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Biomedical subjects

I F Wessels

Publications and source records attributed to I F Wessels.

At least 37 records · Page 2Linked to original sources
PubMed1993

Modifying a Polaroid camera for close-up documentation.

A standard plus-three-diopter trial lens held in front of the objective lens of an inexpensive Polaroid camera produces close-up photographs of acceptable quality. This simple technique can be used to inexpensively document indications for plastic surgery and provide medicolegal documentation. The 23-millimeter-diameter trial lens provided acceptable resolution, but reduced depth of field; it must be well-centered to avoid vignetting.

Forensic Medicine↗
PubMed1993

Indirect micro-ophthalmoscopy: intraoperative binocular indirect ophthalmoscopy with the operating microscope.

A hand-held indirect lens and an operating microscope can provide a view of the fundus similar to that provided by the usual binocular indirect ophthalmoscope headpiece. The only modification required is that the working distance must be increased to allow the microscope to be focused on the aerial image created by the hand-held lens. This technique provides a cost-effective means of retinal examination in preparation for intraocular lens implantation. Also, the view of the fundus it provides when complications such as choroidal hemorrhage or lens nucleus dislocation occur, facilitates appropriate management. It also can be used during posterior segment procedures such as foreign body removal, posterior vitrectomy, and retinal detachment repair. The advantages of this method include the possibility of using the microscope's zoom capability to provide greater magnification, and beam splitters for video or still-camera documentation of the findings during examination under anesthesia.

Cataract Extraction↗
PubMed1992

Intravitreal antibiotics: accuracy of dilution by pharmacists, ophthalmologists, and ophthalmic assistants, using three protocols.

We compared the accuracy with which general ophthalmologists, pharmacy personnel, and ophthalmic assistants diluted intravitreal antibiotics, using a method of their own devising, a new protocol using an insulin syringe, and Duane's protocol. The insulin syringe method proved less accurate and more complex than Duane's protocol, but was better than not using a standardized protocol at all. With all methods, the pharmacy personnel produced the most accurate dilutions, with the least variability. The ophthalmologists' dilutions were much more variable both without a protocol and with the insulin syringe method, but they were acceptable with the Duane's protocol. The ophthalmic assistants produced unacceptable results with all methods. Since the decision to inject antibiotics is usually made under emergency conditions, when errors of dilution are more likely, whenever possible, pharmacy personnel should be entrusted with providing the dosage of medications to be injected intraocularly. If pharmacists are unavailable, ophthalmologists may reconstitute medications using a reliable and simple protocol such as Duane's.

Anti-Bacterial Agents↗
PubMed1990

Tonometer utilization, accuracy, and calibration under field conditions.

A field survey conducted in 94 ophthalmologists' offices in our immediate area assessed the accuracy of tonometers in daily use. One hundred eighty-five instruments were examined: 127 were slit lamp mounted, 48 were hand held, and 10 were noncontact devices. Nineteen percent of applanation tonometers were outside the manufacturers' specifications (1 mm Hg of the calibration) and 4.5% were more than 2 mm Hg in error. The error was constant across the scale. Hand-held applanators were less accurate than those on slit lamps (P less than .02); the latter demonstrated an association between accuracy and age (P less than .05) and heavier use (P less than .01). Annual recalibration was performed in 86% of instruments. Those practitioners who themselves performed the calibration had the most accurate instruments. Less than 15% knew how to perform the calibration check.

Calibration↗
PubMed1990

Posterior infectious crystalline keratopathy with Staphylococcus epidermidis.

Two cases of infectious crystalline keratopathy located in the posterior stroma after penetrating keratoplasty are presented. Topical steroids and suture removal were risk factors in both cases. In the first case, a moderate anterior chamber reaction was present. Crystalline infiltrates persisted on topical and systemic steroid therapy. In the second case, deep corneal ulceration, hypopyon, and vitreitis were noted. A vitreous aspirate showed rare gram-positive cocci in pairs. The corneal ulceration and crystalline keratopathy persisted despite intravitreal and topical antibiotics. Therapeutic penetrating keratoplasty was performed in both cases. Staphylococcus epidermidis sensitive to vancomycin was isolated from corneal tissue. Light microscopy documented aggregates of gram-positive bacteria anterior to Descemet's membrane, with an overlying keratitis. Electron microscopy in the second case showed all bacteria within stromal keratocytes. No clinical recurrence was seen using topical vancomycin. As demonstrated in the cases presented, infectious crystalline keratopathy can occur exclusively in the deeper layers of the cornea. Isolation of S. epidermidis, associated inflammation, and intraocular spread of organisms are rare findings.

Aged↗
PubMed1989

Delayed subretinal fluid absorption after pneumatic retinopexy.

Eight of 38 eyes consecutively treated with pneumatic retinopexy were found to have delayed subretinal fluid absorption (DSRFA). In six of eight eyes, a shallow pocket of loculated fluid developed with small subretinal pigment precipitates, possibly a unique feature associated with pneumatic retinopexy. Although loculated DSRFA may not affect the anatomic success, poor visual outcome can result if the macula is involved (4 eyes). Loculated submacular DSRFA may cause bothersome postoperative symptoms, because its resolution may be prolonged for months. Factors found significantly associated with DSRFA were subretinal precipitates and heavy cryotherapy. Demarcation lines, dependent subretinal fluid by the macula, long duration of detachment, and phakic status were factors more frequently found in eyes with than without DSRFA, although the correlations lacked statistical significance. A detailed description of loculated DSRFA after pneumatic retinopexy not found in the literature is presented.

Absorption↗
PubMed1989

Project Canvas-Back in the Marshall Islands.

Using the catamaran boat "Canvas-Back" during May 1987, a whole-population ocular survey utilizing modern equipment and ophthalmic subspecialists was conducted on one of the atolls (Wotje) in the Marshall Islands. A relatively low prevalence of ocular pathology, especially of cataract, infectious disease, and nutritional blindness was found. A far greater need exists for refractive services than for surgical ophthalmic care. The only exception is related to the high incidence of hyperglycemia, which indicates that greater efforts in the treatment and prevention of retinopathy are required.

Adolescent↗
PubMed1989

Positive anatomic orientation of corneal transplant tissue.

Anatomic orientation of corneal donor tissue is consistently possible by cutting a "V"-shaped notch in the scleral rim at 12 o'clock. An obvious marker improves the evaluation of suspicious lesions by other observers, facilitates accurate communication of findings to corneal surgeons, and aids in instructing new eye bank technicians. A further possible benefit is that the marker permits anatomically correct orientation of corneal tissue.

Cornea↗
PubMed1989

Applicator for cyanoacrylate tissue adhesive.

Cyanoacrylate tissue adhesive (CTA) is very useful for emergency treatment of corneal perforations. Lack of Food and Drug Administration approval as well as concerns about toxicity from the application of large amounts of glue, however, have limited its use. It is difficult to apply a sufficiently small amount of glue or to achieve a water tight seal using published techniques of glue application. We have found a commercially available micropipette (used in dental work) to be more effective than other methods of CTA application. With this apparatus, precise and accurate placement of minimal amounts of CTA at the slit lamp is consistently possible.

Adult↗
PubMed1988

Community eye care 10 years after Alma Ata: progress, problems, and priorities for private voluntary organizations in developing nations.

The 1978 International Conference on Primary Health Care held in Alma Ata, USSR, made a strong appeal for recognizing that blindness is avoidable. Most blindness can be cured by medical and surgical means, or prevented by public health measures. Now, 10 years later, it is appropriate to review and evaluate a decade of primary eye care. This article describes and reviews from a managerial perspective at three levels of intervention a community eye care program for Afghan refugees established in 1982 by the League of Red Cross in Pakistan. Factors for success and problems are analyzed, and priorities for the future are suggested.

Afghanistan↗
PubMed1988

Refugee eye care: a frequently overlooked dimension of disaster assistance.

During the 1986 Refugee Health Group Workshop held at the London School of Hygiene and Tropical Medicine, the lead author surveyed 35 refugee workers' perceptions of blindness and its prevention in refugee communities. This paper analyzes and reports the results. Those surveyed generally agreed that blindness is a community problem of public health magnitude in most, if not all, refugee communities. In addition, respondents reported inadequate eye care services and a scarcity of literature on the topic. Refugee health organizations often overlook the need for eye care, and blindness prevention agencies are often unaware of the needs of particular refugee communities. The authors make recommendations for stimulating greater interest and active involvement in the prevention of blindness among refugees.

Delivery of Health Care↗