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Biomedical subjects

Ian Murdoch

Publications and source records attributed to Ian Murdoch.

5 recordsLinked to original sources
PubMed2003

Assessment of benefit in tele-ophthalmology using a consensus panel.

A videoconferencing link was established from a hospital in South Africa to Moorfields Eye Hospital in London. A clinician in South Africa used a video slit-lamp and videoconferencing equipment to capture images and communicate with a specialist in London. Over 12 months, 113 cases were discussed in teleconsultations. Case-notes were subsequently obtained for 90 cases (80%). Three consultant ophthalmologists took part in the consensus process, one from the UK and two from South Africa. The consensus panel achieved on average 78-96% agreement on the items rated. In approximately half the cases, the panel judged that teleconsultation had had an effect on diagnosis. In nine cases (10%) there was potential for definite improvement in visual health as a result of tele-ophthalmology and in a further 48 cases (53%) there was potential for possible improvement in visual health. The consensus process identified 35 cases (39%) where there was potential improvement in general health as a result of tele-ophthalmology. Despite the methodological limitations of our approach, it was possible to learn a great deal about the effectiveness of the telemedicine intervention.

Adolescent↗
PubMed2002

Learning to live with glaucoma: a qualitative study of diagnosis and the impact of sight loss.

Glaucoma is a major cause of preventable sight loss. As there are no obvious symptoms in the early stages, when it is most beneficial to start treatment, the key to reducing undiagnosed glaucoma in the community is better case finding among those at higher risk. This qualitative study aimed to identify triggers to self-referral for glaucoma symptoms in a sample from Britain, and to explore the meaning of symptoms for people living with moderate to severe glaucoma. Participants (N = 28) reported low levels of awareness of glaucoma prior to their diagnosis, and had assumed that symptoms were the 'normal' deterioration of eyesight expected with other morbidity or advancing age. As symptoms have a gradual onset, participants had learnt to cope with diminishing sight ability. However, many reported that such coping was 'at a cost', and that managing in a world designed for the well sighted caused problems for activities of everyday living, work and family life. The salience of these problems was shaped primarily by social factors, which framed both the practical consequences of sight loss and their meaning for respondents. Findings from this study suggest health promotion is a priority to increase public awareness of the existence and symptoms of glaucoma among those at high risk, and that more attention could be given to reducing the environmental and social causes of disability.

Activities of Daily Living↗
PubMed2002

The role of telemedicine in the assessment of strabismus.

Thirty patients with strabismus were seen face to face by an ophthalmologist and an orthoptist. The patients were then presented by the same orthoptist to a second ophthalmologist via a telemedicine link. Twenty-six patients were seen using a bandwidth of 384 kbit/s and four using 128 kbit/s. There was agreement between the two ophthalmologists about diagnosis and management in 24 cases, partial agreement in one and no agreement in five (17%). Manifest strabismus was safely diagnosed and managed using telemedicine at 128 kbit/s, although 384 kbit/s was preferred because it obviated the need for repeated examination. Latent strabismus and micro-movements were difficult to diagnose using telemedicine even at 384 kbit/s. Young patients who are unable to sit still would not be suitable for strabismus assessment via telemedicine.

Adult↗