75 FR 48976 - National Eye Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel, Epi R01s, Data Analysis... Extramural Research, National Eye Institute, National Institutes of Health, 5635 Fishers Lane, Suite 1300...

77 FR 71428 - National Eye Institute; Notice of Closed Meeting

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2012-11-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Clinical..., Scientific Review Officer, Division of Extramural Research, National Eye Institute, National Institutes of...

77 FR 27784 - Announcement of National Eye Institute Participation in PA-11-347, “NINDS SBIR Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Announcement of National Eye... intended to inform potential applicants that the National Eye Institute (NEI) is participating in PA-11-347... biology related to eye health and eye disease treatments. For more information about the research and...

78 FR 62639 - National Eye Institute; Notice of Closed Meeting

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2013-10-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Clinical and.... Contact Person: Brian Hoshaw, Ph.D., Scientific Review Officer, National Eye Institute, National...

78 FR 46593 - National Eye Institute; Notice of Closed Meeting

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2013-08-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI K99 Review. Date... Person: Brian Hoshaw, Ph.D. Scientific Review Officer, National Eye Institute, National Institutes of...

76 FR 10041 - National Eye Institute; Notice of Closed Meeting

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2011-02-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel, NEI Clinical... agreement applications. Place: National Eye Institute, 5635 Fishers Lane, Rockville, MD 20852. (Telephone...

76 FR 2914 - National Eye Institute; Notice of Closed Meeting

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2011-01-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... National Eye Institute, including consideration of personnel qualifications and performances, and the... invasion of personal privacy. Name of Committee: Board of Scientific Counselors, National Eye Institute...

75 FR 74068 - National Eye Institute; Notice of Closed Meetings

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2010-11-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; U10 Teleconference... applications. Place: National Eye Institute, 5635 Fishers Lane, Rockville, MD 20852. (Telephone Confence Call...

77 FR 24727 - National Eye Institute; Notice of Closed Meeting

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2012-04-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Clinical Trials.... Schaffner, Ph.D., Chief, Scientific Review Branch, Division of Extramural Research, National Eye Institute...

76 FR 66732 - National Eye Institute; Notice of Closed Meetings

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2011-10-27

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75 FR 26968 - National Eye Institute; Notice of Closed Meetings

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2010-05-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Loan Repayment... applications. Place: National Eye Institute, 5635 Fishers Lane, Bethesda, MD (Virtual Meeting). Contact Person...

78 FR 62640 - National Eye Institute; Notice of Closed Meeting

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2013-10-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Bioinformatics..., Division of Extramural Research, National Eye Institute, 5635 Fishers Lane, Suite 1300, MSC 9300, Bethesda...

77 FR 64525 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel, NEI Career Development... Schaffner, Ph.D., Chief, Scientific Review Officer, Division of Extramural Research, National Eye Institute...

76 FR 3917 - National Eye Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel, Training Grants. Date...: National Eye Institute, 5635 Fishers Lane, Rockville, MD 20852 (Virtual Meeting). Contact Person: Daniel R...

78 FR 28233 - National Eye Institute; Notice of Closed Meeting

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2013-05-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute..., National Eye Institute. The meeting will be closed to the public in accordance with the provisions set... individual intramural programs and projects conducted by the National Eye Institute, including consideration...

75 FR 10489 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Clinical Grant..., Division of Extramural Research, National Eye Institute, 5635 Fishers Lane, Suite 1300, Msc 9300, Bethesda...

77 FR 40367 - National Eye Institute; Notice of Closed Meetings

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2012-07-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... unwarranted invasion of personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel..., Washington, DC 20015. Contact Person: Daniel R. Kenshalo, Ph.D., Scientific Review Officer, National Eye...

75 FR 13769 - National Eye Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... unwarranted invasion of personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; National Eye Institute SBIR Special Emphasis Panel. Date: April 9, 2010. Time: 8:30 a.m. to 5 p.m. Agenda...

75 FR 16818 - National Eye Institute; Notice of Closed Meeting

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2010-04-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Training Grants.... [[Page 16819

76 FR 24499 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: June 16, 2011. Open: 8:30 a.m. to 12 p.m. Agenda: Following opening...

75 FR 54642 - National Eye Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute.... App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to the...: National Advisory Eye Council. Date: October 21, 2010. Open: 8:30 a.m. to 12 p.m. Agenda: Following opening...

76 FR 53687 - National Eye Institute Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: October 13, 2011. Open: 8:30 a.m. to 12 p.m. Agenda: Following opening...

77 FR 2076 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: February 2, 2012. Open: 8 a.m. to 12 p.m. Agenda: Following opening...

77 FR 31032 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: June 14, 2012. Open: 8:00 a.m. to 3:00 p.m. Agenda: Following opening...

77 FR 55852 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: October 4, 2012. Open: 8:30 a.m. to 2 p.m. Agenda: Following opening...

75 FR 26260 - National Eye Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Eye Institute Special Emphasis Panel, April 20, 2010, 3 p.m., to April 20, 2010, 4 p.m., National Eye Institute, 5635...

75 FR 76474 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), notice is hereby given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: January 20, 2011. Open: 8:30 a.m. to 12 p.m. Agenda: Following opening...

77 FR 73037 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute....S.C. App.), Notice is Hereby Given of the National Advisory Eye Council. The meeting will be open to...: National Advisory Eye Council. Date: January 10, 2013. Open: 8:30 a.m. to 2:00 p.m. Agenda: Following...

75 FR 11551 - National Eye Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute.... App.), notice is hereby given of a meeting of the National Advisory Eye Council. The meeting will be...: National Advisory Eye Council. Date: June 17, 2010. Closed: 8:30 a.m. to 11 a.m. Agenda: To review and...

77 FR 12318 - National Eye Institute; Notice of Closed Meetings

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2012-02-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... unwarranted invasion of personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Anterior Eye Disease. Date: March 19, 2012. Time: 1 p.m. to 2:30 p.m. Agenda: To review and...

75 FR 20853 - National Eye Institute; Notice of Closed Meeting

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2010-04-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute... unwarranted invasion of personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel, Immunosuppression for Eye Diseases. Date: April 20, 2010. Time: 3 p.m. to 4 p.m. Agenda: To review and evaluate...

78 FR 73867 - National Eye Institute; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute.... App.), notice is hereby given of a meeting of the National Advisory Eye Council. The meeting will be... Advisory Eye Council. Date: January 23, 2014. Open: 8:30 a.m. to 2:00 p.m. Agenda: Following opening...

78 FR 64517 - National Eye Institute; Amended Notice of Meeting

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2013-10-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Eye Institute Special Emphasis Panel, October 21, 2013, 08:00 a.m. to October 23, 2013, 12:00 p.m., National Institutes...

78 FR 56905 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-16

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U... personal privacy. Name of Committee: National Eye Institute Special Emphasis Panel; NEI Career Development...

78 FR 64519 - National Eye Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Advisory Eye Council, October 17, 2013, 8:30 a.m. to October 17, 2013, 5:00 p.m., NIH, Neuroscience Building, 6001...

75 FR 37453 - National Eye Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Amended Notice of Meeting Notice is hearby given of a chance in the meeting of the National Eye Institute Special Emphasis Panel, July 16, 2010, 8 a.m. to July 16, 2010, 5 p.m., Embassy Suites Hotel, Chevy Chase...

76 FR 2913 - National Eye Institute; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Advisory Eye Council, January 20, 2011, 8:30 a.m. to 12 p.m. for Open session and 1:15 p.m. to adjournment for Closed...

Laser Eye Surgery: MedlinePlus Health Topic

MedlinePlus

... types of laser eye surgery. LASIK - laser-assisted in situ keratomileusis - is one of the most common. Many ... Laser (National Institutes of Health) ClinicalTrials.gov: Laser In Situ Keratomileusis (LASIK) (National Institutes of Health) ClinicalTrials.gov: ...

78 FR 55751 - National Institutes of Health

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Eye Institute...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...: National Institutes of Health, Neuroscience Building, Conference Room D, 6001 Executive Boulevard...

Evidence for integrating eye health into primary health care in Africa: a health systems strengthening approach

PubMed Central

2013-01-01

Background The impact of unmet eye care needs in sub-Saharan Africa is compounded by barriers to accessing eye care, limited engagement with communities, a shortage of appropriately skilled health personnel, and inadequate support from health systems. The renewed focus on primary health care has led to support for greater integration of eye health into national health systems. The aim of this paper is to demonstrate available evidence of integration of eye health into primary health care in sub-Saharan Africa from a health systems strengthening perspective. Methods A scoping review method was used to gather and assess information from published literature, reviews, WHO policy documents and examples of eye and health care interventions in sub-Saharan Africa. Findings were compiled using a health systems strengthening framework. Results Limited information is available about eye health from a health systems strengthening approach. Particular components of the health systems framework lacking evidence are service delivery, equipment and supplies, financing, leadership and governance. There is some information to support interventions to strengthen human resources at all levels, partnerships and community participation; but little evidence showing their successful application to improve quality of care and access to comprehensive eye health services at the primary health level, and referral to other levels for specialist eye care. Conclusion Evidence of integration of eye health into primary health care is currently weak, particularly when applying a health systems framework. A realignment of eye health in the primary health care agenda will require context specific planning and a holistic approach, with careful attention to each of the health system components and to the public health system as a whole. Documentation and evaluation of existing projects are required, as are pilot projects of systematic approaches to interventions and application of best practices. Multi-national research may provide guidance about how to scale up eye health interventions that are integrated into primary health systems. PMID:23506686

Analysis of eye health in the Thai population.

PubMed

Yospaiboon, Yosanan; Yospaiboon, Kasem; Ratanapakorn, Tanapat; Sinawat, Suthasinee; Sanguansak, Thuss; Bhoomibunchoo, Chavakij

2012-07-01

To assess national eye health as a baseline for improving medical education, services and research. Information on eye illness among out- and in-patients was based on hospital claims from the three national health insurance schemes in 2010. The data were analyzed by age groups. In 2010, 4,982,025 out-patient visits and 187,080 in-patient admissions were reported. The five most common outpatient eye conditions were disorders of the (1) conjunctiva (H10-H13) (2) eyelid, lacrimal system and orbit (H00-H06) (3) lens (H25-28) (4) sclera, cornea, iris and ciliary body (H15-H22) and (5) glaucoma (H40-H42). The five most common inpatient eye diseases were (1) disorders of lens (H25-H28) (2) conjunctiva (H10-H13) (3) sclera, cornea, iris and ciliary body (H15-H22) (4) choroid and retina (H30-H35) and (5) glaucoma (H40-H42). Information on the most frequent eye diseases-including the types and frequency of high risk conditions, the diseases causing the most impact on vision and resulting in the highest health expenditures-will be used to (a) revise the curricula for medical education (b) to improve eye care services and (c) to improve access to data for research themes tailored to local and national needs.

Prevalence and Factors Associated with the Use of Eye Care Services in South Korea: Korea National Health and Nutrition Examination Survey 2010-2012.

PubMed

Park, Yong Seok; Heo, Hwan; Ye, Byeong Jin; Suh, Young-Woo; Kim, Seung-Hyun; Park, Shin Hae; Lim, Key Hwan; Lee, Sung Jin; Park, Song Hee; Baek, Seung-Hee

2017-02-01

To estimate the factors and prevalence of eye care service utilization in the South Korean population. This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence interval, 58.1%-64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37-6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea.

Use of protective eyewear in U.S. adults: results from the 2002 national health interview survey.

PubMed

Forrest, Kimberly Y Z; Cali, Joseph M; Cavill, Wilma J

2008-01-01

Many eye injuries occur because of not using protective eyewear. This study analyzed the 2002 National Health Interview Survey data to examine the rate of using protective eyewear during activities that could cause eye injuries outside the workplace and the correlates of not using protective eyewear among U.S. adults. The rate of participation in activities that could cause eye injuries and the rate of protective eyewear use during these activities were estimated using sample weights to yield national estimates. A total of 30,894 individuals in the survey provided valid data for the current analysis, which revealed that 29.3% of the U.S. adults reported engaging in activities that could cause an eye injury and 32.1% of those used eye protection while doing such activities. Males were more likely to use eye protection than females (34.7% vs. 25.2%). The age group of 18-24 years was least likely to use eye protection (15.3%). Other factors associated with not using protective eyewear included being black or other races, non-retired individuals, and those from low-income families (all p-values < 0.05). Use of protective eyewear during activities that could cause eye injuries was relatively low in the US adult population. Certain groups were at a higher risk for not using eye protection, including females, young adults aged 18-24 years, black or other races, and individuals with a low socioeconomic status. To promote eye safety, health education programs should target these high-risk groups.

An Overview of Ophthalmologic Survey Methodology in the 2008-2015 Korean National Health and Nutrition Examination Surveys.

PubMed

Yoon, Kyung Chul; Choi, Won; Lee, Hyo Seok; Kim, Sang-Duck; Kim, Seung-Hyun; Kim, Chan Yun; Park, Ki Ho; Park, Young Jeung; Baek, Seung-Hee; Song, Su Jeong; Shin, Jae Pil; Yang, Suk-Woo; Yu, Seung-Young; Lee, Jong Soo; Lim, Key Hwan; Oh, Kyung Won; Kang, Se Woong

2015-12-01

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national program designed to assess the health and nutritional status of the noninstitutionalized population of South Korea. The KNHANES was initiated in 1998 and has been conducted annually since 2007. Starting in the latter half of 2008, ophthalmologic examinations were included in the survey in order to investigate the prevalence and risk factors of common eye diseases such as visual impairment, refractive errors, strabismus, blepharoptosis, cataract, pterygium, diabetic retinopathy, age-related macular degeneration, glaucoma, dry eye disease, and color vision deficiency. The measurements included in the ophthalmic questionnaire and examination methods were modified in the KNHANES IV, V, and VI. In this article, we provide detailed information about the methodology of the ophthalmic examinations in KNHANES in order to aid in further investigations related to major eye diseases in South Korea.

Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

PubMed

Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

2017-12-01

To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

The Eyes Have It.

ERIC Educational Resources Information Center

Walsh, Janet

1982-01-01

Discusses the health hazards of working with the visual display systems of computers, in particular the eye problems associated with long-term use of video display terminals. Excerpts from and ordering information for the National Institute for Occupational Safety and Health report on such hazards are included. (JJD)

Vision health disparities in the United States by race/ethnicity, education, and economic status: findings from two nationally representative surveys.

PubMed

Zhang, Xinzhi; Cotch, Mary Frances; Ryskulova, Asel; Primo, Susan A; Nair, Parvathy; Chou, Chiu-Fang; Geiss, Linda S; Barker, Lawrence E; Elliott, Amanda F; Crews, John E; Saaddine, Jinan B

2012-12-01

To assess vision health disparities in the United States by race/ethnicity, education, and economic status. Cross-sectional, nationally representative samples. We used national survey data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS). Main outcome measures included, from NHANES, age-related eye diseases (ie, age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], glaucoma) and from NHIS, eye care use (ie, eye doctor visits and cannot afford eyeglasses when needed) among those with self-reported visual impairment. The estimates were age- and sex-standardized to the 2000 US Census population. Linear trends in the estimates were assessed by weighted least squares regression. Non-Hispanic whites had a higher prevalence of AMD and cataract surgery than non-Hispanic blacks, but a lower prevalence of DR and glaucoma (all P < .001 in NHANES 2005-2008). From 1999 to 2008, individuals with less education (ie, high school) and lower income (poverty income ratio [PIR] <1.00 vs ≥ 4.00) were consistently less likely to have had an eye care visit in the past 12 months compared with their counterparts (all P < .05). During this period, inability to afford needed eyeglasses increased among non-Hispanic whites and Hispanics (trend P = .004 and P = .007; respectively), those with high school education (trend P = .036), and those with PIR 1.00-1.99 (trend P < .001). Observed vision health disparities suggest a need for educational and innovative interventions among socioeconomically disadvantaged groups. Published by Elsevier Inc.

Securing support for eye health policy in low- and middle-income countries: identifying stakeholders through a multi-level analysis.

PubMed

Morone, Piergiuseppe; Camacho Cuena, Eva; Kocur, Ivo; Banatvala, Nicholas

2014-05-01

This article empirically evaluates advocacy in low- and middle-income countries as a key tool for raising policy priority and securing high-level decision maker support in eye health. We used a unique data set based on a survey conducted by World Health Organization in 2011 on eye care and prevention of blindness in 82 low- and middle-income countries. The theoretical framework derives from the idea that a plethora of stakeholders at local and global level pressure national governments, acting in economic and the political spheres. Previously, eye care has not been investigated in such a framework. We found structural differences across countries with different income levels and proposed policy recommendations to secure high-level decision makers' support for promoting eye health. Three case studies suggest that, in order to secure more support and resources for eye health, domestic and international stakeholders must strengthen their engagement with ministries of health at political and above all economic levels.

National Eye Institute

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

Vision Health Disparities in the United States by Race/Ethnicity, Education, and Economic Status: Findings from Two Nationally Representative Surveys

PubMed Central

Zhang, Xinzhi; Cotch, Mary Frances; Ryskulova, Asel; Primo, Susan A.; Nair, Parvathy; Chou, Chiu-Fang; Geiss, Linda S.; Barker, Lawrence; Elliott, Amanda F.; Crews, John E.; Saaddine, Jinan B.

2014-01-01

Purpose To assess vision health disparities in the United States by race/ethnicity, education, and economic status. Design Cross-sectional, nationally representative samples Methods We used national survey data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS). Main outcome measures included, from NHANES, age-related eye diseases (i.e., age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], glaucoma) and from NHIS, eye care use (i.e., eye doctor visits and cannot afford eyeglasses when needed) among those with self-reported visual impairment. The estimates were age- and sex-standardized to the 2000 US census population. Linear trends in the estimates were assessed by weighted least squares regression. Results Non-Hispanic whites had a higher prevalence of AMD and cataract surgery than non-Hispanic blacks, but a lower prevalence of DR and glaucoma (all P < 0.001 in NHANES 2005–2008). From 1999 to 2008, individuals with less education (i.e., < high school vs. > high school) and lower income (poverty income ratio [PIR] < 1.00 vs. ≥4.00) were consistently less likely to have had an eye care visit in the past 12 months compared with their counterparts (all P < 0.05). During this period, inability to afford needed eyeglasses increased among non-Hispanic whites and Hispanics (trend P = 0.004 and P = 0.007; respectively), those with high school education (trend P = 0.036), and those with PIR 1.00–1.99 (trend P < 0.001). Conclusions Observed vision health disparities suggest a need for educational and innovative interventions among socioeconomically disadvantaged groups. PMID:23158224

Real-world use of ranibizumab for neovascular age-related macular degeneration in Taiwan.

PubMed

Chang, Yi-Sheng; Lee, Wan-Ju; Lim, Chen-Chee; Wang, Shih-Hao; Hsu, Sheng-Min; Chen, Yi-Chian; Cheng, Chia-Yi; Teng, Yu-Ti; Huang, Yi-Hsun; Lai, Chun-Chieh; Tseng, Sung-Huei

2018-05-10

This study investigated the "real-world" use of ranibizumab for neovascular age-related macular degeneration (nAMD) in Taiwan and assessed the visual outcome. We reviewed the medical records at National Cheng Kung University Hospital, Taiwan, during 2012-2014 for 264 consecutive eyes of 229 patients with nAMD, who applied for ranibizumab covered by national health insurance. A total of 194 eyes (73.5%) in 179 patients (65.5% men; mean ± standard deviation age 69.4 ± 10.7 years) were pre-approved for treatment. Applications for treatment increased year by year, but approval rates decreased during this time. The major causes of rejection for funding were diseases mimicking nAMD, including macular pucker/epiretinal membrane, macular scarring, dry-type AMD, and possible polypoidal choroidal vasculopathy. After completion of three injections in 147 eyes, visual acuity significantly improved, gaining ≥1 line in 51.8% of eyes and stabilising in 38.3% of 141 eyes in which visual acuity was measured. The 114 eyes approved with only one application had a better visual outcome than the 27 eyes approved after the second or third applications. In conclusion, ranibizumab is effective for nAMD; however, approval after the second or third application for national health insurance cover is a less favourable predictor of visual outcome.

Skin Aging: MedlinePlus Health Topic

MedlinePlus

... Specifics Bags Under Eyes (Mayo Foundation for Medical Education and Research) Also in Spanish Sagging Skin (American Society for Dermatologic Surgery) Clinical Trials ClinicalTrials.gov: Skin Aging (National Institutes of Health) Journal Articles References and abstracts from MEDLINE/PubMed (National ...

Eye-Tracking Analysis of the Figures of Anti-Smoking Health Promoting Periodical's Illustrations

ERIC Educational Resources Information Center

Maródi, Ágnes; Devosa, Iván; Steklács, János; Fáyné-Dombi, Alice; Buzas, Zsuzsanna; Vanya, Melinda

2015-01-01

Nowadays new education technologies and e-communication devices give new measuring and assessing tools for researchers. Eye-tracking is one of these new methods in education. In our study we assessed 4 figures from the anti-smoking heath issues of National Institute for Health Development. In the study 22 students were included from a 7th grade…

Visual Health and Visual Healthcare Access in Refugees and Displaced Persons: A Systematic Review.

PubMed

Bal, Sila; Duckles, Anne; Buttenheim, Alison

2018-06-02

Vision impairment is a significant global health concern. Still, there remains a gap in our knowledge of visual health in refugees. We conducted a systematic review of the distinctive eye care needs of refugees. We screened PubMed, EMBASE, and Web of Science through February 17, 2017 for studies that focused primarily on visual health in refugees. Risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tools. 26 studies were included in the final review. The prevalence of blindness ranged from 1.3 to 26.2%. Trachoma was the leading infectious cause. Only four studies assessed vision-related care. Time/location of displacement, social unrest, and sanitation impacted severity of eye disease. Refugees have unique eye care needs. Public health interventions should target eye care at every stage of displacement. Providers may use these results to inform future research and improve visual healthcare access in refugee groups.

NIH Institutes and MLN MedlinePlus Advisory Board | NIH MedlinePlus the Magazine

MedlinePlus

... Collins-Lee, National Eye Institute Kathleen Cravedi, National Library of Medicine (ex-officio) Stephanie Dailey, National Institute on Aging Meredith Daly, Eunice Kennedy Shriver National Institute of Child Health and Human Development Marian Emr, National Institute of Neurological Disorders and ...

The accomplishments of the global initiative VISION 2020: The Right to Sight and the focus for the next 8 years of the campaign

PubMed Central

Ackland, Peter

2012-01-01

In the first 12 years of VISION 2020 sound programmatic approaches have been developed that are capable of delivering equitable eye health services to even the most remote and impoverished communities. A body of evidence around the economic arguments for investment in eye health has been developed that has fuelled successful advocacy work resulting in supportive high level policy statements. More than a 100 national plans to achieve the elimination of avoidable blindness have been developed and some notable contributions made from the corporate and government sectors to resource eye health programs. Good progress has been made to control infectious blinding diseases and at the very least there is anecdotal evidence to suggest that the global increase in the prevalence of blindness and visual impairment has been reversed in recent years, despite the ever increasing and more elderly global population. However if we are to achieve the goal of VISION 2020 we require a considerable scaling up of current efforts–this will depend on our future success in two key areas: i) Successful advocacy and engagement at individual country level to secure significantly enhanced national government commitment to financing their own VISION 2020 plans.ii) A new approach to VISION 2020 thinking that integrates eye health into health system development and develops new partnerships with wider health development initiatives. PMID:22944746

Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

PubMed

Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

2016-02-01

To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

Enhancing Advocacy for Eye Care at National Levels: What Steps to Take for the Next Decade?

PubMed Central

Rabiu, Muhammad Mansur; Al Rajhi, Abdulaziz; Qureshi, Mohammed Babar; Gersbeck, Jennifer

2012-01-01

The global initiative for the elimination of avoidable blindness by the year 2020-(VISION 2020- The Right to Sight), established in 1999, is a partnership of nongovernmental organizations (NGOs), governments, bilateral organizations, corporate bodies and the World Health Organization. The goal is to eliminate the major causes of avoidable blindness by the year 2020. Significant progress has been made in the last decade. For example, the adoption of three major World Health Assembly resolutions (WHA 56.26, 59.25 and 62.1) requesting governments to increase support and funding for the prevention of blindness and eye care. Additionally, the approval of the VISION 2020 declaration, development of plans and establishment of prevention of blindness committees and a designation of a coordinator by most participating countries represent other major achievements. Furthermore there has been increased political and professional commitment to the prevention of visual impairment and an increase in the provision of high-quality, sustainable eye care. Most of these achievements have been attributed to the advocacy efforts of VISION 2020 at the international level. The full success of this global initiative will likely depend on the extent to which the WHA resolutions are implemented in each country. However, most ratifying countries have not moved forward with implementation of these resolutions. To date, only few countries have shown consistent government support and funding for eye care pursuant to the resolutions. One of the main reasons for this may be inadequate and inappropriate advocacy for eye care at the national level. As such it is believed that the success of VISION 2020 in the next decade will depend on intense advocacy campaigns at national levels. This review identified some of the countries and health programs that have had fruitful advocacy efforts, to determine the factors that dictated success. The review highlights the factors of successful advocacy in two countries (Australia and Pakistan) that secured continued government support. The review further explores the achievements of the HIV/AIDs control network advocacy in securing global and national government support. Common factors for successful advocacy at the national level were identified to include generation of evidence data and effective utilization of the data with an appropriate forum and media to develop a credible relationship with prominent decision makers. Aligning eye care programming to the broad health and development agendas was a useful advocacy effort. Also a broad all-encompassing coalition of all stakeholders provides a solid platform for effective and persistent advocacy for government support of eye care. PMID:22346118

Is the 2015 eye care service delivery profile in Southeast Asia closer to universal eye health need!

PubMed

Das, Taraprasad; Ackland, Peter; Correia, Marcelino; Hanutsaha, Prut; Mahipala, Palitha; Nukella, Phanindra B; Pokharel, Gopal P; Raihan, Abu; Rao, Gullapalli N; Ravilla, Thulasiraj D; Sapkota, Yudha D; Simanjuntak, Gilbert; Tenzin, Ngwang; Thoufeeq, Ubeydulla; Win, Tin

2018-04-01

The year 2015 status of eye care service profile in Southeast Asia countries was compared with year 2010 data to determine the state of preparedness to achieve the World Health Organization global action plan 2019. Information was collected from the International Agency for Prevention of Blindness country chairs and from the recent PubMed referenced articles. The data included the following: blindness and low vision prevalence, national eye health policy, eye health expenses, presence of international non-governmental organizations, density of eye health personnel, and the cataract surgical rate and coverage. The last two key parameters were compared with year 2010 data. Ten of 11 country chairs shared the information, and 28 PubMed referenced publications were assessed. The prevalence of blindness was lowest in Bhutan and highest in Timor-Leste. Cataract surgical rate was high in India and Sri Lanka. Cataract surgical coverage was high in Thailand and Sri Lanka. Despite increase in number of ophthalmologists in all countries (except Timor-Leste), the ratio of the population was adequate (1:100,000) only in 4 of 10 countries (Bhutan, India, Maldives and Thailand), but this did not benefit much due to unequal urban-rural divide. The midterm assessment suggests that all countries must design the current programs to effectively address both current and emerging causes of blindness. Capacity building and proportionate distribution of human resources for adequate rural reach along with poverty alleviation could be the keys to achieve the universal eye health by 2019.

Development of a preference-based index from the National Eye Institute Visual Function Questionnaire-25.

PubMed

Rentz, Anne M; Kowalski, Jonathan W; Walt, John G; Hays, Ron D; Brazier, John E; Yu, Ren; Lee, Paul; Bressler, Neil; Revicki, Dennis A

2014-03-01

Understanding how individuals value health states is central to patient-centered care and to health policy decision making. Generic preference-based measures of health may not effectively capture the impact of ocular diseases. Recently, 6 items from the National Eye Institute Visual Function Questionnaire-25 were used to develop the Visual Function Questionnaire-Utility Index health state classification, which defines visual function health states. To describe elicitation of preferences for health states generated from the Visual Function Questionnaire-Utility Index health state classification and development of an algorithm to estimate health preference scores for any health state. Nonintervention, cross-sectional study of the general community in 4 countries (Australia, Canada, United Kingdom, and United States). A total of 607 adult participants were recruited from local newspaper advertisements. In the United Kingdom, an existing database of participants from previous studies was used for recruitment. Eight of 15,625 possible health states from the Visual Function Questionnaire-Utility Index were valued using time trade-off technique. A θ severity score was calculated for Visual Function Questionnaire-Utility Index-defined health states using item response theory analysis. Regression models were then used to develop an algorithm to assign health state preference values for all potential health states defined by the Visual Function Questionnaire-Utility Index. Health state preference values for the 8 states ranged from a mean (SD) of 0.343 (0.395) to 0.956 (0.124). As expected, preference values declined with worsening visual function. Results indicate that the Visual Function Questionnaire-Utility Index describes states that participants view as spanning most of the continuum from full health to dead. Visual Function Questionnaire-Utility Index health state classification produces health preference scores that can be estimated in vision-related studies that include the National Eye Institute Visual Function Questionnaire-25. These preference scores may be of value for estimating utilities in economic and health policy analyses.

Patient satisfaction with health care services at a national institute of ophthalmology.

PubMed

Van Huy, Nguyen; Dung, Nguyen Ngoc; Thang, Cao Duc; Hanh, Le Thuy

2018-01-01

Little is known about how patients in developing countries, such as Vietnam, are satisfied with eye care services. The purpose of this study was to assess the satisfaction with health services and its associated factors among patients attending a national institute of ophthalmology in Vietnam. In a cross-sectional study utilizing quantitative methods, 500 inpatients and their relatives attending a national institute of ophthalmology in Vietnam were approached for data collection. The results indicated that under 50% of the patients were satisfied with eye care services. However, when classified by level of satisfaction, only 6.8% were very satisfied with all domains of care. There was no significant difference in satisfaction by gender and income, while significant differences by department, residence, and education were found. Patients who were from rural areas, were better educated, and used the services of the glaucoma department, were more satisfied with eye care than those from urban areas, were less educated, and used the services of treatment-on-demand department. Multivariable regression detected 2 main factors, gender and location, associated with patient satisfaction. Patients who were female and came from rural and remote areas were more likely to be satisfied than patients who were male and living in urban areas. The study suggests that to continue to improve health care quality, it is important to eliminate differences in providing eye care services regardless of whether patients are male or female, and whether they come from a rural or urban area. Copyright © 2017 John Wiley & Sons, Ltd.

Self-reported cataracts in older adults in Ghana: sociodemographic and health related factors.

PubMed

Yawson, Alfred E; Ackuaku-Dogbe, Edith M; Seneadza, Nana A Hagan; Mensah, George; Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul; Biritwum, Richard B

2014-09-12

Changes in function of sensory organs with increasing age have significant impact on health and wellbeing of older persons. This paper describes cataract, a chronic eye condition, self-reported among older adults in Ghana and the need for improving access to eye care services. This work was based on the World Health Organization's multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. SAGE Wave 1 in Ghana was conducted in 2007-2008 in a nationally representative sample of 4278 older adults, ≥ 50 years. Data were obtained on sociodemographic and health factors related to self-reported cataracts in older persons in Ghana. Data were analysed using descriptive measures (frequencies and proportions), chi-square test for associations in categorical outcome measures, and logistic regression for predictors of cataracts with SPSS version 21. Overall prevalence of self-reported cataracts among 4278 older adults in Ghana was 5.4%. Prevalence was proportionately higher for women (5.9%) than men (4.7%). Reported cataracts increased with age, among urban residents, in older adults living without partners and among those with the worse life satisfaction index. Older adults in lower income groups, poorly educated or living alone had difficulty seeking vision care services. Prevalence was 8.4% among persons with diabetes, 10.4% among hypertensives and 11.4% in persons with previous history of stroke. Among older persons who had ever used alcohol or tobacco, prevalence rates of reported cataracts were 5.7% and 4.9%, respectively. Logistic regression analysis indicated that increasing age, lower income status and self-reported hypertension were significantly associated with cataract among older adults in Ghana. Cataract is prevalent in older people in Ghana with approximately 1 in 20 people aged 50 years or older reporting a previous diagnosis of cataract. As cataract surgery is restorative, a public health approach on behavioural modification, well structured national outreach eye care services (for rural residents), inclusion of basic eye health services at sub-district levels, increased family support and national health insurance for older persons is indicated.

Progress Against Zika

MedlinePlus

... to 2016, the World Health Organization declared the Zika virus a world health crisis. The U.S. National Institute ... joint pain, and conjunctivitis (red eyes). However, when Zika infection occurs during pregnancy, the pregnant woman can pass the virus to her fetus, which can result in a ...

Sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea: Korea Health and Nutrition Examination Survey 2008–2012

PubMed Central

Rim, Tyler Hyungtaek; Choi, Moonjung; Yoon, Jin Sook; Kim, Sung Soo

2015-01-01

Objective To determine the sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea. Design Nationwide cross-sectional study Methods 25 752 Koreans over the age of 30 were assessed from a national representative survey. We analysed independent variables of self-reporting eye clinic visits through multivariable analyses of sociodemographic factors. The time since the last visit to an eye clinic was used to assess access to and utilisation of eye care. Results Of the 25 752 respondents, 8237 (32.0%) visited an eye clinic in the past year, 11 028 (42.8%) were seen more than 1 year ago, while 6487 (25.2%) had never seen an ophthalmologist. Eye clinic utilisation was statistically associated with older age, female sex, higher household income, higher education levels, living in an urban area, and having comorbidities including diabetes and hypertension. Middle-aged men between 30 and 49 years were found to be less likely to receive eye care compared to the rest of the population, and the proportion that did plummeted after the financial crisis of 2007. Conclusions There is a substantial sociodemographic disparity in eye care utilisation in Korea, and men with low financial income and education level are especially at risk. Use of eye care among middle-aged men has decreased since the global financial crisis that began in 2007, and therefore healthcare policies and public interventions should be targeted at vulnerable groups to promote access to medical care. PMID:26185177

Machine Learning Approaches for Detecting Diabetic Retinopathy from Clinical and Public Health Records.

PubMed

Ogunyemi, Omolola; Kermah, Dulcie

2015-01-01

Annual eye examinations are recommended for diabetic patients in order to detect diabetic retinopathy and other eye conditions that arise from diabetes. Medically underserved urban communities in the US have annual screening rates that are much lower than the national average and could benefit from informatics approaches to identify unscreened patients most at risk of developing retinopathy. Using clinical data from urban safety net clinics as well as public health data from the CDC's National Health and Nutrition Examination Survey, we examined different machine learning approaches for predicting retinopathy from clinical or public health data. All datasets utilized exhibited a class imbalance. Classifiers learned on the clinical data were modestly predictive of retinopathy with the best model having an AUC of 0.72, sensitivity of 69.2% and specificity of 55.9%. Classifiers learned on public health data were not predictive of retinopathy. Successful approaches to detecting latent retinopathy using machine learning could help safety net and other clinics identify unscreened patients who are most at risk of developing retinopathy and the use of ensemble classifiers on clinical data shows promise for this purpose.

An eye on nutrition: The role of vitamins, essential fatty acids, and antioxidants in age-related macular degeneration, dry eye syndrome, and cataract.

PubMed

McCusker, Meagen M; Durrani, Khayyam; Payette, Michael J; Suchecki, Jeanine

2016-01-01

Visual impairment is a global epidemic. In developing countries, nutritional deficiency and cataracts continue to be the leading cause of blindness, whereas age-related macular degeneration (AMD) and cataracts are the leading causes in developed nations. The World Health Organization has instituted VISION 2020: "The Right to Sight" as a global mission to put an end to worldwide blindness. In industrialized societies, patients, physicians, researchers, nutritionists, and biochemists have been looking toward vitamins and nutrients to prevent AMD, cataracts, and dry eye syndrome (DES). Nutrients from the AREDS2 study (lutein, zeaxanthin, vitamin C, vitamin E, zinc, copper, eicosapentanoic acid [EPA], and docosahexanoic acid [DHA]) set forth by the National Institutes of Health remain the most proven nutritional therapy for reducing the rate of advanced AMD. Omega-3 fatty acids, especially DHA, have been found to improve DES in randomized clinical trials. Conflicting results have been seen with regard to multivitamin supplementation on the prevention of cataract. Copyright © 2016. Published by Elsevier Inc.

Sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea: Korea Health and Nutrition Examination Survey 2008-2012.

PubMed

Rim, Tyler Hyungtaek; Choi, Moonjung; Yoon, Jin Sook; Kim, Sung Soo

2015-07-16

To determine the sociodemographic and health behavioural factors associated with access to and utilisation of eye care in Korea. Nationwide cross-sectional study 25,752 Koreans over the age of 30 were assessed from a national representative survey. We analysed independent variables of self-reporting eye clinic visits through multivariable analyses of sociodemographic factors. The time since the last visit to an eye clinic was used to assess access to and utilisation of eye care. Of the 25,752 respondents, 8237 (32.0%) visited an eye clinic in the past year, 11 028 (42.8%) were seen more than 1 year ago, while 6487 (25.2%) had never seen an ophthalmologist. Eye clinic utilisation was statistically associated with older age, female sex, higher household income, higher education levels, living in an urban area, and having comorbidities including diabetes and hypertension. Middle-aged men between 30 and 49 years were found to be less likely to receive eye care compared to the rest of the population, and the proportion that did plummeted after the financial crisis of 2007. There is a substantial sociodemographic disparity in eye care utilisation in Korea, and men with low financial income and education level are especially at risk. Use of eye care among middle-aged men has decreased since the global financial crisis that began in 2007, and therefore healthcare policies and public interventions should be targeted at vulnerable groups to promote access to medical care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

75 FR 57968 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... closed to the public in accordance with the provisions set forth in section 552b(c)(6), Title 5 U.S.C.... Visitors will be asked to show one form of identification (for example, a government-issued photo ID..., Vision Research, National Institutes of Health, HHS) Dated: September 17, 2010. Jennifer Spaeth, Director...

77 FR 55852 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... in accordance with the provisions set forth in section 552b(c)(6), Title 5 U.S.C., as amended, for.... Visitors will be asked to show one form of identification (for example, a government-issued photo ID... Research, National Institutes of Health, HHS) Dated: September 5, 2012. Melanie J. Gray, Program Analyst...

77 FR 8266 - National Eye Institute; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... in accordance with the provisions set forth in section 552b(c)(6), Title 5 U.S.C., as amended, for.... Visitors will be asked to show one form of identification (for example, a government-issued photo ID... Research, National Institutes of Health, HHS) Dated: February 8, 2012. Jennifer S. Spaeth, Director, Office...

Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey.

PubMed

Do, Young Kyung; Eggleston, Karen N

2011-08-01

To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system. Bivariate and multiple regression analyses of data from a cross-sectional health survey. A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey. Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418). Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale. Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes. While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

Are higher blood mercury levels associated with dry eye symptoms in adult Koreans? A population-based cross-sectional study.

PubMed

Chung, So-Hyang; Myong, Jun-Pyo

2016-04-27

The purpose of this study was to investigate whether blood mercury concentrations associated with the presence of dry eye symptoms in a nationally representative Korean population. Population-based prospective cross-sectional study using the heavy metal data set of the 2010-2012 Korean National Health and Nutrition Examination Survey (KNHANES). A total of 4761 adult Koreans were the eligible population in this study. Of the 7162 survey participants, 2401 were excluded because they were <19 years of age, there were missing data in the heavy metal data set, or they had diabetes, rheumatoid arthritis, thyroid disease, asthma, depression and/or under-the-eye surgery. Blood mercury levels were measured on the day the participants completed a questionnaire regarding the presence of dry eye symptoms (persistent dryness or eye irritation). The population was divided into low and high groups by median level (4.26 and 2.89 µg/L for males and females, respectively). Self-reported dry eye symptoms were present in 13.0% of the cohort. Participants with dry eye symptoms were significantly more likely to have blood mercury levels exceeding the median than those without dry eye symptoms (45.7% vs 51.7%, p=0.021). Logistic regression analysis showed that, after adjusting for age, gender, education, total household income, smoking status, heavy alcohol use, sleep time, perceived stress status, total cholesterol levels and atopy history, dry eye symptoms were significantly associated with blood mercury levels that exceeded the median (reference: lower mercury group; OR, 1.324; 95% CI 1.059 to 1.655; p<0.05). High blood mercury levels were associated with dry eye symptoms in a nationally representative Korean population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prospect of Health-Plan Tax Draws Union Opposition

ERIC Educational Resources Information Center

Klein, Alyson

2009-01-01

The national teachers' unions are nervously eyeing a provision in a Senate version of the health-care overhaul now working its way through Congress that they say could ultimately squeeze medical benefits for educators. The language would tax insurance companies and plan administrators that offer what the measure defines as high-cost health…

NIH Turns Blind Eye to Academics' Financial Conflicts, Audit Says

ERIC Educational Resources Information Center

Brainard, Jeffrey

2008-01-01

Hundreds of financial conflicts of interest among university researchers have not been investigated by the National Institutes of Health, an agency that should police them, according to a new audit report. The report, by the inspector general of the Department of Health and Human Services--NIH's parent agency--describes a dysfunctional system that…

Dry eye in the beaver dam offspring study: prevalence, risk factors, and health-related quality of life.

PubMed

Paulsen, Adam J; Cruickshanks, Karen J; Fischer, Mary E; Huang, Guan-Hua; Klein, Barbara E K; Klein, Ronald; Dalton, Dayna S

2014-04-01

To estimate dry eye prevalence in the Beaver Dam Offspring Study (BOSS), including a young adult population, and investigate associated risk factors and impact on health-related quality of life. Cohort study. The BOSS (2005-2008) is a study of aging in the adult offspring of the population-based Epidemiology of Hearing Loss Study cohort. Questionnaire data on health history, medication use, risk factors, and quality of life were available for 3275 participants. Dry eye was determined by self-report of frequency of symptoms and the intensity of those symptoms. Associations between dry eye and risk factors were analyzed using logistic regression. The prevalence of dry eye in the BOSS was 14.5%: 17.9% of women and 10.5% of men. In a multivariate model, statistically significant associations were found with female sex (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.33-2.11), current contact lens use (OR, 2.01; 95% CI, 1.53-2.64), allergies (OR, 1.59; 95% CI, 1.22-2.08), arthritis (OR, 1.44; 95% CI, 1.12-1.85), thyroid disease (OR, 1.43; 95% CI, 1.02-1.99), antihistamine use (OR, 1.54; 95% CI, 1.18-2.02), and steroid use (OR, 1.54; 95% CI, 1.16-2.06). Dry eye was also associated with lower scores on the Medical Outcomes Study Short Form 36 (β = -3.9, P < .0001) as well as on the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) (β = -3.4, P < .0001) when controlling for age, sex, and comorbid conditions. The prevalence of dry eye and its associated risk factors in the BOSS were similar to previous studies. In this study, dry eye was associated with lower quality of life on a health-related quality-of-life instrument and the vision-specific NEI VFQ-25. Copyright © 2014 Elsevier Inc. All rights reserved.

Molecular medicine in ophthalmic care.

PubMed

Richer, Stuart; Stiles, William; Thomas, Carla

2009-12-01

Lipofuscin is the most consistent and phylogenically constant morphologic marker of cellular aging. Autofluorescence of the A2E fluorophore within retinal pigment epithelial (RPE) lipofuscin affords the opportunity for noninvasive evaluation of age- and disease-related pathophysiological changes in the human retina. It is being used in National Eye Institute/Age-Related Eye Disease Study II to evaluate age-related macular degeneration (AMD) geographic atrophy expansion. Experiments show lipofuscin can be reversed in cell culture and animal models in heart, brain, spinal cord, and retinal tissues, using an array of antioxidants and iron chelators. An 80-year-old man with a gastric resection presented with complaints of unremitting night driving difficulty despite treatment with lutein and omega III fatty acids. Notable parafoveal deposition of retinal lipofuscin by 50 degrees fundus auto-fluorescence (580 nm excitation/660 barrier filters) and concurrent abnormalities in non-Snellen measures of visual function-Contrast Sensitivity Function, 6.5 degrees large field tritan threshold, 10 degrees threshold visual fields, and deficits in the National Institutes of Health/National Eye Institute Visual Function Questionnaire (VFQ) 25 subjective night driving/mental health subscale questionnaire were obtained. The patient was placed on an over-the-counter daily oral polyphenolic mixture containing resveratrol and re-evaluated 5 months later. The data reveal improvements in all measures of visual function, subjective improvement in vision and mental functioning on the VFQ 25, and visible clearing of RPE lipofuscin. To our knowledge, we believe this to be the first reported human clinical case of lipofuscin reversal in the human eye correlated with measured clinical and subjective improvement in visual and mental function after nutraceutical intervention.

Under the Weather: Farmworker Health. A Compendium of Farmworker Testimony before the National Advisory Council on Migrant Health (Fort Lupton, Colorado, September 7, 1991; San Diego, California, April 4, 1992; Portland, Oregon, October 23, 1992).

ERIC Educational Resources Information Center

Galarneau, Charlene A., Ed.

This document highlights farmworkers' testimonies concerning farmworker health taken during three hearings. Six consistent themes emerged from farmworker accounts: (1) health and health care; (2) work conditions; (3) pesticide exposure; (4) housing; (5) women; and (6) children and youth. Farmworkers frequently mentioned injuries, eye problems, and…

Research as Cultural Renewal: Applying Two-Eyed Seeing in a Research Project about Cultural Interventions in First Nations Addictions Treatment

PubMed Central

Hall, Laura; Dell, Colleen A.; Fornssler, Barb; Hopkins, Carol; Mushquash, Christopher; Rowan, Margo

2016-01-01

This article explores the application of two-eyed seeing in the first year of a three-year study about the effectiveness of cultural interventions in First Nations alcohol and drug treatment in Canada. Two-eyed seeing is recognized by Canada’s major health research funder as a starting point for bringing together the strengths of Indigenous and Western ways of knowing. With the aim of developing a culture-based measurement tool, our team carried out an Indigenous-centred research process with our interpretation of two-eyed seeing as a guiding principle. This enabled us to engage in a decolonizing project that prioritized Indigenous methodologies and ways of knowing and knowledge alongside those of Western science. By concentrating on Indigenous governance in the research process, our project supported efforts at Indigenous cultural renewal. Two illustrations are offered, our team’s reconceptualization of Western derived understandings of data collection through Indigenous storytelling and our research grant timeframe with Indigenous knowledge gardening. This article contributes to the Indigenous research and policy literature which is lacking documentation about how Indigenous communities and research teams are benefitting from two-eyed seeing. PMID:27867445

[Dry eye syndrome. Occupational risk factors, valuation and prevention].

PubMed

Vicente-Herrero, M T; Ramírez-Iñiguez de la Torre, M V; Terradillos-García, M J; López González, Á A

2014-03-01

Dry eye syndrome in the workplace is associated with new ways of working, with increasing use of screens and electronic devices and environmental conditions encountered in modern office designs and other environments. Also affect occupational exposure to ionizing radiation, chemicals or atmospheric dust with increased ocular dryness. The study of pathophysiological aspects and laboral causality of the dry eye, must be to develop joint task in Occupational Health, Public Health in coordination with and responsible for the national health system, which would involve primary and secondary preventive measures more effective and proper diagnosis, control and monitoring of the disease, A better knowledge of occupational hazards and actions agreed and coordinated between occupational physicians, preventers, primary care physicians and specialist physicians, such as ophthalmology, will get results much more effective when earlier and optimize available resources. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Prevalence and risk factors of visual impairment and blindness in Korea: the Fourth Korea National Health and Nutrition Examination Survey in 2008-2010.

PubMed

Rim, Tyler H T; Nam, Jae S; Choi, Moonjung; Lee, Sung C; Lee, Christopher S

2014-06-01

To describe the age, gender specific prevalence and risk factors of visual impairment and blindness in Korea. From 2008 to 2010, a total 14 924 randomly selected national representative participants of the Korea National Health and Nutrition Examination Survey underwent additional ophthalmologic examinations by the Korean Ophthalmologic Society. Best Corrected Distance Visual Acuity was measured using an international standard vision chart based on Snellen scale (Jin's vision chart). Independent risk factors for visual impairment were investigated using multivariate logistic regression analysis. The overall prevalence of visual impairment (≤20/40) of adults 40 years and older was 4.1% (95% CI, 3.6-4.6) based on the better seeing eye. The overall prevalence of blindness (≤20/200) for adults 40 years and older was 0.2% (95% CI, 0.1-0.3). Risk indicators of visual impairment were increasing age, low education status, living in rural area, being unemployed, being without spouse and the absence of private health insurance. The visually impaired were more likely to have eye diseases compared with the normal subjects, and they were less likely to utilize eye care. The prevalence of visual impairment was demonstrated to be higher while that of blindness was similar to previous population studies in Asia or U.S. Sociodemographic disparities are present in the prevalence of visual impairment and more targeted efforts are needed to promote vision screening in high risk groups. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

NIH Study Provides Clarity on Supplements for Protection Against Blinding Eye Disease

MedlinePlus

... from the National Institutes of Health (NIH). The plant-derived antioxidants lutein and zeaxanthin also had no ... performed. Omega-3 fatty acids are produced by plants, including algae, and are present in oily fish ...

Ensuring standards for the extended role of optometry.

PubMed

Jarvis, Ian; Ker, Jean

2014-06-01

In optometry, as in other health professions, such as pharmacy and nursing, there has been an expansion in the role of the optometrist in primary eye care, taking on aspects of care such as prescribing, which was traditionally undertaken by general practitioners. In optometry, this extended role involves monitoring eye conditions that do not require treatment or monitoring in secondary care, roles that were traditionally referred on. However, any extended role requires educational support. The development of a national educational programme can prevent any duplication of effort and provide a system of disseminating support to practitioners, who often work in isolation. The National Education Programme was developed and supported by the National Health Service (NHS) Education for Scotland (NES). This a national body responsible for supporting NHS services in Scotland, by developing and delivering education and training for those who work in NHS Scotland. Optometrists were given educational support in three main stages: simulation of component skills; safe learning in a simulated health care context; and support for the transfer of those skills to practice, including the use of mentoring via e-mail. The evaluation of this three-stage process has been positive. To further develop any expanded role in health care practice, safe guidelines for practice are required. Simulation can provide support at the start of this process in setting standards. However, mentorship in the practice area, as reported in this study, was required to embed newly acquired skills. © 2014 John Wiley & Sons Ltd.

Close the gap for vision: The key is to invest on coordination.

PubMed

Hsueh, Ya-seng Arthur; Dunt, David; Anjou, Mitchell D; Boudville, Andrea; Taylor, Hugh

2013-12-01

The study aims to estimate costs required for coordination and case management activities support access to treatment for the three most common eye conditions among Indigenous Australians, cataract, refractive error and diabetic retinopathy. Coordination activities were identified using in-depth interviews, focus groups and face-to-face consultations. Data were collected at 21 sites across Australia. The estimation of costs used salary data from relevant government websites and was organised by diagnosis and type of coordination activity. Urban and remote regions of Australia. Needs-based provision support services to facilitate access to eye care for cataract, refractive error and diabetic retinopathy to Indigenous Australians. Cost (AUD$ in 2011) of equivalent full time (EFT) coordination staff. The annual coordination workforce required for the three eye conditions was 8.3 EFT staff per 10 000 Indigenous Australians. The annual cost of eye care coordination workforce is estimated to be AUD$21 337 012 in 2011. This innovative, 'activity-based' model identified the workforce required to support the provision of eye care for Indigenous Australians and estimated their costs. The findings are of clear value to government funders and other decision makers. The model can potentially be used to estimate staffing and associated costs for other Indigenous and non-Indigenous health needs. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Age-Related Eye Diseases and Visual Impairment Among U.S. Adults

PubMed Central

Chou, Chiu-Fang; Cotch, Mary Frances; Vitale, Susan; Zhang, Xinzhi; Klein, Ronald; Friedman, David S.; Klein, Barbara E.K.; Saaddine, Jinan B.

2014-01-01

Background Visual impairment is a common health-related disability in the U.S. The association between clinical measurements of age-related eye diseases and visual impairment in data from a national survey has not been reported. Purpose To examine common eye conditions and other correlates associated with visual impairment in the U.S. Methods Data from the 2005–2008 National Health and Nutrition Examination Survey of 5222 Americans aged ≥40 years were analyzed in 2012 for visual impairment (presenting distance visual acuity worse than 20/40 in the better-seeing eye), and visual impairment not due to refractive error (distance visual acuity worse than 20/40 after refraction). Diabetic retinopathy (DR) and age-related macular degeneration (AMD) were assessed from retinal fundus images; glaucoma was assessed from two successive frequency-doubling tests and a cup-to-disc ratio measurement. Results Prevalence of visual impairment and of visual impairment not due to refractive error was 7.5% (95% CI=6.9%, 8.1%) and 2.0% (1.7%, 2.3%), respectively. The prevalence of visual impairment not due to refractive error was significantly higher among people with AMD (2.2%) compared to those without AMD (0.8%), or with DR (3.5%) compared to those without DR (1.2%). Independent predictive factors of visual impairment not due to refractive error were AMD (OR=4.52, 95% CI=2.50, 8.17); increasing age (OR=1.09 per year, 95% CI=1.06, 1.13); and less than a high school education (OR=2.99, 95% CI=1.18, 7.55). Conclusions Visual impairment is a public health problem in the U.S. Visual impairment in two thirds of adults could be eliminated with refractive correction. Screening of the older population may identify adults at increased risk of visual impairment due to eye diseases. PMID:23790986

Patient Awareness of Cataract and Age-related Macular Degeneration among the Korean Elderly: A Population-based Study.

PubMed

Lee, Hankil; Jang, Yong Jung; Lee, Hyung Keun; Kang, Hye Young

2017-12-01

Age-related eye disease is often considered part of natural aging. Lack of awareness of eye conditions can result in missed treatment. We investigated the rates of awareness of cataract and age-related macular degeneration, the most common age-related eye-diseases, and the associated factors among elderly Koreans. We identified 7,403 study subjects (≥40 years old) with cataract or age-related macular degeneration based on ophthalmic examination results during the 5th Korean National Health and Nutrition Examination Survey conducted between 2010 and 2012. We assessed whether patients were aware of their eye condition based on a previous diagnosis by a physician. The average awareness rate over the 3-year study period was 23.69% in subjects with cataract and 1.45% in subjects with age-related macular degeneration. Logistic regression analysis showed that patients with cataract were more likely to recognize their condition if they had myopia (odds ratio, 2.08), hyperopia (odds ratio, 1.33), family history of eye disease (odds ratio, 1.44), or a past eye examination (odds ratio, 4.07-29.10). The presence of diabetes mellitus was also a significant predictor of patient awareness of cataract (odds ratio, 1.88). Poor patient recognition of eye disease among the Korean elderly highlights the seriousness of this potential public health problem in our aging society. Pre-existing eye-related conditions and diabetes were significant predictors of awareness; therefore, patients in frequent contact with their doctors have a greater chance of detecting eye disease. © 2017 The Korean Ophthalmological Society

The Relationship between Visual Impairment and Health-Related Quality of Life in Korean Adults: The Korea National Health and Nutrition Examination Survey (2008–2012)

PubMed Central

Park, Yuli; Shin, Jeong Ah; Yang, Suk Woo; Yim, Hyeon Woo; Kim, Hyun Seung; Park, Young-Hoon

2015-01-01

Introduction To evaluate health-related quality of life (HRQoL) in Korean adults with visual impairment(VI) using various measures based on a nationally distributed sample. Methods Using the Korea National Health and Nutrition Examination Survey (KNHANES, 2008–2012) data, we compared EuroQol five-dimensional questionnaire (EQ-5D) and EQ-visual analogue scale (VAS) scores after adjusting for socio-demographic and psychosocial factors as well as for comorbidities with VI. Logistic regressions were used to elucidate determinants for the lowest quintile HRQoL scales according to VI severity. Uncorrected visual acuity (VA) which implies vision of ordinary life was measured using an international standard vision chart based on Snellen scale. Results 28,825 participants (sum of weights; 37,562,376) were included in the analysis. The mean EQ-5D and EQ-VAS scores were significantly lower in the VI groups than in the normal vision (defined as VA 20/20-20/25) group based on the better or worse seeing eye (P<.0001 and P<.0001, respectively). Participants with moderate (VA 20/80-20/160) and severe VI (VA ≤20/200) had higher scores of multivariate-adjusted odd ratios (aORs) for the lowest quintile than did the normal vision group which was particularly evident in the results from EQ-5D, whereas the results of the mild VI (VA 20/32-20/63) group did not identify significant differences from the normal vision group independent of classification according to the better or the worse seeing eye. Conversely, EQ-VAS revealed significantly higher score of multivariate-aORs for the lowest quintile in participants with mild VI either for the better or worse seeing eye. Conclusions The severity of VI was definitely associated with impaired HRQoL compared with the normal vision population. The analyses presented here elicited even mild VI could potentially deteriorate the health-related quality of life (or subjective perception of health quality) and therefore, therapeutic approaches should also focus on the subjective perception and better management of health condition. PMID:26192763

Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study

PubMed Central

Huang, Ling-Ya; Wang, Yu-Chun; Wu, Chin-Ching

2016-01-01

Floods are known to cause serious environmental damage and health impacts. Studies on flood-related diseases have been primarily on individual events, and limited evidence could be drawn on potential health impacts from floods using large population data. This study used reimbursement records of one million people of the Taiwan National Health Insurance program to compare incident diseases of the eyes, skin and gastrointestinal (GI) tract associated with floods. Incidence rates for the selected diseases were calculated according to outpatient/emergency visit data. The incidence rates were evaluated by flood status: in 10 days before floods, during floods and within 10 days after the floods receded. Outpatient/emergency visit rates for the eye, skin and GI tract diseases were highest after floods and lowest during floods. Results from multivariate Poisson regression analyses showed that, when compared with the incidence in 10 days before floods, the incidence rate ratios (IRR) of diseases within 10 days after floods were 1.15 (95% confidence interval (CI) = 1.10–1.20) for eyes, 1.08 (95% C.I. = 1.05–1.10) for skin, and 1.11 (95% CI = 1.08–1.14) for GI tract, after controlling for covariates. All risks increased with ambient temperature. V-shaped trends were found between age and eye diseases, and between age and GI tract diseases. In contrast, the risk of skin diseases increased with age. In conclusion, more diseases of eyes, skin and GI tract could be diagnosed after the flood. PMID:27171415

The Duke Elder Lecture: The challenge of equitable eye care in Pakistan

PubMed Central

Khan, M D

2011-01-01

Purpose Pakistan, like many other developing countries, is caught in the vicious cycle of poverty, illiteracy, violence, and disease. Right from its inception, it has been facing serious challenges of fast growing population, longevity, unemployment, wars, floods, double burden of diseases including blindness, as well as earthquakes, insurgencies, and political instability. Despite such challenges, the country has managed to reduce the burden of blindness from 1.78% in 1987-88 to 0.9% in 2003.This paper will highlight the methods used to achieve such a difficult goal. Methods The country used the report of the World Health Organization (WHO) temporary consultant as the initial tool for advocacy to obtain political and professional commitment. Results from the first National Blindness Survey 1987–1990 were used as baseline for development of the programme. Under the Ministry of Health, national and provincial committees with respective coordinators were constituted. To ensure access and equity, the national programme was developed on the basis of district comprehensive eye care services. The concept was carefully tested in a laboratory and then piloted in a real district before it was rolled over to the country. Strong national institutes for human resource development, research and development, and service delivery were established. A strong network of high-quality national institutes was set up and run by powerful national non-governmental organizations. The second National Blindness Survey evaluated the achievements of the programme in 2001–2003. Conclusion National prevalence of blindness was reduced by 100% by improving the uptake of services at the district level, especially by females. PMID:21252948

The Duke Elder lecture: the challenge of equitable eye care in Pakistan.

PubMed

Khan, M D

2011-04-01

Pakistan, like many other developing countries, is caught in the vicious cycle of poverty, illiteracy, violence, and disease. Right from its inception, it has been facing serious challenges of fast growing population, longevity, unemployment, wars, floods, double burden of diseases including blindness, as well as earthquakes, insurgencies, and political instability. Despite such challenges, the country has managed to reduce the burden of blindness from 1.78% in 1987-88 to 0.9% in 2003.This paper will highlight the methods used to achieve such a difficult goal. The country used the report of the World Health Organization (WHO) temporary consultant as the initial tool for advocacy to obtain political and professional commitment. Results from the first National Blindness Survey 1987-1990 were used as baseline for development of the programme. Under the Ministry of Health, national and provincial committees with respective coordinators were constituted. To ensure access and equity, the national programme was developed on the basis of district comprehensive eye care services. The concept was carefully tested in a laboratory and then piloted in a real district before it was rolled over to the country. Strong national institutes for human resource development, research and development, and service delivery were established. A strong network of high-quality national institutes was set up and run by powerful national non-governmental organizations. The second National Blindness Survey evaluated the achievements of the programme in 2001-2003. National prevalence of blindness was reduced by 100% by improving the uptake of services at the district level, especially by females.

Nutrients for the aging eye

PubMed Central

Rasmussen, Helen M; Johnson, Elizabeth J

2013-01-01

The incidence of age-related eye diseases is expected to rise with the aging of the population. Oxidation and inflammation are implicated in the etiology of these diseases. There is evidence that dietary antioxidants and anti-inflammatories may provide benefit in decreasing the risk of age-related eye disease. Nutrients of interest are vitamins C and E, β-carotene, zinc, lutein, zeaxanthin, and the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. While a recent survey finds that among the baby boomers (45–65 years old), vision is the most important of the five senses, well over half of those surveyed were not aware of the important nutrients that play a key role in eye health. This is evident from a national survey that finds that intake of these key nutrients from dietary sources is below the recommendations or guidelines. Therefore, it is important to educate this population and to create an awareness of the nutrients and foods of particular interest in the prevention of age-related eye disease. PMID:23818772

NIH Casts Critical Eye on How It Gives Grants

ERIC Educational Resources Information Center

Brainard, Jeffrey

2007-01-01

The National Institutes of Health's methods for reviewing and financing academic research proposals are often praised as the gold standard. Some American scientists, though, have recently offered less flattering descriptions, like "broken" and "arbitrary." NIH officials have heard both arguments, and plenty in between, in recent months. They have…

Cost of dry eye treatment in an Asian clinic setting.

PubMed

Waduthantri, Samanthila; Yong, Siew Sian; Tan, Chien Hua; Shen, Liang; Lee, Man Xin; Nagarajan, Sangeetha; Hla, Mynt Htoon; Tong, Louis

2012-01-01

To estimate the cost and patterns of expenditure of dry eye treatment. We retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008-2009) retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD) treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE). Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha  =  0.05. Cost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (p<0.001) whereas number of units purchased in preserved lubricants and ointments/gels have reduced significantly (p<0.001) from 2008 to 2009. Dry eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true societal costs of Dry eye syndrome are likely to be much higher than estimated.

Protect Their Eyes: An Eye Safety Guide for the Classroom.

ERIC Educational Resources Information Center

Ohio Society to Prevent Blindness, Columbus.

This guide provides information on eye safety and aids educators, administrators, and supervisors in the development and implementation of eye safety programs. The American National Standards Institute (AMSI) requirements for both street and safety glasses; essential eyewear for safety in hazardous areas; the National Society to Prevent…

The Cost-Effectiveness of Three Screening Alternatives for People with Diabetes with No or Early Diabetic Retinopathy

PubMed Central

Rein, David B; Wittenborn, John S; Zhang, Xinzhi; Allaire, Benjamin A; Song, Michael S; Klein, Ronald; Saaddine, Jinan B

2011-01-01

Objective To determine whether biennial eye evaluation or telemedicine screening are cost-effective alternatives to current recommendations for the estimated 10 million people aged 30–84 with diabetes but no or minimal diabetic retinopathy. Data Sources United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule. Study Design Cost-effectiveness Monte Carlo simulation. Data Collection/Extraction Methods Literature review, analysis of existing surveys. Principal Findings Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model. Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error. The current annual eye evaluation recommendation was costly compared with either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of U.S.$37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels. Conclusions Annual eye evaluations are costly and add little benefit compared with either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation. PMID:21492158

Protecting your eyes in the laser operating room.

PubMed

Sallavanti, R A

1995-01-01

1. Laser protective eyewear is nearly as important to the OR nurse as the surgical mask in an operating room where laser surgery is performed. 2. Most hospitals require OR personnel to wear protective eyewear during laser procedures in voluntary compliance with American National Standards Institute (ANSI) Z136.3 for the safe use of lasers in health care facilities. 3. The basic steps to protecting your eyes are as follows: Select the appropriate eyewear (plastic or glass); make sure the eyewear fits properly; wear the protective lenses during laser testing and operation; and heed your laser safety officer.

The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.

PubMed

Lipton, Brandy J; Decker, Sandra L

2016-02-01

Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.

Trends in the distribution of donor corneal tissue and indications for corneal transplantation: the New Zealand National Eye Bank Study 2000-2009.

PubMed

Cunningham, William J; Brookes, Nigel H; Twohill, Helen C; Moffatt, S Louise; Pendergrast, David G C; Stewart, Joanna M; McGhee, Charles N J

2012-03-01

To investigate the indications for corneal transplantation and the distribution of donor corneal tissue in New Zealand. Analysis of the prospective database of the New Zealand National Eye Bank. A total of 2205 corneal transplants were assessed. New Zealand National Eye Bank records were analysed for the decade 2000-2009. Variables analysed included donor corneal tissue distribution (including public and private sectors), indications for transplantation, donor corneal tissue recipient demographics (age and gender) and corneal transplantation type. An average of 220 corneal transplants were performed each year over the 10-year period (n=2205). The median recipient age was 45years (range 3 to 102years) and 54.0% of recipients were male. In total 71.8% of transplants were performed in the public health sector. Surgeons in the Auckland metropolitan area performed 47.2% of all corneal transplants. The most common indications for corneal transplantation were: keratoconus (41.1%), repeat transplant (17.0%), aphakic/pseudophakic bullous keratopathy (13.9%), corneal dystrophy (10.7%), keratitis (7.9%) and trauma (3.7%). Overall, penetrating keratoplasty accounted for 90.7% of all corneal transplants, however, during the latter half of the study there was a progressive shift in transplantation type, with deep anterior lamellar keratoplasty and Descemet's stripping endothelial keratoplasty combined accounting for 32.3% of all transplants in the final year of the study period. This New Zealand National Eye Bank study provides valuable data regarding the indications for corneal transplantation, transplant recipient demographics and changes in transplantation type in New Zealand over the past decade. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Cost of close the gap for vision of Indigenous Australians: On estimating the extra resources required.

PubMed

Hsueh, Ya-seng Arthur; Brando, Alex; Dunt, David; Anjou, Mitchell D; Boudville, Andrea; Taylor, Hugh

2013-12-01

To estimate the costs of the extra resources required to close the gap of vision between Indigenous and non-Indigenous Australians. Constructing comprehensive eye care pathways for Indigenous Australians with their related probabilities, to capture full eye care usage compared with current usage rate for cataract surgery, refractive error and diabetic retinopathy using the best available data. Urban and remote regions of Australia. The provision of eye care for cataract surgery, refractive error and diabetic retinopathy. Estimated cost needed for full access, estimated current spending and estimated extra cost required to close the gaps of cataract surgery, refractive error and diabetic retinopathy for Indigenous Australians. Total cost needed for full coverage of all three major eye conditions is $45.5 million per year in 2011 Australian dollars. Current annual spending is $17.4 million. Additional yearly cost required to close the gap of vision is $28 million. This includes extra-capped funds of $3 million from the Commonwealth Government and $2 million from the State and Territory Governments. Additional coordination costs per year are $13.3 million. Although available data are limited, this study has produced the first estimates that are indicative of the need for planning and provide equity in eye care. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

What Is Dry Eye?

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Effect of Education Sessions of a Structured School Eye Screening Programme on Indian Schoolteachers' Knowledge and Responsibility for Children's Eye Health

ERIC Educational Resources Information Center

Thummalapalli, Rohit; Williams, Jachin D.; Khoshnood, Kaveh; Salchow, Daniel J.; Forster, Susan H.

2013-01-01

Objective: To evaluate the effect of education sessions on Indian schoolteacher awareness of childhood eye health issues, responsibility for children's eye health, and successful participation in a teacher-led eye screening health intervention programme in primary schools aimed at addressing avoidable childhood blindness in India. Design:…

Why is the General Ophthalmic Services (GOS) Contract that underpins primary eye care in the U.K. contrary to the public health interest?

PubMed

Shickle, D; Davey, C J; Slade, S V

2015-07-01

The model for delivery of primary eye care in Europe varies from country to country with differing reliance on ophthalmologists, optometrists and dispensing opticians. Comparative analysis of models has tended to focus on interprofessional working arrangements, training and regulatory issues, rather than on whether a particular model is effective for delivering public health goals for that country. National Health Service (NHS) primary eye care services in the UK are predominantly provided under a General Ophthalmic Services (GOS) Contract between the NHS and practice owners (Contractors). Over two-thirds of sight tests conducted in England, Wales and Northern Ireland and all in Scotland are performed under a GOS Contract, however many people entitled to a GOS sight test do not take up their entitlement. The fee paid for sight tests conducted under a GOS Contract in England, Wales and Northern Ireland does not cover the full cost of conducting the examination. The shortfall must be made up through profits of sale of optical appliances but this business model can be a deterrent to establishing practices within socioeconomically deprived communities, and can also be a barrier to uptake of sight tests, even though many people are entitled to a NHS optical voucher towards the cost of spectacles or contact lenses. This paper critiques the GOS Contracts within the UK. We argue that aspects of the way the GOS Contract is implemented are contrary to the public health interest and that different approaches are needed to address eye health inequalities and to reduce preventable sight loss. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Photokeratitis induced by ultraviolet radiation in travelers: A major health problem

PubMed Central

Izadi, M; Jonaidi-Jafari, N; Pourazizi, M; Alemzadeh-Ansari, MH; Hoseinpourfard, MJ

2018-01-01

Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified. PMID:29067921

Photokeratitis induced by ultraviolet radiation in travelers: A major health problem.

PubMed

Izadi, M; Jonaidi-Jafari, N; Pourazizi, M; Alemzadeh-Ansari, M H; Hoseinpourfard, M J

2018-01-01

Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified.

Association between clinical diagnostic tests and health-related quality of life surveys in patients with dry eye syndrome.

PubMed

Mizuno, Yoshinobu; Yamada, Masakazu; Miyake, Yozo

2010-07-01

This study was performed to assess the impact of dry eye on patients' quality of life (QOL) and to analyze the association between subjective symptoms and ocular surface findings of dry eye. The study population consisted of 158 patients with dry eye aged 20 years or older who visited any of the 15 medical care facilities enrolled in the study. The backgrounds and ocular findings of the patients were investigated, and their QOL was evaluated with the Japanese version of the 25-item National Eye Institute Visual Functioning Questionnaire (VFQ-25) and of the Medical Outcomes Study (MOS) 8-item Short-Form Health Survey (SF-8) to examine the association between subjective symptoms and ocular surface findings. Of the patients enrolled, 15 were men and 143 were women, and their average age was 62.5 +/- 12.6 years. Sixty patients (38.0%) had comorbid Sjögren syndrome (SS). The results of Schirmer testing, fluorescein staining, and rose bengal staining for SS patients were significantly worse than those for the non-SS patients, but the VFQ-25 and SF-8 scores were not significantly different between the SS and non-SS patients. In the ocular surface findings, a weak association between the fluorescein staining scores and general vision scores, a subscale of the VFQ-25, was found. However, the ocular surface findings and VFQ-25/SF-8 results in the simple correlation analysis as well as in the multiple linear regression analysis showed no significant associations. Ocular surface findings and QOL scores of patients with dry eye appear to disagree. Therefore, it is necessary to address subjective symptoms and QOL scores in addition to examination findings when evaluating dry eye.

Eye pain

MedlinePlus

Ophthalmalgia; Pain - eye ... Pain in the eye can be an important symptom of a health problem. Make sure you tell your health care provider if you have eye pain that does not go away. Tired eyes or ...

Promoting a Message on Vision Loss to Diverse Groups of Adults: Research Report

ERIC Educational Resources Information Center

Cimarolli, Verena R.; Stuen, Cynthia; Sussman-Skalka, Carol J.

2006-01-01

Visual impairment is the second most prevalent disability among older adults (National Center for Health Statistics, 1993), affecting about 2.9 million Americans aged 65 and older (Eye Diseases Prevalence Research Group, 2004). As the population ages, the number of individuals who will experience age-related vision loss will also increase.…

Pacific Youth and Shifting Thresholds: Understanding Teen Dating Violence in Hawai'i

ERIC Educational Resources Information Center

Baker, Charlene K.; Helm, Susana

2010-01-01

The high prevalence of teen dating violence (TDV) nationally suggests that it is a public health problem in need of intervention. However, there is limited information about what constitutes TDV in the eyes of teens. Equally limited is an understanding of these parameters among diverse cultures. To fill these gaps, the current study conducted…

Nationwide incidence of blindness in South Korea: a 12-year study from 2002 to 2013.

PubMed

Rim, Tyler Hyungtaek; Kim, Dong Wook; Chung, Eun Jee; Kim, Sung Soo

2017-11-01

Blindness is an important public health issue. The background of the study is to determine the incidence of blindness in South Korea. Nationwide population-based retrospective study. All individuals from South Korea (n = 47 516 098). Patients confirmed with legal blindness based on the worse-seeing and better-seeing eyes between 1 January 2002 and 31 December 2013 were included. The Korean National Health Insurance Service (KNHIS) database was used. Using the World Health Organization definition, blindness was defined as best-corrected visual acuity in the worse-seeing and better-seeing eyes of <20/400. The mean incidence of blindness during the 12-year period was estimated. The population of South Korea was estimated using census data in 2005 and 2010. The total number of legal blindness cases in the KNHIS database. We identified 195 004 and 20 492 cases of newly developed legal blindness based on the worse-seeing and better-seeing eyes, respectively, and the mean incidences of blindness were 34.2 and 3.6 cases/100 000 person-years, respectively. The prevalence of blindness based on the worse-seeing and better-seeing eyes was 425.3 and 57.7 cases/100 000 persons, respectively. The incidence of blindness based on the worse-seeing eye was higher in men than in women overall. Additionally, the incidence increased with age and showed a decreasing trend from 2002 to 2013. The prevalence of blindness showed an increasing trend from 2002 to 2013. The findings of our study will help in the assessment of the blindness-related socio-economic burden and in healthcare planning. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

Ozone depletion and solar ultraviolet radiation: ocular effects, a United nations environment programme perspective.

PubMed

Cullen, Anthony P

2011-07-01

To describe he role played by the United Nations Environmental Effects Panel with respect to the ocular effects of stratospheric ozone depletion and present the essence of the Health Chapter of the 2010 Assessment. A consideration of solar ultraviolet radiation (UVR) at the Earth's surface as it is affected by atmospheric changes and how these influence sunlight-related eye diseases. A review of the current Assessment with emphasis on pterygium, cataract, ocular melanoma, and age-related macular degeneration. Although the ozone layer is projected to recover slowly in the coming decades, continuing vigilance is required regarding exposure to the sun. Evidence implicating solar UVR, especially UVB, in every tissue of the eye continues to be amassed. The need for ocular UV protection existed before the discovery of the depletion of the ozone layer and will continue even when the layer fully recovers in approximately 2100.

Effect of school eye health promotion on children's eye health literacy in Vietnam.

PubMed

Paudel, Prakash; Yen, Phung Thi; Kovai, Vilas; Naduvilath, Thomas; Ho, Suit May; Giap, Nguyen Viet; Holden, Brien A

2017-10-06

Health promotion intervention in schools is a useful strategy to improve students' health awareness. The purpose of this study was to assess the effect of eye health promotion interventions on eye health literacy in school children in Vietnam. A piloted questionnaire was administered to 300 children from five secondary schools in Ba Ria-Vung Tau, Vietnam at baseline and re-administered after the eye health promotion interventions. McNemar chi-square and logistic regression were used for statistical analysis. A total of 300 children aged 12-15 years (mean, 13.3 ± 1.3 years; 60% female) participated in the baseline survey. The participation rate in the post-health promotion survey was 94.7%. After the health promotion interventions, number of children who had correct eye health knowledge increased by 10-20% (60-75% to 70-95%), more children reported having had an eye examination (63.3% to 84.7%; p < 0.001) and more reported wearing spectacles (36.1% to 43.4%; p = 0.04). Children in urban schools were twice as likely to have improved knowledge of vision loss compared with children in rural schools (odds ratio, 2.1-4.1; p = 0.01 to p < 0.001). Children from rural schools had significantly higher odds of visiting doctor after the eye problems worsened (odds ratio, 4.5; p < 0.001). These results imply that eye health promotion interventions significantly improve eye health knowledge, attitudes and practices of school children. Additionally, participation of parents and teachers as change agents may further improve children's health literacy. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Association between dry eye symptoms and suicidal ideation in a Korean adult population.

PubMed

Um, Sun-Bi; Yeom, Hyungseon; Kim, Na Hyun; Kim, Hyeon Chang; Lee, Hyung Keun; Suh, Il

2018-01-01

This study assessed the association of dry eyes with depression and suicidal ideation in a Korean adult population. Data from 16408 participants (6972 men and 9436 women) aged ≥ 19 years included in the fifth Korea National Health and Nutrition Examination Survey, conducted from 2010-2012, were analyzed. For dry eyes, surveys of previous diagnosis of dry eye disease (DED) by an ophthalmologist and experience of subjective dry eye symptoms were separately used. Diagnosis of depression and suicidal ideation were obtained via responses to an interviewer-assisted questionnaire, and questions were asked in a closed-ended response format. Logistic regression was used to examine the associations between dry eyes, depression, and suicidal ideation. DED diagnosis exhibited an odds ratio (OR) of 1.32 (95% confidence interval [CI] 1.11-1.57) for depression and 1.24 (95% CI 1.05-1.48) for suicidal ideation compared to those without DED, after adjusting for sex, age, education, occupation, household income, body mass index, smoking behavior, alcohol consumption, physical activity, hypertension, diabetes, dyslipidemia, thyroid diseases, major cardiovascular disease, and cancer. Similarly, the adjusted OR (95% CI) of dry eye symptoms was 1.50 (95% CI 1.30-1.73) for depression and 1.47 (95% CI 1.27-1.70) for suicidal ideation. Our findings suggest that dry eyes (either DED diagnosis or dry eye symptoms) may be associated with the prevalence of depression and suicidal ideation in the Korean adult population.

The geographic distribution of eye care providers in the United States: Implications for a national strategy to improve vision health.

PubMed

Gibson, Diane M

2015-04-01

To describe the patterns of local eye care provider availability in the US. Data from 2011 on the number of ophthalmologists and optometrists in each of the 3143 counties in the US were drawn from the Area Health Resources File. Population-weighted quartiles of the county-level number of ophthalmologists per capita and the county-level number of optometrists per capita were defined. Descriptive statistics were calculated and a cross tabulation of quartiles of ophthalmologist availability and quartiles of optometrist availability was conducted for all the counties in the US and for the set of counties in each region of the US. 24.0% of US counties had no ophthalmologists or optometrists. 60.7% of counties in the US were in one of the lower two quartiles of both ophthalmologist availability and optometrist availability, and 24.1% of counties were in one of the lower two quartiles of ophthalmologist availability but in one of the upper two quartiles of optometrist availability. Public health interventions that are effective in a context of limited local eye care provider availability or that are able to leverage optometrist availability effectively in areas with limited ophthalmologist availability could be of widespread use in the US. Copyright © 2015 Elsevier Inc. All rights reserved.

SEVERITY OF DIABETIC RETINOPATHY AND HEALTH-RELATED QUALITY OF LIFE: THE LOS ANGELES LATINO EYE STUDY

PubMed Central

Mazhar, Kashif; Varma, Rohit; Choudhury, Farzana; McKean-Cowdin, Roberta; Shtir, Corina J.; Azen, Stanley P.

2010-01-01

Objective To assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type 2 diabetes mellitus. Design Cross-sectional population-based study, the Los Angeles Latino Eye Study (LALES). Participants 1,064 LALES participants with diabetes mellitus. Methods HRQOL was measured by the 25 item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). DR was assessed by masked standardized grading of stereoscopic photographs from 7 standard fields. Severity of DR in eyes was graded using a modified Airlie House classification. The severity scores from each eye were then concatenated to create a single per person grade ranging from 1(no DR in either eye) to 15 (bilateral PDR). Multiple linear regression analyses were performed to determine the independent relationship between severity of DR and HRQOL after adjusting for covariates. Main Outcome Measures NEI-VFQ-25 and SF-12 scores. Results More severe DR was associated with worse HRQOL scores on all of the NEI VFQ-25 and SF-12 subscales (P<0.05). Individuals with DR from grade 2 (minimum NPDR) through grade 8 (unilateral moderate NPDR) show a modest decline in HRQOL. However, the decline become significantly steeper between steps 8 (unilateral moderate NPDR) and 9-15 (bilateral moderate NPDR to bilateral PDR). The domains with the most significant impact were for vision-related daily activities, dependency and mental health. Conclusion Greater severity of DR was associated with lower general and vision-specific HRQOL. Persons with bilateral moderate NPDR had the most substantial decrease in quality of life compared to those with less severe DR. The prevention of incident DR and more importantly its progression from unilateral to bilateral NPDR is likely to have a positive impact on a person’s HRQOL and should be considered an important goal in management of individuals with diabetes mellitus. PMID:21035872

A systematic review of epidemiological literature on the eye health of marginalized fishing populations.

PubMed

Ahmad, Khabir; B Zwi, Anthony; J M Tarantola, Daniel; Chand, Bal

2016-10-01

A systematic review was conducted in December 2013 to examine the extent to which health research has been focused on the eye health issues of fishing communities. We searched multiple databases to identify relevant citations, using a combination of Medical Subject Headings (MeSH) and text words representing eye health, fishing populations and measures of disease frequency. The search yielded only 4 studies, described in 5 articles. Three studies (one each in Turkey, Egypt and Spain) provided data on self-reported eye problems in fishermen or fishery workers, with prevalence ranging from 38% to 81%. There was only one study in the literature that objectively assessed the burden and causes of vision impairment and blindness in fishing communities. None of the studies examined availability, accessibility, acceptability and quality of eye care services. We conclude that marginalized fishing communities are almost non-existent in eye health literature. Eye health needs of these and other marginalized populations must be identified and addressed in post-2015 health and development agenda.

[Vision-and health-related quality of life in patients with uveitis].

PubMed

Zhang, J; Yan, H G; Chi, Y; Guo, C Y; Yang, L

2016-06-11

To evaluate vision-and health-related quality of life in patients with uveitis, and to evaluate the relationship between quality of life and visual acuity. Cross-sectional study. One hundred and eleven patients with uveitis were enrolled in the study from January 1, 2013 to April 1, 2014 in Peking University First Hospital. Clinical data collected included medical history, complete ophthalmologic examination and best corrected visual acuity (LogMAR). Basic clinical data (gender, diagnosis, etc.) was also collected. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) and the 36-Item Short Form Health Survey (SF-36) were administered. The patients were divided into two groups, anterior uveitis group (ATU), and other types of uveitis in this study (OTU). T-test was used for analysis of the data which obey standard normal distribution, otherwise rank sum test was used for data analysis. Correlation and Linear regression were constructed between bilateral visual acuity and the scores of NEI VFQ-25 and SF-36 questionnaires. For all the 111 cases included in this study, 87 (78.4%) of them were anterior uveitis (ATU), 5 of them were intermediate uveitis, 7 of them were posterior uveitis and 12 of them were pan uveitis. Mean visual acuity of better and worse eye were 0.0 and 0.2 in ATU patients, respectively. Mean visual acuity of better and worse eye were 0.1 and 0.4 in OTU patients, respectively. Patients rated the general health subscale score of NEI VFQ-25 and SF-36 lower than other subscales, respectively (score of general health was 25.0 (25.0-50.0) in NEI VFQ-25 and 46.8 (19.8) in SF-36). ATU group scored higher that OTU group (Mean score of SF-36 was 77.5 (10.7) and 68.8 (16.9) in ATU and OTU group respectively, P value of SF-36< 0.01, t=9.54. Mean score of NEI VFQ-25 was 77.3 (12.8) and 59.1 (16.5) in ATU and OTU group respectively, P value of NEI VFQ-25<0.01, t=33.16). Mean score of NEI VFQ-25 of all patients was 73.4 (15.5). Mean visual acuity of better eye and worse eye of all patients were 0.0 (-0.2-1.0) and 0.3 (0.5), respectively. The correlation coefficient was -0.497 (P<0.01, t=-5.98) between NEI VFQ -25 score and visual acuity in better eye, and -0.32 (t=-3.48, P<0.01) between NEI VFQ-25 score and visual acuity in worse eye. The coefficient was -3.9 in linear regression of visual acuity in better eye against NEI VFQ-25 score (t=-5.98, P<0.01), and -1.1 of visual acuity in worse eye against NEI VFQ-25 score (t=-3.48,P<0.01). General health was more affected than other function subscales in uveitis. The quality of life in anterior uveitis was higher than other types of uveitis in this study. Vision-related quality of life correlated with both eyes.(Chin J Ophthalmol, 2016, 52: 429-436).

Corneal Laceration

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Perceptions of eye health in schools in Pakistan

PubMed Central

Ahmad, Khabir; Khan, Mohammad Aman; Khan, Mohammad Daud; Qureshi, Mohammad Babar; Chaudhry, Tanveer Anjum; Gilbert, Clare

2006-01-01

Background Research exploring children's and their teachers' perceptions of eye health is lacking. This paper reports for the first time on perceptions of primary schoolchildren and their teachers of healthy and diseased eyes, things that keep eyes healthy and damage them, and what actions to be taken in case of an eye injury. Methods Using draw and write technique, 160 boys and girls (9–12 years old) attending four primary schools in Abbottabad district, northern Pakistan, were invited to draw pictures in response to a set of semi-structured questions and then label them. Sixteen teachers who were currently teaching the selected students were interviewed one-on-one. Results Analysis of text accompanying 800 drawings and of the interview scripts revealed that most children and teachers perceived healthy eyes to be those which could see well, and diseased eyes to be those which have redness, watering, dirty discharge, pain, and itching; or those which have "weak eyesight" and blindness. Among things that students and teachers thought damage the eyes included sun, television, and sharp pointed objects, particularly pencils. Teachers noted that children with eye problems "have difficulty seeing the blackboard well", "screw up their eyes", and "hold their books too close". Conclusion We conclude that schoolchildren and their teachers had a good knowledge of eye health, but many of them had serious misconceptions e.g., use of kohl, medicines and eye drops keeps eyes healthy. Kohl is an important source of lead and can reduce children's intelligence even at low blood levels. Health education in schools must take into account children's existing knowledge of and misconceptions about various aspects of eye health. Such steps if taken could improve the relevance of eye health education to schoolchildren. PMID:16512897

Perceptions of eye health in schools in Pakistan.

PubMed

Ahmad, Khabir; Khan, Mohammad Aman; Khan, Mohammad Daud; Qureshi, Mohammad Babar; Chaudhry, Tanveer Anjum; Gilbert, Clare

2006-03-02

Research exploring children's and their teachers' perceptions of eye health is lacking. This paper reports for the first time on perceptions of primary schoolchildren and their teachers of healthy and diseased eyes, things that keep eyes healthy and damage them, and what actions to be taken in case of an eye injury. Using draw and write technique, 160 boys and girls (9-12 years old) attending four primary schools in Abbottabad district, northern Pakistan, were invited to draw pictures in response to a set of semi-structured questions and then label them. Sixteen teachers who were currently teaching the selected students were interviewed one-on-one. Analysis of text accompanying 800 drawings and of the interview scripts revealed that most children and teachers perceived healthy eyes to be those which could see well, and diseased eyes to be those which have redness, watering, dirty discharge, pain, and itching; or those which have "weak eyesight" and blindness. Among things that students and teachers thought damage the eyes included sun, television, and sharp pointed objects, particularly pencils. Teachers noted that children with eye problems "have difficulty seeing the blackboard well", "screw up their eyes", and "hold their books too close". We conclude that schoolchildren and their teachers had a good knowledge of eye health, but many of them had serious misconceptions e.g., use of kohl, medicines and eye drops keeps eyes healthy. Kohl is an important source of lead and can reduce children's intelligence even at low blood levels. Health education in schools must take into account children's existing knowledge of and misconceptions about various aspects of eye health. Such steps if taken could improve the relevance of eye health education to schoolchildren.

Vision Screening for Children 36 to <72 Months: Recommended Practices

PubMed Central

Cotter, Susan A.; Cyert, Lynn A.; Miller, Joseph M.; Quinn, Graham E.

2015-01-01

ABSTRACT Purpose This article provides recommendations for screening children aged 36 to younger than 72 months for eye and visual system disorders. The recommendations were developed by the National Expert Panel to the National Center for Children’s Vision and Eye Health, sponsored by Prevent Blindness, and funded by the Maternal and Child Health Bureau of the Health Resources and Services Administration, United States Department of Health and Human Services. The recommendations describe both best and acceptable practice standards. Targeted vision disorders for screening are primarily amblyopia, strabismus, significant refractive error, and associated risk factors. The recommended screening tests are intended for use by lay screeners, nurses, and other personnel who screen children in educational, community, public health, or primary health care settings. Characteristics of children who should be examined by an optometrist or ophthalmologist rather than undergo vision screening are also described. Results There are two current best practice vision screening methods for children aged 36 to younger than 72 months: (1) monocular visual acuity testing using single HOTV letters or LEA Symbols surrounded by crowding bars at a 5-ft (1.5 m) test distance, with the child responding by either matching or naming, or (2) instrument-based testing using the Retinomax autorefractor or the SureSight Vision Screener with the Vision in Preschoolers Study data software installed (version 2.24 or 2.25 set to minus cylinder form). Using the Plusoptix Photoscreener is acceptable practice, as is adding stereoacuity testing using the PASS (Preschool Assessment of Stereopsis with a Smile) stereotest as a supplemental procedure to visual acuity testing or autorefraction. Conclusions The National Expert Panel recommends that children aged 36 to younger than 72 months be screened annually (best practice) or at least once (accepted minimum standard) using one of the best practice approaches. Technological updates will be maintained at http://nationalcenter.preventblindness.org. PMID:25562476

What Is Macular Edema?

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Colored Contact Lens Dangers

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The Nigerian national blindness and visual impairment survey: Rationale, objectives and detailed methodology

PubMed Central

Dineen, Brendan; Gilbert, Clare E; Rabiu, Mansur; Kyari, Fatima; Mahdi, Abdull M; Abubakar, Tafida; Ezelum, Christian C; Gabriel, Entekume; Elhassan , Elizabeth; Abiose, Adenike; Faal, Hannah; Jiya, Jonathan Y; Ozemela, Chinenyem P; Lee, Pak Sang; Gudlavalleti, Murthy VS

2008-01-01

Background Despite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken to estimate the prevalence and determine the major causes of blindness and low vision. This paper presents the detailed methodology used during the survey. Methods A nationally representative sample of persons aged 40 years and above was selected. Children aged 10–15 years and individuals aged <10 or 16–39 years with visual impairment were also included if they lived in households with an eligible adult. All participants had their height, weight, and blood pressure measured followed by assessment of presenting visual acuity, refractokeratomery, A-scan ultrasonography, visual fields and best corrected visual acuity. Anterior and posterior segments of each eye were examined with a torch and direct ophthalmoscope. Participants with visual acuity of < = 6/12 in one or both eyes underwent detailed examination including applanation tonometry, dilated slit lamp biomicroscopy, lens grading and fundus photography. All those who had undergone cataract surgery were refracted and best corrected vision recorded. Causes of visual impairment by eye and for the individual were determined using a clinical algorithm recommended by the World Health Organization. In addition, 1 in 7 adults also underwent a complete work up as described for those with vision < = 6/12 for constructing a normative data base for Nigerians. Discussion The field work for the study was completed in 30 months over the period 2005–2007 and covered 305 clusters across the entire country. Concurrently persons 40+ years were examined to form a normative data base. Analysis of the data is currently underway. Conclusion The methodology used was robust and adequate to provide estimates on the prevalence and causes of blindness in Nigeria. The survey would also provide information on barriers to accessing services, quality of life of visually impaired individuals and also provide normative data for Nigerian eyes. PMID:18808712

Impact of Dry Eye Syndrome on Vision-Related Quality of Life in a Non-Clinic-Based General Population

PubMed Central

2012-01-01

Background Dry eye syndrome (DES) is a common ocular disorder occurring in general population. The purpose of this study is to evaluate the impact of DES on vision-related quality of life (QoL) in a non-clinic-based general population. Methods This population-based cross-sectional study enrolled subjects older than 40 years, who took part in an epidemiological study on dry eye in Sanle Community, Shanghai. Apart from the collection of sociodemographics, dry eye symptoms, and other clinical data, a Chinese version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was administered to all subjects. Comparisons of the NEI VFQ-25 subscale item scores and composite score were made among subgroups divided according to the presence of dry eye symptoms or signs. Multivariate regression analysis was performed to investigate the relationship between the clinical variables and the VFQ-25 composite score. Results A total of 229 participants were enrolled in the study, with an average age of (60.7 ±10.1) years old. Majority of these participants were female (59.8 %, 137/229). The total DES symptom scores (TDSS) in subjects either with definite DES or only with dry eye symptoms were significantly higher (F = 60.331, P < 0.001). The values of tear break-up time (TBUT) and Schirmer test were significantly lower in participants with DES and those with dry eye signs only (F = 55.158 and 40.778, P < 0.001). The composite score of the NEI VFQ-25 was significantly lower in subjects with DES (F = 4.901, P = 0.003). Moreover, the subscale scores of ocular pain and mental health were significantly lower in those with either DES or dry eye symptoms only (F = 10.962 and 7.362 respectively, both P < 0.001). The multiple regression analysis showed that the TDSS had a significant negative correlation with the VFQ-25 composite score as well as with the subscale score for ocular pain and mental health, even after the adjustment of all other factors (all P < 0.01). Conclusions The symptoms of dry eye are associated with an adverse impact on vision-related QoL in non-clinic-based general population, which is mainly represented as more ocular pain and discomfort, and impaired mental health as well. Apart from clinical examination, it is also important to refer to subjective symptoms and QoL scores when assessing the severity of DES. PMID:22799274

Eating for Your Eyes

ERIC Educational Resources Information Center

Stastny, Sherri Nordstrom; Garden-Robinson, Julie

2011-01-01

An educational program targeting older adults was developed to increase knowledge regarding nutrition and eye health. With age, the chance for eye disease increases, so prevention is critical. The Eating for Your Eyes program has promoted behavior changes regarding eye health among the participants. This program is easily replicated and use is…

Genetics Home Reference: lacrimo-auriculo-dento-digital syndrome

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... Information Center (1 link) Lacrimo-auriculo-dento-digital syndrome Additional NIH Resources (2 links) National Eye Institute: Facts About Dry Eye National Institute of Dental and Craniofacial Research: ...

Knowledge of Diabetic Eye Disease and Vision Care Guidelines Among Hispanic Individuals in Baltimore With and Without Diabetes

PubMed Central

Muñoz, Beatriz; O'Leary, Michael; Fonseca-Becker, Fannie; Rosario, Evelyn; Burguess, Isabel; Aguilar, Marcela; Fickes, Cynthia; West, Sheila K.

2008-01-01

Objective To determine gaps in knowledge and barriers to care for diabetic eye disease in Hispanic individuals in Baltimore, Maryland. Methods Interviews with a random sample of self-reported Hispanic individuals (n=349), and a convenience sample of Hispanic individuals with diabetes (n=204). Four groups were constructed: without diabetes, with and without a family history of diabetes, newly diagnosed with diabetes, and diagnosed with diabetes more than 1 year before the study. Results Less than 10% of participants preferred reading in English; 50% reported having providers who do not speak Spanish as a barrier to care. Knowledge of eye disease as a consequence of diabetes was reported by 18% of nondiabetic participants with no family history, 29% of nondiabetic participants with a family history, 36% of newly diagnosed diabetic patients, and 52% of participants diagnosed with diabetes more than 1 year before the study. Only 16%, 28%, 13%, and 34%, respectively, knew that strict control could prevent eye problems, and 33%, 51%, 31%, and 48%, respectively, knew that dilated eye examinations were important. A total of 30% of diabetic participants had had an eye examination in the previous year. Conclusions Knowledge of the ocular complications of diabetes is low. The frequency of eye examinations among Hispanic individuals with diabetes is less than the national average for Hispanic individuals. Culturally appropriate health education and innovations to reduce barriers to eye care are needed. PMID:18625945

Quality of life of eye amputated patients.

PubMed

Rasmussen, Marie L R; Ekholm, Ola; Prause, Jan U; Toft, Peter B

2012-08-01

To evaluate eye-amputated patients' health-related quality of life, perceived stress, self-rated health, job separation because of illness or disability and socioeconomic position. Patients were recruited from a tertiary referral centre situated in Copenhagen. Inclusion criteria were eye amputation, i.e. evisceration, enucleation, orbital exenteration or secondary implantation of an orbital implant during the period 1996-2003, and participation in a previous investigation (2005). In total, 159 eye-amputated patients were included, and completed a self-administered questionnaire containing health-related quality of life (SF-36), the perceived stress scale and answered questions about self-rated health, job changes because of illness or disability and socioeconomic status. These results were compared with findings from the Danish Health Interview Survey 2005. The eye-amputated patients had significantly (p < 0.05) lower scores (poorer health) on all SF-36 subscales and more perceived stress compared to the general population. In all, 43.3% of the patients rated their health as excellent or very good compared to 52.1% of the general population. In total, 25% of the study population has retired or changed to a part-time job because of eye disease. The percentage of eye amputated patients, who were divorced or separated, was twice as high as in the general population. The impact of an eye amputation is considerable. The quality of life, perceived stress and self-rated health of many eye-amputated patients are drastically changed. Eye amputation has a marked negative influence on job separation because of illness or disability and on socioeconomic position. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

Construction-related eye injuries in Irish nationals and non-nationals: attitudes and strategies for prevention.

PubMed

Connell, P P; Saddak, T; Harrison, I; Kelly, S; Bobart, A; McGettrick, P; Collum, L T M

2007-03-01

Construction-related ocular injuries are an important cause of vision loss but few studies on the incidence, epidemiology and nature of these injuries exist. Due to the perceived increase in occupation-related eye injuries in non-nationals we aimed to investigate the nature of such injuries presenting to a single eye unit over a two-month period. One hundred and fifty-five patients presenting to the accident and emergency department with construction related ocular injury were examined. Of 155 patients, 80 were Irish and 75 nonnational, of whom 60, 21.3 and 6.7% were Polish, Lithuanian and Romanian, respectively. Common causative factors included hammering, grinding, drilling and splash injury. Average rate of eyewear protection usage was 35%, with attendance at safety courses highest in Irish nationals. A penetrating eye injury rate of 4.9% overall was observed, all in non-nationals. Construction related ocular injury is a serious cause of visual loss in non-nationals. Greater adherence to safety regulations and training is required.

Automated Diabetic Retinopathy Image Assessment Software: Diagnostic Accuracy and Cost-Effectiveness Compared with Human Graders.

PubMed

Tufail, Adnan; Rudisill, Caroline; Egan, Catherine; Kapetanakis, Venediktos V; Salas-Vega, Sebastian; Owen, Christopher G; Lee, Aaron; Louw, Vern; Anderson, John; Liew, Gerald; Bolter, Louis; Srinivas, Sowmya; Nittala, Muneeswar; Sadda, SriniVas; Taylor, Paul; Rudnicka, Alicja R

2017-03-01

With the increasing prevalence of diabetes, annual screening for diabetic retinopathy (DR) by expert human grading of retinal images is challenging. Automated DR image assessment systems (ARIAS) may provide clinically effective and cost-effective detection of retinopathy. We aimed to determine whether ARIAS can be safely introduced into DR screening pathways to replace human graders. Observational measurement comparison study of human graders following a national screening program for DR versus ARIAS. Retinal images from 20 258 consecutive patients attending routine annual diabetic eye screening between June 1, 2012, and November 4, 2013. Retinal images were manually graded following a standard national protocol for DR screening and were processed by 3 ARIAS: iGradingM, Retmarker, and EyeArt. Discrepancies between manual grades and ARIAS results were sent to a reading center for arbitration. Screening performance (sensitivity, false-positive rate) and diagnostic accuracy (95% confidence intervals of screening-performance measures) were determined. Economic analysis estimated the cost per appropriate screening outcome. Sensitivity point estimates (95% confidence intervals) of the ARIAS were as follows: EyeArt 94.7% (94.2%-95.2%) for any retinopathy, 93.8% (92.9%-94.6%) for referable retinopathy (human graded as either ungradable, maculopathy, preproliferative, or proliferative), 99.6% (97.0%-99.9%) for proliferative retinopathy; Retmarker 73.0% (72.0 %-74.0%) for any retinopathy, 85.0% (83.6%-86.2%) for referable retinopathy, 97.9% (94.9%-99.1%) for proliferative retinopathy. iGradingM classified all images as either having disease or being ungradable. EyeArt and Retmarker saved costs compared with manual grading both as a replacement for initial human grading and as a filter prior to primary human grading, although the latter approach was less cost-effective. Retmarker and EyeArt systems achieved acceptable sensitivity for referable retinopathy when compared with that of human graders and had sufficient specificity to make them cost-effective alternatives to manual grading alone. ARIAS have the potential to reduce costs in developed-world health care economies and to aid delivery of DR screening in developing or remote health care settings. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

Occupational dose constraints for the lens of the eye for interventional radiologists and interventional cardiologists in the UK.

PubMed

Mairs, William DA

2016-06-01

The International Commission on Radiological Protection (ICRP) has recommended a 20 mSv year(-1) dose limit for the lens of the eye, which has been adopted in the European Union Basic Safety Standards. Interventional radiologists (IRs) and interventional cardiologists (ICs) are likely to be affected by this. The effects of radiation in the lens are somewhat uncertain, and the ICRP explicitly recommend optimization. Occupational dose constraints are part of the optimization process and define a level of dose which ought to be achievable in a well-managed practice. This commentary calls on the professional bodies to review a need for national constraints to guide local decisions. Consideration is given to developing such constraints using maximum expected doses in high-workload facilities with good radiation protection practices and application of a factor allowing for attenuation by lead glasses (LG). Doses are based on a Public Health England survey of eye dose in the UK. Maximum expected doses for ICs are approximately 21 mSv year(-1), neglecting LG. However, the extent of IR exposure is not yet fully known, and further evidence is required before conclusions are drawn. A Health and Safety Laboratory review of LG established a conservative dose reduction factor of 3 for models available in 2012. Application of this factor provides a dose constraint of 7 mSv year(-1) to the eye for ICs. To achieve this constraint, those employers with the most exposed ICs will have to provide and ensure the correct use of a ceiling-suspended eye shield and LG.

Updating OSHA Standards Based on National Consensus Standards; Eye and Face Protection. Final rule.

PubMed

2016-03-25

On March 13, 2015, OSHA published in the Federal Register a notice of proposed rulemaking (NPRM) to revise its eye and face protection standards for general industry, shipyard employment, marine terminals, longshoring, and construction by updating the references to national consensus standards approved by the American National Standards Institute (ANSI). OSHA received no significant objections from commenters and therefore is adopting the amendments as proposed. This final rule updates the references in OSHA's eye and face standards to reflect the most recent edition of the ANSI/International Safety Equipment Association (ISEA) eye and face protection standard. It removes the oldest-referenced edition of the same ANSI standard. It also amends other provisions of the construction eye and face protection standard to bring them into alignment with OSHA's general industry and maritime standards.

Optometric Manpower: Characteristics of Optometric Practice, United States--1968. Vital and Health Statistics, Series 14, No. 13.

ERIC Educational Resources Information Center

National Center for Health Statistics (DHEW/PHS), Hyattsville, MD.

The report is the second describing the findings of a national survey of manpower in the eye care occupations in 1968 and 1969. It contains primarily 27 statistical tables dealing with specific features of the optometric practice: the number and percentage distribution of optometrists by the number of patient visits per week (tables 1-3); the…

Predictive models for ocular chronic graft-versus-host disease diagnosis and disease activity in transplant clinical practice.

PubMed

Curtis, Lauren M; Datiles, Manuel B; Steinberg, Seth M; Mitchell, Sandra A; Bishop, Rachel J; Cowen, Edward W; Mays, Jacqueline; McCarty, John M; Kuzmina, Zoya; Pirsl, Filip; Fowler, Daniel H; Gress, Ronald E; Pavletic, Steven Z

2015-09-01

Ocular chronic graft-versus-host disease is one of the most bothersome common complications following allogeneic hematopoietic stem cell transplantation. The National Institutes of Health Chronic Graft-versus-Host Disease Consensus Project provided expert recommendations for diagnosis and organ severity scoring. However, ocular chronic graft-versus-host disease can be diagnosed only after examination by an ophthalmologist. There are no currently accepted definitions of ocular chronic graft-versus-host disease activity. The goal of this study was to identify predictive models of diagnosis and activity for use in clinical transplant practice. A total of 210 patients with moderate or severe chronic graft-versus-host disease were enrolled in a prospective, cross-sectional, observational study (clinicaltrials.gov identifier: 00092235). Experienced ophthalmologists determined presence of ocular chronic graft-versus-host disease, diagnosis and activity. Measures gathered by the transplant clinician included Schirmer's tear test and National Institutes of Health 0-3 Eye Score. Patient-reported outcome measures were the ocular subscale of the Lee Chronic Graft-versus-Host Disease Symptom Scale and Chief Eye Symptom Intensity Score. Altogether, 157 (75%) patients were diagnosed with ocular chronic graft-versus-host disease; 133 of 157 patients (85%) had active disease. In a multivariable model, the National Institutes of Health Eye Score (P<0.0001) and Schirmer's tear test (P<0.0001) were independent predictors of ocular chronic graft-versus-host disease (sensitivity 93.0%, specificity 92.2%). The Lee ocular subscale was the strongest predictor of active ocular chronic graft-versus-host disease (P<0.0001) (sensitivity 68.5%, specificity 82.6%). Ophthalmology specialist measures that were most strongly predictive of diagnosis in a multivariate model were Oxford grand total staining (P<0.0001) and meibomian score (P=0.027). These results support the use of selected transplant clinician- and patient-reported outcome measures for ocular chronic graft-versus-host disease screening when providing care to allogeneic hematopoietic stem cell transplantation survivors with moderate to severe chronic graft-versus-host disease. Prospective studies are needed to determine if the Lee ocular subscale demonstrates adequate responsiveness as a disease activity outcome measure. Copyright© Ferrata Storti Foundation.

Predictive models for ocular chronic graft-versus-host disease diagnosis and disease activity in transplant clinical practice

PubMed Central

Curtis, Lauren M.; Datiles, Manuel B.; Steinberg, Seth M.; Mitchell, Sandra A.; Bishop, Rachel J.; Cowen, Edward W.; Mays, Jacqueline; McCarty, John M.; Kuzmina, Zoya; Pirsl, Filip; Fowler, Daniel H.; Gress, Ronald E.; Pavletic, Steven Z.

2015-01-01

Ocular chronic graft-versus-host disease is one of the most bothersome common complications following allogeneic hematopoietic stem cell transplantation. The National Institutes of Health Chronic Graft-versus-Host Disease Consensus Project provided expert recommendations for diagnosis and organ severity scoring. However, ocular chronic graft-versus-host disease can be diagnosed only after examination by an ophthalmologist. There are no currently accepted definitions of ocular chronic graft-versus-host disease activity. The goal of this study was to identify predictive models of diagnosis and activity for use in clinical transplant practice. A total of 210 patients with moderate or severe chronic graft-versus-host disease were enrolled in a prospective, cross-sectional, observational study (clinicaltrials.gov identifier: 00092235). Experienced ophthalmologists determined presence of ocular chronic graft-versus-host disease, diagnosis and activity. Measures gathered by the transplant clinician included Schirmer’s tear test and National Institutes of Health 0–3 Eye Score. Patient-reported outcome measures were the ocular subscale of the Lee Chronic Graft-versus-Host Disease Symptom Scale and Chief Eye Symptom Intensity Score. Altogether, 157 (75%) patients were diagnosed with ocular chronic graft-versus-host disease; 133 of 157 patients (85%) had active disease. In a multivariable model, the National Institutes of Health Eye Score (P<0.0001) and Schirmer’s tear test (P<0.0001) were independent predictors of ocular chronic graft-versus-host disease (sensitivity 93.0%, specificity 92.2%). The Lee ocular subscale was the strongest predictor of active ocular chronic graft-versus-host disease (P<0.0001) (sensitivity 68.5%, specificity 82.6%). Ophthalmology specialist measures that were most strongly predictive of diagnosis in a multivariate model were Oxford grand total staining (P<0.0001) and meibomian score (P=0.027). These results support the use of selected transplant clinician- and patient-reported outcome measures for ocular chronic graft-versus-host disease screening when providing care to allogeneic hematopoietic stem cell transplantation survivors with moderate to severe chronic graft-versus-host disease. Prospective studies are needed to determine if the Lee ocular subscale demonstrates adequate responsiveness as a disease activity outcome measure. PMID:26088932

Examining the types and payments of the disabilities of the insurants in the National Farmers' Health Insurance program in Taiwan.

PubMed

Wang, Jiun-Hao; Chang, Hung-Hao

2010-10-26

In contrast to the considerable body of literature concerning the disabilities of the general population, little information exists pertaining to the disabilities of the farm population. Focusing on the disability issue to the insurants in the Farmers' Health Insurance (FHI) program in Taiwan, this paper examines the associations among socio-demographic characteristics, insured factors, and the introduction of the national health insurance program, as well as the types and payments of disabilities among the insurants. A unique dataset containing 1,594,439 insurants in 2008 was used in this research. A logistic regression model was estimated for the likelihood of received disability payments. By focusing on the recipients, a disability payment and a disability type equation were estimated using the ordinary least squares method and a multinomial logistic model, respectively, to investigate the effects of the exogenous factors on their received payments and the likelihood of having different types of disabilities. Age and different job categories are significantly associated with the likelihood of receiving disability payments. Compared to those under age 45, the likelihood is higher among recipients aged 85 and above (the odds ratio is 8.04). Compared to hired workers, the odds ratios for self-employed and spouses of farm operators who were not members of farmers' associations are 0.97 and 0.85, respectively. In addition, older insurants are more likely to have eye problems; few differences in disability types are related to insured job categories. Results indicate that older farmers are more likely to receive disability payments, but the likelihood is not much different among insurants of various job categories. Among all of the selected types of disability, a highest likelihood is found for eye disability. In addition, the introduction of the national health insurance program decreases the likelihood of receiving disability payments. The experience in Taiwan can be valuable for other countries that are in an initial stage to implement a universal health insurance program.

Funding models for outreach ophthalmology services.

PubMed

Turner, Angus W; Mulholland, Will; Taylor, Hugh R

2011-01-01

This paper aims to describe funding models used and compare the effects of funding models for remuneration on clinical activity and cost-effectiveness in outreach eye services in Australia. Cross-sectional case study based in remote outreach ophthalmology services in Australia. Key stake-holders from eye services in nine outreach regions participated in the study. Semistructured interviews were conducted to perform a qualitative assessment of outreach eye services' funding mechanisms. Records of clinical activity were used to statistically compare funding models. Workforce availability (supply of ophthalmologists), costs of services, clinical activity (surgery and clinic consultation rates) and waiting times. The supply of ophthalmologists (full-time equivalence) to all remote regions was below the national average (up to 19 times lower). Cataract surgery rates were also below national averages (up to 10 times lower). Fee-for-service funding significantly increased clinical activity. There were also trends to shorter waiting times and lower costs per attendance. For outreach ophthalmology services, the funding model used for clinician reimbursement may influence the efficiency and costs of the services. Fee-for-service funding models, safety-net funding options or differential funding/incentives need further exploration to ensure isolated disadvantaged areas prone to poor patient attendance are not neglected. In order for outreach eye health services to be sustainable, remuneration rates need to be comparable to those for urban practice. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

Changes in Tear Volume after 3% Diquafosol Treatment in Patients with Dry Eye Syndrome: An Anterior Segment Spectral-domain Optical Coherence Tomography Study.

PubMed

Lee, Kwan Bok; Koh, Kyung Min; Kwon, Young A; Song, Sang Wroul; Kim, Byoung Yeop; Chung, Jae Lim

2017-08-01

To evaluate changes in the tear meniscus area and tear meniscus height over time in patients with dry eye syndrome, using anterior segment spectral-domain optical coherence tomography after the instillation of 3% diquafosol ophthalmic solution. Sixty eyes from 30 patients with mild to moderate dry eye syndrome were included. Tear meniscus images acquired by anterior segment spectral-domain optical coherence tomography were analyzed using National Institutes of Health's image-analysis software (ImageJ 1.44p). Tear meniscus area and tear meniscus height were measured at baseline, 5 minutes, 10 minutes, and 30 minutes after instillation of a drop of diquafosol in one eye and normal saline in the other eye. Changes in ocular surface disease index score, tear film break-up time, corneal staining score by Oxford schema, and meibomian expressibility were also evaluated at baseline, and after 1 week and 1 month of a diquafosol daily regimen. Sixty eyes from 30 subjects (mean age, 29.3 years; 8 men and 22 women) were included. In eyes receiving diquafosol, tear volume was increased at 5 and 10 minutes compared with baseline. It was also higher than saline instilled eyes at 5, 10, and 30 minutes. Changes in tear volume with respect to baseline were not statistically different after the use of diquafosol for 1 month. Ocular surface disease index score, tear film break-up time, and Oxford cornea stain score were significantly improved after 1 week and 1 month of daily diquafosol instillation, but meibomian expressibility did not change. Topical diquafosol ophthalmic solution effectively increased tear volume for up to 30 minutes, compared to normal saline in patients with dry eye syndrome. © 2017 The Korean Ophthalmological Society

76 FR 2706 - Notice of Extension of Concession Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... Program, National Park Service, 1201 Eye Street, NW., 11th Floor, Washington, DC 20005, Telephone 202/513... Fork National Seashore. York. BLRI004-88 Virginia Peaks of Blue Ridge Parkway. Otter. BUIS001-06..., Commercial Services Program, National Park Service, 1201 Eye Street, NW., 11th Floor, Washington, DC 20005...

Lifestyle Determinants on Prevention and Improvement of Dry Eye Disease from the Perspective of Iranian Traditional Medicine.

PubMed

Haji-Ali-Nili, Neda; Khoshzaban, Fariba; Karimi, Mehrdad

2016-05-01

Dry eye disease is one of the most common public health problems in the field of ophthalmology that causes decreased physical, psychological, social and occupational functioning, and interferes with daily activities like reading, driving, computer work and watching TV. The effect of this disease on quality of life is similar to severe migraine and angina. In addition, the severity of the disease is closely related to depression. Outbreaks are increasing with the use of contact lenses and refractive surgery such as LASIK. The purpose of this paper is to assess the causes of dry eye and its prevention by the principles of hygiene. In this review study, traditional medicine resources like Al canon fil tibb, Sharh-al-Al Asbab and Exir-e-azam have been studied with engine motors such as Google Scholar and PubMed. From the perspective of Iranian traditional medicine, the principles of maintaining health include air, food and drink, exercise and rest, sleep and wakefulness, mental state, retention of essential materials and depletion of wastes from the body. Proper performance of each principle is useful for the prevention of disease in different organs, including the eyes. Recommendations for the prevention or treatment of dry eye disease include the prevention of dryness in the eye or the entire body. In addition, the stomach and brain are important to eye health. Accordingly, one of the most effective managements of dry eye disease is avoiding foods that affect the eye in this way; for example garlic and onion. Maintaining eye health is related to aspects of physical and mental health of the whole body. Therefore, codification of an integrated plan that contains eating and sleeping patterns, exercise, general clearing, eye clearing, and mental health is essential for treating dry eye disease.

Effectiveness of Existing Eye Safety Legislation in Arizona.

ERIC Educational Resources Information Center

Gillaspy, Roy Eugene

This study was designed to ascertain the current practices of eye safety in Arizona high school industrial education laboratories, including the enforcement of eye safety legislation, use of eye protection devices, how the eye ware meets the American National Standards Institute specifications, and the teachers' interpretations of the existing eye…

Eye health promotion and the prevention of blindness in developing countries: critical issues.

PubMed

Hubley, J; Gilbert, C

2006-03-01

This review explores the role of health promotion in the prevention of avoidable blindness in developing countries. Using examples from eye health and other health topics from developing countries, the review demonstrates that effective eye health promotion involves a combination of three components: health education directed at behaviour change to increase adoption of prevention behaviours and uptake of services; improvements in health services such as the strengthening of patient education and increased accessibility and acceptability; and advocacy for improved political support for blindness prevention policies. Current eye health promotion activities can benefit by drawing on experiences gained by health promotion activities in other health topics especially on the use of social research and behavioural models to understand factors determining health decision making and the appropriate choice of methods and settings. The challenge ahead is to put into practice what we know does work. An expansion of advocacy-the third and most undeveloped component of health promotion-is essential to convince governments to channel increased resources to eye health promotion and the goals of Vision 2020.

Training the eye care team: principles and practice.

PubMed

Garg, Prashant; Reddy, Snigdha; Nelluri, Chaitanya

2014-01-01

One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity.

Training the Eye Care Team: Principles and Practice

PubMed Central

Garg, Prashant; Reddy, Snigdha; Nelluri, Chaitanya

2014-01-01

One of the crucial factors to make high quality eye care services available, accessible and affordable to all is the availability of appropriately trained human resources. Providing health through a health care team is a better and cost effective alternative. The concept of the team approach is based on the principles of working together; task shifting; and ensuring continuity of care. Composition of a team varies based on the community needs, population characteristics and disease burden. But for it to be effective, a team must possess four attributes - availability, competency, productivity, and responsiveness. Therefore, training of all team members and training the team to work together as a unit are crucial components in the success of this concept. Some of the critical attributes include: Training across the health spectrum through quality and responsive curricula administered by motivated teachers; accreditation of programs or institutions by national or international bodies; certification and recertification of team members; and training in working together as a team through inter- and intra- disciplinary workshops both during training and as a part of the job activity. PMID:24791103

VISION: A School Program for Grades 4-8. [Revised].

ERIC Educational Resources Information Center

National Eye Inst. (DHEW/PHS), Bethesda, MD.

This document is a curriculum supplement that is part of a nationwide public education program on the eye and marks the 25th anniversary of the National Eye Institute (NEI). The anatomy of the eye and imperfect eye problems are explained. This booklet provides three lesson plans: (1)The Eyes and the Great Brain Connection; (2) The Imperfect Eye;…

Stem Cell Ophthalmology Treatment Study (SCOTS) for retinal and optic nerve diseases: a case report of improvement in relapsing auto-immune optic neuropathy.

PubMed

Weiss, Jeffrey N; Levy, Steven; Benes, Susan C

2015-09-01

We present the results from a patient with relapsing optic neuropathy treated within the Stem Cell Ophthalmology Treatment Study (SCOTS). SCOTS is an Institutional Review Board approved clinical trial and has become the largest ophthalmology stem cell study registered at the National Institutes of Health to date (www.clinicaltrials.gov Identifier NCT 01920867). SCOTS utilizes autologous bone marrow-derived stem cells (BMSCs) for treatment of retinal and optic nerve diseases. Pre-treatment and post-treatment comprehensive eye exams of a 54 year old female patient were performed both at the Florida Study Center, USA and at The Eye Center of Columbus, USA. As a consequence of a relapsing optic neuritis, the patient's previously normal visual acuity decreased to between 20/350 and 20/400 in the right eye and to 20/70 in the left eye. Significant visual field loss developed bilaterally. The patient underwent a right eye vitrectomy with injection of BMSCs into the optic nerve of the right eyeand retrobulbar, subtenon and intravitreal injection of BMSCs in the left eye. At 15 months after SCOTS treatment, the patient's visual acuity had improved to 20/150 in the right eye and 20/20 in the left eye. Bilateral visual fields improved markedly. Both macular thickness and fast retinal nerve fiber layer thickness were maximally improved at 3 and 6 months after SCOTS treatment. The patient also reduced her mycophenylate dose from 1,500 mg per day to 500 mg per day and required no steroid pulse therapy during the 15-month follow up.

ASSOCIATION BETWEEN VISUAL FUNCTION AND SUBRETINAL DRUSENOID DEPOSITS IN NORMAL AND EARLY AGE-RELATED MACULAR DEGENERATION EYES.

PubMed

Neely, David; Zarubina, Anna V; Clark, Mark E; Huisingh, Carrie E; Jackson, Gregory R; Zhang, Yuhua; McGwin, Gerald; Curcio, Christine A; Owsley, Cynthia

2017-07-01

To examine the association between subretinal drusenoid deposits (SDDs) identified by multimodal retinal imaging and visual function in older eyes with normal macular health or in the earliest phases of age-related macular degeneration (AMD). Age-related macular degeneration status for each eye was defined according to the Age-Related Eye Disease Study (AREDS) 9-step classification system (normal = Step 1, early AMD = Steps 2-4) based on color fundus photographs. Visual functions measured were best-corrected photopic visual acuity, contrast and light sensitivity, mesopic visual acuity, low-luminance deficit, and rod-mediated dark adaptation. Subretinal drusenoid deposits were identified through multimodal imaging (color fundus photographs, infrared reflectance and fundus autofluorescence images, and spectral domain optical coherence tomography). The sample included 1,202 eyes (958 eyes with normal health and 244 eyes with early AMD). In normal eyes, SDDs were not associated with any visual function evaluated. In eyes with early AMD, dark adaptation was markedly delayed in eyes with SDDs versus no SDD (a 4-minute delay on average), P = 0.0213. However, this association diminished after age adjustment, P = 0.2645. Other visual functions in early AMD eyes were not associated with SDDs. In a study specifically focused on eyes in normal macular health and in the earliest phases of AMD, early AMD eyes with SDDs have slower dark adaptation, largely attributable to the older ages of eyes with SDD; they did not exhibit deficits in other visual functions. Subretinal drusenoid deposits in older eyes in normal macular health are not associated with any visual functions evaluated.

Hospital benchmarking: are U.S. eye hospitals ready?

PubMed

de Korne, Dirk F; van Wijngaarden, Jeroen D H; Sol, Kees J C A; Betz, Robert; Thomas, Richard C; Schein, Oliver D; Klazinga, Niek S

2012-01-01

Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results with an international initiative. We evaluated multiple cases by applying an evaluation frame abstracted from the literature to five U.S. eye hospitals that used a set of 10 indicators for efficiency benchmarking. Qualitative analysis entailed 46 semistructured face-to-face interviews with stakeholders, document analyses, and questionnaires. The case studies only partially met the conditions of the evaluation frame. Although learning and quality improvement were stated as overall purposes, the benchmarking initiative was at first focused on efficiency only. No ophthalmic outcomes were included, and clinicians were skeptical about their reporting relevance and disclosure. However, in contrast with earlier findings in international eye hospitals, all U.S. hospitals worked with internal indicators that were integrated in their performance management systems and supported benchmarking. Benchmarking can support performance management in individual hospitals. Having a certain number of comparable institutes provide similar services in a noncompetitive milieu seems to lay fertile ground for benchmarking. International benchmarking is useful only when these conditions are not met nationally. Although the literature focuses on static conditions for effective benchmarking, our case studies show that it is a highly iterative and learning process. The journey of benchmarking seems to be more important than the destination. Improving patient value (health outcomes per unit of cost) requires, however, an integrative perspective where clinicians and administrators closely cooperate on both quality and efficiency issues. If these worlds do not share such a relationship, the added "public" value of benchmarking in health care is questionable.

Contribution of Electronic Medical Records to the Management of Rare Diseases.

PubMed

Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

2015-01-01

Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

Contribution of Electronic Medical Records to the Management of Rare Diseases

PubMed Central

Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

2015-01-01

Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. Results. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. Discussion. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Conclusion. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease. PMID:26539543

A comparative review of Haute Autorité de Santé and National Institute for Health and Care Excellence health technology assessments of Ikervis® to treat severe keratitis in adult patients with dry eye disease which has not improved despite treatment with tear substitutes.

PubMed

Eroglu, Yasmina Iffet

2017-01-01

Background: In 2015, Ikervis® became the only EMA-approved cyclosporine A (CsA) eye-drop for the treatment of severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes. Since the 1980s, CsA has been used empirically for ocular conditions in veterinary medicine then in humans. However, its extremely low aqueous solubility led to its administration in vegetable oils, which is characterized by low ocular availability, poor intraocular penetration, poor tolerability and short shelf-life. Concentrations from 0.05% to 2% are compounded on an industrial scale and reimbursed throughout Europe. In France, Ikervis® has been granted an ASMR score of 5 by HAS, whereas in UK NICE endorsed its use. Objective: To review the dry eye disease environment, its challenges and available treatment options, and compare the NICE and HAS assessments to question HAS' decision to maintain full reimbursement of compounded CsA formulations in the absence of evidence, while reimbursing the EMA-approved drug at 15%. extensive search on PubMED. Results: Comparator selection, composite score assessment and use of CE model are key differentiators. Conclusion: In topical formulations, improvements to the vehicle are key innovations that can bring significant benefits. After the USA, a Compounding Act is needed in Europe.

A comparative review of Haute Autorité de Santé and National Institute for Health and Care Excellence health technology assessments of Ikervis® to treat severe keratitis in adult patients with dry eye disease which has not improved despite treatment with tear substitutes

PubMed Central

Eroglu, Yasmina Iffet

2017-01-01

ABSTRACT Background: In 2015, Ikervis® became the only EMA-approved cyclosporine A (CsA) eye-drop for the treatment of severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes. Since the 1980s, CsA has been used empirically for ocular conditions in veterinary medicine then in humans. However, its extremely low aqueous solubility led to its administration in vegetable oils, which is characterized by low ocular availability, poor intraocular penetration, poor tolerability and short shelf-life. Concentrations from 0.05% to 2% are compounded on an industrial scale and reimbursed throughout Europe. In France, Ikervis® has been granted an ASMR score of 5 by HAS, whereas in UK NICE endorsed its use. Objective: To review the dry eye disease environment, its challenges and available treatment options, and compare the NICE and HAS assessments to question HAS’ decision to maintain full reimbursement of compounded CsA formulations in the absence of evidence, while reimbursing the EMA-approved drug at 15%. Method: extensive search on PubMED. Results: Comparator selection, composite score assessment and use of CE model are key differentiators. Conclusion: In topical formulations, improvements to the vehicle are key innovations that can bring significant benefits. After the USA, a Compounding Act is needed in Europe. PMID:28839524

International Vision Care: Issues and Approaches.

PubMed

Khanna, Rohit C; Marmamula, Srinivas; Rao, Gullapalli N

2017-09-15

Globally, 32.4 million individuals are blind and 191 million have moderate or severe visual impairment (MSVI); 80% of cases of blindness and MSVI are avoidable. However, great efforts are needed to tackle blindness and MSVI, as eye care in most places is delivered in isolation from and without significant integration with general health sectors. Success stories, including control of vitamin A deficiency, onchocerciasis, and trachoma, showed that global partnerships, multisectoral collaboration, public-private partnerships, corporate philanthropy, support from nongovernmental organizations-both local and international-and governments are responsible for the success of these programs. Hence, the World Health Organization's universal eye health global action plan for 2014-2019 has a goal of reducing the public health problem of blindness and ensuring access to comprehensive eye care; the plan aims to integrate eye health into health systems, thus providing universal eye health coverage (UEHC). This article discusses the challenges faced by low- and middle-income countries in strengthening the six building blocks of the health system. It discusses how the health systems in these countries need to be geared toward tackling the issues of emerging noncommunicable eye diseases, existing infectious diseases, and the common causes of blindness and visual impairment, such as cataract and refractive error. It also discusses how some of the comprehensive eye care models in the developing world have addressed these challenges. Moving ahead, if we are to achieve UEHC, we need to develop robust, sustainable, good-quality, comprehensive eye care programs throughout the world, focusing on the areas of greatest need. We also need to develop public health approaches for more complex problems such as diabetic retinopathy, glaucoma, childhood blindness, corneal blindness, and low vision. There is also a great need to train high-level human resources of all cadres in adequate numbers and quality. In addition to this, we need to exploit the benefits of modern technological innovations in information, communications, biomedical technology, and other domains to enhance quality of, access to, and equity in eye care.

Big bang health care reform--does it work?: the case of Britain's 1991 National Health Service reforms.

PubMed

Klein, R

1995-01-01

The costs and benefits are examined of one of the very few examples of a government driving through health care reform in the face of near unanimous opposition: Britain's 1991 reforms of the National Health Service (NHS), which sought to inject the dynamics of a market into the framework of a universal, tax-financed service. The political costs to the government have been high. The public continues to see the NHS through the eyes of disgruntled doctors and nurses. The benefits, measured in efficiency gains or service improvements, are as yet difficult to establish. However, the NHS has changed in key respects. The balance has shifted from hospital specialists to general practitioners and from providers to purchasers, with increasing emphasis on professional accountability and consumerism. But the NHS continues to evolve as it strives to resolve the tensions implicit in the reforms, and the only certainty is that no future government can return to the pre-1991 situation.

The Sight Loss and Vision Priority Setting Partnership (SLV-PSP): overview and results of the research prioritisation survey process.

PubMed

Rowe, Fiona; Wormald, Richard; Cable, Richard; Acton, Michele; Bonstein, Karen; Bowen, Michael; Bronze, Carol; Bunce, Catey; Conroy, Dolores; Cowan, Katherine; Evans, Kathy; Fenton, Mark; Giles, Heather; Gordon, Iris; Halfhide, Louise; Harper, Robert; Lightstone, Anita; Votruba, Marcela; Waterman, Heather; Zekite, Antra

2014-07-23

The Sight Loss and Vision Priority Setting Partnership aimed to identify research priorities relating to sight loss and vision through consultation with patients, carers and clinicians. These priorities can be used to inform funding bodies' decisions and enhance the case for additional research funding. Prospective survey with support from the James Lind Alliance. UK-wide National Health Service (NHS) and non-NHS. Patients, carers and eye health professionals. Academic researchers were excluded solely from the prioritisation process. The survey was disseminated by patient groups, professional bodies, at conferences and through the media, and was available for completion online, by phone, by post and by alternative formats (Braille and audio). People were asked to submit the questions about prevention, diagnosis and treatment of sight loss and eye conditions that they most wanted to see answered by research. Returned survey questions were reviewed by a data assessment group. Priorities were established across eye disease categories at final workshops. 2220 people responded generating 4461 submissions. Sixty-five per cent of respondents had sight loss and/or an eye condition. Following initial data analysis, 686 submissions remained which were circulated for interim prioritisation (excluding cataract and ocular cancer questions) to 446 patients/carers and 218 professionals. The remaining 346 questions were discussed at final prioritisation workshops to reach agreement of top questions per category. The exercise engaged a diverse community of stakeholders generating a wide range of conditions and research questions. Top priority questions were established across 12 eye disease categories. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Investigation and strategy research of eye disease prevention resources in community health service centers in Shanghai].

PubMed

He, Jiangnan; Zou, Haidong; Zhu, Jianfeng; He, Xiangui; Lu, Lina

2015-07-01

To investigate the status of eye disease prevention resources in community health service centers, to understand the distribution of ophthalmology service resources in each community, and to understand the main problems existing in the work of blindness prevention and treatment in Shanghai, so as to strengthen the prevention of blindness and improve the primary eye care level. Using the survey method, we carried out the investigation of disease control and prevention resources in all community health service centers to obtain the data of eye disease prevention and treatment resources. Using the descriptive statistics, we described the distribution of resources of eye disease prevention and treatment in different districts. There were 244 communities in 17 districts and counties in Shanghai, of which 236 (96.72%) communities participated in the survey and completed the questionnaires. Forty-nine (20.8%) communities had independent outpatient departments of ophthalmology, 96 (40.7%) had departments of ophthalmology and otorhinolaryngology, 33 (14%) had ophthalmology doctor visits from secondary or tertiary medical institutions, and 87 (36.9%) had no outpatient department of ophthalmology. There were 82 oculists, 129 general or otorhinolaryngology doctors treating eye disease, 9 ophthalmic nurses, and 1 optometrist. There were 36 specialized personnel for public health of eye protection and 217 part-time personnel. Moreover, there were a total of 1 103 pieces of ophthalmic equipment in all communities with the use rate of 91%. Uneven ophthalmology resources and eye care professional ability in community health service centers, lack of technical and public health personnel for prevention of eye disease, backward eye disease screening equipment, and inadequate investment in prevention and treatment of eye disease are major problems. More government supports for prevention and treatment of eye disease in communities and continuous improvement in three-level blindness prevention network systems and information construction are needed.

Proposing new indicators for glaucoma healthcare service.

PubMed

Liang, Yuan Bo; Zhang, Ye; Musch, David C; Congdon, Nathan

2017-01-01

Glaucoma is the first leading cause of irreversible blindness worldwide with increasing importance in public health. Indicators of glaucoma care quality as well as efficiency would benefit public health assessments, but are lacking. We propose three such indicators. First, the glaucoma coverage rate (GCR), which is the number of people known to have glaucoma divided by the total number of people with glaucoma as estimated from population-based studies multiplied by 100%. Second, the glaucoma detection rate (GDR), which is number of newly diagnosed glaucoma patients in one year divided by the population in a defined area in millions. Third, the glaucoma follow-up adherence rate (GFAR), calculated as the number of patients with glaucoma who visit eye care provider(s) at least once a year over the total number of patients with glaucoma in given eye care provider(s) in a specific period. Regularly tracking and reporting these three indicators may help to improve the healthcare system performance at national or regional levels.

[Surgical solution to vitreous floaters visual problem].

PubMed

Martínez-Sanz, F; Velarde, J I; Casuso, P; Fernández-Cotero, J N

2009-05-01

To evaluate the role of 25 gauge pars-plana vitrectomy (25G-PPV), after a careful patient selection, when we find highly annoying vitreous floaters and to question if this is an ethical therapeutic option. A retrospective study of eight eyes (seven patients) aged 58+/-14 years old (range 42-78) high myopes and pseudophakes who underwent 25G-PPV. Clinical data and visual acuity were studied at six to twelve months follow-up. Health-related functioning and quality of life was measured with the 39-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-39). No complications were observed. All patients were satisfied. Safety at third month was 100% and 37.5% improved one or more lines of visual acuity. Vitreous floaters can be often undervaluated by ophthalmologists, resulting in no intervention. Conventional 20 gauge PPV after a carefully examination can be an effective option for some authors. 25G-PPV incorporates also advantages as the early recovery, with little complications in pseudophakic eyes.

Impact of Visual Field Loss on Health-Related Quality of Life in Glaucoma

PubMed Central

McKean-Cowdin, Roberta; Wang, Ying; Wu, Joanne; Azen, Stanley P.; Varma, Rohit

2016-01-01

Purpose To examine the association between health-related quality of life (HRQOL) and visual field (VF) loss in participants with open-angle glaucoma (OAG) in the Los Angeles Latino Eye Study (LALES). Design Population-based cross-sectional study. Participants Two hundred thirteen participants with OAG and 2821 participants without glaucoma or VF loss. Methods Participants in the LALES—a population-based prevalence study of eye disease in Latinos 40 years and older, residing in Los Angeles, California—underwent a detailed eye examination including an assessment of their VF using the Humphrey Automated Field Analyzer (Swedish interactive thresholding algorithm Standard 24-2). Open-angle glaucoma was determined by clinical examination. Mean deviation scores were used to assess severity of VF loss. Health-related QOL was assessed by the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) and 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Linear regression and analysis of covariance were used to assess the relationship between HRQOL scores and VF loss after adjusting for sociodemographic variables and visual acuity. Main Outcome Measures The 25-item NEI-VFQ and SF-12 scores. Results A trend of worse NEI-VFQ-25 scores for most subscales was observed with worse VF loss (using both monocular and calculated binocular data). Open-angle glaucoma participants with VF loss had lower scores than participants with no VF loss. This association was also present in participants who were previously undiagnosed and untreated for OAG (N = 160). Participants with any central VF loss had lower NEI-VFQ-25 scores than those with unilateral or bilateral peripheral VF loss. There was no significant impact of severity or location of VF loss on SF-12 scores. Conclusion Greater severity of VF loss in persons with OAG impacts vision-related QOL. This impact was present in persons who were previously unaware that they had glaucoma. Prevention of VF loss in persons with glaucoma is likely to reduce loss of vision-related QOL. PMID:17997485

Understanding Your Vision: The "Imperfect Eye"

MedlinePlus

... including peripheral awareness (side vision), eye coordination, depth perception, focusing ability, and color vision that make up ... the conditions for which you may be at risk." — Dr. Emily Chew National Eye Institute Farsighted If ...

Equity and Blindness: Closing Evidence Gaps to Support Universal Eye Health.

PubMed

Ramke, Jacqueline; Zwi, Anthony B; Palagyi, Anna; Blignault, Ilse; Gilbert, Clare E

2015-01-01

The World Health Organization Program for the Prevention of Blindness adopted the principles of universal health coverage (UHC) in its latest plan, Universal Eye Health: A Global Action Plan, 2014-2019. This plan builds on the achievements of Vision 2020, which aimed to reduce the global prevalence of avoidable blindness, and its unequal distribution, by the year 2020. We reviewed the literature on health equity and the generation and use of evidence to promote equity, particularly in eye health. We describe the nature and extent of the equity-focused evidence to support and inform eye health programs on the path to universal eye health, and propose ways to improve the collection and reporting of this evidence. Blindness prevalence decreased in all regions of the world between 1990 and 2010, albeit not at the same rate or to the same extent. In 2010, the prevalence of blindness in West Africa (6.0%) remained 15 times higher than in high-income regions (0.4%); within all regions, women had a higher prevalence of blindness than men. Beyond inter-regional and sex differences, there is little comparable data on the distribution of blindness across social groups within regions and countries, or on whether this distribution has changed over time. Similarly, interventions known to address inequity in blindness are few, and equity-relevant goals, targets and indicators for eye health programs are scarce. Equity aims of eye health programs can benefit from the global momentum towards achieving UHC, and the progress being made on collecting, communicating and using equity-focused evidence.

Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008.

PubMed

Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei

2011-12-01

To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

Knowledge and practices of teachers associated with eye health of primary school children in Rawalpindi, Pakistan.

PubMed

Habiba, Ume; Ormsby, Gail M; Butt, Zahid Ahmad; Afghani, Tayyab; Asif, Muhammad

2017-01-01

Teachers' perspectives on eye health can be limited, particularly in developing countries. The aim of this study was to assess teachers' knowledge and practices associated with eye health of primary students in Rawalpindi, Pakistan. This was a cross-sectional survey of primary school teachers. Simple random sampling technique was used to select 443 participants from 34 private and 17 public schools. A self-administered questionnaire was used. Teachers' knowledge ranged from "high" (35.89%), "moderate" (49.89%), and "low" (14.22%). Teachers' practices associated with students' eye health ranged from "high" (10.16%), "moderate" (23.02%), and "low" (66.82%). The teachers' knowledge index scores increased 4.28 points with successive age groups and increased 2.41 points with each successive level of education. For teachers whose close relatives experienced eye disease, their knowledge index score was 4.51 points higher than those teachers whose relatives never had any eye disease. Teachers' age, education level, and their close relatives experiencing eye disease were significant predictors of their knowledge ( R 2 = 0.087, P < 0.001). Female teachers' practices index score was 10.35 points higher than the male teachers and public school teachers had 10.13 points higher than the private school teachers. Teachers' gender and type of school were significant predictors of their practices ( R 2 = 0.06, P < 0.001). There was a significant gap among primary school teachers' knowledge and practices related to students' eye health. Innovative strategies are needed to improve how teachers address students' eye health issues in the classroom.

RLE (Research Laboratory of Electronics) Progress Report Number 130

DTIC Science & Technology

1988-07-01

Ippen, James G. Fujimoto, Wei-Zhu Lin, Beat Zysset, Robert W. Schoenlein, 4 Michael J. Lagasse The investigation of transient carrier dynamics in GaAs...G. Fujimoto, Wei-Zhu Lin, Reginald Birngruber, Beat Zysset, Robert W. Schoenleln Working in collaboration with researchers at the Massachusetts Eye... Binaural Hearing National Institutes of Health (Grant 5 RO 1 NS 10916) H. Steven Colburn, Nathaniel 1. Durlach, Patrick M. Zurek 17 Brooklyn College14 141

Scientific Resistance to Research, Training and Utilization of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Treating Post-War Disorders

DTIC Science & Technology

2008-01-01

Affairs/Department ofDefense (2004), APA (2004), Israeli NationalMentalHealth Council (Bleich, Kotler , Kutz, & Shalev, 2002), Clinical Resource...Thus EMDR appears to provide excep- tionally poor Exposure Therapy. For instance, it violates principles of corrective emotional processing... marketing that outstrips empirical support and results in its being labeled as ‘pseudo-science’ (see Devilly, 2002). However, EMDR’s information

Circumventing 'free care' and 'shouting louder': using a health systems approach to study eye health system sustainability in government and mission facilities of north-west Tanzania.

PubMed

Palmer, Jennifer J; Gilbert, Alice; Choy, Michelle; Blanchet, Karl

2016-09-09

Little is known about the contributions of faith-based organisations (FBOs) to health systems in Africa. In the specialist area of eye health, international and domestic Christian FBOs have been important contributors as service providers and donors, but they are also commonly critiqued as having developed eye health systems parallel to government structures which are unsustainable. In this study, we use a health systems approach (quarterly interviews, a participatory sustainability analysis exercise and a social network analysis) to describe the strategies used by eye care practitioners in four hospitals of north-west Tanzania to navigate the government, church mission and donor rules that govern eye services delivery there. Practitioners in this region felt eye care was systemically neglected by government and therefore was 'all under the NGOs', but support from international donors was also precarious. Practitioners therefore adopted four main strategies to improve the sustainability of their services: (1) maintain 'sustainability funds' to retain financial autonomy over income; (2) avoid granting government user fee exemptions to elderly patients who are the majority of service users; (3) expand or contract outreach services as financial circumstances change; and (4) access peer support for problem-solving and advocacy. Mission-based eye teams had greater freedom to increase their income from user fees by not implementing government policies for 'free care'. Teams in all hospitals, however, found similar strategies to manage their programmes even when their management structures were unique, suggesting the importance of informal rules shared through a peer network in governing eye care in this pluralistic health system. Health systems research can generate new evidence on the social dynamics that cross public and private sectors within a local health system. In this area of Tanzania, Christian FBOs' investments are important, not only in terms of the population health outcomes achieved by teams they support, but also in the diversity of organisational models they contribute to in the wider eye health system, which facilitates innovation.

Health Hazard Evaluation Report No. HETA-81-083-933, Salem Area Family Counseling Service, Salem, Oregon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Apol, A.G.

In November 1980, the National Institute for Occupational Safety and Health (NIOSH) received a request for a Health Hazard Evaluation from the Salem Area Family Counseling Service to determine the cause of the adverse health responses (headache, dizziness, irritation of the eyes and throat, dry and sore throat, fatigue, and lethargy) experienced by six of the seven employees in the office. NIOSH conducted an environmental survey on December 29-30, 1980. Due to the persistence of symptoms after the carpets and drapes were steamed cleaned, and the ventilation system cleaned, the firm relocated in another office building. Two months after relocation,more » the symptoms appeared to have disappeared.« less

[Analysis on the trend of innovation and development in the field of ophthalmology].

PubMed

Shan, L H; An, X Y; Xu, M M; Fan, S P; Zhong, H; Ni, P; Chi, H

2018-06-11

Objective: To systematically analyze the innovation and development trend in the field of ophthalmology. Methods: The latest ophthalmology funding program from the National Eye Institute and National Natural Science Foundation of China, and funding project for 2012 to 2016 from the National Institutes of Health, National Natural Science Foundation of China and National key research and development plan of China was collected. Using the comparative analysis method, the major ophthalmology funding areas at home and abroad were analyzed. Papers published in 2012 to 2016 in the field of ophthalmology were collected from the Web of Science Core Collection, among which ESI highly cited papers and hot papers were particularly selected. Using bibliometric methods, the time trend of the number of papers and the citation frequency were analyzed. Using the co-occurrence cluster analysis method, the continued focuses and emerging concerns of ophthalmology papers was analyzed. Results: The funding plan of the National Eye Institute mainly covers nine major diseases in ophthalmology. NSFC focuses on retinal damage and repair mechanisms. The National Key Research and Development Program of China focuses on research on high-end ophthalmic implants. NIH continues to focus on the molecular mechanisms of blinding eye disease such as diabetic retinopathy, age-related macular degeneration, glaucoma, corneal disease and cataracts, basic research in genetics, and advanced diagnostic techniques such as imaging. Latest areas of interest involve gene editing techniques and the application of stem cell technology in ophthalmology. In China, research and application of stem cells in ophthalmic diseases, intraocular sustained-release drug carrier, and precision medicine research in ophthalmology are emerging areas of funding. In 2012 to 2016, research topics of 168 papers collected by ESI focused on macular degeneration, retinal diseases, glaucoma and other eye diseases. How to quickly promote new drugs and new technological achievements to the clinical application is a problem in the field of ophthalmology. How to change the ophthalmology clinic model, so as to provide patients with convenient and quality service, has become a research topic that needs to be given attention to. Conclusions: Based on the multidimensional analysis of innovation and development in the field of ophthalmology, cross application and integration of ophthalmology and high - tech fields such as advanced imaging technology, stem cell technology, gene editing technology, molecular targeting, and artificial intelligence will provide a strong basis for the enhancement of China's ophthalmology research innovation and international competitiveness. Research efforts for ophthalmic transformation should be strengthened, in order to realize the clinical application of the achievements as soon as possible. (Chin J Ophthalmol, 2018, 54: 452 - 463) .

Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020.

PubMed

Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

2014-08-15

Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa.

Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

PubMed Central

2014-01-01

Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed (CSR P = 0.0042, ophthalmologists P = 0.0034, cataract surgeons, ophthalmic nurses and optometrists 0.1 > P > 0.05). Conclusions With only a minority of countries in our sample having reached suggested ophthalmic cadre targets and none having reached targets for refractionists in 2011, substantially more targeted investment in HReH may be needed for VISION 2020 aims to be achieved in sub-Saharan Africa. PMID:25128163

[Macroeconomic costs of eye diseases].

PubMed

Hirneiß, C; Kampik, A; Neubauer, A S

2014-05-01

Eye diseases that are relevant regarding their macroeconomic costs and their impact on society include cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors. The aim of this article is to provide a comprehensive overview of direct and indirect costs for major eye disease categories for Germany, based on existing literature and data sources. A semi-structured literature search was performed in the databases Medline and Embase and in the search machine Google for relevant original papers and reviews on costs of eye diseases with relevance for or transferability to Germany (last research date October 2013). In addition, manual searching was performed in important national databases and information sources, such as the Federal Office of Statistics and scientific societies. The direct costs for these diseases add up to approximately 2.6 billion Euros yearly for the Federal Republic of Germany, including out of the pocket payments from patients but excluding optical aids (e.g. glasses). In addition to those direct costs there are also indirect costs which are caused e.g. by loss of employment or productivity or by a reduction in health-related quality of life. These indirect costs can only be roughly estimated. Including the indirect costs for the eye diseases investigated, a total yearly macroeconomic cost ranging between 4 and 12 billion Euros is estimated for Germany. The costs for the eye diseases cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors have a macroeconomic relevant dimension. Based on the predicted demographic changes with an ageing society an increase of the prevalence and thus also an increase of costs for eye diseases is expected in the future.

Factors associated with vision-related quality of life among the adult population living in Nagorno Karabagh.

PubMed

Harutyunyan, T; Giloyan, A; Petrosyan, V

2017-12-01

Visual impairment and blindness are major public health problems causing significant suffering, disability, loss of productivity, and diminishing quality of life for millions of people. This study explored the factors associated with the overall vision-related quality of life (VRQoL) and its different domains in the adult population of Nagorno Karabakh and assessed the independent contribution of specific eye diseases to VRQoL. A cross-sectional study. We conducted interviewer-administered survey along with free eye screenings among adult residents of Hadrut and Martuni regions of Nagorno Karabakh (Artsakh) in 2014-2015. The study questionnaire included questions about sociodemographic characteristics, non-communicable diseases, use of eye care services, visual acuity, eye diseases, and VRQoL. National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) was used to assess VRQoL. In total, 531 adults participated in the study. The mean age of participants was 60.1 years (standard deviation [SD] = 13.7), ranging from 18 to 90 years. The majority of participants were female (71.4%). The most frequently diagnosed eye disorder was cataract (33.8%). The prevalence of moderate and severe visual impairment was 7.0% and 0.8%, respectively. Almost 2.8% (15) of participants were blind. The mean global score of VFQ-25 in all study participants was 71.1 ± 19.28 (SD), whereas the mean global scores of VFQ-25 among not visually impaired, visually impaired, and blind participants were 74.0 ± 16.47 (SD), 51.7 ± 21.77 (SD), and 30.9 ± 20.2 (SD), respectively. In the adjusted linear regression model having moderate/severe visual impairment or blindness, age, socio-economic status, and having eye diseases such as glaucoma and cataract were significantly associated with VFQ-25 global score. The subscales of near vision, distance vision, peripheral vision, role difficulties, and mental health had significant associations with severe/moderate visual impairment in the adjusted analysis. After adjusting for visual impairment and demographic variables, participants with cataract and glaucoma were found to have statistically significant lower subscale scores than those without eye disease. Our data suggest that visual impairment was associated with lower scores of VRQoL. The strength of that association correlated with the increase in the level of visual impairment (from moderate/severe impairment to blindness). VRQoL was also shown to be affected by age, socio-economic status, and having eye diseases such as glaucoma and cataract. Further actions of remediation of visual impairment in this population are warranted. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Eye health care in the Czech Republic.

PubMed

Kocur, Ivo; Kuchynka, Pavel

2002-01-01

An analysis of eye health care in the Czech Republic as of 1998 was performed. A questionnaire was used to obtain information from all 59 in-patient eye departments. The number of ophthalmologists per 1 million inhabitants was 95. The number of cataract operations per 1 million inhabitants was 4,209: phaco-emulsification (36,926 surgeries, 85.2%), extracapsular extraction (6,094 surgeries, 14.1%) and intracapsular extraction (90 surgeries, 0.2%). Intra-ocular lenses were implanted in 99% of cases; 404 corneal transplantations and 1,220 operations for retinal detachment were performed. The number of pars plana vitrectomies for diabetic eye complications was 661. Selected regional clinical centres should be equipped and preferred by health insurance companies to provide comprehensive eye health care services and training. Copyright 2002 S. Karger AG, Basel

Association Between County-Level Characteristics and Eye Care Use by US Adults in 22 States After Accounting for Individual-Level Characteristics Using a Conceptual Framework.

PubMed

Chou, Chiu-Fang; Beckles, Gloria L; Cheng, Yiling J; Saaddine, Jinan B

2016-10-01

Individual-level characteristics are associated with eye care use. The influence of contextual factors on vision and eye health, as well as health behavior, is unknown. To examine the association between county-level characteristics and eye care use after accounting for individual-level characteristics using a conceptual framework. This investigation was a cross-sectional study of respondents 40 years and older participating in the Behavioral Risk Factor Surveillance System surveys between 2006 and 2010 from 22 states that used the Visual Impairment and Access to Eye Care module. Multilevel regressions were used to examine the association between county-level characteristics and eye care use after adjusting for individual-level characteristics (age, sex, race/ethnicity, educational attainment, annual household income, employment status, health care insurance coverage, eye care insurance coverage, personal established physician, poor vision or eye health, and diabetes status). Data analysis was performed from March 23, 2014, to June 7, 2016. Eye care visit and receipt of a dilated eye examination in the past year. Among 117 295 respondents who resided in 828 counties, individual-level data were obtained from the Behavioral Risk Factor Surveillance System surveys. All county-level variables were aggregated at the county level from the Behavioral Risk Factor Surveillance System surveys except for a high geographic density of eye care professionals, which was obtained from the 2010 Area Health Resource File. After controlling for individual-level characteristics, the odds of reporting an eye care visit in the past year were significantly higher among people living in counties with high percentages of black individuals (adjusted odds ratio [aOR], 1.12; 95% CI, 1.01-1.24; P = .04) or low-income households (aOR, 1.12; 95% CI, 1.00-1.25; P = .045) or with a high density of eye care professionals (aOR, 1.18; 95% CI, 1.07-1.29; P < .001) than among those living in counties with the lowest tertile of each county-level characteristic. The odds of reporting receipt of a dilated eye examination in the past year were also higher among people living in counties with the highest percentages of black individuals (aOR, 1.20; 95% CI, 1.07-1.34; P = .002) or low-income households (aOR, 1.17; 95% CI, 1.04-1.32; P = .01). However, the odds of reported receipt of a dilated eye examination in the past year were lower in counties with the highest percentages of people with poor vision and eye health compared with counties with lower percentages (aOR, 0.85; 95% CI, 0.77-0.94; P = .002). Contextual factors, measured at the county level, were associated with eye care use independent of individual-level characteristics. The findings suggest that, while individual characteristics influence health care use, it is also important to address contextual factors to improve eye care use and ultimately vision health.

Knowledge and attitude of guardians towards eye health of primary school pupils in Ilorin, Nigeria.

PubMed

Ayanniyi, A A; Olatunji, F O; Mahmoud, A O; Ayanniyi, R O

2010-03-01

To determine guardians' knowledge and attitude towards pupils' eye health and draw implication for designing children-oriented ocular health messages. A survey of 1,393 guardians selected through multistage random sampling in Ilorin, Nigeria. Using structured questionnaire, information sought included guardians' demographic characteristics, relationship to pupils, occupation, awareness of eye specialists, perception of normal vision, pupils' eye complaints, and ways of treating children eye conditions. Data analysis was done with SPSS 12.0.1. The test of significance was performed using Chi square test and significance was taken at p < 0.05. Guardians comprised 689 (49.4%) males and 704 (50.6%) females, mean age 43.61 SD 11.45. Most (88.54%) were pupils' parents and (11.46%) were relations (n=1,318); (55.15%) were in low-paying occupations (n=1,311); (87.92%) were aware of eye specialists, (12.08%) unaware, (n=1192); (97.27%) adjudged normal vision at least important, (2.73%) not important (n=1,174). Pupils' eye complaints (n=914) included pain (26.04%), itching (24.73%), redness (21.12%), discharge (8.53%), blur vision (8.21%), photophobia (7.33%) and lacrimation (4.05%). Guardians (n=1,069) managed pupils' eye diseases using hospital treatment (61.65%), neglect (21.33%), self medication (9.26%) and traditional medication (7.76%). There were no significant associations between guardians' ways of managing pupils' eye diseases and their views on normal vision (p = 0.940); awareness of eye care specialists (p = 0.952); and economic occupational grouping (p = 0.959). The negative implications of neglecting eye diseases and use of self and harmful traditional eye-medications by some of the guardians need to be discouraged by appropriate eye health education.

Health system dynamics analysis of eyecare services in Trinidad and Tobago and progress towards Vision 2020 Goals.

PubMed

Braithwaite, Tasanee; Winford, Blaine; Bailey, Henry; Bridgemohan, Petra; Bartholomew, Debra; Singh, Deo; Sharma, Subash; Sharma, Rishi; Silva, Juan Carlos; Gray, Alastair; Ramsewak, Samuel S; Bourne, Rupert R A

2018-01-01

Avoidable blindness is an important global public health concern. This study aimed to assess Trinidad and Tobago's progress towards achieving the Pan American Health Organization, 'Strategic Framework for Vision 2020: The Right to Sight-Caribbean Region,' indicators through comprehensive review of the eyecare system, in order to facilitate health system priority setting. We administered structured surveys to six stakeholder groups, including eyecare providers, patients and older adult participants in the National Eye Survey of Trinidad and Tobago. We reviewed reports, registers and policy documents, and used a health system dynamics framework to synthesize data. In 2014, the population of 1.3 million were served by a pluralistic eyecare system, which had achieved 14 out of 27 Strategic Framework indicators. The Government provided free primary, secondary and emergency eyecare services, through 108 health centres and 5 hospitals (0.26 ophthalmologists and 1.32 ophthalmologists-in-training per 50 000 population). Private sector optometrists (4.37 per 50 000 population), and ophthalmologists (0.93 per 50 000 population) provided 80% of all eyecare. Only 19.3% of the adult population had private health insurance, revealing significant out-of-pocket expenditure. We identified potential weaknesses in the eyecare system where investment might reduce avoidable blindness. These included a need for more ophthalmic equipment and maintenance in the public sector, national screening programmes for diabetic retinopathy, retinopathy of prematurity and neonatal eye defects, and pathways to ensure timely and equitable access to subspecialized surgery. Eyecare for older adults was responsible for an estimated 9.5% (US$22.6 million) of annual health expenditure. This study used the health system dynamics framework and new data to identify priorities for eyecare system strengthening. We recommend this approach for exploring potential health system barriers to addressing avoidable blindness, and other important public health problems. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Breeding for better eye health in Finnish blue fox (Vulpes lagopus).

PubMed

Kempe, R; Strandén, I

2016-02-01

The frequency of eye infections in the Finnish blue fox population has increased during the past decade. Eye infection may incur economic losses to producers due to reduced selection intensity, but ethical aspects need to be considered as well because eye infection can be quite painful and reduce animal well-being. The purpose of this study was to determine the potential for genetic selection against susceptibility to eye infection. The data were collected from 2076 blue foxes at the MTT fur animal research station. Genetic parameters were estimated using single- and multiple-trait animal models. The heritability estimate for eye infection was analysed as a binary trait (EYE) and was moderate (0.24 ± 0.07). EYE had a moderate antagonistic genetic correlation (-0.49 ± 0.20) with grading density (thick underfur). The genetic correlation of EYE with grading size or body condition score was estimated without precision, but all size traits had a low antagonistic phenotypic correlation with EYE. Our results suggest that there is genetic variance in susceptibility to EYE, indicating that eye health can be improved through selection. The current recommendation is that the sick animals should be culled immediately. If more efficient selection is needed, the selection index and multiple-trait animal models can be applied in breeding for better eye health. © 2015 Blackwell Verlag GmbH.

Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation.

PubMed

Gold, Jeffrey Allen; Stephenson, Laurel E; Gorsuch, Adriel; Parthasarathy, Keshav; Mohan, Vishnu

2016-09-01

Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians' failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit-based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record-based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability. © The Author(s) 2015.

A behavioral analysis of eye protection use by soldiers.

PubMed

Wong, T Y; Seet, B

1997-11-01

One of the major problems faced by eye injury prevention programs in the military is the low compliance among individual soldiers with eye armor use. We use three different health behavioral models (the health belief model, the social learning theory, and the PRECEDE model) to analyze and explore the various factors involved in the use of eye armor. Some of the factors that appear to be important in affecting the behavior include environmental conditions (e.g., actual military deployment versus nondeployment activity), organizational attitude toward eye protection programs, community influence, individual knowledge and perception of eye injury, and belief in the efficacy of eye armor. An understanding of these factors can help influence the development of more effective strategies for eye injury prevention in the military.

Epidemiology of infant ocular and periocular injuries from consumer products in the United States, 2001-2008.

PubMed

Chen, Allison J; Linakis, James G; Mello, Michael J; Greenberg, Paul B

2013-06-01

To quantify and characterize eye injuries related to consumer products in the infant population (0-12 months) treated in United States hospital emergency departments during the period from 2001 to 2008. This study is a descriptive analysis of consumer-product related eye injury data derived from the National Electronic Injury Surveillance System, a probability sample of 100 hospitals nationwide with 24-hour emergency departments. Narrative data were used to assign each case with the consumer products (CPs) causing the eye injury. The proportions of eye injury visits were calculated by age, sex, diagnosis, disposition, locale of incident, and CP categories. We examined the US Consumer Product Safety Commission National Electronic Injury Surveillance System data for all nonfatal eye injuries (853 cases) in the infant population (0-12 months) treated in US emergency departments from 2001 to 2008. These data can be used to project national, annual, weighted estimates of nonfatal injury treated in US emergency departments. There were an estimated 21,271 visits to US emergency departments by patients aged 0-12 months for CP-related eye injuries during the study period. Of these, 63% involved infants aged 9-12 months and 54% involved male patients; 78% of all injuries occurred at home. The CPs causing the most eye injuries belonged to the categories of chemical (46%) and household items (24%). Contusions and abrasions were the leading eye injuries diagnoses (37%). This study suggests that most CP-related infant eye injuries in the United States occur at home and are predominantly caused by chemicals and household products. Published by Mosby, Inc.

Incidence of eye cancer in Taiwan: an 18-year review.

PubMed

Cheng, C-Y; Hsu, W-M

2004-02-01

To describe the incidence and histologic patterns of eye cancers in Chinese in Taiwan. Beginning in 1979, cases of cancer in Taiwan were reported to the Taiwan National Cancer Registry. Information on all Chinese patients diagnosed with eye malignancies under the International Classification of Disease, Ninth Revision, site 190, was retrieved for analysis from the data bank of the Taiwan National Cancer Registry. In all, 733 cases with primary eye cancers were identified from 1979 to 1996, an 18-year period. The average annual age-standardized incidence of eye cancers was 2.46 per million population (2.57 for male and 2.33 for female). For cases less than 15 years of age, the most common eye malignancy was retinoblastoma (86.0%), followed by rhabdomyosarcoma (3.9%) and lymphoma (2.8%). For cases 15 years of age or older, the most common eye malignancy was melanoma (28.6%), followed by squamous cell sarcoma (21.0%) and lymphoma (20.8%). The time trends of the incidence of eye cancers were relatively stable over the 18-year period in Taiwan. Retinobalstoma, melanoma, and lymphoma were the three most common eye cancers in this Chinese population.

75 FR 432 - Notice of Extension of Concession Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... Service, 1201 Eye Street, NW., 11th Floor, Washington, DC, 20005, Telephone 202/513-7156. SUMMARY... Park, Inc..... Biscayne National Park. BLRI004-88 Virginia Peaks of Otter Blue Ridge Parkway. EVER004... Services Program, National Park Service, 1201 Eye Street, NW., 11th Floor, Washington, DC 20005, Telephone...

The effect of an eye health promotion program on the health protective behaviors of primary school students

PubMed Central

Kirag, Nukhet; Temel, Ayla Bayik

2018-01-01

INTRODUCTION: Undiagnosed and uncorrected refractive errors in childhood can negatively affect the development of vision and cause students to have low academic success and even quit school before graduation. This study aims to determine the effects of an eye health promotion program on the health protective behaviors of primary school students. MATERIALS AND METHODS: This experimental study using a pretest-posttest design with a control group was conducted in three public primary schools in Aydın, a city in the Western Anatolia Region of Turkey, between April and November 2014. The eye health promotion program was provided by the researchers to the experimental Group 2 days in 4 weeks. The data were analyzed using the t-test, Chi-square analysis, the Mann–Whitney U-test, the Wilcoxon signed-rank test, and the McNemar test. RESULTS: The average age of the students was identified as 9.0 ± 3.64 years. The students wearing glasses all in the experimental group and 53.3% in the control group were found to always wear their glasses after the education program was completed (P < 0.05). These students, 97.9% in the experimental group and 58.1% in the control group underwent eye examinations from an ophthalmologist (P < 0.05). The eye health protective behaviors of the experimental group were found to have positively changed in the final follow-up, compared to the control group (P < 0.05). CONCLUSION: The eye health promotion program was found to be effective in improving eye health protective behaviors within the experimental group. PMID:29619388

Vision-related quality of life in patients after ocular penetrating injuries.

PubMed

Yüksel, Harun; Türkcü, Fatih M; Ahin, Muhammed; Cinar, Yasin; Cingü, Abdullah K; Ozkurt, Zeynep; Bez, Yasin; Caça, Hsan

2014-04-01

To measure and investigate visual functioning and health-related quality of life (QOL) in patients after ocular penetrating injuries (OPI). Fifty-four adult patients with OPI and 26 healthy control subjects were enrolled in the study. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) and the 36-Item Short Form Health Survey (SF 36) were administered. Sociodemographic and clinical data also were collected. The primary outcome measures were comparisons and multivariate analysis among groups for the NEI VFQ-25 and SF 36 subscale scores. All NEI VFQ-25 scores, except general health, were significantly lower in the OPI group than those in the control group. All SF 36 scores were significantly lower in the OPI group than in the control group. The NEI VFQ-25 subscale item scores showed no significant differences with respect to age, educational level, or visual acuity in the injured eye. The SF 36 subscale item scores revealed no significant differences according to gender or educational level. Patients with OPI have increased psychological symptoms and lower levels of QOL than healthy control subjects have. Deteriorations in QOL should be kept in mind when managing patients with OPI.

Eye Health in New Zealand: A Study of Public Knowledge, Attitudes, and Practices Related to Eye Health and Disease

ERIC Educational Resources Information Center

Ahn, Mark J.; Frederikson, Lesley; Borman, Barry; Bednarek, Rebecca

2011-01-01

Purpose: This study seeks to measure the public knowledge, attitudes, and practices related to eye health and disease in New Zealand (NZ). Design/methodology/approach: A 22-item survey of 507 adults in NZ was conducted. The survey was developed using interviews and focus groups, as well as comparisons with other benchmark international studies.…

Which lamp will be optimum to eye? Incandescent, fluorescent or LED etc

PubMed Central

Chen, Liang; Zhang, Xiao-Wei

2014-01-01

Low frequency flicker, high frequency flicker, strong light, strong blue light, infrared, ultraviolet, electromagnetic radiation, ripple flicker and dimming flicker produced by different lamps have negative impact on vision, eyes and health. Negative impact on eyes resulting in myopia or cataract etc: the solution is to remove all the negative factors by applying upright lighting technology and that is optimum to vision, eyes and health. PMID:24634884

Which lamp will be optimum to eye? Incandescent, fluorescent or LED etc.

PubMed

Chen, Liang; Zhang, Xiao-Wei

2014-01-01

Low frequency flicker, high frequency flicker, strong light, strong blue light, infrared, ultraviolet, electromagnetic radiation, ripple flicker and dimming flicker produced by different lamps have negative impact on vision, eyes and health. Negative impact on eyes resulting in myopia or cataract etc: the solution is to remove all the negative factors by applying upright lighting technology and that is optimum to vision, eyes and health.

A cross-sectional study of pediatric eye care perceptions in Ghana, Honduras, and India.

PubMed

Ramai, Daryl; Elliott, Ryan; Goldin, Shoshanna; Pulisetty, Tejas

2015-06-01

Of the more than 1.4 million blind children worldwide, 75% live in developing countries. To reduce the prevalence of childhood blindness and associated diseases, attention is given to understanding the perceptions and level of awareness held by caregivers. This understanding can enable tailored health programs to reduce the global prevalence of blindness with increased efficiency. This study, which took place in Ghana, Honduras, and India, found that 95% of caregivers believed in the importance of eye exams for children, yet 66% of caregivers said that none of their children had ever received an eye exam. Participants' major reasons for not bringing their children included the belief that their child had no eye problems along with similar and unique socio-economic barriers. Further information was gained through the use of a five-question test on basic child eye care symptoms, which showed that out of the three country locations, the studied population in India had the least understanding about pediatric eye symptoms. Further analysis revealed significant gaps in understanding of general eye health while detected knowledge barriers provide evidence that fundamental misconceptions appear to be inhibiting caregivers' competence in facilitating their children's eye health. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Teaching tools to engage Anishinaabek First Nations women in cervical cancer screening: Report of an educational workshop.

PubMed

Zehbe, Ingeborg; Wood, Brianne; Wakewich, Pamela; Maar, Marion; Escott, Nicholas; Jumah, Naana; Little, Julian

2016-04-01

To explore educational strategies for engaging First Nations women in Canada to attend cervical cancer screening. Within a participatory action research framework, semi-structured interviews with health-care providers in First Nations communities revealed that education about the value of screening is perceived as being a key factor to promote cervical cancer screening. To obtain feedback from workshop informants, a 1-day educational workshop was held to identify appropriate educational intervention strategies, which would be applied in a forthcoming randomised controlled cervical screening trial. Common discussion and discussion groups, which were facilitated by a First Nations workshop moderator and a note taker. This workshop helped to strengthen the ethical space dialogue with the First Nations communities with whom the study team had established research partnerships. The workshop atmosphere was relaxed and the invited informants decided that an educational health promotion event for community women needed to be held prior to inviting them to the cervical screening trial. Such an event would provide an opportunity to communicate the importance of attending regular cervical screening allowing women to make informed decisions about screening participation. Complementary promotional items, including an eye-catching pamphlet and storytelling, were also suggested. The key messages from the events and promotional items can help to destigmatise women who develop a type of cancer that is caused by a sexually transmitted virus that affects both men and women. Developing and implementing positive health education that respectfully depicts female bodies, sexuality and health behaviours through a First Nations lens is strongly warranted.

Teaching tools to engage Anishinaabek First Nations women in cervical cancer screening: Report of an educational workshop

PubMed Central

Zehbe, Ingeborg; Wood, Brianne; Wakewich, Pamela; Maar, Marion; Escott, Nicholas; Jumah, Naana; Little, Julian

2016-01-01

Objective To explore educational strategies for engaging First Nations women in Canada to attend cervical cancer screening. Design Within a participatory action research framework, semi-structured interviews with health-care providers in First Nations communities revealed that education about the value of screening is perceived as being a key factor to promote cervical cancer screening. Setting To obtain feedback from workshop informants, a 1-day educational workshop was held to identify appropriate educational intervention strategies, which would be applied in a forthcoming randomised controlled cervical screening trial. Methods Common discussion and discussion groups, which were facilitated by a First Nations workshop moderator and a note taker. Results This workshop helped to strengthen the ethical space dialogue with the First Nations communities with whom the study team had established research partnerships. The workshop atmosphere was relaxed and the invited informants decided that an educational health promotion event for community women needed to be held prior to inviting them to the cervical screening trial. Such an event would provide an opportunity to communicate the importance of attending regular cervical screening allowing women to make informed decisions about screening participation. Complementary promotional items, including an eye-catching pamphlet and storytelling, were also suggested. Conclusion The key messages from the events and promotional items can help to destigmatise women who develop a type of cancer that is caused by a sexually transmitted virus that affects both men and women. Developing and implementing positive health education that respectfully depicts female bodies, sexuality and health behaviours through a First Nations lens is strongly warranted. PMID:27867211

Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020.

PubMed

Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

2014-08-15

Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with high CSR, regardless of the type of surgeon employed. The cataract surgeon workforce is growing proportionately faster than the ophthalmologist. The HReH workforce is not growing fast enough to achieve global eye health targets in most of the sub-Saharan countries we surveyed by 2020. Countries seeking to make rapid progress to improve CSR could prioritise investment in training new cataract surgeons over ophthalmologists and improving surgical output efficiency.

Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020

PubMed Central

2014-01-01

Background Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Methods Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. Results In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with high CSR, regardless of the type of surgeon employed. The cataract surgeon workforce is growing proportionately faster than the ophthalmologist. Conclusions The HReH workforce is not growing fast enough to achieve global eye health targets in most of the sub-Saharan countries we surveyed by 2020. Countries seeking to make rapid progress to improve CSR could prioritise investment in training new cataract surgeons over ophthalmologists and improving surgical output efficiency. PMID:25128287

Compiling a national register of babies born with anophthalmia/microphthalmia in England 1988-94

PubMed Central

Busby, A.; Dolk, H.; Collin, R.; Jones, R; Winter, R.

1998-01-01

AIM—To describe the prevalence of anophthalmia/microphthalmia in babies born in England 1988-94, as well as their overall survival, and the incidence of associated eye and non-eye malformations; to determine the usefulness of different sources of medical and health service information for establishing a retrospective register of anophthalmia/microphthalmia.
METHODS—Multiple sources for initial (retrospective) case ascertainment were surveyed, followed by questionnaires to clinicians to establish severity, associated malformations, and aetiology for England, 1988-94. The population surveyed was all births in England for this time period (4 570 350 births). Cases included live births, stillbirths, or terminations after prenatal diagnosis of congenital anomaly, with anophthalmia/microphthalmia, with or without other malformations and syndromes. Trisomy 13 was subsequently excluded.
RESULTS—The proportion of cases notified by any one information source was not more than 26% (Office for National Statistics Register 22%, paediatricians 26%, district sources 25%). Sixty nine per cent of cases (51% of severe cases) were notified by only one source. A total of 449 cases were reported, prevalence 1.0 per 10 000 births. The prevalence was stable over time, although the proportion notified by clinicians rose in more recent years. Thirty four per cent of affected babies had mild microphthalmia. Of those with severe anophthalmia/microphthalmia, 51% were bilateral, other eye malformations were present in 72%, non-eye malformations in 65%, and a "known aetiology" was attributed in 22%. Three quarters of those severely affected survived infancy.
CONCLUSIONS—Despite high response rates from the sources of information contacted, the lack of duplication between sources indicates the difficulties of retrospective ascertainment and the need for multiple sources when establishing a register. Anophthalmos/microphthalmos is usually associated with other malformations. Most cases are of unknown aetiology.

 PMID:10194985

Emergency eye care in rural Australia: role of internet.

PubMed

Kumar, S; Yogesan, K; Hudson, B; Tay-Kearney, M-L; Constable, I J

2006-12-01

Significant differences exist in the utilization of emergency eye care services in rural and urban Australia. Meanwhile, influence of internet-based technology in emergency eye care service utilization has not been established. This study aims to demonstrate, from a health provider perspective, an internet-based service's impact on emergency eye care in rural Australia. The teleophthalmology service was initiated in the Carnarvon Regional Hospital (CRH) of the Gascoyne region in Western Australia. A digital, slit lamp and fundus camera were used for the service. Economic data was gathered from the Department of Health of Western Australia (DOHWA), the CRH and the Lions Eye Institute. During the study period (January-December, 2003) 118 persons took part in teleophthalmology consultations. Emergency cases constituted 3% of these consultations. Previous year, there were seven eye-related emergency evacuations (inter-hospital air transfers) from the Gascoyne region to City of Perth. Analysis demonstrates implementation of internet-based health services has a marked impact on rural emergency eye care delivery. Internet is well suited to ophthalmology for the diagnosis and management of acute conditions in remote areas. Integration of such services to mainstream health care is recommended.

The National Eye Institute Annual Report: FY 1974.

ERIC Educational Resources Information Center

National Eye Inst. (DHEW/PHS), Bethesda, MD.

Presented is an annual report of research and supported by the National Eye Institute (NEI) during the 1974 fiscal year. It is explained that the purpose of NEI research programs is to develop scientific knowledge which can be applied to the improved prevention, diagnosis, and treatment of visual disorders. The section on extramural and…

Improving access to eye health services in rural Timor-Leste.

PubMed

Pereira, Sara M; Blignault, Ilse; du Toit, Renee; Ramke, Jacqueline

2012-01-01

Delivering eye health services to people in rural areas, especially in fragile, post-conflict countries, is a major challenge. This article reports on the implementation and evaluation of an innovative district-based outreach service. The main project partners were the Timor-Leste Ministry of Health and an international non-government organization, with assistance from a local non-government organization. An eye care nurse in Covalima District, a remote location 178 km from Timor-Leste's capital, Dili, was provided with a motor-bike for transport and regular support for outreach eye services to sub-district facilities. Data collected over the first year of operation were examined and included: services provided, spectacles dispensed, health promotion activities conducted and the cost of providing these. The project was also evaluated for its relevance, effectiveness, efficiency, impact and sustainability. In the first 12 months, 55 outreach visits were conducted across the district's seven sub-districts during which 1405 people received vision screening, and 777 spectacles were dispensed. In addition to meeting the five evaluation criteria, compared with the hospital-based eye clinic the outreach service resulted in significantly greater gender equity among eye health service beneficiaries. This pilot project demonstrates what can be achieved when a Ministry of Health (central and district level) and non-government organizations (international and local) work in partnership to support a dedicated health care provider.

The Barrie Jones Lecture—Eye care for the neglected population: challenges and solutions

PubMed Central

Rao, G N

2015-01-01

Globally, pockets of ‘neglected populations' do not have access to basic health-care services and carry a much greater risk of blindness and visual impairment. While large-scale public health approaches to control blindness due to vitamin A deficiency, onchocerciasis, and trachoma are successful, other causes of blindness still take a heavy toll in the population. High-quality comprehensive eye care that is equitable is the approach that needs wide-scale application to alleviate this inequity. L V Prasad Eye Institute of India developed a multi-tier pyramidal model of eye care delivery that encompasses all levels from primary to advanced tertiary (quaternary). This has demonstrated the feasibility of ‘Universal Eye Health Coverage' covering promotive, preventive, corrective, and rehabilitative aspects of eye care. Using human resources with competency-based training, effective and cost-effective care could be provided to many disadvantaged people. PMID:25567375

Cranial mononeuropathy III

MedlinePlus

... is one of the cranial nerves that control eye movement. Causes may include: Brain aneurysm Infections Abnormal blood ... show: Enlarged (dilated) pupil of the affected eye Eye movement abnormalities Eyes that are not aligned Your health ...

A pilot study to evaluate incorporating eye care for children into reproductive and child health services in Dar-es-Salaam, Tanzania: a historical comparison study

PubMed Central

2014-01-01

Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede’s prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede’s prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs-60.7%). Mystery mothers observed health education sessions in 7/10 RCH clinics with trained staff, five (71.4%) of which included eye conditions. Conclusions Primary eye care for children in Dar-es-Salaam is inadequate but training RCH staff can improve knowledge in the short term and change practices. Attendance by mothers and their children is high in RCH clinics, making them ideal for delivery of PEC. Ongoing supportive supervision is required to maintain knowledge and practices, as well as systems to track referrals. PMID:24932133

Adult vaccination: Now is the time to realize an unfulfilled potential

PubMed Central

Tan, Litjen

2015-01-01

Each year, vaccine-preventable diseases kill thousands of adults, both in the United States and across the planet, causing a significant human toll and severe economic burden on the world's healthcare systems. In the United States, while immunization is recognized as one of the most effective primary prevention services that improves health and well-being, adult immunization rates remain low and large gaps exist between national adult immunization goals and actual adult immunization rates. Closing these gaps requires a commitment by national leaders to a multifaceted national strategy to: (1) establish the value of adult vaccines in the eyes of the public, payers, policy makers, and health care professionals; (2) improve access to recommended adult vaccinations by improving the adult vaccine infrastructure in the United States and developing public-private partnerships to facilitate effective immunization behaviors; and (3) ensure fair and appropriate payment for adult immunization. Many of the situations that result in low adult immunizations rates in the United States also exist in many other countries around the world. Successful strategies to improve adult immunization coverage rates will result in reductions in morbidity, mortality, and healthcare costs. All medical and public health stakeholders must now collaborate to realize the significant health benefits that come with a strong adult immunization program. PMID:26091249

Evaluation of a community-based participatory farmworker eye health intervention in the "black dirt" region of New York state.

PubMed

Earle-Richardson, Giulia; Wyckoff, Lynae; Carrasquillo, Marilyn; Scribani, Melissa; Jenkins, Paul; May, John

2014-09-01

Eye irritation is a constant hazard for migrant and seasonal farmworkers, but there are few studies of the problem or how to address it. Researchers evaluated the effect of a community-based participatory eye health intervention on farmworker eye symptoms in the Hudson Valley, NY. A randomized pre-post intervention with 2, 4-week follow-up periods was implemented with a sample of 97 farmworkers. Five eye symptoms were measured, along with utilization of protective eyewear and eye drops. Leading baseline eye symptoms were redness (49%), blurred vision (43%), itching (43%), and eye pain (29%). Significant reductions in eye pain (P = 0.009), and non-significant reductions in redness were observed for the intervention group while controls experienced increases in both. The intervention was effective in significantly reducing eye pain, and to a lesser extent, redness. Future eyewear promotion programs should offer a range of eye wear, tailor offerings to local climate and tasks, evaluate eyewear durability, and include eye drops. © 2014 Wiley Periodicals, Inc.

Self-Reported Type 2 Diabetes and Diabetes-Related Eye Disease in Jews and Arabs in Israel.

PubMed

Zucker, Inbar; Arditi-Babchuk, Hadar; Enav, Teena; Shohat, Tamar

2016-12-01

Prevalence rates of diabetes and its complications may be higher in minorities. We assessed these rates in Jews and Arabs living in Israel. Data were pooled from the first and second Israeli national health interview surveys. 9625 Jews and 2401 Arabs participated in the analysis. The age adjusted rate of self-reported diabetes was 10.7 % among Arabs and 5.7 % among Jews [odds ratio (OR) 2.14, 95 % confidence interval 1.77-2.60]. After adjustment for risk factors the OR decreased to 1.28 (95 % CI 1.04-1.59). The rate of self-reported diabetes-related eye disease was 37.6 % among Arabs with diabetes and 18.3 % among Jews (OR 2.69, 95 % CI 1.84-3.93). After adjustment the odds among Arabs were still double that of Jews (OR 2.26, 95 % CI 1.44-3.56). Self-reported type 2 diabetes and diabetes-related eye disease were higher among Arabs. Multi-disciplinary and cultural sensitive approach is required in order to improve diabetes care among the Arab population.

Ocular Health and Safety Assessment among Mechanics of the Cape Coast Metropolis, Ghana.

PubMed

Abu, Emmanuel Kwasi; Boadi-Kusi, Samuel Bert; Opuni, Prince Quarcoo; Kyei, Samuel; Owusu-Ansah, Andrew; Darko-Takyi, Charles

2016-01-01

To conduct an ocular health and safety assessment among mechanics in the Cape Coast Metropolis, Ghana. This descriptive cross sectional study included 500 mechanics using multistage sampling. All participants filled a structured questionnaire on demographic data, occupational history and ocular health history. Study participants underwent determination of visual acuity (VA) using LogMAR chart, external eye examination with a handheld slit lamp biomicroscope, dilated fundus examination, applanation tonometry and refraction. Out of 500 mechanics, 433 were examined (response rate, 87%) comprised of 408 (94.2%) male and 25 (5.8%) female subjects. The prevalence of visual impairment (i.e. presenting VA < 6/18) among the respondents was 2.1%. Eye injuries were reported in 171 (39.5%) mechanics probably due to the large number of workers, 314 (72.5%), who did not use eye protective devices. Mechanics in the auto welding category were at the highest risk of sustaining an eye injury (odds ratio [OR], 13.4; P < 0.001). Anterior segment ocular disorders were mostly pterygia while posterior segment eye disorders included glaucoma suspects and retinochoroidal lesions. The development of pterygia was associated with the number of years a mechanic stayed on the job. Eye care seeking behavior among the participants was poor. Eye injuries were prevalent among the mechanics as the use of eye protection was low. Eye safety should be made an integral part of the public health agenda in the Cape Coast Metropolis.

Ophthalmic patients' utilization of technology and social media: an assessment to improve quality of care.

PubMed

Aleo, Chelsea L; Hark, Lisa; Leiby, Benjamin; Dai, Yang; Murchison, Ann P; Martinez, Patricia; Haller, Julia A

2014-10-01

E-health tools have the potential to improve the quality of care for ophthalmic patients, many of whom have chronic conditions. However, little research has assessed ophthalmic patients' use or acceptance of technological devices and social media platforms for health-related purposes. The present study evaluated utilization of technological devices and social media platforms by eye clinic patients, as well as their willingness to receive health reminders through these technologies. A 31-item paper questionnaire was administered to eye clinic patients (n=843) at an urban, tertiary-care center. Questions focused on technology ownership, comfort levels, frequency of use, and preferences for receiving health reminders. Demographic data were also recorded. Eye clinic patients most commonly owned cellular phones (90%), landline phones (81%), and computers (80%). Overall, eye clinic patients preferred to receive health reminders through phone calls and e-mail and used these technologies frequently and with a high level of comfort. Less than 3% of patients preferred using social networking to receive health reminders. In addition, age was significantly associated with technology ownership, comfort level, and frequency of use (p<0.05). The majority of patients 18-45 years of age preferred to receive appointment reminders via text message (57%) and e-mail (53%). This age group also used these technologies more frequently and with a higher comfort level (p<0.001). These data support the proposal that e-mail and text-messaging e-health tools are likely to be immediately adopted by eye clinic patients and therefore have the greatest potential to improve health outcomes and increase quality of care. Eye clinic patients are interested in these technologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these purposes.

Informal alcohol in Malawi: stakeholder perceptions and policy recommendations.

PubMed

Limaye, Rupali J; Rutkow, Lainie; Rimal, Rajiv N; Jernigan, David H

2014-02-01

Through the eyes of those involved in the alcohol policy-making process in Malawi, we explored the role of informal (non-commercial) alcohol in rural communities, its harmful effects, and implications for appropriate national policy. Harms included early drinking initiation, violence, and sexual risk exposure. Informants suggested that policy should address informal alcohol's content, selling times, and easy access. Because most informal alcohol producers are women who rely upon sales for subsistence, policies must avoid limiting women's economic opportunities while protecting community health.

76 FR 66081 - Proposed Information Collection; Nomination of Properties for Listing on the National Register of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

..., 1201 Eye St., NW., MS 1242, Washington, DC 20005 (mail); or [email protected] (e-mail). Please reference Information Collection 1024- 0018. FOR FURTHER INFORMATION CONTACT: Lisa Deline, NPS Historian, National Register of Historic Places, 1201 Eye St., NW, 20005. You may send an e-mail to Lisa[email protected

Biosensors and Your Health: What's Your Body Trying to Tell You?

MedlinePlus

... of our normal health care routines. New sensor technologies are opening avenues to better health. Researchers are working to develop the biosensors of tomorrow. These could provide access to better health in ways we can’t yet imagine. Related Stories Keep an Eye on Your Eyes Struggling to ...

Eye Tracking Outcomes in Tobacco Control Regulation and Communication: A Systematic Review.

PubMed

Meernik, Clare; Jarman, Kristen; Wright, Sarah Towner; Klein, Elizabeth G; Goldstein, Adam O; Ranney, Leah

2016-10-01

In this paper we synthesize the evidence from eye tracking research in tobacco control to inform tobacco regulatory strategies and tobacco communication campaigns. We systematically searched 11 databases for studies that reported eye tracking outcomes in regards to tobacco regulation and communication. Two coders independently reviewed studies for inclusion and abstracted study characteristics and findings. Eighteen studies met full criteria for inclusion. Eye tracking studies on health warnings consistently showed these warnings often were ignored, though eye tracking demonstrated that novel warnings, graphic warnings, and plain packaging can increase attention toward warnings. Eye tracking also revealed that greater visual attention to warnings on advertisements and packages consistently was associated with cognitive processing as measured by warning recall. Eye tracking is a valid indicator of attention, cognitive processing, and memory. The use of this technology in tobacco control research complements existing methods in tobacco regulatory and communication science; it also can be used to examine the effects of health warnings and other tobacco product communications on consumer behavior in experimental settings prior to the implementation of novel health communication policies. However, the utility of eye tracking will be enhanced by the standardization of methodology and reporting metrics.

Eye Tracking Outcomes in Tobacco Control Regulation and Communication: A Systematic Review

PubMed Central

Meernik, Clare; Jarman, Kristen; Wright, Sarah Towner; Klein, Elizabeth G.; Goldstein, Adam O.; Ranney, Leah

2016-01-01

Objective In this paper we synthesize the evidence from eye tracking research in tobacco control to inform tobacco regulatory strategies and tobacco communication campaigns. Methods We systematically searched 11 databases for studies that reported eye tracking outcomes in regards to tobacco regulation and communication. Two coders independently reviewed studies for inclusion and abstracted study characteristics and findings. Results Eighteen studies met full criteria for inclusion. Eye tracking studies on health warnings consistently showed these warnings often were ignored, though eye tracking demonstrated that novel warnings, graphic warnings, and plain packaging can increase attention toward warnings. Eye tracking also revealed that greater visual attention to warnings on advertisements and packages consistently was associated with cognitive processing as measured by warning recall. Conclusions Eye tracking is a valid indicator of attention, cognitive processing, and memory. The use of this technology in tobacco control research complements existing methods in tobacco regulatory and communication science; it also can be used to examine the effects of health warnings and other tobacco product communications on consumer behavior in experimental settings prior to the implementation of novel health communication policies. However, the utility of eye tracking will be enhanced by the standardization of methodology and reporting metrics. PMID:27668270

Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

PubMed Central

Dhallu, Sandeep K; Maurino, Vincenzo; Wilkins, Mark R

2016-01-01

Objectives To describe the initial outcomes following installation of a cataract surgery laser system. Setting National Health Service cataract surgery day care unit in North London, UK. Participants 158 eyes of 150 patients undergoing laser-assisted cataract surgery. Interventions Laser cataract surgery using the AMO Catalys femtosecond laser platform. Primary and secondary outcome measures Primary outcome measure: intraoperative complications including anterior and posterior capsule tears. Secondary outcome measures: docking to the laser platform, successful treatment delivery, postoperative visual acuities. Results Mean case age was 67.7±10.8 years (range 29–88 years). Docking was successful in 94% (148/158 cases), and in 4% (6/148 cases) of these, the laser delivery was aborted part way during delivery due to patient movement. A total of 32 surgeons, of grades from junior trainee to consultant, performed the surgeries. Median case number per surgeon was 3 (range from 1–20). The anterior capsulotomy was complete in 99.3% of cases, there were no anterior capsule tears (0%). There were 3 cases with posterior capsule rupture requiring anterior vitrectomy, and 1 with zonular dialysis requiring anterior vitrectomy (4/148 eyes, 2.7%). These 4 cases were performed by trainee surgeons, and were either their first laser cataract surgery (2 surgeons) or their first and second laser cataract surgeries (1 surgeon). Conclusions Despite the learning curve, docking and laser delivery were successfully performed in almost all cases, and surgical complication rates and visual outcomes were similar to those expected based on national data. Complications were predominately confined to trainee surgeons, and with the exception of intraoperative pupil constriction appeared unrelated to the laser-performed steps. PMID:27466243

An Introduction to Eye Safety. General Metals I, Lesson Plan No. 1.

ERIC Educational Resources Information Center

Higa, Floyd

Designed for a 110-hour general metals course, this lesson plan presents an introduction to eye safety, including a brief guided imagery prelude, an overview of the lesson, an overview of Occupational Safety and Health Administration (OSHA) and Department of Occupational Safety and Health (DOSH) rules and regulations regarding eye and face…

Danish Rural Eye Study: the association of preschool vision screening with the prevalence of amblyopia.

PubMed

Høeg, Tracy B; Moldow, Birgitte; Ellervik, Christina; Klemp, Kristian; Erngaard, Ditte; la Cour, Morten; Buch, Helena

2015-06-01

To determine the prevalence of amblyopia in Denmark before and after the initiation of the Danish national preschool vision screening programme. In a population-based cross-sectional study, 3826 participants of the Danish General Suburban Population Study (GESUS) aged 20 years and older from a Danish rural municipality received a complete general health examination and an ophthalmological interview and examination. This study included a comprehensive ophthalmologic interview, measurement of best corrected visual acuity (BCVA) in each eye, Hirschberg's test for strabismus and two 45-degree retinal fundus photographs of each eye. A complete ophthalmologic examination was performed when indicated. The prevalence of monocular visual impairment (MVI) was 4.26% (95% CI, 3.66-4.95, n = 163). Amblyopia was the most common cause, accounting for 33%. The prevalence of amblyopia was 1.44% (95% CI, 1.01-1.81, n = 55), being higher among non-preschool vision screened persons compared to those who were offered (estimated 95% attendance) preschool vision screening (1.78%, n = 41, 95% CI 1.24-2.33 versus 0.44%, n = 2, 95% CI, 0.12-1.60, p = 0.024). The leading cause of amblyopia was anisometropia (45.5%, 25/55). Amblyopia was the most common cause of MVI. Following the initiation of the Danish national preschool vision screening programme, which has an approximate attendance rate of 95%, the prevalence of amblyopia decreased by fourfold. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Education of eye health professionals to meet the needs of the Pacific.

PubMed

du Toit, Renee; Brian, Garry; Palagyi, Anna; Williams, Carmel; Ramke, Jacqueline

2009-03-13

Vision impairment has significant impact on quality of life and substantial economic consequences. Yet, in the Pacific Islands, as in other low resource settings, it is predominantly caused by chronic conditions that can be treated or prevented. A whole of health approach is required to rectify this, and must include an increase in workforce capacity, both in size and effectiveness, by providing competency-based education for eye care professionals. Training in curative clinical skills is not sufficient: broader competencies--including those for chronic conditions, issues of care quality, integration into the wider health care system, and commitment to professionalism and life-long learning--need to be addressed. Using current best practice approaches in education, and taking into consideration local needs, The Pacific Eye Institute, an initiative of The Fred Hollows Foundation New Zealand, aims to produce graduates with these core competencies who are capable of effectively and acceptably working in community or hospital settings to provide sustainable high quality, comprehensive eye care with ongoing desirable and consistent eye health outcomes.

Experiencing health care service quality: through patients' eyes.

PubMed

Schembri, Sharon

2015-02-01

The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.

Examining Wrong Eye Implant Adverse Events in the Veterans Health Administration With a Focus on Prevention: A Preliminary Report.

PubMed

Neily, Julia; Chomsky, Amy; Orcutt, James; Paull, Douglas E; Mills, Peter D; Gilbert, Christina; Hemphill, Robin R; Gunnar, William

2018-03-01

The study goals were to examine wrong intraocular lens (IOL) implant adverse events in the Veterans Health Administration (VHA), identify root causes and contributing factors, and describe system changes that have been implemented to address this challenge. This study represents collaboration between the VHA's National Center for Patient Safety (NCPS) and the National Surgery Office (NSO). This report includes 45 wrong IOL implant surgery adverse events reported to established VHA NCPS and NSO databases between July 1, 2006, and June 31, 2014. There are approximately 50,000 eye implant procedures performed each year in the VHA. Wrong IOL implant surgery adverse events are reported by VHA facilities to the NCPS and the NSO. Two authors (A.C. and J.N.) coded the reports for event type (wrong lens or expired lens) and identified the primary contributing factor (coefficient κ = 0.837). A descriptive analysis was conducted, which included the reported yearly event rate. The main outcome measure was the reported wrong IOL implant surgery adverse events. There were 45 reported wrong IOL implant surgery adverse events. Between 2011 and June 30, 2014, there was a significant downward trend (P = 0.02, R = 99.7%) at a pace of -0.08 (per 10,000 cases) every year. The most frequently coded primary contributing factor was incomplete preprocedure time-out (n = 12) followed by failure to perform double check of preprocedural calculations based upon original data and implant read-back at the time the surgical eye implant was performed (n = 10). Preventing wrong IOL implant adverse events requires diligence beyond performance of the preprocedural time-out. In 2013, the VHA has modified policy to ensure double check of preprocedural calculations and implant read-back with positive impact. Continued analysis of contributing human factors and improved surgical team communication are warranted.

Healthcare in Asia: a perspective from primary care at the gateway to a continent.

PubMed

Jiwa, Moyez; Othman, Sajaratulnisah; Hanafi, Nik Sherina; Ng, Chirk Jenn; Khoo, Ee Ming; Chia, Yook Chin

2012-01-01

Malaysia has achieved reasonable health outcomes even though the country spends a modest amount of Gross Domestic Product on healthcare. However, the country is now experiencing a rising incidence of both infectious diseases and chronic lifestyle conditions that reflect growing wealth in a vibrant and successful economy. With an eye on an ageing population, reform of the health sector is a government priority. As in other many parts of the world, general practitioners are the first healthcare professional consulted by patients. The Malaysian health system is served by public and private care providers. The integration of the two sectors is a key target for reform. However, the future health of the nation will depend on leadership in the primary care sector. This leadership will need to be informed by research to integrate care providers, empower patients, bridge cultural gaps and ensure equitable access to scarce health resources.

Domestic use of dirty energy and its effects on human health: empirical evidence from Bhutan

NASA Astrophysics Data System (ADS)

Rahut, Dil Bahadur; Ali, Akhter; Behera, Bhagirath

2017-11-01

Use of dirty fuels such as fuelwood, charcoal, cow dung and kerosene is common in developing countries, which adversely affects the health of people living in the dwellings, especially children and women. Using the data from a comprehensive and nationally representative Bhutan Living Standard Survey 2012, the present study examines the effects of dirty fuels on human health and household health expenditure. The result from propensity score-matching approach indicate that households using dirty fuels have a higher incidence of respiratory disease by 2.5-3% compared to households using cleaner fuels. The chances of household contracting tuberculosis are higher for households using dirty fuel in the range of 5-6%. It is also observed that the incidence of eye diseases and health expenditures among households using dirty fuels is higher. Hence the policy should focus on providing access to clean sources of energy to wider population.

Risk Factors for High Myopia in Koreans: The Korea National Health and Nutrition Examination Survey.

PubMed

Hwang, Ho Sik; Chun, Min Young; Kim, Jin Sun; Oh, Bumjo; Yoo, Sang Ho; Cho, Bum-Joo

2018-05-02

To investigate risk factors for high myopia in the general Korean population. In this nationwide population study, the dataset of the Korea National Health and Nutrition Examination Survey 2008-2012 was analyzed. The study cohort included 11 703 participants, aged 25-49 years, who underwent neither refractive nor cataract surgery. The association between demographic, socioeconomic, behavioral, and systemic variables and high myopia was investigated. The mean participant age was 37.9 ± 6.8 years, and the prevalence of high myopia ≤-6.0D was 7.0 ± 0.3% in the study population. The right eyes (-1.76 ± 0.03 D) were more myopic than the left eyes (-1.70 ± 0.03 D; P < 0.001). In multivariate logistic regression analysis, high myopia was associated with age (odds ratio [OR], 0.97 per 1 year-increase) and female sex (OR, 1.24). Other identified risk factors included education level ≥ university graduation (OR, 1.91), the presence of hypertension (OR, 1.69), and serum glucose level (OR, 1.01 per 1 mg/dL). Sunlight exposure of ≥5 h/day (OR, 0.67) and serum 25-hydroxyvitamin D level (OR, 0.97 per 1 ng/mL) showed protective effect against high myopia. High myopia is associated with younger age, female sex, high education level, longer sunlight exposure, and some other systemic conditions.

Healthy Eyes in Schools: An Evaluation of a School and Community-Based Intervention to Promote Eye Health in Rural Timor-Leste

ERIC Educational Resources Information Center

Hobday, Karen; Ramke, Jacqueline; du Toit, Rènée; Pereira, Sara M.

2015-01-01

Objective: To assess whether there was an improvement in the knowledge, attitudes and practices of students after the Healthy Eyes in Schools Project intervention and to complete a process evaluation to inform future implementation of health promotion interventions. Design: A descriptive, mixed-methods design was used, including questionnaires and…

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

29 CFR 1918.101 - Eye and face protection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Eye and face protection. 1918.101 Section 1918.101 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.101 Eye and... uses appropriate eye and/or face protection when the employee is exposed to an eye or face hazard, and...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organ, tissue, and eye... HOSPITALS Basic Hospital Functions § 482.45 Condition of participation: Organ, tissue, and eye procurement... medical suitability for tissue and eye donation, using the definition of potential tissue and eye donor...

42 CFR 482.45 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Organ, tissue, and eye... HOSPITALS Basic Hospital Functions § 482.45 Condition of participation: Organ, tissue, and eye procurement... medical suitability for tissue and eye donation, using the definition of potential tissue and eye donor...

29 CFR 1918.101 - Eye and face protection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Eye and face protection. 1918.101 Section 1918.101 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.101 Eye and... uses appropriate eye and/or face protection when the employee is exposed to an eye or face hazard, and...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

33 CFR 150.609 - When is eye and face protection required?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false When is eye and face protection... SECURITY (CONTINUED) DEEPWATER PORTS DEEPWATER PORTS: OPERATIONS Workplace Safety and Health Eyes and Face § 150.609 When is eye and face protection required? The operator must provide eye and face protectors...

Restoring a reputation: invoking the UNESCO Universal Declaration on Bioethics and Human Rights to bear on pharmaceutical pricing.

PubMed

Hurst, Daniel J

2017-03-01

In public health, the issue of pharmaceutical pricing is a perennial problem. Recent high-profile examples, such as the September 2015 debacle involving Martin Shkreli and Turing Pharmaceuticals, are indicative of larger, systemic difficulties that plague the pharmaceutical industry in regards to drug pricing and the impact it yields on their reputation in the eyes of the public. For public health ethics, the issue of pharmaceutical pricing is rather crucial. Simply, individuals within a population require pharmaceuticals for disease prevention and management. In order to be effective, these pharmaceuticals must be accessibly priced. This analysis will explore the notion of corporate social responsibility in regards to pharmaceutical pricing with an aim of restoring a positive reputation upon the pharmaceutical industry in the public eye. The analysis will utilize the 2005 United Nations Educational, Scientific, and Cultural Organization's Universal Declaration on Bioethics and Human Rights (UDBHR) to establish implications regarding the societal responsibilities of pharmaceutical companies in a global context. To accomplish this, Article 14 of the UDBHR-social responsibility and health-will be articulated in order to advocate a viewpoint of socially responsible capitalism in which pharmaceutical companies continue as profit-making ventures, yet establish moral concern for the welfare of all their stakeholders, including the healthcare consumer.

29 CFR 1915.5 - Incorporation by reference.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Occupational and Educational Eye and Face Protection; IBR approved for § 1915.153(b)(1)(i). Copies of ANSI Z87... National Standard Practice for Occupational and Educational Eye and Face Protection; IBR approved for... Eye and Face Protection; IBR approved for § 1915.153(b)(1)(iii). (ix) ANSI Z89.1-2003, American...

Provider Behavior Under Global Budgeting and Policy Responses: An Observational Study on Eye Care Services in Taiwan.

PubMed

Chang, Chao-Kai; Xirasagar, Sudha; Chen, Brian; Hussey, James R; Wang, I-Jong; Chen, Jen-Chieh; Lian, Ie-Bin

2015-01-01

Third-party payer systems are consistently associated with health care cost escalation. Taiwan's single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists' response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior to region-wise service cap implementation period, and the post-service cap period, respectively. Repeated measures multilevel regression analysis was used to study the changes adjusting for clinic characteristics and competition within each health care market. SCF service volume (low-revenue, fixed-price patient visits) remained constant throughout the study period, but SCCs (covering services involving variable provider effort and resource use with flexibility for discretionary billing) increased in 2005 with no further change in 2007. The latter is attributable to a 30% cap negotiated by the NHI Bureau with the ophthalmology association and enforced by the association. This study demonstrates that GB deployed with ongoing monitoring and timely policy responses that are designed in collaboration with professional stakeholders can contain costs in a health insurance-financed health care system. © The Author(s) 2015.

Exercise program improved subjective dry eye symptoms for office workers.

PubMed

Sano, Kokoro; Kawashima, Motoko; Takechi, Sayuri; Mimura, Masaru; Tsubota, Kazuo

2018-01-01

We investigated the benefits of a cognitive behavior therapy-based exercise program to reduce the dry eye symptoms of office workers. We recruited 11 office workers with dry eye symptoms, aged 31-64 years, who voluntarily participated in group health guidance at a manufacturing company. Participants learned about the role of physical activity and exercise in enhancing wellness and performed an exercise program at home 3 days per week for 10 weeks. We estimated the indexes of body composition, dry eye symptoms, and psychological distress using the Dry Eye-Related Quality of Life Score and the World Health Organization's Subjective Well-Being Inventory questionnaires pre- and postintervention. The 10-week exercise program and the questionnaires were completed by 48.1% (39 of 81) of the participants. Body composition did not change pre- and postintervention. However, the average of the Dry Eye-Related Quality of Life Score scores in participants with subjective dry eye significantly improved after the intervention. Moreover, the World Health Organization's Subjective Well-Being Inventory positive well-being score tended to increase after the intervention. In this study, we showed that a 10-week exercise program improved subjective dry eye symptoms of healthy office workers. Our study suggests that a cognitive behavior therapy-based exercise program can play an important role in the treatment of patients with dry eye disease.

LIMNOLOGICAL OPTOMETRY: EXAMINING EARTH'S EYE

EPA Science Inventory

In Thoreau's Walden, a lake is described as the landscape's most expressive feature and the earth's eye. Collectively, scientists are charged by society to assess, monitor, and remedy maladies of earth's eye in the same way optometrists maintain the health of the human eye. This ...

Knowledge, Attitude, and Practice of Dry Eye Treatment by Institutional Chinese Physicians in Singapore

PubMed Central

Lan, Wanwen; Lee, Sze Yee; Lee, Man Xin; Tong, Louis

2012-01-01

Dry eye is a common health problem worldwide, causing significant discomfort and inconvenience to sufferers. The conventional treatment of dry eye via topical administration of eye drops is deemed palliative and unsatisfactory to many. Traditional Chinese medicine (TCM) has shown some promise in dry eye treatment; however, the extent of its use and acceptance is uncertain. We evaluated the knowledge, attitude, and practice of institutional TCM practitioners in the treatment of dry eye in Singapore. A questionnaire was generated to address the study aims and sent to TCM practitioners listed in the Singapore TCM practitioners' board database. About three quarters of respondents thought that dry eye was not severe enough to be a public health burden but most thought that TCM was effective in the treatment of dry eye. Acupuncture and herbal medicine were most commonly used TCM modalities in dry eye treatment, and a single TCM treatment session would be charged S$20–50 by the practitioner. The majority of surveyed institutional TCM practitioners in Singapore believe that TCM is relevant in dry eye treatment. Public awareness should be raised regarding the availability of TCM as alternative medicine for dry eye. PMID:23213306

Automatic Classification of Users’ Health Information Need Context: Logistic Regression Analysis of Mouse-Click and Eye-Tracker Data

PubMed Central

Pian, Wenjing; Khoo, Christopher SG

2017-01-01

Background Users searching for health information on the Internet may be searching for their own health issue, searching for someone else’s health issue, or browsing with no particular health issue in mind. Previous research has found that these three categories of users focus on different types of health information. However, most health information websites provide static content for all users. If the three types of user health information need contexts can be identified by the Web application, the search results or information offered to the user can be customized to increase its relevance or usefulness to the user. Objective The aim of this study was to investigate the possibility of identifying the three user health information contexts (searching for self, searching for others, or browsing with no particular health issue in mind) using just hyperlink clicking behavior; using eye-tracking information; and using a combination of eye-tracking, demographic, and urgency information. Predictive models are developed using multinomial logistic regression. Methods A total of 74 participants (39 females and 35 males) who were mainly staff and students of a university were asked to browse a health discussion forum, Healthboards.com. An eye tracker recorded their examining (eye fixation) and skimming (quick eye movement) behaviors on 2 types of screens: summary result screen displaying a list of post headers, and detailed post screen. The following three types of predictive models were developed using logistic regression analysis: model 1 used only the time spent in scanning the summary result screen and reading the detailed post screen, which can be determined from the user’s mouse clicks; model 2 used the examining and skimming durations on each screen, recorded by an eye tracker; and model 3 added user demographic and urgency information to model 2. Results An analysis of variance (ANOVA) analysis found that users’ browsing durations were significantly different for the three health information contexts (P<.001). The logistic regression model 3 was able to predict the user’s type of health information context with a 10-fold cross validation mean accuracy of 84% (62/74), followed by model 2 at 73% (54/74) and model 1 at 71% (52/78). In addition, correlation analysis found that particular browsing durations were highly correlated with users’ age, education level, and the urgency of their information need. Conclusions A user’s type of health information need context (ie, searching for self, for others, or with no health issue in mind) can be identified with reasonable accuracy using just user mouse clicks that can easily be detected by Web applications. Higher accuracy can be obtained using Google glass or future computing devices with eye tracking function. PMID:29269342

Diagnosing Stroke in Acute Vertigo: The HINTS Family of Eye Movement Tests and the Future of the "Eye ECG".

PubMed

Newman-Toker, David E; Curthoys, Ian S; Halmagyi, G Michael

2015-10-01

Patients who present to the emergency department with symptoms of acute vertigo or dizziness are frequently misdiagnosed. Missed opportunities to promptly treat dangerous strokes can result in poor clinical outcomes. Inappropriate testing and incorrect treatments for those with benign peripheral vestibular disorders leads to patient harm and unnecessary costs. Over the past decade, novel bedside approaches to diagnose patients with the acute vestibular syndrome have been developed and refined. A battery of three bedside tests of ocular motor physiology known as "HINTS" (head impulse, nystagmus, test of skew) has been shown to identify acute strokes more accurately than even magnetic resonance imaging with diffusion-weighted imaging (MRI-DWI) when applied in the early acute period by eye-movement specialists. Recent advances in lightweight, high-speed video-oculography (VOG) technology have made possible a future in which HINTS might be applied by nonspecialists in frontline care settings using portable VOG. Use of technology to measure eye movements (VOG-HINTS) to diagnose stroke in the acute vestibular syndrome is analogous to the use of electrocardiography (ECG) to diagnose myocardial infarction in acute chest pain. This "eye ECG" approach could transform care for patients with acute vertigo and dizziness around the world. In the United States alone, successful implementation would likely result in improved quality of emergency care for hundreds of thousands of peripheral vestibular patients and tens of thousands of stroke patients, as well as an estimated national health care savings of roughly $1 billion per year. In this article, the authors review the origins of the HINTS approach, empiric evidence and pathophysiologic principles supporting its use, and possible uses for the eye ECG in teleconsultation, teaching, and triage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Orbital pseudotumor

MedlinePlus

... Pain in eye, and it may be severe Restricted eye movement Decreased vision Double vision Eye swelling ( ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

A nationwide population-based study of low vision and blindness in South Korea.

PubMed

Park, Shin Hae; Lee, Ji Sung; Heo, Hwan; Suh, Young-Woo; Kim, Seung-Hyun; Lim, Key Hwan; Moon, Nam Ju; Lee, Sung Jin; Park, Song Hee; Baek, Seung-Hee

2014-12-18

To investigate the prevalence and associated risk factors of low vision and blindness in the Korean population. This cross-sectional, population-based study examined the ophthalmologic data of 22,135 Koreans aged ≥5 years from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V, 2010-2012). According to the World Health Organization criteria, blindness was defined as visual acuity (VA) less than 20/400 in the better-seeing eye, and low vision as VA of 20/60 or worse but 20/400 or better in the better-seeing eye. The prevalence rates were calculated from either presenting VA (PVA) or best-corrected VA (BCVA). Multivariate regression analysis was conducted for adults aged ≥20 years. The overall prevalence rates of PVA-defined low vision and blindness were 4.98% and 0.26%, respectively, and those of BCVA-defined low vision and blindness were 0.46% and 0.05%, respectively. Prevalence increased rapidly above the age of 70 years. For subjects aged ≥70 years, the population-weighted prevalence rates of low vision, based on PVA and BCVA, were 12.85% and 3.87%, respectively, and the corresponding rates of blindness were 0.49% and 0.42%, respectively. The presenting vision problems were significantly associated with age (younger adults or elderly subjects), female sex, low educational level, and lowest household income, whereas the best-corrected vision problems were associated with age ≥ 70 years, a low educational level, and rural residence. This population-based study provides useful information for planning optimal public eye health care services in South Korea. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

Development of a vision-targeted health-related quality of life item measure

PubMed Central

Slotkin, Jerry; McKean-Cowdin, Roberta; Lee, Paul; Owsley, Cynthia; Vitale, Susan; Varma, Rohit; Gershon, Richard; Hays, Ron D.

2013-01-01

Purpose To develop a vision-targeted health-related quality of life (HRQOL) measure for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Methods We conducted a review of existing vision-targeted HRQOL surveys and identified color vision, low luminance vision, distance vision, general vision, near vision, ocular symptoms, psychosocial well-being, and role performance domains. Items in existing survey instruments were sorted into these domains. We selected non-redundant items and revised them to improve clarity and to limit the number of different response options. We conducted 10 cognitive interviews to evaluate the items. Finally, we revised the items and administered them to 819 individuals to calibrate the items and estimate the measure’s reliability and validity. Results The field test provided support for the 53-item vision-targeted HRQOL measure encompassing 6 domains: color vision, distance vision, near vision, ocular symptoms, psychosocial well-being, and role performance. The domain scores had high levels of reliability (coefficient alphas ranged from 0.848 to 0.940). Validity was supported by high correlations between National Eye Institute Visual Function Questionnaire scales and the new-vision-targeted scales (highest values were 0.771 between psychosocial well-being and mental health, and 0.729 between role performance and role difficulties), and by lower mean scores in those groups self-reporting eye disease (F statistic with p < 0.01 for all comparisons except cataract with ocular symptoms, psychosocial well-being, and role performance scales). Conclusions This vision-targeted HRQOL measure provides a basis for comprehensive assessment of the impact of eye diseases and treatments on daily functioning and well-being in adults. PMID:23475688

Respiratory and ocular symptoms among employees of a hotel indoor waterpark resort--Ohio, 2007.

PubMed

2009-02-06

During January--March 2007, the Warren County Combined Health District (WCCHD) received 665 reports of respiratory and eye irritation from patrons and lifeguards at a hotel indoor waterpark resort in Ohio. Tests revealed normal water chemistry and air chlorine concentrations, and exposure to airborne trichloramine in the waterpark was suspected as the cause of the symptoms. Because of the number of symptom reports and WCCHD's limited ability to measure trichloramine, the district requested an investigation by CDC's National Institute for Occupational Safety and Health (NIOSH). This report describes the results of that investigation, which revealed that trichloramine concentrations in the waterpark ranged from below the limit of detection to 1.06 mg/m3, and some concentrations were at levels that have been reported to cause irritation symptoms (>/=0.5 mg/m3). Lifeguards reported significantly more work-related symptoms (e.g., cough, wheezing, shortness of breath, chest tightness, and eye irritation) than unexposed hotel employees. Lifeguards also reported significantly more eye irritation and cough on days when hotel occupancy was high versus low. Insufficient air movement and distribution likely led to accumulation of trichloramine and exacerbation of symptoms. Based on recommendations to increase air movement and distribution at pool deck level, hotel management modified the ventilation system extensively, and subsequently no new cases were reported to WCCHD. The results of this investigation emphasize the importance of appropriate design and monitoring of ventilation and water systems in preventing illness in indoor waterparks.

'In the eye of the beholder': perceptions of local impact in English Health Action Zones.

PubMed

Sullivan, Helen; Judge, Ken; Sewel, Kate

2004-10-01

Contemporary efforts to promote population health improvement and to reduce inequalities in the UK are characterised by their complexity as they engage with a multiplicity of agencies and sectors. Additionally, the emphasis on promoting evidence-based practice has challenged evaluators tasked with collecting and interpreting evidence of impact in complex local health economies. National policy makers, local implementers and other stakeholders will have varying perspectives on impact and the Labour Government's centralising tendencies have acted to 'crowd out' local voices from the policy process. Drawing on the national evaluation of Health Action Zones (HAZ) this article 'gives voice' to local stakeholders and their perceptions of impact. Informed by a Theories of Change perspective, we explore HAZ interventions to articulate the nature of impact and its limits. We analyse the claims made by local HAZs with reference to the evidence base and examine their significance in the context of overall HAZ objectives. We conclude that local implementer perspectives are no less sophisticated than those at the policy centre of central government, but that they are informed by three important factors: the local context, a need to be pragmatic and the limited potency of evidence in the public policy system.

Orphan disease: Cherubism, optic atrophy, and short stature.

PubMed

Jeevanandham, Balaji; Ramachandran, Rajoo; Dhanapal, Vignesh; Subramanian, Ilanchezhian; Sai, Venkata

2018-01-01

A 12-year-old female presented with complaints of progressive visual impairment in both her eyes. On clinical examination, she was short for her age and her ophthalmoscopic examination revealed bilateral optic atrophy. Computed tomography of the patient revealed multiple expansile lytic lesions of mandible suggesting cherubism. The optic atrophy was confirmed on magnetic resonance imaging, which additionally revealed bilateral retrocerebellar arachnoid cysts. This association of cherubism with optic atrophy and short stature was grouped as orphan disease by National Institutes of Health and only one case was reported in the literature so far.

Eye muscle repair

MedlinePlus

... and physical exam before the procedure Orthoptic measurements (eye movement measurements) Always tell your child's health care provider: ... D, Plummer LS, Stass-Isern M. Disorders of eye movement and alignment. In: Kliegman RM, Stanton BF, St. ...

Eye Health and Safety Among Latino Farmworkers

PubMed Central

Verma, Amit; Schulz, Mark R.; Quandt, Sara A.; Robinson, Erin N.; Grzywacz, Joseph G.; Chen, Haiying; Arcury, Thomas A.

2011-01-01

Farmworkers face a variety of risk factors for eye injuries. Measures of eye protection use and of eye safety knowledge and beliefs are based on a survey of 300 Latino farmworkers in North Carolina. Few farmworkers report using eye protection (8.3%); most (92.3%) report that employers do not provide eye protection. Approximately 70% report that they are not trained in preventing eye injuries; 81% believe that their chances of getting an eye injury are low. Many farmworkers choose to take risks in order to save time. Interventions are needed that target farmworker knowledge and beliefs about eye safety. PMID:21462026

Lasik eye surgery - slideshow

MedlinePlus

... this page: //medlineplus.gov/ency/presentations/100206.htm Lasik eye surgery - series—Normal anatomy To use the ... A.M. Editorial team. Related MedlinePlus Health Topics Laser Eye Surgery A.D.A.M., Inc. is accredited by ...

21 CFR 886.3320 - Eye sphere implant.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Eye sphere implant. 886.3320 Section 886.3320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3320 Eye sphere implant. (a) Identification. An eye...

21 CFR 886.3320 - Eye sphere implant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Eye sphere implant. 886.3320 Section 886.3320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3320 Eye sphere implant. (a) Identification. An eye...

21 CFR 878.4440 - Eye pad.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Eye pad. 878.4440 Section 878.4440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4440 Eye pad. (a) Identification. An eye pad is...

21 CFR 878.4440 - Eye pad.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Eye pad. 878.4440 Section 878.4440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4440 Eye pad. (a) Identification. An eye pad is...

21 CFR 878.4440 - Eye pad.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Eye pad. 878.4440 Section 878.4440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4440 Eye pad. (a) Identification. An eye pad is...

Ensuring Universal Access to Eye Health in Urban Slums in the Global South: The Case of Bhopal (India).

PubMed

Pregel, Andrea; Vaughan Gough, Tracy; Jolley, Emma; Buttan, Sandeep; Bhambal, Archana

2016-01-01

Sightsavers is an international organisation working with partners in over 30 countries to eliminate avoidable blindness and help people with disabilities participate more fully in society. In the context of its Urban Eye Health Programme in Bhopal (India), the organisation launched a pilot approach aimed at developing an Inclusive Eye Health (IEH) model and IEH Minimum Standards. Accessibility audits were conducted in a tertiary eye hospital and four primary vision centres located within urban slums, addressing the accessibility of physical infrastructures, communication and service provision. The collection and analysis of disaggregated data inform the inclusion strategy and provide a baseline to measure the impact of service provision. Trainings of eye health staff and sensitisation of decision makers on accessibility, Universal Design, disability and gender inclusion are organised on a regular basis. A referral network is being built to ensure participation of women, people with disabilities and other marginalised groups, explore barriers at demand level, and guarantee wider access to eye care in the community. Finally, advocacy interventions will be developed to raise awareness in the community and mainstream disability and gender inclusion within the public health sector. Founded on principles of Universal Design, accessibility and participation, and in line with international human rights treaties, Agenda 2030 and the Sustainable Development Goals (SDGs), Sightsavers' IEH model ultimately aims to develop a sustainable, scalable and universally accessible system-strengthening approach, capable of ensuring more inclusive services to people with disabilities, women and other marginalised groups, and designed to more effectively meet the health needs of the entire population.

Associations of Eye Diseases and Symptoms with Self-Reported Physical and Mental Health

PubMed Central

Lee, Paul P.; Cunningham, William E.; Nakazono, Terry T.; Hays, Ron D.

2009-01-01

Purpose To study the associations of eye diseases and visual symptoms with the most widely used health-related quality of life (HRQOL) generic profile measure. Design HRQOL was assessed using the SF-36® version 1 survey administered to a sample of patients receiving care provided by a physician group practice association. Methods Eye dieases, ocular symptoms, and general health was assessed in a sample of patients from 48 physician groups. A total of 18,480 surveys were mailed out and 7,093 returned; 5,021of these had complete data. Multiple linear regression models were used to examine the decrements in self-reported physical and mental health associated with eye diseases and symptoms, including trouble seeing and blurred vision. Results Nine percent of the respondents had cataracts, 2% had age-related macular degeneration, 2% glaucoma, 8% blurred vision, and 13% trouble seeing. Trouble seeing and blurred vision both had statistically unique associations with worse scores on the SF-36 mental health summary score. Only trouble seeing had a significant association with the SF-36 physical health summary score. While these ocular symptoms were significantly associated with SF-36® scores, having an eye disease (cataracts, glaucoma, macular degeneration) was not, after adjusting for other variables in the model. Conclusions Our results suggest an important link between visual symptoms and general HRQOL. The study extends the findings of prior research to show that both trouble seeing and blurred vision have independent, measurable associations with HRQOL, while the presence of specific eye diseases may not. PMID:19712923

A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.

PubMed

Murchison, Ann P; Friedman, David S; Gower, Emily W; Haller, Julia A; Lam, Byron L; Lee, David J; McGwin, Gerald; Owsley, Cynthia; Saaddine, Jinan; Insight Study Group

2016-01-01

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years within the United States. The Innovative Network for Sight Research group (INSIGHT) designed the Diabetic Eye Screening Study (DESS) to examine the feasibility and short-term effectiveness of non-mydriatic diabetic retinopathy (DR) screening for adults with diabetes in community-based settings. Study enrollment began in December 2011 at four sites: an internal medicine clinic at a county hospital in Birmingham, Alabama; a Federally-qualified community healthcare center in Miami-Dade County, Florida; a university-affiliated outpatient pharmacy in Philadelphia, Pennsylvania; and a medical home in Winston-Salem, North Carolina. People 18 years or older with previously diagnosed diabetes were offered free DR screening using non-mydriatic retinal photography that was preceded by a brief questionnaire addressing demographic information and previous eye care use. Visual acuity was also measured for each eye. Images were evaluated at a telemedicine reading center by trained evaluators using the National Health System DR grading classification. Participants and their physicians were sent screening report results and telephoned for a follow-up survey 3 months post-screening to determine whether participants had sought follow-up comprehensive eye care and their experiences with the screening process. Target enrollment at each site was a minimum of 500 persons. Three of the four sites met this enrollment goal. The INSIGHT/DESS is intended to establish the feasibility and short-term effectiveness of DR screening using non-mydriatic retinal photography in persons with diabetes who seek services in community-based clinic and pharmacy settings.

The development and demise of a cataract surgery database.

PubMed

Lum, Flora; Schachat, Andrew P; Jampel, Henry D

2002-03-01

The American Academy of Ophthalmology (AAO; San Francisco) launched a national eye care outcomes initiative in 1996, in response to strong interest by third-party payers and managed care in performance measurement and outcomes. The AAO's outcomes initiative NEON (National Eyecare Outcomes Network) began with the design and launch of a prospective observational registry of patients undergoing cataract surgery. Participants submitted a common set of data regarding patients' demographics, preoperative ophthalmologic history, physical exam, test results, functional status and symptoms, intraoperative procedures and events, and postoperative outcomes for all patients undergoing first or second eye cataract surgery. Between January 1, 1996, and March 30, 2001, a total of 249 ophthalmologists submitted data on 17,876 patients undergoing first or second eye surgery. All preoperative, intraoperative, and postoperative clinical data forms were submitted for 9,937 patients (55.7%). After surgery, 93% of patients achieved a best corrected visual acuity of 20/40, 89% improved their visual functioning, and 92% experienced fewer cataract-related symptoms. At the end of March 2001, NEON was discontinued because of a lack of participation and demand by members or third parties for this information. The momentum for accountability and performance measures never quite materialized into advantages for contracting for physicians or requirements by payers. In the future, more scientific evidence regarding the validity and meaning of outcome measures and differences in measurements, investment in health information technology infrastructure, use of technology to collect information at the point of care, and incentives favoring data collection and analysis will be needed to pave the way for renewed interest in outcomes.

Diabetic Eye Problems - Multiple Languages

MedlinePlus

... Eye Problems - العربية (Arabic) Bilingual PDF Health Information Translations Diabetic Retinopathy - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section Diabetic ...

Identification of Diabetic Retinopathy and Ungradable Image Rate with Ultrawide Field Imaging in a National Teleophthalmology Program.

PubMed

Silva, Paolo S; Horton, Mark B; Clary, Dawn; Lewis, Drew G; Sun, Jennifer K; Cavallerano, Jerry D; Aiello, Lloyd Paul

2016-06-01

To compare diabetic retinopathy (DR) identification and ungradable image rates between nonmydriatic ultrawide field (UWF) imaging and nonmydriatic multifield fundus photography (NMFP) in a large multistate population-based DR teleophthalmology program. Multiple-site, nonrandomized, consecutive, cross-sectional, retrospective, uncontrolled imaging device evaluation. Thirty-five thousand fifty-two eyes (17 526 patients) imaged using NMFP and 16 218 eyes (8109 patients) imaged using UWF imaging. All patients undergoing Joslin Vision Network (JVN) imaging with either NMFP or UWF imaging from May 1, 2014, through August 30, 2015, within the Indian Health Service-JVN program, which serves American Indian and Alaska Native communities at 97 sites across 25 states, were evaluated. All retinal images were graded using a standardized validated protocol in a centralized reading center. Ungradable rate for DR and diabetic macular edema (DME). The ungradable rate per patient for DR and DME was significantly lower with UWF imaging compared with NMFP (DR, 2.8% vs. 26.9% [P < 0.0001]; DME, 3.8% vs. 26.2% [P < 0.0001]). Identification of eyes with either DR or referable DR (moderate nonproliferative DR or DME or worse) was increased using UWF imaging from 11.7% to 24.2% (P < 0.0001) and from 6.2% to 13.6% (P < 0.0001), respectively. In eyes with DR imaged with UWF imaging (n = 3926 eyes of 2402 patients), the presence of predominantly peripheral lesions suggested a more severe level of DR in 7.2% of eyes (9.6% of patients). In a large, widely distributed DR ocular telehealth program, as compared with NMFP, nonmydriatic UWF imaging reduced the number of ungradable eyes by 81%, increased the identification of DR nearly 2-fold, and identified peripheral lesions suggesting more severe DR in almost 10% of patients, thus demonstrating significant benefits of this imaging method for large DR teleophthalmology programs. Copyright © 2016 American Academy of Ophthalmology. All rights reserved.

Assessment of sensory function in the National Social Life, Health, and Aging Project.

PubMed

Schumm, L Philip; McClintock, Martha; Williams, Sharon; Leitsch, Sara; Lundstrom, Johan; Hummel, Thomas; Lindau, Stacy Tessler

2009-11-01

The National Social Life, Health, and Aging Project assessed functioning of all 5 senses using both self-report and objective measures. We evaluate the performance of the objective measures and model differences in sensory function by gender and age. In the process, we demonstrate how to use and interpret these measures. Distance vision was assessed using a standard Sloan eye chart, and touch was measured using a stationary 2-point discrimination test applied to the index fingertip of the dominant hand. Olfactory function (both intensity detection and odor identification) was assessed using odorants administered via felt-tip pens. Gustatory function was measured via identification of four taste strips. The performance of the objective measures was similar to that reported for previous studies, as was the relationship between sensory function and both gender and age. Sensory function is important in studies of aging and health both because it is an important health outcome and also because a decline in functioning can be symptomatic of or predict other health conditions. Although the objective measures provide considerably more precision than the self-report items, the latter can be valuable for imputation of missing data and for understanding differences in how older adults perceive their own sensory ability.

Assessment of Sensory Function in the National Social Life, Health, and Aging Project

PubMed Central

McClintock, Martha; Williams, Sharon; Leitsch, Sara; Lundstrom, Johan; Hummel, Thomas; Lindau, Stacy Tessler

2009-01-01

Objectives The National Social Life, Health, and Aging Project assessed functioning of all 5 senses using both self-report and objective measures. We evaluate the performance of the objective measures and model differences in sensory function by gender and age. In the process, we demonstrate how to use and interpret these measures. Methods Distance vision was assessed using a standard Sloan eye chart, and touch was measured using a stationary 2-point discrimination test applied to the index fingertip of the dominant hand. Olfactory function (both intensity detection and odor identification) was assessed using odorants administered via felt-tip pens. Gustatory function was measured via identification of four taste strips. Results The performance of the objective measures was similar to that reported for previous studies, as was the relationship between sensory function and both gender and age. Discussion Sensory function is important in studies of aging and health both because it is an important health outcome and also because a decline in functioning can be symptomatic of or predict other health conditions. Although the objective measures provide considerably more precision than the self-report items, the latter can be valuable for imputation of missing data and for understanding differences in how older adults perceive their own sensory ability. PMID:19549923

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals.

PubMed

Bozzani, Fiammetta Maria; Griffiths, Ulla Kou; Blanchet, Karl; Schmidt, Elena

2014-02-28

VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress.

Parasitic infections of the external eye.

PubMed

Pahuja, Shivani; Puranik, Charuta; Jelliti, Bechir; Khairallah, Moncef; Sangwan, Virender S

2013-08-01

To review the published literature on parasitic infections of external eye. Published articles and case reports on parasitic infections of external eye were reviewed and relevant information was collected. Parasitic infections of the eye are rare. However, being more commonly seen in developing nations, they require active measures for screening, diagnosis, and therapy. Parasites of importance causing external ocular disease are protozoan parasites, such as Leishmania; metazoans, such as nematodes (roundworms), cestodes (tapeworms), and trematodes (flatworms); or ectoparasites, such as Phthirus pubis and Demodex.

Automatic Classification of Users' Health Information Need Context: Logistic Regression Analysis of Mouse-Click and Eye-Tracker Data.

PubMed

Pian, Wenjing; Khoo, Christopher Sg; Chi, Jianxing

2017-12-21

Users searching for health information on the Internet may be searching for their own health issue, searching for someone else's health issue, or browsing with no particular health issue in mind. Previous research has found that these three categories of users focus on different types of health information. However, most health information websites provide static content for all users. If the three types of user health information need contexts can be identified by the Web application, the search results or information offered to the user can be customized to increase its relevance or usefulness to the user. The aim of this study was to investigate the possibility of identifying the three user health information contexts (searching for self, searching for others, or browsing with no particular health issue in mind) using just hyperlink clicking behavior; using eye-tracking information; and using a combination of eye-tracking, demographic, and urgency information. Predictive models are developed using multinomial logistic regression. A total of 74 participants (39 females and 35 males) who were mainly staff and students of a university were asked to browse a health discussion forum, Healthboards.com. An eye tracker recorded their examining (eye fixation) and skimming (quick eye movement) behaviors on 2 types of screens: summary result screen displaying a list of post headers, and detailed post screen. The following three types of predictive models were developed using logistic regression analysis: model 1 used only the time spent in scanning the summary result screen and reading the detailed post screen, which can be determined from the user's mouse clicks; model 2 used the examining and skimming durations on each screen, recorded by an eye tracker; and model 3 added user demographic and urgency information to model 2. An analysis of variance (ANOVA) analysis found that users' browsing durations were significantly different for the three health information contexts (P<.001). The logistic regression model 3 was able to predict the user's type of health information context with a 10-fold cross validation mean accuracy of 84% (62/74), followed by model 2 at 73% (54/74) and model 1 at 71% (52/78). In addition, correlation analysis found that particular browsing durations were highly correlated with users' age, education level, and the urgency of their information need. A user's type of health information need context (ie, searching for self, for others, or with no health issue in mind) can be identified with reasonable accuracy using just user mouse clicks that can easily be detected by Web applications. Higher accuracy can be obtained using Google glass or future computing devices with eye tracking function. ©Wenjing Pian, Christopher SG Khoo, Jianxing Chi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.12.2017.

Effects of Aging in Dry Eye

PubMed Central

de Paiva, Cintia S.

2017-01-01

Dry eye affects millions of people worldwide and causes eye well recognized risk factors for dry eye. Anatomical and inflammation-induced age-related changes affect all components of the lacrimal gland functional unit, inclusive of lacrimal gland, conjunctiva, meibomian gland and compromise ocular surface health. There is increased evidence that inflammation plays a role in dry eye. This review will summarize the current knowledge about aging and dry eye, inclusive of lessons learned from animal models and promising therapies. PMID:28282314

The Effect of a Monocular Helmet-Mounted Display on Aircrew Health: A Longitudinal Cohort Study of Apache AH Mk 1 Pilots -(Vision and Handedness)

DTIC Science & Technology

2015-05-19

reported by U.S. Army aviators using NVG for night flights (Glick and Moser, 1974). It was initially, and incorrectly, called “brown eye syndrome ...112 FREQUENCY Never Rarely Occasionally Often Eye irritation Eye pain Blurred vision Dry eye ... Eye pain Blurred vision Dry eye Light sensitivity j. Since your last contact lens review, did you experience any of the following

Eye Injury Prevention for the Pediatric Population.

PubMed

Hoskin, Annette K; Philip, Swetha S; Yardley, Anne-Marie E; Mackey, David A

2016-05-01

Each year an estimated 3.3 to 5.7 million pediatric eye injuries occur worldwide. It is widely reported that 90% of ocular injuries are preventable. Our aim was to identify legislation and policies, education, and mandatory eye protection strategies that have successfully contributed to reducing rates of children's eye injuries. A literature search was conducted using the terms "pediatric" or "children" or "adolescent" and "ocular" or "eye" and "protection" or "injury prevention." Articles were retrieved based on titles and abstracts and assessed in the context of our research question. Strategies identified aimed at reducing ocular trauma fell into 3 broad categories: legislation and policies, education, and personal eye protection. Policies including restrictions on the sale and supply of certain consumer products, mandatory vehicle seatbelts, and laminated windscreens in vehicles have assisted in reducing children's eye injuries. Educational tools aimed at children and their caregivers have been effective in changing attitudes to eye health and safety. Effective pediatric eye injury prevention systems require a multifactorial approach combining legislation, policies, standards, education, and personal eye protection to limit exposure to ocular hazards. A paucity of standardized measurement and lack of funding have limited advances in the field of children's eye injury prevention. Improved eye injury surveillance and research funding along with collaboration with health care providers are important components for strategies to prevent pediatric ocular trauma.

42 CFR 485.643 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition of participation: Organ, tissue, and eye... participation: Organ, tissue, and eye procurement. The CAH must have and implement written protocols that: (a... absence of alternative arrangements by the CAH, the OPO determines medical suitability for tissue and eye...

38 CFR 1.485a - Eye, organ and tissue donation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health care...

38 CFR 1.485a - Eye, organ and tissue donation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Eye, organ and tissue... GENERAL PROVISIONS Disclosures Without Patient Consent § 1.485a Eye, organ and tissue donation. A VHA... organ, eye, or tissue donor if: (a) The individual is currently an inpatient in a VHA health care...

77 FR 41406 - Evaluation of In Vitro Tests for Identifying Eye Injury Hazard Potential of Chemicals and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Evaluation of In Vitro Tests for Identifying Eye Injury...-animal testing strategies proposed for identifying eye injury hazard potential of chemicals and products... Panel and submission of data from substances tested in in vitro tests for identifying eye injury hazard...

42 CFR 485.643 - Condition of participation: Organ, tissue, and eye procurement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organ, tissue, and eye... participation: Organ, tissue, and eye procurement. The CAH must have and implement written protocols that: (a... absence of alternative arrangements by the CAH, the OPO determines medical suitability for tissue and eye...

Using Eye Trackers for Usability Evaluation of Health Information Technology: A Systematic Literature Review

PubMed Central

Yang, Yushi

2015-01-01

Background Eye-tracking technology has been used to measure human cognitive processes and has the potential to improve the usability of health information technology (HIT). However, it is still unclear how the eye-tracking method can be integrated with other traditional usability methodologies to achieve its full potential. Objective The objective of this study was to report on HIT evaluation studies that have used eye-tracker technology, and to envision the potential use of eye-tracking technology in future research. Methods We used four reference databases to initially identify 5248 related papers, which resulted in only 9 articles that met our inclusion criteria. Results Eye-tracking technology was useful in finding usability problems in many ways, but is still in its infancy for HIT usability evaluation. Limited types of HITs have been evaluated by eye trackers, and there has been a lack of evaluation research in natural settings. Conclusions More research should be done in natural settings to discover the real contextual-based usability problems of clinical and mobile HITs using eye-tracking technology with more standardized methodologies and guidance. PMID:27026079

Histopathologic changes in punctal stenosis.

PubMed

Port, Alexander D; Chen, Yao-Tseng; Lelli, Gary J

2013-01-01

To describe the pathologic changes in punctal stenosis by reporting the histopathologic findings in a series of punctoplasty specimens. Observational retrospective chart review. Electronic health records of all patients having punctoplasty over a 2-year period at an academic oculoplastic practice were examined. All patients whose records included pathology reports were entered into a database. Twenty-four patients, representing 30 eyes, had pathology records in the electronic health records. Patients were 75% women and had an average age of 65 (19-88) years. Associated conditions included blepharitis (71%), dry eye syndrome, or Meibomian gland dysfunction (63%). Histopathologic examination demonstrated chronic inflammation in 11 eyes (36.7%), fibrosis in 7 eyes (23.3%), chronic inflammation and fibrosis in 4 eyes (13.3%), squamous metaplasia in 3 eyes (10%), normal conjunctival mucosa in 3 eyes (10%), and Actinomyces israelii canaliculitis in 2 eyes (6.7%). Nearly all histopathologic specimens revealed findings consistent with inflammation, fibrosis, or both. These findings provide evidence to support the hypothesis that the many etiologic causes of punctal stenosis are linked by a common pathophysiologic mechanism involving inflammation.

Why don't older adults in England go to have their eyes examined?

PubMed

Shickle, Darren; Griffin, Marcus

2014-01-01

Preventable sight loss is one of the Public Health Outcome Indicators in England. Despite availability of NHS-funded eye examinations, many people do not take up their entitlement. This paper explores older adults understanding of eye health and the purpose of eye examinations and the reasons why they do or do not attend for eye examinations. The aim is to provide evidence to inform policy on increasing uptake of eye examinations among older people who have increased risk of preventable sight loss. 10 focus-group meetings were held with people living in deprived areas of Leeds, recruited via community groups and neighbourhood networks. Focus groups were transcribed and a thematic analysis approach was used. The majority of participants were aged over 60, wore spectacles, and had regular eye examinations. Most were eligible for a NHS-funded eye examination. There was poor knowledge about eye disease and the purpose of different elements of the eye examination. Participants felt very vulnerable about getting the tests 'wrong' and looking foolish. Wearing of spectacles was associated with appearing old and frail. Many did not trust the veracity of optometrists, and perceived opticians to be expensive places, where it was difficult to control spending. Many had experienced 'hard sell' and opaque pricing. Most, but not all, were happy with the optometric services received. Participants indicated a preference for utilising a local optometrist located alongside other familiar health care services. Not-for-profit services co-located with other public services are needed to address concerns about cost of spectacles, lack of trust in optometrists, and poor access to eye examinations in local settings. It will also be important to raise public understanding about the purpose of eye examinations in terms of other causes of preventable sight loss and not just refractive error and need for spectacles. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

Incidence and characteristics of chemical burns.

PubMed

Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

2017-05-01

Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Longitudinal Changes in Visual Acuity and Health Related Quality of Life. The Los Angeles Latino Eye Study

PubMed Central

McKean-Cowdin, Roberta; Varma, Rohit; Hays, Ron D.; Wu, Joanne; Choudhury, Farzana; Azen, Stanley P.

2010-01-01

Purpose To examine the association between longitudinal changes in visual acuity (VA) and Health Related Quality of Life (HRQOL) in a population-based sample of adult Latinos. Design A population-based cohort study of eye disease in Latinos. Participants 3,169 adult Latino participants who live in the city of La Puente, California. Methods Data for these analyses were collected for the Los Angeles Latino Eye Study (LALES). Distance visual acuity (VA) was measured during a detailed ophthalmologic examination using the standard Early Treatment Diabetic Retinopathy Study protocol at baseline and a 4 year follow-up examination. HRQOL was assessed by the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-Item Short-Form Health Survey version 1 (SF-12 v.1). Main Outcome Measures Mean differences in HRQOL composite and subscale scores between baseline and follow-up were calculated for 3,169 participants with complete clinical examination and HRQOL data at both time points. Mean differences and effect sizes (ES) for NEI-VFQ and SF-12 v.1 scores were calculated for 3 categories of VA change over the 4 year follow-up period (VA improved ≥ 2 lines, no change in VA or −2

Mixed Influence of Electronic Health Record Implementation on Diabetes Order Patterns for Michigan Medicaid Adults.

PubMed

Corser, William; Yuan, Sha

2015-08-20

These 2011-2013 analyses examined the authors' hypothesis that relative diabetes care order changes would be measured after electronic health record (EHR) implementation for 291 Medicaid adults who received all of their office-based care at one midwestern federally qualified health center (FQHC) over a 24-month period (n = 2727 encounters, 2489 claims). Beneficiary sociodemographic, clinical, and claims data were validated with clinic EHR and state Medicaid claims linked to providers' national identifier numbers. Overall pre-post order rate comparisons, and a series of controlled within group binary logistic models were conducted under penalized maximum likelihood estimation terms. After EHR implementation, both the overall order rates and odds ratios of per beneficiary hemoglobin A1C (HbA1C) orders increased significantly (ie, from mean of 0.65 [SD = 1.19] annual tests to 0.96 tests [SD = 1.24] [P < .001]). Although the overall post-EHR order rates of dilated eye exams and microalbumin urine tests appeared fairly stable, the odds of eye exam orders being placed at the claims level decreased significantly (OR = 0.774, P = .0030). These mixed results provide evidence of the varied diabetes care ordering patterns likely seen from increased office use of EHR technologies. The authors attempt to explain these post-EHR differences (or lack of) that generally resemble some of the authors' results from another funded project. Ideally, these findings provide Medicaid and health care officials with a more realistic indication of how EHRs may, or may not, influence diabetes care ordering patterns for vulnerable lower-income primary health care consumers. © 2015 Diabetes Technology Society.

Exposure-related health effects of silver and silver compounds: a review.

PubMed

Drake, Pamela L; Hazelwood, Kyle J

2005-10-01

A critical review of studies examining exposures to the various forms of silver was conducted to determine if some silver species are more toxic than others. The impetus behind conducting this review is that several occupational exposure limits and guidelines exist for silver, but the values for each depend on the form of silver as well as the individual agency making the recommendations. For instance, the American Conference of Governmental Industrial Hygienists has established separate threshold limit values for metallic silver (0.1 mg/m3) and soluble compounds of silver (0.01 mg/m3). On the other hand, the permissible exposure limit (PEL) recommended by the Occupational Safety and Health Administration and the Mine Safety and Health Administration and the recommended exposure limit set by the National Institute for Occupational Safety and Health is 0.01 mg/m3 for all forms of silver. The adverse effects of chronic exposure to silver are a permanent bluish-gray discoloration of the skin (argyria) or eyes (argyrosis). Most studies discuss cases of argyria and argyrosis that have resulted primarily from exposure to the soluble forms of silver. Besides argyria and argyrosis, exposure to soluble silver compounds may produce other toxic effects, including liver and kidney damage, irritation of the eyes, skin, respiratory, and intestinal tract, and changes in blood cells. Metallic silver appears to pose minimal risk to health. The current occupational exposure limits do not reflect the apparent difference in toxicities between soluble and metallic silver; thus, many researchers have recommended that separate PELs be established.

Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices.

PubMed

Tandon, Radhika; Singh, Archita; Gupta, Noopur; Vanathi, M; Gupta, Vivek

2017-02-01

The purpose of this study is to review the history and evolution of the National Eye Bank (NEB) and analyze the impact over the years and report the outcome of the invested resources. Review of archival material, records, project reports, policy and procedures' manuals, and publications was done. Descriptive and analytical processing of data obtained was undertaken. Parameters evaluated included total collection, transplantation, utilization rates of donor cornea, changing trends over time in terms of numbers and duration of recipients waiting, impactful research translated into changes in standard operating protocols, new facilities, and subsequent effects on numbers or quality assurance measures and overview of major achievements. Periodic situational analysis with contextual relevance and interpretation of outcomes was done pertaining to national goals and international standards. The NEB and cornea services have played a key leadership role in furthering the development of eye banking and corneal transplantation services. The contribution extends beyond routine patient care to education, training, generation of resources, advocacy, and policymaking. In quantifiable terms, the overall performance has steadily increased over the years. Major contributions include training of doctors, eye bank staff and corneal surgeons, introduction of innovative techniques for corneal transplantation, setting of national standards for eye banking and provision of preservation media, customized corneal, and ocular surface cell replacement therapy in collaboration with other departments and institutes. The eye banking and corneal transplantation facilities have evolved with time providing quality services, modernized as appropriate with updated knowledge and incorporating technological advances supported by the systematic evidence-based approach.

Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices

PubMed Central

Tandon, Radhika; Singh, Archita; Gupta, Noopur; Vanathi, M; Gupta, Vivek

2017-01-01

Purpose: The purpose of this study is to review the history and evolution of the National Eye Bank (NEB) and analyze the impact over the years and report the outcome of the invested resources. Methods: Review of archival material, records, project reports, policy and procedures' manuals, and publications was done. Descriptive and analytical processing of data obtained was undertaken. Parameters evaluated included total collection, transplantation, utilization rates of donor cornea, changing trends over time in terms of numbers and duration of recipients waiting, impactful research translated into changes in standard operating protocols, new facilities, and subsequent effects on numbers or quality assurance measures and overview of major achievements. Periodic situational analysis with contextual relevance and interpretation of outcomes was done pertaining to national goals and international standards. Results: The NEB and cornea services have played a key leadership role in furthering the development of eye banking and corneal transplantation services. The contribution extends beyond routine patient care to education, training, generation of resources, advocacy, and policymaking. In quantifiable terms, the overall performance has steadily increased over the years. Major contributions include training of doctors, eye bank staff and corneal surgeons, introduction of innovative techniques for corneal transplantation, setting of national standards for eye banking and provision of preservation media, customized corneal, and ocular surface cell replacement therapy in collaboration with other departments and institutes. Conclusion: The eye banking and corneal transplantation facilities have evolved with time providing quality services, modernized as appropriate with updated knowledge and incorporating technological advances supported by the systematic evidence-based approach. PMID:28345565

Effect of poverty on eye health and implications for nursing practice.

PubMed

Williamson, Swapna; Seewoodhary, Ramesh; Dampies, Lavona

2016-08-10

Poverty is a global issue that affects the health and quality of life of millions of people. It predisposes people to many health conditions, including sight loss or blindness as a result of the immune system becoming compromised. Blindness is common in areas of the world where there is extreme poverty. In the UK, poverty has become a major social issue, contributing to many health problems, including eye conditions. These eye conditions can result in sight loss if they are not managed effectively. Psychosocial care is an essential aspect of patient care, because poverty and sight loss are interrelated. Healthcare practitioners have a significant role in the management and prevention of blindness. Blindness caused by poverty is largely preventable, and health promotion is an important strategy in care management.

Behavioral economics and diabetic eye exams.

PubMed

Williams, Andrew M; Liu, Peggy J; Muir, Kelly W; Waxman, Evan L

2018-07-01

Diabetic retinopathy is a common microvascular complication of diabetes mellitus and is the leading cause of new blindness among working-age adults in the United States. Timely intervention to prevent vision loss is possible with early detection by regular eye examinations. Unfortunately, adherence to recommended annual diabetic eye exams is poor. Public health interventions have targeted traditional barriers to care, such as cost and transportation, with limited success. Behavioral economics provides an additional framework of concepts and tools to understand low screening rates and to promote regular diabetic eye exams for populations at risk. In particular, behavioral economics outlines biases and heuristics that affect decision-making and underlie pervasive barriers to care, such as not viewing diabetic eye exams as a priority or perceiving oneself as too healthy to need an examination. In this review, we examine the literature on the use of behavioral economics interventions to promote regular diabetic eye exams. From the results of the included studies, we outline how concepts from behavioral economics can improve eye examination rates. In particular, the default bias, present bias, and self-serving bias play a significant role in precluding regular diabetic eye examinations. Potential tools to mitigate these biases include leveraging default options, using reminder messages, providing behavioral coaching, applying commitment contracts, offering financial incentives, and personalizing health messages. When combined with traditional public health campaigns, insights from behavioral economics can improve understanding of pervasive barriers to care and offer additional strategies to promote regular preventive eye care for patients with diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

The depiction of protective eyewear use in popular television programs.

PubMed

Glazier, Robert; Slade, Martin; Mayer, Hylton

2011-04-01

Media portrayal of health related activities may influence health related behaviors in adult and pediatric populations. This study characterizes the depiction of protective eyewear use in the scripted television programs most viewed by the age group that sustains the largest proportion of eye injuries. Viewership ratings data were acquired to assemble a list of the 24 most-watched scripted network broadcast programs for the 13-year-old to 45-year-old age group. The six highest average viewership programs that met the exclusion criteria were selected for analysis. Review of 30 episodes revealed a total of 258 exposure scenes in which an individual was engaged in an activity requiring eye protection (mean, 8.3 exposure scenes per episode; median, 5 exposure scenes per episode). Overall, 66 (26%) of exposure scenes depicted the use of any eye protection, while only 32 (12%) of exposure scenes depicted the use of adequate eye protection. No incidences of eye injuries or infectious exposures were depicted within the exposure scenes in the study set. The depiction of adequate protective eyewear use during eye-risk activities is rare in network scripted broadcast programs. Healthcare professionals and health advocacy groups should continue to work to improve public education about eye injury risks and prevention; these efforts could include working with the television industry to improve the accuracy of the depiction of eye injuries and the proper protective eyewear used for prevention of injuries in scripted programming. Future studies are needed to examine the relationship between media depiction of eye protection use and viewer compliance rates.

Implementation evaluation of a culturally competent eye injury prevention program for citrus workers in a Florida migrant community.

PubMed

Luque, John S; Monaghan, Paul; Contreras, Ricardo B; August, Euna; Baldwin, Julie A; Bryant, Carol A; McDermott, Robert J

2007-01-01

The Partnership for Citrus Worker Health (PCWH) is a coalition that connects academic institutions, public health agencies, industry and community-based organizations for implementation of an eye safety pilot project with citrus workers using the Camp Health Aide (CHA) model. This project was an implementation evaluation of an eye safety curriculum using modeling and peer-to-peer education among Mexican migrant citrus workers in a southwest Florida community to increase positive perceptions toward the use of safety eyewear and reduce occupational eye injuries. CHAs have been employed and trained in eye safety and health during harvesting seasons since 2004. Field observations, focus group interviews, and written questionnaires assessed program implementation and initial outcomes. There was an increase in positive perceptions toward use of safety eyewear between 2004 and 2005. Evaluation of training suggested ways to improve the curriculum. The modest literacy level of the CHAs necessitated some redesign of the curriculum and its implementation (e.g., introduction of and more reliance on use of training posters). PCWH benefited by extensive documentation of the training and supervision, a pilot project that demonstrated the potential effectiveness of CHAs, and having a well-defined target population of citrus workers (n = 427). Future research can rigorously test the effectiveness of CHAs in reducing eye injuries among citrus workers.

Cost-Utility Analysis of Extending Public Health Insurance Coverage to Include Diabetic Retinopathy Screening by Optometrists.

PubMed

van Katwyk, Sasha; Jin, Ya-Ping; Trope, Graham E; Buys, Yvonne; Masucci, Lisa; Wedge, Richard; Flanagan, John; Brent, Michael H; El-Defrawy, Sherif; Tu, Hong Anh; Thavorn, Kednapa

2017-09-01

Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness in Canada. Eye examinations play an important role in early detection. However, DR screening by optometrists is not always universally covered by public or private health insurance plans. This study assessed whether expanding public health coverage to include diabetic eye examinations for retinopathy by optometrists is cost-effective from the perspective of the health care system. We conducted a cost-utility analysis of extended coverage for diabetic eye examinations in Prince Edward Island to include examinations by optometrists, not currently publicly covered. We used a Markov chain to simulate disease burden based on eye examination rates and DR progression over a 30-year time horizon. Results were presented as an incremental cost per quality-adjusted life year (QALY) gained. A series of one-way and probabilistic sensitivity analyses were performed. Extending public health coverage to eye examinations by optometrists was associated with higher costs ($9,908,543.32) and improved QALYs (156,862.44), over 30 years, resulting in an incremental cost-effectiveness ratio of $1668.43/QALY gained. Sensitivity analysis showed that the most influential determinants of the results were the cost of optometric screening and selected utility scores. At the commonly used threshold of $50,000/QALY, the probability that the new policy was cost-effective was 99.99%. Extending public health coverage to eye examinations by optometrists is cost-effective based on a commonly used threshold of $50,000/QALY. Findings from this study can inform the decision to expand public-insured optometric services for patients with diabetes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The Health Of Patients' Eyes (HOPE) Glaucoma study. The effectiveness of a 'glaucoma personal record' for newly diagnosed glaucoma patients: study protocol for a randomised controlled trial.

PubMed

Forbes, Marina; Fairlamb, Helen; Jonker, Leon

2015-08-07

Glaucoma involves progressive optic nerve fibre loss, subsequently leading to irreversible and disabling visual field defects. In Europe, the prevalence of glaucoma is approximately 2.2 % of all people aged over 40 years; this equates to 12 million people. Glaucoma patients require regular lifelong follow-up, contributing to a large financial and resource burden for the National Health Service (NHS) in the UK. This study aims to determine whether providing newly diagnosed glaucoma patients with a personalised client-held eye health summary ('glaucoma personal record'), improves patients' knowledge of their glaucoma condition. A potential long-term benefit could be improved self-management and henceforth a slower rate of deterioration. HOPE Glaucoma is a 3-year, prospective, parallel-group, pragmatic, single-centred, randomised controlled trial. An anticipated 122 adults, newly diagnosed with glaucoma (including ocular hypertension, suspected glaucoma and/or chronic open-angle glaucoma) will be recruited from a nurse-led ophthalmology outpatient clinic at a medium-sized NHS Trust. Participants will be randomly allocated to receive standard clinical care (control arm) or standard care plus a glaucoma personal record, detailing the current state of their condition (interventional arm). Participant assessments are designed to test whether provision of a glaucoma personal record 1) improves patient knowledge of glaucoma and 2) contributes to improvements in clinical outcomes, i.e. delay of visual field loss. The primary outcome measure is better client knowledge of glaucoma at the 9-12 month follow-up visit. Secondary outcome measures include the rate of visual field loss and patient-reported outcome measures on visual function (National Eye Institute VFQ - 25) measured at baseline, 9-12 months, 24 months and 36 months. Estimating a 20 % drop-out rate, the study will have 90 % power to detect a mean two-point difference in glaucoma knowledge score between groups at 5 % significance - based on two-sided Mann-Whitney U test. If a glaucoma personal record is found to significantly improve glaucoma patients' knowledge of their condition, this intervention could potentially provide a low-cost, straightforward tool to educate and engage glaucoma patients. Subsequently, this could have the potential to increase patient self-management and therefore allow glaucoma patients to prolong their sight functionality for longer. ISRCTN41306818 , registered on 22 August 2013.

History of community health center affiliations with The New England College of Optometry.

PubMed

Wilson, Roger; Sharda, Vandhana

2008-10-01

Since the 1970s, The New England College of Optometry (NECO) has been a leader in community-based educational programming. This was accomplished through the development of affiliation agreements with health care facilities that care for the underserved, notably community health centers (CHCs). The college's clinical system, the New England Eye Institute (NEEI), develops CHC programs, manages professional services agreements, initiates teaching affiliation agreements, and leads staff recruitment and retention efforts. CHC collaborations, which effectively address disparities in access to health care and visual health status, represent a significant component of the college's primary care clinical training venues. Since their inception in 1972, these CHC academic-community partnerships have provided more than 650,000 eye examinations to the underserved and have trained more than 3,200 graduates in community-based eye care, interdisciplinary care management environment, clinical prevention strategies, and population health. This report describes NECO's longstanding success with CHCs, explains the scope of practice at CHCs, explains how students are involved in the CHCs' eye care services, and discusses the various management and business arrangements. The benefits and challenges of CHC affiliations with optometry schools and colleges are also discussed.

Incidence and Characteristics of Cataract Surgery in Poland, during 2010-2015.

PubMed

Nowak, Michał S; Grabska-Liberek, Iwona; Michalska-Małecka, Katarzyna; Grzybowski, Andrzej; Kozioł, Milena; Niemczyk, Wojciech; Więckowska, Barbara; Szaflik, Jacek P

2018-03-02

Background: To assess the incidence and characteristic of cataract surgery in Poland from 2010 to 2015 and to interpret these findings. Patients and methods: Data from all patients who underwent cataract surgery alone or in combined procedures in Poland between January 2010 and December 2015 were evaluated. Patient data were from the national database of hospitalizations maintained by National Health Fund. Data on the population of Poland were obtained from Central Statistical Office of Poland. Results: In total, 1,218,777 cataract extractions (alone or combined with other procedures) were performed in 1,081,345 patients during 2010-2015. Overall, the incidence of cataract surgery increased from 5.22/1000 person-years in 2010 to 6.17/1000 person-years in 2015. Phacoemulsification was performed in 97.46% of cataract extractions, and 3.02% of cataract extractions were combined procedures. The rate of one-day procedures increased from 28.3% in 2010 to 43.1% in 2015. The probability of second-eye surgery 12 months after the first-eye surgery increased from 44% in 2010 to 73% in 2015 (log-rank test p < 0.0001). Conclusion: In Poland, from 2010 to 2015, the total incidence of cataract surgery, the number of people who underwent surgery, and the number of one-day cataract surgeries increased significantly.

Health systems analysis of eye care services in Zambia: evaluating progress towards VISION 2020 goals

PubMed Central

2014-01-01

Background VISION 2020 is a global initiative launched in 1999 to eliminate avoidable blindness by 2020. The objective of this study was to undertake a situation analysis of the Zambian eye health system and assess VISION 2020 process indicators on human resources, equipment and infrastructure. Methods All eye health care providers were surveyed to determine location, financing sources, human resources and equipment. Key informants were interviewed regarding levels of service provision, management and leadership in the sector. Policy papers were reviewed. A health system dynamics framework was used to analyse findings. Results During 2011, 74 facilities provided eye care in Zambia; 39% were public, 37% private for-profit and 24% owned by Non-Governmental Organizations. Private facilities were solely located in major cities. A total of 191 people worked in eye care; 18 of these were ophthalmologists and eight cataract surgeons, equivalent to 0.34 and 0.15 per 250,000 population, respectively. VISION 2020 targets for inpatient beds and surgical theatres were met in six out of nine provinces, but human resources and spectacles manufacturing workshops were below target in every province. Inequalities in service provision between urban and rural areas were substantial. Conclusion Shortage and maldistribution of human resources, lack of routine monitoring and inadequate financing mechanisms are the root causes of underperformance in the Zambian eye health system, which hinder the ability to achieve the VISION 2020 goals. We recommend that all VISION 2020 process indicators are evaluated simultaneously as these are not individually useful for monitoring progress. PMID:24575919

Factors That Influence the Receipt of Eye Care

PubMed Central

Alexander, Robert L.; Miller, Nancy A.; Cotch, Mary Frances; Janiszewski, Rosemary

2010-01-01

Objectives To better understand what factors influence the receipt of eye care so that screening and education programs can be designed to promote early detection and treatment. Methods Twenty focus groups were conducted. Analyses entailed debriefing sessions, coding, and interpreting transcribed data. Results Attitudes about eyesight and eye exams influence the receipt of preventive eye care. Limited knowledge about certain eye diseases and conditions was reported. Participants stated that their primary care providers did not communicate information with them about eyesight nor did they conduct basic eye screenings. Conclusions Improving provider-patient interactions and developing public health messages about eye diseases and preventive eye care can facilitate increased use of appropriate eye care services. PMID:18241139

A situational analysis of ocular health promotion in the South African primary health-care system.

PubMed

Sithole, Hlupheka Lawrence

2017-03-01

South Africa has a serious burden of avoidable blindness and visual impairment, which may be due to poor ocular health promotional policies and programs or implementation. Therefore, this paper sought to critically analyse the South African primary health-care policies and programs, to identify the components of ocular health promotional policies and programs as well as how they are currently being implemented and to suggest areas that can be improved in order to minimise the burden of blindness and visual impairment. Triangulated quantitative and qualitative research methods were used in the study. Questionnaire and interviews were used to solicit data from national and provincial managers of different health directorates. Eye-care managers from each province also completed the questionnaire. Furthermore, relevant health policy and program documents from national and provincial departments of health were studied to identify areas relating to ocular health promotion. The study found varying degrees of implementation of various ocular health promotional activities in the provinces with the majority of respondents (62 per cent) indicating that ocular health promotion was not part of their responsibility and another 81 per cent revealing that vision screening does not form part of their health promotional programs. It further revealed a lack of a dedicated directorate for ocular health-care issues and the absence of an integrated ocular health promotional policy. Ocular health promotional activities were absent in other provinces. This may be a major contributing factor to poor ocular health promotion in South Africa and hence, the high prevalence of blindness and visual impairment. Therefore, it is recommended that an integrated ocular health promotional model (directorate and policies) be developed and be part of the South African primary health-care system. © 2016 Optometry Australia.

The eye amputated - consequences of eye amputation with emphasis on clinical aspects, phantom eye syndrome and quality of life.

PubMed

Rasmussen, Marie Louise Roed

2010-12-01

In this thesis the term eye amputation (EA) covers the removing of an eye by: evisceration, enucleation and exenteration. Amputation of an eye is most frequently the end-stage in a complicated disease, or the primary treatment in trauma and neoplasm. In 2010 the literature is extensive due to knowledge about types of surgery, implants and surgical technique. However, not much is known about the time past surgery. To identify the number of EA, the causative diagnosis and the indication for surgical removal of the eye, the chosen surgical technique and to evaluate a possible change in surgical technique in Denmark from 1996 until 2003 (paper I); To describe the phantom eye syndrome and its prevalence of visual hallucinations, phantom pain and phantom sensations (paper II); To characterise the quality of phantom eye pain, including its intensity and frequency among EA patients. We attempted to identify patients with increased risk of developing pain after EA and investigated if preoperative pain is a risk factor for a later development of phantom pain (paper III); In addition we wanted to investigate the health related quality of life, perceived stress, self rated health, job separation due to illness or disability and socio-economic position of the EA in comparison with the general Danish population (paper IV). Records on 431 EA patients, clinical ophthalmological examination and an interview study of 173 EA patients and a questionnaire answered by 120 EA patients. The most frequent indications for EA in Denmark were painful blind eye (37%) and neoplasm (34%). During the study period 1996-2003, the annual number of eye amputations was stable, but an increase in bulbar eviscerations was noticed. Orbital implants were used with an increasing tendency until 2003. The Phantom eye syndrome is frequent among EA patients. Visual hallucinations were described by 42% of the patients. The content were mainly elementary visual hallucinations, with white or colored light as a continuous sharp light or as moving dots. The most frequent triggers were darkness, closing of the eyes, fatigue and psychological stress. Fifty-four percent of the patients had visual hallucinations more than once a week. Ten patients were so visually disturbed that it interfered with their daily life. Approximately 23% of all EA experience phantom pain for several years after the surgery. Phantom pain was reported to be of three different qualities: (i) cutting, penetrating, gnawing or oppressive (n=19); (ii) radiating, zapping or shooting (n=8); (iii) superficial burning or stinging (n=5); or a mixture of these different pain qualities (n=7). The median intensity on a visual analogue scale, ranging from 0 to 100, was 36 [range: 1-89]. One-third of the patients experienced phantom pain every day. Chilliness, windy weather and psychological stress/fatigue were the most commonly reported triggers for pain. Factors associated with phantom pain were: ophthalmic pain before EA, the presence of implant and a patient reported high degree of conjunctival secretion. A common reason for EA is the presence of a painful blind eye. However, one third of these patients continue to have pain after the EA. Phantom sensations were present in 2% of the patients. The impact of an eye amputation is considerable. EA patients have poorer health related quality of life, poorer self-rated health and more perceived stress than does the general population. The largest differences in health related quality of life between the EA patients and the general population were related to role limitations due to emotional problems and mental health. Patients with the indication painful blind eye are having lower scores in all aspects of health related quality of life and perceived stress than patients with the indication neoplasm and trauma. The percentage of eye amputated which is divorced or separated was twice as high as in the general population. Furthermore, 25% retired or changed to part-time jobs due to eye disease and 39.5% stopped participating in leisure activities due to their EAs. © 2010 The Author. Acta Ophthalmologica © 2010 Acta Ophthalmologica Scandinavica Foundation.

Vision-related quality of life after transsphenoidal surgery for pituitary adenoma.

PubMed

Okamoto, Yoshifumi; Okamoto, Fumiki; Yamada, Shozo; Honda, Maiko; Hiraoka, Takahiro; Oshika, Tetsuro

2010-07-01

PURPOSE. To use the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) to evaluate vision-related quality of life (VR-QOL) in patients with pituitary adenoma who undergo transsphenoidal surgery. METHODS. The VFQ-25 was self-administered by 74 patients with pituitary adenoma before and 3 months after surgery. Pre- and postoperative clinical data were collected, including age, sex, tumor type and size, logarithm of minimum angle of resolution best corrected visual acuity (logMAR BCVA), critical flicker fusion frequency, static perimetry scores (mean deviation [MD] and corrected pattern SD [CPSD]), duration of ocular symptoms, and number of systemic comorbidities. RESULTS. Seventy-four patients with a mean age of 48.2 years were studied. Transsphenoidal surgery for pituitary adenoma significantly improved logMAR BCVA and critical fusion flicker frequency in the worse-seeing eye and MD and CPSD scores in both the better- and worse-seeing eyes (P < 0.001). The VFQ-25 composite score and all subscale scores, except those for the general health and color vision subscales, improved significantly (P < 0.05). A multivariate regression analysis revealed that the preoperative VFQ-25 composite score and the preoperative MD and CPSD scores in the better-seeing eye were related to the postoperative VFQ-25 composite score (P < 0.05). CONCLUSIONS. This study quantitatively demonstrated that transsphenoidal surgery can dramatically improve VR-QOL in pituitary adenoma and that the preoperative VFQ-25 composite score and visual field disturbance in the better-seeing eye are particularly important predictors associated with the postoperative VR-QOL. The use of VFQ-25 provides a more comprehensive overview of the effectiveness of transsphenoidal surgery.

Introduction

NASA Technical Reports Server (NTRS)

Wotring, Virginia E.; Southern, Sarka O.; Mentzer, Mark A.; Rodriquez-Chavez, Isaac

2014-01-01

The 2014 SPIE Sensing Technologies for Global Health, Military Medicine and Environmental Monitoring conference embraced a wealth of state-of-the-art information in basic and applied science. This event covered the latest developments in the following areas: Non-invasive Disease Diagnostics for Global Health- This opening series of two consecutive sessions focused on oral biospecimen based rapid assays and point-of-care devices for the detection of pathogens causing infectious diseases, biomarkers for cancer, and analytes for noncommunicable diseases such as diabetes. They also covered presentations on the human proteasome and microbiome with linkage to human diseases and diagnostic approaches. The sessions were built on the past experience and expertise of the National Institutes of Health, National Institutes of Dental and Craniofacial Research. Military Medicine I: Traumatic Brain Injury and PTSD-This assembly covered oral-biomarker based diagnostics for brain damage and TBI as well as prevention and rehabilitation technologies. Neurorehabilitation and noninvasive neuromodulation were also discussed as critical approaches for effective functioning. Military Medicine II: Physiology and Medicine of Extreme Environments and Spaceflight-This scientific segment showcased physiological, pharmacological and diagnostic sensing methodologies during spaceflight per the National Aeronautics and Space Administration as well as military-relevant toxicans and future sensing trends per the Department of Defense. It also included latest technologies to determine hydration status in warfighters, eye surgery using the latest laser technologies, and sensing tools for blood analysis. ? Sensing Technologies for Disease Diagnostics and Environmental Monitoring-This closing series of two consecutive sessions provided the venues to learn and discuss more results on the next generation of diagnostic tools and field technologies for diseases, including biomarker detection by digital imaging, multiplex technologies, capillary electrophoresis and molecular platforms serving as labs-on-chips. This conference allowed cross-fertilization of ideas, projects and collaborative work by a multidisciplinary audience of national and international colleagues from the academia, industry and federal government: The National Institutes of Health, National Aeronautics and Space Administration, and the Department of Defense.

An observational study to assess if automated diabetic retinopathy image assessment software can replace one or more steps of manual imaging grading and to determine their cost-effectiveness.

PubMed

Tufail, Adnan; Kapetanakis, Venediktos V; Salas-Vega, Sebastian; Egan, Catherine; Rudisill, Caroline; Owen, Christopher G; Lee, Aaron; Louw, Vern; Anderson, John; Liew, Gerald; Bolter, Louis; Bailey, Clare; Sadda, SriniVas; Taylor, Paul; Rudnicka, Alicja R

2016-12-01

Diabetic retinopathy screening in England involves labour-intensive manual grading of retinal images. Automated retinal image analysis systems (ARIASs) may offer an alternative to manual grading. To determine the screening performance and cost-effectiveness of ARIASs to replace level 1 human graders or pre-screen with ARIASs in the NHS diabetic eye screening programme (DESP). To examine technical issues associated with implementation. Observational retrospective measurement comparison study with a real-time evaluation of technical issues and a decision-analytic model to evaluate cost-effectiveness. A NHS DESP. Consecutive diabetic patients who attended a routine annual NHS DESP visit. Retinal images were manually graded and processed by three ARIASs: iGradingM (version 1.1; originally Medalytix Group Ltd, Manchester, UK, but purchased by Digital Healthcare, Cambridge, UK, at the initiation of the study, purchased in turn by EMIS Health, Leeds, UK, after conclusion of the study), Retmarker (version 0.8.2, Retmarker Ltd, Coimbra, Portugal) and EyeArt (Eyenuk Inc., Woodland Hills, CA, USA). The final manual grade was used as the reference standard. Arbitration on a subset of discrepancies between manual grading and the use of an ARIAS by a reading centre masked to all grading was used to create a reference standard manual grade modified by arbitration. Screening performance (sensitivity, specificity, false-positive rate and likelihood ratios) and diagnostic accuracy [95% confidence intervals (CIs)] of ARIASs. A secondary analysis explored the influence of camera type and patients' ethnicity, age and sex on screening performance. Economic analysis estimated the cost per appropriate screening outcome identified. A total of 20,258 patients with 102,856 images were entered into the study. The sensitivity point estimates of the ARIASs were as follows: EyeArt 94.7% (95% CI 94.2% to 95.2%) for any retinopathy, 93.8% (95% CI 92.9% to 94.6%) for referable retinopathy and 99.6% (95% CI 97.0% to 99.9%) for proliferative retinopathy; and Retmarker 73.0% (95% CI 72.0% to 74.0%) for any retinopathy, 85.0% (95% CI 83.6% to 86.2%) for referable retinopathy and 97.9% (95% CI 94.9 to 99.1%) for proliferative retinopathy. iGradingM classified all images as either 'disease' or 'ungradable', limiting further iGradingM analysis. The sensitivity and false-positive rates for EyeArt were not affected by ethnicity, sex or camera type but sensitivity declined marginally with increasing patient age. The screening performance of Retmarker appeared to vary with patient's age, ethnicity and camera type. Both EyeArt and Retmarker were cost saving relative to manual grading either as a replacement for level 1 human grading or used prior to level 1 human grading, although the latter was less cost-effective. A threshold analysis testing the highest ARIAS cost per patient before which ARIASs became more expensive per appropriate outcome than human grading, when used to replace level 1 grader, was Retmarker £3.82 and EyeArt £2.71 per patient. The non-randomised study design limited the health economic analysis but the same retinal images were processed by all ARIASs in this measurement comparison study. Retmarker and EyeArt achieved acceptable sensitivity for referable retinopathy and false-positive rates (compared with human graders as reference standard) and appear to be cost-effective alternatives to a purely manual grading approach. Future work is required to develop technical specifications to optimise deployment and address potential governance issues. The National Institute for Health Research (NIHR) Health Technology Assessment programme, a Fight for Sight Grant (Hirsch grant award) and the Department of Health's NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and the University College London Institute of Ophthalmology.

The Royal College of Ophthalmologists' National Ophthalmology Database Study of cataract surgery: report 2, relationships of axial length with ocular copathology, preoperative visual acuity, and posterior capsule rupture

PubMed Central

Day, A C; Donachie, P H J; Sparrow, J M; Johnston, R L

2015-01-01

Purpose To describe the relationships of axial length with ocular copathology, preoperative visual acuity, and posterior capsule rupture rates in patients undergoing cataract surgery. Design The Royal College of Ophthalmologists' National Ophthalmology Database (NOD) study. Methods Anonymised data on 180 114 eyes from 127 685 patients undergoing cataract surgery between August 2006 and November 2010 were collected prospectively from 28 sites. Data parameters included: demographics, biometry, ocular copathology, visual acuity measurements, and surgical complications including posterior capsule rupture, or vitreous loss or both (PCR). Results Consultant surgeons performed a higher proportion of operations on eyes whose axial length were at the extremes. Glaucoma and age related macular degeneration were more common in eyes with shorter axial lengths, whilst previous vitrectomy was associated with longer axial lengths. Eyes with brunescent or white cataracts or amblyopia were more common at both axial length extremes. Preoperative visual acuities were similar for eyes with axial length measurements up to approximately 28 mm and worse for eyes with longer axial length measurements. PCR rates showed little change with axial length (overall mean 1.95%, 95% CI: 1.89 to 2.01%), except for a borderline increase in eyes with axial length <20.0 mm where rates were 3.6% (95% CI: 2.0 to 6.3%). The likelihood of PCR in eyes with axial length <20.0 mm was 1.88 times higher than those of ≥20.0 mm (P=0.0373). Conclusion Rates of ocular comorbidities vary by axial length. PCR rates in eyes with very short or long axial lengths were lower than expected. PMID:26493034

The role of optometrists in India: An integral part of an eye health team

PubMed Central

De Souza, Neilsen; Cui, Yu; Looi, Stephanie; Paudel, Prakash; Shinde, Lakshmi; Kumar, Krishna; Berwal, Rajbir; Wadhwa, Rajesh; Daniel, Vinod; Flanagan, Judith; Holden, Brien

2012-01-01

India has a proud tradition of blindness prevention, being the first country in the world to implement a blindness control programme which focused on a model to address blinding eye disease. However, with 133 million people blind or vision impaired due to the lack of an eye examination and provision of an appropriate pair of spectacles, it is imperative to establish a cadre of eye care professionals to work in conjunction with ophthalmologists to deliver comprehensive eye care. The integration of highly educated four year trained optometrists into primary health services is a practical means of correcting refractive error and detecting ocular disease, enabling co-managed care between ophthalmologists and optometrists. At present, the training of optometrists varies from two year trained ophthalmic assistants/optometrists or refractionists to four year degree trained optometrists. The profession of optometry in India is not regulated, integrated into the health care system or recognised by the majority of people in India as provider of comprehensive eye care services. In the last two years, the profession of optometry in India is beginning to take the necessary steps to gain recognition and regulation to become an independent primary health care profession. The formation of the Indian Optometry Federation as the single peak body of optometry in India and the soon to be established Optometry Council of India are key organisations working towards the development and regulation of optometry. PMID:22944749

Notes from the Field: Respiratory Symptoms and Skin Irritation Among Hospital Workers Using a New Disinfection Product - Pennsylvania, 2015.

PubMed

Hawley, Brie; Casey, Megan L; Cox-Ganser, Jean M; Edwards, Nicole; Fedan, Kathleen B; Cummings, Kristin J

2016-04-22

In March 2014, a new disinfection product, consisting of hydrogen peroxide, peroxyacetic acid, and acetic acid, was introduced at a Pennsylvania hospital to aid in the control of health care-associated infections. The product is an Environmental Protection Agency-registered non-bleach sporicide advertised as a one-step cleaner, disinfectant, and deodorizer. According to the manufacturer's safety data sheet, the product requires no personal protective equipment when it is diluted with water by an automated dispenser before use. On January 30, 2015, CDC's National Institute for Occupational Health (NIOSH) received a confidential employee request to conduct a health hazard evaluation at the hospital. The request cited concerns about exposure of hospital environmental services staff members to the product and reported symptoms among persons who had used the product that included eye and nasal problems, asthma-like symptoms, shortness of breath, skin problems, wheeze, chest tightness, and cough.

Mapping chronic illness in the age of globalization: reclaiming the good for the chronically ill.

PubMed

del Pilar Camargo Plazas, Maria

2009-01-01

Until recently, infectious diseases were the main cause of death worldwide. New medical discoveries and the evolution of public health improved life expectancy and the ability to survive acute threats, thus changing the course of diseases from acute to chronic. Today, chronic illness is the most important health concern worldwide. Chronic illness increases existing poverty and pushes other people into it. As nurses, members of the healthcare system and members of this world, we cannot forget that our response toward globalization and chronic disease has to be centered in leadership through reorienting local and national healthcare systems. All actions must be grounded in the ethical treatment of the ill; we cannot close our eyes in hospitals or communities to what is happening now worldwide because our responsibility is to promote health, prevent disease, and care for human beings.

The cost of vision loss in Canada. 2. Results.

PubMed

Cruess, Alan F; Gordon, Keith D; Bellan, Lorne; Mitchell, Scott; Pezzullo, M Lynne

2011-08-01

This study was conducted to provide the financial underpinnings necessary for effective planning for the provision of eye health services in Canada. Canada is facing an aging demographic and all the major eye diseases are diseases associated with aging. It is essential that we have information based on the best available data to support national and provincial vision health plans. The design associated with the prevalence-based approach used in this study was outlined previously in detail in The Cost of Vision Loss in Canada: Methodology. The methods associated with the prevalence-based approach used in this study were previously outlined in detail in The Cost of Vision Loss in Canada: Methodology. The financial cost of VL in Canada in 2007 was estimated to be $15.8 billion per annum: $8.6 billion (54.6%) represents direct health system expenditure; $4.4 billion (28.0%) was productivity lost due to lower employment, higher absenteeism, and premature death of Canadians with VL; $1.8 billion (11.1%) was the dead weight losses (DWL) from transfers including welfare payments and taxation forgone; $0.7 billion (4.4%) was the value of the care for people with VL; $305 million (1.9%) was other indirect costs such as aids and home modifications and the bring forward of funeral costs. Additionally, the value of the lost well-being (disability and premature death) was estimated at a further $11.7 billion. In per capita terms, this amounts to a financial cost of $19370 per person with VL per annum. Including the value of lost well-being, the cost is $33704 per person per annum. There is a growing awareness in Canada and around the world of the impact of VL on health costs and on the economy in general. This awareness is supported by the growing number of independent studies on the cost of vision loss both nationally and globally. Because most of these studies are limited by the minimal amount of available data, the overall cost of vision loss is likely underestimated. Nevertheless, this study reports the cost of vision loss in Canada as being greater than previously reported, making the problem even more urgent to address. A comprehensive national vision health plan, that is a coordinated federal, provincial and territorial initiative dealing with all aspects of vision loss prevention, sight restoration, and vision rehabilitation is called for. Copyright © 2011 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Strengthening primary eye care in South Africa: An assessment of services and prospective evaluation of a health systems support package

PubMed Central

Lilian, Rivka R.; Railton, Jean; Schaftenaar, Erik; Mabitsi, Moyahabo; Grobbelaar, Cornelis J.; Khosa, N. Sellina; Maluleke, Babra H.; Struthers, Helen E.; McIntyre, James A.

2018-01-01

Visual impairment is a significant public health concern, particularly in low- and middle-income countries where eye care is predominantly provided at the primary healthcare (PHC) level, known as primary eye care. This study aimed to perform an evaluation of primary eye care services in three districts of South Africa and to assess whether an ophthalmic health system strengthening (HSS) package could improve these services. Baseline surveys were conducted in Cape Winelands District, Johannesburg Health District and Mopani District at 14, 25 and 36 PHC facilities, respectively. Thereafter, the HSS package, comprising group training, individual mentoring, stakeholder engagement and resource provision, was implemented in 20 intervention sites in Mopani District, with the remaining 16 Mopani facilities serving as control sites. At baseline, less than half the facilities in Johannesburg and Mopani had dedicated eye care personnel or sufficient space to measure visual acuity. Although visual acuity charts were available in most facilities, <50% assessed patients at the correct distance. Median score for availability of nine essential drugs was <70%. Referral criteria knowledge was highest in Cape Winelands and Johannesburg, with poor clinical knowledge across all districts. Several HSS interventions produced successful outcomes: compared to control sites there was a significant increase in the proportion of intervention sites with eye care personnel and resources such as visual acuity charts (p = 0.02 and <0.01, respectively). However, engaging with district pharmacists did not improve availability of essential drugs (p = 0.47). Referral criteria knowledge improved significantly in intervention sites (p<0.01) but there was no improvement in clinical knowledge (p = 0.76). Primary eye care in South Africa faces multiple challenges with regard to organisation of care, resource availability and clinical competence. The HSS package successfully improved some aspects of this care, but further development is warranted together with debate regarding the positioning of eye services at PHC level. PMID:29758069

Local co-ordination and case management can enhance Indigenous eye care – a qualitative study

PubMed Central

2013-01-01

Background Indigenous adults suffer six times more blindness than other Australians but 94% of this vision loss is unnecessary being preventable or treatable. We have explored the barriers and solutions to improve Indigenous eye health and proposed significant system changes required to close the gap for Indigenous eye health. This paper aims to identify the local co-ordination and case management requirements necessary to improve eye care for Indigenous Australians. Methods A qualitative study, using semi-structured interviews, focus groups, stakeholder workshops and meetings was conducted in community, private practice, hospital, non-government organisation and government settings. Data were collected at 21 sites across Australia. Semi-structured interviews were conducted with 289 people working in Indigenous health and eye care; focus group discussions with 81 community members; stakeholder workshops involving 86 individuals; and separate meetings with 75 people. 531 people participated in the consultations. Barriers and issues were identified through thematic analysis and policy solutions developed through iterative consultation. Results Poorly co-ordinated eye care services for Indigenous Australians are inefficient and costly and result in poorer outcomes for patients, communities and health care providers. Services are more effective where there is good co-ordination of services and case management of patients along the pathway of care. The establishment of clear pathways of care, development local and regional partnerships to manage services and service providers and the application of sufficient workforce with clear roles and responsibilities have the potential to achieve important improvements in eye care. Conclusions Co-ordination is a key to close the gap in eye care for Indigenous Australians. Properly co-ordinated care and support along the patient pathway through case management will save money by preventing dropout of patients who haven’t received treatment and a successfully functioning system will encourage more people to enter for care. PMID:23822115

CHARACTERIZATION OF ANTERIOR SEGMENT OPHTHALMOLOGIC LESIONS IDENTIFIED IN FREE-RANGING DOLPHINS AND THOSE UNDER HUMAN CARE.

PubMed

Colitz, Carmen M H; Walsh, Michael T; McCulloch, Stephen D

2016-03-01

Cetaceans in the wild and under human care develop a variety of ocular lesions. Although they have echolocation, cetacean species have good sight, making ocular health an important part of overall health care. The cornea is the primary site of abnormalities in both populations. Typical lesions of cetaceans under human care are characterized in this retrospective review of cases. One hundred eighty animals (n = 360 eyes) were chosen from the author's ophthalmologic examination reports from different geographic areas; they included Atlantic bottlenose dolphins (Tursiops truncatus), Pacific bottle nose dolphins (Tursiopstruncatus gilli), Indopacific bottlenose dolphins (Steno bredanensis), Indopacific humpback dolphins (Sousa chinensis), and roughtooth dolphins (Steno bredanensis). These animals were examined at least once, although most were examined numerous times over many years; lesions were categorized and are described. Seventy-seven eyes from 47 animals were normal. Medial keratopathy was the most common lesion and identified in 180 eyes from 97 animals, with 83 affected bilaterally. Horizontal keratopathy was identified in 69 eyes from 41 animals, with 28 affected bilaterally. Axial keratopathy and nonspecific axial opacities were identified in 67 eyes from 44 animals, with 21 affected bilaterally. Seventy-eight eyes from 50 animals, with 28 affected bilaterally, had more than one type of corneal lesion. Cataracts were identified in 32 eyes from 19 animals, with 13 affected bilaterally. Traumatic injuries were also common and involved eyelids and cornea. Sixteen eyes from 11 animals were blind; five dolphins were blind bilaterally due to phthisis bulbi secondary to corneal perforation or severe trauma. None of the diseases had a sex predisposition; however, medial keratopathy was significantly more common as a bilateral presentation than as a unilateral presentation. Cetaceans under human care with impaired sight can use echolocation; however, ocular health should definitely be a priority in their overall health plan.

Vision-related quality of life in patients with chronic central serous chorioretinopathy.

PubMed

Türkcü, Fatih Mehmet; Şahin, Alparslan; Bez, Yasin; Yüksel, Harun; Cinar, Yasin; Kürşat Cingü, Abdullah; Çaça, İhsan

2015-07-01

To evaluate vision-related quality of life in patients with chronic central serous chorioretinopathy (CSCR). Prospective, cross-sectional study. The interviewer-administered National Eye Institute visual function questionnaire (NEI-VFQ-25) was used in 30 adult consecutive patients with chronic CSCR patients. The controls were 30 gender- and age-matched people with normal visual function who came from the same socioeconomic and educational background as the participants. Patients with CSCR had statistically significant lower scores than controls for all the subscales, except for general health. In the study group, all subscale scores of vision-related quality of life, except general health, showed statistically significant negative correlations with the visual acuity. People with CSCR have worse vision-related quality of life than people without the condition.

Party foam-induced eye injuries and the power of media intervention.

PubMed

Abulafia, Adi; Segev, Fani; Platner, Eva; Ben Simon, Guy J

2013-06-01

To describe the clinical features and treatment outcome of eye injuries sustained as a result of contact with artificial snow spray ("party foam"/"silly string") during 2 consecutive Israeli Independence Day celebrations. Retrospective, multicenter, consecutive case series. Institutional. INTERVENTION/STUDY POPULATION: All patients who presented to 2 ophthalmology emergency services in 2007 and in 2008 with eye injury caused by contact with the foam. The medical records of the foam-induced eye injury cases were retrieved and analyzed. Data on injury type, comprehensive ophthalmic examination, and time to resolution were collected and analyzed. The assessed variables included the number of cases per year, injury type, visual acuity, treatment, and outcome. A total of 96 patients (135 eyes) had suffered from foam-induced ocular chemical injuries during the 2 celebrations. Sex and laterality were evenly distributed in the study population. The mean ± SD age was 12.8 ± 2.14 years (range, 7-17 years). All patients suffered from chemical conjunctivitis (100%) and superficial punctate keratopathy (79%), corneal erosion (27%), and conjunctival erosion (5%). More patients were seen during 2007 compared with 2008 [85 (117 eyes) and 11 (18 eyes), respectively]. This reduction was directly attributable to increased public awareness because of media coverage (newspapers, radio, and national TV). Sprayed foam used in parties and public celebrations can cause mild-to-severe ocular surface injuries. Increased public awareness will inevitably reduce the use of this dangerous agent, but warnings need to be repeated yearly in the national media.

The National Basketball Association eye injury study.

PubMed

Zagelbaum, B M; Starkey, C; Hersh, P S; Donnenfeld, E D; Perry, H D; Jeffers, J B

1995-06-01

To investigate the epidemiology of eye injuries sustained by professional basketball players in the National Basketball Association (NBA). A prospective study involving all NBA athletes who sustained eye injuries between February 1, 1992, and June 20, 1993, was conducted. Twenty-seven NBA team athletic trainers, physicians, and ophthalmologists were provided data forms to complete for any player examined for an eye injury. Practice and game exposures during the preseason, regular season, playoffs, and championships were included. Of the 1092 injuries sustained by NBA players during the 17-month period, 59 (5.4%) involved the eye and adnexa. Eighteen (30.5%) of the injuries occurred while the player was in the act of rebounding, and 16 (27.1%) while the player was on offense. The most common diagnoses included 30 abrasions or lacerations to the eyelid (50.9%), 17 contusions (edema and/or ecchymosis) to the eyelid or periorbital region (28.8%), and seven corneal abrasions (11.9%). There were three orbital fractures (5.1%). Most injuries were caused by fingers (35.6%) or elbows (28.8%). Nine players (15.3%) missed subsequent games because of their injury. Fifty-seven players (96.6%) were not wearing protective eyewear at the time of injury. The incidence of eye injuries in NBA players during the 17-month period was 1.44 per 1000 game exposures. Frequent physical contact in professional basketball players leaves them at great risk for sustaining eye injuries. To prevent these injuries, protective eyewear is recommended.

30 CFR 57.15014 - Eye protection when operating grinding wheels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Eye protection when operating grinding wheels. 57.15014 Section 57.15014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... NONMETAL MINES Personal Protection Surface and Underground § 57.15014 Eye protection when operating...

30 CFR 57.15014 - Eye protection when operating grinding wheels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Eye protection when operating grinding wheels. 57.15014 Section 57.15014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... NONMETAL MINES Personal Protection Surface and Underground § 57.15014 Eye protection when operating...

Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients

PubMed Central

Stonecipher, Karl G; Chia, Jenny; Onyenwenyi, Ahunna; Villanueva, Linda; Hollander, David A

2013-01-01

Background Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis®) use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Methods Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. Results The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40–69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008–2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months’ supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Conclusion Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies. PMID:24179335

Health claims database study of cyclosporine ophthalmic emulsion treatment patterns in dry eye patients.

PubMed

Stonecipher, Karl G; Chia, Jenny; Onyenwenyi, Ahunna; Villanueva, Linda; Hollander, David A

2013-01-01

Dry eye is a multifactorial, symptomatic disease associated with ocular surface inflammation and tear film hyperosmolarity. This study was designed to assess patterns of topical cyclosporine ophthalmic emulsion 0.05% (Restasis®) use in dry eye patients and determine if there were any differences in use based on whether dry eye is physician-coded as a primary or nonprimary diagnosis. Records for adult patients with a diagnosis of dry eye at an outpatient visit from January 1, 2008 to December 31, 2009 were selected from Truven Health MarketScan® Research Databases. The primary endpoint was percentage of patients with at least one primary versus no primary dry eye diagnosis who filled a topical cyclosporine prescription. Data analyzed included utilization of topical corticosteroids, oral tetracyclines, and punctal plugs. The analysis included 576,416 patients, accounting for 875,692 dry eye outpatient visits: 74.7% were female, 64.2% were ages 40-69 years, and 84.4% had at least one primary dry eye diagnosis. During 2008-2009, 15.9% of dry eye patients with a primary diagnosis versus 6.5% with no primary diagnosis filled at least one cyclosporine prescription. For patients who filled at least one prescription, the mean months' supply of cyclosporine filled over 12 months was 4.44. Overall, 33.9% of dry eye patients filled a prescription for topical cyclosporine, topical corticosteroid, or oral tetracycline over 2 years. Patients with a primary dry eye diagnosis were more likely to fill a topical cyclosporine prescription. Although inflammation is key to the pathophysiology of dry eye, most patients seeing a physician for dry eye may not receive anti-inflammatory therapies.

Adapting the World Federation for Medical Education standards for use in a self-audit of an eye care training programme.

PubMed

Tousignant, B; Du Toit, R

2011-12-01

In 2006, a Postgraduate Diploma in Eye Care (PGDEC) for mid-level health personnel was initiated in Papua New Guinea, in partnership with The Fred Hollows Foundation New Zealand, the local government and Divine Word University. In the absence of national accreditation and with limited resources, an interim evaluation was needed. We adapted the World Federation for Medical Education (WFME) standards to use in a self-audit to evaluate nine areas and 38 subareas of programme structure, processes and implementation. We developed a rating system: each area and subarea was scored for partial or complete attainment of basic or quality development levels. Ratings were referenced with supporting documents. Data were gathered internally, through document census and meetings between stakeholders. A qualitative and quantitative portrait emerged: all nine programme areas completely attained at least basic level and two completely attained the quality development level. Twenty-six (68%) subareas completely attained the quality development level. Key successes included the administration of the PGDEC, synergies between the partnership's stakeholders and its relationship with the public health system. This self-audit adapted from WFME standards provided a simple, yet systematic and largely objective evaluation. It proved beneficial to further develop the programme, highlighting strengths and areas for improvement.

Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention.

PubMed

Montague, Enid; Asan, Onur

2014-03-01

The aim of this study was to examine eye gaze patterns between patients and physicians while electronic health records were used to support patient care. Eye gaze provides an indication of physician attention to patient, patient/physician interaction, and physician behaviors such as searching for information and documenting information. A field study was conducted where 100 patient visits were observed and video recorded in a primary care clinic. Videos were then coded for gaze behaviors where patients' and physicians' gaze at each other and artifacts such as electronic health records were coded using a pre-established objective coding scheme. Gaze data were then analyzed using lag sequential methods. Results showed that there are several eye gaze patterns significantly dependent to each other. All doctor-initiated gaze patterns were followed by patient gaze patterns. Some patient-initiated gaze patterns were also followed by doctor gaze patterns significantly unlike the findings in previous studies. Health information technology appears to contribute to some of the new significant patterns that have emerged. Differences were also found in gaze patterns related to technology that differ from patterns identified in studies with paper charts. Several sequences related to patient-doctor-technology were also significant. Electronic health records affect the patient-physician eye contact dynamic differently than paper charts. This study identified several patterns of patient-physician interaction with electronic health record systems. Consistent with previous studies, physician initiated gaze is an important driver of the interactions between patient and physician and patient and technology. Published by Elsevier Ireland Ltd.

Dynamic modeling of patient and physician eye gaze to understand the effects of electronic health records on doctor-patient communication and attention

PubMed Central

Montague, Enid; Asan, Onur

2014-01-01

Objective The aim of this study was to examine eye gaze patterns between patients and physicians while electronic health records were used to support patient care. Background Eye gaze provides an indication of physician attention to patient, patient/physician interaction, and physician behaviors such as searching for information and documenting information. Methods A field study was conducted where 100 patient visits were observed and video recorded in a primary care clinic. Videos were then coded for gaze behaviors where patients’ and physicians’ gaze at each other and artifacts such as electronic health records were coded using a pre-established objective coding scheme. Gaze data were then analyzed using lag sequential methods. Results Results showed that there are several eye gaze patterns significantly dependent to each other. All doctor-initiated gaze patterns were followed by patient gaze patterns. Some patient-initiated gaze patterns were also followed by doctor gaze patterns significantly unlike the findings in previous studies. Health information technology appears to contribute to some of the new significant patterns that have emerged. Differences were also found in gaze patterns related to technology that differ from patterns identified in studies with paper charts. Several sequences related to patient-doctor- technology were also significant. Electronic health records affect the patient-physician eye contact dynamic differently than paper charts. Conclusion This study identified several patterns of patient-physician interaction with electronic health record systems. Consistent with previous studies, physician initiated gaze is an important driver of the interactions between patient and physician and patient and technology. PMID:24380671

Assessment of Annual Diabetic Eye Examination Using Telemedicine Technology Among Underserved Patients in Primary Care Setting.

PubMed

Hatef, Elham; Alexander, Miriam; Vanderver, Bruce G; Fagan, Peter; Albert, Michael

2017-01-01

Digital retinal imaging with the application of telemedicine technology shows promising results for screening of diabetic retinopathy in the primary care setting without requiring an ophthalmologist on site. We assessed whether the establishment of telemedicine technology was an effective and efficient way to increase completion of annual eye examinations among underserved, low-income (Medicaid) diabetic patients. A cross-sectional study in a primary care setting. Health care claims data were collected before the establishment of telemedicine technology in 2010 and after its implementation in 2012 for Medicaid patients at East Baltimore Medical Center (EBMC), an urban health center that is part of Johns Hopkins Health System. The primary outcome measure was the compliance rate of patients with diabetic eye examinations; calculated as the number of diabetic patients with a completed telemedicine eye examination, divided by the total number of diabetic patients. In 2010, EBMC treated 213 Medicaid diabetic patients and in 2012 treated 228 Medicaid patients. In 2010, 47.89% of patients completed their annual diabetic eye examination while in 2012 it was 78.07% ( P < 0.001). After adjustment for age, gender, HgBA1C, disease severity, using resource utilization band score as a proxy, and medication possession ratio; telemedicine technology significantly increased the compliance (odds ratio: 4.98, P < 0.001). Adherence to annual eye examinations is low in the studied Medicaid diabetic population. Telemedicine technology in a primary care setting can increase compliance with annual eye examinations.

Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs.

PubMed

Dreer, Laura E; Weston, June; Owsley, Cynthia

2014-01-01

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research.

Retrospective data on causes of childhood vision impairment in Eritrea.

PubMed

Gyawali, Rajendra; Bhayal, Bharat Kumar; Adhikary, Rabindra; Shrestha, Arjun; Sah, Rabindra Prasad

2017-11-22

Proper information on causes of childhood vision loss is essential in developing appropriate strategies and programs to address such causes. This study aimed at identifying the causes of vision loss in children attending the national referral eye hospital with the only pediatric ophthalmology service in Eritrea. A retrospective data review was conducted for all the children (< 16 years of age) who attended Berhan Aiyni National Referral Eye Hospital in five years period from January 2011 to December 2015. Causes of vision loss for children with vision impairment (recorded visual acuity less than 6/18 for distance in the better eye) was classified by the anatomical site affected and by underlying etiology based on the timing of the insult and causal factor. The medical record cards of 22,509 children were reviewed, of whom 249 (1.1%) were visually impaired. The mean age of the participants was 7.82 ± 5.43 years (range: one month to 16 years) and male to female ratio was 1:0.65. The leading causes of vision loss were cataract (19.7%), corneal scars (15.7%), refractive error and amblyopia (12.1%), optic atrophy (6.4%), phthisis bulbi (6.4%), aphakia (5.6%) and glaucoma (5.2%). Childhood factors including trauma were the leading causes identified (34.5%) whereas other causes included hereditary factors (4%), intrauterine factors (2.0%) and perinatal factors (4.4%). In 55.0% of the children, the underlying etiology could not be attributed. Over two-thirds (69.9%) of vision loss was potentially avoidable in nature. This study explored the causes of vision loss in Eritrean children using hospital based data. Cataract corneal opacities, refractive error and amblyopia, globe damage due to trauma, infection and nutritional deficiency, retinal disorders, and other congenital abnormalities were the leading causes of childhood vision impairment in children attending the tertiary eye hospital in Eritrea. As majority of the causes of vision loss was due to avoidable causes, we recommended primary level public health strategies to prevent ocular injuries, vitamin A deficiency, perinatal infections and retinopathy of prematurity as well as specialist pediatric eye care facilities for cataract, refractive errors, glaucoma and rehabilitative services to address childhood vision loss in Eritrea.

How to Keep Your Sight for Life

MedlinePlus

... through early detection and treatment of eye diseases. This year marks the 40th anniversary of the National Eye ... 28, according to one recent NEI-funded study. This figure is projected to reach 5.5 million by the year 2020. Low vision and blindness increase significantly with ...

30 CFR 56.15014 - Eye protection when operating grinding wheels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Eye protection when operating grinding wheels. 56.15014 Section 56.15014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... MINES Personal Protection § 56.15014 Eye protection when operating grinding wheels. Face shields or...

30 CFR 56.15014 - Eye protection when operating grinding wheels.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Eye protection when operating grinding wheels. 56.15014 Section 56.15014 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... MINES Personal Protection § 56.15014 Eye protection when operating grinding wheels. Face shields or...

21 CFR 886.3200 - Artificial eye.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Artificial eye. 886.3200 Section 886.3200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... device resembling the anterior portion of the eye, usually made of glass or plastic, intended to be...

21 CFR 886.3200 - Artificial eye.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Artificial eye. 886.3200 Section 886.3200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... device resembling the anterior portion of the eye, usually made of glass or plastic, intended to be...

21 CFR 886.3200 - Artificial eye.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Artificial eye. 886.3200 Section 886.3200 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... device resembling the anterior portion of the eye, usually made of glass or plastic, intended to be...

Eye Injuries in High School and Collegiate Athletes.

PubMed

Boden, Barry P; Pierpoint, Lauren A; Boden, Rebecca G; Comstock, R Dawn; Kerr, Zachary Y

Although eye injuries constitute a small percentage of high school and college sports injuries, they have the potential to be permanently debilitating. Eye injury rates will vary by sport, sex, and between the high school and college age groups. Descriptive epidemiology study. Level 3. Data from eye injury reports in high school and college athletes were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online (HS RIO) database over a 10-year span (2005-2006 through 2014-2015 school years) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) over an 11-year span (2004-2005 through 2014-2015 school years). Injury rates per 100,000 athlete-exposures (AEs), injury rate ratios (RRs), and 95% CIs were calculated. Distributions of eye injuries by diagnosis, mechanism, time loss, and surgery needs were also examined. A total of 237 and 273 eye injuries were reported in the HS RIO and the NCAA ISP databases, respectively. The sports with the highest eye injury rates (per 100,000 AEs) for combined high school and college athletes were women's basketball (2.36), women's field hockey (2.35), men's basketball (2.31), and men's wrestling (2.07). Overall eye injury rates at the high school and college levels were 0.68 and 1.84 per 100,000 AEs, respectively. Eye injury rates were higher in competition than practice in high school (RR, 3.47; 95% CI, 2.69-4.48) and college (RR, 3.13; 95% CI, 2.45-3.99). Most injuries were contusions (high school, 35.9%; college, 33.3%) and due to contact (high school, 89.9%; college, 86.4%). Only a small percentage of injuries resulted in time loss over 21 days (high school, 4.2%; college, 3.0%). Eye injury rates and patterns vary by sport, sex, and between the high school and college age groups. Although severe injuries do occur, most eye injuries sustained by high school and college athletes are minor, with limited time loss and full recovery. Additional focus needs to be placed on preventing eye injuries at the collegiate level in women's and men's basketball, women's field hockey, and men's wrestling.

Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol.

PubMed

King, Anthony J; Fernie, Gordon; Azuara-Blanco, Augusto; Burr, Jennifer M; Garway-Heath, Ted; Sparrow, John M; Vale, Luke; Hudson, Jemma; MacLennan, Graeme; McDonald, Alison; Barton, Keith; Norrie, John

2017-10-26

Presentation with advanced glaucoma is the major risk factor for lifetime blindness. Effective intervention at diagnosis is expected to minimise risk of further visual loss in this group of patients. To compare clinical and cost-effectiveness of primary medical management compared with primary surgery for people presenting with advanced open-angle glaucoma (OAG). Design : A prospective, pragmatic multicentre randomised controlled trial (RCT). Twenty-seven UK hospital eye services. Four hundred and forty patients presenting with advanced OAG, according to the Hodapp-Parish-Anderson classification of visual field loss. Participants will be randomised to medical treatment or augmented trabeculectomy (1:1 allocation minimised by centre and presence of advanced disease in both eyes). The primary outcome is vision-related quality of life measured by the National Eye Institute-Visual Function Questionnaire-25 at 24 months. Secondary outcomes include generic EQ-5D-5L, Health Utility Index-3 and glaucoma-related health status (Glaucoma Utility Index), patient experience, visual field measured by mean deviation value, logarithm of the mean angle of resolution visual acuity, intraocular pressure, adverse events, standards for driving and eligibility for blind certification. Incremental cost per quality-adjusted life-year (QALY) based on EQ-5D-5L and glaucoma profile instrument will be estimated. The study will report the comparative effectiveness and cost-effectiveness of medical treatment against augmented trabeculectomy in patients presenting with advanced glaucoma in terms of patient-reported health and visual function, clinical outcomes and incremental cost per QALY at 2 years. Treatment of Advanced Glaucoma Study will be the first RCT reporting outcomes from the perspective of those with advanced glaucoma. ISRCTN56878850, Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improvements in diabetes processes of care and intermediate outcomes: United States, 1988-2002.

PubMed

Saaddine, Jinan B; Cadwell, Betsy; Gregg, Edward W; Engelgau, Michael M; Vinicor, Frank; Imperatore, Giuseppina; Narayan, K M Venkat

2006-04-04

Progress of diabetes care is a subject of public health concern. To assess changes in quality of diabetes care in the United States by using standardized measures. National population-based, serial cross-sectional surveys. National Health and Nutrition Examination Survey (1988-1994 and 1999-2002) and the Behavioral Risk Factor Surveillance System (1995 and 2002). Survey participants 18 to 75 years of age who reported a diagnosis of diabetes. Glycemic control, blood pressure, low-density lipoprotein (LDL) cholesterol level, annual cholesterol level monitoring, and annual foot and dilated eye examination, as defined by the National Diabetes Quality Improvement Alliance measures. In the past decade, the proportion of persons with diabetes with poor glycemic control (hemoglobin A1c > 9%) showed a nonstatistically significant decrease of 3.9% (95% CI, -10.4% to 2.5%), while the proportion of persons with fair or good lipid control (LDL cholesterol level < 3.4 mmol/L [<130 mg/dL]) had a statistically significant increase of 21.9% (CI, 12.4% to 31.3%). Mean LDL cholesterol level decreased by 0.5 mmol/L (18.8 mg/dL). Although mean hemoglobin A1c did not change, the proportion of persons with hemoglobin A(1c) of 6% to 8% increased from 34.2% to 47.0%. The blood pressure distribution did not change. Annual lipid testing, dilated eye examination, and foot examination increased by 8.3% (CI, 4.0% to 12.7%), 4.5% (CI, 0.5% to 8.5%), and 3.8% (CI, -0.1% to 7.7%), respectively. The proportion of persons reporting annual influenza vaccination and aspirin use improved by 6.8 percentage points (CI, 2.9 percentage points to 10.7 percentage points) and 13.1 percentage points (CI, 5.4 percentage points to 20.7 percentage points), respectively. Data are self-reported, and the surveys do not have all National Diabetes Quality Improvement Alliance indicators. Diabetes processes of care and intermediate outcomes have improved nationally in the past decade. But 2 in 5 persons with diabetes still have poor LDL cholesterol control, 1 in 3 persons still has poor blood pressure control, and 1 in 5 persons still has poor glycemic control.

Use of Corrective Lenses among Adolescents: Findings from the National Health and Nutrition Examination Survey

PubMed Central

Kemper, Alex R.; Gurney, James G.; Eibschitz-Tsimhoni, Maya; DelMonte, Monte A.

2007-01-01

Purpose To evaluate demographic variations in the use of corrective lenses among adolescent children. Methods Cross-sectional analysis of 3,916 children 12-18 years who participated in the 1999-2002 National Health and Nutrition Examination Survey (NHANES) vision examination component, which included: questions regarding use of corrective lenses; distance visual acuity, with corrective lenses if available; and non-cycloplegic autorefraction. Results reflect population-level estimates. Results Overall, 32.2% (95% confidence interval [CI]: 29.5%-35.0%) reported wearing corrective lenses. Girls and those with any private insurance had greater adjusted odds of reporting wearing corrective lenses. In contrast, children aged 15 through 18 years versus those 12 through 14 years, and white children compared to Black or Hispanic children had greater adjusted odds of actually having them available at the time of NHANES participation. Although 12.6% (95% CI: 8.8%-16.3%) of those who did not have their previously prescribed corrective lenses available had 20/25 or better distance visual acuity in both eyes without correction, 26.9% (95% CI:21.6%-32.1%) with their corrective lenses had distance visual acuity of 20/40 or worse in at least one eye when using their corrective lenses. Limitations Near visual acuity was not measured and children with corrective lenses available only had their corrected distance visual acuity measured. No data regarding the accuracy of the NHANES assessment of distance visual acuity are available. Autorefraction was performed without cycloplegia. Conclusions Many adolescent children report wearing corrective lenses. Variations across demographic characteristics appear to be due to a combination of undertreatment, overtreatment, and compliance with previously recommended corrective lenses. PMID:18062494

Awareness and eye health-seeking practices for cataract among urban slum population of Delhi: The North India eye disease awareness study.

PubMed

Misra, Vasundhra; Vashist, Praveen; Singh, Senjam Suraj; Malhotra, Sumit; Gupta, Vivek; Dwivedi, S N; Gupta, Sanjeev K

2017-12-01

The objective of the study was to assess the awareness and health-seeking practices related to cataract in urban slums of Delhi. This study design was a population-based cross-sectional study. Participants aged 18-60 years were recruited from randomly selected five slums of South Delhi. They were interviewed using a semi-structured interview schedule on awareness and eye health-seeking practices related to cataract. The practices were recorded if the respondents themselves or any other member of the family was diagnosed with cataract in previous 2 years. A total of 1552 respondents participated in the study, of which, 89.9% had heard of cataract but only (42%) were aware of any symptom of cataract. The common symptoms of cataract reported by the participants were white opacity in eyes (25.9%) and loss of vision (20.6%). Surgery as a treatment of cataract was known to only 559 (40.1%) participants. Awareness about surgery as treatment of cataract was significantly higher among people aged 45-60 years (adjusted odds ratio = 2.89, 95% confidence interval = 2.11-3.97) and in educated people (adjusted OR = 3.69 95% CI = 2.37-5.73). Out of 84 respondents who had been diagnosed with cataract, the health-seeking practices were observed by 70 (83.3%) participants. Among them, 51 (72.9%) had undergone surgery and another 19 (27.1%) had been advised to wait for surgery. Most of the operated patients 48 (94.1%) attended the postoperative follow-up. The study findings suggest the majority of participants have heard of cataract, but there is low awareness of its symptoms and treatment, and good eye health-seeking practices observed for cataract in urban slum population. Gaps in awareness observed can be filled up by implementing proper eye health education programs.

Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico

PubMed Central

R Soohoo, Jeffrey; Lynch, Anne; N Bonell, Levi; Martinez, Karina; Turati, Mauricio; Gonzalez-Salinas, Roberto; Jimenez-Roman, Jesus; Y Kahook, Malik

2017-01-01

ABSTRACT Aim To describe the demographic characteristics, ocular comorbidities, and clinical outcomes of patients with neovascular glaucoma (NVG) and to determine the number of patients who returned for a follow-up eye examination. Materials and methods We examined the clinical data of patients with NVG, who attended a glaucoma clinic between July 2010 and November 2014. We collected information on the demographic characteristics of the patients to include the level of education, ocular comorbidities, NVG stage, visual acuity, glaucoma medications, intraocular pressure (IOP), and the number of patients who had a follow-up ocular examination at month 1, 3, 6, and 12. Results Data from 350 patients (473 eyes) with NVG were collected. We found 91% of the cohort had proliferative diabetic retinopathy (PDR). We found blindness in both or one eye in 14% and 31% of the cohort respectively. Low vision was found in both or one eye in 14% and 32% of the eyes respectively. By 6 months follow-up, only 32% of the patients were seen at our clinic and by 12 months follow-up, this number decreased to 15%. Around 60% of the patients were on no IOP lowering drugs at the first visit. We found 53% of the cohort had an incomplete elementary school education. Conclusion The results suggest that advanced NVG is a significant ocular problem for patients referred to our clinic with just over half of the patients presenting as blind. We also found that several socioeconomic factors that had an important role in the development of PDR and NVG, specifically, educational status. Clinical significance We described the characteristics of a large cohort of patients with very advanced NVG, reflecting the fact that the strict control of the underlying disease must be the main goal of the Mexican national health system. How to cite this article Lazcano-Gomez G, Soohoo JR, Lynch A, Bonell LN, Martinez K, Turati M, González-Salinas R, Jimenez-Roman J, Kahook MY. Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico. J Curr Glaucoma Pract 2017;11(2):48-51. PMID:28924338

Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico.

PubMed

Lazcano-Gomez, Gabriel; R Soohoo, Jeffrey; Lynch, Anne; N Bonell, Levi; Martinez, Karina; Turati, Mauricio; Gonzalez-Salinas, Roberto; Jimenez-Roman, Jesus; Y Kahook, Malik

2017-01-01

To describe the demographic characteristics, ocular comorbidities, and clinical outcomes of patients with neovascular glaucoma (NVG) and to determine the number of patients who returned for a follow-up eye examination. We examined the clinical data of patients with NVG, who attended a glaucoma clinic between July 2010 and November 2014. We collected information on the demographic characteristics of the patients to include the level of education, ocular comorbidities, NVG stage, visual acuity, glaucoma medications, intraocular pressure (IOP), and the number of patients who had a follow-up ocular examination at month 1, 3, 6, and 12. Data from 350 patients (473 eyes) with NVG were collected. We found 91% of the cohort had proliferative diabetic retinopathy (PDR). We found blindness in both or one eye in 14% and 31% of the cohort respectively. Low vision was found in both or one eye in 14% and 32% of the eyes respectively. By 6 months follow-up, only 32% of the patients were seen at our clinic and by 12 months follow-up, this number decreased to 15%. Around 60% of the patients were on no IOP lowering drugs at the first visit. We found 53% of the cohort had an incomplete elementary school education. The results suggest that advanced NVG is a significant ocular problem for patients referred to our clinic with just over half of the patients presenting as blind. We also found that several socioeconomic factors that had an important role in the development of PDR and NVG, specifically, educational status. We described the characteristics of a large cohort of patients with very advanced NVG, reflecting the fact that the strict control of the underlying disease must be the main goal of the Mexican national health system. Lazcano-Gomez G, Soohoo JR, Lynch A, Bonell LN, Martinez K, Turati M, González-Salinas R, Jimenez-Roman J, Kahook MY. Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico. J Curr Glaucoma Pract 2017;11(2):48-51.

In Search of the Third Eye, When the Two Others Are Shamefacedly Shut? Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development".

PubMed

Keygnaert, Ines

2016-02-11

Ivanova et al explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies in 4 countries. They adapted the EquiFrame of Amin and colleagues of 2011, to SRH vulnerable groups which we believe could now be used for analysis of national SRH polices beyond those 4 countries. Although we fully agree with the authors' two main findings that vulnerable groups and human rights' principles are not sufficiently integrated in SRH policies nor granted the possibility to participate in the process of development in those four countries, we do believe that these shortcomings are not limited to those countries only nor to the identified vulnerable groups either. We are convinced that the issue of SRH as such is still framed within a very limited logic for all with vulnerable groups being perceived as an extra threat or an extra burden. © 2016 by Kerman University of Medical Sciences.

Participation in a National Lifestyle Change Program is associated with improved diabetes Control outcomes.

PubMed

Jackson, Sandra L; Staimez, Lisa R; Safo, Sandra; Long, Qi; Rhee, Mary K; Cunningham, Solveig A; Olson, Darin E; Tomolo, Anne M; Ramakrishnan, Usha; Narayan, Venkat K M; Phillips, Lawrence S

2017-09-01

Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥25kg/m 2 ) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! Included patients were 96% male, 77% white, with mean age 58years and BMI 34kg/m 2 . Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (-0.6kg), random plasma glucose (-2.8mg/dL), and HbA1c (-0.1%) at 12months compared to nonparticipants (each p<0.001). In multivariable Cox models, MOVE! participants had lower incidence of eye disease (hazard ratio 0.80, 95% CI 0.75-0.84) and renal disease (HR 0.89, 95% CI 0.86-0.92) and reduced medication intensification (HR 0.82, 95% CI 0.80-0.84). If able to overcome participation challenges, lifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes. Published by Elsevier Inc.

Building the biomedical data science workforce.

PubMed

Dunn, Michelle C; Bourne, Philip E

2017-07-01

This article describes efforts at the National Institutes of Health (NIH) from 2013 to 2016 to train a national workforce in biomedical data science. We provide an analysis of the Big Data to Knowledge (BD2K) training program strengths and weaknesses with an eye toward future directions aimed at any funder and potential funding recipient worldwide. The focus is on extramurally funded programs that have a national or international impact rather than the training of NIH staff, which was addressed by the NIH's internal Data Science Workforce Development Center. From its inception, the major goal of BD2K was to narrow the gap between needed and existing biomedical data science skills. As biomedical research increasingly relies on computational, mathematical, and statistical thinking, supporting the training and education of the workforce of tomorrow requires new emphases on analytical skills. From 2013 to 2016, BD2K jump-started training in this area for all levels, from graduate students to senior researchers.

Building the biomedical data science workforce

PubMed Central

Dunn, Michelle C.; Bourne, Philip E.

2017-01-01

This article describes efforts at the National Institutes of Health (NIH) from 2013 to 2016 to train a national workforce in biomedical data science. We provide an analysis of the Big Data to Knowledge (BD2K) training program strengths and weaknesses with an eye toward future directions aimed at any funder and potential funding recipient worldwide. The focus is on extramurally funded programs that have a national or international impact rather than the training of NIH staff, which was addressed by the NIH’s internal Data Science Workforce Development Center. From its inception, the major goal of BD2K was to narrow the gap between needed and existing biomedical data science skills. As biomedical research increasingly relies on computational, mathematical, and statistical thinking, supporting the training and education of the workforce of tomorrow requires new emphases on analytical skills. From 2013 to 2016, BD2K jump-started training in this area for all levels, from graduate students to senior researchers. PMID:28715407

Visual attention to health warnings on plain tobacco packaging in adolescent smokers and non-smokers.

PubMed

Maynard, Olivia M; Munafò, Marcus R; Leonards, Ute

2013-02-01

Previous research with adults indicates that plain packaging increases visual attention to health warnings in adult non-smokers and weekly smokers, but not daily smokers. The present research extends this study to adolescents aged 14-19 years. Mixed-model experimental design, with smoking status as a between-subjects factor and pack type (branded or plain pack) and eye gaze location (health warning or branding) as within-subjects factors. Three secondary schools in Bristol, UK. A convenience sample of adolescents comprising never-smokers (n = 26), experimenters (n = 34), weekly smokers (n = 13) and daily smokers (n = 14). Number of eye movements to health warnings and branding on plain and branded packs. Analysis of variance, irrespective of smoking status revealed more eye movements to health warnings than branding on plain packs, but an equal number of eye movements to both regions on branded packs (P = 0.033). This was observed among experimenters (P < 0.001) and weekly smokers (P = 0.047), but not among never-smokers or daily smokers. Among experimenters and weekly smokers, plain packaging increases visual attention to health warnings and away from branding. Daily smokers, even relatively early in their smoking careers, seem to avoid the health warnings on cigarette packs. Adolescent never-smokers attend the health warnings preferentially on both types of packs, a finding which may reflect their decision not to smoke. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

[National survey of blindness and avoidable visual impairment in Honduras].

PubMed

Alvarado, Doris; Rivera, Belinda; Lagos, Luis; Ochoa, Mayra; Starkman, Ivette; Castillo, Mariela; Flores, Eduardo; Lansingh, Van C; Limburg, Hans; Silva, Juan Carlos

2014-11-01

To determine the prevalence of blindness and visual impairment in Honduras, its causes and the response by the health services to growing demand. A cross-sectional population study was conducted between June and December 2013 using the standard methodology of the Rapid Assessment of Avoidable Blindness. A random sample survey was done in 63 clusters of 50 individuals aged ≥ 50, representative of the country as a whole. Visual acuity (VA) was assessed using a Snellen eye chart, and the condition of the lens and posterior pole was examined by direct ophthalmoscopy. Cataract surgical coverage was calculated and an assessment made of its quality, the causes of VA < 20/60 and the barriers to accessing surgical treatment. A total of 2 999 people were examined (95.2% of the forecast total). Blindness prevalence was 1.9% (confidence interval of 95%: 1.4-2.4%) and 82.2% of these cases were avoidable. The main causes of blindness were unoperated cataracts (59.2%) and glaucoma (21.1%). Uncorrected refraction error was the main cause of severe (19.7%) and moderate (58.6%) visual impairment. Cataract surgical coverage was 75.2%. 62.5% of the eyes operated for cataracts achieved a VA > 20/60 with available correction. The main barriers against cataract surgery were cost (27.7%) and the lack of availability or difficulty of geographical access to the treatment (24.6%). The prevalence of blindness and visual impairment in Honduras is similar to that of other Latin American countries. 67% of cases of blindness could be resolved by improving the response capacity of the ophthalmological services, especially of cataract surgery, improving optician services and incorporating eye care in primary health care.

Effect of the angle of the operating microscope light beam on visual recovery after phacoemulsification: Randomized trial.

PubMed

Harman, Francesca E; Corbett, Melanie C; Stevens, Julian D

2010-08-01

To evaluate differences in visual recovery after phacoemulsification with direct or tilted surgical microscope illumination using a macular photostress test. Western Eye Hospital, Imperial College Health Care National Health Service Trust, London, United Kingdom. This randomized double-masked controlled trial enrolled patients presenting to a daycare unit for single-eye cataract surgery. Inclusion criteria were no ocular pathology other than cataract, corneal keratometric astigmatism less than 1.50 diopters, intended target of emmetropia in the operated eye, and cataract grade 1 to 3 (Lens Opacification Classification System II). Exclusion criteria were an abnormal preoperative photostress test. Patients were randomized to have phacoemulsification with the operating microscope angled 15 degrees nasal to the fovea (study group) or with the operating microscope directly overhead around the optic disc region (control group). The same surgeon performed all phacoemulsification procedures using a standardized technique and topical anesthesia. Outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuity 10 minutes and 60 minutes postoperatively. In the 30 patients evaluated, the mean UDVA 10 minutes postoperatively was 0.40 logMAR +/- 0.26 (SD) in the study group and 0.72 +/- 0.36 logMAR in the control group (P<.01). The mean CDVA was 0.18 +/- 0.26 logMAR and 0.44 +/- 0.30 logMAR, respectively (P = .016). There was no significant between-group difference in acuity at 60 minutes. Tilting the microscope beam away from the fovea resulted in faster visual recovery and less macular photic stress. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

[Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China].

PubMed

Zhou, Jia; Ma, Yinghua; Ma, Jun; Zou, Zhiyong; Meng, Xiangkun; Tao, Fangbiao; Luo, Chunyan; Jing, Jin; Pan, Dehong; Luo, Jiayou; Zhang, Xin; Wang, Hong; Zhao, Haiping

2016-01-01

To understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors. Primary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students. The prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (P<0.01). The prevalence of myopia increased with age obviously. The prevalence was 35.8% in age group 6-8 years, 58.9% in age group 10-12 years, 73.4% in age group 13-15 years and 81.2% in age group 16-18 years, the differences were statistically significant (P<0.001). Single factor and multivariate analysis showed that parents' myopia, distance between computer screen and eyes, distance less than 30 cm between eyes and book while reading, distance less than 10 cm between chest and the table edge while studying, distance less than 3 cm between fingers and pen tip, sleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia. The prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.

The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment.

PubMed

Cavan, D; Makaroff, L; da Rocha Fernandes, J; Sylvanowicz, M; Ackland, P; Conlon, J; Chaney, D; Malhi, A; Barratt, J

2017-07-01

To assess the level of awareness, prevention and treatment of Diabetic Eye Disease (DED) comprising Diabetic Retinopathy (DR) and Diabetic Macula Edema (DME) retinopathy among adults with diabetes and health professionals. The Diabetic Retinopathy Barometer Study consisted of a qualitative study, which consisted of semi-structured interviews, and a quantitative study using online surveys for adults with diabetes and for health professionals. A total of 4340 adults with diabetes and 2329 health professionals participated in the surveys. Diabetic eye disease (DED) without macular edema (DME) was reported by 19.5% of adults with diabetes and a further 7.6% reported that they had DME. Although 94% of adults with diabetes saw a health care professional for their diabetes, only 79% had ever had an eye examination for DED, and 23% had not had an eye examination in the last year. Moreover, 65% of the ophthalmologists surveyed reported that most patients presented when visual problems had already occurred. Overall, 62% of people with DED had received treatment. Of these, 74% had laser therapy, 29% surgery and 24% anti-VEGF therapy. Strategic investment is required to enhance patient education and professional training on the importance of regular eye examinations; and in providing accessible DR screening programmes and proactive treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

The New Zealand National Eye Bank study: trends in the acquisition and storage of corneal tissue over the decade 2000 to 2009.

PubMed

Cunningham, William J; Moffatt, S Louise; Brookes, Nigel H; Twohill, Helen C; Pendergrast, David G C; Stewart, Joanna M; McGhee, Charles N J

2012-05-01

To evaluate trends in the acquisition, storage, and utilization of donated corneal tissue in New Zealand, 2000 to 2009. The New Zealand National Eye Bank records were analyzed for the decade January 2000 to December 2009. Variables analyzed included donor demographics (age, sex, and ethnicity), donor source, donor cause of death, death-to-preservation interval (DPI), corneal storage time, tissue contamination, endothelial assessment, cornea suitability for transplantation, and corneal tissue utilization. A total of 1268 eye donors were identified during the 10-year period. Overall, 36% (n = 457) were female and 64% male (n = 813). Median donor age was 67 years, and 23% of donors were younger than 50 years (range, 5-90 years). There was a decrease in donor age over the decade (P = 0.006). The median DPI was 18.5 hours. No relationship was identified between cornea suitability for transplantation and DPI (P = 0.28) or donor gender (P = 0.54). There was a low microbial contamination rate (1%). Human immunodeficiency virus, hepatitis B, or hepatitis C serology was positive in 48 donors (4%). Overall, 90% of corneas were suitable for transplantation with a high utilization rate (88%). A novel association was identified between male sex and lower corneal endothelial cell density (P = 0.03). This New Zealand National Eye Bank analysis identified trends in the acquisition, storage, and utilization of donated corneal tissue throughout New Zealand over the past decade and provides valuable additional information to the international eye bank data.

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S...

38 CFR 1.514b - Disclosures to procurement organizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... procurement organization of whether the individual is a suitable potential organ, eye, or tissue donor if: (a... verify annually in January of each calendar year with FDA that an eye bank or tissue bank has complied... before permitting an eye bank or tissue bank to receive protected health information. (Authority: 38 U.S...

Awareness, Knowledge, and Concern about Age-Related Macular Degeneration

ERIC Educational Resources Information Center

Cimarolli, Verena R.; Laban-Baker, Allie; Hamilton, Wanda S.; Stuen, Cynthia

2012-01-01

Age-related macular degeneration (AMD)--a common eye disease causing vision loss--can be detected early through regular eye-health examinations, and measures can be taken to prevent visual decline. Getting eye examinations requires certain levels of awareness, knowledge, and concern related to AMD. However, little is known about AMD-related…

Eye Care: MedlinePlus Health Topic

MedlinePlus

... and Research) Prevention and Risk Factors Diet and Nutrition ... (American Academy of Ophthalmology) Also in Spanish Selecting PPE for the Workplace (Personal Protective Equipment for the Eyes and Face) ( ...

Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI

DTIC Science & Technology

2017-06-01

report. 10 Supporting Data None. Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI Psychological Health...Award Number: W81XWH-13-1-0095 TITLE: Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI PRINCIPAL INVESTIGATOR...COVERED 08 MAR 2016 – 07 MAR 2017 4. TITLE AND SUBTITLE Integrated Eye Tracking and Neural Monitoring for Enhanced Assessment of Mild TBI 5a

Analysis of Ocular Firework-Related Injuries and Common Eye Traumata: a 5-year Clinical Study.

PubMed

Frimmel, S; Theusinger, O M; Kniestedt, C

2017-04-01

Background A comparative study of eye injuries related to fireworks or acts of violence around New Year's Eve and the Swiss National Day on August 1st. The two groups were compared with respect to the overall numbers of eye accidents within the period of review. Patients and Methods Retrospective analysis of emergency consultations at the Department of Ophthalmology, University Hospital Zurich with eye accidents around the Swiss National Day on August 1st and New Year's Eve over the last 5 years. Two subgroups were formed: (1) Firework-related eye traumata, (2) Eye injuries due to acts of violence. The groups were analysed by age, gender, active participant or bystander, eye involved, severity of trauma (from clinical findings), surgical interventions, time of follow-up and visits, visual acuity and outcome. Results The study included 97 patients (100 eyes) with 74 male (76 %) and 23 female (24 %) victims. After filtering out 67 common traumata cases (all unilateral), 17 patients (18 eyes) with firework-related injuries and 13 patients (15 eyes) with damage due to an act of violence remained. Firework injuries accounted for 18 % of cases (65 % men); eye injuries caused by an act of violence accounted for 15 % of cases (92 % men). In the fireworks group, women were significantly older than men (mean age men 32 ± 14 years versus women 38 ± 16 years, p = 0.002). 65 % of cases were bystanders. The two subgroups contained 30 patients (33 eyes) with 22 left eyes (67 %, p < 0.001). The anterior segment was most frequently involved (79 %), significantly more often than the posterior part of the eye (p < 0.001). The posterior segment was injured more often in the fireworks group (28 %), than in the violence group (13 %). 87 % of the victims in the group of common traumata were mild trauma, 10 % moderate and 3 % severe. In the fireworks group the distribution was 53 % mild, 12 % moderate and 35 % severe, in the violence group 46 %, 23 % and 31 % respectively. Severe trauma cases occurred significantly more often around the New Year, with 36 % versus August 1st with 18 % (p = 0.0028). They are more often related to firework injuries than caused by violence (40 % versus 33 %). In summary, 7 victims (23 %) needed 8 interventions, with 3 having additional issues with their intraocular pressure. Full final visual acuity was noted in 88 %, which was alike in the two subgroups. On the contrary common traumata happened significantly more often around August 1st (66 %) than New Year (34 %; p < 0.001). Conclusions The number of injured eyes in the two subgroups of fireworks and violence was twice as high around New Year's Eve than around the Swiss National Day. If the two events were combined, eye injuries were caused by an act of violence in 45 % and by fireworks in 55 % of cases. Injuries from fireworks can be decreased by professional fireworks. Both types of accident can be decreased by public awareness. Georg Thieme Verlag KG Stuttgart · New York.

The Prevalence and Causes of Vision Loss in Indigenous and Non-Indigenous Australians: The National Eye Health Survey.

PubMed

Foreman, Joshua; Xie, Jing; Keel, Stuart; van Wijngaarden, Peter; Sandhu, Sukhpal Singh; Ang, Ghee Soon; Fan Gaskin, Jennifer; Crowston, Jonathan; Bourne, Rupert; Taylor, Hugh R; Dirani, Mohamed

2017-12-01

To conduct a nationwide survey on the prevalence and causes of vision loss in Indigenous and non-Indigenous Australians. Nationwide, cross-sectional, population-based survey. Indigenous Australians aged 40 years or older and non-Indigenous Australians aged 50 years and older. Multistage random-cluster sampling was used to select 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 sites across 5 remoteness strata (response rate of 71.5%). Sociodemographic and health data were collected using an interviewer-administered questionnaire. Trained examiners conducted standardized eye examinations, including visual acuity, perimetry, slit-lamp examination, intraocular pressure, and fundus photography. The prevalence and main causes of bilateral presenting vision loss (visual acuity <6/12 in the better eye) were determined, and risk factors were identified. Prevalence and main causes of vision loss. The overall prevalence of vision loss in Australia was 6.6% (95% confidence interval [CI], 5.4-7.8). The prevalence of vision loss was 11.2% (95% CI, 9.5-13.1) in Indigenous Australians and 6.5% (95% CI, 5.3-7.9) in non-Indigenous Australians. Vision loss was 2.8 times more prevalent in Indigenous Australians than in non-Indigenous Australians after age and gender adjustment (17.7%, 95% CI, 14.5-21.0 vs. 6.4%, 95% CI, 5.2-7.6, P < 0.001). In non-Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (61.3%), cataract (13.2%), and age-related macular degeneration (10.3%). In Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (60.8%), cataract (20.1%), and diabetic retinopathy (5.2%). In non-Indigenous Australians, increasing age (odds ratio [OR], 1.72 per decade) and having not had an eye examination within the past year (OR, 1.61) were risk factors for vision loss. Risk factors in Indigenous Australians included older age (OR, 1.61 per decade), remoteness (OR, 2.02), gender (OR, 0.60 for men), and diabetes in combination with never having had an eye examination (OR, 14.47). Vision loss is more prevalent in Indigenous Australians than in non-Indigenous Australians, highlighting that improvements in eye healthcare in Indigenous communities are required. The leading causes of vision loss were uncorrected refractive error and cataract, which are readily treatable. Other countries with Indigenous communities may benefit from conducting similar surveys of Indigenous and non-Indigenous populations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Assessment of the vision-specific quality of life using clustered visual field in glaucoma patients.

PubMed

Sawada, Hideko; Yoshino, Takaiko; Fukuchi, Takeo; Abe, Haruki

2014-02-01

To investigate the significance of vision-specific quality of life (QOL) in glaucoma patients based on the location of visual field defects. We examined 336 eyes of 168 patients. The 25-item National Eye Institute Visual Function Questionnaire was used to evaluate patients' QOL. Visual field testing was performed using the Humphrey Field Analyzer; the visual field was divided into 10 clusters. We defined the eye with better mean deviation as the better eye and the fellow eye as the worse eye. A single linear regression analysis was applied to assess the significance of the relationship between QOL and the clustered visual field. The strongest correlation was observed in the lower paracentral visual field in the better eye. The lower peripheral visual field in the better eye also showed a good correlation. Correlation coefficients in the better eye were generally higher than those in the worse eye. For driving, the upper temporal visual field in the better eye was the most strongly correlated (r=0.509). For role limitation and peripheral vision, the lower peripheral visual field in the better eye had the highest correlation coefficients at 0.459 and 0.425, respectively. Overall, clusters in the lower hemifield in the better eye were more strongly correlated with QOL than those in the worse eye. In particular, the lower paracentral visual field in the better eye was correlated most strongly of all. Driving, however, strongly correlated with the upper hemifield in the better eye.

To heal the mind's eye of hate--Dr. Ludwik Zamenhof.

PubMed

Wincewicz, Andrzej; Sulkowska, Mariola; Sulkowski, Stanislaw

2007-05-01

Ludwik Zamenhof (1859-1917), born in Poland, invented and propagated Esperanto - an artificial, easy-to-learn language. Literally meaning "language of hope," Esperanto was constructed to avoid misunderstandings, establish communication and facilitate harmony among different nationalities. Simply, he wanted people to accept one another despite observed differences. He was a skilled ophthalmologist, but figuratively, he wished to heal the eyes of humankind to look without hate, just as the biblical Tobias removed the cataract from the corners of his father's eyes to restore his sight.

The Status of Childhood Blindness and Functional Low Vision in the Eastern Mediterranean Region in 2012

PubMed Central

Khandekar, Rajiv; Kishore, H.; Mansu, Rabiu M.; Awan, Haroon

2014-01-01

Childhood blindness and visual impairment (CBVI) are major disabilities that compromise the normal development of children. Health resources and practices to prevent CBVI are suboptimal in most countries in the Eastern Mediterranean Region (EMR). We reviewed the magnitude and the etiologies of childhood visual disabilities based on the estimates using socioeconomic proxy indicators such as gross domestic product (GDP) per capita and <5-year mortality rates. The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region. The current study determined the rates of bilateral blindness (defined as  Best corrected visual acuity(BCVA)) less than 3/60 in the better eye or a visual field of 10° surrounding central fixation) and functional low vision (FLV) (visual impairment for which no treatment or refractive correction can improve the vision up to >6/18 in a better eye) in children <15 years old. We used the 2011 population projections, <5-year mortality rates and GDP per capita of 23 countries (collectively grouped as EMR). Based on the GDP, we divided the countries into three groups; high, middle- and low-income nations. By applying the bilateral blindness and FLV rates to high, middle- and low-income countries from the global literature to the population of children <15 years, we estimated that there could be 238,500 children with bilateral blindness (rate 1.2/1,000) in the region. In addition, there could be approximately 417,725 children with FLV (rate of 2.1/1,000) in the region. The causes of visual disability in the three groups are also discussed based on the available data. As our estimates are based on hospital and blind school studies in the past, they could have serious limitations for projecting the present magnitude and causes of visual disabilities in children of EMR. An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed. The objectives, strategies, and operating procedures for child eye-care are presented. Variables impacting proper screening are discussed. To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children. PMID:25371641

The status of childhood blindness and functional low vision in the Eastern Mediterranean region in 2012.

PubMed

Khandekar, Rajiv; Kishore, H; Mansu, Rabiu M; Awan, Haroon

2014-01-01

Childhood blindness and visual impairment (CBVI) are major disabilities that compromise the normal development of children. Health resources and practices to prevent CBVI are suboptimal in most countries in the Eastern Mediterranean Region (EMR). We reviewed the magnitude and the etiologies of childhood visual disabilities based on the estimates using socioeconomic proxy indicators such as gross domestic product (GDP) per capita and <5-year mortality rates. The result of these findings will facilitate novel concepts in addressing and developing services to effectively reduce CBVI in this region. The current study determined the rates of bilateral blindness (defined as  Best corrected visual acuity(BCVA)) less than 3/60 in the better eye or a visual field of 10° surrounding central fixation) and functional low vision (FLV) (visual impairment for which no treatment or refractive correction can improve the vision up to >6/18 in a better eye) in children <15 years old. We used the 2011 population projections, <5-year mortality rates and GDP per capita of 23 countries (collectively grouped as EMR). Based on the GDP, we divided the countries into three groups; high, middle- and low-income nations. By applying the bilateral blindness and FLV rates to high, middle- and low-income countries from the global literature to the population of children <15 years, we estimated that there could be 238,500 children with bilateral blindness (rate 1.2/1,000) in the region. In addition, there could be approximately 417,725 children with FLV (rate of 2.1/1,000) in the region. The causes of visual disability in the three groups are also discussed based on the available data. As our estimates are based on hospital and blind school studies in the past, they could have serious limitations for projecting the present magnitude and causes of visual disabilities in children of EMR. An effective approach to eye health care and screening for children within primary health care and with the available resources are discussed. The objectives, strategies, and operating procedures for child eye-care are presented. Variables impacting proper screening are discussed. To reach the targets, we recommend urgent implementation of new approaches to low vision and rehabilitation of children.

SU-G-IeP4-09: Method of Human Eye Aberration Measurement Using Plenoptic Camera Over Large Field of View

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lv, Yang; Wang, Ruixing; Ma, Haotong

Purpose: The measurement based on Shack-Hartmann wave-front sensor(WFS), obtaining both the high and low order wave-front aberrations simultaneously and accurately, has been applied in the detection of human eyes aberration in recent years. However, Its application is limited by the small field of view (FOV), slight eye movement leads the optical bacon image exceeds the lenslet array which result in uncertain detection error. To overcome difficulties of precise eye location, the capacity of detecting eye wave-front aberration over FOV much larger than simply a single conjugate Hartmann WFS accurately and simultaneously is demanded. Methods: Plenoptic camera’s lenslet array subdivides themore » aperture light-field in spatial frequency domain, capture the 4-D light-field information. Data recorded by plenoptic cameras can be used to extract the wave-front phases associated to the eyes aberration. The corresponding theoretical model and simulation system is built up in this article to discuss wave-front measurement performance when utilizing plenoptic camera as wave-front sensor. Results: The simulation results indicate that the plenoptic wave-front method can obtain both the high and low order eyes wave-front aberration with the same accuracy as conventional system in single visual angle detectionand over FOV much larger than simply a single conjugate Hartmann systems. Meanwhile, simulation results show that detection of eye aberrations wave-front in different visual angle can be achieved effectively and simultaneously by plenoptic method, by both point and extended optical beacon from the eye. Conclusion: Plenoptic wave-front method possesses the feasibility in eye aberrations wave-front detection. With larger FOV, the method can effectively reduce the detection error brought by imprecise eye location and simplify the eye aberrations wave-front detection system comparing with which based on Shack-Hartmann WFS. Unique advantage of the plenoptic method lies in obtaining wave-front in different visual angle simultaneously, which provides an approach in building up 3-D model of eye refractor tomographically. Funded by the key Laboratory of High Power Laser and Physics, CAS Research Project of National University of Defense Technology No. JC13-07-01; National Natural Science Foundation of China No. 61205144.« less

Simple Solutions for Dry Eye

MedlinePlus

Patient Education Sheet Simple Solutions for Dry Eye The SSF thanks J. Daniel Nelson, MD, Associate Medical Director, Specialty Care HealthPartners Medical Group & Clinics, and Professor of Ophthalmology, University of ...

Eyes May Be 'Windows to the Brain' in Stroke Patients

MedlinePlus

... their stroke—without the need for an MRI. SOURCE: National Institute of Neurological Disorders and Stroke (NINDS): Stroke Research ... & Players Friends of the National Library of Medicine (FNLM) top

[Randomly sampling survey of dry eye awareness in general eye clinic].

PubMed

Qiu, Wei-qiang; Liu, Zi-yuan; Ji, Jing; Zeng, Lin; Li, Xue-min; Wang, Wei

2013-03-01

To determine the dry eye awareness in the populations visiting general eye clinic. This was a cross-sectional study. A questionnaire about dry eye was designed and administrated to Peking University Third Hospital General Eye Clinic patients (n = 804) from June 2010 to June 2011. The questionnaire contents included general demographic characteristics, experience of health-related work, past medical history, medication history and ocular surface symptoms associated with dry eye, contact lens wearing, ocular operation history, etc. Chi-square and Binary logistic regression analysis was used to determine the influence of demographic and clinical features on awareness of dry eye. Awareness of "dry eye" in the general eye clinical patients was relatively low (26.9%, 216/804). Participants whose age were between 40 and 60 years had better dry eye awareness (41.7%, 73/175) (χ(2) = 27.365, P = 0.000). Dry eye awareness of female was better than that of male [female: 33.8% (151/447), male: 18.2% (65/357), χ(2) = 24.500, P = 0.000]. Those who had been in health-related work (71.4%, 30/42), and whose friends or relatives were ophthalmologists (54.7%, 52/95) had better dry eye awareness (χ(2) = 31.582, 36.400; both P < 0.01). Participants with a history of rheumatoid arthritis (7/10) or diabetes mellitus (63.0%, 17/27) had better dry eye awareness (χ(2) = 32.301, 29.887;both P < 0.01). Those who had been using artificial tears (77.5%, 31/40), oral contraceptives (9/14), diuretics (10/18), sedatives (70.4%, 19/27) and anti-depression drugs (4/4) had better dry eye awareness (χ(2) = 54.928, 10.154, 7.713, 26.912, 10.943; all P < 0.01). Except frequently blinking (29.5%), participants who had ocular irrigating symptoms (all > 33.0%) had better awareness than those who had not (χ(2) = 7.831 - 32.522, all P < 0.01). Those who were allergic to environment irritating factors (all > 30.0%) had better awareness (χ(2) = 5.033 - 24.564, all P < 0.01). Participants who had medical history of ocular surgery (47.2%, 34/72), experience of wearing contact lens (33.2%, 94/283), who were diagnosed as dry eye (100.0%, 45/45) and who had regular ocular examinations (31.0%, 96/310) had better awareness (χ(2) = 4.321 - 129.763, all P < 0.01). Those who had visited general practitioners (14.8%, 16/108) had lower awareness than those who went to hospital of higher level (28.7%, 200/696) (χ(2) = 9.324, P = 0.002). The result of binary logistic regression analysis showed that gender, health-related working experience, relatives or friends working as Ophthalmologists, using artificial tears, oral contraceptives and sedatives, ocular irritations or environment sensitivity, eye surgeries and wearing contact lens were factors that affected dry eye awareness (OR > 1.000, P < 0.10). Dry eye awareness in the population who visit general eye clinic is low. The knowledge of dry eye should be added to the patient education and public popularization.

Understanding Health Literacy Measurement Through Eye Tracking

PubMed Central

Mackert, Michael; Champlin, Sara E.; Pasch, Keryn E.; Weiss, Barry D.

2013-01-01

This study used eye-tracking technology to explore how individuals with different levels of health literacy visualize health-related information. The authors recruited 25 university administrative staff (more likely to have adequate health literacy skills) and 25 adults enrolled in an adult literacy program (more likely to have limited health literacy skills). The authors administered the Newest Vital Sign (NVS) health literacy assessment to each participant. The assessment involves having individuals answer questions about a nutrition label while viewing the label. The authors used computerized eye-tracking technology to measure the amount of time each participant spent fixing their view at nutrition label information that was relevant to the questions being asked and the amount of time they spent viewing nonrelevant information. Results showed that lower NVS scores were significantly associated with more time spent on information not relevant for answering the NVS items. This finding suggests that efforts to improve health literacy measurement should include the ability to differentiate not just between individuals who have difficulty interpreting and using health information, but also between those who have difficulty finding relevant information. In addition, this finding suggests that health education material should minimize the inclusion of nonrelevant information. PMID:24093355

Prevalence of Undiagnosed Age-Related Macular Degeneration in Primary Eye Care.

PubMed

Neely, David C; Bray, Kevin J; Huisingh, Carrie E; Clark, Mark E; McGwin, Gerald; Owsley, Cynthia

2017-06-01

Age-related macular degeneration (AMD) is the leading cause of irreversible vision impairment in older adults in the United States, yet little is known about whether AMD is appropriately diagnosed in primary eye care. To examine the prevalence of eyes with AMD in patients seen in primary eye care clinics who purportedly have normal macular health per their medical record and the association of AMD with patient and physician characteristics. In this cross-sectional study of primary eye care practices in Birmingham, Alabama, 644 persons 60 years or older with normal macular health per medical record based on their most recent dilated comprehensive eye examination by a primary eye care ophthalmologist or optometrist were enrolled from May 1, 2009, through December 31, 2011. Data analysis was performed from May 1, 2016, through December 20, 2016. Presence of AMD as defined by the Clinical Age-Related Maculopathy Staging system based on color fundus photography and a masked grader. Types of AMD-associated lesions were noted. Patient health and physician characteristics were collected. The sample consisted of 1288 eyes from 644 participants (231 [35.9%] male and 413 [64.1%] female; mean [SD] age, 69.4 [6.1] years; 611 white [94.9%]) seen by 31 primary eye care ophthalmologists or optometrists. A total of 968 eyes (75.2%) had no AMD, in agreement with their medical record; 320 (24.8%) had AMD despite no diagnosis of AMD in the medical record. Among eyes with undiagnosed AMD, 32 (10.0%) had hyperpigmentation, 43 (13.4%) had hypopigmentation, 249 (77.8%) had small drusen, 250 (78.1%) had intermediate drusen, and 96 (30.0%) had large drusen. Undiagnosed AMD was associated with older patient age (odds ratio [OR], 1.06; 95% CI, 1.04-1.09; P < .001), male sex (age-adjusted OR, 1.39; 95% CI, 1.02-1.91; P = .04), and less than a high school education (age-adjusted OR, 2.40; 95% CI, 1.03-5.62; P = .04). Prevalence of undiagnosed AMD was not different for ophthalmologists and optometrists (age adjusted OR, 0.99; 95% CI, 0.71-1.36; P = .94). Approximately 25.0% of eyes deemed to be normal based on dilated eye examination by primary eye care physicians had macular characteristics that indicated AMD revealed by fundus photography and trained raters. A total of 30.0% of eyes with undiagnosed AMD had AMD with large drusen that would have been treatable with nutritional supplements had it been diagnosed. Improved AMD detection strategies may be needed in primary eye care as more effective treatment strategies for early AMD become available in the coming years.

Expressing the sense of the House of Representatives that any conference committee or other meetings held to determine the content of national health care legislation be conducted in public under the watchful eye of the people of the United States.

THOMAS, 111th Congress

Rep. Buchanan, Vern [R-FL-13

2009-10-20

House - 01/13/2010 Motion to Discharge Committee filed by Mr. Buchanan. Petition No: 111-9. (All Actions) Notes: On 1/13/2010, a motion was filed to discharge the Committee on Rules from the consideration of H.Res.847. A discharge petition requires 218 signatures for further action. (Discharge Petition No. 111-9: text with signatures.) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

29 CFR Appendix C to Subpart L of... - Fire Protection References For Further Information

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Standard for Occupational and Educational Eye and Face Protection, ANSI Z87.1; American National..., Batterymarch Park, Quincy, MA 02269 9. Standard for Dry Chemical Extinguishing Systems, ANSI/NFPA 17; National... systems—dry chemical: 1. Standard for Dry Chemical Extinguishing Systems, ANSI/NFPA 17; National Fire...

Important knowledge gaps among pastoralists on causes and treatment of udder health problems in livestock in southern Ethiopia: results of qualitative investigation.

PubMed

Amenu, Kebede; Szonyi, Barbara; Grace, Delia; Wieland, Barbara

2017-10-23

Ethiopia has high prevalences of udder health problems including clinical and subclinical mastitis across production systems in different livestock species. Previous studies on udder health problems have largely focused on identification of mastitis causing microbial pathogens and associated risk factors. However, relatively little is known about the knowledge and beliefs of livestock keepers regarding udder health problems. An understanding of the beliefs on the other hand would facilitate effective communication between livestock keepers and animal health professionals. Therefore, this study aimed at exploring the knowledge and belief surrounding the causes, clinical signs and treatments for udder health problems in (agro-) pastoral communities in southern Ethiopia using qualitative investigation. The result showed that udder health problem, locally known as 'dhukkuba muchaa', which translates to 'disease of teats', was classified into three main types: (1) tick infestation (dirandisa), (2) swelling of udder often with pus discharge (nyaqarsa) and (3) acute mastitis caused by evil eye (buda) with 'bloody milk'. Tick infestation was perceived to directly cause mechanical damage to udder tissue or to resulting in swelling leading to nyaqarsa. Our analysis also revealed the strong misperception that acute and severe swelling of udder was caused by evil eye. According to the pastoralists, cows with large udders in the late pregnancy are prone to evil eye infliction upon giving birth. The pastoralists often treat udder health problems by combining both modern and traditional methods. Removal of ticks by hand and acarcide application were the preferred methods for limiting tick infestation while swelling and evil eye cases were treated with antibiotics (e.g. oxytetracycline). The study also revealed that specific herbs, only known by the herbalists, were used for traditional treatment of udder health. Although this information could not be divulged at the time, it should form the subject of further investigation. Traditional treatment for evil eye was often administered through nostrils, raising questions about its effectiveness. The narration given by the pastoralists in associating tick infestation with udder health problems was compatible with existing scientific evidences. In this respect, such local knowledge can be better utilized for the educational messages targeting control and management of tick infestation in livestock. However, the misperception of causes for acute udder swelling as evil eye can be problematic as far as the application of appropriate treatment and management of the problem is concerned. The misperception can significantly impact the welfare of animals and highlights the need for capacity building of the pastoralists on the causes and treatment of udder health problems.

Roles of the eye care workforce for task sharing in management of diabetic retinopathy in Cambodia

PubMed Central

Shah, Mufarriq; Ormsby, Gail M.; Noor, Ayesha; Chakrabarti, Rahul; Mörchen, Manfred; Islam, Fakir M Amirul; Harper, C Alex; Keeffe, Jill E

2018-01-01

AIM To identify the current roles of eye and health care workers in eye care delivery and investigate their potential roles in screening and detection for management of diabetic retinopathy (DR) through task sharing. METHODS Purposive sampling of 24 participants including health administrators, members from non-government organizations and all available eye care workers in Takeo province were recruited. This cross sectional mixed method study comprised a survey and in-depth interviews. Data were collected from medical records at Caritas Takeo Eye Hospital (CTEH) and Kiri Vong District Referral Hospital Vision Centre, and a survey and interviews with participants were done to explore the potential roles for task sharing in DR management. Qualitative data were transcribed into a text program and then entered into N-Vivo (version 10) software for data management and analysis. RESULTS From 2009 to 2012, a total of 105 178 patients were examined and 14 030 eye surgeries were performed in CTEH by three ophthalmologists supported by ophthalmic nurses in operating and eye examination for patients. Between January 2011 and September 2012, 151 patients (72 males) with retinal pathology including 125 (83%) with DR visited CTEH. In addition 170 patients with diabetes were referred to CTEH for eye examinations from Mo Po Tsyo screening programs for people with diabetes. Factors favouring task sharing included high demand for eye care services and scarcity of ophthalmologists. CONCLUSION Task sharing and team work for eye care services is functional. Participants favor the potential role of ophthalmic nurses in screening for DR through task sharing. PMID:29375999

Novel shadowless imaging for eyes-like diagnosis in vivo

NASA Astrophysics Data System (ADS)

Xue, Ning; Jiang, Kai; Li, Qi; Zhang, Lili; Ma, Li; Huang, Guoliang

2016-10-01

Eyes-like diagnosis was a traditional Chinese medicine method for many diseases, such as chronic gastritis, diabetes, hypertension etc. There was a close relationship between viscera and eyes-like. White-Eye was divided into fourteen sections, which corresponded to different viscera, so eyes-like was the reflection of status of viscera, in another words, it was an epitome of viscera health condition. In this paper, we developed a novel shadowless imaging technology and system for eyes-like diagnosis in vivo, which consisted of an optical shadowless imaging device for capturing and saving images of patients' eyes-like, and a computer linked to the device for image processing. A character matching algorithm was developed to extract the character of white-eye in corresponding sections of eyes-like images taken by the optical shadowless imaging device, according to the character of eyes-like, whether there were viscera diseases could be learned. A series of assays were carried out, and the results verified the feasibility of eyes-like diagnosis technique.

Dry Eye Symptoms, Patient-Reported Visual Functioning, and Health Anxiety Influencing Patient Satisfaction After Cataract Surgery.

PubMed

Szakáts, Ildikó; Sebestyén, Margit; Tóth, Éva; Purebl, György

2017-06-01

To evaluate how patient satisfaction after cataract surgery is associated with postoperative visual acuity, visual functioning, dry eye signs and symptoms, health anxiety, and depressive symptoms. Fifty-four patients (mean age: 68.02 years) were assessed 2 months after uneventful phacoemulsification; 27 were unsatisfied with their postoperative results and 27 were satisfied. They completed the following questionnaires: Visual Function Index-14 (VF-14), Ocular Surface Disease Index (OSDI), Shortened Health Anxiety Inventory (SHAI), and Shortened Beck Depression Inventory. Testing included logarithm of the Minimum Angle of Resolution (logMAR) uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), dry eye tests (tear meniscus height and depth measured by spectral optical coherence tomography, tear film break-up time (TBUT), ocular surface staining, Schirmer 1 test, and meibomian gland dysfunction grading). Postoperative UCVA, BCVA, and the dry eye parameters - except TBUT - showed no statistically significant difference between the two groups (p > 0.130). However, the VF-14 scores, the OSDI scores, and the SHAI scores were significantly worse in the unsatisfied patient group (p < 0.002). No significant correlations were found between visual acuity measures and visual functioning (r < 0.170, p > 0.05). However, the VF-14 scores correlated with the OSDI scores (r = -0.436, p < 0.01) and the OSDI scores correlated with the SHAI scores (r = 0.333, p < 0.05). Multiple logistic regression revealed an adjusted association between patient satisfaction and dry eye symptoms (odds ratio = 1.46, 95% CI = 1.02-2.09, p = 0.038) and visual functioning (odds ratio = 0.78, 95% CI = 0.60-1.0, p = 0.048). Our results suggest that patient-reported visual functioning, dry eye symptoms, and health anxiety are more closely associated with patients' postoperative satisfaction than with the objective clinical measures of visual acuity or the signs of dry eye.

Your Child's Vision

MedlinePlus

... 3½, kids should have eye health screenings and visual acuity tests (tests that measure sharpness of vision) ... eye rubbing extreme light sensitivity poor focusing poor visual tracking (following an object) abnormal alignment or movement ...

Healthy Eyes

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

Witnessing Evolution First Hand: A K-12 Laboratory Exercise in Genetics & Evolution Using "Drosophila"

ERIC Educational Resources Information Center

Heil, Caiti S. S.; Manzano-Winkler, Brenda; Hunter, Mika J.; Noor, Juliet K. F.; Noor, Mohamed A. F.

2013-01-01

We present a laboratory exercise that leverages student interest in genetics to observe and understand evolution by natural selection. Students begin with white-eyed fruit fly populations, to which they introduce a single advantageous variant (one male with red eyes). The superior health and vision associated with having the red-eye-color allele…

Vision loss among diabetics in a group model Health Maintenance Organization (HMO).

PubMed

Fong, Donald S; Sharza, Mohktar; Chen, Wansu; Paschal, John F; Ariyasu, Reginald G; Lee, Paul P

2002-02-01

To report the management of diabetic retinopathy in one group model health maintenance organization and assess the quality of care. Cross-sectional study. A chart review of 1200 randomly identified patients with diabetes mellitus, continuously enrolled for 3 years in Kaiser Permanente (KP) Southern California, the largest provider of managed care in Southern California, was performed. A total of 1047 patients were included in the analyses. Patient characteristics as well as information from the last eye examination were abstracted. Charts from patients with visual acuity less than 20/200 in their better eye (legal blindness) were selected for extensive chart review to determine the cause of visual loss and the antecedent process of care. T tests or the Wilcoxon rank sum test was used to compare continuous variables. The chi(2) test or the Fisher exact test was used to compare categorical variables. All analyses were performed on the Statistical Analyses System (SAS Institute, North Carolina). Our study population of 1047 diabetic patients was 51.7% male, had a mean age of 60.4 years, a mean duration of diabetes of 9.6 years, and a mean hemoglobin A1c of 8.3%. During the study period, 77.5% of patients received a screening eye examination with examination by an ophthalmologist, an optometrist, or review of a retinal photograph. Of those with a visual acuity assessment (n = 687, 65.6% of 1047), 1.5% had visual acuity of 20/200 or worse (legally blind) in the better eye, while 8.2% had this level of visual acuity in the worse eye. Of eyes with new onset clinically significant macular edema and visual acuity < 20/40, 40% had documentation of focal laser performed within 1 month of diagnosis. Of eyes with vitreous hemorrhage and visual acuity < 20/40, 50% had documentation of vitrectomy. Among eyes that had vitrectomy, over 80% had this procedure within 1 year of diagnosis of vitreous hemorrhage. The current report is the largest study of diabetic retinopathy outcomes among patients enrolled in a prepaid health plan. Further research is necessary to investigate the impact of managed care on health outcomes.

Risk factors for open-angle glaucoma in Nigeria: results from the Nigeria National Blindness and Visual Impairment Survey.

PubMed

Kyari, Fatima; Abdull, Mohammed M; Wormald, Richard; Evans, Jennifer R; Nolan, Winifred; Murthy, Gudlavelleti V S; Gilbert, Clare E

2016-06-07

The glaucoma-specific blindness prevalence in Nigeria (0.7 %, 95 % CI 0.6-0.9 %) among those aged ≥40 years is one of the highest ever reported. This study determined the risk factors for open-angle glaucoma (OAG) in adults examined in the Nigeria National Blindness and Visual Impairment Survey. A nationally representative sample of 13,591 people aged ≥40 years in 305 clusters in Nigeria were examined (response rate 90.4 %) between January 2005 to June 2007. Everyone had logMAR visual acuity measurement, Frequency Doubling Technology (FDT) visual field testing, autorefraction, A-scan biometry and optic disc assessment. Full ocular examination (n = 6397), included Goldmann applanation tonometry. Values for defining glaucoma using International Society of Geographical and Epidemiological Ophthalmology criteria were derived from the study population. Disc images were graded by Moorfields Eye Hospital Reading Centre. Socio-demographic factors (age, gender, ethnicity, literacy and place of residence), ocular parameters (intraocular pressure [IOP], axial length and mean ocular perfusion pressure [MOPP]) and systemic parameters (blood pressure, blood glucose and body mass index [BMI]) were assessed for association with OAG. Thirteen thousand eighty-one (96 %) of 13,591 participants had vertical cup:disc ratio measured in at least one eye. 682 eyes of 462 participants were classified as OAG, with 12,738 controls. In univariate analyses the following were associated with OAG: increasing age, male gender, Igbo and Yoruba ethnic groups, illiteracy, longer axial length, higher IOP, lower MOPP, greater severity of hypertension and low BMI (underweight). In multivariate analysis, increasing age (odds ratio [OR] 1.04, 95 % CI 1.03-1.05), higher IOP (OR 1.22, 95 % CI 1.18-1.25) and Igbo ethnicity (OR 1.73, 95 % CI 1.18-2.56) were independent risk factors for OAG. Case detection strategies for OAG should be improved for those aged ≥40 years and for ethnic groups most at risk as a public health intervention.

Glaucoma Medication Adherence among African Americans: Program Development

PubMed Central

Dreer, Laura E.; Girkin, Christopher A.; Campbell, Lisa; Wood, Andy; Gao, Liyan; Owsley, Cynthia

2014-01-01

Purpose To elucidate barriers and facilitators related to glaucoma medication adherence among African Americans (AA) with glaucoma and to elicit input from a community-based participatory research team in order to guide the development of a culturally informed, health promotion program for improving glaucoma medication adherence among AA’s. Methods The nominal group technique (NGT), a highly structured focus group methodology, was implemented with 12 separate groups of AA’s patients with glaucoma (N = 89) to identify barriers and facilitators related to glaucoma medication usage. Participant rank-ordering votes were summed across groups and categorized into themes. Next, an individually and culturally targeted health promotion program promoting appropriate medication adherence was developed based on focus group results and input from a community-based participatory research team. Results The top five barriers included problems with 1) forgetfulness, 2) side effects, 3) cost/affordability, 4) eye drop administration, and 5) the eye drop schedule. The most salient top five facilitators were 1) fear or thoughts about the consequences of not taking eye drops, 2) use of memory aids, cues, or strategies, 3) maintaining a regular routine or schedule for eye drop administration, 4) ability to afford eye drops, and 5) keeping eye drops in the same area. The resulting health promotion program was based on a multi-component empowerment framework that included glaucoma education, motivational interviewing, and problem-solving training to improve glaucoma medication adherence. Conclusions Barriers and facilitators related to glaucoma medication adherence among AA’s are multifactorial. Based on the NGT themes and input from the community-based participatory research team, a culturally informed, health promotion program was designed and holds great promise for improving medication adherence among this vulnerable population. PMID:23873033

What do Canadian seniors say supports their quality of life? Findings from a national participatory research study.

PubMed

Bryant, Toba; Brown, Ivan; Cogan, Tara; Dallaire, Clemence; Laforest, Sophie; McGowan, Patrick; Raphael, Dennis; Richard, Lucie; Thompson, Loraine; Young, Joyce

2004-01-01

A national project investigated seniors' perceptions of the influences upon their quality of life. The seven participating cities were Montreal, Quebec City, Ottawa, Toronto, Regina, Vancouver and Whitehorse. The project focussed on policy decisions affecting the quality of life of seniors. It was a participatory study in which seniors controlled the direction and shape of the project in each city. Focus groups and individual interviews with seniors and stakeholders. Data analysis used qualitative methods to see the world through the eyes of participants. Each project was committed to hearing the voices of seniors and their views on which issues were affecting the quality of their lives. Across the seven cities, seniors highlighted access to information, health care, housing, income security, safety and security, social contacts and networks, and transportation as key issues that affect the quality of life of seniors in Canada. The findings affirm the value of participatory activities that involve seniors working with other sectors as a productive policy-informing approach. The Seniors' Quality of Life projects demonstrate the conceptual power of the determinants of health perspective to understand seniors' quality of life issues. While seniors considered health care to be a continuing concern, they also recognized socio-economic issues as significantly affecting the quality of their lives.

Case-control study on the prevention of occupational eye injuries.

PubMed

Ho, Chi-Kung; Yen, Ya-Lin; Chang, Cheng-Hsien; Chiang, Hung-Che; Shen, Ying-Ying; Chang, Po-Ya

2008-01-01

The risk factors for occupational eye injuries have never been published in Taiwan. We conducted a case-control study to analyze the differences among workers on their knowledge, attitude to and practice (KAP) of occupational accident prevention. In the study, a statistical model was also set up for predicting the occupational problem. Subjects, including 31 cases of work-related eye injuries and 62 controls, completed a structured questionnaire on KAP, which revealed that 80.6% and 62.7% of workers in the case and control groups, respectively, did not wear eye protection during work. Furthermore, we found that temporary employment (OR, 10.7; 95% CI, 3.03-36.16) and fewer than 10 years of education (OR, 4.44; 95% CI, 1.73-11.44) were the major risk factors for occupational eye injuries. In addition, we developed a logistic regression model with four predictors (temporary employment, education years less than 10, poor management of industrial health and safety in the workplace, and poor attitude towards accident prevention) for the occurrence of occupational eye injuries. In conclusion, in Taiwan, compulsory regulation of wearing eye protection during work, good education, management of work safety and hygiene and employee (especially temporary worker) commitment to safety and health are strongly recommended prevention strategies.

Eye Disease Simulations

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

Smoking and Eye Health

MedlinePlus

... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

46 CFR 197.555 - Personal protective clothing and equipment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SAFETY AND HEALTH STANDARDS GENERAL PROVISIONS Benzene § 197.555 Personal protective clothing and..., tight-fitting eye goggles to limit dermal exposure to, and prevent eye contact with, liquid benzene. ...

46 CFR 197.555 - Personal protective clothing and equipment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SAFETY AND HEALTH STANDARDS GENERAL PROVISIONS Benzene § 197.555 Personal protective clothing and..., tight-fitting eye goggles to limit dermal exposure to, and prevent eye contact with, liquid benzene. ...

46 CFR 197.555 - Personal protective clothing and equipment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SAFETY AND HEALTH STANDARDS GENERAL PROVISIONS Benzene § 197.555 Personal protective clothing and..., tight-fitting eye goggles to limit dermal exposure to, and prevent eye contact with, liquid benzene. ...

Role of Chronic Inflammation in Myopia Progression: Clinical Evidence and Experimental Validation.

PubMed

Lin, Hui-Ju; Wei, Chang-Ching; Chang, Ching-Yao; Chen, Ter-Hsin; Hsu, Yu-An; Hsieh, Yi-Ching; Chen, Hsuan-Ju; Wan, Lei

2016-08-01

Prevention and treatment of myopia is an important public problem worldwide. We found a higher incidence of myopia among patients with inflammatory diseases such as type 1 diabetes mellitus (7.9%), uveitis (3.7%), or systemic lupus erythematosus (3.5%) compared to those without inflammatory diseases (p<0.001) using data from children (<18years old) in the National Health Insurance Research database. We then examined the inhibition of myopia by atropine in Syrian hamsters with monocular form deprivation (MFD), an experimental myopia model. We found atropine downregulated inflammation in MFD eyes. The expression levels of c-Fos, nuclear factor κB (NFκB), interleukin (IL)-6, and tumor necrosis factor (TNF)-α were upregulated in myopic eyes and downregulated upon treatment with atropine. The relationship between the inflammatory response and myopia was investigated by treating MFD hamsters with the immunosuppressive agent cyclosporine A (CSA) or the inflammatory stimulators lipopolysaccharide (LPS) or peptidoglycan (PGN). Myopia progression was slowed by CSA application but was enhanced by LPS and PGN administration. The levels of c-Fos, NF-κB, IL-6, and TNF-α were upregulated in LPS- and PGN-treated eyes and downregulated by CSA treatment. These findings provide clinical and experimental evidence that inflammation plays a crucial role in the development of myopia. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

The Role of Health Anxiety and Depressive Symptoms in Dry Eye Disease.

PubMed

Szakáts, Ildikó; Sebestyén, Margit; Németh, János; Birkás, Emma; Purebl, György

2016-08-01

To investigate the associations between health anxiety, depressive and anxiety symptoms, and the severity of the subjective and objective symptoms of dry eye disease (DED). Participants completed the following psychological questionnaires: Shortened Health Anxiety Inventory, Shortened Beck Depression Inventory, and Beck Anxiety Inventory. Dry eye symptoms were evaluated using the ocular surface disease index (OSDI). Bilateral tear osmolarity measurement, tear film break-up time (TBUT), ocular surface staining, Schirmer 1 test, and meibomian gland dysfunction assessment were performed. Based on the OSDI score, 56 of the 84 participants enrolled were symptomatic and 28 asymptomatic. According to the objective parameters, 48/56 (85.7%) in the symptomatic group and 23/28 (82.1%) in the asymptomatic group were diagnosed with DED. In terms of the objective parameters, except for TBUT, there were no statistically significant differences between the symptomatic and asymptomatic group (p > 0.108), or between the subgroups with objectively proven dry eye (p > 0.233). The results of the psychological questionnaires were significantly worse in the symptomatic group (p < 0.01) and the symptomatic subgroup with objective dry eye (p < 0.05), than in the asymptomatic groups. In the overall study population the scores of the psychological questionnaires demonstrated significant positive correlations with the OSDI scores (r > 0.306, p < 0.01). These results support the role of health anxiety and of depressive and anxiety symptoms in DED, and may serve as an explanation for the lack of correlation between subjective symptoms and objective signs of the disease.

Diagram of the Eye

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

Sulfuric acid poisoning

MedlinePlus

... skin or eye contact may include: Skin burning, drainage, and pain Eye burning, drainage, and pain Vision loss ... The health care provider will measure and monitor the person's vital ... pressure Symptoms will be treated as appropriate. The person ...

Eye Health in Sports and Recreation

MedlinePlus

... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

Severity of Visual Field Loss and Health Related Quality of Life

PubMed Central

McKean-Cowdin, Roberta; Varma, Rohit; Wu, Joanne; Hays, Ron D.; Azen, Stanley P.

2009-01-01

Purpose To examine the association between severity of visual field loss (VFL) and self-reported health-related quality of life (HRQOL) in a population-based sample. Design Population-based cross-sectional study. Methods Participants in the Los Angeles Latino Eye Study underwent a comprehensive ophthalmic examination including visual field testing using the Humphrey Automated Field Analyzer II (SITA Standard 24-2). Mean Deviation (MD) scores were used to determine severity of VFL both as a continuous variable and stratified by severity: no VFL (MD≥ − 2 decibels [dB]), mild VFL (6dB

Coping with dry eyes: a qualitative approach.

PubMed

Yeo, Sharon; Tong, Louis

2018-01-16

Dry eye is a common problem that affects many people worldwide, reducing quality of life and impacting daily activities. A qualitative approach often used in medicine and other disciplines is used to evaluate how people with dry eye cope with this impact. Six focus group sessions were conducted at the Singapore National Eye Centre (SNEC), premises of an eye research institute. These focus groups consist of a spectrum of dry eye sufferers (30 women, 8 men, aged 61 ± 11.8 years). Standard methods of coding followed by determination of themes were adhered to. Where classification was difficult, consensus was made between 3 assessors. Audio-recorded transcripts were coded in 10 themes by 3 assessors independently. Four of the themes involved traditional measures such as lid warming, cleansing, lubrication and oral dietary supplements. The other themes discovered were Traditional Chinese Medicine, modification of eye-care habits (e.g. wearing sunglasses), environmental humidity, lifestyle (e.g. sleeping habits), psychological attitude, and lastly sharing and communication. Holistic coping strategies were found to be prominent in dry eye sufferers from these focus groups, and people tend to find personalised ways of coping with the impact of dry eye on daily living.

Ocular surface changes in thyroid eye disease.

PubMed

Ismailova, Dilyara S; Fedorov, Anatoly A; Grusha, Yaroslav O

2013-04-01

To study the incidence and risk factors of ocular surface damage in thyroid eye disease (TED) and to determine histological changes underlying positive vital staining in this condition. Forty-six patients (92 eyes) with TED were included in this study. Routine ophthalmologic examination, Schirmer test I, vital staining and corneal sensitivity were performed. Fifteen patients with positive vital staining underwent impression cytology and incisional biopsy. Positive vital staining with lissamine green was observed in 56 eyes (60.9%), 30 patients (65.2%). The average degree of staining was 4.57 ± 0.44 (National Eye Institute Workshop grading system). Severe dry eye syndrome was found in 16%. The following histological changes of conjunctiva were revealed: significant epithelial dystrophy with cell polymorphism, goblet cells loss, excessive desquamation and epithelial keratinization with local leukocytic infiltration of substantia propria. According to our results dry eye syndrome is present in 65.2% of patients (60.9% eyes) with TED. Significant risk factors of ocular surface damage in TED were exophthalmos, lagophthalmos, palpebral fissure height and lower lid retraction. Positive conjunctival staining results from punctuate epithelial erosions and excessive desquamation of superficial cells. Histopathologic changes detected in conjunctiva consistent with dry eye and are not specific for TED.

Data from: Solving the Robot-World Hand-Eye(s) Calibration Problem with

Science.gov Websites

Iterative Methods | National Agricultural Library Skip to main content Home National Agricultural Library United States Department of Agriculture Ag Data Commons Beta Toggle navigation Datasets . License U.S. Public Domain Funding Source(s) National Science Foundation IOS-1339211 Agricultural Research

Big data and ophthalmic research.

PubMed

Clark, Antony; Ng, Jonathon Q; Morlet, Nigel; Semmens, James B

2016-01-01

Large population-based health administrative databases, clinical registries, and data linkage systems are a rapidly expanding resource for health research. Ophthalmic research has benefited from the use of these databases in expanding the breadth of knowledge in areas such as disease surveillance, disease etiology, health services utilization, and health outcomes. Furthermore, the quantity of data available for research has increased exponentially in recent times, particularly as e-health initiatives come online in health systems across the globe. We review some big data concepts, the databases and data linkage systems used in eye research-including their advantages and limitations, the types of studies previously undertaken, and the future direction for big data in eye research. Copyright © 2016 Elsevier Inc. All rights reserved.

Holocamera for 3-D micrography of the alert human eye

NASA Astrophysics Data System (ADS)

Tokuda, A. R.; Auth, D. C.; Bruckner, A. P.

1980-07-01

A holocamera that safely records holograms of the full depth of the alert human eye with a spatial resolution of about 20 microns is described. A single-mode argon-ion laser generating 2 W at 5145 A serves as the illuminating source. Holographic exposure times of 0.3 msec are achieved by means of a fail-safe electromechanical shutter system. Integrated retinal irradiance levels are well under the American National Standards Institute safety standards. Reconstructed real images are projected directly onto the vidicon faceplate of a closed-circuit TV system, enabling convenient scanning in the x-y-z dimensions of the reconstructed eyeball. Serially reconstructed holograms of cataractous rabbit eyes and normal human eyes are presented.

36 CFR 1280.8 - May I bring a seeing-eye dog or other assistance animal?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false May I bring a seeing-eye dog or other assistance animal? 1280.8 Section 1280.8 Parks, Forests, and Public Property NATIONAL... dog or other assistance animal? Yes, persons with disabilities may bring guide dogs or other animals...

36 CFR 1280.8 - May I bring a seeing-eye dog or other assistance animal?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false May I bring a seeing-eye dog or other assistance animal? 1280.8 Section 1280.8 Parks, Forests, and Public Property NATIONAL... dog or other assistance animal? Yes, persons with disabilities may bring guide dogs or other animals...

36 CFR 1280.8 - May I bring a seeing-eye dog or other assistance animal?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false May I bring a seeing-eye dog or other assistance animal? 1280.8 Section 1280.8 Parks, Forests, and Public Property NATIONAL... dog or other assistance animal? Yes, persons with disabilities may bring guide dogs or other animals...

36 CFR 1280.8 - May I bring a seeing-eye dog or other assistance animal?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false May I bring a seeing-eye dog or other assistance animal? 1280.8 Section 1280.8 Parks, Forests, and Public Property NATIONAL... dog or other assistance animal? Yes, persons with disabilities may bring guide dogs or other animals...

EEG Brain Activity in Dynamic Health Qigong Training: Same Effects for Mental Practice and Physical Training?

PubMed

Henz, Diana; Schöllhorn, Wolfgang I

2017-01-01

In recent years, there has been significant uptake of meditation and related relaxation techniques, as a means of alleviating stress and fostering an attentive mind. Several electroencephalogram (EEG) studies have reported changes in spectral band frequencies during Qigong meditation indicating a relaxed state. Much less is reported on effects of brain activation patterns induced by Qigong techniques involving bodily movement. In this study, we tested whether (1) physical Qigong training alters EEG theta and alpha activation, and (2) mental practice induces the same effect as a physical Qigong training. Subjects performed the dynamic Health Qigong technique Wu Qin Xi (five animals) physically and by mental practice in a within-subjects design. Experimental conditions were randomized. Two 2-min (eyes-open, eyes-closed) EEG sequences under resting conditions were recorded before and immediately after each 15-min exercise. Analyses of variance were performed for spectral power density data. Increased alpha power was found in posterior regions in mental practice and physical training for eyes-open and eyes-closed conditions. Theta power was increased after mental practice in central areas in eyes-open conditions, decreased in fronto-central areas in eyes-closed conditions. Results suggest that mental, as well as physical Qigong training, increases alpha activity and therefore induces a relaxed state of mind. The observed differences in theta activity indicate different attentional processes in physical and mental Qigong training. No difference in theta activity was obtained in physical and mental Qigong training for eyes-open and eyes-closed resting state. In contrast, mental practice of Qigong entails a high degree of internalized attention that correlates with theta activity, and that is dependent on eyes-open and eyes-closed resting state.

Pediatric eye injuries due to nonpowder guns in the United States, 2002-2012.

PubMed

Lee, Rachel; Fredrick, Douglas

2015-04-01

To identify epidemiologic trends in nonpowder gun-related pediatric eye injuries and to determine factors associated with severe injury requiring hospital admission. US emergency department data on pediatric eye injuries between 2002 and 2012 were reviewed using the National Electronic Injury Surveillance System. Literature review was conducted to determine trends in visual outcomes after treatment and use of eye protection. In 2012 roughly 3,161 children were treated in US emergency departments for nonpowder gun-related eye injuries. Since 2010 rates of severe nonpowder gun pediatric eye injury have increased by over 500% (P = 0.039). Specifically, while rates of hospital admission due to paintball gun eye injury have dropped precipitously (P = 0.0077), rates of admissions for air gun eye injuries have increased by over 600% since 2010 (P = 0.033). Children sustaining eye injury due to air guns are more likely to be diagnosed and admitted with foreign body or ocular puncture injury. Roughly 28% of documented cases of airsoft or BB gun-related injury had visual acuity worse than 20/50 after initial treatment. Over 98% of injuries occurred without eye protection. Air guns are rising in popularity and now account for the majority of pediatric eye injuries requiring hospital admissions. These eye injuries occur without ocular protection and may lead to permanent eye injury. Increasing regulations for eye protection, sales, and usage of air guns are needed to prevent serious pediatric eye injuries. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?

PubMed

Courtright, Paul; Mathenge, Wanjiku; Kello, Amir Bedri; Cook, Colin; Kalua, Khumbo; Lewallen, Susan

2016-03-16

With a global target set at reducing vision loss by 25% by the year 2019, sub-Saharan Africa with an estimated 4.8 million blind persons will require human resources for eye health (HReH) that need to be available, appropriately skilled, supported, and productive. Targets for HReH are useful for planning, monitoring, and resource mobilization, but they need to be updated and informed by evidence of effectiveness and efficiency. Supporting evidence should take into consideration (1) ever-changing disease-specific issues including the epidemiology, the complexity of diagnosis and treatment, and the technology needed for diagnosis and treatment of each condition; (2) the changing demands for vision-related services of an increasingly urbanized population; and (3) interconnected health system issues that affect productivity and quality. The existing targets for HReH and some of the existing strategies such as task shifting of cataract surgery and trichiasis surgery, as well as the scope of eye care interventions for primary eye care workers, will need to be re-evaluated and re-defined against such evidence or supported by new evidence.

What Is a Comprehensive Dilated Eye Exam?

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

When to Have an Eye Exam

MedlinePlus

... What health problems have you had in recent years? Are you taking any medications? Do you have any allergies to medications, food or other substances? Have you ever had eye surgery? Does anyone in your family ...

Does Marijuana Help Treat Glaucoma?

MedlinePlus

... Ophthalmologist Patient Stories Español Eye Health / Tips & Prevention Marijuana Sections Does Marijuana Help Treat Glaucoma? Why Eye ... Don't Recommend Marijuana for Glaucoma Infographic Does Marijuana Help Treat Glaucoma? Leer en Español: La marihuana ...

Impact of vision impairment and self-reported barriers to vision care: The views of elders in Nuwara Eliya district, Sri Lanka.

PubMed

Holmes, W; Shajehan, R; Kitnasamy, S; Abeywickrama, C; Arsath, Y; Gnanaraj, F; Inbaraj, S; Jayakody, G; Durrant, K; Luchters, S

2018-05-01

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. They worry about becoming dependent. VI restricts their ability to contribute to their families and communities, access information, socialise, maintain their health, and earn. Barriers to eye care services include transport difficulties, costs of treatment, fear, lack of knowledge, waiting times, and health staff attitudes. Older people experience and fear the impacts of VI on their health and well-being. Eye health promotion and care services need strengthening and integration with the primary health care system to address the backlog and growing need among older people in an equitable way. Older people should be consulted about how to overcome the economic, social, and cultural barriers to access to eye care and to minimise the impact of VI. FGDs: focus group discussions; GBD: global burden of disease; NCDs: non-communicable diseases; VI: vision impairment.

Analysis and Outcomes of Cataract Surgery in Patients with Acquired Immunodeficiency Syndrome.

PubMed

Chew, Grace W M; Teoh, Stephen C B; Agrawal, Rupesh

2017-08-01

To investigate the surgical outcomes, complications and postoperative progression in HIV patients undergoing cataract surgery in a teaching hospital. A retrospective cohort study of patients with HIV/AIDS who had cataract surgery from January 2000 until December 2011 at a tertiary referral multidisciplinary hospital in Singapore. We identified 44 eyes from 29 patients. Preoperatively, 41.3% had no ophthalmic manifestations of HIV/AIDS, while 16 eyes had quiescent cytomegalovirus retinitis (CMVR). Postoperatively, 1 eye developed new CMVR, while 1 eye had reactivation of previous CMVR. Of eyes with new or previous CMVR, 1 eye developed rhegmatogenous retinal detachment (RD) postoperatively. Only 3 eyes had prolonged postoperative inflammation. There were no cases of endophthalmitis or cystoid macular edema. Postoperative improvement of at least two Snellen lines was achieved in 86.6% of eyes. Cataract surgery in HIV patients is generally safe, regardless of CD4 count, but their general and ocular health should be optimized preoperatively.

The occurrence of visual and cognitive impairment, and eye diseases in the super-elderly in Japan: a cross-sectional single-center study.

PubMed

Fukuoka, Hideki; Nagaya, Masahiro; Toba, Kenji

2015-10-29

The current state of eye diseases and treatments in the elderly as well as the relationships between dementia and systemic diseases remain unclear. Therefore, this study evaluated the prevalence of eye diseases, visual impairment, cognitive impairment, and falls (which are an important health issue and are considered one of the Geriatric Giants) in super-elderly people in Japan. The subjects were 31 elderly people (62 eyes; mean age: 84.6 ± 8.8 years; age range 61-98 years) who were admitted to a geriatric health services facility. Eye treatment status, systemic diseases, dementia, and recent falls were investigated. Eye examinations including vision and intraocular pressure measurement, and slit-lamp biomicroscopy were conducted. Mean best corrected visual acuity (logMAR) was 0.51 ± 0.56, and mean intraocular pressure was 13.7 ± 3.5 mmHg. Approximately half of the subjects exhibited excavation of the optic nerve head including cataracts and glaucoma. Ten subjects had visual impairment (i.e., visual acuity of the eye with the better vision <20/40). The mean Hasegawa dementia scale scores between the visually impaired and non-visually impaired groups were 10.2 ± 6 and 16 ± 8 points, respectively (p < 0.05). Furthermore, 70% of subjects with visual impairment experienced a fall in the past year compared to 48% of those without visual impairment, although the difference was not significant. Regarding systemic diseases, there were 6, 5, and 15 cases of diabetes, hyperlipidemia, and hypertension, respectively. There was no significant difference between these systemic diseases and visual function after adjusted for age and gender. The percentages of patients with age-related eye diseases and poor visual acuity in a geriatric health services facility were extremely high. Compared to those without visual impairment, those with visual impairment had lower dementia scores and a higher rate of falls.

Developing an online tool for identifying at-risk populations to wildfire smoke hazards.

PubMed

Vaidyanathan, Ambarish; Yip, Fuyuen; Garbe, Paul

2018-04-01

Wildfire episodes pose a significant public health threat in the United States. Adverse health impacts associated with wildfires occur near the burn area as well as in places far downwind due to wildfire smoke exposures. Health effects associated with exposure to particulate matter arising from wildfires can range from mild eye and respiratory tract irritation to more serious outcomes such as asthma exacerbation, bronchitis, and decreased lung function. Real-time operational forecasts of wildfire smoke concentrations are available but they are not readily integrated with information on vulnerable populations necessary to identify at-risk communities during wildfire smoke episodes. Efforts are currently underway at the Centers for Disease Control and Prevention (CDC) to develop an online tool that utilizes short-term predictions and forecasts of smoke concentrations and integrates them with measures of population-level vulnerability for identifying at-risk populations to wildfire smoke hazards. The tool will be operationalized on a national scale, seeking input and assistance from several academic, federal, state, local, Tribal, and Territorial partners. The final product will then be incorporated into CDC's National Environmental Public Health Tracking Network (http://ephtracking.cdc.gov), providing users with access to a suite of mapping and display functionalities. A real-time vulnerability assessment tool incorporating standardized health and exposure datasets, and prevention guidelines related to wildfire smoke hazards is currently unavailable for public health practitioners and emergency responders. This tool could strengthen existing situational awareness competencies, and expedite future response and recovery efforts during wildfire episodes. Published by Elsevier B.V.

Health Inequalities Associated with Post-Stroke Visual Impairment in the United Kingdom and Ireland: A Systematic Review

PubMed Central

Hanna, K. L.; Rowe, F. J.

2017-01-01

ABSTRACT The aim of this study was to report on the health inequalities facing stroke survivors with visual impairments as described in the current literature. A systemic review of the literature was conducted to investigate the potential health inequalities facing stroke survivors with subsequent visual impairments. A quality-of-evidence and risk-of-bias assessment was conducted for each of the included articles using the appropriate tool dependent on the type of article. Only four articles discussed health inequalities affecting stroke survivors with visual impairment specifically. A further 23 articles identified health inequalities after stroke, and 38 reported on health inequalities within the visually impaired UK or Irish population. Stroke survivors with visual impairment face inconsistency in eye care provision nationally, along with variability in the assessment and management of visual disorders. The subgroups identified as most at risk were females; black ethnicity; lower socioeconomic status; older age; and those with lower education attainment. The issue of inconsistent service provision for this population must be addressed in future research. Further research must be conducted in order to firmly establish whether or not stroke survivors are at risk of the aforementioned sociodemographic and economic inequalities. PMID:28512502

Can dimensions of national culture predict cross-national differences in medical communication?

PubMed

Meeuwesen, Ludwien; van den Brink-Muinen, Atie; Hofstede, Geert

2009-04-01

This study investigated at a country level how cross-national differences in medical communication can be understood from the first four of Hofstede's cultural dimensions, i.e. power distance, uncertainty avoidance, individualism/collectivism and masculinity/femininity, together with national wealth. A total of 307 general practitioners (GPs) and 5820 patients from Belgium, Estonia, Germany, Great Britain, the Netherlands, Poland, Romania, Spain, Sweden and Switzerland participated in the study. Medical communication was videotaped and assessed using Roter's interaction analysis system (RIAS). Additional context information of physicians (gender, job satisfaction, risk-taking and belief of psychological influence on diseases) and patients (gender, health condition, diagnosis and medical encounter expectations) was gathered by using questionnaires. Countries differ considerably form each other in terms of culture dimensions. The larger a nation's power distance, the less room there is for unexpected information exchange and the shorter the consultations are. Roles are clearly described and fixed. The higher the level of uncertainty avoidance, the less attention is given to rapport building, e.g. less eye contact. In 'masculine' countries there is less instrumental communication in the medical interaction, which was contrary to expectations. In wealthy countries, more attention is given to psychosocial communication. The four culture dimensions, together with countries' wealth, contribute importantly to the understanding of differences in European countries' styles of medical communication. Their predictive power reaches much further than explanations along the north/south or east/west division of Europe. The understanding of these cross-national differences is a precondition for the prevention of intercultural miscommunication. Improved understanding may occur at microlevel in the medical encounter, as well as on macrolevel in pursuing more effective cooperation and integration of European health care policies.

Eye care in the elderly.

PubMed

Green, Catherine; Goodfellow, Jonathan; Kubie, Jessica

2014-07-01

Eye disease and visual impairment are common in the elderly and are associated with social and functional decline, the need to access community support services, depression, falls, nursing home placement and increased mortality. To provide guidance for general practitioners in the detection and recommended management of the most important eye conditions in the elderly in Australia: refractive error, cataract, diabetic retinopathy, age-related macular degeneration and glaucoma. Timely detection and treatment of eye disease can greatly reduce its morbidity. Elderly patients should be encouraged to undergo eye testing every 2 years. Health professionals, including general practitioners, optometrists and ophthalmologists should work collaboratively to ensure patients have access to appropriate disease detection and treatment.

Impact of visors on eye and orbital injuries in the National Hockey League.

PubMed

Micieli, Jonathan A; Zurakowski, David; Ahmed, Iqbal Ike K

2014-06-01

Eye and orbital injuries are a significant risk to professional hockey league players and have resulted in career-ending injuries. The goal of this study was to determine the incidence, value lost, mechanism, and effect of visors on eye and orbital injuries over the last 10 National Hockey League (NHL) seasons: 2002-2003 to 2012-2013. Retrospective case-control study. Participants were 8741 NHL players who had played at least 1 game during the last 10 seasons. Using The Sports Network (TSN), ProSportsTransactions, and the Sporting News Hockey Register, NHL players were searched to identify eye and orbital injuries. The mechanism of injury was obtained from media reports and direct observation from online videos. The number of players wearing visors each year was obtained from The Hockey News annual visor survey. A total of 149 eye or orbital injuries over the last 10 seasons resulted in an overall incidence of 2.48 per 10 000 athlete exposures. A total of 1120 missed games led to a lost financial value of more than $33 million. Visor use among players grew from 32% in 2002-2003 to 73% in 2012-2013, and there was a significantly increased risk for having an eye or orbital injury when a visor was not worn (OR 4.23, 95% CI 2.84-6.30). Most injuries were a result of being hit by a deflected or direct puck (37%) followed by being struck by a high stick (28%). Players who did not wear a visor were found to be involved in more fights, hits, and penalty minutes (p < 0.001). Eye and orbital injuries are mostly accidental in nature and represent a significant risk and cost to the NHL and its players. Eye and orbital injuries are significantly more likely in players who do not wear visors. Copyright © 2014 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Reliability and validity of abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire: The Study of Osteoporotic Fractures

PubMed Central

Gergana, Kodjebacheva; Coleman, Anne L.; Ensrud, Kristine E.; Cauley, Jane A.; Yu, Fei; Stone, Katie L.; Pedula, Kathryn L.; Hochberg, Marc C.; Mangione, Carol M.

2010-01-01

Purpose To test the reliability and validity of questionnaires shortened from the National Eye Institute 25-item Vision Function Questionnaire (NEI VFQ-9 and NEI VFQ-8). Design A cross-sectional multi-center cohort study. Methods Reliability was assessed by Cronbach alpha coefficients. Validity was evaluated by studying the association of vision-targeted quality-of-life composite scores with objective visual function measurements. Study population: A total of 5,482 women between the ages of 65 and 100 years participated in the Year-10 clinic visit in the Study of Osteoporotic Fractures (SOF). A total of 3,631 women with complete data were included in the visual acuity (VA) and visual field (VF) analysis of the NEI VFQ-9, which is defined for those who care to drive. and 5,311 in the analysis of the NEI VFQ-8. To assess differences in prevalent eye diseases, which were ascertained for a random sample of SOF participants, 853 and 1,237 women were included in the NEI VFQ-9 and the NEI VFQ-8 analyses, respectively. Results Cronbach alpha coefficient for the NEI VFQ-9 scale was 0.83 and that of the NEI VFQ-8 was 0.84. Using both questionnaires, women with VA worse than 20/40 had lower composite scores compared to those with VA 20/40 or better (p<0.001). Participants with mild, moderate, and severe binocular VF loss had lower composite scores compared to those with no binocular VF loss (p<0.001).Compared to women without chronic eye diseases in both eyes, women with at least one chronic eye disease in at least one eye had lower composite scores. Conclusions Both questionnaires showed high reliability across items and validity with respect to clinical markers of eye disease Future research should compare the properties of these shortened surveys to those of the NEI VFQ-25. PMID:20103058

New Eye-Tracking Techniques May Revolutionize Mental Health Screening

DTIC Science & Technology

2015-11-04

health? Recent progress in eye-tracking tech- niques is opening new avenues for quanti - tative, objective, simple, inexpensive, and rapid evaluation ...to check with your doctor whether any corrective action should be taken. What if similar devices could be made available for the evaluation of mental... evaluations , especially for those disor- ders for which a clear chemical, genetic, morphological, physiological, or histologi- cal biomarker has not yet

Retrospective economic analysis of the transfer of services from hospitals to the community: an application to an enhanced eye care service.

PubMed

Mason, Thomas; Jones, Cheryl; Sutton, Matt; Konstantakopoulou, Evgenia; Edgar, David F; Harper, Robert A; Birch, Stephen; Lawrenson, John G

2017-07-10

This research aims to evaluate the wider health system effects of the introduction of an intermediate-tier service for eye care. This research employs the Minor Eye Conditions Scheme (MECS), an intermediate-tier eye care service introduced in two London boroughs, Lewisham and Lambeth, in April 2013. Retrospective difference-in-differences analysis comparing changes over time in service use and costs between April 2011 and October 2014 in two commissioning areas that introduced an intermediate-tier service programme with changes in a neighbouring area that did not introduce the programme. MECS audit data; unit costs for MECS visits; volumes of first and follow-up outpatient attendances to hospital ophthalmology; the national schedule of reference costs. Volumes and costs of patients treated. In one intervention area (Lewisham), general practitioner (GP) referrals to hospital ophthalmology decreased differentially by 75.2% (95% CI -0.918% to -0.587%) for first attendances, and by 40.3% for follow-ups (95% CI -0.489% to -0.316%). GP referrals to hospital ophthalmology decreased differentially by 30.2% (95% CI -0.468% to -0.137%) for first attendances in the other intervention area (Lambeth). Costs increased by 3.1% in the comparison area between 2011/2012 and 2013/2014. Over the same period, costs increased by less (2.5%) in one intervention area and fell by 13.8% in the other intervention area. Intermediate-tier services based in the community could potentially reduce volumes of patients referred to hospitals by GPs and provide replacement services at lower unit costs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The effects of dance training program on the postural stability of middle aged women.

PubMed

Kostić, Radmila; Uzunović, Slavoljub; Purenović-Ivanović, Tijana; Miletić, Đurđica; Katsora, Georgija; Pantelić, Saša; Milanović, Zoran

2015-11-01

The aim of the study was to determine the effects of Greek folk dancing on postural stability in middle age women. Sixty-three women aged from 47-53 participated in this study. All participants were randomly divided into the experimental group - 33 participants (mean ± SD; body height=160.13 ± 12.07 cm, body mass=63.81 ± 10.56 kg), and the control group - 30 participants (mean ± SD; body height=160.63 ± 6.22 cm, body mass=64.79 ± 8.19 kg). The following tests were used to evaluate the motor balance and posture stability of participants; the double-leg stance along the length of a balance beam (eyes open), the double-leg stance along the width of a balance beam (eyes open), the single-leg stance (eyes open) and the double-leg stance on one's toes (eyes closed). The Functional Reach Test for balance and the Star Excursion Balance Test were used to evaluate dynamic balance. The multivariate analysis of covariance of static and dynamic balance between participants of the experimental and control group at the final measuring, with neutralized differences at the initial measuring (Wilks' λ=0.45), revealed a significant difference (p<0.05). The intergroup difference at the final measuring was also found to be significant (p<0.05) for the following variables; the double-leg stance on one's toes, the Functional Reach Test, balance of the right anterolateral, balance of the right posterolateral and balance of the left posteromedial. An organized dance activity programme does lead to the improvement of static and dynamic balance in middle aged women. Copyright© by the National Institute of Public Health, Prague 2015.

Ocular health assessment of cocoa farmers in a rural community in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

2014-01-01

Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

Doctor-Shopping Behavior among Patients with Eye Floaters

PubMed Central

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-01-01

Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters. PMID:26184266

Doctor-Shopping Behavior among Patients with Eye Floaters.

PubMed

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-07-13

Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.

77 FR 50157 - Agency Information Collection Activities: 30-Day Notice of Intention To Request Clearance of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

... CONTACT: Sherry Hutt, Manager, National NAGPRA Program, National Park Service, 1201 Eye Street NW., 8th..., sacred objects and objects of cultural patrimony. Museums identify NAGPRA protected items in the...

Eye health programs within remote Aboriginal communities in Australia: a review of the literature.

PubMed

Durkin, Shane R

2008-11-01

To review the literature regarding the most sustainable and culturally appropriate ways in which to implement eye health care programs within remote Aboriginal communities in Australia from a primary health care perspective. The search included letters, editorials and papers (published and unpublished) from January 1955 to April 2006. The search revealed 1,106,758 papers, books and other related material. The relevancy of this material was determined by abstract and 378 relevant articles were reviewed in their entirety. After reading the relevant articles and the interview transcripts the themes that emerged from each source were extracted. The ten areas to consider include: clinical practice and access, sustainability, regional-based programs, information technology systems, health worker training, self-determination, cultural and language barriers, funding body responsibilities, embedding specialist programs in primary care services, and other considerations. Further research needs to be undertaken within Aboriginal communities in the area of primary eye health care and barriers to the acceptance of treatment. This may be undertaken using more interactive research methods such as cooperative and narrative inquiry.

Molecular Diagnosis of an Ocular Toxocariasis Patient in Vietnam

PubMed Central

Trung, Nguyen Vu; Duyet, Le Van; Chai, Jong-Yil

2013-01-01

An ocular Toxocara canis infection is reported for the first time in Vietnam. A 34-year-old man residing in a village of Son La Province, North Vietnam, visited the National Eye Hospital (NEH) in August 2011. He felt a bulge-sticking pain in his left eye and loss of vision occurred over 3 months before visiting the hospital. The eye examination in the hospital showed damage of the left eye, red eye, retinal fibrosis, retinal detachment, inflammation of the eye tissues, retinal granulomas, and a parasitic cyst inside. A larva of Toxocara was collected with the cyst by a medical doctor by surgery. Comparison of 264 nucleotides of internal transcribed spacer 2 (ITS2) of ribosomal DNA was done between our Vietnamese Toxocara canis and other Toxocara geographical isolates, including Chinese T. canis, Japanese T. canis, Sri Lankan T. canis, and Iranian T. canis. The nucleotide homology was 97-99%, when our T. canis was compared with geographical isolates. Identification of a T. canis infection in the eye by a molecular method was performed for the first time in Vietnam. PMID:24327783

Molecular diagnosis of an ocular toxocariasis patient in Vietnam.

PubMed

Van De, Nguyen; Trung, Nguyen Vu; Duyet, Le Van; Chai, Jong-Yil

2013-10-01

An ocular Toxocara canis infection is reported for the first time in Vietnam. A 34-year-old man residing in a village of Son La Province, North Vietnam, visited the National Eye Hospital (NEH) in August 2011. He felt a bulge-sticking pain in his left eye and loss of vision occurred over 3 months before visiting the hospital. The eye examination in the hospital showed damage of the left eye, red eye, retinal fibrosis, retinal detachment, inflammation of the eye tissues, retinal granulomas, and a parasitic cyst inside. A larva of Toxocara was collected with the cyst by a medical doctor by surgery. Comparison of 264 nucleotides of internal transcribed spacer 2 (ITS2) of ribosomal DNA was done between our Vietnamese Toxocara canis and other Toxocara geographical isolates, including Chinese T. canis, Japanese T. canis, Sri Lankan T. canis, and Iranian T. canis. The nucleotide homology was 97-99%, when our T. canis was compared with geographical isolates. Identification of a T. canis infection in the eye by a molecular method was performed for the first time in Vietnam.

Eye movement control in reading unspaced text: the case of the Japanese script.

PubMed

Kajii, N; Nazir, T A; Osaka, N

2001-09-01

The present study examines the landing-site distributions of the eyes during natural reading of Japanese script: a script that mixes three different writing systems (Kanji, Hiragana, and Katakana) and that misses regular spacing between words. The results show a clear preference of the eyes to land at the beginning rather than the center of the word. In addition, it was found that the eyes land on Kanji characters more frequently than on Hiragana or Katakana characters. Further analysis for two- and three-character words indicated that the eye's landing-site distribution differs depending on type of the characters in the word: the eyes prefer to land at the word beginning only when the initial character of the word is a Kanji character. For pure Hiragana words, the proportion of initial fixations did not differ between character positions. Thus, as already indicated by Kambe (National Institute of Japanese Language Report 85 (1986) 29), the visual distinctiveness of the three Japanese scripts plays a role in guiding eye movements in reading Japanese.

Notice and Credits Page - NOAA's National Weather Service

Science.gov Websites

- Visolve is a software application (free for personal use) that transforms colors of the computer display Mac OS X 10.2 or later. (Purchase) - A 30-day free trial of eyePilot is available from eyePilot web site - http://www.colorhelper.com/ Java Java Virtual Machine - free download from java.com Adobe Reader

What do patients think about the role of optometrists in providing advice about smoking and nutrition?

PubMed

Downie, Laura E; Douglass, Amanda; Guest, Daryl; Keller, Peter R

2017-03-01

Tobacco smoking and nutrition are key lifestyle factors with long-term effects on eye health. However, little is known about patients' perceptions and experiences in these areas in relation to the care received from optometrists. The main aim was to survey patients' perceptions and prior experience regarding the role of optometrists in enquiring and providing advice about tobacco smoking and nutrition. An anonymous, paper-based survey was distributed to a convenience sample of 225 adults attending the University of Melbourne eye care clinic. Respondents provided demographic and other information (age, sex, length of time since last eye examination, country of most recent eye examination, smoking status and intake of nutritional supplements) and indicated their level of agreement (using a five-step Likert scale) with a series of statements relating to the care provided by optometrists in the areas of health, smoking and nutrition. The statements were designed to assess the perceived scope of practice of optometrists and the extent to which patients expect, and feel comfortable, discussing these issues with their optometrist. 220 completed surveys were returned. Most respondents (>80%) agreed that they visit their optometrist to quantify their refractive error and to examine their eye health. About two-thirds of respondents indicated that they expect their optometrist to ask about their general health, with almost half expecting their optometrist to communicate with their general medical practitioner. Approximately one-third of respondents indicated having been routinely questioned about their smoking status, diet and nutritional supplement intake by their optometrist. This was despite about half expecting their optometrist to question them about these factors and almost three out of four respondents indicating that they felt comfortable talking with their optometrist about these lifestyle behaviours. This study provides novel insight into patients' perceptions and experience with optometric practice in the areas of tobacco smoking and nutrition. The majority of respondents expected their optometrist to examine their eye health, ask them about their smoking and diet habits, and indicated feeling comfortable discussing these topics with their primary eye care provider. These findings suggest that brief advice interventions relating to tobacco use and diet are likely to be acceptable to deliver in optometry practice. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Causes of blindness and visual impairment in Pakistan. The Pakistan national blindness and visual impairment survey

PubMed Central

Dineen, B; Bourne, R R A; Jadoon, Z; Shah, S P; Khan, M A; Foster, A; Gilbert, C E; Khan, M D

2007-01-01

Objective To determine the causes of blindness and visual impairment in adults (⩾30 years old) in Pakistan, and to explore socio‐demographic variations in cause. Methods A multi‐stage, stratified, cluster random sampling survey was used to select a nationally representative sample of adults. Each subject was interviewed, had their visual acuity measured and underwent autorefraction and fundus/optic disc examination. Those with a visual acuity of <6/12 in either eye underwent a more detailed ophthalmic examination. Causes of visual impairment were classified according to the accepted World Health Organization (WHO) methodology. An exploration of demographic variables was conducted using regression modeling. Results A sample of 16 507 adults (95.5% of those enumerated) was examined. Cataract was the most common cause of blindness (51.5%; defined as <3/60 in the better eye on presentation) followed by corneal opacity (11.8%), uncorrected aphakia (8.6%) and glaucoma (7.1%). Posterior capsular opacification accounted for 3.6% of blindness. Among the moderately visually impaired (<6/18 to ⩾6/60), refractive error was the most common cause (43%), followed by cataract (42%). Refractive error as a cause of severe visual impairment/blindness was significantly higher in rural dwellers than in urban dwellers (odds ratio (OR) 3.5, 95% CI 1.1 to 11.7). Significant provincial differences were also identified. Overall we estimate that 85.5% of causes were avoidable and that 904 000 adults in Pakistan have cataract (<6/60) requiring surgical intervention. Conclusions This comprehensive survey provides reliable estimates of the causes of blindness and visual impairment in Pakistan. Despite expanded surgical services, cataract still accounts for over half of the cases of blindness in Pakistan. One in eight blind adults has visual loss from sequelae of cataract surgery. Services for refractive errors need to be further expanded and integrated into eye care services, particularly those serving rural populations. PMID:17229806

Radiation Protection Quantities for Near Earth Environments

NASA Technical Reports Server (NTRS)

Clowdsley, Martha S.; Wilson, John W.; Kim, Myung-Hee; Anderson, Brooke M.; Nealy, John E.

2004-01-01

As humans travel beyond the protection of the Earth's magnetic field and mission durations grow, risk due to radiation exposure will increase and may become the limiting factor for such missions. Here, the dosimetric quantities recommended by the National Council on Radiation Protection and Measurements (NCRP) for the evaluation of health risk due to radiation exposure, effective dose and gray-equivalent to eyes, skin, and blood forming organs (BFO), are calculated for several near Earth environments. These radiation protection quantities are evaluated behind two different shielding materials, aluminum and polyethylene. Since exposure limits for missions beyond low Earth orbit (LEO) have not yet been defined, results are compared to limits recommended by the NCRP for LEO operations.

GOES-S Atlas V Centaur Stage Transport from ASOC to DOC

NASA Image and Video Library

2018-01-24

Under the watchful eyes of technicians and engineers, the Centaur upper stage that will help launch NOAA's Geostationary Operational Environmental Satellite-S, or GOES-S, arrives inside the Delta Operations Center at Cape Canaveral Air Force Station for further processing. GOES-S is the second in a series of four advanced geostationary weather satellites. The GOES-R series - consisting of the GOES-R, GOES-S, GOES-T and GOES-U spacecraft - will significantly improve the detection and observation of environmental phenomena that directly affect public safety, protection of property and the nation's economic health and prosperity. GOES-S is slated to launch March 1, 2018 aboard a United Launch Alliance Atlas V rocket.

Association between eye diagnosis and positive syphilis test results in a large, urban sexually transmitted infection/primary care clinic population.

PubMed

Lobo, Ann-Marie; Gao, Yan; Rusie, Laura; Houlberg, Magda; Mehta, Supriya D

2018-03-01

In 2015, the Centers for Disease Control and Prevention (CDC) and the American Academy of Ophthalmology (AAO) released clinical advisories on rising cases of ocular syphilis. We examined the association between eye disease and syphilis infection among primary care and sexually transmitted infection (STI) clinic patients attending an urban lesbian, gay, bisexual, transgender (LGBT) health center. We conducted a retrospective medical record review of all patients who underwent syphilis testing at Howard Brown Health between 1 January 2010 and 31 December 2015. Confirmed eye diagnosis was based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes for conjunctivitis, uveitis, keratitis, retinitis, and red eye. Demographic information, syphilis treatment, HIV status, and high-risk behaviors were abstracted. Syphilis diagnosis was defined by available laboratory data (enzyme immunoassay [EIA], rapid plasma reagin [RPR] titer, fluorescent treponemal antibody absorption [FTA-Abs], Treponema pallidum Ab). Multivariable logistic regression with robust variance was used to identify independent associations. During the study period, 71,299 syphilis tests were performed on 30,422 patients. There were 2288 (3.2%) positive syphilis tests. Seventy-seven patients had a confirmed eye diagnosis (0.25%). Patients with eye disease had higher probability of at least one positive syphilis test (33%) compared to those without eye disease (8%) ( p < 0.01). Of patients with eye disease, 77% were men who had sex with men (MSM) and 65% were HIV-positive. Patients with eye disease had 5.97 (95% CI: 3.70, 9.63) higher odds of having syphilis compared to patients without eye disease. When adjusted for age, race, gender/sexual orientation, insurance status, and HIV status, this association between positive syphilis test and eye disease decreased but was still significant (OR 2.00, 95% CI 1.17, 3.41). Patients who present with an eye diagnosis to STI/primary care clinic have a higher probability of positive syphilis tests even after adjusting for other risk factors for syphilis. High-risk patients with eye symptoms should have routine STI testing and in keeping with CDC and AAO recommendations, full ophthalmologic examination.

Hyphema

MedlinePlus

... your vision. Privacy Policy Related Laser Pointers Are Still Not Toys Jun 22, 2018 Is Your Laser Pointer Dangerous Enough to Cause Eye Injury? Jun 22, 2018 Top 5 Eye Health Stories of 2017 Dec 21, 2017 Solar Eclipse Inflicts Damage in the Shape of the ...

Post-Ocular Trauma Corneal Staphyloma in a Child Living in an Underdeveloped Region of Eastern Indonesia

PubMed Central

Sitompul, Ratna; Kusumowidagdo, Gladys; Matiur, Eiko B.; Barliana, Julie D.; Sitorus, Rita S.; Sungkar, Saleha

2018-01-01

Ocular trauma occurring in children often leads to visual impairment or blindness when it is not properly managed. This often occurs in underdeveloped regions with difficult access to professional care at local health facilities. We report a case of post-trauma corneal staphyloma in an underdeveloped region of eastern Indonesia to illustrate the importance of proper management of ocular trauma in areas lacking such expertise and where patients have difficulty accessing even basic health care. During a community health outreach in Southwest Sumba, eastern Indonesia in May 2017, a 7-year-old boy presented with white protrusion of the left eye of 3 years' duration following an event of sharp trauma. The patient lived in an inaccessible and impoverished area. Upon contemporary examination, visual acuity of the left eye was 1/300 while that of the right eye was 6/6. Anterior examination revealed corneal staphyloma of the left eye, and its posterior segment could not be evaluated. The patient was transported to an eye care center in Jakarta, receiving a stock prosthesis implant while awaiting a corneal evisceration procedure with dermofat graft. Ocular trauma is one of the most common causes of visual impairment in children. This case illustrates the consequences of inadequate post-trauma management and the importance of prevention of infection. PMID:29681830

Cost-effectiveness of detecting and treating diabetic retinopathy.

PubMed

Javitt, J C; Aiello, L P

1996-01-01

To determine, from the health insurer's perspective, the cost of preventing vision loss in patients with diabetes mellitus through ophthalmologic screening and treatment and to calculate the cost-effectiveness of these interventions as compared with that of other medical interventions. Computer modeling, incorporating data from population-based epidemiologic studies and multicenter clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. Screening and treatment of eye disease in patients with diabetes mellitus costs $3190 per quality-adjusted life-year (QALY) saved. This average cost is a weighted average (based on prevalence disease) of the cost-effectiveness of detecting and treating diabetic eye disease in those with insulin-dependent diabetes mellitus ($1996 per QALY), those with non-insulin-dependent diabetes mellitus (NIDDM) who use insulin for glycemic control ($2933 per QALY), and those with NIDDM who do not use insulin for glycemic control ($3530 per QALY). Our analysis indicates that prevention programs aimed at improving eye care for diabetic persons not only result in substantial federal budgetary savings but are highly cost-effective health investments for society. Ophthalmologic screening for diabetic persons is more cost-effective than many routinely provided health interventions. Because diabetic eye disease is the leading cause of new cases of blindness among working-age Americans, these results support the widespread use of screening and treatment for diabetic eye disease.

Improving eye safety in citrus harvest crews through the acceptance of personal protective equipment, community-based participatory research, social marketing, and community health workers.

PubMed

Tovar-Aguilar, J Antonio; Monaghan, Paul F; Bryant, Carol A; Esposito, Andrew; Wade, Mark; Ruiz, Omar; McDermott, Robert J

2014-01-01

For the last 10 years, the Partnership for Citrus Workers Health (PCWH) has been an evidence-based intervention program that promotes the adoption of protective eye safety equipment among Spanish-speaking farmworkers of Florida. At the root of this program is the systematic use of community-based preventive marketing (CBPM) and the training of community health workers (CHWs) among citrus harvester using popular education. CBPM is a model that combines the organizational system of community-based participatory research (CBPR) and the strategies of social marketing. This particular program relied on formative research data using a mixed-methods approach and a multilevel stakeholder analysis that allowed for rapid dissemination, effective increase of personal protective equipment (PPE) usage, and a subsequent impact on adoptive workers and companies. Focus groups, face-to-face interviews, surveys, participant observation, Greco-Latin square, and quasi-experimental tests were implemented. A 20-hour popular education training produced CHWs that translated results of the formative research to potential adopters and also provided first aid skills for eye injuries. Reduction of injuries is not limited to the use of safety glasses, but also to the adoption of timely intervention and regular eye hygiene. Limitations include adoption in only large companies, rapid decline of eye safety glasses without consistent intervention, technological limitations of glasses, and thorough cost-benefit analysis.

Cataracts in congenital toxoplasmosis.

PubMed

Arun, Veena; Noble, A Gwendolyn; Latkany, Paul; Troia, Robert N; Jalbrzikowski, Jessica; Kasza, Kristen; Karrison, Ted; Cezar, Simone; Sautter, Mari; Greenwald, Mark J; Mieler, William; Mets, Marilyn B; Alam, Ambereen; Boyer, Kenneth; Swisher, Charles N; Roizen, Nancy; Rabiah, Peter; Del Monte, Monte A; McLeod, Rima

2007-12-01

To determine the incidence and natural history of cataracts in children with congenital toxoplasmosis. Children referred to the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS) between 1981 and 2005 were examined by ophthalmologists at predetermined times according to a specific protocol. The clinical course and treatment of patients who developed cataracts were reviewed. In the first year of life, 134 of 173 children examined were treated with pyrimethamine, sulfadiazine, and leukovorin, while the remaining 39 were not treated. Cataracts occurred in 27 eyes of 20 patients (11.6%, 95% confidence interval [7.2%, 17.3%]). Fourteen cataracts were present at birth and 13 developed postnatally. Locations of the cataracts included anterior polar (three eyes), anterior subcapsular (six eyes), nuclear (five eyes), posterior subcapsular (seven eyes), and unknown (six eyes). Thirteen cataracts were partial, nine total, and five with unknown complexity. Twelve cataracts remained stable, 12 progressed, and progression was not known for 3. Five of 27 eyes had cataract surgery, with 2 of these developing glaucoma. Sixteen eyes of 11 patients had retinal detachment and cataract. All eyes with cataracts had additional ocular lesions. In the NCCCTS cohort, 11.6% of patients were diagnosed with cataracts. There was considerable variability in the presentation, morphology, and progression of the cataracts. Associated intraocular pathology was an important cause of morbidity.

Epidemiology of Eye-Related Emergency Department Visits.

PubMed

Channa, Roomasa; Zafar, Syed Nabeel; Canner, Joseph K; Haring, R Sterling; Schneider, Eric B; Friedman, David S

2016-03-01

Determining the epidemiology of eye-related emergency department (ED) visits on a national level can assist policymakers in appropriate allocation of resources. To study ED visits related to ocular conditions for all age groups across the United States. Nationally representative data from the US Nationwide Emergency Department Sample (NEDS) were used to analyze ED visits from January 1, 2006, to December 31, 2011 (6 years). All patients with eye problems presenting to EDs across the United States were eligible for inclusion. A weighted count of 11 929 955 ED visits were categorized as possibly emergent (emergent), unlikely to be emergent (nonemergent), or could not be determined. Data were analyzed from March 1 to May 30, 2015. Population-based incidence rates of eye-related ED visits, incidence rates of eye injuries, relative proportions of emergent vs nonemergent eye-related ED visits among different age groups, and independent factors associated with emergent vs nonemergent visits. From 2006 to 2011, 11 929 955 ED visits (male patients, 54.2%; mean [SD] age, 31 [22] years) for ocular problems across the United States were categorized as emergent (41.2%), nonemergent (44.3%), or could not determine (14.5%). Corneal abrasions (13.7%) and foreign body in the external eye (7.5%) were the leading diagnoses in the emergent category. More than 4 million visits were for conjunctivitis (28.0%), subconjunctival hemorrhages (3.0%), and styes (3.8%). Emergent visits were significantly more likely to occur among males (odds ratio [OR], 2.00; 95% CI, 2.00-2.01), patients in the highest income quartile (OR, 1.47; 95% CI, 1.46-1.49), older patients (OR, 2.38; 95% CI, 2.38-2.44), and patients with private insurance (OR, 1.29; 95% CI, 1.28-1.30). Mean annual inflation-adjusted charges for all eye-related ED visits totaled $2.0 billion. Across the United States, nonemergent conditions accounted for almost half of all eye-related ED visits. Interventions to facilitate management of these cases outside the ED could make ED resources more available for truly emergent ophthalmic and medical issues.

Visualization of semantic relations in geosicences

NASA Astrophysics Data System (ADS)

Ritschel, Bernd; Pfeiffer, Sabine; Mende, Vivien

2010-05-01

The discovery of semantic relations related to the content and context of scientific geophysical and geodetic data and information is a fundamental concept for an integrated scientific approach for the research of multidisciplinary and complex questions of the permanent changing Earth system. Large high-quality and multi-domain geosciences datasets which are qualified by significant and standardized metadata describing the content and especially the context of the data are suitable for the search and discovery of semantic relations. Nowadays such data collections are ingested and provided by many national and international geoscientific data centers, such as e.g. the GFZ ISDC(1). Beside automatic and machine-based algorithm for the discovery of semantic relations, the graphical visualization of such relations are extremely capable for scientist in order to analyze complex datasets and to find sophisticated relations as well as for the public in order to understand the relations within geosciences and between geosciences and societal domains. There are different tools for the visualization of relations, especially in the object-oriented based analysis and development of systems and software. The tool eyePlorer(2) is an awarded program for the visualization of multi-domain semantic relations in the public world of Wikipedia. The data and information for the visualization of keyword based terms and concepts within one domain or topic as well as the relations to other topics are mainly based on wiki content and appropriate structures. eyePlorer's main topics structured and combined in super topics are Health, Species and Life Sciences, Persons and Organisations, Work and Society, Science & Technology as well as Time and Places. Considering the domains or topics of the conceptual model of the GFZ ISDC's data collection, such topics as geosciences-related project, platform, instrument, product type, publication and institution as well as space and time are disjunct and complement sets or subsets or intersections of eyePlorer's topics. The introduction of new topics and the enhancement of the conceptual data model of the eyePlorer as well as the transformation of GFZ ISDC's metadata into a wiki structure or into eyePlorer's internal data format are necessary for the use in eyePlorer for the visualization of geosciences and societal relations based on both, the Wikipedia information collection and the GFZ ISDC metadata. This paper deals with the analysis of eyePlorer's and GFZ ISDC's concepts for the creation of an integrated conceptual model. Furthermore, the transformation model for the conversion of ISDC's metadata into appropriate structures for the use of eyePlorer is described. Finally, the process of semantic visualization of geosciences and societal relations within eyePlorer and using eyePlorer's GUI are illustrated on a climate research related example which is capable to generate knowledge not only for geoscientists but also for the public. (1) GFZ ISDC: GFZ Information System and Data Center, http://isdc.gfz-potsdam.de (2) eyePlorer: http://en.eyeplorer.com/show/

Psychometric performance of the National Eye Institute visual function questionnaire in Latinos and non-Latinos.

PubMed

Baker, Richard S; Bazargan, Mohsen; Calderón, José L; Hays, Ron D

2006-08-01

To compare the psychometric performance of Spanish versions of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the NEI VFQ-39 administered to Latino patients with the psychometric performance of the standard English NEI VFQ-25 and NEI VFQ-39 administered to non-Latino patients. Clinic-based cross-sectional survey. Four hundred three patients (160 Latinos and 243 non-Latinos) recruited from general ophthalmology clinics of an urban public hospital over a 6-month period. Structured face-to-face interviews were conducted in Spanish and English to collect data for the NEI VFQ-25 and NEI VFQ-39. We calculated the mean, standard deviation, and percentage of participants having the minimum (floor) and maximum (ceiling) possible score for each item and scale. Internal consistency reliability of the NEI VFQ-25 and NEI VFQ-39 was estimated using the Cronbach alpha and average inter-item correlation. Construct validity for the instruments was assessed by comparing scores for participants classified as having normal versus impaired visual acuity. Instrument scales for general health; general vision; ocular pain; near activities; distance activities; vision-specific social functioning, mental health, role difficulties, and dependency; driving; color vision; and peripheral vision. Internal consistency reliability was significantly lower in the Spanish version than in the English version for 3 scales of the NEI VFQ-25. More importantly, 3 scales in the Spanish version manifested inadequate reliability (alpha< or =0.70), compared with only 1 inadequately reliable subscale in the English version. Reliability coefficients associated with the Spanish NEI VFQ-39 scales exceeded commonly accepted minimum standards. Comparison of reliability coefficients between Latino and non-Latino subgroups demonstrated statistically significant differences for 4 scales: Ocular Pain, Mental Health, Role Difficulties, and Dependency. In each case, the Latino group had the lower internal consistency reliability. However, only for the Ocular Pain subscale was reliability both significantly lower and inadequate (alpha<0.70). Overall performance of the NEI VFQ in Latino populations is adequate. However, in the absence of modifications to improve the reliability of specific Spanish version subscales, comparisons between Latino and non-Latino subgroups using the NEI VFQ must be interpreted with appropriate caution.

The Impact of the Medicare-Eligible Retiree Health Care Fund on Navy Military Treatment Facilities’ Demand-to-Capacity Solution

DTIC Science & Technology

2012-03-01

Physical Therapy, Optometry, Audiology, Tele-Dermatology and Eyes, Nose & Throat (ENT); (3) Dental Care, i.e., General Dentistry , Oral Surgery...Physical Therapy, Chiropractic, Optometry, Audiology, Public Health and Eyes, Nose & Throat (ENT); (3) Dental Care, including General Dentistry ...guidelines. Version 3.2. Unified biostatistical utility. Retrieved September 14, 2010, from http://www.dtic.mil/whs/directives/corres/pdf/601517p.pdf

Ocular Health (OH) Fundoscope Exam

NASA Image and Video Library

2013-06-05

ISS036-E-006520 (5 June 2013) --- NASA astronaut Karen Nyberg, Expedition 36 flight engineer, conducts an ocular health exam on herself in the Destiny laboratory of the Earth-orbiting International Space Station. NASA astronaut Chris Cassidy, flight engineer, nearby but out of frame, assisted in the testing, part of a suite of eye exams carried out over a two-day period on various crew members to gather information on intraocular pressure and eye anatomy.

[Energy saving and LED lamp lighting and human health].

PubMed

Deĭnego, V N; Kaptsov, V A

2013-01-01

The appearance of new sources of high-intensity with large proportion of blue light in the spectrum revealed new risks of their influence on the function of the eye and human health, especially for children and teenagers. There is an urgent need to reconsider the research methods of vision hygiene in conditions of energy-saving and LED bulbs lighting. On the basis of a systematic approach and knowledge of the newly discovered photosensitive receptors there was built hierarchical model of the interaction of "light environment - the eye - the system of formation of visual images - the hormonal system of the person - his psycho-physiological state." This approach allowed us to develop a range of risk for the negative impact of spectrum on the functions of the eye and human health, as well as to formulate the hygiene requirements for energy-efficient high-intensity light sources.

Fundus autofluorescence patterns in primary intraocular lymphoma.

PubMed

Casady, Megan; Faia, Lisa; Nazemzadeh, Maryam; Nussenblatt, Robert; Chan, Chi-Chao; Sen, H Nida

2014-02-01

To evaluate fundus autofluorescence (FAF) patterns in patients with primary intraocular (vitreoretinal) lymphoma. Records of all patients with primary intraocular lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were evaluated with respect to clinical disease status and the findings on fluorescein angiography and spectral-domain optical coherence tomography. There were 18 eyes (10 patients) with primary intraocular lymphoma that underwent FAF imaging. Abnormal autofluorescence in the form of granular hyperautofluorescence and hypoautofluorescence was seen in 11 eyes (61%), and blockage by mass lesion was seen in 2 eyes (11%). All eyes with granular pattern on FAF had active primary intraocular lymphoma at the time of imaging, but there were 5 eyes with unremarkable FAF, which were found to have active lymphoma. The most common pattern on fluorescein angiography was hypofluorescent round spots with a "leopard spot" appearance (43%). These hypofluorescent spots on fluorescein angiography correlated with hyperautofluorescent spots on FAF in 5 eyes (36%) (inversion of FAF). Nodular hyperreflective spots at the level of retinal pigment epithelium on optical coherence tomography were noted in 43% of eyes. The hyperautofluorescent spots on FAF correlated with nodular hyperreflective spots on optical coherence tomography in 6 eyes (43%). Granularity on FAF was associated with active lymphoma in majority of the cases. An inversion of FAF (hyperautofluorescent spots on FAF corresponding to hypofluorescent spots on fluorescein angiography) was observed in less than half of the eyes.

Oral antioxidant therapy for marginal dry eye.

PubMed

Blades, K J; Patel, S; Aidoo, K E

2001-07-01

To assess the efficacy of an orally administered antioxidant dietary supplement for managing marginal dry eye. A prospective, randomised, placebo controlled trial with cross-over. Eye Clinic, Department of Vision Sciences, Glasgow Caledonian University. Forty marginal dry eye sufferers composed of 30 females and 10 males (median age 53 y; range 38-69 y). Baseline assessments were made of tear volume sufficiency (thread test), tear quality (stability), ocular surface status (conjunctival impression cytology) and dry eye symptoms (questionnaire). Each subject was administered courses of active treatment, placebo and no treatment, in random order for 1 month each and results compared to baseline. Tear stability and ocular surface status were significantly improved following active treatment (P<0.05). No changes from baseline were detected following administration of placebo and no treatment (P>0.05). Absolute increase in tear stability correlated with absolute change in goblet cell population density. Tear volume was not improved following any treatment period and dry eye symptom responses were subject to placebo effect. Oral antioxidants improved both tear stability and conjunctival health, although it is not yet understood whether increased ocular surface health mediates increased tear stability or vice versa. This study was supported by a PhD scholarship funded by the Department of Vision Sciences, Glasgow Caledonian University, Scotland. Antioxidant supplements and placebos were kindly donated by Vitabiotics.

Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema.

PubMed

Kiss, Szilárd; Chandwani, Hitesh S; Cole, Ashley L; Patel, Vaishali D; Lunacsek, Orsolya E; Dugel, Pravin U

2016-01-01

To examine the comorbidity profile and update estimates of health care resource utilization for commercially insured, working-age adults with diabetic macular edema (DME) relative to a matched comparison group of diabetic adults without DME. Additional comparisons were made in the subgroup of pseudophakic patients. A retrospective matched-cohort study of commercially insured diabetic adults aged 18-63 years was conducted using medical and outpatient pharmacy claims (July 1, 2008-June 30, 2013). Outcomes included diabetes-related and ocular comorbidities and health care resource utilization (any health care visit days, outpatient visit days, inpatient visit days, emergency room visits, eye care-related visit days, unique medications) in the 12-month post-index period. All diabetes-related and ocular comorbidities were significantly more prevalent in DME cases versus non-DME controls ( P <0.05). A significantly greater proportion of DME cases utilized eye care-related visits compared with non-DME controls ( P <0.001). DME cases had almost twice the mean number of total health care visit days compared to non-DME controls (28.6 vs 16.9 days, P <0.001), with a minority of visit days being eye care-related (mean 5.1 vs 1.5 days, P <0.001). Similar trends were observed in pseudophakic cohorts. This working-age DME population experienced a mean of 29 health care visit days per year. Eye care-related visit days were a minority of the overall visit burden (mean 5 days) emphasizing the trade-offs DME patients face between managing DME and their overall diabetic disease. Insights into the complex comorbidity profile and health care needs of diabetic patients with DME will better inform treatment decisions and help optimize disease management.

Goal-directed visual attention drives health goal priming: An eye-tracking experiment.

PubMed

van der Laan, Laura N; Papies, Esther K; Hooge, Ignace T C; Smeets, Paul A M

2017-01-01

Several lab and field experiments have shown that goal priming interventions can be highly effective in promoting healthy food choices. Less is known, however, about the mechanisms by which goal priming affects food choice. This experiment tested the hypothesis that goal priming affects food choices through changes in visual attention. Specifically, it was hypothesized that priming with the dieting goal steers attention toward goal-relevant, low energy food products, which, in turn, increases the likelihood of choosing these products. In this eye-tracking experiment, 125 participants chose between high and low energy food products in a realistic online supermarket task while their eye movements were recorded with an eye-tracker. One group was primed with a health and dieting goal, a second group was exposed to a control prime, and a third group was exposed to no prime at all. The health goal prime increased low energy food choices and decreased high energy food choices. Furthermore, the health goal prime resulted in proportionally longer total dwell times on low energy food products, and this effect mediated the goal priming effect on choices. The findings suggest that the effect of priming on consumer choice may originate from an increase in attention for prime-congruent items. This study supports the effectiveness of health goal priming interventions in promoting healthy eating and opens up directions for research on other behavioral interventions that steer attention toward healthy foods. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Prevalence of Adult Vision Impairment and Age-Related Eye Diseases in America

MedlinePlus

... is to “conduct and support research, training, health information dissemination, and other programs with respect to blinding eye ... Media Policies and Other Important Links NEI Employee Emergency Information NEI Intranet (Employees Only) *PDF files require ...

Twenty-five-gauge vitrectomy versus 23-gauge vitrectomy in the management of macular diseases: a comparative analysis through a Health Technology Assessment model.

PubMed

Grosso, Andrea; Charrier, Lorena; Lovato, Emanuela; Panico, Claudio; Mariotti, Cesare; Dapavo, Giancarlo; Chiuminatto, Roberto; Siliquini, Roberta; Gianino, Maria Michela

2014-04-01

Small-gauge vitreoretinal techniques have been shown to be safe and effective in the management of a wide spectrum of vitreoretinal diseases. However, the costs of the new technologies may represent a critical issue for national health systems. The aim of the study is to plan a Health Technology Assessment (HTA) by performing a comparative analysis between the 23- and 25-gauge techniques in the management of macular diseases (epiretinal membranes, macular holes, vitreo-macular traction syndrome). In this prospective study, 45-80-year-old patients undergoing vitrectomy surgery for macular disease were enrolled at the Torino Eye Hospital. In the HTA model we assessed the safety, clinical effectiveness, and cost and financial evaluation of 23-gauge compared with 25-gauge vitrectomies. Fifty patients entered the study; 14 patients underwent 23-gauge vitrectomy and 36 underwent 25-gauge vitrectomy. There was no statistically significant difference in post-operative visual acuity at 1 year between the two groups. No cases of retinal detachment or endophtalmitis were registered at 1-year follow-up. The 23-gauge technique was slightly more expensive than the 25-gauge: the total surgical costs were EUR1217.70 versus EUR1164.84 (p = 0.351). We provide a financial comparison between new vitreoretinal procedures recently introduced in the market and reimbursed by the Italian National Health System and we also stimulate a critical debate about the expensive technocratic model of medicine.

Epidemiology of hereditary ocular disorders.

PubMed

Rosenberg, Thomas

2003-01-01

Molecular genetic evidence has contributed significantly to the understanding of the fundamental molecular biology of the eye in health and disease, but it has also exposed the inadequacy of our traditional clinically based classification of hereditary eye disorders by unravelling significant genetic non-allelic heterogeneity in many eye disorders. Furthermore, our understanding of the epidemiology of hereditary ocular disorders has gained considerably by the establishment of mutation spectra in a rapidly growing number of monogenic eye disorders. In this overview, special emphasis has been put on the growing impact of genetic eye diseases in visual impairment, genetic heterogeneity, and the role of founder mutations for the skewed appearance of certain hereditary ocular disorders in some populations.

Childhood blindness in the context of VISION 2020--the right to sight.

PubMed Central

Gilbert, C.; Foster, A.

2001-01-01

The major causes of blindness in children vary widely from region to region, being largely determined by socioeconomic development, and the availability of primary health care and eye care services. In high-income countries, lesions of the optic nerve and higher visual pathways predominate as the cause of blindness, while corneal scarring from measles, vitamin A deficiency, the use of harmful traditional eye remedies, and ophthalmia neonatorum are the major causes in low-income countries. Retinopathy of prematurity is an important cause in middle-income countries. Other significant causes in all countries are cataract, congenital abnormalities, and hereditary retinal dystrophies. It is estimated that, in almost half of the children who are blind today, the underlying cause could have been prevented, or the eye condition treated to preserve vision or restore sight. The control of blindness in children is a priority within the World Health Organization's VISION 2020 programme. Strategies need to be region specific, based on activities to prevent blindness in the community--through measles immunization, health education, and control of vitamin A deficiency--and the provision of tertiary-level eye care facilities for conditions that require specialist management. PMID:11285667

36 CFR § 1280.8 - May I bring a seeing-eye dog or other assistance animal?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true May I bring a seeing-eye dog or other assistance animal? § 1280.8 Section § 1280.8 Parks, Forests, and Public Property NATIONAL... dog or other assistance animal? Yes, persons with disabilities may bring guide dogs or other animals...

A national survey of psychosocial job stressors and their implications for health among working people in Taiwan.

PubMed

Cheng, Y; Guo, Y L; Yeh, W Y

2001-09-01

The prevalence of job stress, distributions of major job stressors, and the associations of job stress with multiple self-reported health complaints were examined in a national survey conducted in 1994 in Taiwan. A total of 9,746 men and 5,599 women who were employed at the time of the survey and aged between 25 and 65-years were studied. Information on employment status, perceived level of job stress, major job stressors, and health complaints were obtained by a self-administered questionnaire. Overall, 7.6% of men and 6.5% of women reported often or always feeling very stressed at work. Higher levels of perceived job stress were found among subjects who were younger, with higher education level, working in a larger firm, working for longer hours per week, and who were administrators or managers. Problems with individual job content were ranked as the most important job stressor in men across all employment categories and in most women. Other major job stressors included problems with monetary rewards and lack of career prospects. The patterns of major job stressors appear to vary by employment grade and by gender. After adjustment for age and education, employees who perceived higher levels of job stress had significantly increased risks of multiple health problems, including strained eyes, ringing ears, chronic cough with phlegm, chest tightness. stomach problems, headache, and musculoskeletal discomfort. These results suggest that psychosocial stress in the workplace has profound impacts on health. This study identified high-risk groups and major types of job stressors for further investigation.

[Emphasis on standardization and refinement in the diagnosis and treatment of dry eye].

PubMed

Liu, Z G

2017-09-11

Dry eye is the second most common ocular disease. In China, the incidence rate of dry eye has reached 21% to 30%, and dry eye patients have accounted for more than 30% of the total ophthalmology outpatients. Dry eye has become a common health problem that affects the working efficiency and life quality of Chinese people. Over the past decade, due to the rapid development of diagnostic equipments and new treatments for dry eye, dry eye has become one of the areas with greatest concerns in ophthalmology, and many eye institutions have set up their dry eye clinics. Although the diagnosis and treatment of dry eye has been improved in recent years, the awareness of dry eye in Chinese ophthalmologists is still too simple. In the diagnosis, the interrogation and basic examination are not given enough attention, and we are over-relying on equipments. Clinical examination and instrument operation also have not been standardized. This article emphasizes that we should pay attention to the interrogation, basic examination and standardization of clinical examination and equipment operation in diagnosing dry eye. The treatment regimen should be mostly refined and optimized to be individualized and comprehensive based on the causes, types and severity of dry eye. In addition, the physical and adjuvant therapy of dry eye should be given sufficient attention and applied reasonably. (Chin J Ophthalmol, 2017, 53: 641-644) .

How lay people understand and make sense of personalized disease risk information.

PubMed

Damman, Olga C; Bogaerts, Nina M M; van den Haak, Maaike J; Timmermans, Danielle R M

2017-10-01

Disease risk calculators are increasingly web-based, but previous studies have shown that risk information often poses problems for lay users. To examine how lay people understand the result derived from an online cardiometabolic risk calculator. A qualitative study was performed, using the risk calculator in the Dutch National Prevention Program for cardiometabolic diseases. The study consisted of three parts: (i) attention: completion of the risk calculator while an eye tracker registered eye movements; (ii) recall: completion of a recall task; and (iii) interpretation: participation in a semi-structured interview. We recruited people from the target population through an advertisement in a local newspaper; 16 people participated in the study, which took place in our university laboratory. Eye-tracking data showed that participants looked most extensively at numerical risk information. Percentages were recalled well, whereas natural frequencies and verbal labels were remembered less well. Five qualitative themes were derived from the interview data: (i) numerical information does not really sink in; (ii) the verbal categorical label made no real impact on people; (iii) people relied heavily on existing knowledge and beliefs; (iv) people zoomed in on risk factors, especially family history of diseases; and (v) people often compared their situation to that of their peers. Although people paid attention to and recalled the risk information to a certain extent, they seemed to have difficulty in properly using this information for interpreting their risk. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

The Criteria People Use in Relevance Decisions on Health Information: An Analysis of User Eye Movements When Browsing a Health Discussion Forum.

PubMed

Pian, Wenjing; Khoo, Christopher Sg; Chang, Yun-Ke

2016-06-20

People are increasingly accessing health-related social media sites, such as health discussion forums, to post and read user-generated health information. It is important to know what criteria people use when deciding the relevance of information found on health social media websites, in different situations. The study attempted to identify the relevance criteria that people use when browsing a health discussion forum, in 3 types of use contexts: when seeking information for their own health issue, when seeking for other people's health issue, and when browsing without a particular health issue in mind. A total of 58 study participants were self-assigned to 1 of the 3 use contexts or information needs and were asked to browse a health discussion forum, HealthBoards.com. In the analysis, browsing a discussion forum was divided into 2 stages: scanning a set of post surrogates (mainly post titles) in the summary result screen and reading a detailed post content (including comments by other users). An eye tracker system was used to capture participants' eye movement behavior and the text they skim over and focus (ie, fixate) on during browsing. By analyzing the text that people's eyes fixated on, the types of health information used in the relevance judgment were determined. Post-experiment interviews elicited participants' comments on the relevance of the information and criteria used. It was found that participants seeking health information for their own health issue focused significantly more on the poster's symptoms, personal history of the disease, and description of the disease (P=.01, .001, and .02). Participants seeking for other people's health issue focused significantly more on cause of disease, disease terminology, and description of treatments and procedures (P=.01, .01, and .02). In contrast, participants browsing with no particular issue in mind focused significantly more on general health topics, hot topics, and rare health issues (P=.01, .01, and .01). Users browsing for their own health issues used mainly case-based relevance criteria to relate the poster's health situation to their own. Participants seeking for others' issues used mostly general knowledge-based criteria, whereas users with no particular issue in mind used general interest- and curiosity-based criteria.

The Criteria People Use in Relevance Decisions on Health Information: An Analysis of User Eye Movements When Browsing a Health Discussion Forum

PubMed Central

Khoo, Christopher SG; Chang, Yun-Ke

2016-01-01

Background People are increasingly accessing health-related social media sites, such as health discussion forums, to post and read user-generated health information. It is important to know what criteria people use when deciding the relevance of information found on health social media websites, in different situations. Objective The study attempted to identify the relevance criteria that people use when browsing a health discussion forum, in 3 types of use contexts: when seeking information for their own health issue, when seeking for other people’s health issue, and when browsing without a particular health issue in mind. Methods A total of 58 study participants were self-assigned to 1 of the 3 use contexts or information needs and were asked to browse a health discussion forum, HealthBoards.com. In the analysis, browsing a discussion forum was divided into 2 stages: scanning a set of post surrogates (mainly post titles) in the summary result screen and reading a detailed post content (including comments by other users). An eye tracker system was used to capture participants’ eye movement behavior and the text they skim over and focus (ie, fixate) on during browsing. By analyzing the text that people’s eyes fixated on, the types of health information used in the relevance judgment were determined. Post-experiment interviews elicited participants’ comments on the relevance of the information and criteria used. Results It was found that participants seeking health information for their own health issue focused significantly more on the poster’s symptoms, personal history of the disease, and description of the disease (P=.01, .001, and .02). Participants seeking for other people’s health issue focused significantly more on cause of disease, disease terminology, and description of treatments and procedures (P=.01, .01, and .02). In contrast, participants browsing with no particular issue in mind focused significantly more on general health topics, hot topics, and rare health issues (P=.01, .01, and .01). Conclusion Users browsing for their own health issues used mainly case-based relevance criteria to relate the poster's health situation to their own. Participants seeking for others’ issues used mostly general knowledge–based criteria, whereas users with no particular issue in mind used general interest– and curiosity-based criteria. PMID:27323893

Biocompatibility of poloxamer hydrogel as an injectable intraocular lens: a pilot study.

PubMed

Kwon, Ji Won; Han, Young Keun; Lee, Woo Jin; Cho, Chong Su; Paik, Seung Joon; Cho, Dong Il; Lee, Jin Hak; Wee, Won Ryang

2005-03-01

To induce irreversible gelation of poloxamer, a thermosensitive polymer hydrogel, by using a photoinitiator and ultraviolet (UV) irradiation and to verify the biocompatibility and use of poloxamer as an injectable intraocular lens (IOL) material. Department of Ophthalmology, Seoul National University College of Medicine, Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea. In 10 rabbits, endocapsular phacoemulsification was performed and a poloxamer-photoinitiator mixture was injected into the capsular bag through a small capsulorhexis site. In 1 eye, the capsulorhexis site was closed with a small plug and the entire eye was irradiated with UV light for 5 minutes. Postoperatively, poloxamer transparency and effect on the conjunctiva, cornea, iris, vitreous, and retina were observed. A mixture comprising 25% poloxamer and 0.01% photoinitiator produced a poloxamer that remained transparent in the lens capsule for up to 6 months. No inflammatory response or toxicity was observed in the conjunctiva, cornea, iris, vitreous, or retina. Poloxamer is a potentially suitable material for an injectable IOL. Further study is needed.

Minimum visual requirements in different occupations in Finland.

PubMed

Aine, E

1984-01-01

In Finland the employers can individually fix the minimum visual requirements for their personnel in almost every occupation. In transportation, in police and national defence proper eyesight is regarded so important that strict visual requirements for these have been fixed by the Government. The regulations are often more close when accepting the person to the occupation than later on when working. The minimum requirements are mostly stated for visual acuity, colour perception and visual fields. In some occupations the regulations concern also the refractive error of the eyes and possible eye diseases. In aviation the regulations have been stated by the International Civil Aviation Organization ( ICAO ). The minimum visual requirements for a driving license in highway traffic are classed according to the types of motor vehicles. In railways , maritime commerce and national defence the task of the worker determines the specified regulations. The policeman must have a distant visual acuity of 0.5 without eyeglasses in both eyes and nearly normal colour perception when starting the training course.

East London's Homeless: a retrospective review of an eye clinic for homeless people.

PubMed

D'Ath, Penny J; Keywood, Laura J; Styles, Elaine C; Wilson, Clare M

2016-02-16

There is very little published work on the visual needs of homeless people. This paper is the first study to investigate the visual needs of homeless people in the UK. Although similar work has been done in other countries, this study is unique because the United Kingdom is the only country with a National Health Service which provides free healthcare at the point of access. This study analysed the refractive status of the sample used, determined the demographics of homeless people seeking eye care and established if there is a need for community eye health with access to free spectacle correction in East London. This retrospective case study analysed the clinical records of 1,141 homeless people using the Vision Care for Homeless People services at one of their clinics in East London. All eye examinations were carried out by qualified optometrists and, where appropriate, spectacles were dispensed to patients. Data captured included age, gender, ethnicity and refractive error. Results were analysed using two-sample t-tests with Excel and Minitab. Demographics of age, gender and ethnicity are described. Spherical equivalents (SE) were calculated from prescription data available for 841 clinic users. Emmetropia was defined as SE-0.50DS to +1DS, myopia as SE < -0.50DS, and hyperopia as SE > +1DS. The majority of clinic users were male (79.2 %, n = 923). Approximately 80 % (n = 583) of clinic users were white, 10 % (n = 72) were 'black', 4 % (n = 29) 'Asian' and the remaining 5.6 % (n = 40) were of 'mixed ethnicity' and 'other' groups. The mean age of females attending the clinic was significantly lower than that of males (45.9 years, SD = 13.8 vs' 48.4 years, SD = 11.8) when analysed using a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were aged between 50-59 years. Myopia and hyperopia prevalence rates were 37.0 % and 21.0 % respectively. A total of 34.8 % of homeless people were found to have uncorrected refractive error, and required spectacle correction. This study has identified a high proportion of uncorrected refractive error in this sample and therefore a need for regular eye examinations and provision of refractive correction for homeless people.

Sexual Violence: Psychiatric Healing With Eye Movement Reprocessing and Desensitization

PubMed Central

POSMONTIER, BOBBIE; DOVYDAITIS, TIFFANY; LIPMAN, KENNETH

2011-01-01

Sexual violence, which affects one in three women worldwide, can result in significant psychiatric morbidity and suicide. Eye movement desensitization and reprocessing (EMDR) offers health care providers the option of a brief psychiatric intervention that can result in psychiatric healing in as few as four sessions. Because health care providers often hear stories of sexual violence from their patients, they are in an ideal position to make recommendations for treatment. The purpose of this article is to introduce health care providers to the technique of EMDR, review safety and appropriateness, and discuss clinical and research implications. PMID:20623397

Vision related quality of life in patients with type 2 diabetes in the EUROCONDOR trial.

PubMed

Trento, Marina; Durando, Olga; Lavecchia, Sonia; Charrier, Lorena; Cavallo, Franco; Costa, Miguel Angelo; Hernández, Cristina; Simó, Rafael; Porta, Massimo

2017-07-01

To evaluate vision related quality of life in the patients enrolled in The European Consortium for the Early Treatment of Diabetic Retinopathy, a clinical trial on prevention of diabetic retinopathy. Four-hundred-forty-nine patients, 153 women, with type 2 Diabetes and no or mild diabetic retinopathy were enrolled in a 2-year multicenter randomized controlled trial. The 25-item National Eye Institute Visual Functioning Questionnaire was used to explore 12 subscales of vision related quality of life. The patients were 62.8 ± 6.7 years old and had 11.1 ± 5.6 years known disease duration. Diabetic retinopathy was absent in 193 (43.0 %) and mild in 256 (57.0 %). Patients without diabetic retinopathy were older, had shorter diabetes duration and used less insulin and glucose-lowering agents but did not differ by gender, best corrected visual acuity or any subscale, except vision specific mental health and vision specific role difficulties. Patients with reduced retinal thickness at the ganglion cell layer (n = 36) did not differ for diabetic retinopathy but were older, had lower best corrected visual acuity and worse scores for ocular pain, color vision and peripheral vision. On multivariable analysis, worse scores for general vision remained associated with reduced retinal thickness, diabetes duration and best corrected visual acuity, and scores for visual specific mental health with diabetic retinopathy and lower best corrected visual acuity. Visual specific role difficulties were only associated with reduced best corrected visual acuity. Scores for driving decreased among females, with worsening of Hemoglobin A1c and best corrected visual acuity. Color vision depended only on reduced retinal thickness, and peripheral vision on both reduced thickness and best corrected visual acuity. The National Eye Institute Visual Functioning Questionnaire could detect subtle changes in patients' perception of visual function, despite absent/minimal diabetic retinopathy.

Ocular manifestations of xeroderma pigmentosum: long term follow-up highlights the role of DNA repair in protection from sun damage

PubMed Central

Brooks, Brian P; Thompson, Amy H; Bishop, Rachel J; Clayton, Janine A; Chan, Chi-Chao; Tsilou, Ekaterini T; Zein, Wadih M; Tamura, Deborah; Khan, Sikandar G.; Ueda, Takahiro; Boyle, Jennifer; Oh, Kyu-Seon; Imoto, Kyoko; Inui, Hiroki; Moriwaki, Shin-Ichi; Emmert, Steffen; Iliff, Nicholas T.; Bradford, Porcia; DiGiovanna, John J.; Kraemer, Kenneth H

2013-01-01

Objective Xeroderma pigmentosum (XP) is a rare autosomal recessive disease caused by mutations in DNA repair genes. Clinical manifestations of XP include mild to extreme sensitivity to ultraviolet radiation resulting in inflammation and neoplasia in sun-exposed areas of the skin, mucous membranes, and ocular surfaces. This report describes the ocular manifestations of XP in patients systematically evaluated in the Clinical Center at the National Institutes of Health. Design Retrospective Observational Case Series Participants Eighty-seven participants, aged 1.3 to 63.4 years, referred to the National Eye Institute for examination from 1964 to 2011. Eighty-three had XP, 3 had XP/Cockayne Syndrome complex, and 1 had XP/trichothiodystrophy complex. Methods Complete, age- and developmental stage-appropriate ophthalmic examination. Main Outcome Measures Visual acuity; eyelid, ocular surface and lens pathology; tear film and tear production measures; and cytological analysis of conjunctival surface swabs. Results Of the 87 patients, 91% had at least one ocular abnormality. The most common abnormalities were conjunctivitis (51%), corneal neovascularization (44%), dry eye (38%), corneal scarring (26%), ectropion (25%), blepharitis (23%), conjunctival melanosis (20%), and cataracts (14%). Thirteen percent of patients had some degree of visual axis impingement and 5% had no light perception in one or both eyes. Ocular surface cancer or a history of ocular surface cancer was present in 10% of patients. Patients with an acute sunburning skin phenotype were less likely to develop conjunctival melanosis and ectropion but more likely to develop neoplastic ocular surface lesions than non-burning patients. Some patients also showed signs of limbal stem cell deficiency. Conclusions Our longitudinal study reports the ocular status of the largest group of XP patients systematically examined at one facility over an extended period of time. Structural eyelid abnormalities, neoplasms of the ocular surface and eyelids, tear film and tear production abnormalities, ocular surface disease and inflammation, as well as corneal abnormalities were present in this population. Burning and non-burning XP patients exhibit different rates of important ophthalmologic findings, including neoplasia. Additionally, ophthalmic characteristics can help refine diagnoses in the case of XP complex phenotypes. DNA repair plays major role in protection of the eye from sunlight induced damage. PMID:23601806

Septic safe interactions with smart glasses in health care.

PubMed

Czuszynski, K; Ruminski, J; Kocejko, T; Wtorek, J

2015-08-01

In this paper, septic safe methods of interaction with smart glasses, due to the health care environment applications consideration, are presented. The main focus is on capabilities of an optical, proximity-based gesture sensor and eye-tracker input systems. The design of both interfaces is being adapted to the open smart glasses platform that is being developed under the eGlasses project. Preliminary results obtained from the proximity sensor show that the recognition of different static and dynamic hand gestures is promising. The experiments performed for the eye-tracker module shown the possibility of interaction with simple Graphical User Interface provided by the near-to-eye display. Research leads to the conclusion of attractiveness of collaborative interfaces for interaction with smart glasses.

Research to Improve Emotional Health and Quality of Life Among Service Members with Disabilities (RESTORE LIVES)

DTIC Science & Technology

2012-10-01

and Eye Movement Desensitization and Reprocessing ( EMDR ) which lead to clinically improved outcomes in...that uses eye movements and is designed to be brief (i.e. 1-5 treatment sessions). • By use of a randomized controlled trial, to evaluate ART versus...as to specific therapeutic role of eye movements , and 3-month follow-up results (sustainability) are pending. • Given short treatment duration

Eye health seeking habits and barriers to accessing curative services among blind beggars in an urban community in Northern Nigeria.

PubMed

Balarabe, Aliyu Hamza; Hassan, Ramatu; Fatai, Olatunji O

2014-01-01

The aim of the following study was to determine the types of intervention sought by the blind street beggars and assess the barriers to accessing available eye care services. This cross-sectional study was conducted among consenting blind street beggars in Sokoto, Nigeria between May and June, 2009. A semi-structured interview was conducted to probe issues on historical antecedents of the blindness and the eye heath seeking behavior including the use of traditional eye medications. Assessment of barriers to accessing curative services among the blind persons was explored. Questions were asked and the individual responses were recorded in the questionnaire under the appropriate sections. Two hundred and two of 216 (94.7%) of the examined subjects were found to be blind and included in the analysis. The principal cause of blindness was corneal opacity. Overall 82% of the blindness was due to avoidable causes with majority irreversibly blind. Only 38 subjects (18.8%) sought for intervention in hospitals, others resorted to self-medication (42.1%), medicine store (31.2%) and traditional facility (7.9%). Those that accessed treatment at a hospital did so mainly at a primary health center (50.0%) and General Hospitals (34.2%). The barriers to accessing treatment at the hospital were mainly due to "not taken to any hospital" by the parents/relatives (50.3%) and "services not available" (25.2%). Most respondents resorted to ocular self-medication particularly traditional eye medicines. We advocate for a provision of affordable, accessible and qualitative eye care services with a strong health education component on avoidable causes of blindness.

Competency based ophthalmology training curriculum for undergraduate medical students in Zimbabwe.

PubMed

Masanganise, R; Samkange, C; Mukona, D; Aagaard, E

2015-01-01

The establishment of a credible, defensible and acceptable “formal competency based ophthalmology training curriculum for undergraduate medical and dental students” is fundamental to program recognition, monitoring and evaluation. The University of Zimbabwe College of Health Sciences (UZ-CHS) has never had a formal ophthalmology training curriculum for medical graduates since its inception. This has cast doubts on the quality of medical graduates produced with regards to delivery of basic primary eye care in the community. The aim of this project was to develop a formal “competency based ophthalmology training curriculum” (CBOTC) for medical graduates in Zimbabwe. Institution based (University of Zimbabwe College of Health Sciences and Parirenyatwa Group of Hospitals), cross-sectional analytic study. A review of undergraduate medical training curriculum and literature was done to identify gaps in the ophthalmology training curriculum. A local needs assessment was conducted through interviews of major stake holders in the University of Zimbabwe College of Health Sciences and Parirenyatwa Group of Hospitals. This project confirmed the lack of a formal ophthalmology training curriculum for medical graduates at the UZCHS, ad-hoc training of undergraduate ophthalmology and inconsistent student assessment in knowledge of and care of eye complaints. Cataract, glaucoma, refractive errors, ocular tumours, conjunctivitis, eye infection and eye injuries were suggested as priority conditions every student should learn during the rotation. A formal CBOTC for medical graduates based on identified needs and priority eye diseases has been developed in response. A CBOTC based on identified needs and focused on targeted diseases has been proposed geared towards producing medical graduates with the basic knowledge, skills and attitudes to deliver adequate primary eye care.

Scattered UV irradiation during VISX excimer laser keratorefractive surgery.

PubMed

Hope, R J; Weber, E D; Bower, K S; Pasternak, J P; Sliney, D H

2008-04-01

To evaluate the potential occupational health hazards associated with scattered ultraviolet (UV) radiation during photorefractive keratectomy (PRK) using the VISX Star S3 excimer laser. The Laser Vision Center, National Naval Medical Center, Bethesda, Maryland, USA. Intraoperative radiometric measurements were made with the Ophir Power/Energy Meter (LaserStar Model PD-10 with silicon detector) during PRK treatments as well as during required calibration procedures at a distance of 20.3 cm from the left cornea. These measurements were evaluated using a worst-case scenario for exposure, and then compared with the American Conference of Governmental Industrial Hygeinists (ACGIH) Threshold Value Limits (TVL) to perform a risk/hazard analysis. During the PRK procedures, the highest measured value was 248.4 nJ/pulse. During the calibration procedures, the highest measured UV scattered radiation level was 149.6 nJ/pulse. The maximum treatment time was 52 seconds. Using a worst-case scenario in which all treatments used the maximum power and time, the total energy per eye treated was 0.132 mJ/cm2 and the total UV radiation at close range (80 cm from the treated eye) was 0.0085 mJ/cm2. With a workload of 20 patients, the total occupational exposure at 80 cm to actinic UV radiation in an 8-hour period would be 0.425 mJ/cm2. The scattered actinic UV laser radiation from the VISX Star S3 excimer laser did not exceed occupational exposure limits during a busy 8-hour workday, provided that operating room personnel were at least 80 cm from the treated eye. While the use of protective eyewear is always prudent, this study demonstrates that the trace amounts of scattered laser emissions produced by this laser do not pose a serious health risk even without the use of protective eyewear.

Domains of health-related quality of life in age-related macular degeneration: a qualitative study in the Chinese cultural context.

PubMed

Bian, Wei; Wan, Junli; Smith, Graeme; Li, Shiying; Tan, Mingqiong; Zhou, Fengjiao

2018-04-17

To explore which areas of health-related quality of life were affected in Chinese patients, and to identify whether the areas are well covered by validated questionnaires. A qualitative study based on semistructured interviews was conducted. A qualitative thematic analysis following the approach of Colaizzi was used to analyse the interview data for significant statements and phrases. The themes and subthemes organised from the analysis were then compared by using the following current instruments: National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), Macular Disease Quality of life Questionnaire (MacDQoL) and Low-Luminance Questionnaire (LLD). Twenty-one patients with age-related macular degeneration were recruited from the eye clinic of Southwest Eye Hospital in Chongqing, mainland China. The mean age of the participants was 69.8 years (range 57-82 years) and the duration of the disease ranged from 3 months to 6 years. The qualitative analysis revealed nine important domains including symptoms, difficulties with daily activities, depending on others, depression and uncertainty, optimism and hope, social isolation, role change, family support and financial burden. However, all the three questionnaires were insufficient to capture the full extent of quality of life issues of Chinese patients with AMD, and MacDQoL covered more domains when compared with NEI-VFQ-25 and LLD. The domains of concepts important to people with AMD in the Chinese culture are not fully represented in the three widely used questionnaires. Nine important domains were identified for the assessment of quality of life and should be considered when assessing the impact of AMD on Chinese individuals. Further studies are needed to develop an AMD quality of life questionnaire, better tailored to the needs and culture of Chinese patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Domains of health-related quality of life in age-related macular degeneration: a qualitative study in the Chinese cultural context

PubMed Central

Bian, Wei; Wan, Junli; Smith, Graeme; Li, Shiying; Tan, Mingqiong; Zhou, Fengjiao

2018-01-01

Objective To explore which areas of health-related quality of life were affected in Chinese patients, and to identify whether the areas are well covered by validated questionnaires. Design A qualitative study based on semistructured interviews was conducted. A qualitative thematic analysis following the approach of Colaizzi was used to analyse the interview data for significant statements and phrases. The themes and subthemes organised from the analysis were then compared by using the following current instruments: National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), Macular Disease Quality of life Questionnaire (MacDQoL) and Low-Luminance Questionnaire (LLD). Participants and setting Twenty-one patients with age-related macular degeneration were recruited from the eye clinic of Southwest Eye Hospital in Chongqing, mainland China. Results The mean age of the participants was 69.8 years (range 57–82 years) and the duration of the disease ranged from 3 months to 6 years. The qualitative analysis revealed nine important domains including symptoms, difficulties with daily activities, depending on others, depression and uncertainty, optimism and hope, social isolation, role change, family support and financial burden. However, all the three questionnaires were insufficient to capture the full extent of quality of life issues of Chinese patients with AMD, and MacDQoL covered more domains when compared with NEI-VFQ-25 and LLD. Conclusion The domains of concepts important to people with AMD in the Chinese culture are not fully represented in the three widely used questionnaires. Nine important domains were identified for the assessment of quality of life and should be considered when assessing the impact of AMD on Chinese individuals. Further studies are needed to develop an AMD quality of life questionnaire, better tailored to the needs and culture of Chinese patients. PMID:29666126

A systematic review of best practices in teaching ophthalmology to medical students.

PubMed

Succar, Tony; Grigg, John; Beaver, Hilary A; Lee, Andrew G

2016-01-01

Ophthalmic medical student education is a cornerstone to improving eye health care globally. We review the current state of the literature, listing barriers to potential best practices for undergraduate ophthalmology teaching and learning within medical curricula. We describe recent advances and pedagogical approaches in ophthalmic education and propose specific recommendations for further improvements and research. Future research should concentrate on developing teaching and learning innovations that may result in a more time- and resource-effective models for interactive and integrated learning. As well as demonstrating that a competency-based approach results not just in better eye health, but also improvements in patient care, education, and medical care in general. By optimizing teaching available through improved evidence-based education, the ultimate goal is to increase medical students' knowledge and produce graduates who are highly trained in eye examination skills, resulting in improved patient eye care through timely diagnosis, referrals, and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Opening our eyes to Global Health; a philosophy of universal values.

PubMed

Wass, Val

2015-12-01

Globalization is advancing at a pace. As we strive to introduce 'Global Health' into clinical curricula we risk fundamental misunderstandings unless we clearly define what we aim to achieve. Clinicians must be prepared for a life time of uncertainty, change and challenge. The fluctuating world arena will undoubtedly impact on their future work in ways we cannot predict. Population migration, climate change and shifts in cultural dominance are already at play. Global health risks being translated through the eyes of Western ideology as disease-based curricula focused paternalistically on 'helping' the developing world. We must not lack humility to open eyes to learning within the context of increasingly diverse environments and patient populations. Global health is as 'local' as it is 'international'. It should be viewed, I argue, as a philosophy based on the values and expectations found within ourselves and our communities. Responding to globalization lies not only in knowledge but embraces human rights, justice and, most importantly, self-awareness. Knowledge is more easily translated into curriculum objectives. We risk letting future clinicians and their patients down if we ignore the other universal values.

n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease.

PubMed

Asbell, Penny A; Maguire, Maureen G; Pistilli, Maxwell; Ying, Gui-shuang; Szczotka-Flynn, Loretta B; Hardten, David R; Lin, Meng C; Shtein, Roni M

2018-05-03

Dry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements of n-3 fatty acids (often called omega-3 fatty acids) to relieve symptoms. In a multicenter, double-blind clinical trial, we randomly assigned patients with moderate-to-severe dry eye disease to receive a daily oral dose of 3000 mg of fish-derived n-3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at 6 and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result on Schirmer's test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs. A total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (-13.9 points and -12.5 points, respectively; mean difference in change after imputation of missing data, -1.9 points; 95% confidence interval [CI], -5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in change, 0.0 points; 95% CI, -0.2 to 0.1), corneal staining score (0.1 point; 95% CI, -0.2 to 0.4), tear break-up time (0.2 seconds; 95% CI, -0.1 to 0.5), and result on Schirmer's test (0.0 mm; 95% CI, -0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n-3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups. Among patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo. (Funded by the National Eye Institute, National Institutes of Health; DREAM ClinicalTrials.gov number, NCT02128763 .).

77 FR 11584 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... County Nahant Life--Saving Station, 96 Nahant Rd., Nahant, 12000133 NEW YORK Seneca County Women's Rights... St. NW., MS 2280, Washington, DC 20240; by all other carriers, National Register of Historic Places, National Park Service,1201 Eye St. NW., 8th Floor, Washington DC 20005; or by fax, 202-371-6447. Written or...

Eye TVR: Eye Trauma and Visual Restoration Team

DTIC Science & Technology

2013-03-01

distribution unlimited The views, opinions and/or findings contained in this report are those of the author(s) and should not be construed as an...cocktail containing ketamine (54 mg/kg body weight) and xylazine (6 mg/kg body weight). In the meantime, the pupils were dilated with 10...multichannel neural data acquisition was developed using the Visual Basic 6.0 (Microsoft Corp.) and Measurement Studio ActiveX components (National

U.S. Unmanned Aerial Systems

DTIC Science & Technology

2012-01-03

that time, they have been called drones, robot planes, pilotless aircraft, RPVs (remotely piloted vehicles), RPAs (remotely piloted aircraft) and...Paul Jackson, p. 728. OSD. UAS Roadmap 2005-2030. August, 2005, Section 2, p.10. 82 National Journal’s Congress Daily. “ Pilotless Aircraft Makers Seek...Eye Proposed by the Boeing Phantom Works, Phantom Eye would use hydrogen-fueled automobile engines to carry a 3,000-pound payload for ten days.195 A

Impact of a national system for waitlist prioritization: the experience with NIKE and cataract surgery in Sweden.

PubMed

Ng, Jonathon Q; Lundström, Mats

2014-06-01

  To evaluate waiting times for first-eye cataract surgery in Sweden following widespread adoption of the Nationell Indikationsmodell for Kataraktextraktion (NIKE) tool for prioritizing patients for cataract surgery.   Waiting times for all first-eye cataract surgeries in Sweden in 2009-2011 were identified from the Swedish National Cataract Register. Waiting times were compared according to demographic, clinical and NIKE indication group for surgery. Multivariate logistic regression modelling was used to determine factors associated with waiting times less than the 3-month Government guarantee period.   There were 141,070 first-eye cataract surgeries in 2009 to 2011; an annual increase of around 6%. Over the study period, mean waiting times decreased across all NIKE groups. The proportion waiting <3 months for surgery also increased across all NIKE groups. Surgery within 3 months of waitlisting was more likely for patients with a NIKE 1 indication classification (most need for surgery), in later years, male patients, younger patients and patients with a preoperative visual acuity in the better eye worse than 6/24.   Prioritizing patients for cataract surgery using NIKE reduces waiting times for those with the greatest need. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Corneal sensitivity, ocular surface health and tear film stability after punctal plug therapy of aqueous deficient dry eye

PubMed Central

Said, Azza Mohamed Ahmed; Farag, Mona Elsayed; Abdulla, Tarek Mohamed; Ziko, Othman Ali Othman; Osman, Wesam Mohamed

2016-01-01

AIM To evaluate the effect of punctal occlusion using thermosensitive (smart plug) versus silicone plug for management of aqueous deficient dry eye on corneal sensitivity, ocular surface health and tear film stability. METHODS A comparative prospective interventional case study included 45 patients with bilateral severe form of aqueous deficient dry eye. In each patient, the smart plug was inserted in the lower punctum of the right eye which was considered as study group 1 and silicone plug was inserted in the lower punctum of the left eye of the same patient which was considered as study group 2. All patients were subjected to careful history taking and questionnaire for subjective assessment of severity of symptoms. Corneal sensitivity, corneal fluorescein, rose bengal staining, Schirmer's I test, tear film break up time and conjunctival impression cytology were performed pre and 1, 3 and 6mo post plug insertion. RESULTS A statistically significant improvement in subjective and objective manifestations occurred following treatment with both types of plugs (P<0.01). The thermosensitive plug caused significant overall improvement, decrease in frequency of application of tear substitutes and improvement of conjunctival impression cytology parameters in the inserted side (P<0.01). Canaliculitis was reported in two eyes (4.4%) following punctal occlusion using thermosensitive plug (study group 1). Spontaneous plug loss occurred in 21 eyes (46.6%) in the silicone plug group (study group 2). CONCLUSION Improvement of subjective and objective manifestations of aqueous deficient dry eye occurs following punctal plug occlusion. Thermosensitive plug has good patient's compliance with fewer complications and lower rates of loss compared to the silicone plug. PMID:27990362

Avoidance of Cigarette Pack Health Warnings among Regular Cigarette Smokers

PubMed Central

Maynard, Olivia M.; Attwood, Angela; O’Brien, Laura; Brooks, Sabrina; Hedge, Craig; Leonards, Ute; Munafò, Marcus R.

2016-01-01

Background Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: 1) are familiar with the health warnings, 2) preferentially attend to branding, or 3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology. Method A convenience sample of 30 adult dependant smokers were recruited to participate in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded. Results Analysis of variance indicated that regular smokers were biased towards fixating the branding location rather than the health warning location on all three pack types (p < 0.002). This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10 seconds of the stimulus presentation, while for blank packs this occurred for the last 8 seconds of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location. Conclusion Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have policy implications for the design of health warning on cigarette packs. PMID:24485554

Introducing Creativity in the Ensemble Setting: National Standards Meet Comprehensive Musicianship

ERIC Educational Resources Information Center

Norris, Charles E.

2010-01-01

This article explores realistic ways with which ensemble conductors can facilitate the conceptual acquisition of their students via creative activities. Creativity, as included in the National Standards, is presented through the "eyes" of comprehensive musicianship. (Contains 2 figures, 2 tables, and 9 notes.)

Eye Exam: Is a Laser Retina Scan Worthwhile?

MedlinePlus

Healthy Lifestyle Adult health Is a laser retina scan necessary? My eye care provider offers the test, but I'm not sure if I need it. Answers from Alaina ... Softing Hataye, O.D. For most people, a laser retina scan isn't necessary. If you choose ...

Nutrition and age-related eye diseases

USDA-ARS?s Scientific Manuscript database

Vision loss among the elderly is an important health problem. Approximately one person in three has some form of vision-reducing eye disease by the age of 65 [1]. Age-related cataract, age-related macular degeneration (AMD), diabetic retinopathy and glaucoma are the major diseases resulting in visu...

How to achieve universal coverage of cataract surgical services in developing countries: lessons from systematic reviews of other services.

PubMed

Blanchet, Karl; Gordon, Iris; Gilbert, Clare E; Wormald, Richard; Awan, Haroon

2012-12-01

Since the Declaration of Alma Ata, universal coverage has been at the heart of international health. The purpose of this study was to review the evidence on factors and interventions which are effective in promoting coverage and access to cataract and other health services, focusing on developing countries. A thorough literature search for systematic reviews was conducted. Information resources searched were Medline, The Cochrane Library and the Health System Evidence database. Medline was searched from January 1950 to June 2010. The Cochrane Library search consisted of identifying all systematic reviews produced by the Cochrane Eyes and Vision Group and the Cochrane Effective Practice and Organisation of Care. These reviews were assessed for potential inclusion in the review. The Health Systems Evidence database hosted by MacMaster University was searched to identify overviews of systematic reviews. No reviews met the inclusion criteria for cataract surgery. The literature search on other health sectors identified 23 systematic reviews providing robust evidence on the main factors facilitating universal coverage. The main enabling factors influencing access to services in developing countries were peer education, the deployment of staff to rural areas, task shifting, integration of services, supervision of health staff, eliminating user fees and scaling up of health insurance schemes. There are significant research gaps in eye care. There is a pressing need for further high quality primary research on health systems-related factors to understand how the delivery of eye care services and health systems' capacities are interrelated.

Invasive procedures on newly deceased examined with an ethical eye.

PubMed

1995-01-01

Death is a hot topic. Books on death are making the best-seller lists and their authors are on speaker circuits, TV talk shows, and at book-signing parties. No longer a taboo topic in polite conversation, our society has become voyeuristic and hell-bent on unmasking death. At the Brooklyn Academy, for example, a dance/theater troupe is performing choreographer Bill T. Jones's "Still/Here," which incorporates videotaped segments of real people who are terminally ill and talk about it. Given the nation's preoccupation with death and dying, it should come as no surprise that the issue of how the newly deceased are treated within health care institutions has become a current topic in the literature, as the following articles show.

Conducting drug abuse investigations in natural environments: potential directions for medical toxicology research.

PubMed

Boyer, Edward W; Fay, Richard J; Cook, Aaron; Buckosh, Martin; Hibberd, Patricia L; Case, Patricia

2010-03-01

Physician-scientists, in the eyes of the National Institutes of Health (NIH), are crucial to the biomedical research enterprise since the development of evidence-based practice based on cutting-edge research. At the same time, NIH has heightened the importance of research mentorship by permitting investigators to revise an application a single time. The current NIH approach, therefore, narrows the margin of error allowable in a proposal and requires that investigators fully develop research protocols for initial submission. The purpose of this manuscript, therefore, is to provide medical toxicologists with a proven research methodology that can be applied to substance abuse investigations. A secondary aim is to provide successful grant language that can be used in subsequent applications for research funding.

The changing pattern of cataract surgery indications: a 5-year study of 2 cataract surgery databases.

PubMed

Lundström, Mats; Goh, Pik-Pin; Henry, Ype; Salowi, Mohamad A; Barry, Peter; Manning, Sonia; Rosen, Paul; Stenevi, Ulf

2015-01-01

The aim of this study was to describe changes over time in the indications and outcomes of cataract surgery and to discuss optimal timing for the surgery. Database study. Patients who had undergone cataract extraction in the Netherlands, Sweden, or Malaysia from 2008 through 2012. We analyzed preoperative, surgical, and postoperative data from 2 databases: the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) and the Malaysian National Cataract Registry. The EUREQUO contains complete data from the national cataract registries in the Netherlands and Sweden. Preoperative and postoperative corrected distance visual acuity, preoperative ocular comorbidity in the surgery eye, and capsule complications during surgery. There were substantial differences in indication for surgery between the 3 national data sets. The percentage of eyes with a preoperative best-corrected visual acuity of 20/200 or worse varied from 7.1% to 72%. In all 3 data sets, the visual thresholds for cataract surgery decreased over time by 6% to 28% of the baseline values. The frequency of capsule complications varied between the 3 data sets, from 1.1% to 3.7% in 2008 and from 0.6% to 2.7% in 2012. An increasing postoperative visual acuity was also seen for all 3 data sets. A high frequency of capsule complication was related significantly to poor preoperative visual acuity, and a high frequency of decreased visual acuity after surgery was related significantly to excellent preoperative visual acuity. The 5-year trend in all 3 national data sets showed decreasing visual thresholds for surgery, decreasing surgical complication rates, and increasing visual outcomes regardless of the initial preoperative visual level. Cataract surgery on eyes with poor preoperative visual acuity was related to surgical complications, and cataract surgery on eyes with excellent preoperative visual acuity was related to adverse visual results. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Contact lens strategies for the patient with dry eye.

PubMed

Sindt, Christine W; Longmuir, Reid A

2007-10-01

Dry eye is the most common reason for contact lens (CL) discontinuation, and the patient with pre-existing dry eye presents particular challenges to the CL fitter. Poor tear film quality/stability, oxygen deprivation, lens deposits, and adverse reactions to CL solutions all contribute to dry eye, and lid disease, allergies, environmental factors, and medications can further hamper successful CL wear by the patient with dry eye. Health and comfort of the ocular surface is affected by the water content, ionicity, oxygen permeability, and modulus of elasticity of the lens, as well as by surface characteristics, such as protein, lipid, and mucin deposition; protein adsorption; and wettability. The choice of CL cleaning solutions with regard to action, cytotoxicity, and biocompatibility are as important as the choice of the CL itself. With appropriate management of the lid, meibomian gland, and ocular surface conditions that produce dry eye, careful selection of lenses and solutions, and vigilant follow-up, successful CL wear should be achievable for the dry eye patient.

Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life.

PubMed

Shekhawat, Nakul S; Stock, Michael V; Baze, Elizabeth F; Daly, Mary K; Vollman, David E; Lawrence, Mary G; Chomsky, Amy S

2017-10-01

To compare the impact of first eye versus second eye cataract surgery on visual function and quality of life. Cohort study. A total of 328 patients undergoing separate first eye and second eye phacoemulsification cataract surgeries at 5 veterans affairs centers in the United States. Patients with previous ocular surgery, postoperative endophthalmitis, postoperative retinal detachment, reoperation within 30 days, dementia, anxiety disorder, hearing difficulty, or history of drug abuse were excluded. Patients received complete preoperative and postoperative ophthalmic examinations for first eye and second eye cataract surgeries. Best-corrected visual acuity (BCVA) was measured 30 to 90 days preoperatively and postoperatively. Patients completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) 30 to 90 days preoperatively and postoperatively. The NEI-VFQ scores were calculated using a traditional subscale scoring algorithm and a Rasch-refined approach producing visual function and socioemotional subscale scores. Postoperative NEI-VFQ scores and improvement in NEI-VFQ scores comparing first eye versus second eye cataract surgery. Mean age was 70.4 years (±9.6 standard deviation [SD]). Compared with second eyes, first eyes had worse mean preoperative BCVA (0.55 vs. 0.36 logarithm of the minimum angle of resolution (logMAR), P < 0.001), greater mean BCVA improvement after surgery (-0.50 vs. -0.32 logMAR, P < 0.001), and slightly worse postoperative BCVA (0.06 vs. 0.03 logMAR, P = 0.039). Compared with first eye surgery, second eye surgery resulted in higher postoperative NEI-VFQ scores for nearly all traditional subscales (P < 0.001), visual function subscale (-3.85 vs. -2.91 logits, P < 0.001), and socioemotional subscale (-2.63 vs. -2.10 logits, P < 0.001). First eye surgery improved visual function scores more than second eye surgery (-2.99 vs. -2.67 logits, P = 0.021), but both first and second eye surgeries resulted in similar improvements in socioemotional scores (-1.62 vs. -1.51 logits, P = 0.255). Second eye cataract surgery improves visual function and quality of life well beyond levels achieved after first eye cataract surgery alone. For certain socioemotional aspects of quality of life, second eye cataract surgery results in comparable improvement to first eye cataract surgery. Copyright © 2017 American Academy of Ophthalmology. All rights reserved.

Sociodemographic correlates of eye care provider visits in the 2006-2009 Behavioral Risk Factor Surveillance Survey.

PubMed

Caban-Martinez, Alberto J; Davila, Evelyn P; Lam, Byron L; Arheart, Kristopher L; McCollister, Kathryn E; Fernandez, Cristina A; Ocasio, Manuel A; Lee, David J

2012-05-23

Research has suggested that adults 40 years old and over are not following eye care visit recommendations. In the United States, the proportion of older adults is expected to increase drastically in the coming years. This has important implications for population ocular disease burden, given the relationship between older age and the development of many ocular diseases and conditions. Understanding individual level determinants of vision health could support the development of tailored vision health campaigns and interventions among our growing older population. Thus, we assessed correlates of eye care visits among participants of the Behavior Risk Factor Surveillance System (BRFSS) survey. We pooled and analyzed 2006-2009 BRFSS data from 16 States (N = 118,075). We assessed for the proportion of survey respondents 40 years of age and older reporting having visited an eye care provider within the past two years, two or more years ago, or never by socio-demographic characteristics. Nearly 80% of respondents reported an eye care visit within the previous two years. Using the 'never visits' as the referent category, the groups with greater odds of having an ocular visit within the past two years included those: greater than 70 years of age (OR = 6.8 [95% confidence interval = 3.7-12.6]), with college degree (5.2[3.0-8.8]), reporting an eye disease, (4.74[1.1-21.2]), diagnosed with diabetes (3.5[1.7-7.5]), of female gender (2.9[2.1-3.9]), with general health insurance (2.7[1.8-3.9]), with eye provider insurance coverage (2.1[1.5-3.0]), with high blood pressure (1.5[1.1-2.2]), and with moderate to extreme near vision difficulties (1.42[1.11-2.08]). We found significant variation by socio-demographic characteristics and some variation in state-level estimates in this study. The present findings suggest that there remains compliance gaps of screening guidelines among select socio-demographic sub-groups, as well as provide evidence and support to the CDC's Vision Health Initiative. This data further suggests that there remains a need for ocular educational campaigns in select socio-demographic subgroups and possibly policy changes to enhance insurance coverage.

A Multidisciplinary Approach for Rehabilitation of Enucleated Sockets: Ocular Implants with Custom Ocular Prosthesis.

PubMed

Choudhury, Minati; Banu, Fathima; Natarajan, Shanmuganathan; Kumar, Anand; Tv, Padmanabhan

2018-02-16

Interdisciplinary prosthodontics goes beyond our imagination into fields that have a direct effect on our total body health and quality of life. Removal of an eye has a detrimental effect on the psychology of the patient. Enucleation involves removal of the eyeball proper and leads to an enophthalmic socket with a shrunken eye, which has a crippling effect on patient's emotional and social life. Custom-made eye prosthesis simulates the characteristics of the companion eye and helps in restoring the normal facial appearance. Restoration of saccadic eye movements occurring during speech is desirable because this greatly contributes to a normal facial expression. This can be achieved by an orbital implant, which helps in orbital volume replacement and restoration of prosthesis movement and comfort. This article describes prosthodontic rehabilitation of enucleated eye sockets with orbital implants for two patients.