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Optometry clinics : the official publication of the Prentice Society最新文献

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Management of corneal burns. 角膜烧伤的处理。
B E Onofrey

Ocular trauma represents one of the most frequent and challenging clinical presentations confronting the primary eye care provider. Damage to the cornea from burns can range from mild to severe, requiring clinicians to rapidly assess the level of injury and take appropriate steps to minimize loss of visual function. Ocular burns can be divided into two major categories: chemical and radiant energy. This discussion considers the general management of these conditions.

眼外伤是初级眼保健提供者面临的最常见和最具挑战性的临床表现之一。烧伤对角膜的损害从轻微到严重不等,要求临床医生迅速评估损伤程度,并采取适当措施,尽量减少视觉功能的丧失。眼部烧伤可分为两大类:化学性烧伤和辐射性烧伤。本讨论考虑这些条件的一般管理。
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引用次数: 0
The role of contact lenses in the management of the radial keratotomy patient. 隐形眼镜在桡骨角膜切开术患者治疗中的作用。
M D DePaolis

Approximately 15% of radial keratotomy procedures result in a residual refractive error of at least 1.00 D. Contact lenses may be used in these cases to optimize visual acuity. Patients who have undergone radial keratotomy present unique physiological challenges because of the corneal incisions; wear of lenses can produce epithelial erosion, infiltrative keratitis, neovascularization, and chronic edema. The corneal topography is altered by the surgery, with the central cornea flattened and the midperiphery steepened; these changes influence contact lens design. The lens of choice is a large, thin, rigid gas-permeable lens with a fairly small optic zone. Hydrogel lenses can also be used, but complications of wear can include neovascularization and corneal edema. Toric hydrogel lenses can be used to minimize residual astigmatism.

大约15%的放射状角膜切开术导致至少1.00 d的残余屈光不正,在这些情况下可以使用隐形眼镜来优化视力。由于角膜切口,接受放射状角膜切开术的患者呈现出独特的生理挑战;佩戴隐形眼镜可引起上皮糜烂、浸润性角膜炎、新生血管和慢性水肿。手术改变角膜地形图,角膜中央变平,中周变陡;这些变化影响了隐形眼镜的设计。透镜的选择是一个大的,薄的,刚性的透气性透镜,具有相当小的光学区。也可以使用水凝胶镜片,但佩戴的并发症可能包括新生血管和角膜水肿。环面水凝胶镜片可用于减少残余散光。
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引用次数: 0
Co-management of patients with diabetes. 糖尿病患者的共同管理。
M T Dunbar

Co-management of the diabetic patient emphasizes interdisciplinary care between optometry and ophthalmology, and between optometry and the patient's primary physician. For the optometrist and the patient's primary physician, the emphasis is on written communication with regard to the ocular health of the patient's eyes. The optometrist also participates in educating patients about the complications related to diabetes mellitus, as well as reinforcing medical compliance and encouraging lifestyle changes for better health. By providing this scope of care, optometry becomes an integral part of the health care team. Between ophthalmology and optometry, the success of co-managing diabetic patients will be dependent on several factors, including demonstrating expertise in managing diabetic retinopathy, making timely and appropriate referrals based on results from national clinical trials, and developing a trusting relationship built over time. This paper emphasizes the multi-dimensional role the optometrist plays in the co-management of the diabetic patient with the patient's primary physician and with the ophthalmologist in treating and managing diabetic retinopathy.

糖尿病患者的共同管理强调验光与眼科之间以及验光与患者主治医师之间的跨学科护理。对于验光师和患者的主治医生来说,重点是关于患者眼睛健康的书面沟通。验光师也参与教育病人有关糖尿病的并发症,以及加强依从性和鼓励改变生活方式以改善健康。通过提供这种范围的护理,验光成为医疗保健团队不可或缺的一部分。在眼科和验光之间,共同管理糖尿病患者的成功将取决于几个因素,包括展示管理糖尿病视网膜病变的专业知识,根据国家临床试验的结果及时和适当地转诊,以及随着时间的推移建立信任关系。本文强调了验光师在糖尿病患者的治疗和管理中与患者的主治医生和眼科医生共同管理糖尿病视网膜病变的多维作用。
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引用次数: 0
Protocols for co-management. 共同管理协议。
J G Classé, L J Alexander

Co-management by optometrists and ophthalmologists requires a written expression of the protocol for examination, treatment, and follow-up of patients. The protocol should also describe how and when information is to be shared between practitioners. To facilitate the communication process, standard forms should be adopted for use by all practitioners. Example protocols and sample forms are provided for the most common types of clinical situations in which co-management is required: postoperative care of cataract patients; treatment of glaucoma patients; and preoperative and postoperative management of radial keratotomy patients.

由验光师和眼科医生共同管理需要一份书面的检查、治疗和随访方案。该协议还应描述从业者之间如何以及何时共享信息。为方便沟通过程,应采用标准表格供所有从业人员使用。为需要共同管理的最常见类型的临床情况提供了示例方案和示例表格:白内障患者的术后护理;青光眼患者的治疗;桡骨角膜切开术患者的术前及术后处理。
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引用次数: 0
Management of the patient with diabetes mellitus. 糖尿病患者的处理。
J D Bartlett, R Nowakowski, M W Swanson
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引用次数: 0
Hematologic disorders. 血液疾病。
J T Wing

Hematology is the study of the cellular elements of blood. Essentially all diseases affect blood components and compromise their important functions, which include transport of nutrients and wastes, cellular defenses, and clot formation. When the disease process manifests itself in the eye, the optometrist should make every effort to determine an underlying cause. This chapter attempts to provide a basic understanding of laboratory tests evaluating hematologic function and to develop a diagnostic approach toward this group of disorders.

血液学是研究血液细胞成分的学科。基本上,所有疾病都会影响血液成分并损害其重要功能,包括营养物质和废物的运输、细胞防御和凝块的形成。当疾病过程在眼睛中表现出来时,验光师应该尽一切努力确定潜在的原因。本章试图提供一个基本的了解实验室测试评估血液学功能和发展诊断方法对这组疾病。
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引用次数: 0
Recordkeeping and contact lens practice. 记录保存和隐形眼镜练习。
J G Classé

Recordkeeping in contact lens practice may be based on a problem-oriented system that emphasizes the use of forms. Fitting agreements and informed consent agreements are the most important components of such a system. Progress notes are also used to document the episodic care that is an integral part of contact lens practice. Examination findings should be described with descriptive language whenever possible; warnings, diagnoses, patient management, and recall and referral appointments should be conscientiously documented in the record of care.

在隐形眼镜的实践中,记录的保存可能是基于一个以问题为导向的系统,强调表格的使用。合适协议和知情同意协议是这一制度的最重要组成部分。进度记录也用于记录阶段性护理,这是隐形眼镜实践的一个组成部分。检查结果应尽可能用描述性语言描述;警告,诊断,病人管理,召回和转诊预约应认真记录在护理记录。
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引用次数: 0
How to make co-management work. 如何让共同管理发挥作用。
R L Noblitt, M E John, R K Norlund, J F Faust, S A VanCleve, W G Carey
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引用次数: 0
Rigid bifocal contact lenses. 硬性双焦点隐形眼镜。
D W Hansen

Rigid bifocal contact lens options continue to improve, with several new designs available in both the simultaneous and alternating vision categories. This paper reviews the selection of bifocal lens patients, describes basic lens designs, and provides guidelines for the successful fitting of rigid bifocal lenses.

刚性双焦点隐形眼镜的选择继续改进,在同步和交替视觉类别中都有几种新设计。本文综述了双聚焦镜患者的选择,介绍了基本的双聚焦镜设计,并为成功配戴刚性双聚焦镜提供了指导。
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引用次数: 0
Carotid artery disease. 颈动脉疾病。
M L Pohl

Carotid artery disease is often implicated in primary ischemic stroke secondary to thrombosis or embolism and may indicate concurrent cardiovascular disease. Atherosclerosis is the underlying cause of the majority of strokes. It is highly correlated with carotid artery disease because it occurs most often at the bifurcation of the common carotids. Transient ischemic attacks are an important clinical syndrome in the diagnostic evaluation of patients with carotid insufficiency. Amaurosis fugax is typically the most common ocular symptom. In addition to a careful history and physical examination, definitive diagnosis and appropriate management of carotid disease mandates defining the location and extent of stenosis. Noninvasive duplex scanning is an ideal technique for determining which patients should proceed with invasive arteriography and carotid endarterectomy. Clinical trials have now officially established the value of endarterectomy in patients with carotid artery disease.

颈动脉疾病常与继发于血栓形成或栓塞的原发性缺血性中风有关,并可能提示并发心血管疾病。动脉粥样硬化是大多数中风的潜在原因。它与颈动脉疾病高度相关,因为它最常发生在总颈动脉分叉处。短暂性脑缺血发作是颈动脉功能不全患者诊断评价的重要临床证候。黑朦是最常见的眼部症状。除了仔细的病史和体格检查外,明确的诊断和适当的颈动脉疾病管理要求明确狭窄的位置和程度。无创双相扫描是一种理想的技术来确定哪些患者应该进行有创动脉造影和颈动脉内膜切除术。临床试验现已正式确立了颈动脉内膜切除术在颈动脉疾病患者中的价值。
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引用次数: 0
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Optometry clinics : the official publication of the Prentice Society
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