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.
{"title":"Management of corneal burns.","authors":"B E Onofrey","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 3","pages":"31-40"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18766864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"The role of contact lenses in the management of the radial keratotomy patient.","authors":"M D DePaolis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 1","pages":"25-34"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18812308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Co-management of patients with diabetes.","authors":"M T Dunbar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 2","pages":"43-62"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18848901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Protocols for co-management.","authors":"J G Classé, L J Alexander","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 2","pages":"101-22"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18848944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of the patient with diabetes mellitus.","authors":"J D Bartlett, R Nowakowski, M W Swanson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"3 4","pages":"175-85"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18919511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Hematologic disorders.","authors":"J T Wing","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"3 4","pages":"23-44"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18919513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Recordkeeping and contact lens practice.","authors":"J G Classé","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 1","pages":"69-91"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18812312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R L Noblitt, M E John, R K Norlund, J F Faust, S A VanCleve, W G Carey
{"title":"How to make co-management work.","authors":"R L Noblitt, M E John, R K Norlund, J F Faust, S A VanCleve, W G Carey","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 2","pages":"123-30"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18848945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Rigid bifocal contact lenses.","authors":"D W Hansen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"4 1","pages":"103-19"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18812385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Carotid artery disease.","authors":"M L Pohl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":77312,"journal":{"name":"Optometry clinics : the official publication of the Prentice Society","volume":"3 4","pages":"157-74"},"PeriodicalIF":0.0,"publicationDate":"1994-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18919509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}