简介:Simulationcanbedefinedasmalingering,orsometimesfunctionalvisualloss(FVL).Itmanifestsaseithersimulatinganophthalmicdisease(positivesimulation),ordenialofophthalmicdisease(negativesimulation).Consciousbehaviorandcompensationorindemnityclaimsareprominentfeaturesofsimulation.Sincesomeauthorssuggestthatthisisamanifestationofunderlyingpsychopathology,evenconversionisincludedinthiscontext.Intoday’sworld,everyophthalmologistcanfacewithsimulationofophthalmicdiseaseordisorder.Incaseofsimulationsuspect,thephysician’sresponsibilityistoprovethesimulationconsideringthedisease/disorderfirst,andsimulationasanexclusion.Insimulationexaminations,thephysicianshouldbefirmandsmarttoselectappropriatetest(s)toconvincenotonlythesubject,butalsothejudgeincaseofindemnityorcompensationtrials.Almostallophthalmicsensoryandmotorfunctionsincludingvisualacuity,visualfield,colorvisionandnightvisioncanbethesubjectofsimulation.Examinermustbeskillfulinselectingthemostappropriatetest.Apartfromthoseintheliterature,weincludedallkindsofsimulationinophthalmology.Inaddition,simulationexaminationtechniques,suchas,useofOCT(opticalcoherencetomography),frequencydoublingperimetry(FDP),andmodifiedpolarizationtestswerealsoincluded.Inthisreview,wemadeathoroughliteraturesearch,andaddedourexperiencestogivethereadersup-to-dateinformationonmalingeringorsimulationinophthalmology.
简介:AIM:Toevaluatetheepidemiologic,anatomic,andclinicalfeaturesofopenglobeinjuriesinchildren.METHODS:Themedicalfilesofpatientsundertheageof16whohadbeenoperatedforanopenglobeinjuryatAkdenizUniversityHospital’sDepartmentofOphthalmologywereretrospectivelyevaluated.RESULTS:Atotalof90patientswereevaluatedinthisstudy.Amongthesepatients,26(28.9%)werefemaleand64(71.1%)weremale.Themeanageofthepatientswas7.7±4.2years.Themale/femaleratiowasobservedtoincreasewithincreasingage(P=0.006,P=7.48).Injuriesweremostlikelytooccurinspringandautumn(P=0.028).Thetimeintervalbetweentheinjuryandthesurgicalrepairwas9.36±27.4h.Forty(44.4%)oftheinjuriesoccurredinthehome,27(30%)occurredintheyard,and21(23.3%)happenedwhileplayinginthestreet.Themostcommoncausesofinjuryweresharpmetalobjects(P<0.001).Injurytothecorneaoccurredin47(52.2%)ofthepatients(P<0.001).Themostcommoncomplicationtooccurwascataractformation.Additionaloperationswerenecessaryfor37(41.1%)ofthepatients.Thefinalvisualacuitywascorrelatedwithboththeinitialvisualacuityofthewoundedeyepriortosurgeryandthelengthofthewound(P<0.001,r=0.502andP<0.001,r=-0.442,respectively).CONCLUSION:Openglobeinjuriesthataresufferedinchildhoodgenerallyoccureitherathome,intheyard,oronthestreet,withsharpmetalobjectsbeingthemostcommoncauseofinjury.Theinitialvisualacuityandthelengthofthewoundarethemostimportantdeterminantsofthefinalvisualacuity.
简介:目的以接受免费白内障手术的患者电话随访结果为依据,对我省防盲项目完成效果进行评价、分析,探讨提出加强和完善基层医院眼科参与大规模防盲项目患者的可持续随访体系。方法通过以电话随访的方式,对2012年云南省'光明工程'6万例免费白内障手术患者中随机抽取2000例患者就手术视力提高程度及满意度进行电话随访。随访统一使用云南省卫生厅《2012年云南省'光明工程'患者电话随访表》,由专人于4周内完成电话随访。结果患者术后视力明显提高者占90.20%;患者对术后满意度达93.27%;从生活不能自理到能自理占86.41%;术后生活质量明显提高占85.79%;术后患眼有不适者占17.76%;知道如出现不适如何处理的患者占70%;新农合占93.81%,居民医保5.56%,职工医保1.64%,其他医保占0.88%;所有患者均为免费手术,无自付比例。结论在基层开展大规模集中白内障防盲项目的过程中,在严格监控患者术后质量、手术费用、住院天数、降低患者的医疗费用的同时,更应该加强对手术患者的长效管理机制,建立合理的患者随访体系,总结经验,不断完善工作流程,真正改善患者的生活质量,提高患者满意度,体现防盲工作的真正含义。