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Arquivos Brasileiros de Oftalmologia 2019This review aims to caution ophthalmologists about the ocular consequences leading to the diagnosis of hepatitis C virus infection. In addition, in this context, the... (Review)
Review
This review aims to caution ophthalmologists about the ocular consequences leading to the diagnosis of hepatitis C virus infection. In addition, in this context, the effects of old and new drugs are discussed in the ophthalmological setting. The importance of early diagnosis and the curative treatment of the disease has been reported in the national and international literature, demonstrating that its progression has important implications for daily clinical and surgical ophthalmological practice. Despite the scarcity of studies on new direct-acting antiviral drugs, fewer side effects of these drugs have been shown when compared with conventional interferon treatment with or without ribavirin. The ophthalmologist's risk of becoming infected, as demonstrated by the presence of the virus in ocular structures, and the possibility of contamination, is also discussed.
Topics: Antiviral Agents; Eye Infections, Viral; Hepatitis C; Humans; Interferons; Ribavirin; Risk Factors
PubMed: 30698233
DOI: 10.5935/0004-2749.20190027 -
Eye (London, England) Jun 2021
Topics: Antirheumatic Agents; Humans; Hydroxychloroquine; Ophthalmologists; Prevalence; Retinal Diseases; United Kingdom
PubMed: 33514907
DOI: 10.1038/s41433-021-01411-6 -
Klinische Monatsblatter Fur... Apr 2023Assessment of diagnostic and therapeutic strategies currently used in routine practice for myopia management in Europe.
PURPOSE
Assessment of diagnostic and therapeutic strategies currently used in routine practice for myopia management in Europe.
METHODS
Online survey study including 11 main questions. The questionnaire was sent to members of the European Paediatric Ophthalmology Society (EPOS). The following items and questions were surveyed: I. Profession and workplace of the survey participants. II. Preventive measures and recommendations for myopia management, a) regarding reading distance and near work, b) optical tools, i.e., application of Defocus Incorporated Multiple Segments (DIMS) glasses, near additions, or contact lenses, and c) the application of atropine eye drops. III. Application of additional diagnostic tools.
RESULTS
Forty-eight individuals completed the survey. Of the respondents, 88% (n = 42) affirmed that they generally gave advice on strategies for myopia prevention and management strategies. Almost all study participants (n = 41; 85%) recommend outdoor time as a preventive measure. The recommendation on near distance is given less frequently, with 28 (58%) participants confirming that they do recommend a "safe" reading distance, and 15 (31%) negating this. Eight (17%) survey participants recommend using near addition glasses, while 36 (75%) do not. Similarly, 35 (73%) respondents do not apply DIMS glasses and 8 (17%) apply them. Fourteen (29%) participants recommend myopia-reducing contact lenses while 30 (63%) do not, and 29 (60%) confirmed that they applied atropine eye drops to slow myopia progression while 14 (29%) do not prescribe these eye drops. The majority of respondents (n = 25; 86%) who prescribe atropine eye drops use atropine 0.01% eye drops.
CONCLUSIONS
Prevention and therapeutic management of childhood myopia is an essential part in the daily routine of pediatric ophthalmologists. Substantial agreement was found for the protective role of outdoor time (85%). The only common therapeutic approach is the administration of atropine eye drops (60%).
Topics: Humans; Child; Ophthalmologists; Disease Progression; Myopia; Atropine; Surveys and Questionnaires; Ophthalmic Solutions; Refraction, Ocular
PubMed: 37164443
DOI: 10.1055/a-2013-2713 -
Ceska a Slovenska Oftalmologie :... 2020Carotid-cavernous fistula (CCF) is an abnormal communication - vascular connection between arteries and veins in the cavernous sinus. Classification according to... (Review)
Review
Carotid-cavernous fistula (CCF) is an abnormal communication - vascular connection between arteries and veins in the cavernous sinus. Classification according to etiology is traumatic vs spontaneous. According to blood flow rate per high flow vs low flow fistula. According to anatomy of direct vs indirect: Direct (direct) CCF arises through direct communication between the internal carotid artery (ICA) and the cavernous sinus. Indirect CCF originates through indirect communication through the meningeal branches of ICA, external carotid artery and cavernous sinus (not directly with ICA) and Barrow type A, B, C, D division. Patients subjective complaints depend on the type of CCF. Most often it is pulsating tinnitus, synchronous with blood pulse. Typical findings include protrusion and pulsation of the eyeball, corkscrew vessels - arterialization of conjunctival and episleral vessels, increased intraocular pressure, not responding to local antiglaucomatous therapy, keratopathy a lagophthalmo, corneal ulcers. In the later untreated stages of CCF, secondary, venous stasis or central retinal vein occlusion can occur. Diagnostic procedures include B-scan and color Doppler ultrasonography, digital ophthamodynamometry, computer tomography, nuclear magnetic resonance and digital subtraction angiography. CCF can simulate orbitopathy, conjunctivitis symptoms, carotid occlusion, scleritis or cavernous sinus thrombosis. The ophthalmologist should recognize and indicate the necessary examinations in a timely manner. The therapy is ophthalmological, neuroradiological, sterotactic, surgical and conservative.
Topics: Carotid-Cavernous Sinus Fistula; Cavernous Sinus; Fistula; Humans; Magnetic Resonance Imaging; Ophthalmologists
PubMed: 33086846
DOI: 10.31348/2020/8 -
Trends in Molecular Medicine Jun 2020The current coronavirus disease 2019 (COVID-19) pandemic is rapidly spreading around the world. The first doctor to report this new disease was an ophthalmologist: this... (Review)
Review
The current coronavirus disease 2019 (COVID-19) pandemic is rapidly spreading around the world. The first doctor to report this new disease was an ophthalmologist: this exemplifies the role of ophthalmologists in an infectious disease pandemic. Here we review how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the eye and discuss implications for ophthalmologists.
Topics: Betacoronavirus; COVID-19; Conjunctiva; Conjunctivitis, Viral; Coronavirus Infections; Eye; Humans; Ophthalmologists; Ophthalmology; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32470381
DOI: 10.1016/j.molmed.2020.03.008 -
Survey of Ophthalmology 2022Vision loss with clinical findings that are incompatible with the symptoms and recognized neurological or ophthalmic conditions is a common presentation of patients to... (Review)
Review
Vision loss with clinical findings that are incompatible with the symptoms and recognized neurological or ophthalmic conditions is a common presentation of patients to neurologists, ophthalmologists, and neuro-ophthalmologists. The accepted terminology to describe such patients has evolved over time, including functional visual disorder (FVD), non-organic vision loss, non-physiologic vision loss, functional vision loss, psychogenic, psychosomatic, and medically unexplained visual loss. Likewise, attitudes and recommended management options have changed over the years in the fields of psychiatry and neurology. FVD is a diagnosis of inclusion, and it is critical that the diagnosis be made and delivered efficiently and effectively to reduce patient and physician duress. We review the current Diagnostic and Statistical Manual (DSM V) terminology and the prior literature on FVD and describe how the approaches to diagnosis and management have changed. We provide recommendations on the appropriate techniques and diagnostic approach for patients with FVD. We also propose a protocol for consistent and standardized discussion with the patient of the diagnosis of FVD. We believe that the adoption of FVD as both a paradigm and nomenclature shift in ophthalmology will improve patient care.
Topics: Adult; Humans; Ophthalmologists; Ophthalmology; Vision Disorders
PubMed: 33737039
DOI: 10.1016/j.survophthal.2021.03.002 -
Indian Journal of Ophthalmology Nov 2019
Topics: Clinical Competence; Delivery of Health Care; Education, Medical, Graduate; Eye Diseases; Humans; Ophthalmologists; Ophthalmology; Point-of-Care Systems
PubMed: 31638034
DOI: 10.4103/ijo.IJO_1922_19 -
JAMA Network Open Aug 2023Large language models (LLMs) like ChatGPT appear capable of performing a variety of tasks, including answering patient eye care questions, but have not yet been...
IMPORTANCE
Large language models (LLMs) like ChatGPT appear capable of performing a variety of tasks, including answering patient eye care questions, but have not yet been evaluated in direct comparison with ophthalmologists. It remains unclear whether LLM-generated advice is accurate, appropriate, and safe for eye patients.
OBJECTIVE
To evaluate the quality of ophthalmology advice generated by an LLM chatbot in comparison with ophthalmologist-written advice.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used deidentified data from an online medical forum, in which patient questions received responses written by American Academy of Ophthalmology (AAO)-affiliated ophthalmologists. A masked panel of 8 board-certified ophthalmologists were asked to distinguish between answers generated by the ChatGPT chatbot and human answers. Posts were dated between 2007 and 2016; data were accessed January 2023 and analysis was performed between March and May 2023.
MAIN OUTCOMES AND MEASURES
Identification of chatbot and human answers on a 4-point scale (likely or definitely artificial intelligence [AI] vs likely or definitely human) and evaluation of responses for presence of incorrect information, alignment with perceived consensus in the medical community, likelihood to cause harm, and extent of harm.
RESULTS
A total of 200 pairs of user questions and answers by AAO-affiliated ophthalmologists were evaluated. The mean (SD) accuracy for distinguishing between AI and human responses was 61.3% (9.7%). Of 800 evaluations of chatbot-written answers, 168 answers (21.0%) were marked as human-written, while 517 of 800 human-written answers (64.6%) were marked as AI-written. Compared with human answers, chatbot answers were more frequently rated as probably or definitely written by AI (prevalence ratio [PR], 1.72; 95% CI, 1.52-1.93). The likelihood of chatbot answers containing incorrect or inappropriate material was comparable with human answers (PR, 0.92; 95% CI, 0.77-1.10), and did not differ from human answers in terms of likelihood of harm (PR, 0.84; 95% CI, 0.67-1.07) nor extent of harm (PR, 0.99; 95% CI, 0.80-1.22).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study of human-written and AI-generated responses to 200 eye care questions from an online advice forum, a chatbot appeared capable of responding to long user-written eye health posts and largely generated appropriate responses that did not differ significantly from ophthalmologist-written responses in terms of incorrect information, likelihood of harm, extent of harm, or deviation from ophthalmologist community standards. Additional research is needed to assess patient attitudes toward LLM-augmented ophthalmologists vs fully autonomous AI content generation, to evaluate clarity and acceptability of LLM-generated answers from the patient perspective, to test the performance of LLMs in a greater variety of clinical contexts, and to determine an optimal manner of utilizing LLMs that is ethical and minimizes harm.
Topics: Humans; Artificial Intelligence; Ophthalmologists; Cross-Sectional Studies; Software; Language
PubMed: 37606922
DOI: 10.1001/jamanetworkopen.2023.30320 -
Irish Journal of Medical Science Dec 2023Healthcare systems have increasingly limited and stretched budgets. Clinicians have a key role in budget allocation. Awareness of the costs of high-use clinical items is...
BACKGROUND
Healthcare systems have increasingly limited and stretched budgets. Clinicians have a key role in budget allocation. Awareness of the costs of high-use clinical items is important.
AIMS
Assess awareness of the cost of commonly utilised clinical items amongst Irish Ophthalmologists METHODS: Irish ophthalmologists were contacted and asked to fill out an anonymous survey. We assessed knowledge of hospital costs of surgical materials, medications and anti VEGF drugs as well as retail pharmacy costs of commonly prescribed medications. The cost of items to the hospital was recorded from pharmacy and ward order receipts from a single university hospital. The costs of items to the patient were calculated by taking an average of 3 prices charged by local retail pharmacies. For each estimate we calculated the absolute error from the true price. We calculated the mean absolute errors (MAE) and percentage errors (MAPE) across the different groups.
RESULTS
We received responses from 47 participants (15 Senior House Officers, 11 Registrars, 21 Consultant/Community Ophthalmologists). Despite 70% of respondents agreeing that the cost of an item should have a major role in its use, the average estimate was 124% inaccurate. Less than 50% of responses were within 50% of the true cost of the item. Self-perceived knowledge was acknowledged to be limited or very limited in 73% of responses.
CONCLUSIONS
We demonstrate variable and limited levels of cost awareness. Seniority and better self-perceived knowledge were not found to be associated with better estimate accuracy.
Topics: Humans; Ophthalmologists; Surveys and Questionnaires; Health Personnel; Hospitals, University
PubMed: 37119367
DOI: 10.1007/s11845-023-03332-7 -
International Journal of Ophthalmology 2020We are living in a mobile world, where the number of medical apps is surging in recent years. Over 320 000 healthcare apps are now available as shown in the latest... (Review)
Review
We are living in a mobile world, where the number of medical apps is surging in recent years. Over 320 000 healthcare apps are now available as shown in the latest research. The major function and potential of these apps vary, from assisting the learning and practice of clinicians as well as achieving better outcomes of patients to preventing eye diseases through the education of healthy individuals. However, based on the various features, ophthalmology apps nowadays contain a wide range of subjects and focus on different stakeholders in the ophthalmic practice, including but not limited to doctors, patients, and researchers. Here, we review special and advanced apps that ophthalmologists will find useful in their clinical practice.
PubMed: 32821689
DOI: 10.18240/ijo.2020.08.21