Journal of the American Optometric Association最新文献

As e-mail becomes an everyday part of more people's lives--and an important part of the way business is done--optometrists are naturally beginning to use it with patients. However, e-mail communication with patients creates a new set of potential dangers that doctors must consider: What defines the doctor-patient relationship? Should diagnoses be made and delivered via e-mail? How can privacy and confidentiality be maintained? Can marketing be done tastefully via e-mail? This author addresses each of these issues from a medico-legal perspective and offers advice on professional, ethical ways to communicate with patients via e-mail.

Background: Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that manifests a range of ocular anomalies, including leukocoria, microphthalmia, cataract, and a retrolental fibrovascular membrane. In general, the prognosis for visual acuity with PHPV has been poor. A recent report on six patients who have myopia associated with PHPV showed that these patients were not microphthalmic, did not manifest leukocoria, and showed a mean visual acuity at final followup of 20/160.

Case report: The case of a 3-year-old boy with myopic PHPV of the left eye is presented. Full-time wear of the cycloplegic refraction, combined with patching of the non-amblyopic eye, resulted in an improvement in visual acuity.

Results: PHPV with myopia may constitute a distinct subtype of PHPV. Patients with myopic PHPV tend to seek treatment later than patients with anterior or posterior PHPV as a result of the lack of microphthalmia and leukocoria. These individuals do not show the long-term complications, such as secondary glaucoma and intraocular hemorrhages, associated with PHPV.

Conclusion: The acuity improvement in this case of myopic PHPV suggests that a more conservative approach to its surgical management may be appropriate while pursuing refractive correction and amblyopia therapy to attain the best acuity possible.

Background: The primary purpose of this study was to investigate hand-eye dominance in a population with mental handicaps and how the distribution compared with the general population. In addition, this study investigated the correlation between two methods of hand-eye dominance testing.

Methods: Two methods were used to determine eye dominance: the hole-in-the-hand method and the eye dominance wand. Hand dominance was determined by the subject's choice of accepting hand. The sample was comprised of a population of 421 athletes participating in the 1997 Special Olympic Games in Toronto. All subjects unable to give a dominant hand or unable to perform either of the ocular dominance tests were eliminated from analysis. Athletes who demonstrated strabismus or a difference in visual acuity between the two eyes of greater than 1 line were separated in the analysis, reducing the sample population to 191.

Results: The hole-in-the-hand method of eye dominance showed that 40.3% of this population exhibited crossed dominance. The eye dominance wand found crossed dominance in 36.6% of this population. The eye dominance wand demonstrated moderate agreement with the hole-in-the-hand method; however, there was some crossover of eye dominance between tests, when the tests were compared on a case-by-case basis.

Conclusions: The prevalence rate of this population of persons with mental handicaps agrees with the prevalence rates found by Robison et al., in which 41% of a general nonhandicapped population demonstrated crossed dominance. The results suggest that persons with mental handicaps have prevalence rates of crossed dominance similar to those found in the general population.

As advertising by health care professionals becomes more common, it is possible to gain the benefits of well-designed advertising without sacrificing professionalism. This author explains how, with a special emphasis on Yellow Pages advertising.

Background: Percutaneous transluminal coronary angioplasty (PTCA) for the treatment of coronary artery disease has increased in frequency as technological advances have made the procedure more effective and cost-efficient. In spite of the number of procedures that have been performed, ocular complications have rarely been reported.

Case report: A case of asymptomatic unilateral microembolic retinopathy one month after PTCA is presented. Embolic events to the retinal circulation and their relationship to invasive cardiac procedures is discussed.

Conclusions: The embolic ocular complications of PTCA is probably underestimated due to the lack of symptoms from the partial occlusion of the larger retinal arteries and the total occlusion of the remote smaller vessels.