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BACKGROUND: Incorporation of the rapid advances in ophthalmologic surgical and diagnostic techniques inherent in the field poses a challenge to residency training programs. This study investigates exposure to new technologies during residency and perception of its impact on practice patterns. METHODS: Ophthalmology residents at various training levels and practicing ophthalmologists who had completed their training were invited to participate in a survey study assessing exposure to various technologies in residency and in practice. Data collection occurred from December 2022 to June 2023. Descriptive statistics were performed. RESULTS: The study received 132 unique responses, including 63 ophthalmology residents and 69 practicing ophthalmologists. 65.2% (n = 45) of practicing ophthalmologists and 47.6% (n = 30) of current residents reported discussion/training on newly developed products on the market (e.g. premium IOLS, MIGS), was minimally discussed but not emphasized or not discussed at all in residency. 55.1% (n = 38) of practicing ophthalmologists reported that exposure to new technologies during residency did influence types of technologies employed during practice. The majority resident physicians reported enjoying being trained on newer technology and feeling more prepared for future changes in the field (95.2%, n = 60) and felt that having industry partnerships in residency enhances education and training (90.5%, n = 57). CONCLUSIONS: Considering how to maximize exposure to newer technologies/devices during residency training is important, and may contribute to training more confident, adaptable surgeons, who are more likely to critically consider new technologies and adopt promising ones into their future clinical practice.

Introduction Artificial Intelligence (AI) chatbots are able to explain complex concepts using plain language. The aim of this study was to assess the accuracy of three AI chatbots answering common questions related to contact lens (CL) wear. Methods: Three open access AI chatbots were compared: Perplexity, Open Assistant and ChatGPT 3.5. Ten general CL questions were asked to all AI chatbots on the same day in two different countries, with the questions asked in Spanish from Spain and in English from the U.K. Two independent optometrists with experience working in each country assessed the accuracy of the answers provided. Also, the AI chatbots’ responses were assessed if their outputs showed any bias towards (or against) any eye care professional (ECP). Results: The answers obtained by the same AI chatbots were different in Spain and the U.K. Also, statistically significant differences were found between the AI chatbots for accuracy. In the U.K., ChatGPT 3.5 was the most and Open Assistant least accurate (p < 0.01). In Spain, Perplexity and ChatGPT were statistically more accurate than Open Assistant (p < 0.01). All the AI chatbots presented bias, except ChatGPT 3.5 in Spain. Conclusions: AI chatbots do not always consider local CL legislation, and their accuracy seems to be dependent on the language used to interact with them. Hence, at this time, although some AI chatbots might be a good source of information for general CL related questions, they cannot replace an ECP

[Abstract]: Introduction Artificial Intelligence (AI) chatbots are able to explain complex concepts using plain language. The aim of this study was to assess the accuracy of three AI chatbots answering common questions related to contact lens (CL) wear. Methods Three open access AI chatbots were compared: Perplexity, Open Assistant and ChatGPT 3.5. Ten general CL questions were asked to all AI chatbots on the same day in two different countries, with the questions asked in Spanish from Spain and in English from the U.K. Two independent optometrists with experience working in each country assessed the accuracy of the answers provided. Also, the AI chatbots’ responses were assessed if their outputs showed any bias towards (or against) any eye care professional (ECP). Results The answers obtained by the same AI chatbots were different in Spain and the U.K. Also, statistically significant differences were found between the AI chatbots for accuracy. In the U.K., ChatGPT 3.5 was the most and Open Assistant least accurate (p < 0.01). In Spain, Perplexity and ChatGPT were statistically more accurate than Open Assistant (p < 0.01). All the AI chatbots presented bias, except ChatGPT 3.5 in Spain. Conclusions AI chatbots do not always consider local CL legislation, and their accuracy seems to be dependent on the language used to interact with them. Hence, at this time, although some AI chatbots might be a good source of information for general CL related questions, they cannot replace an ECP.

PurposeTo investigate the socioeconomic effect on pediatric ophthalmologists (POs) of the first year of the COVID-19 pandemic and to assess the association of practice type with financial impact.MethodsAn email follow-up survey of all AAPOS active members (POs) in April 2021, was used in conjunction with two prior surveys. The majority of US states were represented, and respondents were categorized as academic/university (AU), hospital employee (H), or one of three types of private practice: multispecialty ophthalmology practice (MSP), pediatric ophthalmology/strabismus group (PG), or solo practice (SP).ResultsThe cumulative results during this one-year period revealed 1,533,203 examinations not performed, of which 498,291 were Medicaid. Over 65,000 surgeries were not performed. The average salary loss per PO was $57,188. The total loss of revenue for the pediatric ophthalmology sector was over $303,788,000. Practice groups making at least 75% of their prior year revenue were as follows: H, 81%; AU, 64%; MSP, 52%; PG, 50%; SP, 40%. Salary reduction in each group was as follows: H, 4.2%; AU, 15.4%; MSP, 17.2%; PG, 23.1%; SP, 40.9%. The average loss per practice was $290,151. More than 95% of private practice POs received funds from the Paycheck Protection Program.ConclusionsAt the one-year mark of the pandemic, patient care had been severely disrupted, with subsequent financial consequences. Private practice providers (and especially solo practices) were disproportionally negatively affected.

PurposeTo identify the role of gender and other factors in influencing ophthalmologists' compensation.DesignCross-sectional study.ParticipantsU.S. practicing ophthalmologists.MethodsBetween January and March 2020, an anonymous survey was sent to U.S. residency program directors and practicing ophthalmologists who recently completed residency training. Respondents who completed residency ≤ 10 years ago and responded to questions about gender, fellowship training, state of practice, and salary were included. Propensity score match (PSM) analysis was performed with age, academic residency, top residency, fellowship, state median wage, practice type, ethnicity, and number of workdays. Multivariate linear regression (MLR) analysis controlled for additional factors along with the aforementioned variables.Main outcome measuresBase starting salary with bonus (SWB) received in the first year of clinical position was the main outcome measure. A multiplier of 1.2 (20%) was added to the base salary to account for bonus.ResultsOf 684 respondents, 384 (56% were female, 44% were male) from 68 programs were included. Female ophthalmologists received a mean initial SWB that was $33 139.80 less than that of their male colleagues (12.5%, P = 0.00). The PSM analysis showed an SWB difference of -$27 273.89 (10.3% gap, P = 0.0015). Additionally, SWB differences were calculated with the number of workdays substituted by operating room (OR) days (-$27 793.67 [10.5% gap, P = 0.0013]) and clinic days (-$23 597.57 [8.90% gap, P = 0.0064]) in separate PSM analyses. The SWB differences between genders were significant using MLR analyses, which also controlled for work, clinic, and OR days separately (-$22 261.49, $-18 604.65, and $-16 191.26, respectively; P = 0.017, P = 0.015, P = 0.002, respectively). Gender independently predicted income in all 3 analyses (P < 0.05). Although an association between gender and the attempt to negotiate was n

PurposeTo identify the role of gender and other factors in influencing ophthalmologists' compensation.DesignCross-sectional study.ParticipantsU.S. practicing ophthalmologists.MethodsBetween January and March 2020, an anonymous survey was sent to U.S. residency program directors and practicing ophthalmologists who recently completed residency training. Respondents who completed residency ≤ 10 years ago and responded to questions about gender, fellowship training, state of practice, and salary were included. Propensity score match (PSM) analysis was performed with age, academic residency, top residency, fellowship, state median wage, practice type, ethnicity, and number of workdays. Multivariate linear regression (MLR) analysis controlled for additional factors along with the aforementioned variables.Main outcome measuresBase starting salary with bonus (SWB) received in the first year of clinical position was the main outcome measure. A multiplier of 1.2 (20%) was added to the base salary to account for bonus.ResultsOf 684 respondents, 384 (56% were female, 44% were male) from 68 programs were included. Female ophthalmologists received a mean initial SWB that was $33 139.80 less than that of their male colleagues (12.5%, P = 0.00). The PSM analysis showed an SWB difference of -$27 273.89 (10.3% gap, P = 0.0015). Additionally, SWB differences were calculated with the number of workdays substituted by operating room (OR) days (-$27 793.67 [10.5% gap, P = 0.0013]) and clinic days (-$23 597.57 [8.90% gap, P = 0.0064]) in separate PSM analyses. The SWB differences between genders were significant using MLR analyses, which also controlled for work, clinic, and OR days separately (-$22 261.49, $-18 604.65, and $-16 191.26, respectively; P = 0.017, P = 0.015, P = 0.002, respectively). Gender independently predicted income in all 3 analyses (P < 0.05). Although an association between gender and the attempt to negotiate was n

Order entry via mobile client was associated with decreased after-hours EHR use in a cohort of 139 academic ophthalmologists. EHR audit log data can provide insights into strategies for optimizing efficiency of EHR use.

BackgroundA transition from a subtyping to a phenotyping approach in rosacea is underway, allowing individual patient management according to presenting features instead of categorization by predefined subtypes. The ROSacea COnsensus (ROSCO) 2017 recommendations further support this transition and align with guidance from other working groups.ObjectivesTo update and extend previous global ROSCO recommendations in line with the latest research and continue supporting uptake of the phenotype approach in rosacea through clinical tool development.MethodsNineteen dermatologists and two ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and management. Voting was electronic and blinded.ResultsDelphi statements on which the panel achieved consensus of ≥ 75% voting 'Agree' or 'Strongly agree' are presented. The panel recommends discussing disease burden with patients during consultations, using four questions to assist conversations. The primary treatment objective should be achievement of complete clearance, owing to previously established clinical benefits for patients. Cutaneous and ocular features are defined. Treatments have been reassessed in line with recent evidence and the prior treatment algorithm updated. Combination therapy is recommended to benefit patients with multiple features. Ongoing monitoring and dialogue should take place between physician and patients, covering defined factors to maximize outcomes. A prototype clinical tool (Rosacea Tracker) and patient case studies have been developed from consensus statements.ConclusionsThe current survey updates previous recommendations as a basis for local guideline development and provides clinical tools to facilitate a phenotype approach in practice and improve rosacea patient management. What's already known about this topic? A transition to a phenotype approach in rosacea is underway and is being recommended by mu

In recent months, the COVID-19 pandemic has threatened the financial viability of pediatric ophthalmology practices. To measure the economic impact, the American Association of Pediatric Ophthalmology and Strabismus (AAPOS) Socio-economic Committee surveyed current US members at the peak of the COVID shutdown, in April 2020. With a robust response rate, the survey portrays that some pediatric ophthalmology practices are ominously strained, if not irreparably harmed.

Background: The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. Methods: Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C−NF−), (2) NPs positive and Cs negative (NFs+Cs−), (3) NPs negative and Cs positive (NFs−Cs+), and (4) NPs and Cs both positive (NFs−Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). Results: A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF−C− group (98%) and the lowest (90%) in the group NF+C+ (p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups (p = 0.019). Pulmonary impairment score increased from NFs−Cs− group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). Conclusions: In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. Trial registration: Clinicaltrials.gov registration. Ethical committee authorization: ID number: 0013008/20

Background: Ophthalmologists – Eye Doctors working in academic eye hospitals confront various barriers in their information use. The purpose of this study is to investigate the barriers of ophthalmologists in their information use. Methodology: The study design is cross sectional and convenience sampling method is adopted. A structured questionnaire was used to collect data. SPSS 18 PASW Statistical package was used for statistical analysis. Frequencies, percentages, Mann Whitney U test, Kruskal-Wallis test, Factor Analysis, Wilcoxon signed rank test were used in the study. Findings: Around 633 ophthalmologists working in 47 academic eye hospitals from 16 states of India were included in the study. The study results revealed that majority of the ophthalmologists encountered the barrier "Information scattered in too many sources". The statistical test results showed up that there exist a significant difference between barriers in using information among ophthalmologists and institution type. The two major factors of barriers in using information among ophthalmologists were for lack of motivation and support and brunt of technology. The barriers due to brunt of technology were significantly higher than the lack of motivation and support. Conclusion: The barriers faced by ophthalmologists can be jointly handled by the ophthalmic libraries, ophthalmic institutions, information service providers and ophthalmic community.

PurposeTo investigate ophthalmologists' rate of attestation to meaningful use (MU) of their electronic health record (EHR) systems in the Medicare EHR Incentive Program and their continuity and success in receiving payments in comparison with other specialties.DesignAdministrative database study.ParticipantsEligible professionals participating in the Medicare EHR Incentive Program.MethodsBased on publicly available data sources, subsets of payment and attestation data were created for ophthalmologists and for other specialties. The number of eligible professionals attesting was determined using the attestation data for each year and stage of the program. The proportion of attestations by EHR vendor was calculated using all attestations for each vendor.Main outcome measuresNumbers of ophthalmologists attesting by year and stage of the Medicare EHR Incentive Program, incentive payments, and number of attestations by EHR vendor.ResultsIn the peak year of participation, 51.6% of ophthalmologists successfully attested to MU, compared with 37.1% of optometrists, 50.2% of dermatologists, 54.5% of otolaryngologists, and 64.4% of urologists. Across the 6 years of the program, ophthalmologists received an average of $17 942 in incentive payments compared with $11 105 for optometrists, $16 617 for dermatologists, $20 203 for otolaryngologists, and $23 821 for urologists. Epic and Nextgen were the most frequently used EHRs for attestation by ophthalmologists.ConclusionsOphthalmology as a specialty performed better than optometry and dermatology, but worse than otolaryngology and urology, in terms of the proportion of eligible professionals attesting to MU of EHRs. Ophthalmologists were more likely to remain in the program after their initial year of attestation compared with all eligible providers. The top 4 EHR vendors accounted for 50% of attestations by ophthalmologists.

PurposeTo evaluate depth of field, lateral resolution, and image quality of a heads-up 3D visualization system for vitreoretinal surgery using physician survey and optical measurement outcomes.MethodsDepth of field and lateral resolution were compared between the standard ocular viewing system and the digital 3D system at ×5, ×13, and ×18 magnification by 6 retinal surgeons. Optical techniques were used as well as a survey of surgeon impression. Surgeon impression surveys were performed after 6 weeks of surgical use of the device.ResultsPhysician questionnaire survey scores for depth of field at high magnification were better for the digital 3D system and equivalent for all other categories. Measured lateral resolution was 36.7 mm and 16.6 mm at ×5 magnification (P < 0.001), 14.3 mm and 6.4 mm at ×13 magnification (P < 0.001), and 9.8 mm and 4.2 mm (P < 0.001) at ×18 magnification for the digital 3D and oculars, respectively. Measured depth of field was 4.00 mm and 6.78 mm at ×5 magnification (P = 0.027), 0.72 mm and 0.86 mm at ×13 (P = 0.311), and 0.28 mm and 0.40 mm at ×18 magnification (P = 0.235) for the oculars and digital 3D, respectively.ConclusionLateral resolution of the digital 3D system was half that of the ocular viewing system and there was some improvement in depth of field with the digital system. Surgeon impression suggested that the digital system was superior when evaluating depth of field at high magnification.

Health workforce planning is essential in the provision of quality healthcare. Several approaches to planning are customarily used and advocated, each with unique underlying assumptions. Thus, a thorough understanding of each assumption is required in order to make an informed decision on the choice of forecasting approach to be used. For illustration, we compare results for eye care requirements in Singapore using three established workforce forecasting approaches – workforce-to-population-ratio, needs based approach, utilization based approach – and a proposed robust integrated approach to discuss the appropriateness of each approach under various scenarios. Four simulation models using the systems modeling methodology of system dynamics were developed for use in each approach. These models were initialized and simulated using the example of eye care workforce planning in Singapore, to project the number of ophthalmologists required up to the year 2040 under the four different approaches. We found that each approach projects a different number of ophthalmologists required over time. The needs based approach tends to project the largest number of required ophthalmologists, followed by integrated, utilization based and workforce-to-population ratio approaches in descending order. The four different approaches vary widely in their forecasted workforce requirements and reinforce the need to be discerning of the fundamental differences of each approach in order to choose the most appropriate one. Further, health workforce planning should also be approached in a comprehensive and integrated manner that accounts for developments in demographic and healthcare systems.

ImportanceWomen in ophthalmology are growing in number and have made strides in traditional metrics of professional achievement. Professional ties to industry represent another potential means of career advancement, recognition, and income.ObjectiveTo report the representation of women among ophthalmologists receiving industry remuneration for research, consulting, honoraria, grants, royalties, and faculty/speaker roles.Design, setting, and participantsIn this observational, retrospective study, the Centers for Medicare and Medicaid Services Open Payments database for payments to ophthalmologists by biomedical companies was reviewed for representation, median payments, and mean payments by women and men for industry relationships in 2013 and 2014. The analysis was performed from July 2015 to November 2015.Main outcomes and measuresThe primary outcome measures were percentage representation of women vs men overall and in industry research, consulting, speaking roles, royalties and licenses, grants, services other than consulting, and honoraria. Secondary outcome measures included mean and median payments from industry to female vs male ophthalmologists.ResultsIn 2013, 4164 of 21 380 (19.5%) ophthalmologists were women, and of 1204 ophthalmologists analyzed for industry payments, 176 (4.2%) women had industry ties compared with 1028 (6%) men (P < .001). Mean payments to women were $11 419 compared with $20 957 for men (P = .001), and median payments to women were $3000 compared with $4787 for men (P = .007). In 2013, women were underrepresented among ophthalmologists receiving industry payments for research (49 of 462 [10.6%]), consulting (96 of 610 [15.7%]), honoraria (3 of 47 [6.4%]), industry grants (1 of 7 [14.3%]), royalties and licenses (1 of 13 [7.7%]), and faculty/speaker roles (2 of 48 [4.2%]). In 2014, 4352 of 21 531 (20.2%) of ophthalmologists were women. Of 1518 ophthalmologists analyzed for industry payments, 255 (6%) women had industry ties compared w

ImportanceWomen in ophthalmology are growing in number and have made strides in traditional metrics of professional achievement. Professional ties to industry represent another potential means of career advancement, recognition, and income.ObjectiveTo report the representation of women among ophthalmologists receiving industry remuneration for research, consulting, honoraria, grants, royalties, and faculty/speaker roles.Design, setting, and participantsIn this observational, retrospective study, the Centers for Medicare and Medicaid Services Open Payments database for payments to ophthalmologists by biomedical companies was reviewed for representation, median payments, and mean payments by women and men for industry relationships in 2013 and 2014. The analysis was performed from July 2015 to November 2015.Main outcomes and measuresThe primary outcome measures were percentage representation of women vs men overall and in industry research, consulting, speaking roles, royalties and licenses, grants, services other than consulting, and honoraria. Secondary outcome measures included mean and median payments from industry to female vs male ophthalmologists.ResultsIn 2013, 4164 of 21 380 (19.5%) ophthalmologists were women, and of 1204 ophthalmologists analyzed for industry payments, 176 (4.2%) women had industry ties compared with 1028 (6%) men (P < .001). Mean payments to women were $11 419 compared with $20 957 for men (P = .001), and median payments to women were $3000 compared with $4787 for men (P = .007). In 2013, women were underrepresented among ophthalmologists receiving industry payments for research (49 of 462 [10.6%]), consulting (96 of 610 [15.7%]), honoraria (3 of 47 [6.4%]), industry grants (1 of 7 [14.3%]), royalties and licenses (1 of 13 [7.7%]), and faculty/speaker roles (2 of 48 [4.2%]). In 2014, 4352 of 21 531 (20.2%) of ophthalmologists were women. Of 1518 ophthalmologists analyzed for industry payments, 255 (6%) women had industry ties compared w

OBJECTIVES: To understand the attitudes and perceptions of ophthalmologists toward an electronic health record (EHR) system, before and after its clinical implementation. METHODS: Ophthalmologists at a single large academic ophthalmology department were surveyed longitudinally before and after implementation of a new EHR system. The survey measured ophthalmologists attitudes toward implementation of a new EHR. Questions focused on satisfaction, efficiency, and documentation. All attending physicians (between 56 and 61 at various time points) in the University of Michigan Department of Ophthalmology and Visual Sciences were surveyed. We plotted positive responses to survey questions and assessed whether perceptions followed a J-curve with an initial decrease followed by an increase surpassing pre-implementation levels. RESULTS: Survey responses were received from 32 (52%) ophthalmologists pre-implementation, and 28 (46%) at 3 months, 35 (57%) at 7 months, 40 (71%) at 13 months and 39 (67%) at 24 months post-implementation. After EHR implementation respondents were more likely to express concerns about their ability to create high-quality documentation (p<0.01) and the impact of an electronic health record on meaningful patient interaction (p<0.01). Physicians did not report a significant change in the amount of time spent documenting outside of regular clinical work hours (p=0.54) or on their clinic efficiency and workflow (p=0.97). There was no significant change in overall job satisfaction during the study period (p=0.69). We did not observe a J-curve for any of the survey responses analyzed. CONCLUSIONS: As ophthalmology practices continue to transition to EHRs, adapting them to their specific culture and needs is important to maintain efficiency and user satisfaction. This study identifies areas of concern to ophthalmologists that may be addressed through education of physicians and customization of software as other practices move forward with EHR implemen

#### Background Singapore’s population, as that of many other countries, is aging; this is likely to lead to an increase in eye diseases and the demand for eye care. Since ophthalmologist training is long and expensive, early planning is essential. This paper forecasts workforce and training requirements for Singapore up to the year 2040 under several plausible future scenarios. #### Methods The Singapore Eye Care Workforce Model was created as a continuous time compartment model with explicit workforce stocks using system dynamics. The model has three modules: prevalence of eye disease, demand, and workforce requirements. The model is used to simulate the prevalence of eye diseases, patient visits, and workforce requirements for the public sector under different scenarios in order to determine training requirements. #### Results Four scenarios were constructed. Under the baseline business-as-usual scenario, the required number of ophthalmologists is projected to increase by 117% from 2015 to 2040. Under the current policy scenario (assuming an increase of service uptake due to increased awareness, availability, and accessibility of eye care services), the increase will be 175%, while under the new model of care scenario (considering the additional effect of providing some services by non-ophthalmologists) the increase will only be 150%. The moderated workload scenario (assuming in addition a reduction of the clinical workload) projects an increase in the required number of ophthalmologists of 192% by 2040. Considering the uncertainties in the projected demand for eye care services, under the business-as-usual scenario, a residency intake of 8–22 residents per year is required, 17–21 under the current policy scenario, 14–18 under the new model of care scenario, and, under the moderated workload scenario, an intake of 18–23 residents per year is required. #### Conclusions The results show that under all scenarios considered, Singapore’s aging and growing population w

The research was done with the application of “Methodology of definition of normative workload of physicians of in-hospital departments of intensive care hospitals” approved by the Ministry of health care of Ukraine on the basis of two ophthalmological departments of hospital N 8 in Dniptropetrovsk, where a routine and urgent intensive and secondary care of ophthalmological profile is provided in twenty-four-hour regime.Normative workload of ophthalmologists is substantiated coming from on the number of cured patients and number of surgeries per year., Исследование выполнено с использованием «Методики определения норм нагрузки врачей стаци­онарных отделений больниц интенсивного лечения (ЛИЛ)», утвержденной Министерством здравоохранения Украины, на базе двух офтальмологических отделений больницы № 8 г. Днепропетровска, в которых предо­ставляется в круглосуточном режиме интенсивная плановая и ургентная вторичная помощь офтальмоло­гического профиля. Обоснованы нормативы нагрузки на врачей – офтальмологов, исходя из числа пролеченных ими больных и числа выполненных операций в год.

The Foundation Fighting Blindness Clinical Research Institute (FFBCRI) {formerly National Neurovision Research Institute (NNRI)], the clinical arm of the Foundation Fighting Blindness (FFB), proposes to establish the National Eye Evaluation Research (NEER) Network to be composed of a collaborative group of five Clinical Treatment and Evaluation Centers (CTECs). The intent of this new network is to advance the science of therapeutic and preventive interventions for inherited orphan retinal degenerative diseases and dry age-related macular degeneration (AMD) through the conduct of clinical trials and other clinically relevant research. The scope of research to be carried out encompasses: (i) Phase I and Phase II clinical trials to evaluate the safety and efficacy of new therapeutic and preventive approaches, including devices, biopharmaceuticals, small molecules, nutritional supplements, and gene transfer approaches; (ii) natural history studies to develop standardized criteria to define disease stage, severity and progression; (iii) observational studies to enhance understanding of the natural history of these diseases for different genotypes and phenotypes; and (iv) evaluations of the reliability and validity of different available treatment outcomes measures to determine those that are most appropriate for various genotypes and phenotypes as well as for specific interventions. The NEER Network will also develop standard protocols for data collection, maintain and expand patient databases, classified by genotype and phenotype, to allow for the timely identification of eligible patients and facilities patient access for clinical trial participation, and design and conduct, in collaboration with the Department of Defense, training programs for military ophthalmologists in the latest technologies and diagnostic training regimens.

During the past year we have obtained approval from our institutional and University Conflict of Interest Committees, which limited the ability of Dr. Sassani to actively participate in data collection or interpretation in the study. In order to compensate for this reduction in effective researchers, Dr. Esther Bowie, an Ophthalmologist on the faculty of our Department of Ophthalmology, will assist Dr. David Liang in performing the clinical studies and data collection. To date we have completed our first cohort of 4 volunteers at the once daily, 1 x 10-6 dosage, of topical Naltrexone in Vigamox eyedrops in one eye of each volunteer. No untoward side effects were noted in this group of volunteers. We also have recruited and treated three patients for the second cohort who have completed the treatment schedule. We need to recruit one more volunteer for this cohort and complete the other three cohorts. We are committed to completing the study, and have requested a one year extension of the grant period with no additional funds in order to complete our study., The original document contains color images.

Postprint (published version)

The National Neurovision Research Institute (NNRI), the clinical arm of the Foundation Fighting Blindness (FFB), has established the National Eye Evaluation Research (NEER) Network composed of a collaborative group of five Clinical Treatment and Evaluation Centers (CTECs) and a support Clinical Coordinating Center. The intent of this new Network is to advance the science of therapeutic and preventive interventions for inherited orphan retinal degenerative diseases and dry age-related macular degeneration (AMD) through the conduct of clinical trials and other clinically relevant research. The scope of research to be carried out encompasses: (i) Phase I and Phase II clinical trials to evaluate the safety and efficacy of new therapeutic and preventive approaches, including devices, biopharmaceuticals, small molecules, nutritional supplements, and gene transfer approaches; natural history studies to develop standardized criteria to define disease stage, severity and progression; (iii) observational studies to enhance understanding of the natural history of these diseases for different genotypes and phenotypes; and (iv) evaluations of the reliability and validity of different available treatment outcomes measures to determine those that are most appropriate for various genotypes and phenotypes as well as for specific interventions. The NEER Network will also develop standard protocols for data collection, maintain and expand patient databases, classified by genotype and phenotype, to allow for the timely identification of eligible patients and facilitate patient access for clinical trial participation, and design and conduct, in collaboration with the Department of Defense, training programs for military ophthalmologists in the latest technologies and diagnostic and treatment regimens., The original document contains color images.

The National Neurovision Research Institute (NNRI}, the clinical arm of the Foundation Fighting Blindness (FFB), has established the National Eye Evaluation Research (NEER) Network composed of a collaborative group of five Clinical Treatment and Evaluation Centers (CTECs) and a support Clinical Coordinating Center. The intent of this new Network is to advance the science of therapeutic and preventive interventions for inherited orphan retinal degenerative diseases and dry age-related macular degeneration (AMD) through the conduct of clinical trials and other clinically relevant research. The scope of research to be carried out encompasses: (i) Phase I and Phase II clinical trials to evaluate the safety and efficacy of new therapeutic and preventive approaches, including devices, biopharmaceuticals, small molecules, nutritional supplements, and gene transfer approaches; natural history studies to develop standardized criteria to define disease stage, severity and progression; (iii) observational studies to enhance understanding of the natural history of these diseases for different genotypes and phenotypes; and (iv) evaluations of the reliability and validity of different available treatment outcomes measures to determine those that are most appropriate for various genotypes and phenotypes as well as for specific interventions. The NEER Network will also develop standard protocols for data collection, maintain and expand standardized patient databases, classified by patient genotype and phenotype, to allow for the timely identification of eligible patients and facilitate patient access for clinical trial participation, and design and conduct, in collaboration with the Department of Defense, training programs for military ophthalmologists in the latest technologies and diagnostic and treatment regimens.

The Journal of Special Operations Forces Medicine is a peer reviewed journal for SOF Medical Professionals. Articles in this publication include: Compartment Syndrome of the Lower Extremity: Blast Injuries in a Ranger Battalion Don't Miss the Diagnosis, American Guerrilla Warfare Medical Doctrine--The First Manuals: Lessons Learned, Combat Ophthalmology When There Isn't an Assigned Ophthalmologist as well as book reviews, upcoming events and conferences, education and training issues, persona reports and a medical quiz., ISSN 1553-9768

With the ever increasing costs of health care today finding, testing, and, if found workable, utilizing a new technology is an absolute must. Teleophthalmology is just such a technology. This service will greatly benefit the present and growing diabetic population. One of the major complications of diabetes is diabetic retinopathy, which eventually causes blindness. The effects of diabetic retinopathy can be limited if early and effective treatment is provided. The key to early intervention is an annual eye exam. The compliance rate for annual eye exams for Great Plains Regional Medical Command is less than the 90% required to meet HEDIS as well as our own Clinical Practice Guideline metric. Teleophthalmology is a way to meet the needs of the patient for an eye exam without a second visit to the hospital. Utilizing a digital ophthalmic camera allows the patient's pupils to be dilated, the films obtained and sent for review by an ophthalmologist during their routine primary care visit. This decreases the hassle factor for the patient, it frees up ophthalmology clinic visits held for routine diabetic eye exams, and best utilizes the limited number of ophthalmology providers available in the region., The original document contains color images.

The need has existed for many years to automate the therapeutic process of placing laser-induced lesions on a patient's retina at specific locations while protecting the critical vision anatomy. Furthermore, it is desirable for the lesions to be of consistent and controllable size (diameter and/or depth). Partial solutions have been designed with varying degrees of success, but no system has yet been developed which can both track the moving eye at clinically acceptable speeds and control the lesion formation in real time. This dissertation describes research toward the development of a Computer Aided Laser Optics System for Ophthalmic Surgery (CALOSOS): a reliable, safe, cost-effective system which can control laser photocoagulators of the type found in an ophthalmologist's office. The system will safely create therapeutic retinal lesions of a specified number and location in minimal time with little or no human intervention.

This document is a proposal for a publishable research paper. Ophthalmologists at the USAF School of Aerospace Medicine suspect one of the two depth perception tests used to screen candidates for Undergraduate Pilot Training (UPT) inadequately evaluates depth perception abilities required to operate high performance jet aircraft. They hypothesize that candidates passing only the Verhoeff test for near stereopsis have higher attrition rates from UPT than candidates passing the VTA, a test of distant stereopsis. A historical prospective study will be used to test this hypothesis. A cohort of students attending USAF UPT during Fiscal Year 1990 will be compared. UPT attrition rates will be compared among type of depth perception test passed. Multiple logistic regression methods will be used to study attrition rate increases. Confounding variables evaluated include: commissioning source, previous flying experience, training base assigned, degree of phoria and gender of student. If this hypothesis is validated, the USAF may amend its pre-selection depth perception criterion for medical qualification of UPT candidates, thus resulting in significant financial savings to the US Air Force.

This special report was written for USAF vision specialists to use as a guide when prescribing spectacles for military aviators and to extend to the civilian sector the knowledge gained from the USAF experience. Visual correction in flyers presents some unique problems, especially for presbyopes. The demands of each individual aircraft environment need to be well understood. Ophthalmologists and optometrists must consider all pertinent aeromedical factors before prescribing spectacles for ametropic aviators., Published in Aviation, Space, and Environmental Medicine, p80-84 January 1992.

During the two and a half day meeting 28 papers were presented. The seventeen papers in classified sessions provided a broad overview of the natural and man-made visual hazards to which aviators may be exposed. In addition, more detailed analysis of damage mechanisms, of the effects on visual performance, and of methods of providing protection to aircrew were presented. In unclassified sessions, 11 ophthalmological papers were presented. Those covered the operational use of contact lenses by military aircrew, cataract surgery and intra-ocular lenses, the corrections of refractive errors by radial keratotomy, impairment of colour vision in ophthalmologists using argon lasers, and the medical management of combat laser eye injuries.

A choroidal nevus may be mistaken for a melanoma or it may develop into a malignant melanoma. We reviewed the records of over 5,000 aviators examined over the past 14 years at the USAF School of Aerospace Medicine. One hundred and fourteen aviators were noted to have one or more choroidal nevi (2. 2%). These lesions were found not to affect the aviators' visual performance. However, it is recommended that these lesions be followed at regular intervals by an ophthalmologist.

This dissertation describes the experimental analysis and design of a second generation robotic laser system used for ophthalmic surgery. The goal of this research project is to develop an automated laser delivery and retinal observation system that is capable of placing multiple lesions of predetermined sizes into known locations in the retina. The goal of this dissertation is to show that from an economic, scientific, and engineering standpoint, the proposed design for this new system is feasible. The first generation laser system is the slitlamp microscope with a laser delivery system, where the laser is controlled by the manual dexterity of the ophthalmologist. This new system is designed to augment the ophthalmologist, making the operator more efficient with less training. The system is intended to simplify the surgical process while improving accuracy, speed, and safety. This task can be divided into three areas. The first is to completely develop an automated retina observation system, which will allow the computer to observe all areas of the retina automatically. The second part of the task is to design a computer controlled pointing and tracking system for the laser, which will keep the laser positioned onto one spot on retina during small movements of the eye. The third portion is to design and a test a reflectance measuring system that monitors and controls the size of the lesion. All three parts must be integrated into one cohesive, economical system. Thesis.

This is a report of an occupational survey of personnel in the Operating Room )902X2), Ophthalmology Surgical (912X0), Otorhinolaryngology Surgical (912X1), Urology Surgical (912X2), Orthopaedic Clinic (912X3), and Optometry (912X5) career ladders, completed by the Occupational Survey Branch, USAF Occupational Measurement Center, during April 1979. This report is one of three prepared for the Classification Branch of the Air Force Manpoweer and Personnel Center (AFMPC/MPCRPQ) in response to their request for occupational data concerning selected AFSCs within the Medical career field 'to determine if the current classification structure is adequate.'

This special report was written as a review and reference for USAF vision specialists in prescribing spectacles for aviators. Vision correction in flyers presents unique problems especially for the presbyopes. The demands of each individual aircraft environment need to be well understood. USAF ophthalmologists and optometrists must consider the pertinent aeromedical factors before prescribing spectacles for ametropic aircrew members. This report includes a comprehensive guide to cockpit instrument panel distances and print sizes for most USAF aircraft. Keywords: Human factors engineering; Eyeglasses; Cockpits; Spectacles; Presbyopia; Bifocals; Trifocals; Multifocals; Vision; Aviators; Flyers; Aircrew members; Prescribing eyeglasses. (KT)

Disc-related defects constitute over 90% of field defects found in typical outpatient clinical population--e.g., ischemic neuropathy, optic neuritis, glaucoma. This handout is designed for anyone who uses a Goldman Visual Field Perimeter. It describes an efficient standardized screening examination that, when mastered, should take the ophthalmologist, ophthalmology resident, and experienced or inexperienced ophthalmic technician only 5 to 10 minutes per eye to perform. The technique, developed by Armaly and modified by Drance, is a combination of kinetic and suprathreshold static perimetry. Detection of disc-related field defects has shown to improve to 95% after a single day of instruction in the Armaly-Drance method.

Carte-de-visite of Louis Auguste Desmarres (1810-1882), French ophthalmologist. Photograph by Antoine Rene Trinquart.

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Carte-de-visite of Ernst Fuchs (1850-1930), Austrian ophthalmologist and physician. Photograph by J. Lowy.

Carte-de-visite of Charles Stedman Bull (1846-1911), American ophthalmologist. Photograph by William Kurtz.

Carte-de-visite of Friedrich Wilhelm Ernst Albrecht von Graefe (1828-1870), Prussian-born ophthalmologist.

Carte-de-visite of Henry Drury Noyes (1831-1900), American physician and oculist. Photograph by Benjamin. J. Falk.

Carte-de-visite of Louis Auguste Desmarres (1810-1882), French ophthalmologist. Photograph by Antoine Rene Trinquart.

The couple arrives on the US liner 'George Washington' after three months on the continent where Dr. Morton addressed the Congress of Ophthalmologists in Amsterdam.