Ophthalmology Patients Research Articles

Orbital MRI 3D Reconstruction Based on Volume Rendering in Evaluating Dysthyroid Optic Neuropathy

Purpose To perform orbital magnetic resonance imaging (MRI) three-dimensional (3D) reconstruction based on volume rendering and analyse changes in soft tissues in dysthyroid optic neuropathy (DON) patients. Methods Using MRI 3D reconstruction based on volume rendering, orbital model parameters were compared with measurements made by observers. The fat volume (FV) and extraocular rectus muscle volume (EOMV) of subjects were calculated via MRI 3D reconstruction. Visual functions were assessed for all thyroid-associated ophthalmology (TAO) patients. Receiver operating characteristic (ROC) curves were analysed to evaluate DON in soft tissues. Correlations between visual function parameters and 3D reconstruction measurement were analysed. Results All interclass correlation coefficients between the 3D reconstruction and observer measurements were above 0.950. A total of 21 healthy orbits, 38 TAO orbits without DON and 23 TAO orbits with DON were studied. The FV and EOMV were greater in the DON group than in the healthy and non-DON groups (all p < 0.05). EOM enlargement contributed the most to the DON (odds ratio = 2.79, 95% confidence interval = 1.53, 5.07). The areas under the ROC curves of the reconstruction measurements were as follows: EOMV, 0.850; FV, 0.674; whole volume, 0.726; and EOMV/FV, 0.712. Visual function impairment was positively associated with EOM enlargement. When the EOMV was above 4.035 ml, the occurrence of DON was probable. Conclusions MRI 3D reconstruction based on volume rendering is a reliable method for analysing orbital soft tissues. A larger the EOMV was the most relevant factor in DON.

The impact of having a relative in a need for cornea: the Knowledge, Attitude, and Willingness for Corneal Donation (KAWCD) questionnaire.

Despite the advancement in the field of corneal transplantation, corneal donation is still the only source for cornea. In our study, we aimed to find predictors for a person's willingness toward cornea donation, and the impact of having a relative in a need for cornea transplantation on the willingness to donate cornea. The study included two cohorts to be compared, first degree relatives of patients waiting for corneal transplantation, and general ophthalmology patients who do not have relatives waiting for corneal donation. We designed questionnaire on Knowledge, Attitude, and Willingness for Cornea Donation (KAWCD), a tool specifically designed to measure the knowledge about corneal donation, and the attitude towards it. A total of 269 participants were included in this study, with a mean age of 49.59 (± 17.24) years. We included 182 (67.7%) participants who did not have a relative with or in need for corneal transplantation, and 87 (32.3%) participants who are first degree relatives to patients on the waiting list for corneal transplantation. Upon assessing factors predicting willingness for corneal donation, we found that attitude (p < 0.001; OR 1.126 (95% CI 1.08 to 1.17)) and age (p = 0.022; OR 0.973 (95% CI 0.95 to 0.99)) are the only predictors for willingness to donate. We found that the willingness to donate cornea is related to the attitude, rather than the knowledge about corneal donation. We believe awareness campaigns should focus on encouragement to donate corneas, rather than providing information about it.

Quality of life associated with no light perception vision

ObjectifL'analyse d'utilité de l'arbitrage temporel (time trade-off) permet de quantifier la qualité de vie associée à la vision dans le meilleur œil. Nous avons comparé la qualité de vie de patients qui ont une absence de perception de la lumière (APL) unilatérale ou bilatérale à celle de sujets sans APL. NatureSérie d'entrevues transversales réalisées à l'aide d'un outil validé et fiable permettant une analyse d'utilité de l'arbitrage temporel en ce qui a trait à la vision. ParticipantsUn total de 1598 patients consécutifs provenant des cabinets d'ophtalmologie des auteurs. MéthodesLes dossiers des patients ont été passés en revue selon la méthode cas-témoins. Les résultats de l'analyse d'utilité des participants présentant une vision de type APL unilatérale ou bilatérale ont été comparés à ceux de patients sans APL. RésultatsParmi les 99 patients du groupe APL, celle-ci était unilatérale chez 93 sujets (94 %) et bilatérale chez 6 sujets (6 %), pour un total de 105 yeux dans ce groupe. L'analyse de régression multiple a mis au jour la corrélation la plus marquée entre l'utilité et l'acuité visuelle dans le meilleur œil (p = 0,001), sans lien avec l’âge, les maladies ophtalmologiques, le moment de la perte de vision, la race ou l’éducation. Les résultats moyens de l'analyse d'utilité de l'APL unilatérale s’échelonnaient de 0,55 dans la sous-cohorte « compter les doigts à perception de la lumière » à 0,80 dans la sous-cohorte « vision 20/20 à 20/25 ». Les résultats de l'analyse d'utilité dans la sous-cohorte formée des 6 sujets dont l'APL était bilatérale s’élevaient à 0,54. Les résultats moyens de l'analyse d'utilité dans la cohorte des 99 patients du groupe APL étaient de 0,69 comparativement à 0,80 chez les 1499 patients sans APL appariés pour la vision dans le meilleur œil, ce qui correspond à une baisse de la qualité de vie de 55 % en présence d'APL (p < 0,001). ConclusionsLes résultats de l'analyse d'utilité de l'arbitrage temporel étaient moins bons chez les patients ayant une APL unilatérale que chez les patients sans APL appariés pour la vision dans le meilleur œil. On doit considérer la baisse de la qualité de vie des patients qui ont une APL unilatérale dans l'analyse coût-utilité et la prise en charge clinique. Les résultats de l'analyse d'utilité chez les patients qui avaient une APL bilatérale (0,54) étaient légèrement inférieurs (0,55) à ceux des patients qui avaient une APL unilatérale et dont l’œil controlatéral permettait de compter les doigts ou arrivait à percevoir la lumière, ce qui donne à penser que de plus amples études devront être réalisées à cet égard.

Clinical Profile of Proptosis in Dr. M. Djamil General Hospital Padang

Background. Proptosis is a condition that describes a protrusion or forward shift of the eyeball and is commonly used to describe the condition of protrusion of the eyeball. Proptosis generally occurs due to a mismatch between the orbital capacity and the volume of the tissue structure in the orbital cavity. It is a common manifestation of a wide variety of diseases of the structures in and around the orbit and in some systemic diseases. This study aimed to describe the clinical profile of proptosis patients in Dr. M. Djamil General Hospital Padang.&#x0D; Methods. We reviewed the medical record of the oncology subdivision of ophthalmology patients associated with proptosis retrospectively, such as inflammatory, infectious, tumors, and vascular, admitted to the M.Djamil General Hospital in Padang from January 2019 to August 2020. The ocular and systemic history and examination details were recorded.&#x0D; Results. We found 48 proptosis patients from January 2019 to August 2020, consisting of 30(62.5%) males and 18(37,5%) females. The majority of subjects were in the Adult age group (79,17%). Unilateral and bilateral proptosis were found in 37(77%) and 11(23%), with mostly axial proptosis (83,33%). Inflammatory tumors were found in 17(35,41) and 29(60%) patients.&#x0D; Conclusion. Proptosis is a common clinical feature of various local and systemic diseases. Even though proptosis have diverse etiology and pathogenesis, they usually present with similar clinical manifestation. Proptosis may be one of the most important keys to disease guidance from a close structure that requires a multidisciplinary approach.

Interprofessional Teamwork in a Tertiary Referral Academic Hospital in Boston

From the Front Lines| April 2022 Interprofessional Teamwork in a Tertiary Referral Academic Hospital in Boston Shahla Siddiqui, MD, MSc, FCCM; Shahla Siddiqui, MD, MSc, FCCM Search for other works by this author on: This Site PubMed Google Scholar Vanessa T. Wong, BS; Vanessa T. Wong, BS Search for other works by this author on: This Site PubMed Google Scholar Mary Ellis, BSN, RN; Mary Ellis, BSN, RN Search for other works by this author on: This Site PubMed Google Scholar Tara S. Kent, MD, MS, FACS; Tara S. Kent, MD, MS, FACS Search for other works by this author on: This Site PubMed Google Scholar Michael J. Chen, BS; Michael J. Chen, BS Search for other works by this author on: This Site PubMed Google Scholar John D. Mitchell, MD John D. Mitchell, MD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor April 2022, Vol. 86, 40–41. https://doi.org/10.1097/01.ASM.0000827012.35158.01 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share MailTo Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Shahla Siddiqui, Vanessa T. Wong, Mary Ellis, Tara S. Kent, Michael J. Chen, John D. Mitchell; Interprofessional Teamwork in a Tertiary Referral Academic Hospital in Boston. ASA Monitor 2022; 86:40–41 doi: https://doi.org/10.1097/01.ASM.0000827012.35158.01 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: patient referral, work teams Our institution, Beth Israel Deaconess Medical Center (BIDMC) in Boston, is a teaching tertiary referral academic hospital of Harvard Medical School. There are 673 licensed beds, including 493 medical/surgical beds. There are 77 critical care beds and 62 OB/GYN beds. The perioperative nursing staff provides patient-focused care to the surgical patient population as well as surge ICUs during the pandemic. The patient population includes cardiothoracic, vascular, orthopedics, neurosurgery, transplant, general surgery, trauma, ENT, GYN, podiatry, GI, ophthalmology, cardiology, and urology patients on two campuses. A multidisciplinary team consisting of RNs and surgical and anesthesia teams provide perioperative patient care. The COVID-19 pandemic has wrought havoc among health care staff and the general population. Communication and teamwork among anesthesia providers, surgeons, and nurses can be key in the smooth transition and delivery of perioperative patient care and satisfaction. Therefore, interprofessional interaction and teamwork are valuable skills for our anesthesiology residents rotating... You do not currently have access to this content.

Patients' Perception of COVID-19 Preventive Measures in Ophthalmology: Satisfaction and Impact on Glaucoma Care and Follow-up.

In response to the spread of COVID-19 in Switzerland, ophthalmology practices implemented a variety of preventive measures in order to minimise the risk of contamination to their patients and staff. Yet, some studies suggested that over a quarter of all glaucoma patients never returned to the clinic after the first lockdown eased. This raises the question of the factors influencing Patients' likelihood to keep their appointments in this COVID-19 era. The aim of this study was therefore to assess ophthalmology Patients' perception of COVID-19 preventive measures, as well as their impact on glaucoma Patients' clinic attendance and follow-up. This was a prospective study based on primary data collected from 12 private ophthalmology clinics in French-speaking Switzerland. A web-based patient experience questionnaire was designed to assess Patients' appreciation of the preventive measures in place at their eye care provider as well as their intention to attend further follow-up appointments. These measures were made on modified 10-point Likert scales. Every patient who attended an appointment at one of the participating clinics on randomly selected dates in October 2020 was offered voluntary enrolment into the study. In all, 118 surveys were completed and analysed. The mean age of respondents was 57.8 ± 18.0 years, 59.3% were female, and 71.2% were Swiss nationals. Fifty-four (45.8%) of them suffered from glaucoma. Overall, patients were highly satisfied with the measures in place to safeguard them from COVID-19 infection, with a mean score of 9.29 ± 1.35. This was higher amongst Swiss nationals (9.55 ± 0.77) than foreigners (8.65 ± 2.09). On average, responders expressed a 90.2 ± 17.5 percent likelihood to keep their follow-up appointment. The figure went down to 88.5 ± 19.9 percent amongst glaucoma patients (p = 0.58), and 86.3 ± 22.1 percent amongst glaucoma patients aged 65 and over (p = 0.29). Interestingly, older glaucoma Patients' satisfaction with preventive measures in place strongly correlated with their likelihood to keep follow-up appointments (r = 0.72). The correlation was moderate amongst all glaucoma patients (r = 0.46) and weak amongst all respondents (r = 0.38) and those over 65 (r = 0.44). The present research highlights the importance of Patients' perception on COVID-19 preventive measures in place in ophthalmology clinics, which was directly associated with their likelihood to keep follow-up appointments. Vulnerable subgroups of patients were more likely to miss their follow-up appointments altogether, and their decision to attend was more strongly influenced by their perceived risk of contracting COVID-19. This suggests a role for telemedicine in more vulnerable patients suffering from progressive diseases such as glaucoma.

РАСПРОСТРАНЕННОСТЬ СИНДРОМА СУХОГО ГЛАЗА СРЕДИ СТУДЕНТОВ МЕДИЦИНСКОГО УНИВЕРСИТЕТА В ЗАВИСИМОСТИ ОТ РАЗЛИЧНЫХ ФАКТОРОВ РИСКА

Abstract. Dry eye syndrome is widespread, with an incidence ranging from 5% to 50%, reaching up to 75% in some populations. The number of patients with this pathology is growing every year, while there is a tendency to increase in the incidence at a young age. Aim of the study. To estimate the frequency of DES among medical university students depending on various risk factors. Materials and methods. 52 students of medical university participated in extensive ophthalmic investigation, the median age was 22.8 ± 2.6 years. The OSDI (ocular surface disease index) questionnaire is used to evaluate subjective symptoms of dry eye syndrome. Risk factors for the development and progression of DES were registered: long-term wearing of personal protective equipment (PPE) for respiratory organs and the eye surface, wearing of soft contact lenses, keratorefractive surgery, and diseases of eye and blepharon in past medical history, duration of electronic devices use. Results. The OSDI questionnaire revealed the presence of DES in 56% of the subjects: mild — in 38%, moderate — in 12%, severe — in 6%; the tear film break-up time (TFBT) revealed the presence of DES in 48%. The presence of at least one DES risk factor was found in 71% of students, two factors — in 26.9%, and three or more — in 13.5%. Long-term computer use (50%), prolonged wearing of PPE for respiratory organs and the eye surface (30.7%) and wearing soft contact lenses (19.2%) were the most common. A relationship between the presence of risk factors and the prevalence of DES has been established: according to OSDI questionnaire the prevalence of DES is greater than 30% in persons with risk factors, and according to TFBT is greater than 14%. Conclusion. The revealed high incidence of DES among medical students is a result of scientific and technological progress (computerization in all areas including education), current epidemiological situation (wearing of personal protective equipment) and noticeable increase in the number of ophthalmological patients who need vision correction (with soft contact lenses or keratorefractive surgery). The presence of these risk factors reinforces already existing increasing trend in the prevalence of DES.

Quantifying the Magnitude of Visual Impairment with Multi-Flash Campimetry

Multi-flash campimetry is a computer implemented clinical psy­chophysical technique that uses the ability to detect flicker to distinguish between healthy observers and ophthalmological patients. On each trial, a computer randomly selects a point from a 36 point display and begins to flicker it at 5 Hz. The duty cycle of this flickering point (the proportion of the flicker period that is lit), is decreased from 100% in 1 .4% steps each cycle until the observer makes a manual response indicating that flicker has been detected.

Einstellung von Patienten zu möglicher Telemedizin in der Ophthalmologie

HintergrundDie COVID-19-Pandemie im Jahr 2020 und 2021 schränkt die Versorgung augenärztlicher Patienten vielfach ein. Teleophthalmologische Leistungen wie Videokonsultation oder medizinische Telefonberatungen könnten den Mangel an notwendigen Kontrollen bei chronischen Erkrankungen, zumindest teilweise, kompensieren. Teleophthalmologische Angebote sind jedoch in Deutschland aktuell noch deutlich unterrepräsentiert.Ziel der ArbeitUm die Bereitschaft auf Patientenseite zur Telemedizin und virtuellen Klinik zu ermitteln, führten wir bei Patienten der Hochschulmedizin mit bekanntem Glaukom als chronische Erkrankung eine Umfrage mittels Fragebogen während der ersten Welle der COVID-19-Pandemie zum Thema Teleophthalmologie durch.MethodenEs wurden 100 Patienten befragt. Der Fragenkatalog beinhaltete 22 Fragen mit Mehrfachwahl-Antwortmöglichkeiten. Als Einschlusskriterium galten das Vorhandensein eines Glaukoms als chronische Erkrankung, Alter über 18 Jahre sowie eine ausreichende sprachliche Verständigung zur Beantwortung der Fragen. Die Daten wurden anonymisiert erhoben, analysiert und ausgewertet.ErgebnisseIn der Patientenumfrage konnte aufgezeigt werden, dass eine hohe Bereitschaft zur Teleophthalmologie bei den Befragten im Bereich des Glaukoms als chronische Erkrankung vorhanden ist und diese in Anspruch genommen werden würde; 74,0 % der Befragten würden Telemedizin und virtuelle Kliniken akzeptieren; 54,0 % der Befragten ophthalmologischen Patienten gab an, dass ihr Arzt‑/Klinikbesuch aufgrund von SARS-CoV‑2 nicht stattfinden konnte; 17,0 % der Patienten gaben an, dass sich durch die SARS-CoV-2-Pandemie ihre Meinung gegenüber der Telemedizin geändert hat.DiskussionDie Akzeptanz der Patienten für Telemedizin bei Patienten mit chronischem Offenwinkelglaukom scheint erstaunlich hoch. Diese ist durch die SARS-CoV-2-Pandemie noch weiter gesteigert worden. Diese Ergebnisse spiegeln eine generelle Bereitschaft bei Patienten mit chronischer Augenerkrankung wider, reflektieren jedoch nicht die Anwendbarkeit sowie die Akzeptanz aus ärztlicher Sicht. Diese Form der virtuellen Konsultation findet jedoch bei einem Großteil der Patienten mit Glaukom Akzeptanz und könnte überdacht werden.

Effects of the First COVID-19 Lockdown on Ophthalmological Patient Care.

To determine the effect of lockdown on medical care, with the example of ophthalmology. Patients in a period during the first lockdown were compared to a non-lockdown period, with a total of 12 259 patients included in an observational study. Changes in different areas (elective, emergency, inpatients, surgeries) and eye care subspecialties were compared. Emergency patients were analyzed according to severity and urgency. Patients showing hints requiring treatment for urgent cardiovascular diseases were determined. Differences in patients who would have suffered severe vision loss without treatment were identified and the QALY (quality-adjusted life years) loss was determined accordingly. A model to prioritize patient visits after the end of lockdown or in future lockdown scenarios was developed. Data were collected at the University Eye Hospital LMU Munich and patient files were reviewed individually by ophthalmologists. The average patient number decreased by - 59.4% (p < 0.001), with a significant loss in all areas (elective, emergency, inpatients, surgeries; p < 0.001). There was a decline of - 39.6% for patients at high risk/high severity. Patients with indications of a risk factor of future stroke declined significantly (p = 0.003). QALY loss at the university eye hospital was 171, which was estimated to be 3160 - 24 143 for all of Germany. Working up high losses of outpatients during these 8 weeks of projected lockdown in Germany would take 7 - 23 weeks under normal circumstances, depending on ophthalmologist density. The prioritization model can reduce morbidity by up to 78%. There was marked loss of emergency cases and patients with chronic diseases. Making up for the losses in examinations and treatments will theoretically take weeks to months. To reduce the risk of morbidity, we recommend a prioritization model for rescheduling and future lockdown scenarios.

Effects of COVID-19 protective measures on the ophthalmological patient examination with an emphasis on gender-specific differences

ObjectiveIn response to the COVID-19 pandemic, strict hygiene and containment measures have been instituted in the clinical ophthalmological examination to prevent virus transmission. The aim of this study is to...

Ophthalmologic assessments in patients with newly diagnosed sarcoidosis: An observational study from a universal healthcare system

IntroductionConsensus guidelines for the management of sarcoidosis recommend screening eye examinations for all patients, even in those without ocular symptoms. We aimed to determine the proportion of sarcoidosis patients that complete ophthalmologic evaluations and factors associated with their performance. MethodsWe identified patients with sarcoidosis using population health services data from Ontario, Canada between 1991 and 2019. Sarcoidosis was defined by ≥ 2 physician visits for sarcoidosis within a two-year period. Ophthalmologic evaluations were based on an optometrist or ophthalmologist visit within the year prior or two years following the diagnosis. We estimated correlations between the number of eye care professionals and proportion of sarcoidosis patients completing ophthalmologic assessments within regional health units. We evaluated for associations between ophthalmologic screening and patient characteristics using multivariable logistic regression. ResultsWe identified 21,679 patients with sarcoidosis in Ontario. An ophthalmologic evaluation was performed in 14,751 (68.0%), with a similar number of individuals seeing ophthalmologists and optometrists (43.7% vs. 42.2%). The percentage of sarcoidosis patients undergoing an ophthalmologic evaluation within corresponding regional health units was moderately correlated with the number of practicing ophthalmologists (r = 0.64, p = 0.01), but not the number of optometrists (r = 0.08, p = 0.77). Patients who were older [OR per year 1.02 (95% CI 1.01–1.02), p < 0.001] and female [OR 1.54 (95% CI 1.44–1.63), p < 0.001] were more likely to complete ophthalmologic evaluations. Immigrants to Canada were less likely to undergo ophthalmologic assessments [OR 0.66 (95% CI 0.60–0.73), p < 0.001]. ConclusionsMost patients with sarcoidosis complete ophthalmologic examinations, though a substantial proportion does not. Young adults, men and immigrants were less likely to complete ophthalmologic evaluations. Limited access to ophthalmologists may at least in part explain why some sarcoidosis patients fail to complete ophthalmologic screening.

Impact of socioeconomic inequities and adverse childhood experiences on visual function in pediatric ophthalmology patients

Impact of socioeconomic inequities and adverse childhood experiences on visual function in pediatric ophthalmology patients

Can Visual Acuity Be Reliably Measured at Home? Validation of Telemedicine Remote Computerised Visual Acuity Measurements.

Purpose:The recent pandemic has identified the need for telemedicine assessment of ophthalmology patients. A vital component of such assessment is visual acuity (VA) measurement. The aim of this study was to determine the feasibility and reliability of computerised ‘at home’ VA measurements using COMPlog software.Methods:A Bland Altman method comparison study of worse eye ‘in clinic’ and ‘at home’ orthoptist-supervised COMPlog computerised VA measurements. Subjects underwent gold standard semi-automated computerised test and retest logMAR VA measurements on their habitually corrected worse eye both ‘in clinic’ and ‘at home.’ The orthoptist ran the test from the eye clinic with the patient viewing a secondary PC monitor either in the same clinic room or at home. A screen sharing voice and video conferencing application and standard consumer IT hardware were employed to present the test optotypes in the patient’s home.Results:23 paediatric and 13 adult patients with a range of ocular diseases and worse eye visual acuities were included (range –0.14 to 1.06 logMAR). No significant bias was found between ‘in clinic’ and ‘at home’ measurements (mean –0.01 logMAR and 95% confidence interval –0.03, 0.00 logMAR). Test-retest variability of ‘in clinic,’ ‘at home’ and ‘in clinic’ versus ‘at home’ measurements were within normal reported ranges at 0.12 logMAR (6 ETDRS letters) or less.Conclusion:Remote home VA testing performed by an eye care professional using a semi-automated VA measurement program and video conferencing application provided unbiased measurements with acceptable test-retest reliability. Home testing was both feasible and acceptably reliable in appropriately equipped patients.

Five-Category Intelligent Auxiliary Diagnosis Model of Common Fundus Diseases Based on Fundus Images.

PurposeThe discrepancy of the number between ophthalmologists and patients in China is large. Retinal vein occlusion (RVO), high myopia, glaucoma, and diabetic retinopathy (DR) are common fundus diseases. Therefore, in this study, a five-category intelligent auxiliary diagnosis model for common fundus diseases is proposed; the model's area of focus is marked.MethodsA total of 2000 fundus images were collected; 3 different 5-category intelligent auxiliary diagnosis models for common fundus diseases were trained via different transfer learning and image preprocessing techniques. A total of 1134 fundus images were used for testing. The clinical diagnostic results were compared with the diagnostic results. The main evaluation indicators included sensitivity, specificity, F1-score, area under the concentration-time curve (AUC), 95% confidence interval (CI), kappa, and accuracy. The interpretation methods were used to obtain the model's area of focus in the fundus image.ResultsThe accuracy rates of the 3 intelligent auxiliary diagnosis models on the 1134 fundus images were all above 90%, the kappa values were all above 88%, the diagnosis consistency was good, and the AUC approached 0.90. For the 4 common fundus diseases, the best results of sensitivity, specificity, and F1-scores of the 3 models were 88.27%, 97.12%, and 84.02%; 89.94%, 99.52%, and 93.90%; 95.24%, 96.43%, and 85.11%; and 88.24%, 98.21%, and 89.55%, respectively.ConclusionsThis study designed a five-category intelligent auxiliary diagnosis model for common fundus diseases. It can be used to obtain the diagnostic category of fundus images and the model's area of focus.Translational RelevanceThis study will help the primary doctors to provide effective services to all ophthalmologic patients.

Oral antibiotics for chronic blepharitis.

Oral antibiotics for chronic blepharitis.

Impact of the SARS-CoV-2 pandemic on ophthalmic care in Germany.

BackgroundSurvey by the commission for cross-sectoral ophthalmology, as a joint commission of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (BVA) on the effects of the SARS-CoV‑2 pandemic on ophthalmological patient care in Germany.MethodsOnline-based survey.ResultsA total of 1190 questionnaires were (partly) answered. With respect to outpatient care and consultations from 15 March to 15 April 2020, a total of 69 (5.8%) participants indicated unlimited, 756 (63.5%) reduced and 330 (27.7%) emergency care only, independent of the type of institution. Outpatient surgery was restricted to emergency surgery in 68% of clinics, 42.0% of inpatient wards, 45.0% of surgical medical care centers and group practices and 33.0% of private practices. Inpatient procedures were limited to emergency care in 75.0% of inpatient wards and in 71.0% of clinics. With the exception of endophthalmitis (+8.2%), the number of urgent indications and emergencies declined: retinal detachment (−34.8%), perforating eyeball injuries (−7.3%), acute glaucoma (−17.8%), central retinal artery occlusion and anterior ischemic optic neuropathy (−31.0%), others (−30.9%), penetrating keratoplasty and amniotic membrane transplantation (−59.1%). Institutional or professional policy requirements (76.0%) and appointment cancellation by patients (84.0%) were the most common reasons for limitations in ophthalmic patient care.ConclusionThe initial phase of the pandemic was characterized by a massive reduction in non-urgent conservative and surgical treatment that affected all areas of ophthalmology. Due to intensive care capacities required for COVID-19 patients, inpatient treatment was largely restricted to emergencies. Treatment of ophthalmological patients, including ocular emergencies and urgent treatment, was maintained across all sectors with a (considerable) decrease in the number of cases even in these groups.

Оценка показателей качества жизни и состояния зрения у пациентов с патологией заднего отрезка глаза

Purpose. Comparative analysis of the quality of life profiles in patients with various vitreoretinal diseases. Material and methods. The study included 76 patients with established diseases of the retina and vitreous body aged 17 to 82 years, of which 25 were men and 51 were women. All participants were interviewed using a special questionnaire assessment of vision Visual Functioning Questionnaire 25 (VFQ-25). Quantitative data are processed using descriptive statistics and presented as medians and quartiles. The reliability of differences between patients from different observation groups was confirmed by nonparametric statistics (the Mann–Whitney test). The reliability of the differences was considered established at p&lt;0.05. Results. The results of patients' subjective assessment of various social aspects of their life activity are shown. The results of a comparative assessment of quality of life indicators depending on the diagnosis are given. Conclusion. The quality of life profile of patients with vitreoretinal pathology is characterized by a low assessment of patients ‘General health status and a high level of dependence on external assistance. Patients experience significant difficulties when driving a car. There is also a low level of role difficulties reflecting the individual's adaptive reserves in society. There were significant differences in the levels of assessment of quality of life indicators by respondents with various vitreoretinal diseases on the scales: «General health», «near visual function». Key words: quality of life, diseases of the posterior segment of the eye, VFQ-25 questionnaire, ophthalmological patients.

The Readability of Ophthalmological Patient Education Materials Provided by Major Academic Hospitals

ABSTRACT Introduction The internet is an increasingly important resource for patients seeking health-related information. Because of this trend, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online patient education materials (PEMs) be written between a third and seventh grade level. The present study evaluates the readability levels of ophthalmological PEMs provided by five major academic hospitals, quantifies the availability of accompanying videos and graphics, and examines the extent to which readability may be increased. Methods In March 2021, 397 PEMs from five major academic hospitals were extracted for subsequent analysis by seven validated readability assessments. The presence of an accompanying video or graphic was noted. Statistical significance was assessed using the Kruskal-Wallis test with Dunn’s multiple comparisons test and the chi-square test. Results Nearly all articles were written above the recommended reading level of 7th grade. After averaging the scales for each article, the median grade level was 11.7 (interquartile range [IQR], 10.7–12.7). The PEMs with the highest median reading level were provided by the Johns Hopkins University Wilmer Institute (12.6, IQR, 11.3 – 13.6). Only 13.6% and 13.1% of articles had an accompanying video and graphic, respectively. Reduction of sentence length beneath 15 words resulted in an improvement of readability by 2.7 grade levels. Conclusions The readability of online patient resources provided by major academic hospitals were above the literacy guidelines recommended by the NIH and AMA. Furthermore, most articles did not include a video or graphic, both of which could potentially improve patient understandability of educational materials. By altering these PEMs, as demonstrated here, institutions could increase the value these articles provide for patients and therefore the quality of the patient-physician relationship.

A Remote Surveillance Platform to Monitor General Care Ward Surgical Patients for Acute Physiologic Deterioration.

BACKGROUND:The traditional paradigm of hospital surgical ward care consists of episodic bedside visits by providers with periodic perusals of the patient’s electronic health record (EHR). Vital signs and laboratory results are directly pushed to the EHR but not to providers themselves. Results that require intervention may not be recognized for hours. Remote surveillance programs continuously monitor electronic data and provide automatic alerts that can be routed to multidisciplinary providers. Such programs have not been explored in surgical general care wards.METHODS:We performed a quality improvement observational study of otolaryngology and ophthalmology patients on a general care ward from October 2017 to March 2019 during nighttime hours (17:00–07:00). The study was initiated due to the loss of on-site anesthesiology resources that historically helped respond to acute physiologic deterioration events. We implemented a remote surveillance software program to continuously monitor patients for severe vital signs and laboratory abnormalities and automatically alert the ward team and a remote critical care anesthesiology team. The primary end point was the true positive rate, defined as the proportion of alerts that were associated with a downstream action that changed the care of the patient. This was determined using systematic chart review. The secondary end point, as a measure of alarm fatigue, was the average number of alerts per clinician shift.RESULTS:The software monitored 3926 hospital visits and analyzed 1,560,999 vitals signs and 16,635 laboratories. It generated 151 alerts, averaging 2.6 alerts per week. Of these, 143 (94.7%) were numerically accurate and 8 (5.3%) were inaccurate. Hypoxemia with oxygen saturation <88% was the most common etiology (92, 63%) followed by tachycardia >130 beats per minute (19, 13.3%). Among the accurate alerts, 133 (88.1%) were true positives with an associated clinical action. Actions included a change in management 113 (67.7%), new diagnostic test 26 (15.6%), change in discharge planning 20 (12.0%), and change in level of care to the intensive care unit (ICU) 8 (4.8%). As a measure of alarm fatigue, there were 0.4 alerts per clinician shift.CONCLUSIONS:In a surgical general care ward, a remote surveillance software program that continually and automatically monitors physiologic data streams from the EHR and alerts multidisciplinary providers for severe derangements provided highly actionable alarms at a rate that is unlikely to cause alarm fatigue. Such programs are feasible and could be used to change the paradigm of monitoring.