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J T Gillow

Publications and source records attributed to J T Gillow.

11 recordsLinked to original sources

Are patient information leaflets contributing to informed consent for cataract surgery?

AIM: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent. METHOD: Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union the leaflets were assessed for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed. RESULTS: All the units' leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50-75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high. CONCLUSION: Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets.

Cataract Extraction↗

Is the role of trabeculectomy in glaucoma management changing?

BACKGROUND: In recent years there have been significant developments in the diagnosis and treatment of glaucoma. We conducted a study to determine whether there has been an associated change in trabeculectomy rates in England over this period. METHODS: Figures for the total number of trabeculectomies and cataract operations performed in England for each year from 1989/90 to 1999/2000 were obtained from the Department of Health, Hospital Episode Statistics Division. RESULTS: The available data show that the number of trabeculectomies and cataract operations increased year on year from 1990/91 until 1995/96. Since then, the number of cataract procedures has continued to rise dramatically, whereas the number of trabeculectomies has fallen progressively by 7%, 23%, 37% and 53% in the last 4 years. CONCLUSION: The perceived need for surgical intervention would appear to have been delayed or prevented. We postulate that several factors underlie this trend and that there are a number of implications regarding the future management of glaucoma patients.

Cataract Extraction↗

Primary open angle glaucoma and hypothyroidism: chance or true association?

The prevalence of hypothyroidism in British patients with primary open angle glaucoma (POAG) was examined. A recently reported study from Montreal had shown a significant increase (p < 0.004) in biochemical hypothyroidism (23.4%) in a population of 64 POAG patients compared with controls (4.7%). Mechanisms for a possible causal association between the two diseases are discussed, including mucopolysaccharide deposition in the trabecular meshwork and vasculopathy altering ocular bloodflow. Reports of improved glaucoma control following treatment of hypothyroidism are discussed. This study examined 100 consecutive patients with POAG in a specialist glaucoma clinic. All patients were questioned regarding symptoms of thyroid dysfunction and previous thyroid disease. All patients not already taking thyroxine underwent an assay of thyroid stimulating hormone. The 4% (95% CI 1.1-9.4%) prevalence of overt hypothyroidism in our study shows no clinically significant increase either over controls in the Montreal study or over our local population. We conclude that in our local population there is no evidence for a clinically important association of hypothyroidism with glaucoma.

Aged↗

Ocular perforation during peribulbar anaesthesia.

Six cases of ocular perforation after peribulbar anaesthesia are reported. They were referred to our vitreoretinal unit from other hospitals over a 6 week period. Some recent reports of ocular perforation with peribulbar anaesthesia suggest a good prognosis. In this series all six required surgical intervention and most cases associated with a retinal detachment had a poor outcome. This study highlights the dangers of ocular perforation and emphasises the need for supervised training of peribulbar anaesthesia and early referral should ocular perforation occur.

Aged↗

A survey of ocular perforation during ophthalmic local anaesthesia in the United Kingdom.

A survey of local anaesthetic related ocular perforation in the United Kingdom is reported. A total of 531 consultant ophthalmologists were sent a postal questionnaire and there was a 71% response rate. Thirty respondents reported 39 perforations occurring under their care during the previous year. Details of the cases are presented. The rate of local anaesthetic related ocular perforation is higher than in previous reported series. Efforts to reduce the incidence will require consideration of alternative techniques, audit, and training.

Anesthesia, Local↗

Another weapon too far: the anti-personnel laser.

The last decade has seen the development of military lasers designed to blind. Medical professionals dedicated to the prevention and treatment of visual disability, and particularly ophthalmologists under the terms of their newly acquired Royal Charter, have a responsibility to: document this new technology; explain its medical effects; and influence the threshold at which these weapons might be used. Proposals to prohibit anti-eye laser warfare at The United Nations Convention Conference in September 1995 present a unique opportunity to stigmatize blinding as a method of warfare.

Blindness↗

The erection sign.

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Humans↗