RESUMEN
We report a case of a patient who incurred spontaneous anterior dislocation of a mature cataract which required prompt surgical removal. Some years previous to this, he had sustained blunt trauma to the eye.
Asunto(s)
Catarata/complicaciones , Lesiones Oculares/complicaciones , Subluxación del Cristalino/etiología , Extracción de Catarata , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Mentoring is widely used in medicine and is an established means of professional development. We have all been mentored, knowingly or otherwise at some stage of our careers. AIMS: To provide an overview of mentoring in clinical and academic medicine, review the literature, discuss various mentoring styles and weigh the advantages and disadvantages of mentoring. METHOD: A discussion paper that describes good mentoring, promotes mentoring as a performance enhancer and gives examples to illustrate issues. It draws on available literature and introduces several novel ideas in mentoring. RESULTS: Doctors at all career stages including medical students can benefit from mentoring. Benefits of mentoring include; benefits to the mentee, benefits to the mentor and benefits to the organization. Overall, both mentees and mentors are highly satisfied with mentoring. Nevertheless, problems exist, such as conflict between the mentoring and supervisory roles of the mentor, confidentiality breaches, mentor bias, lack of "active listening" and role confusion. Problems usually stem from poor implementation of mentoring. Mentors should not be the mentee's educational supervisor or line manager or otherwise be involved in their assessment or appraisal to avoid blurring of these distinct roles. Safeguards of confidentiality are of vital importance in maintaining the integrity of the mentoring process. Good mentoring is a facilitative, developmental and positive process which requires good interpersonal skills, adequate time, an open mind and a willingness to support the relationship. Mentors should encourage critical reflection on issues to enable mentees to find solutions to their own problems. CONCLUSIONS: Mentoring is an important developmental process for all involved. There is a perception amongst mentors and mentees that well conducted, well timed mentoring can reap enormous benefits for mentees and be useful to mentors and organizations. However strong evidence for this is lacking and there is need for further research in this area.
Asunto(s)
Mentores , Médicos , Movilidad Laboral , Humanos , Reino UnidoRESUMEN
BACKGROUND: Scott described a method of achieving the effect of a posterior fixation procedure by combining resection and recession of a rectus muscle, while maintaining the ability to adjust primary position alignment with adjustable sutures. METHODS: A retrospective review of combined recession-resection procedures on rectus muscles between 1998 and 2002 was carried out. RESULTS: We identified 22 patients, 17 females and 5 males. The mean age at presentation was 44 years. The etiology was felt to be paralytic in seven patients (31.8%), mechanical/restrictive in seven patients (31.8%), and due to residual childhood strabismus in eight patients (36.4%). Twenty patients had undergone previous strabismus surgery, ranging from one to six operations (mean, 1.75). Scott procedures were performed on 25 rectus muscles of 22 patients; 12 on the lateral rectus muscles, 7 on the inferior rectus muscles, 3 on the medial rectus muscles, and 3 on the superior rectus muscles. All but one patient had a measurable improvement in gaze incomitance, and 11 of 12 who had a measurement of the field of binocular single vision showed improvement. Twenty patients had follow-up periods of 3 months or more, with a range of 3 to 30 months and a mean of 9.35 months. CONCLUSIONS: The combined recession-resection procedure advocated by Scott has a role in the management of incomitant strabismus.
Asunto(s)
Músculos Oculomotores/cirugía , Procedimientos Quirúrgicos Oftalmológicos , Estrabismo/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Phlyctenulosis is an uncommon condition that usually affects children's cornea or conjunctiva. Although its exact aetiology is unknown, it is thought to be a non-specific delayed hypersensitivity reaction to staphylococci or other bacterial, fungal or parasitic antigens. Herein a case of a 3.5-year-old boy with corneal phlyctenulosis is described in whom the phlycten appears to have has migrated from its origin at the limbus to the central cornea (fascicular keratitis) and become visually disabling. At his last follow up he was asymptomatic. Some stromal scarring of the right cornea remained and his visual acuity improved in both eyes following treatment.
Asunto(s)
Úlcera de la Córnea/patología , Blefaritis/patología , Preescolar , Humanos , Limbo de la Córnea/patología , MasculinoRESUMEN
PURPOSE: To determine the incidence of scleral perforations in strabismus surgery in a tertiary centre setting in India and to evaluate the risk or benefit, if any, of prophylactic cryotherapy following experimental scleral perforations in rabbits. METHODS: Seven hundred eyes of patients that had undergone strabismus surgery (1121 procedures) were examined postoperatively by indirect ophthalmoscopy. In the experimental component, 20 rabbit eyes were perforated with a 6-0 polyglactin suture. In each rabbit, one eye acted as a control while the other eye received a 20 seconds application of prophylactic cryo at the perforation site. They were then monitored for 6 weeks before subjecting some to histopathological examination by light and electron microscopy. RESULTS: Ten scleral perforations were detected in 9 of the patients (incidence of 1.42% of the eyes and 0.89% of the strabismus procedures). In the rabbits, a chorioretinal scar was seen in all perforated eyes. A mild cryo reaction was observed in the cryoed eyes. No other sequelae were seen. Histopathologic studies showed changes consistent with the normal healing process. CONCLUSIONS: Of the human eyes screened, 1.42% showed evidence of scleral perforation following strabismus surgery. In no case were sequelae leading to visual loss observed. In the rabbits no sequelae were observed at 6 weeks of follow-up apart from a chorioretinal scar and a cryoreaction in those eyes in which cryoprophylaxis had been given. Mild cryoprophylaxis did not exert any positive or negative influence on the natural course of scleral perforation in our short-term animal study.