Digital journal of ophthalmology : DJO最新文献

Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness in children worldwide. Middle-income nations are currently experiencing epidemic levels of ROP, because greater access to neonatal intensive care units has improved survival rates of premature infants, but without sophisticated oxygen regulation. The epidemiology, screening infrastructure, treatment options, and challenges that these countries face are often tied to unique local socioeconomic, cultural, geopolitical, and medical factors. We present an overview and narratives of the current state of ROP in eight countries that are or soon will be experiencing ROP epidemics-India, Kenya, Mexico, Nigeria, Phillipines, Romania, Thailand, and Venezuela-with a view to fostering both an understanding of the differences in the ROP landscape in various settings and an interest in the further development of ROP screening and treatment services tailored to local requirements.

Cystinosis, a rare autosomal recessive lysosomal storage disease, can be difficult to detect. The most common form of the disease is infantile or nephropathic cystinosis. Crystals can accumulate in the eye as early as 1 year of age. Early recognition and prompt investigations prevent further accumulation of cystine and resultant end-organ injury. The disease is usually confirmed through biochemical and genetic testing, which can be time consuming. Looking for cystine corneal deposits remains an important diagnostic criterion and is the least invasive test to perform. It is recommended that ophthalmic manifestations of cystinosis be confirmed by an ophthalmologist. We describe the case of a 3-year-old girl who presented with worsening emesis, pyrexia, and lethargy, and was diagnosed with infantile cystinosis. This case is used to present a technique that can facilitate the preliminary search for corneal cystine crystals by using equipment as readily available as two smartphones. The technique may be easily used in a variety of settings, including hospitals, clinics, and primary care centers where there is delayed or difficult access to ophthalmologists.

Purpose: Burnout affects half of doctors in the United States. Programs to decrease burnout and foster resilience are needed to prevent loss of doctors in the workforce and maintain quality care. To ameliorate burnout at our eye center, we developed a resilience program and used a survey to identify additional groups with higher burnout for future interventions.

Methods: The eye center-wide resilience program consisted of the baseline burnout survey, short email wellness tips, a grand rounds presentation, short wellness presentations at faculty meetings, and a small group discussion series with clinical faculty. The anonymous burnout survey was performed prospectively online at the beginning of this program. The survey participants consisted of respondents at the Duke Eye Center, including all doctors, scientists, clinical and research staff, trainees, and administrative and educational staff, in June and July of 2017. The short, anonymous electronic survey consisted of 10 demographic questions, 2 validated burnout questions, and 1 validated work-life balance question.

Results: A total of 593 individuals were invited to participate, of whom 252 completed the survey. Overall, 37% of the respondents reported being emotionally exhausted, and 17% had experienced depersonalization. With regard to work-life balance, 43% of the respondents were satisfied and 34% were dissatisfied. Burnout was higher in respondents who participated in clinical care (P = 0.001), particularly among ophthalmic technicians (P = 0.044). Feedback from the doctors participating in the "Doctors Lounge" suggested perceived benefits, including enhanced collegiality, life skills, and improved self-management.

Conclusions: Our baseline burnout survey showed higher burnout in our clinical workers, particularly in our ophthalmic technicians. Planning for next year will include the providers identified in the survey.

Purpose: To describe a simple and inexpensive model eye that allows lifelike simulation of indirect ophthalmoscopy and retinal photocoagulation.

Methods: A 60 D examination lens, a bulb syringe, foam poster-board, a manila folder, a hobby knife, a fine pair of scissors, a glue gun, and a 2.5 cm square Optos color fundus photograph printed at 1200 dpi resolution on glossy photographic paper were used to create a model eye.

Results: This model produces a high-quality, inverted, and aerial image that closely simulates clinical indirect ophthalmoscopy. Pupil size and retinal pathology can be easily changed. Binocular indirect laser photocoagulation can also be simulated, because white laser burns will appear on the glossy inkjet photograph.

Conclusions: Binocular indirect ophthalmoscopy and indirect laser photocoagulation are technically challenging diagnostic and therapeutic techniques. This simple and easy-to-build eye model allows for lifelike simulation of indirect ophthalmoscopy and indirect laser retinal photocoagulation.