DOCSLIB.ORG

Ophthalmic Study Guide

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

67859 study guide cover:Layout 1 21/10/2009 11:18 Page 1 The Ophthalmic Study Guide Study Ophthalmic The In recent years, an increasing variety of professionals have been involved in the care of ophthalmic patients. This study guide, written by a team of specialist ophthalmic practitioners, enables nurses, healthcare assistants and other health professionals to The develop useful, basic ophthalmic knowledge quickly, whether they need it for their day-to-day work or as preparation for taking a higher qualification in ophthalmology. The Ophthalmic Study Guide has a number of helpful features, including red and amber flags to indicate urgent and less urgent symptoms, plentiful diagrams, lists of useful online resources, and simple questions at the end of many of the chapters, which Ophthalmic can be used for self-testing or as a basis for mentors’ questions to their students. There are also ‘To do’ boxes, which allow students to reflect on their own practice and develop good habits of self-assessment and self-directed learning. Study Guide Contents include G Basic anatomy and physiology of the eye G Basic pharmacology Other titles include G Treatment of cataracts G Treatment of glaucomas G Retinal problems G Macular degeneration G Ophthalmic equipment for Nurses and G Basic ophthalmic procedures Health Professionals Ophthalmology Books available from M&K Research Issues in Health Routine Blood Results The ECG Workbook and Social Care Explained 2/e ISBN: 978-1-905539-14-7 • 2008 ISBN: 978-1-905539-20-8 • 2009 ISBN: 978-1-905539-38-3 • 2007 Field/Tillotson/Macfarlane Issues in Ophthalmic Practice: Current and future challenges ISBN: 978-1-905539-17-8 • 2009 The Clinician’s Guide to Nurses and Their Patients: The Management of COPD Chronic Disease Management Informing practice through in Primary and Secondary for Long-term Conditions: psychodynamic insights Care A cognitive–behavioural ISBN: 978-1-905539-31-4 • 2009 ISBN: 978-1-905539-28-4 • 2007 approach ISBN: 978-1-905539-15-4 • 2008 ISBN: 978 1-905539-40-6 Dorothy Field PUBLISHING is an imprint of M&K Update Ltd Julie Tillotson Eye Emergencies: Mandy Macfarlane The practitioner’s guide For books and training courses visit: PUBLISHING ISBN: 978-1-905539-08-6 • 2008 www.mkupdate.co.uk 67859 osg prelims:Layout 1 21/10/2009 11:17 Page i Ophthalmic Study Guide for Nurses and Health Professionals i 67859 osg prelims:Layout 1 21/10/2009 11:17 Page ii Other Ophthalmology books from M&K: Eye Emergencies: The practitioner’s guide ISBN: 978-1-905539-08-6 · 2007 Issues in Ophthalmic Practice: Current and future challenges ISBN: 978-1-905539-17-8 · 2009 Other Health & Social Care books from M&K include: Routine Blood Results Explained 2/e ISBN: 978-1-905539-38-3 · 2008 The ECG Workbook ISBN: 978-1-905539-14-7 · 2008 Arterial Blood Gas Analysis: An easy learning guide ISBN: 978-1-905539-04-8 · 2008 Nurses and Their Patients: Informing practice through psychodynamic insights ISBN: 978-1-905539-31-4 · 2009 The Management of COPD in Primary and Secondary Care ISBN: 978-1-905539-28-4 · 2007 The Clinician’s Guide to Chronic Disease Management for Long Term Conditions: A cognitive-behavioural approach ISBN: 978-1-905539-15-4 · 2008 Identification and Treatment of Alcohol Dependency ISBN: 978-1-905539-16-1 · 2008 Perspectives on Death & Dying ISBN: 978-1-905539-21-5 · 2009 67859 osg prelims:Layout 1 21/10/2009 11:17 Page iii Ophthalmic Study Guide for Nurses and Health Professionals Edited by Dorothy Field Julie Tillotson Mandy Macfarlane 67859 osg prelims:Layout 1 21/10/2009 11:17 Page iv The Ophthalmic Study Guide Dorothy Field, Julie Tillotson and Mandy Macfarlane ISBN: 978-1-905539-40-6 First published 2009 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: 01768 773030, fax: 01768 781099 or email: [email protected] Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Notice Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the Publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication. The Publisher To contact M&K Publishing write to: M&K Update Ltd · The Old Bakery · St. John's Street Keswick · Cumbria CA12 5AS Tel: 01768 773030 · Fax: 01768 781099 [email protected] www.mkupdate.co.uk Designed and typeset in 11pt Usherwood Book by Mary Blood Illustrations by Mary Blood Printed in England by Reed’s Printers, Penrith 67859 osg prelims:Layout 1 21/10/2009 11:17 Page v Contents List of figures vii List of tables viii About the editors ix About the contributors ix Acknowledgements x Preface ix More about this book xiii 1 Information for students and mentors 1 Dorothy Field 2 Basic anatomy and physiology of the eye 7 Dorothy Field 3 Basic refraction 25 Dorothy Field 4 Basic pharmacology 37 Julie Tillotson and Dorothy Field 5 Preoperative cataract information 49 Claire Adams and Dorothy Field 6 Intraoperative management of cataract patients 63 Dorothy Field 7 Postoperative cataract care 73 Claire Adams, Pauline Haley and Dorothy Field 8 The glaucomas, primary open-angle glaucoma and congenital glaucoma 85 Lynn Ring 9 Primary angle-closure glaucoma 101 Lynn Ring 10 The secondary glaucomas 109 Lynn Ring v 67859 osg prelims:Layout 1 21/10/2009 11:17 Page vi 11 Retinal problems 119 Dorothy Field 12 Age-related macular degeneration 133 Dorothy Field and Mandy Macfarlane 13 Ophthalmic equipment 145 Sue Cox 14 Basic ophthalmic procedures 155 Dorothy Field Appendix 1 Record of ophthalmic knowledge and skills development 187 Appendix 2 Glossary of common ophthalmic abbreviations and terms 195 Answers to self tests 203 Index 207 vi 67859 osg prelims:Layout 1 21/10/2009 11:17 Page vii List of figures 2.1 The eye 7 2.2 The eyelid 8 2.3 The tear film 9 2.4 The lacrimal apparatus 11 2.5 The conjunctival fornices 11 2.6 The cornea 12 2.7 Aqueous drainage 16 2.8 The layers of the retina 17 2.9 The optic pathways 19 3.1 Viewing a distant object (top) and viewing a near object (below) 26 3.2 Uncorrected myopia (top) and corrected myopia (below) 27 3.3 Uncorrected hypermetropia (top) and corrected hypermetropia (below) 28 3.4 Corrected astigmatism (top) and uncorrected astigmatism (below) 29 3.5 Lens box and trial frame 31 5.1 A focimeter 55 5.2 The IOL Master 57 13.1 The exophthalmometer 145 13.2 The indirect exophthalmometer 148 13.3 Humphrey field analyser 151 14.1 The Ishihara test (P7) 160 14.2 The modified Amsler grid 162 14.3 Folded Schirmer’s papers 166 14.4 Patient with Schirmer s papers inserted 166 14.5 Schirmer’s papers are removed simultaneously 166 14.6 Measurement of the wetted area of a Sno-strip 166 14.7 Goldman applanation tonometry 168 14.8 The TonoPen 170 14.9 Bandage contact lens ready for insertion 178 14.10 Bandage contact lens applied 179 vii 67859 osg prelims:Layout 1 21/10/2009 11:17 Page viii List of tables 3.1 Optical prescriptions 32 5.1 Age at first spectacles 54 5.2 Checking your readings by comparing biometry readings with spectacle prescriptions 59 7.1 Postoperative examination conducted at the nurses cataract clinic at Bournemouth Eye Unit 79 7.2 Nursing discharge protocol (with permission from Bournemouth Eye Unit) 81 8.1 Glaucoma drugs 93 14.1 Inflammatory cells seen in the slit lamp beam 173 14.2 Grading of aqueous flare seen in the slit lamp beam 173 viii 67859 osg prelims:Layout 1 21/10/2009 11:17 Page ix About the editors Dorothy Field RGN, OND, BSc (Hons), MA, EdD recently retired as Senior Lecturer Practitioner (ophthalmic nursing) at Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Bournemouth University. She has worked in ophthalmic departments at Bristol, Glasgow and Dublin before spending 23 years in a range of positions in Bournemouth Eye Unit. She is currently employed by Bournemouth eye unit as a ‘bank’ staff nurse, and is enjoying remaining close to patients and the joys and trials of practice within a busy eye unit. Her most recent publication Eye Emergencies was written with Julie Tillotson and published by M&K Update. Julie Tillotson RGN, OND, BSc (Hons) is currently working as a Nurse Consultant in the Acute Referral Clinic at Bournemouth Eye Unit.
Recommended publications
  • Summary Benchmarks for Preferred Practice Pattern® Guidelines

    Summary Benchmarks for Preferred Practice Pattern® Guidelines

    SUMMARY BENCHMARKS FOR PREFERRED PRACTICE PATTERN® GUIDELINES TABLE OF CONTENTS Summary Benchmarks for Preferred Practice Pattern Guidelines Introduction . 1 Glaucoma Primary Open-Angle Glaucoma (Initial Evaluation) . 3 Primary Open-Angle Glaucoma (Follow-up Evaluation) . 5 Primary Open-Angle Glaucoma Suspect (Initial and Follow-up Evaluation) . 6 Primary Angle-Closure Disease (Initial Evaluation and Therapy) . 8 Retina Age-Related Macular Degeneration (Initial and Follow-up Evaluation) . 10 Age-Related Macular Degeneration (Management Recommendations) . 11 Diabetic Retinopathy (Initial and Follow-up Evaluation) . 12 Diabetic Retinopathy (Management Recommendations) . 13 Idiopathic Epiretinal Membrane and Vitreomacular Traction (Initial Evaluation and Therapy) . 14 Idiopathic Macular Hole (Initial Evaluation and Therapy) . 15 Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration (Initial and Follow-up Evaluation) . 17 Retinal and Ophthalmic Artery Occlusions (Initial Evaluation and Therapy) . 18 Retinal Vein Occlusions (Initial Evaluation and Therapy) . 19 Cataract/Anterior Segment Cataract (Initial and Follow-up Evaluation) . 20 Cornea/External Disease Bacterial Keratitis (Initial Evaluation) . 22 Bacterial Keratitis (Management Recommendations) . 23 Blepharitis (Initial and Follow-up Evaluation) . 24 Conjunctivitis (Initial Evaluation) . 25 Conjunctivitis (Management Recommendations) . 26 Corneal Ectasia (Initial Evaluation and Follow-up) . 27 Corneal Edema and Opacification (Initial Evaluation) . 28 Corneal Edema
  • Treacher Collins Prize Essay the Significance of Nystagmus

    Treacher Collins Prize Essay the Significance of Nystagmus

    Eye (1989) 3, 816--832 Treacher Collins Prize Essay The Significance of Nystagmus NICHOLAS EVANS Norwich Introduction combined. The range of forms it takes, and Ophthalmology found the term v!to"[<xy!too, the circumstances in which it occurs, must be like many others, in classical Greece, where it compared and contrasted in order to under­ described the head-nodding of the wined and stand the relationships between nystagmus of somnolent. It first acquired a neuro-ophthal­ different aetiologies. An approach which is mological sense in 1822, when it was used by synthetic as well as analytic identifies those Goodl to describe 'habitual squinting'. Since features which are common to different types then its meaning has been refined, and much and those that are distinctive, and helps has been learned about the circumstances in describe the relationship between eye move­ which the eye oscillates, the components of ment and vision in nystagmus. nystagmus, and its neurophysiological, Nystagmus is not properly a disorder of eye neuroanatomic and neuropathological corre­ movement, but one of steady fixation, in lates. It occurs physiologically and pathologi­ which the relationship between eye and field cally, alone or in conjunction with visual or is unstable. The essential significance of all central nervous system pathology. It takes a types of nystagmus is the disturbance in this variety of different forms, the eyes moving relationship between the sensory and motor about one or more axis, and may be conjugate ends of the visual-oculomotor axis. Optimal or dysjugate. It can be modified to a variable visual performance requires stability of the degree by external (visual, gravitational and image on the retina, and vision is inevitably rotational) and internal (level of awareness affected by nystagmus.
  • 2018 Department of Ophthalmology Chair Report

    2018 Department of Ophthalmology Chair Report

    SAVE THE▼ DATE Department of 200 Ophthalmology Years www.NYEE.edu Anniversary SPECIALTY REPORT | FALL 2018 www.NYEE.edu Celebration Join us for 200 Years and Counting: Bicentennial Cocktail Celebration October 15, 2020 Research Breakthrough: The Plaza 768 5th Avenue Gene Transfer New York, NY Therapy Restores 200 Years and Counting: Ophthalmology Vision in Mice Symposium October 16, 2020 Stay tuned for details on tickets and registration information. Cover image: Slice of a central retina section showing all layers (ONL, INL, GCL). Red indicates rod photoreceptors, located in outer nuclear layer (ONL). Green indicates Müller glial cells, whose cell bodies are located in inner nuclear layer (INL), and their branches across all three layers. Dark blue indicates the nucleus of all cells in three layers (GCL). Icahn School of Medicine at Medical Directors Neuro-Ophthalmology Uveitis and Ocular Immunology Mount Sinai Departmental Mark Kupersmith, MD Douglas Jabs, MD, MBA Avnish Deobhakta, MD Leadership System Chief, System Chief, Uveitis and Ocular Medical Director, NYEE - Neuro-Ophthalmology, Immunology, MSHS James C. Tsai, MD, MBA East 85th Street MSHS President, NYEE Stephanie Llop, MD System Chair, Department of Robin N. Ginsburg, MD 3 Message From the System Chair of the DepartmentValerie Elmalem, of Ophthalmology MD Sophia Saleem, MD Ophthalmology, MSHS Medical Director, NYEE- Joel Mindel, MD East 102nd Street Louis4 R. Pasquale,Breaking MD New Ground in Gene Transfer Therapy to Restore Vision Affiliated Leadership Ocular Oncology Site Chair, Department of Gennady Landa, MD Paul Finger, MD Ebby Elahi, MD, MBA Ophthalmology, MSH and MSQ Medical Director, NYEE- 6 This i-Doctor Is Transforming the Field of Ophthalmology President, NYEE/MSH System Vice Chair, Translational Williamsburg and Tribeca Ophthalmic Pathology Ophthalmology Alumni Ophthalmology Research, MSHS Jodi Sassoon, MD Society Kira Manusis, MD Inside Feature Site Chair, Pathology, NYEE Medical Director, NYEE- Paul A.
  • Description of Alternative Approaches to Measure and Place a Value on Hospital Products in Seven Oecd Countries

    Description of Alternative Approaches to Measure and Place a Value on Hospital Products in Seven Oecd Countries

    OECD Health Working Papers No. 56 Description of Alternative Approaches to Measure Luca Lorenzoni, and Place a Value Mark Pearson on Hospital Products in Seven OECD Countries https://dx.doi.org/10.1787/5kgdt91bpq24-en Unclassified DELSA/HEA/WD/HWP(2011)2 Organisation de Coopération et de Développement Économiques Organisation for Economic Co-operation and Development 14-Apr-2011 ___________________________________________________________________________________________ _____________ English text only DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS HEALTH COMMITTEE Unclassified DELSA/HEA/WD/HWP(2011)2 Health Working Papers OECD HEALTH WORKING PAPERS NO. 56 DESCRIPTION OF ALTERNATIVE APPROACHES TO MEASURE AND PLACE A VALUE ON HOSPITAL PRODUCTS IN SEVEN OECD COUNTRIES Luca Lorenzoni and Mark Pearson JEL Classification: H51, I12, and I19 English text only JT03300281 Document complet disponible sur OLIS dans son format d'origine Complete document available on OLIS in its original format DELSA/HEA/WD/HWP(2011)2 DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS www.oecd.org/els OECD HEALTH WORKING PAPERS http://www.oecd.org/els/health/workingpapers This series is designed to make available to a wider readership health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language – English or French – with a summary in the other. Comment on the series is welcome, and should be sent to the Directorate for Employment, Labour and Social Affairs, 2, rue André-Pascal, 75775 PARIS CEDEX 16, France. The opinions expressed and arguments employed here are the responsibility of the author(s) and do not necessarily reflect those of the OECD.
  • Anesthesia for Eye Surgery

    Anesthesia for Eye Surgery

    Anesthesia for Eye Surgery Having a surgery can be stressful. We would like to provide you the following information to help you prepare for your eye surgery. Eye surgeries are typically done under topical or local anesthesia with or without mild sedation. Topical Anesthesia This is administered via special eye drops by a preoperative nurse. Local Anesthesia This is administered via injection by an ophthalmologist. Your ophthalmologist will inject local anesthesia to the eye that is to undergo the operation. During the injection, you will be lightly sedated. In the operating room During the procedure it is very important that you remain still. This is a very delicate surgery; any abrupt movement can hinder a surgeon’s performance. If you have any concerns during the surgery, such as pain, urge to cough or itching, please let us know immediately. Typically, patients are not heavily sedated for this type of procedure. Therefore, it is normal for patients to feel pressure around their eyes, but not pain. In order to maintain surgical sterility, your face and body will be covered with a sterile drape. You will be given supplemental oxygen to breathe. An anesthesia clinician will continue to monitor your vital signs for the duration of the procedure. The length of the procedure usually ranges from 10 minutes to 30 minutes. In the recovery room After surgery, you will be brought to the recovery room. A recovery room nurse will continue to monitor your vital signs for the next 20 to 30 minutes. It is important that you do not drive or operate any machinery for the next 24 hours.
  • Table of Contents

    Table of Contents

    Leadership Development Program Project Abstracts Table of Contents LDP XXII, CLASS OF 2020 GRADUATES Name/Society/Project Page John J. Chen, MD, PhD 1 North American Neuro-Ophthalmology Society Project: The Neuro-Ophthalmology career path: misconceptions and barriers to recruitment Jeremy D. Clark, MD 2 Kentucky Academy of Eye Physicians and Surgeons Project: The Web of Innovation: Silent Auction Benefitting Political Action funds in Kentucky Gennifer J. Greebel, MD 3 New York State Ophthalmological Society Project: Inspiring Professional Aspirations in Adolescents with Low Vision Mark A. Greiner, MD 4 Eye Bank Association of America Project: Revisiting Eye Banking Medical Standards To Accommodate Emerging Technologies Jennifer F. Jordan, MD 5 North Carolina Society of Eye Physicians and Surgeons Project: Advocacy Exposure for North Carolina Ophthalmologists in Training Kapil G. Kapoor, MD 6 Virginia Society of Eye Physicians and Surgeons Project: Unwrapping Virginia Bill 506B Erin Lichtenstein, MD 7 Maine Society of Eye Physicians and Surgeons Project: Bringing Ophthalmology Residents to Maine Jennifer L. Lindsey, MD 8 Association of Veterans Affairs Ophthalmologists Project: Illuminating the Path to Advocacy for Veterans Affairs Ophthalmologists Donald A. Morris, DO 9 American Osteopathic College of Ophthalmology Project: Single Accreditation of Ophthalmology residencies is here. What is the next step? Lisa Nijm, MD, JD 10 Women in Ophthalmology Project: Implementing a Clinical Trials Training Program to Increase Diversity of Primary Investigators Involved in Ophthalmic Research LDP XXII, CLASS OF 2020 GRADUATES (cont’d) Name/Society/Project Page Roma P. Patel, MD, MBA 11 California Academy of Eye Physicians and Surgeons Project: Increasing Membership Value to our CAEPS Members Jelena Potic, MD, PhD 12 European Society of Ophthalmology Project: Harmonization of Surgical Skills Standards for Young Ophthalmologists across Europe Pradeep Y.
  • Laser Vision Correction Surgery

    Laser Vision Correction Surgery

    Patient Information Laser Vision Correction 1 Contents What is Laser Vision Correction? 3 What are the benefits? 3 Who is suitable for laser vision correction? 4 What are the alternatives? 5 Vision correction surgery alternatives 5 Alternative laser procedures 5 Continuing in glasses or contact lenses 5 How is Laser Vision Correction performed? 6 LASIK 6 Surface laser treatments 6 SMILE 6 What are the risks? 7 Loss of vision 7 Additional surgery 7 Risks of contact lens wear 7 What are the side effects? 8 Vision 8 Eye comfort 8 Eye Appearance 8 Will laser vision correction affect my future eye health care? 8 How can I reduce the risk of problems? 9 How much does laser vision correction cost? 9 2 What is Laser Vision Correction? Modern surgical lasers are able to alter the curvature and focusing power of the front surface of the eye (the cornea) very accurately to correct short sight (myopia), long sight (hyperopia), and astigmatism. Three types of procedure are commonly used in If you are suitable for laser vision correction, your the UK: LASIK, surface laser treatments (PRK, surgeon will discuss which type of procedure is the LASEK, TransPRK) and SMILE. Risks and benefits are best option for you. similar, and all these procedures normally produce very good results in the right patients. Differences between these laser vision correction procedures are explained below. What are the benefits? For most patients, vision after laser correction is similar to vision in contact lenses before surgery, without the potential discomfort and limitations on activity. Glasses may still be required for some activities after Short sight and astigmatism normally stabilize in treatment, particularly for reading in older patients.
  • Pediatric Ophthalmology/Strabismus 2017-2019

    Pediatric Ophthalmology/Strabismus 2017-2019

    Academy MOC Essentials® Practicing Ophthalmologists Curriculum 2017–2019 Pediatric Ophthalmology/Strabismus *** Pediatric Ophthalmology/Strabismus 2 © AAO 2017-2019 Practicing Ophthalmologists Curriculum Disclaimer and Limitation of Liability As a service to its members and American Board of Ophthalmology (ABO) diplomates, the American Academy of Ophthalmology has developed the Practicing Ophthalmologists Curriculum (POC) as a tool for members to prepare for the Maintenance of Certification (MOC) -related examinations. The Academy provides this material for educational purposes only. The POC should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all the circumstances presented by that patient. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any information contained herein. References to certain drugs, instruments, and other products in the POC are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved FDA labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law.
  • Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy

    Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy

    Medical Coverage Policy Effective Date ............................................. 7/10/2021 Next Review Date ....................................... 3/15/2022 Coverage Policy Number .................................. 0554 Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy Table of Contents Related Coverage Resources Overview .............................................................. 1 Balloon Sinus Ostial Dilation for Chronic Sinusitis and Coverage Policy ................................................... 2 Eustachian Tube Dilation General Background ............................................ 3 Drug-Eluting Devices for Use Following Endoscopic Medicare Coverage Determinations .................. 10 Sinus Surgery Coding/Billing Information .................................. 10 Rhinoplasty, Vestibular Stenosis Repair and Septoplasty References ........................................................ 28 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence
  • UCSF Ophthalmology Advice Guide Authors: Seanna Grob, MD, MAS

    UCSF Ophthalmology Advice Guide Authors: Seanna Grob, MD, MAS

    UCSF Ophthalmology Advice Guide Authors: Seanna Grob, MD, MAS and Neeti Parikh, MD Hello! We are excited that you are interested in ophthalmology! It is truly a special field in medicine. From saving someone’s vision after severe eye trauma, to restoring vision with cataract, retina, or cornea surgery, to preserving someone’s vision with glaucoma management and surgery, to reconstructing someone’s periocular area after trauma, burns, or tumor removal, amazing things can happen in ophthalmology. Ophthalmologists love their job and the majority say they would pick this specialty again if they had the choice. An incredible amount of job satisfaction comes from saving someone’s vision! We are here for you in the UCSF Department of Ophthalmology! We have put together this guide to help you through the process. This guide is meant to be very comprehensive. We want to make sure you are aware of all the opportunities and resources you have so that you can plan accordingly. You do not have to do everything we mention! Please feel free to reach out with questions about the specialty, how to get involved, and how to become a great ophthalmology applicant! 1 Medical School A well-rounded application is important for a successful match and any way you can prove to ophthalmology programs that you are dedicated to the field will be helpful to you. As more objective data (such as grades and board scores become less prevalent) other parts of your application will become more important. Various experiences you seek out are not only fun and educational, but will offer exposure to this wonderful field.
  • Eye Tester's Manual

    Eye Tester's Manual

    EYE TESTER’S MANUAL Before using your vision (eye) tester GnomE read this manual carefully to ensure correct use. 1. GENERAL INSTRUCTIONS The home Eye Tester GnomE (or Tester) is a compact, autonomous optical instrument protected by the patent of Russian Federation No. 2202937. The main function of the Tester is to quickly check the parameters of the vision on your own at home or at working place. The Tester can be used in room conditions: - ambient temperature from +10 C to +35 C; average humidity at ambient temperature +25 C from 30% to 80% Absolute measurement accuracy is 0.25 diopter. Dimensions: 14 mm in diameter and 75 mm long Weight (without a case) up to 20g As the Tester is used in proximity to eyes take care of your movements. The Tester is made from safe materials (glass and metals). Please, avoid strong impacts caused by bumping or dropping the tester. The Tester imitates the operation of different kinds of glasses when eye watches remote objects. MEASURING PARAMETERS OF VISION. Checking near- and farsightedness Sit down and make yourself comfortable, take off your glasses or contact lens and hold that part of the Tester where the objective is with your hand (see photo). Look inside the tester through a lens with a checking eye, and read minimal and maximal digits at the scale. The scale looks like a watch, where 12 o’clock corresponds to zero on the scale and normal vision. There are negative values to the left from zero, and positive numbers to the right on the scale too.
  • 672 Rapid Development of Visual Field Defects Associated with Vigabatrin Therapy

    672 Rapid Development of Visual Field Defects Associated with Vigabatrin Therapy

    Case report The incidence of penetrating injury is thought in part to be due to globe shape, with myopic eyes being at A 64-year-old woman presented to eye casualty with a greater risk. Vohra and Good7 suggest, however, that a second episode of right dacryocystitis. The visual acuity medial canthal approach is the safest, especially in larger was 6/6 bilaterally. She was given a 7 day course of oral globes? This is because of a reduction in the equatorial amoxicillin 500 mg t.d.s. with flucloxacillin 250 mg q.d.s. width to axial length ratio in high degrees of axial and was reviewed when the infection had settled. myopia. Inflammation of the tissues surrounding the Syringing showed patent canaliculi with regurgitation usual landmarks, for example following dacryocystitis, and she was listed for dacryocystorhinostomy (DCR) as in this patient, can alter the anatomy of the injection under local anaesthesia. site and increase the risk of perforation. MeyerS reports In the anaesthetic room the patient was sedated with some success with topical anaesthetic techniques which 2.5 mg of intravenous midazolam. Two drops of would eliminate the risk of penetrating ocular injury. amethocaine were instilled into both eyes. Two puffs of Early diagnosis and treatment of ocular perforations 2% lignocaine spray were applied to the right nasal are essential for a good visual outcome6,9 and therefore passage. A nasal pack of 5% cocaine with adrenaline was there should be a high index of suspicion in those cases placed in the right nasal antrum. A local anaesthetic where the injections are excessively painful, or mixture containing 4 ml of 2% lignocaine with 1:200 000 ineffective, or if there is hypotony of the globe or a adrenaline and 4 ml of 0.75% bupivacaine was decrease in visual acuity.