Military Ophthalmology Research Articles

Dmitry S. Gorbachev – the path of a military doctor

The name of Dmitry S. Gorbachev has a worthy place in the list of teachers and ophthalmic surgeons of the Department of Ophthalmology of the Kirov Military Medical Academy and military ophthalmology in general.D.S. Gorbachev dedicated his life to military medicine, training and education of future military doctors. He is a student of Professor V.V. Volkov, and was deeply immersed in the complex problem of orbital surgery. At the Department, D.S. Gorbachev, due to his deep scientific immersion in the problem, brought the field of orbital surgery to a modern multidisciplinary level. He constantly passed on his knowledge and skills to his students, who are currently continuing his work.

Corneal Laser Refractive Surgery Curriculum Development in the Military: Using the Nominal Group Technique.

Corneal laser refractive surgery (CRS) has emerged over the past three decades as a surgical method for correcting or improving vision. In the military, CRS helps warfighters achieve weapon grade vision, which offers a tactical advantage in the deployed environment. As refractive surgery has become more prevalent in both the military and civilian sector, more ophthalmologists need to learn about treatment options as well as management of complications in order to meet increasing patient demand. Currently, little is known about the most effective curriculum for teaching refractive surgery in training programs, and a standardized curriculum does not exist. Since unification of training programs is a Defense Health Agency priority, this study aimed to collect expert consensus on a standardized curriculum for CRS training in the military. To achieve this goal, the Nominal Group Technique (NGT) was used wherein a panel of experts, currently practicing refractive surgeons involved in military refractive surgery training programs, arrived at consensus on a standardized CRS curriculum. The framework for developing this curriculum is based on Kern's Six-Step Approach to Curriculum Development. The International Council of Ophthalmology refractive surgery curriculum, National Curriculum for Ophthalmology Residency Training, Accreditation Council for Graduate Medical Education competencies and surgical minimums, and American Academy of Ophthalmology Refractive Surgery Preferred Practice Guidelines were used as the starting materials from which panelists' consensus was drawn. This consensus-building method allowed for equal representation of experts' ideas and fostered collaboration to aid in the creation of a robust and standardized curriculum for refractive surgery training programs in the military. The panelist experts from this NGT were able to reach consensus on the components of a standardized military refractive surgery curriculum to include generalized and targeted needs assessment, goals and objectives, educational strategies, and curriculum implementation. A standardized CRS curriculum is warranted in military training programs. This NGT achieved expert consensus on the goals, objectives, educational methods, and implementation strategies for a standardized CRS curriculum in military ophthalmology residency.

Patient Perception of Physician Attire in a Military Ophthalmology Clinic.

IntroductionThe purpose of this study is to investigate patient preferences of physician attire in an outpatient military ophthalmology clinic to determine how these preferences affect patients’ perceptions of physician competence and their overall clinical experience.Materials and methodsThis study is a prospective survey administered to patients at the ophthalmology clinic at Brooke Army Medical Center. USA. Patients who were willing to participate in a volunteer survey were included in this study. Demographic information and survey questions were utilized in this study along with words and pictures for patients to select a preference in physician attire in the clinic setting (scrubs, military uniform, or civilian professional attire) and surgical setting (surgical cap or a surgical bouffant). The survey asks patients if physician attire impacts patient confidence in physician abilities (yes or no) and if surgeon attire impacts the likelihood of the patient taking the surgeon’s advice (yes or no).ResultsThe demographic distribution includes 57-77 years old participants (53%), females (61%), retirees (49%), and dependent spouses (40%). The racial distribution includes 46% - Caucasian, 20% - African American, 22% - Hispanic, 6 - % Asian, and 6% - other. Most patient appointment types were established follow-up (77%) with only 12% new and 11% walk-in. The survey results (N=308) indicate that most patients (64%) did not have a preference in physician clinical attire, while 22% preferred scrubs, 11% preferred military uniform, and 3% preferred civilian attire. Most patients (66%) did not have a preference for surgical headwear, while 27% preferred the surgical cap, and 7% preferred the surgical bouffant. Only 9% of the patients surveyed indicated that physician attire impacted their confidence in their physician’s ability, and 12% reported that attire impacted the likelihood of taking advice.ConclusionsMost patients in an outpatient military ophthalmology clinic do not have a preference for physician attire or surgical headwear when surveyed. The majority of patients did not feel physician attire impacted their perception of physician's ability or their likelihood of taking advice. When indicating a preference, patients tended to prefer scrubs to outpatient civilian attire or military attire and trended towards preferring surgical cap over surgical bouffant for headwear.

The 200th Anniversary of the Ophthalmology Department at the Military Medical Academy: Modern Aspects of Cataract Surgery at the Conference “General and Military Ophthalmology”

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Sine wave mesopic contrast sensitivity – defining the normal range in a young population

Limited information is available regarding the normal range of mesopic sine wave contrast sensitivity (CS). The aim of this study was therefore to define a reference range and in addition to identify factors related to mesopic CS in a young population. Individuals with normal visual acuity (VA) were included from a population of air crew members visiting the Institute of Aviation Medicine for routine medical examinations. CS was measured using the Optec 6500/FACT and evaluated by (i) the CS curve with five frequencies and (ii) the index of contrast sensitivity (ICS). ICS was defined as the sum of the weighted differences from the median CS value for each frequency. Multivariate analyses were performed to identify factors related to CS. In a total of 197 subjects included, the mean mesopic CS score was significantly lower compared to the corresponding photopic measurements for all five frequencies tested. Median CS score for frequencies 1.5, 3, 6, 12 and 18 cycles per degree was 50, 114, 180, 60 and 33 for photopic and 71, 80, 90, 22 and 12 for mesopic (- glare) conditions, respectively. Better binocular VA was positively associated, while the use of corrective lenses was negatively associated with CS performance. We have provided reference values for mesopic CS and identified factors important for CS. The difference between mesopic and photopic measurements highlights the need for separate population norms. The new ICS score may be a useful collective descriptor of the traditional CS curve with five frequencies.

Military ophthalmology in the Vietnam War.

This overview of the practice of military ophthalmology by US army ophthalmologists during the Vietnam War focuses on administrative management of eye and adnexal injuries, care of the wounded military and of Vietnamese civilians, and research activities. It concludes with improvements that have been subsequently adopted.

Military ophthalmology in Singapore and Malaya.

The U .S. system works smoothly and well. There is a delay of fifteen minutes or more between cases. The cough reflex usually returns during pharyngeal and tracheal toilet. Post-operatively the patients seem to do well. All cases, apart from the thoracic and E.N.T., are transferred to a postoperative ward next to the theatre where there is a specially trained staff. The anresthesiologist visits this ward from time to time during the day and is on close call at any time if required. Unconscious patients are nursed in the lateral or semi-prone position. My feeling is that the system is simple and safe, and the results good. Possibly the results are not quite so good as ours where we have doctors administering the anresthetics and are therefore allowed a wider and more appropriate range of agents. I do not like their extensive use of spinals.

Gonioscopy in foreign bodies of the chamber angle.

THE ROLE of gonioscopy is widely appreciated at present, particularly in the management of glaucomatous processes; however, a valuable use of this technique appears to need emphasis. Gonioscopy permits the visualization of foreign particles in the anterior chamber angle, including those which are not demonstrable by other methods. Therefore, the procedure is of practical importance both in civilian and in military ophthalmology. The clinical manifestations of foreign bodies retained in the anterior chamber angle depend in great part on the composition and chemical activity of such objects. Retained copper and iron are poorly tolerated, leading to chalcosis and siderosis respectively. 1 Nickel, chromium, zinc, and lead are somewhat less active, while aluminum, gold, silver, and stainless steel may be well tolerated. Nonmetallic particles—sand, stone, glass, and Bakelite—may produce little or no response. 2 Stallard 1 stated that small fragments of glass and bakelite may remain quiescent in the eye for

Military Ophthalmology in the European Theater

Military Ophthalmology in the European Theater

ATROPHY OF THE OPTIC NERVE FOLLOWING HEMORRHAGE

AMBLYOPIA following acute loss of blood is an old, but relatively rare, disease. An average of 1 case a year has been reported in the world's literature in the past twenty-five years. Colonel Derrick Vail saw only 4 cases of such visual loss in his vast experience in military ophthalmology in Europe in World War II. That the pathogenesis of atrophy of the optic nerve following hemorrhage is imperfectly understood is evidenced by the numerous and varied theories (recently summarized by Cox 1 ) that have been put forth to explain the condition. Knowledge of its pathogenesis is limited because few such blind eyes have ever been examined microscopically. The few histologic studies made have revealed edema of the retinas and optic disks with degenerative changes in the retinal ganglion cells, similar to those associated with quinine poisoning. In addition, Goerlitz 2 observed foci of degeneration in the optic nerve behind

Studies from the George Washington University School of Medicine, 1943-1944.

Among the forty-eight reprints there are two on the eye: Military Ophthalmology, by W. T. Davis, and Leiomyoma of the Iris, by W. T. Davis, E. Sheppard and W. J. Romejko. Both these articles were published in theAmerican Journal of Ophthalmologyand have been reviewed.

Military Ophthalmology

Military Ophthalmology

The Corneo-Scleral Suture in Military Ophthalmology

The Corneo-Scleral Suture in Military Ophthalmology

Malingering in Military Ophthalmology

Malingering in Military Ophthalmology

Military Ophthalmology

Military Ophthalmology

An American School of Military Ophthalmology

An American School of Military Ophthalmology