by Ramson, Prasidh, Govender, Pirindha, Naidoo, Kovin [2016-01-01]
Background: In South Africa, there is a paucity of optometrists serving the needs of the larger public sector. KwaZulu-Natal is one of the most densely populated provinces and home to several of the poorest districts. Despite an optometry school in the province, and with a lack of compulsory community service for new graduates, more optometrists are needed to serve the public sector. While studies on the recruitment and retention of medical and allied health professionals have been conducted, limited evidence exists on work trends of public sector optometrists. Methods: A cross-sectional study design using both quantitative and qualitative data collection methods was used. All public sector optometrists and local district health co-ordinators in the province were contacted, with an 80% (41 out of 51) and 75% (9 out of 12) response rate, respectively. Questionnaires containing demographic, recruitment, retention and open-ended questions were distributed by post, fax and email and via an online survey to both groups. Telephonic interviews were also conducted using semi-structured techniques. Frequency distributions, Fisher's exact test and odds ratios were used to statistically describe the demographic data, while qualitative responses were recorded and analysed for commonly occurring themes. Results: The present public sector optometry workforce comprises mainly young (73%), black (70%), women (66%). They chose to work in the public sector to 'make a difference' and were attracted by 'good working hours' and 'job security'. Fifty-three percent of optometrists work in the public sector due to a study bursary, for which there was a statistically significant association for race (p = 0.01), gender (p = 0.05) and background origin (p = 0.05). To aid their retention in public service, improved salaries, career progression, recognition, improved management relations and improved instrumentation were ranked highest by these optometrists. Conclusion: The demographic profile of presently serving public sector optometrists poses many human resource (HR) challenges and opportunities. Universities should pay attention to rural origin of students and provide exposure to rural clinical experiences during study. Departments of Health use study bursary incentives to recruit optometrists, but need to consider financial and non-financial incentives for their retention. At hospital level, a responsive HR management system should be implemented with emphasis on career management, recognition, improving infrastructure and supporting professional development. [ABSTRACT FROM AUTHOR]
by Abelson, Mark B., Dewey-Mattia, Daniel, Crawford, Kathy [2009-02-01]
The article offers information concerning ocular pharmacokinetics. Ocular pharmacokinetics (PKs) refers to the study of evaluating the amount of drugs and the required dosage that should be given to patients suffering from eye diseases. It discusses the results of the ocular PK studies conducted which was carried out in animal models as well as drug formulation and alternative therapy.
by Mahmoud, Abdulraheem O., Ayanniyi, Abdulkabir A., Lawal, Abdu, Omolase, Charles O., Ologunsua, Yinka, Samaila, Elsie [2011-04-01]
Purpose: To study the views of ophthalmologists on research priorities and outcomes in Nigeria. Materials and Methods: A structured questionnaire was distributed to 120 ophthalmologists and ophthalmic residents who were attending an annual congress in Nigeria. The participants' background information, relative research priorities, frequency of publications, research types, publication media, challenges faced in publishing and impact on health practice or policy were collected. Results: Eighty-nine (74.2%) of the 120 questionnaires were returned. Childhood blindness was given the highest priority for ophthalmic research by 42.9% of the respondents, and genetic studies had the least priority (19.8%). About two-thirds of the respondents had either never been involved or only involved occasionally in any type of ophthalmic research. Clinical trials (13.1%) and basic science studies (12%) were the least-performed types of research. About 51% of the respondents indicated that they had never published in journals nor did so "occasionally"; only 9% quarterly and 43% published less than once a year. They also indicated that their research very rarely resulted in change of clinical practice or health policy (20%). Conclusions: Research works conducted by respondents were largely simple low-budget ones that rarely had significant impacts and outcomes, including publication. There is a need to retrain and emphasize the importance of research during undergraduate and postgraduate medical education. Adequate resources and research infrastructure should be provided for ophthalmic research in Nigeria. [ABSTRACT FROM AUTHOR]
by Enders, Christian, Braig, Eva-Maria, Scherer, Kai, Werner, Jens U., Lang, Gerhard K., Lang, Gabriele E., Pfeiffer, Franz, Noël, Peter, Rummeny, Ernst, Herzen, Julia [2017-01-27]
Due to limited X-ray contrast, the use of micro-CT in histology is so far not as widespread as predicted. While specific staining procedures—mostly using iodine—address this shortcoming, long diffusion times restrict its use in the often time-constrained daily routine. Recently, a novel staining protocol has been proposed using a biochemical preconditioning step, which increases the permeability of the cells for the staining agent. This could enable the imaging of entire organs of small mammals at a yet unmatched image quality with reasonable preparation and scan times. We here propose an adaptation of this technique for virtual ophthalmology and histology by volumetrically assessing both human and porcine eyes. Hereby, we demonstrate that (contrast-enhanced) micro-CT can outperform conventional histology in the assessment of tumor entities, as well as functioning as a supplementary tool for surgeons in the positioning of intraocular implants in-vitro and as a general assessment tool for ophthalmologic specimens. [ABSTRACT FROM AUTHOR]
by Kunnazarovich, Kurbanazarov Muratbai, Zhalgasovna, Abdullaeva Nuria, Parahatovna, Palekeeva Gulzhakhan [2018-03-01]
In parallel with the deterioration of the ecological situation, there were high rates of registration of morbidity in the South Priaralye region. Risk factors that determine the changes in the functional state of the human body are singled out, which reduces its stability, depletes the protective forces, strengthens the pre-pathological conditions, and exacerbates infectious processes. In the region with increased influence of environmental and climatic factors, high rates of extracardicular pathology in children with myopia are noted. [ABSTRACT FROM AUTHOR]
by Narayanan, Raja, Stewart, Michael W., Chhablani, Jay, Panchal, Bhavik, Reddy Pappuru, Rajeev, Das, Taraprasad, Jalali, Subhadra, Ali, M. Hasnat, Pappuru, Rajeev Reddy [2018-09-01]
Purpose: To determine the predictive values of baseline optical coherence tomography (OCT) abnormalities on 12-month visual acuity changes in eyes with macular edema (ME) caused by branch retinal vein occlusions (BRVO).Methods: We performed a post hoc analysis of data from 75 participants in the 12-month MARVEL trial. OCT abnormalities at baseline, including ganglion cell layer cystoid spaces (GCL), intraretinal hyper-reflective dots, and central subfield thickness (CST), were correlated with improvements in visual acuity and the number of anti-vascular endothelial growth factor injections required using a multivariate regression model.Results: Eyes with baseline CST > 500 μm had greater visual gains compared to those with CST
by Mafwiri, Milka Madaha, Kisenge, Rodrick, Gilbert, Clare Elizabeth [2014-06-01]
Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede's prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede's prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs- 60.7%). Mystery mothers observed health education sessions in 7/10 RCH clinics with trained staff, five (71.4%) of which included eye conditions. Conclusions Primary eye care for children in Dar-es-Salaam is inadequate but training RCH staff can improve knowledge in the short term and change practices. Attendance by mothers and their children is high in RCH clinics, making them ideal for delivery of PEC. Ongoing supportive supervision is required to maintain knowledge and practices, as well as systems to track referrals. [ABSTRACT FROM AUTHOR]
by Colquhoun, P. Jeffrey [2005-06-01]
Reports on the nonprofit organization, Friends of Zambia's travel to Zambia to share their knowledge about ophthalmology. Sessions concerning ophthalmology held by the group with the Zambian government and citizens; Factors that influence the status of ophthalmic services in the country; Common diseases suffered from by the population of the country. INSET: Take-Home Message.
by Al-Bdour, Muawyah D., Al-Till, Maha I., Idrees, Ghaida M., Abu Samra, Khawla M. [2008-11-01]
Purpose: This study aimed to estimate the prevalence of pseudoexfoliation syndrome (PXS) and analyse its association with particular ocular diseases in patients attending the Department of Ophthalmology at Jordan University Hospital. Methods: A total of 1195 consecutive patients, aged 40–90 years, who attended the Department of Ophthalmology at Jordan University Hospital between December 2005 and March 2007 were included in the study. Each patient underwent complete ophthalmic evaluation, including: relevant history; visual acuity testing; slit-lamp examination, applanation tonometry, gonioscopy and dilated fundus examination. Patients with typical pseudoexfoliative material on the anterior lens surface and/or the pupillary margin in either or both eyes were labelled as having PXS. Results: Of the 1195 patients, 9.1% had pseudoexfoliation (PXF). Their mean age was 68.3 years (standard deviation [SD] 9.57). The prevalence of PXS had a tendency to increase with age but had no sex predilection. Pseudoexfoliation was bilateral in 65.7% of cases. It was significantly associated with cataract, glaucoma and phacodenesis. Of the eyes with PXF, 92.1% had cataract, 33.1% had glaucoma and 7.9% had phacodenesis. Conclusions: Although this study was not population-based, its findings increase our knowledge of PXS in a Middle Eastern country. Few data on PXS are available from this part of the world. [ABSTRACT FROM AUTHOR]
by Parikh, Rajul, Muliyil, Jayaprakash, George, Ronnie, Bhat, Savita, Thomas, Ravi [2008-01-01]
Purpose: To evaluate the repeatability of frequency doubling technology perimetry (FDT, screening-20-1 program) and the effect of pupillary dilatation on its interpretation. Methods: Group I comprised 85 eyes (85 glaucoma patients) with field defects on automated perimetry classified on the basis of severity. Group II comprised 41 normal eyes (41 subjects). At baseline all subjects underwent conventional automated perimetry using the Swedish Interactive Testing Algorithm program (SITA standard). On two subsequent visits both groups underwent FDT (C20-1 FDT). At the final (third after baseline) visit, all patients underwent C 20-1 test before and after pupillary dilatation. Sensitivity and specificity was calculated for each test. Mean number of defective points for 20-1 test at each test was noted; differences between the repeat 20-1 tests were calculated. Reproducibility of repeated FDT was tested by the limits of agreement plot. Results: The sensitivity and specificity of the first test was 85% and 95% and did not vary much between visits; sensitivity and specificity were 77.6% and 97.7% for the "dilated" test. The mean difference (with 95% CI) in number of defective points per patient between tests 1 and 2 and between test 1 and the "dilated" test for both glaucoma group and normal group was not significant. On the limits of agreement plot more than 95% points lay between 2 SD. Conclusions: FDT has a clinically acceptable repeatability. Dilatation decreases sensitivity but not specificity. [ABSTRACT FROM AUTHOR]
by Büyükbaş, Zeynep, Gündüz, Mehmet Kemal, Bozkurt, Banu, Zengin, Nazmi [2012-06-01]
by Farrant, Sarah [2014-08-01]
The article discusses the implications of Demodex blepharitis infection which is associated with Demodex mites. Topics mentioned include a brief history of the discovery of Demodex mites during the late 1800s, statistics on the prevalence of mites in various patient groups, and an overview of the typical patient symptoms for Demorex blepharitis which includes itching and burning, red eyelids, and blurry vision.
by Lois, Noemi, Hossain, Parwez, Azuara-Blanco, Augusto [2012-01-01]
This E-book provides the reader with a detailed up-to-date review of diagnostic technologies and their role in clinical practice. Chapters are dedicated specifically to describe the role of current technologies in the management of the leading causes of visual impairment such as age-related macular degeneration, diabetic retinopathy, glaucoma, vitreo-retinal disorders, cornea and anterior segment diseases. This E-book will help clinicians to understand and interpret diagnostic tests and critically appraise their performance and limitations. This book is intended for general ophthalmologists and clinicians with a special interest in retinal diseases, glaucoma, anterior segment and cornea. It will also be of interest and value to ophthalmologists in training, scientists, ophthalmic photographers and optometrists.
by Badano, Aldo, Revie, Craig, Casertano, Andrew, Cheng, Wei-Chung, Green, Phil, Kimpe, Tom, Krupinski, Elizabeth, Sisson, Christye, Skrøvseth, Stein, Treanor, Darren, Boynton, Paul, Clunie, David, Flynn, Michael, Heki, Tatsuo, Hewitt, Stephen, Homma, Hiroyuki, Masia, Andy, Matsui, Takashi, Nagy, Balázs, Nishibori, Masahiro [2015-02-01]
This article summarizes the consensus reached at the Summit on Color in Medical Imaging held at the Food and Drug Administration (FDA) on May 8-9, 2013, co-sponsored by the FDA and ICC (International Color Consortium). The purpose of the meeting was to gather information on how color is currently handled by medical imaging systems to identify areas where there is a need for improvement, to define objective requirements, and to facilitate consensus development of best practices. Participants were asked to identify areas of concern and unmet needs. This summary documents the topics that were discussed at the meeting and recommendations that were made by the participants. Key areas identified where improvements in color would provide immediate tangible benefits were those of digital microscopy, telemedicine, medical photography (particularly ophthalmic and dental photography), and display calibration. Work in these and other related areas has been started within several professional groups, including the creation of the ICC Medical Imaging Working Group. [ABSTRACT FROM AUTHOR]
An interview with four cataract surgeons that includes Scott Laborwit, Parag Majmudar and Carlos Martinez, is presented. Among the issues they discussed include their experiences using the LenS Laser System and ORA SYSTEM Technology to achieve surgical success and satisfied patients, their motivation to using the technology, and how their practice is structured for counseling patients about their surgical options.
by Heo, Dong Won, Kim, Kyoung Nam, Lee, Min Woo, Lee, Sung Bok, Kim, Chang-sik
Purpose: To evaluate the properties of pattern standard deviation (PSD) according to localization of the glaucomatous optic neuropathy. Methods: We enrolled 242 eyes of 242 patients with primary open-angle glaucoma, with a best-corrected visual acuity ≥ 20/25, and no media opacity. Patients were examined via dilated fundus photography, spectral-domain optical coherence tomography, and Humphrey visual field examination, and divided into those with hemi-optic neuropathy (superior or inferior) and bi-optic neuropathy (both superior and inferior). We assessed the relationship between mean deviation (MD) and PSD. Using broken stick regression analysis, the tipping point was identified, i.e., the point at which MD became significantly associated with a paradoxical reversal of PSD. Results: In 91 patients with hemi-optic neuropathy, PSD showed a strong correlation with MD (r = −0.973, β = −0.965, p < 0.001). The difference between MD and PSD (“−MD−PSD”) was constant (mean, −0.32 dB; 95% confidence interval, −2.48~1.84 dB) regardless of visual field defect severity. However, in 151 patients with bi-optic neuropathy, a negative correlation was evident between “−MD−PSD” and MD (r2 = 0.907, p < 0.001). Overall, the MD tipping point was −14.0 dB, which was close to approximately 50% damage of the entire visual field (p < 0.001). Conclusions: Although a false decrease of PSD usually begins at approximately 50% visual field damage, in patients with hemi-optic neuropathy, the PSD shows no paradoxical decrease and shows a linear correlation with MD. [ABSTRACT FROM AUTHOR]
by Aliferis, K., Hell, S., Gyapay, G., Duchatelet, S., Stoetzel, C., Mandel, J.-L., Dollfus, H.
Introduction: Early onset retinal degeneration associated with obesity can present a diagnostic challenge in paediatric ophthalmology practice. Clinical overlap between Bardet-Biedl syndrome (BBS) and Alström syndrome has been described, although the two entities are genetically distinct. To date, 16 genes are known to be associated with BBS (BBS1-16) and only one gene has been identified for Alström syndrome (ALMS1). Materials and Methods: In collaboration with the French National Center for Sequencing (CNS, Evry), all coding exons and flanking introns were sequenced for 27 ciliopathy genes (BBS1-12, MGC1203, TTC21b, AHI1, NPHP2-8 (NPHP6==BBS14), MKS1(BBS13), MKS3, C2ORF86, SDCCAG8, ALMS1) in 96 patients referred with a clinical diagnosis of BBS. ALMS1 gene analysis included sequencing of all coding exons. Results: BBS known gene mutations were found in 44 patients (36 with two mutations and 8 heterozygous). ALMS1 mutations were found in four cases. The rate of ALMS1 mutations among patients suspected of having BBS was 4.2%. Discussion: Clinically, all four patients presented early-onset severe retinal degeneration with congenital nystagmus associated with obesity. The difficult early differential diagnosis between the two syndromes is outlined. One mutation had already been reported (c.11310delAGAG/p.R3770fsX) and three were novel (c.2293C>T/p.Q765X, c.6823insA/p.R2275fsX, c.9046delA/p.N3016fsX). Conclusions: Ciliopathy genes sequencing can be very helpful in providing a timely diagnosis in this group of patients, hence appropriate genetic counselling for families and adequate medical follow-up for affected children. [ABSTRACT FROM AUTHOR]
by Raju, Tonse N.K.
Profiles Allvar Gullstrand, who received the 1911 Nobel Prize in Physiology or Medicine. His work on the dioptrics of the eye; Brief biographical data; The application of the principles of physics and geometry to anatomy and physiology; Gullstrand developing models showing how extracapsular and intracapsular lens refractory power affected accommodaton; Invention of the slit lamp and the reflex-free ophthalmoscope.
by Winkler, Thomas W., Brandl, Caroline, Grassmann, Felix, Gorski, Mathias, Stark, Klaus, Loss, Julika, Weber, Bernhard H. F., Heid, Iris M., null, null
Late-stage age-related macular degeneration (AMD) is the leading cause of visual impairment in the elderly with a complex etiology. The most important non-modifiable risk factors for onset and progression of late AMD are age and genetic risk factors, however, little is known about the interplay between genetics and age or sex. Here, we conducted a large-scale age- and sex-stratified genome-wide association study (GWAS) using 1000 Genomes imputed genome-wide and ExomeChip data (>12 million variants). The data were established by the International Age-related Macular Degeneration Genomics Consortium (IAMDGC) from 16,144 late AMD cases and 17,832 controls. Our systematic search for interaction effects yielded significantly stronger effects among younger individuals at two known AMD loci (near CFH and ARMS2/HTRA1). Accounting for age and gene-age interaction using a joint test identified two additional AMD loci compared to the previous main effect scan. One of these two is a novel AMD GWAS locus, near the retinal clusterin-like protein (CLUL1) gene, and the other, near the retinaldehyde binding protein 1 (RLBP1), was recently identified in a joint analysis of nuclear and mitochondrial variants. Despite considerable power in our data, neither sex-dependent effects nor effects with opposite directions between younger and older individuals were observed. This is the first genome-wide interaction study to incorporate age, sex and their interaction with genetic effects for late AMD. Results diminish the potential for a role of sex in the etiology of late AMD yet highlight the importance and existence of age-dependent genetic effects. [ABSTRACT FROM AUTHOR]
by Reilly, Charles D., Waller, Stephen G., Flynn, William J., Montalvo, Miguel A., Ward, Jane B.
Objective: The objective of this study was to report the evolution of the U.S. Air Force Mobile Ophthalmic Surgical Team (MOST). Methods: U.S. Air Force ophthalmologists at Wilford Hall Medical Center in San Antonio. Texas, designed a small, portable, rapid-response eye surgical team. Field testing with humanitarian deployments refined the deployment package and provided operational training. Results: MOST successfully deployed to Central and South America, the Caribbean, and Africa 42 times since 1991, with 50,287 patients examined/ treated and 4,812 surgeries performed. Realistic readiness training was provided for 80% of U.S. Air Force ophthalmologists and Army. Navy, and Reserve colleagues. Subsequent modifications to the MOST improved its capability while reducing the size and weight of the team, equipment, and supplies by 50%. Conclusions: Using MOST humanitarian missions as a refining model, U.S. Air Force deployable ophthalmic assets are modular, lightweight, and multifunctional, which allows commanders to custom-build an appropriate response to each unique contingency, disaster, or humanitarian need with mission-ready ophthalmologists. [ABSTRACT FROM AUTHOR]
by El-Mekkawi, Tamer, Mostafa, Moamen, Soliman, Ashraf, Hamed Khedr, Yahya Abdulla
Background: The accurate measurement of the horizontal corneal white-to-white (WTW) diameter is essential and has multiple applications in the field of ophthalmology whether medical or surgical. There are many means of measuring the horizontal white-to-white, which includes the Pentacam, the IOL Master and Manual Calipers. Both the Pentacam and Manual Calipers measure the external white-to-white diameter, whereas the IOL Master measures the internal white-to-white diameter. Objective: The aim of this study is to measure the accuracy of the Pentacam white-to-white camera in measuring the horizontal corneal WTW diameter in comparison to the Manual Calipers, which is considered to be the basic standard. Patients and Methods: The study was a cross sectional one, conducted at Maghrabi Eye Hospital, Cairo, Egypt. It was conducted in accordance with the ethical standards stated by the Ethical Committee of Ain Shams University. Informed consent was obtained from each participant following the explanation of the academic nature of the study. Results: Our study compared the accuracy of the Pentacam HR to the Manual Calipers and found a strong correlation between both methods regarding all parameters. A difference of 0.44 ± 0.17 mm was found between the manual calipers and the Pentacam (HVID Automated) measurements and a lesser difference of 0.24 ± 0.27 mm when comparing the manual calipers with the Pentacam manual digital calipers. On the other hand, the difference between the 2 methods of the Pentacam measurement used was 0.19 ± 0.13 mm. All of which, showed a highly significant correlation. Conclusion: The Pentacam gives larger WTW measurements than the manual calipers as it relies on the gray scale analysis of the HVID in the iris image display. [ABSTRACT FROM AUTHOR]
by Scott, Philip J., Williams, Paul B.
There are major problems with the content, structure and management of paper health records. Electronic document management (EDM) has the potential to reduce the costs and risks associated with paper records management. Portsmouth Hospitals NHS Trust has a programme to introduce an EDM solution for health records. The solution has so far been introduced into the ophthalmology and disablement services departments, both of which held separate sets of patient records independent of those in the main records library. This paper discusses the background to the programme and presents the early results, issues and lessons learned so far. The implementation of EDM highlights and magnifies the many problems of historically overstretched records management. Fundamentally, the unsolved question is whether a historical record can be tidied, sorted and indexed sufficiently to make it as usable as the paper record for clinicians in high-volume services. Finding the balance of affordable levels of file preparation to achieve acceptable clinical utility remains a challenge to be resolved. [ABSTRACT FROM AUTHOR]