The cornea is clear, but why?
15/12/00
An essential prerequisite for proper vision is a clear and healthy cornea. But what makes this tough connective tissue transparent to visible light? The key is thought to lie in the arrangement of collagen
Andrew J Quantock BSc, PhD
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Optometric assessment and management in dyslexia
15/12/00
Dyslexia has been described as a language coding problem and can be considered to be synonymous with the term specific reading problem. It is not related to social, emotional, economic or obvious disease (e.g. Down?s syndrome) problems and can only be diagnosed by an educational or child psychologist. There may be difficulty with reading, spelling, understanding language that is heard, and clear expression when speaking or writing.
Frank Eperjesi BSc, PhD, MCOptom, FAAO
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Neurology and the eye - Case histories
01/12/00
Module 2 part 12 is devoted to five case histories to demonstrate the real life clinical presentations of neuro-ophthalmic conditions and some of the important features to aid diagnosis and management
Adrian Parnaby-Price MA, MB, BChir (Cantab), FRCSEd
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Managing corneal abrasions
01/12/00
The cornea, with its plethora of ocular nerves, precise anatomical structure, clarity and curvature, is a significant ocular structure. In fact, it accounts for two thirds of the total power of the eye (43.00D). When injured or damaged, sight threatening consequences are possible. Armed with only the eyelid and reflexes for protection, the tissue is exposed and vulnerable to injury.
Andrew S. Gurwood OD, FAAO
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The genetics of cataract
17/11/00
Cataract describes any opacity which affects the cortex of nucleus of the lens. Cataracts are broadley divisible into two major groups. First, developmental or congenital cataract in which the normal development of the lens is affected by genetic, nutritional or inflammatory changes and second, degenerative cataract, which includes senile cataract and cataract, associated with radiation or systemic disease.
Richard A Armstrong BSc, DPhil and Stephen N Smith, BSc, PhD
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The Chromagen method for colour deficiency and specific learning difficulties
17/11/00
Chromagen therapy was first devised by dispensing optician, David Harris, who undertook his original research and development at the Corneal Laser Centre in Clatterbridge. Since then, the product has been bought and licensed by the Ultralase clinic in Chester. Recently Cantor and Nissel has become the new owner and sole distributor of Chromagen products. In the first instance, Chromagen contact lenses were used to help patients with colour deficiency.
Nigel Burnett Hodd Bsc, FCOptom, Dip.CLP
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Thyroid ophthalmology (Grave's disease)
03/11/00
Thyroid eye disease, Grave?s ophthalmology, dysthyroid ophthalmology, and Grave?s disease are all synonymous terms connoting a process that is clinically characterised by eyelid retraction, proptosis, conjunctival exposure, ocular injection, ocular chemosis, corneal compromise, extraocular muscle infiltration and fibrosis with the potential for compressive optic neuropathy. It is the most common cause of bilateral, symmetric proptosis in adults.
Andrew S Gurwood OD, FAAO
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Localised CNS lesions and their effect on visual function
03/11/00
The theme of this article is the description of visual disorders after acquired posterior brain injury. There is evidence of selective disorders of the perception of colour, movement, space, and objects and faces, supporting the view that the human visual cortex is anatomically segregated and functionally specialised.
Professor Josef Zihl PhD
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National service frameworks and screening for diabetes
20/10/00
National Service Frameworks (NSFs) are documents which set national standards and define service models for a particular are of the Health Service. To date, NSFs have been published for coronary care and mental health.
Trevor Warburton BSc, FCOptom, Stockport LOC Chairman and AOP General Councillor
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Exudative age related macular degeneration
06/10/00
Age related macular degeneration (ARMD) is the most common cause of blindness in patients older than 65 years in the United States, Canada, United Kingdom and Australia, and it ranks second after diabetic retinopathy as the leading cause of blindness in the 45-64 age group. Nearly 30 per cent of persons older than 75 years of age are affected by ARMD.
Marvyn Elton BPharm, MRPharmS, ACPP, BSc, MCOptom and Dr Juan Giralt MD
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The differential diagnosis of diplopia
06/10/00
Every clinician should be aware of the importance of an appropriate response to the symptom of diplopia. The aetiology can vary from uncorrected astigmatism to life threatening intracranial anomalies. A previous article (CPD Module 2 Part 6) has described many of the different causes of diplopia. This article discusses the ways in which they can be differentiated.
Dr Alison Finlay BSc, PhD, DIC, MCOptom, DBO, lecturer, Department of Optometry
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Understanding disease. Medicine and surgery for the optometrist
22/09/00
In this series of articles, a moderately detailed account of human disease, their pathology, clinical features, investigative findings and briefly treatment will be give.
Mukesh Patel, BSc(Hons) Optom, Pharmacol, DOpt.
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CMV retinitis associated with patients with AIDS
22/09/00
Cytomegalovirus is a herpes family, DNA virus that is not commonly discussed yet it is, by nature, a highly ubiquitous micro-organism.
Kevin B. Wynne OD, FAA0
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The visual pathways: disorders of the optic chiasm and beyond
08/09/00
The most important diagnosis to be discussed is compression of the optic chiasm. This is because visual symptoms may be the only symptoms and visual signs the only signs of this problem, and in the early stages visual loss is reversible.
Chris Hammond MRCP, FRCOphth
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A survey of specified recall intervals for eye examinations
18/08/00
his survey examines the recall intervals specified by optometrists for a variety of different patient groups. Two years is shown to be the most frequently specified interval for normal, healthy adults. The consensus view for children is that they should be routinely examined at intervals of one year or less.
Trevor Warburton BSc, FCOptom, Charles Wass FBOA,, Bob Wilkes BSc, MCOptom
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How to use the small claims court
28/07/00
If a customer or a supplier owes you money and refuses to settle, the only solution may be to go to court. For claims up to ?5,000 you often hear of the - ?small claims court?, but what this really means is the special procedure for handling smaller claims in a county court. The small claims track is designed to be quick, cheap and easy to use.
Wilf Altman
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Disorders of the visual pathway: from the optic disc to the visual cortex
28/07/00
Diagnosis of neuro ophthalmological disorders has been transformed over the last 20 years with the advent of CT (computed tomography) and MRI (magnetic resonance imaging) scanning to examine the brain and optic nerves. However, before these examinations are performed, someone has to detect an abnormality of appearance of the optic disc or reduced function of the afferent visual system to warrant expensive and in the case of CT scan x-ray radiation potentially harmful investigations. Patients will often first present to their optometrist with vague complaints, and their practitioner must make the decision whether or not to refer.
Chris Hammond MRCP, FRCOphth.
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Valid clinical reasons for patient re-examination
14/07/00
Jane Bell, Chairman of Dorset LOC, expresses her personal opinions on the frequency of NHS sight tests and reports the results of a small survey she undertook in practice
Jane Bell, Chairman of Dorset, LOC
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Bilateral penetrating keratoplasties - A case report
14/07/00
A 47-year-old woman was referred to the eye department of St. George?s Hospital due to gradually deteriorating vision. It was established that she had bilateral penetrating keratoplasties (RE 1978, LE 1983) due to advanced keratoconus. Although the grafts were well-positioned and clear, they had induced high, oblique and irregular corneal astigmatism.
Alex Levit BSc (Hons), FCOptom (CL CVP)
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Afferent pupillary defect associated with Optic Nerve Head Drusen
14/07/00
This article examines Optic Nerve Head Drusen (ONHD) which are a relatively uncommon finding with an estimated prevalence of anywhere from 0.3 to 2%. Reports of relative afferent pupillary defects (RAPD) associated with ONHD are scarce. But it is important for the clinician to consider an RAPD as a possible pathological feature of ONHD, especially with an asymmetric presentation.
Hal Bohlman OD
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Central retinal vein occlusion
30/06/00
Most optometrists will be familiar with the acute central retinal vein occlusion (CRVO) and the blood and thunder appearance of the retina. This appearance is one of the most striking in ophthalmology.
Marvyn Elton BPharm, MRPharmS, ACPP, BSc, MCOptom
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Adult neuro-degenerative diseases and their neuro-ophthalmological features
30/06/00
A wide range of primary neuro-degenerative diseases occurs in adult life. This article will concentrate on idiopathic Parkinson?s disease and other primary degenerations causing Parkinsonism, Huntingtons disease, multiple sclerosis, Alzheimer?s disease and motor neuron disease. The detection of certain neuro-ophthalmological signs is not essential for the correct diagnoses of these diseases, but when seen alongside the neurological and neuropsychological features, they can be diagnostically informative.
Dominic J. Mort BA, MBBS, MRCP and Professor Christopher Kennard PhD, FRCP
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The use of data analysis methods
16/06/00
This article is the first in a series on data analysis methods. It is aimed primarily at eyecare practitioners in primary care hospital or university settings who are undertaking clinical research, and who require a basic knowledge of statistics to analyse their experimental data.
Richard A. Armstrong BSc, DPhil & Frank Eperjesi BSc, MCOptom, FAAO
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Non-laser refractive surgery procedures
16/06/00
This article, the final in this series on refractive surgery, provides information on and an overview of the method, potential risks and benefits of non-laser refractive surgery procedures. It is hoped that it will enable optometrists to provide their patients with accurate advice and counselling.
Emanuel Rosen BSc, MBCh, MD, FRCS, FRCOphth, Elizabeth Kowalewski BSc, FCOptom a
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Eye movement disorders
02/06/00
When we look at the world with two eyes, we take it for granted that we see one single impression of the external world. The visual system that brings about this situation is very complex, and represents a delicate balance between neural and muscular processes.
Chris Bentley BSc, FRCOphth and Angela Rees BSc, MBBS
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LASIK
19/05/00
LASIK has revolutionised refractive surgery and is a quantum improvement over previous methods. This article will explain why.
Simon G. Levy MD, MRCP, FRCS, FRCOphth
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Post-operative cataract care in the community The patient's view
19/05/00
The results of a survey of patients who took part in a cataract shared care pilot scheme in the Stockport area last year, are reported in this article.
Trevor J. Warburton BSc, FCOptom, Chairman of Stockport LOC
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Differential diagnosis of headache
05/05/00
Headache is a very common symptom in optometric practice. Patients presenting with headache and visual symptoms are an important sub-group.
Gavin Giovannoni FCP, PhD
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Effective management of induced dry eye syndrome with soft CLs
21/04/00
In 1998, over 98% of new fits in the UK were for multi use and single use disposable soft contact lenses. Although patient drop-out rates have fallen and are now estimated to be less than 10%, adverse responses to soft lenses are continuing.
Ron Loveridge FBDO (Hons)CL, FAAO, FIACLE, DMS, MIMgt
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Photorefractive keratectomy
21/04/00
Lasers have been associated with ophthalmology since their inception. Ophthalmology was the first speciality in medicine to utilise lasers and is still the field in which the greatest variety and numbers are used.
David O'Brart MD, FRCS, FRCOphth
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Pupil abnormalities Module 2 Part 4
07/04/00
This article will summarise the relevant anatomy and physiology of pupillary control, outline the pharmacological aspects of pupillary evaluation and discuss common pupil abnormalities and their clinical significance. There are a number of excellent reviews of this subject for the interested reader
F. D. Bremner MBBS, BSc, PhD, FRCOphth
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Refractive cataract surgery
24/03/00
Life has never been so exciting for the cataract surgeon and his/her patient. The optometrist--s role will soon be revolutionised by new government guidelines on cataract surgery. This review explains why.
Simon G. Levy MBBS, MD, MRCP(UK), DO, FRCS (Ed), FRCOphth
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Anterior uveitis
24/03/00
Uveitis is an intraocular inflammatory disease of the uveal tract (iris, cilliary body and choroid) and secondarily involved adjacent structures (e.g. cornea, sclera). It occurs at an incidence of approximately 1 in 8,333 Americans and typically affects patients between the ages of 20 and 60.
Michael J. Trad OD
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Visual pathways, Part 2
10/03/00
The theme of this article is the distribution of the visual input relayed from the lateral geniculate nucleus to the cerebral cortex, and the subsequent partitioning of different aspects of visual function to largely distinct cortical regions. Not all of the visual areas will be considered in depth. Instead, the article concentrates on those areas about which most is known and the functional segregation amongst them.
Dr Gary Baker BSc, MSc, PhD
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Preventing irrecoverable visual loss in CQ and HCQ therapy
10/03/00
Optometrists may encounter patients treated with either chloroquine (CQ) or hydroxychloroquine (HCQ). These drugs are quinolones, and have been known to cause irreversible retinal toxicity.
Frederick G. Brown FBOA, HD, FSMC, Dorth
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Ocular side-effects of systemic drugs NSAIDs, anti-histamines and anti-migraine drugs
10/03/00
In the final part of his series on the ocular side-effects of systemic drugs, Mukesh Patel looks at the ocular effects of NSAIDs, anti-histamines and anti-migraine drugs.
Mukesh Patel BSc (Hons) Pharmacol, BSc (Hons) Optom
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Corneal topography
25/02/00
Corneal topography plays an important role in the management of patients undergoing refractive surgery. It is therefore vital for any eyecare professionals involved in this field to have a good understanding of its principles and applications.
Melanie C. Corbett MD, FRCS
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Neuro-ophthalmology imaging techniques and applications
11/02/00
Earlier methods, using plain X-rays and tomograms, have been surpassed by high resolution, cross sectional imaging techniques such as computed tomography (CT) and more recently, diagnostic magnetic resonance imaging (MRI) and computational morphometrics. Blood vessels can now be imaged non-invasively with CT and MRI, and vascular lesions can be treated by endovascular techniques. Furthermore, insight into cerebral physiology can be obtained with positron emission tomography (PET) and a variety of functional MR techniques. These include diffusion weighted imaging (DWI), perfusion imaging, spectroscopy and blood oxygenation level dependent (BOLD) imaging. These new techniques continue to advance at a rapid pace, affording new insights into the structure and function of the brain and visual system in clinical and research settings.
Catriona D. Good MB, ChB, FFRad, FRCR
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Clinical case history - Q&A
28/01/00
Case number 6 A 26-year old woman developed a lump in her right upper lid.
Chris Heaven FRCOphth, FCOptom
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Refractive Surgery and the Optometrist
28/01/00
In this first article of a new, six-part College-accredited series on refractive surgery, consultant ophthalmic surgeon, Sheraz M. Daya, considers the role and responsibility of the optometrist in the rapidly evolving area of refractive surgery.
Sheraz M. Daya MD, FACP, FACS, FRCS (Ed)
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Visual pathways, Part 1
14/01/00
The visual system is arguably the most thoroughly studied of all the sensory systems. This is probably due not only to the importance of this particular sensory modality, but also in part because of its utility as an experimental model for the study of the anatomical and physiological organisation of central nervous pathways. Visual stimuli are more readily controlled and presented than other sensory stimuli, and the system is relatively accessible for experimental manipulation.
Dr Gary Baker BSc, MSc, PhD
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Clinical case history - Q&A
14/01/00
Case number five. Expand your clinical knowledge with our series of cases from the files of consultant ophthalmic surgeon, Chris Heaven.
Chris Heaven FRCOphth, FCOptom
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