Clinical photography in the field of oculoplastic surgery has many applications. It is possible for clinicians to obtain standardized clinical photographs without a studio. A clinician photographer has the advantage of knowing exactly what to photograph as well as having immediate access to the images. In order to maintain standardization in the photographs, the photographic settings should remain constant. This article covers essential photographic equipment, camera settings, patient pose, and digital asset management.
Test anxiety is defined as the reaction to stimuli that is associated with an individual's experience of testing or evaluating situations. This study aims to examine the fluctuation pattern of anxiety symptoms during a clinical examination and its relationship with underlying anxiety traits. Fourth year medical students of Penang Medical College undertaking the Ophthalmology clinical examination participated in this study. First phase of the survey, on anxiety symptoms was conducted immediately after the Ophthalmology clinical examination while the second phase, on pre-existing anxiety traits was conducted six weeks later with the aid of STAI instrument. Responses for both stages were combined and analyzed. Sixty-three of 122 students responded to both phases of the study, giving a response rate of 52%. All symptoms except trembling peaked 10 minutes before the exam begun showing a downward progression with no resurgence thereafter. Students with pre-existing anxiety traits had high anxiety scores 10 minutes into the examination and while with the examiners. Anticipatory anxiety is a source of concern and can effect performance and appropriate steps should be taken to help the students with this. A few other studies should be done to conclude.
Rising demand of ophthalmology care is increasingly straining Malaysia's public healthcare sector due to its limited human and financial resources. Improving the effectiveness of ophthalmology service delivery can promote national policy goals of population health improvement and system sustainability. This study examined the performance variation of public ophthalmology service in Malaysia, estimated the potential output gain and investigated several factors that might explain the differential performance.
The knowledge and clinical and minor surgical skills acquired by 257 medical students in three universities in Sri Lanka and Malaysia were assessed by a questionnaire after they had completed their training period in ophthalmology. This study showed that many medical students graduating from these universities lacked the basic clinical and minor surgical skills essential for a doctor practising in a community in south-east Asia. The responses also indicated that teaching by consultants in all three universities was inadequate and due to these inadequacies the students requested that the duration of their training period be doubled. Ophthalmology is an important component of clinical practice and proper education in this subject is important. An urgent revision of the aims and objectives of the curriculum in ophthalmology is essential to place greater emphasis on this important and much neglected subject, for which very little curricular time is allotted.
BACKGROUND: Although lecture handouts are commonly given to students during theory lectures, students' perception, as well as their performance, can vary depending on the type of handouts they receive for information processing.
METHODOLOGY: This is a quasi-experimental study involving 6(th) semester medical students. The study was conducted during theory lectures on ophthalmology. The two types of notes given to the students were comprehensive handout and a skeleton handout, which included some lecture notes but required substantial annotation by the students. Pre-test and post-test in the form of multiple choice questions were conducted before and after the lecture session, respectively.
RESULTS: There was a significant difference of mean score of pre- and post-test between skeletal handout (pre = 1.85 ± 1.275, post = 4.85 ± 0.363) and full handout (pre = 1.92 ± 1.09 post = 2.61 ± 0.771) with P < 0.001. However, the students' responses to questionnaires indicated a strong preference for much detailed handouts as essential to preparation for examinations.
CONCLUSION: The student can improve their performance during examination while working on skeletal handouts during theory lectures i n spite of showing a preference for complete handouts.
KEYWORDS:Handout; interactive; lecture; medical student; skeleton
With an increase in the advancement of digital imaging and computing power, computationally intelligent technologies are in high demand to be used in ophthalmology cure and treatment. In current research, Retina Image Analysis (RIA) is developed for optometrist at Eye Care Center in Management and Science University. This research aims to analyze the retina through vessel detection. The RIA assists in the analysis of the retinal images and specialists are served with various options like saving, processing and analyzing retinal images through its advanced interface layout. Additionally, RIA assists in the selection process of vessel segment; processing these vessels by calculating its diameter, standard deviation, length, and displaying detected vessel on the retina. The Agile Unified Process is adopted as the methodology in developing this research. To conclude, Retina Image Analysis might help the optometrist to get better understanding in analyzing the patient's retina. Finally, the Retina Image Analysis procedure is developed using MATLAB (R2011b). Promising results are attained that are comparable in the state of art.
During the period 1996-1998, 134 patients suspected of having ocular toxoplasmosis were seen in the Ophthalmology Clinic of the University Hospital, Kuala Lumpur. Clinical presentations in these patients ranged from poor vision to severe retinal detachment. Of these patients, 72% were confirmed positive for Toxoplasma gondii infection by serological methods. Chorioretinjtis and vitritis were found to be the most apparent symptoms, both having 100%correlation with serological positivity, This was followed by uveitis, floaters, and retinal detachment with correlation at 78%, 75%and 75%, respectively. However, there was no correlation between level of serotitre and ocular presentations. KEYWORDS: Toxoplasmosis, serology, chorioretinitis, uveitis
A Web-based service was set up to link subspecialist ophthalmologists with those seeking advice on particular clinical problems in ophthalmology. The service operated between countries, with centres in Malaysia, Ghana, Tanzania, South Africa and Gambia seeking advice from Moorfields Eye Hospital in the UK. It also operated within country, where a rural clinic in The Gambia sought advice from the central hospital on difficult cases or cases for possible referral. Provision of Web access and training in image capture and manipulation were undertaken in each participating centre. During the first 12 months, 132 cases were posted to the Website from five of the six centres participating. The rate of case referral rose to about 12-14 cases per month by the end of the study. Overall, 24% of referrals did not use images. In the first four months the response time was 13 days, and in the last four months it was three days. Most cases were answered with a single response from the specialist. The main problem was the amount of Internet down-time in each of the locations. The main benefit was safe and reliable access to specialist advice for practitioners.
Matched MeSH terms: Ophthalmology/methods*; Ophthalmology/statistics & numerical data
AIMS: To apply cumulative sum (CUSUM) in monitoring performance of surgeons in cataract surgery and to evaluate the response of performance to intervention.
METHOD: A CUSUM analysis was applied to 80 phacoemulsification performed by three ophthalmic trainees and one consultant, for the occurrence of posterior capsular rupture and postoperative refracted vision of worse than 6/12 among patients without pre-existing ocular comorbidity. The CUSUM score of each consecutive procedure performed by an individual surgeon was calculated and charted on CUSUM chart. When trainees' CUSUM charts showed an unacceptable level of performance, their supervisors would give feedback and impose closer monitoring of subsequent surgeries.
RESULTS: CUSUM charts of the trainees demonstrated an initial upward followed by flattening trend. This reflects learning curves in their process of acquiring competency in phacoemulsification. In contrast, the consultant showed a flat curve indicating an ongoing maintenance of competence.
CONCLUSION: The CUSUM analysis is able to monitor and promptly detect adverse events and trends of unacceptable outcomes in cataract surgery. This objective and dynamic monitoring makes CUSUM a useful audit tool for individual surgeons, but more so for busy consultants who need to supervise trainees.
Full thickness macular hole is an eye disease, which can cause permanent visual impairment. Current advancement in vitreoretinal surgery has high success rates in repairing them, leading to a significant visual improvement, especially if patient presents early. In this article, three cases of idiopathic full thickness macular hole with different visual outcomes have been presented. All cases were referred by the primary care practitioners and had undergone macular hole surgery with the same vitreoretinal surgeon. The visual outcome was best in the patient who had the earliest presentation and referral. Early detection and referral of these patients is vital so that early surgical intervention can be carried out to improve their vision.
Sino-nasal osteoma is a common benign tumour of paranasal
sinuses and usually asymptomatic. Here, we presented a case of a huge sinonasal osteoma. Despite the large size of the tumour, the only presentation
was epiphora. There were no headache, facial pain or diplopia. Nasal
obstruction only occurred after involvement of the nasal cavity. In diagnosing
aetiology of the epiphora, sino-nasal pathology needed to be ruled out after
excluding ocular causes. Multidisciplinary approach between otolaryngology
(ORL) team and ophthalmology team was essential in managing the case.
The tumour was successfully removed surgically via endoscopic approach;
and dacryocystorhinostomy (DCR) was performed to alleviate the epiphora.
The purpose of this study was to identify the most common forms of age-related cataracts and to estimate possible risk factors for age-related cataracts in a sample of cataract patients at the National University of Malaysia Hospital. Thirty five patients (17 males and 18 female) with cataracts were recruited from the ophthalmology ward and clinic at the hospital. The age range of the patients was between 39 to 93 years (mean 64.9 11.5 years). The Lens Opacities Classification System (Locs) III was used to grade nuclear, cortical and posterior subcapsular lens opacities. Grading of the cataract was carried out and the following information was collected: initial visual acuity and best-corrected visual acuity, demographic details, health history, dietary intake of antioxidants and lifetime ocular ultraviolet B exposure. Analyses were conducted using a standard case-control design. T-tests were used to assess the significance of continuous variables and chi-squared tests were used for categorical variables. The overall prevalence of cortical cataract was 34.4% (12 patients), nuclear cataract was 60.0% (21 patients), and posterior subcapsular cataract was 57.1% (20 patients). No significant potential risk factor was found for nuclear cataracts. In the case of posterior subcapsular cataract, hypertension was the only potential significant risk factor (x2 = 4.38, p = 0.036), and in the case of cortical cataract, cigarette smoking was the only significant risk factor. Although lifetime effective ocular UV-B exposure was found to be not a significant potential risk factor, but it was seen that for cortical cataracts, the mean difference of lifetime effective ocular UV-B exposure between those with cortical and those without cortical cataracts was larger compared to others with nuclear and posterior subcapsular cataracts. Hypertension was found to be a potential significant risk factor for posterior subcapsular cataract whereas cigarette smoking was a potentially significant risk factor for cortical cataract. Although not statistically significant, lifetime effective ocular UV-B exposure maybe a potential risk factor for cortical cataract.
Contact lenses provide an alternative to spectacles for many people. However, the hazard of bacterial corneal ulcers exists. This article describes a soft contact lens wearer who developed a bacterial corneal ulcer. Prompt diagnosis and treatment is essential for eradication of the infection and prevention of loss of vision.
Sinus surgery has the potential of allowing ENT surgeons to encroach the boundaries of our colleagues in ophthalmology and neurosurgery. The advent of nasal endoscope and lately powered instrumentation and computer-assisted navigational systems has avoided the use of the conventional and more radical approaches by the ENT surgeon for the treatment of inflammatory pathology or tumors of the orbit and skull base. As rhinologists have gained more experience in endoscopic surgery, more areas related to the orbit and the anterior skull base are accessible and surgery is safer.