deficits more readily than standard automated visual field testing, especially for optic neuritis and multiple sclerosis. Further evaluations will be necessary to define the effects of fatigue for SWAP visual fields in neuro-ophthalmologic disorders.

Adult↗
PubMed2005

[Monitoring, reporting, and preventing nosocomial infections in ophthalmology. Creation of the National Endophthalmitis Observation Database (ONDE)].

INTRODUCTION: Fighting against nosocomial infections (NI) is one of the missions of every healthcare institution (Decree No. 99-1034, 6 December 1999 and circular No. DGS-DHOS-2600-645, 29 December 2000). Setting up epidemiological surveillance for NI is an essential factor in preventing such infection as well as operation-site infections (OSI). It forms one of the priorities defined by the National Technical Committee for Nosocomial Infections (CTIN). In this context, the National Observation Endophthalmitis Database (ONDE) was born under the auspices of the Académie d'Ophtalmologie to coordinate epidemiological surveillance of OSI in ophthalmology, principally after cataract surgery. In addition, recent legislation (Decree No. 2001-671 of 26 July 2001 and circular No. DHOS/E2-DGS/SD/5C no 2001-383 of 30 July 2001) introduced the obligatory reporting of certain NI through the coordination centers to fight nosocomial infections (CCLIN) and to the DDASS, with the aim of alerting and assisting medical institutions. The interaction between these professional initiatives and regulatory obligations remains to be defined. MATERIALS AND METHODS: The ONDE project establishes surveillance of postoperative endophthalmitis by collecting information on cases of OSI and their circumstances of onset using a standardized, anonymous questionnaire. This questionnaire can be viewed online on the website . In conjunction, and as stipulated in Decree 671 dated 26.07.2001, it is essential to install the continuous reporting of endophthalmitis of infectious origin in every health care institution, thereby enabling transmission of these NI data in ophthalmology to various healthcare bodies (C-CLIN, DDASS, In Vs). This reporting does not replace the reporting obligations associated with safety monitoring. Patient information, another aspect of the regulatory device, is essential to the patient-healthcare professional confidence relationship. RESULTS: The creation of ONDE and an explanation of its objectives were announced by mail at the beginning of 2003 to all French ophthalmologists: 424 answers were received, 346 (82%) ophthalmologists stating that they were ready to take part in this project. Despite the length of the questionnaire, the project coordinators hoped to recover a sufficient number of observations, thereby repeating the success of the first prospective national survey piloted by GEEP in 1991. This project was presented to the Network for Advancing and Investigating the Surveillance of Nosocomial Infections (RAISIN), which is an association of CCLIN and the Institute for Health Monitoring. The ONDE process was received with interest and RAISIN offered its methodological support. The potential synergism between the ONDE work and that of other RAISIN studies was highlighted. The results of the surveillance network for OSI identified an ophthalmological infection rate in surgery in 2002 of 0.27 OSI per 100 operative procedures. The endophthalmitis reports received since 2001 make up 3% of the reports received at InVs, making this a warning event and justifying specific studies and the need for a case-control study to better understand the risk factors for this type of infection: ONDE will be associated with the RAISIN working group on this subject. DISCUSSION: Setting up a dialogue between ophthalmology professionals (surgeons, manufacturers of medical devices), and those in hygiene, and the surveillance of NI on regional and national scales, will help to increase the cooperation specifically required to introduce quality procedures and improve the understanding of the risk of infection in ophthalmology. Although sending data to ONDE cannot substitute for regulatory reporting, it will help to obtain additional information and to improve this knowledge. The American SENIC Project (Study of the Efficacy of Nosocomial Infection Control) in the 1970s found that the introduction of epidemiological surveillance could reduce NI by 30%. CONCLUSION: The need to regularly update epidemiological data on NI in ophthalmological surgery justifies this new effort required from the profession and will enable it to perform part of a permanent evaluation process for the multifactorial risk of infection. Ophthalmologists have long shown their involvement in mobilizing forces to fight infection.

Cross Infection↗
PubMed2002

Ophthalmological abnormalities in children with cerebral white matter disorders.

The use of magnetic resonance imaging (MRI) in children with severe neurological impairment has defined a subgroup with increased T2-signals from cerebral white matter. The causes of white matter abnormalities are for the most part unknown, despite extensive investigation. Their clinical correlates and characteristics have still to be systematically analysed and described. We have compared clinical, ophthalmological and electro-ophthalmological findings in such children to delineate neurological and MRI patterns and have sought to correlate with the progression of disease. Clinical and electro-ophthalmological investigations were performed in 26 children with cerebral white matter abnormalities of unknown aetiology; 25 of the 26 children showed abnormalities, 23 clinical and 18 electro-ophthalmological. Optic nerve abnormalities, severe visual impairment and strabismus were the most common. Electro-ophthalmological abnormalities were increased latencies and abnormal waveform of the visual evoked potentials (VEP). Children with progressive disease all had abnormal VEP, whereas none of the ten children with a normal VEP deteriorated. We conclude that children with cerebral white matter abnormalities almost invariably had ophthalmological and often VEP abnormalities. Normal VEP was correlated with non-progressive disorder, as was hypoplasia or malformation of the papilla, whereas abnormal VEP were associated with progressive disease.

Adolescent↗
PubMed2004

Neuro-ophthalmological disorders in HIV infected subjects with neurological manifestations.

AIMS: To determine the frequency and features of neuro-ophthalmological manifestations in neurologically symptomatic HIV infected patients and to assess whether or not the visual evoked potential (VEP) features in these patients differ from those of neurologically asymptomatic HIV infected patients. METHODS: Neuro-ophthalmological evaluation was performed in 166 neurologically symptomatic confirmed HIV positive patients, of whom 75 with normal ophthalmological examination were further studied by means of VEPs. The VEPs values were compared to those obtained from 53 other confirmed HIV positive subjects with neither ophthalmological nor neurological manifestations, who served as a comparison group and to the references values of our laboratory. RESULTS: An abnormal neuro-ophthalmological examination was noted in 99/166 patients (60%). Eye movement disorders were present in 99 patients (51%). Visual field defects were detected in 39% of the patients. Optic neuropathy was noted in 31%, papilloedema in 27% and ocular motor nerve palsies in 26% of the patients. Toxoplasmosis and cryptococcosis were the most frequent associated pathologies, though in some patients the HIV itself was the presumed cause. VEPs were abnormal in 57% and 42% of patients with and without neurological manifestations, respectively. Compared to asymptomatic patients, symptomatic patients had a significantly increased mean latency; however, both groups had significant increase in mean latency compared to reference values. CONCLUSION: Neuro-ophthalmological manifestations are common in neurologically symptomatic HIV infected patients. Subclinical dysfunction in the visual pathways is a common phenomenon in both HIV infected patients with and without neurological symptoms, but neurologically symptomatic patients seem to have more damage in their visual pathways.

Adult↗
PubMed2006

Remote ophthalmology services: cost comparison of telemedicine and alternative service delivery options.

We calculated the cost of an established tele-ophthalmology service, from a health-provider's perspective, and compared this with the cost of three other existing eye-care service delivery options. During a 12-month study period, 118 persons took part in the tele-ophthalmology consultations between a rural clinic located approximately 900 km from the Lions Eye Institute in Perth. The variable costs of tele-ophthalmology were 166.89 dollars(Australian dollars) per patient, and the alternatives cost 445.96 dollars, 271.48 dollars and 665.44 dollars per patient. Tele-ophthalmology incurred a set-up cost of 13,340 dollars. The threshold at which tele-ophthalmology became cheaper than any of the alternative options occurred at a workload of 128 patients. Tele-ophthalmology offers a viable alternative to conventional eye-care service in rural and remote areas.

Delivery of Health Care↗