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Primary eye care

W Holmes, R Shajehan, S Kitnasamy, C Abeywickrama, Y Arsath, F Gnanaraj, S Inbaraj, G Jayakody, K Durrant, S Luchters
: The growing burden of vision impairment (VI) among older people is a development challenge in Asian countries. This study aimed to understand older people's views and experiences about the impact of VI and barriers to eye care to inform policies to address this challenge. We conducted 12 focus group discussions in 2013 with retired Tamil and Sinhala elders in Nuwara Eliya district, Sri Lanka (n = 107). Data were analysed thematically. Older people described the broad impacts VI has on their lives...
October 19, 2016: Global Public Health
Fabiana Q Silva, Mehreen Adhi, Karen M Wai, Leann Olansky, M Cecilia Lansang, Rishi P Singh
BACKGROUND AND OBJECTIVE: The purpose of this study was to identify whether endocrinologists and primary care physicians (PCP) adequately screen for ophthalmic symptoms/signs within office visits and provide timely ophthalmology referrals in patients with diabetes. PATIENTS AND METHODS: Patients between the ages of 18 years and 80 years with diabetes who underwent an office visit with an endocrinologist or a PCP between January 1, 2014, and December 31, 2014, were identified...
October 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
A Pareja-Ríos, S Bonaque-González, M Serrano-García, F Cabrera-López, P Abreu-Reyes, M D Marrero-Saavedra
PURPOSE: To describe the results of a diabetic retinopathy screening program implemented in a primary care area. METHODS: A retrospective study was conducted using data automatically collected since the program began on 1 January 2007 until 31 December 2015. RESULTS: The number of screened diabetic patients has progressively increased, from 7,173 patients in 2007 to 42,339 diabetic patients in 2015. Furthermore, the ability of family doctors to correctly interpret retinographies has improved, with the proportion of retinal images classified as normal having increased from 55% in 2007 to 68% at the end of the study period...
October 15, 2016: Archivos de la Sociedad Española de Oftalmología
David T Truong, Minh-Thuy Bui, H Dwight Cavanagh
PURPOSE: To review the epidemiology, risk factors, microbiologic spectrum, and treatment of microbial keratitis during a 5-year period at an urban public hospital in comparison with an adjacent private university practice. METHODS: Retrospective chart review in the 5-year interval, 2009 through 2014. Primary outcome measures included patient age at presentation, best-corrected visual acuity (BCVA), risk factors, culture and sensitivities, treatment, and complication occurrence...
October 7, 2016: Eye & Contact Lens
Sotiria Palioura, Kathryn Colby
PURPOSE: To evaluate the feasibility of Descemet stripping endothelial keratoplasty using grafts preloaded by an eye bank in a commercially available insertion device. METHODS: In this retrospective case series, a series of 35 eyes in 34 consecutive patients who underwent Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy or previously failed full-thickness grafts at a single tertiary care center from March 2013 to March 2014 was included...
October 12, 2016: Cornea
Sonja Heinzelmann, Daniel Böhringer, Philipp Eberwein, Thomas Reinhard, Philip Maier
PURPOSE: Although the functional results following DMEK are better than after DSAEK, DSAEK still seems to be the standard procedure, as surgeons fear losing grafts during DMEK graft preparation. Therefore, eye banks offer precut DMEK grafts for direct use by the surgeon. Here, we analysed the functional results and complication rates for a precut technique compared to fresh preparations. METHODS: We retrospectively compared 453 standard to 11 precut (1-2 days before surgery) DMEK cases...
October 8, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Stuart J McCarter, Michael J Howell
Sleep disorders and neurodegenerative diseases are commonly encountered in primary care. A common, but underdiagnosed sleep disorder, rapid eye movement sleep behavior disorder (RBD), is highly associated with Parkinson disease and related disorders. Rapid eye movement sleep behavior disorder is common. It is estimated to affect 0.5% of the general population and more than 7% of individuals older than 60 years; however, most cases go unrecognized. Rapid eye movement sleep behavior disorder presents as dream enactment, often with patients thrashing, punching, and kicking while they are sleeping...
October 2016: Mayo Clinic Proceedings
Augusto Azuara-Blanco, Jennifer Burr, Craig Ramsay, David Cooper, Paul J Foster, David S Friedman, Graham Scotland, Mehdi Javanbakht, Claire Cochrane, John Norrie
BACKGROUND: Primary angle-closure glaucoma is a leading cause of irreversible blindness worldwide. In early-stage disease, intraocular pressure is raised without visual loss. Because the crystalline lens has a major mechanistic role, lens extraction might be a useful initial treatment. METHODS: From Jan 8, 2009, to Dec 28, 2011, we enrolled patients from 30 hospital eye services in five countries. Randomisation was done by a web-based application. Patients were assigned to undergo clear-lens extraction or receive standard care with laser peripheral iridotomy and topical medical treatment...
October 1, 2016: Lancet
Davorina Petek, Mitja Mlakar
BACKGROUND: A new organisation at the primary level, called model practices, introduces a 0.5 full-time equivalent nurse practitioner as a regular member of the team. Nurse practitioners are in charge of registers of chronic patients, and implement an active approach into medical care. Selected quality indicators define the quality of management. The majority of studies confirm the effectiveness of the extended team in the quality of care, which is similar or improved when compared to care performed by the physician alone...
September 1, 2016: Zdravstveno Varstvo
Osamah Saeedi, Hasan Ashraf, Eric P Slade, Deborah R Medoff, Lan Li, David S Friedman, Julie Kreyenbuhl
PURPOSE: To assess trends in prevalence of diagnosed ocular disease and utilization of eye care services in the VA healthcare system. DESIGN: Prevalence study METHODS: We performed a retrospective study of all eligible Veterans in the VA Capitol Health Care Network from 2007 to 2011. The VA database was used to abstract demographic and socioeconomic variables including age, race, gender, marital status, service connection, prescription copay, homelessness, VA facility...
October 1, 2016: American Journal of Ophthalmology
Zenia P Aguilera, Pauline L Chen
Primary care physicians are often the first to see a child with the complaint of eye pain. The eye examination in children is not easy, and the entities that can cause pain in children range from a foreign body in the cornea to the most serious amblyogenic (inducing decreased vision) and life-threatening conditions. Eye pain is a red flag for ocular and systemic conditions, either in a "quiet eye" or "red eye." A detailed history of present illness; pertinent review of systems; close attention to the past medical, family, and social histories; and meticulous physical examination can help to determine the cause, establish the correct treatment, and serve as the basis for referral to a pediatric ophthalmologist if necessary...
October 2016: Pediatrics in Review
Shubhank Khare, Jolly Rohatgi, Manjeet Singh Bhatia, Upreet Dhaliwal
CONTEXT: Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. AIM: To assess burden and depression in persons caring for blind individuals. SETTINGS AND DESIGN: This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. MATERIALS AND METHODS: Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study...
August 2016: Indian Journal of Ophthalmology
Kelsey Hegarty, Laura Tarzia, Leesa Hooker, Angela Taft
Experiences of domestic and sexual violence are common in patients attending primary care. Most often they are not identified due to barriers to asking by health practitioners and disclosure by patients. Women are more likely than men to experience such violence and present with mental and physical health symptoms to health practitioners. If identified through screening or case finding as experiencing violence they need to be supported to recover from these traumas. This paper draws on systematic reviews published in 2013-2015 and a further literature search undertaken to identify recent intervention studies relevant to recovery from domestic and sexual violence in primary care...
October 2016: International Review of Psychiatry
Thusa Sabapathy, Douglas L Vanderbilt, Irina Zamora, Marilyn Augustyn
Juanita is a 13-year-old non-verbal Latina girl with autism spectrum disorder, moderate intellectual disability, and a seizure disorder whose aggressive behaviors toward her parents have significantly worsened over the past few months.Juanita's monolingual Spanish-speaking parents are here today for medication management at her primary care clinic. The parents report that Juanita pinches them, pulls their hair, and hits her head with her fists. Her aggression toward them is usually triggered by feelings of frustrations, leaving her parents feeling like they have to walk on eggshells around her and have led to differing parenting styles...
October 2016: Journal of Developmental and Behavioral Pediatrics: JDBP
Sara Marelli, Paola M V Rancoita, Federica Giarrusso, Andrea Galbiati, Marco Zucconi, Alessandro Oldani, Clelia Di Serio, Luigi Ferini-Strambi
We validated the Italian version of the rapid eye movement sleep behavior disorder (RBD) screening questionnaire (RBDSQ) and calculated its cut-off value for discriminating RBD group from other sleep disorders and healthy controls (HC). 380 patients with sleep disorders and 101 HC were enrolled. RBDSQ achieved an acceptable Cronbach's α value of 0.787 and item 10 was the only one with a very low item-total biserial correlation (0.141). At ROC analysis, we obtained an AUC of 0.888, denoting a good performance of the RBDSQ total score for predicting the RBD status...
September 26, 2016: Journal of Neurology
Ilknur Tugal-Tutkun
PURPOSE OF REVIEW: The primary systemic vasculitides represent a spectrum of rare but life-threatening conditions that may also affect the eye in various forms. This article reviews recently published data on ocular manifestations of systemic vasculitis. RECENT FINDINGS: Early diagnosis and timely treatment has led to better visual outcomes in giant cell arteritis (GCA). Gene expression from orbital tissues could distinguish granulomatosis with polyangiitis (GPA) from sarcoidosis and Graves disease, but not from idiopathic orbital inflammation...
September 21, 2016: Current Opinion in Rheumatology
Lisa A Hark, Deiana M Johnson, Giuliana Berardi, Neal S Patel, Lichuan Zeng, Yang Dai, Eileen L Mayro, Michael Waisbourd, L Jay Katz
PURPOSE: Patients with glaucoma who do not keep their follow-up eye care appointments are at risk for developing more severe ocular disease. The primary aim of the current study was to evaluate whether the use of a patient navigator altered adherence to follow-up eye care appointments in community-versus office-based settings. PATIENTS AND METHODS: Patients diagnosed with a glaucoma-related condition following a comprehensive eye examination at 43 community sites in Philadelphia, PA, USA, were enrolled in this prospective, randomized, controlled trial...
2016: Patient Preference and Adherence
Maria W Mauritz, Betsie G I Van Gaal, Ruud A Jongedijk, Lisette Schoonhoven, Maria W G Nijhuis-van der Sanden, Peter J J Goossens
BACKGROUND: In the Netherlands, most patients with severe mental illness (SMI) receive flexible assertive community treatment (FACT) provided by multidisciplinary community mental health teams. SMI patients with comorbid posttraumatic stress disorder (PTSD) are sometimes offered evidence-based trauma-focused treatment like eye movement desensitization reprocessing or prolonged exposure. There is a large amount of evidence for the effectiveness of narrative exposure therapy (NET) within various vulnerable patient groups with repeated interpersonal trauma...
2016: European Journal of Psychotraumatology
Renato Antunes Schiave Germano, Marcelo Hatanaka, Remo Susanna
PURPOSE: To evaluate variations in choroidal thickness (CT) during the water drinking test (WDT) in emmetropic eyes (EE) and highly myopic eyes (ME) using spectral-domain optical coherence tomography (SD-OCT). METHODS: Clinical trial performed at a tertiary care hospital comprising 30 randomly selected eyes. The WDT and SD-OCT macular scans were performed 10 and 45 min after water ingestion in 15 myopic and 15 EE of 15 healthy patients in each group. Primary study outcomes were average macular CT measured by SD-OCT and intraocular pressure (IOP) during the WDT...
July 2016: Arquivos Brasileiros de Oftalmologia
Shabnam Zargar, Kevin John Prendiville, Eladio Martinez
PURPOSE: We report a case of iris pigment epithelial cysts in a newborn and discuss the importance of an accurate diagnosis for prevention of amblyopia. METHODS: We describe a case of an abnormal red reflex seen on a newborn exam. RESULTS: A full-term female born via normal spontaneous vaginal delivery without any complications was seen in the newborn nursery. She was noted to have an abnormal eye exam. Pupils were large with circular dark excrescences of the iris pigment epithelium...
2016: GMS Ophthalmol Cases
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