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Biomedical subjects

J G Classé

Publications and source records attributed to J G Classé.

At least 37 records · Page 2Linked to original sources
PubMed1995

Lasers and liability.

Ophthalmic laser procedures are not a significant cause of liability claims. When claims are brought, they usually allege negligence, breach of the doctrine of informed consent, or both. The most likely cause of a liability claim is laser photocoagulation for diabetic retinopathy. Among anterior segment procedures, treatment for glaucoma is most likely to produce a claim.

Anterior Eye Segment↗
PubMed1995

Binocular vision anomalies: an emerging cause of malpractice claims.

BACKGROUND: Tumors that affect the visual system are a significant cause of liability claims involving eyecare practitioners. Individuals with brain tumors or intraocular tumors may seek examination for associated binocular vision disorders such as strabismus and reduced acuity. A disporportionate number of these individuals are children. METHODS: A review of malpractice claims was performed to identify representative clinical presentations in which binocular vision disorders were the cause for examination. RESULTS: Strabismus and amblyopia in children, if not promptly diagnosed and properly treated, can be the basis for a malpractice claim. Binocular vision disorders may also result from brain or intraocular tumors affecting children, and failure to timely detect the presence of these underlying diseases can also become the basis for a malpractice claim. CONCLUSIONS: Eyecare practitioners should examine carefully children with binocular vision disorders to rule out the possibility of an associated brain or intraocular tumor. Key findings include decreased visual acuity, acute strabismus, and indications of neurological disease such as optic atrophy, papilledema, visual field loss, and problems with gait and coordination.

Brain Neoplasms↗
PubMed1995

Five liability claims involving the cornea and how they could have been prevented.

Five recent professional liability claims involving the cornea are reviewed, arising from five unusual conditions: fungal infection following corneal abrasion with a tree branch; herpes simplex-induced neurotrophic keratitis resulting from contact lens wear; corneal necrotization caused by lime particulate matter splashed into the eye; siderosis-related retinal detachment secondary to a penetrating iron foreign body; and fluctuating acuity, halos, and flare resulting from radial keratotomy. Emphasis is on how these claims might have been avoided.

Adult↗
PubMed1994

Avoiding liability in contact lens practice.

Contact lens practice is the leading source of liability claims involving optometrists. Claims most often allege negligence, although informed consent or product liability may also be causes of legal claims for damages. For daily wear patients, the most likely causes of claims are nonapproved use of lenses or solutions, monovision contact lenses, negligence by a contact lens technician, failure to verify lenses before dispensing, mismanagement of contact lens-related corneal abrasions, and inadequate monitoring of ocular health. For extended-wear patients, the most common sources of liability claims are inappropriate patient selection, inadequate training of patients, improper wearing schedules, improper management of contact lens-related corneal complications, and inadequate monitoring of ocular health.

Contact Lenses↗
PubMed1994

Recordkeeping and contact lens practice.

Recordkeeping in contact lens practice may be based on a problem-oriented system that emphasizes the use of forms. Fitting agreements and informed consent agreements are the most important components of such a system. Progress notes are also used to document the episodic care that is an integral part of contact lens practice. Examination findings should be described with descriptive language whenever possible; warnings, diagnoses, patient management, and recall and referral appointments should be conscientiously documented in the record of care.

Contact Lenses↗
PubMed1994

Management of contact lens prescriptions.

A patient's access to information in an optometrist's record is regulated by an amalgam of federal and state laws and judicial decisions. The inspection of records by patients is permitted except under extraordinary circumstances, and optometrists who refuse access in contravention to legal requirements face disciplinary action from regulatory boards. Although contact lens prescriptions are part of an optometrist's record, the obligation to release prescriptions is restricted to 17 states. Optometrists in these states must comply with the requirements of state law; in other states, optometrists should establish an office policy for the release of contact lens prescriptions, communicate this policy to patients at the start of the doctor-patient relationship, and ensure that it is properly administered.

Contact Lenses↗
PubMed1994

Protocols for co-management.

Co-management by optometrists and ophthalmologists requires a written expression of the protocol for examination, treatment, and follow-up of patients. The protocol should also describe how and when information is to be shared between practitioners. To facilitate the communication process, standard forms should be adopted for use by all practitioners. Example protocols and sample forms are provided for the most common types of clinical situations in which co-management is required: postoperative care of cataract patients; treatment of glaucoma patients; and preoperative and postoperative management of radial keratotomy patients.

Eye Diseases↗
PubMed1993

Brain tumors, malpractice, and optometry.

Intracranial tumors affecting the visual system are a source of malpractice claims involving optometrists. Signs and symptoms of disease, such as papilledema, optic atrophy, decreased visual acuity, headache, loss of visual field, acute onset incomitant strabismus, and gradually worsening coordination, should prompt optometrists to rule out the possibility of an underlying intracranial lesion. Appropriate optometric and medical evaluation should be provided. Co-management of care with other health care practitioners should be scrupulously coordinated and documented.

Brain Neoplasms↗
PubMed1993

Legal aspects of management of ocular trauma.

Patients suffering from blunt ocular trauma pose several legal challenges for primary eye care practitioners. Although optometrists in private practice are under no legal duty to examine patients with ocular trauma, failure to do so breaches ethical considerations. When an optometrist undertakes examination of an injured patient, a medical standard of care will be applied, and "Good Samaritan" statutes afford no shield from liability for negligence committed during the course of examination and treatment. If specialized care is necessary, a timely referral must be arranged. Practitioners are liable for the acts or omissions of employees, and receptionists who schedule appointments should be able to triage patient complaints so that same-day appointments are scheduled for patients requiring urgent assessment and care. Documentation of the disposition of these patients is essential; forms are an ideal way to record and preserve essential information.

Eye Injuries↗
PubMed1993

The initial assessment of ocular contusion injury.

The initial assessment of blunt ocular trauma requires taking a thorough history, measuring visual acuity, evaluating pupils, extraocular muscles, intraocular pressure, and anterior adnexa, and examining the interior of the eye by means of biomicroscopy and ophthalmoscopy. More sophisticated means of examination may be necessary before treatment strategies can be determined. The most common types of injuries are contusions, abrasions, lacerations, and penetrating wounds of the eye. The most serious injuries requiring treatment are penetrating wounds, hyphemas, and retinal detachments. The initial goal of management is to provide timely recognition and treatment of the injury, and to stabilize the condition and promptly refer the patient if specialized care is necessary.

Eye Foreign Bodies↗