C-11440 Intraoperative Complications
19/06/09
Cataract surgery is the most commonly performed operation worldwide. Technological progress has enabled major advances in this procedure. However, as with any surgery there are inherent risks, some of which are related to the increased complexity of the operation. There are four main forms of cataract extraction surgery: intracapsular (ICCE), extracapsular (ECCE), phacoemulsification (PHACO) and manual small incision (MSICS). This article is the first of three that identifies the more common complications that occur intraoperatively during phacoemulsification and intraocular lens (IOL) implantation. Future articles will describe the early and late post-operative complications that may occur.
Louise Stainer BSc (Hons)
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C-10558 Digital imaging and screening for diabetic retinopathy
05/06/09
The National Screening Committee has stated that "All people with diabetes aged 12 years and older should be offered screening for sight - threatening diabetic retinopathy using digital photography," Digital imaging offers several advantages such as archiving, ease of viewing, evidence of progression, quality assurance, patient education and immediate indication of ungradeable images. Knowledge of key aspects of digital imaging technology and performance therefore underpin screening for diabetic retinopathy in the UK. The final article in the 'Optometric Management of Diabetic Eye Disease' series aims to discuss the technical aspects of digital imaging related to diabetic screening as well as provide an indication of how computers can be used to automatically screen for sight - threatening retinopathy.
Christopher C. Hull, PhD
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C-11112 Clinical protocol and the role of the eye care pratitioner
22/05/09
This series of articles has described various aspects of visual characteristics of reading dificulties and the background behind techniques such as the use of coloured filters in helping to reduce the difficulties that are experienced. The present article, which is the last in series, aims to describe a clinical protocol that can be used by the busy eye care practitioner for the investigation and management of such patients. It also describes the testing techniques that can be used for the various assessments. Warning: DO NOT LOOK AT FIGURE 7 IF YOU HAVE MIGRAINE OR EPILEPSY.
Dr Peter Allen, Prof Bruce Evans, Prof Arnold Wilkins
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C-10557 Non-Retinal Complications of Diabetes Mellitus
08/05/09
Diabetes mellitus (DM) ia a chronic disease that occurs when a) the pancreas does not produce enough insulin (insulin dependent diabetes or Type 1 diabetes), which is typically of early onset or b) when the body cannot effectively use the insulin it produces (maturity onset or non-insulin dependent diabetes). Type 1 diabetes can be regarded as an autoimmune disorder in which there is destruction of the pancreatic islet cells in a genetically susceptible host. The world is currently experiencing a global epidemic of this incurable disease and the human and economic costs are enormous. Predictions estimate a doubling of the number affected from 180 million reaching an estimated 366 million by 2030. The global increase in diabetes is attributed to increased life expectancy, urbanisation and changes in lifestyle and diet. Although previously recognised as a disease of the developed world, diabetes is becoming increasingly prevalent in the Developing World. In India alone, the number affected is expected to reach 80 million by 2030. Unforunately, the majority of the burden from the disease is also now predicted to lie in low income countries and in those of working age.
Shaheen P Shah MRCOphth MSc
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Vision & Reading Difficulties Part 4: Coloured Filters - How Do They Work?
24/04/09
This article is the fourth in a series of five about vision and reading difficulties. The first article provided a general overview and the second covered conventional optometric correlates of reading difficulties (e.g. binocular vision problems). The present article continues on from the third article by describing the use of coloured filters in treating a condition now known as visual stress. Visual stress is often associated with reading difficulties, but also a variety of other neurological conditions. This article concentrates on the possible mechanisms for the benefit from coloured filters, beginning with obvious peripheral factors. The terminology for this condition has changed over the years (e.g. Scotopic Sensitivity Syndrome, and Meares-Irlen Syndrome) and the issue of terminology is discussed at the end of this article. Warning: DO NOT LOOK AT FIGURE 6 ON PAGE 28 IF YOU HAVE A MIGRAINE OR EPILEPSY.
Wilkins, Allen, Evans
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Evaluating and recording soft contact lens fit
23/04/09
Life through the lens: The OT guide to contact lenses. Evaluating and Recording Soft Contact Lens Fit.
Professor James Wolffsohn, Ophthalmic Research Group, Life and Health Sciences, Aston University
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C-10560 Monitoring and Controlling Diabetes
10/04/09
Diabetes mellitus (DM) is defined as a group of metabolic diseases characterised by hyperglycaemia resulting in defects in insulin secretion, insulin action, or both secretion and action. It is essential to control plasma glucose levels in order to reduce the risk of diabetic complications. Other complications, such as hypertension, also need to be considered.
Professor Rachel North PhD MSc FCOptom
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C-10717 Coloured Filters - Do They Work?
27/03/09
This is the third article in a series of five on Vision and Reading Difficulties. The first article provided a general overview of learning disabilities and specific learning difficulties (SpLD). It outlined the role of the optometrist in helping people with SpLD. The second article covered conventional optometric correlates of reading difficulties (e.g. binocular vision problems) This article and the next will describe the use of coloured filters to treat a condition now know as "visual stress", which is often associated with reading difficulties; the symptoms of visual stress were described in Part 1. The terminology for this condition has changed over the years (e.g. Scotopic Sensitivity syndrome, Meares-Irlen syndrome). Terminology is discussed more in Part 4.
Arnold J Wilkins, Bruce JW Evans, Peter M Allen
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c-10559 Diabetes: Indications for treatment
13/03/09
It is estimated that there are currently 180 million people wordwide affected with diabetes. Diabetes is the leading cause of blindness for people under the age of 65 years in the Developing World. The prevalence and incidence of diabeties in our modern society is currently on the increase. It is important to recognise this and the impact it has on the provision of care to the diabetic patient in the ophthalmic setting. It is also important to realise the overall impact of diabetes on the eye. Although this article concentrates on the retina, diabetics can suffer a myriad of signs and symptoms: cataracts, cranial nerve palsies, pupillary abnormalities, neovascular glaucoma; and are more susceptible to vein and artery occlusions and ocular ischaemic syndromes. The treatment of such conditions should ideally be based on current scientific evidence and clinical trials showing the effectiveness of the treatment provided. However, itis important to consider each individual patient and their specific needs as well as taking into account the experience of the practitioner administering the treatment needed.
Dr Brinda Muthusamy MRCP MRCOphth
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Optometric Correlates of Reading Difficulties
27/02/09
In this second article of the series on vision and reading difficulties, the optometric factors (for example refractive error and orthoptic function) that may be associated with reading problems are discussed in detail. The first article of this series introduced the correlates of, and interventions for, reading difficulties that have been supported by evidence-based research. This present article describes the optometric correlates more specifically, providing details of the aspects of visual function that ought to be considered for further investigation.
Bruce JW Evans, Peter M Allen, Arnold J Wilkins
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C-10556 Features of Diabetic Retinopathy and Grading Protocols
13/02/09
Diabetic retinopathy is a chronic progressive sight-threatening disease of the retinal microvasculature. People with diabetes are 25 times more likely than the general population to become blind. In developed countries, diabetic eye disease represents the leading cause of blindness in adults under 65 years of age. In 2003, it was estimated that there were 194 million people, or 5.1% of the adult population worldwide withdiabetes. With the epidemic of obesity that is currently being experienced in the developed world, it is predicted that this fiqure will rise to 333 million, or 6.3%, by 2025.
Louise O'Toole FRCSI(Ophth), MRCOphth, MMedSci FEBO
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C-10508 Specific Learning Difficulties and Vision
30/01/09
This article is the first in a series of five about vision and reading difficulties, and provides an introduction and an overview of learning disabilities and specific learning difficulties. It outlines the role of the optometrist in helping people with such problems; it describes the symptoms that optometrists should look for and it provides an introduction of the evidence-based approach. The second article in this series will cover the optometric and orthoptic correlates of reading difficulties. Articles three and four will describe the use of coloured filters, including background, techniques, evidence, and mechanism. The final article will draw together the themes in the series of articles and discuss the clinical protocol and the role of the eye care practitioner in managing visual factors associated with reading difficulties.
Dr Peter Allen, Prof Bruce Evans, Prof Arnold Wilkins
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C-10413/0 The Time bomb of Diabetes - Module 12 Part 1
16/01/09
This article highlights the need for appropriate management of diabetic patients, in order to improve both their ophthalmic and their systemic health. The microvascular and macrovascular complications of diabetes are discussed as well as some of the newer treatments. As the incidence of diabetes is rising, it is important that an optometrist has a good working knowledge of this systemic disease. It is important that there is good communication between the optometrist and the patient’s GP as the management of diabetes calls for a multidisciplinary approach.
Louise O'Toole FRCSI(Ophth), MRCOphth, MMedSci and FEBO
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