Asunto(s)
Optometristas , Satisfacción del Paciente , Glaucoma , Humanos , Optometría , EspecializaciónRESUMEN
PURPOSE: This study assessed the role of specialist optometrists who were working in the community and sharing the care for glaucoma patients with, and under close supervision of, a consultant ophthalmologist working in the Hospital Eye Services (HES) to ensure high-quality standards, safety, and care. METHODS: From February 2005 onwards, the majority of all new glaucoma referrals to our eye department were diverted to our specialist optometrists in glaucoma (SOGs) in their own community practices. Selected patients in the HES setting who were already diagnosed with stable glaucoma were also transferred to the SOGs. The completed clinical finding details of the SOGs, including fundus photographs and Humphrey visual field tests, were scrutinised by the project lead. RESULTS: This study included 1184 new patients seen by specialist optometrists between February 2005 and March 2007. A total of 32% of patients were referred on to the hospital, leaving the remaining 68% patients to be seen for at least their next consultation in the community by the SOGs. The following levels of disagreement were observed between SOGs and the project lead: on cup:disc ratio (11%), visual field interpretation (7%), diagnosis (12%), treatment plan (10%), and outcome (follow-up interval and location) (17%). CONCLUSION: This study indicates that there is potential for a significant increase in the role of primary care optometry in glaucoma management. The study also confirms a need for a significant element of supervision and advice from a glaucoma specialist. The important issue of cost effectiveness is yet to be confirmed.
Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Glaucoma/diagnóstico , Optometría/organización & administración , Educación Médica Continua/organización & administración , Estudios de Factibilidad , Humanos , Optometría/educación , Derivación y Consulta/organización & administración , EspecializaciónAsunto(s)
Antihipertensivos/efectos adversos , Enfermedades de la Coroides/inducido químicamente , Cloprostenol/análogos & derivados , Hipotensión Ocular/inducido químicamente , Trabeculectomía/efectos adversos , Anciano , Cloprostenol/efectos adversos , Glaucoma/cirugía , Humanos , Presión Intraocular/fisiología , Masculino , TravoprostRESUMEN
OBJECTIVE: To examine the role of inflammatory cell invasion and aspects of tissue reaction on refractive regression and corneal haze after myopic PRK in rabbits. METHODS: Measurements were made for 12 weeks postoperatively of haze intensity, corneal topography, tear cytology, inflammatory cell invasion, subepithelial fibroblast density, and the thickness of the newly laid down connective tissue and of the regrown epithelium. RESULTS: Inflammatory cell invasion could be prevented by fitting a soft contact lens, but this had no effect on the haze or the regression. Haze intensity correlated with subepithelial fibroblast proliferation but not with new connective tissue formation or epithelial hyperplasia. Neither connective tissue nor epithelium regrew in the form of a lens and thus they could not account for regression. Intensive treatment with corticosteroids resulted in a marked reduction in postoperative haze and a slight lessening of long-term regression. Correspondingly, it reduced fibroblast proliferation. CONCLUSIONS: Haze appears, at least in part, to be a result of fibroblast proliferation. Regression is possibly caused by slow distortion of existing tissue rather than the growth of new.
Asunto(s)
Córnea/patología , Queratectomía Fotorrefractiva , Refracción Ocular , Corticoesteroides/uso terapéutico , Animales , Antiinflamatorios/uso terapéutico , Dexametasona/uso terapéutico , Epitelio/patología , Femenino , Fibroblastos/patología , Inflamación/patología , Láseres de Excímeros , Masculino , Conejos , Irrigación TerapéuticaRESUMEN
OBJECTIVE: To design and evaluate an instrument for the objective measurement of haze in rabbits after myopic PRK. METHODS: A circular fluorescent lamp bulb projected light onto the cornea through a circular collimating aperture covered with an orange filter. The image was collected on a centrally mounted CCD camera and the profile of the haze circle along its horizontal diameter determined. RESULTS: Haze circles were observed and quantitated. In the first weeks, they were donut-shaped, frequently with a central bright area, but later they became square-topped. The instrument reproduced measurements with an error of a few percentage points and showed good long-term stability.
Asunto(s)
Córnea/patología , Miopía/cirugía , Queratectomía Fotorrefractiva , Animales , Fluorescencia , Láseres de Excímeros , Oftalmología/instrumentación , ConejosRESUMEN
A randomised double blind trial of 2-(2-Hydroxy-4-methylphenyl) Aminothiazole Hydrochloride 0.1% (CBS 113A) versus placebo was carried out in 43 eyes with episcleritis. Our results show that CBS 113A is effective in reducing the signs of conjunctival and episcleral inflammation in mild episcleritis within the first week of administration of the drug (Day 3: Total Score p = 0.0013, Conjunctival Injection p = 0.017, Episcleral Injection p = 0.0018 and Day 7: Total Score p = 0.01, Conjunctival Injection p = 0.014, Episcleral Injection p = 0.027). CBS 113A was not effective against severe episcleritis. No significant side effects were found apart from a stinging sensation. There was no effect on intraocular pressure. The potential use of this new drug is discussed.