PubMed Health⌕ Search

Biomedical subjects

M W Austin

Publications and source records attributed to M W Austin.

12 recordsLinked to original sources
PubMed2006

Quality of life and visual rehabilitation: an observational study of low vision in three general practices in West Glamorgan.

AIM: To survey low vision in an urban population and assess impact on quality of life, rehabilitation and support. METHODS: In a cross-sectional population survey, 66 patients were identified from databases of three general practices and surveyed by investigator administered questionnaire. Main outcome measures were ocular diagnoses, (US) National Eye Institute Visual Function-Questionnaire (NEI-VFQ) scores assessing visual and nonvisual disability, eligibility for, awareness and receipt of rehabilitation and support. RESULTS: Of 24,420 individuals on the lists of the three study practices, we found 101 registered as blind or partially sighted (prevalence 0.41%). A total of 66 patients participated with ocular diseases of age-related macular degeneration 39 (59%), glaucoma 11 (17%), diabetic retinopathy two (3%), retinitis pigmentosa two (3%), and 12 (18%) 'others'. Better eye visual acuity was counting fingers or worse in 32 (48.5%). NEI-VFQ scores were poor-overall mean 41.5% (SD 23.5). In all, 80% had a social services home visit with one-third of these still in contact. In all, 66% had undergone a low vision aid assessment and 57.6% of these used their aid. The awareness and receipt of benefits arising from registration as visually impaired were lower than for other supportive measures available for reasons unrelated to vision. None had a guide dog. CONCLUSIONS: We found expected patterns of low vision but poorer levels of function and support that may reflect age and deprivation in a population failed by the current systems for identification, registration, and rehabilitation based on legislation overtaken by demographic change and social provision independent of visual status.

Activities of Daily Living↗
PubMed2003

Initial management of ocular hypertension and primary open-angle glaucoma: an evaluation of the royal college of ophthalmologists' guidelines.

PURPOSE: The purpose of this study was to identify any consensus of opinion among consultant ophthalmologists in Wales with respect to the initial management of glaucoma referrals based on the published guidelines of the Royal College of Ophthalmologists (RCO) and to compare consultant opinion with the practice in a typical hospital. METHOD: The RCO guidelines document was studied to identify clear statements, which could be adopted as standards for audit purposes. A questionnaire was designed and sent to all consultant ophthalmologists in Wales (n=37) to obtain their opinions. An audit was performed of 100 consecutive patients referred to our unit as glaucoma suspects with regard to initial management. Descriptive statistical analysis was performed. RESULTS: A good response rate for a postal questionnaire was obtained (81%) with 79.1% of responders finding the guidelines of at least some help. Levels of agreement with the definitions of ocular hypertension (OH) and primary open-angle glaucoma (POAG) were 76.7 and 86.7%, respectively. There was consensus of consultant opinion regarding many of the elements of the baseline clinical assessment with the significant exceptions of the necessity for dilated fundoscopy, gonioscopy, retinal nerve fibre layer assessment, and drawing of optic discs. The various 'clinical scenarios' for management of the RCO document were not all endorsed. The clinical audit results of the initial management of glaucoma referrals accurately reflected the consensus of the consultant opinion. DISCUSSION: The RCO guidelines document represents a useful contribution to the management of patients with OH and POAG. Nevertheless, considerable variation in opinion exists concerning even the most basic areas. With the advent of clinical governance, bridging the gap between the conclusions of College working parties and realities of everyday practice will assume greater importance.

Attitude of Health Personnel↗
PubMed1994

Flicker perimetry using a luminance threshold strategy at frequencies from 5-25 Hz in glaucoma, ocular hypertension and normal controls.

A prototype automated flicker perimeter was used to investigate flicker luminance thresholds in glaucoma patients (n = 11), ocular hypertensives (high risk n = 10, low and intermediate risk n = 21) and normal controls (n = 10). Differential light sensitivity was measured for one eye of each subject using a flickering stimulus at frequencies of 5, 10, 15, 20 and 25 Hz at ten test locations of 1 degree in the arcuate and nasal regions of the central 50 degrees of the visual field using a 4-2 dB staircase. The glaucoma patients had significantly reduced sensitivities for all frequencies (p < 0.001) with minimum sensitivity at 15 Hz. The 'high risk' ocular hypertensives had significantly reduced sensitivities at 10 and 15 Hz (p < 0.02). At present the ocular hypertensive patients in this study show no abnormalities demonstrable by conventional automated static perimetry. These findings may represent the earliest of perimetric deficits in patients with glaucomatous optic neuropathy.

Female↗
PubMed1993

Combined cataract extraction and trabeculectomy: phacoemulsification compared with extracapsular technique.

Thirty-four eyes undergoing phacoemulsification and trabeculectomy (PHACO + TRAB) were followed prospectively for 1 year postoperatively. The results of surgery were compared with those, obtained retrospectively, of the previous 34 extracapsular cataract extractions with trabeculectomy (ECCE + TRAB) performed by the same surgical team. All eyes received posterior chamber intraocular lens implants. Preoperatively, the two groups did not differ significantly in terms of age, gender distribution, or degree and duration of glaucoma and cataract. Mean postoperative follow up for the ECCE+TRAB group was 13.6 months; for the PHACO + TRAB group, 12.6 months (P = .1). As compared with the ECCE + TRAB group, the PHACO + TRAB group had earlier visual rehabilitation, less postoperative astigmatism (P < .001), and improved long-term intraocular pressure control (P = .04). Early postoperative pressure spikes occurred in 32% of the ECCE + TRAB eyes and in 23.5% of the PHACO + TRAB eyes (P = .2). Other postoperative complications occurred more commonly in the ECCE + TRAB group: hyphema (P < .001), fibrinous iritis (P < .01), choroidal detachment (P < .05), and hypotony (P < .05). Posterior capsular opacification was significantly more common in the ECCE + TRAB group (P < .02). These major differences probably are attributable primarily to the small incision used in phacoemulsification, which is associated with sustained IOP control during the operation, a small stable wound with low postoperative astigmatism, and early stabilization of refraction.

Aged↗
PubMed1993

Reformation of the anterior chamber following trabeculectomy.

Sixteen eyes requiring surgical reformation of the anterior chamber (AC) in our Unit from December 1987 to August 1991 were studied retrospectively to determine the incidence of the problem in our hospital and to evaluate the operative measures used to restore the AC. The mean preoperative AC depth of these 16 eyes was 1.92 mm (range, 1.50 to 2.50 mm). Nine had a history of angle-closure glaucoma. Poor surgical technique was a contributing factor in the development of a flat AC in 3. Of the remaining 13 eyes, 11 had a trabeculectomy with a fornix-based, and 2 with a limbus-based, conjunctival flap. Wound leaks occurred in 10 eyes with fornix-based flaps, but in none of the eyes with limbus-based flaps. Factors associated significantly with the development of flat AC following trabeculectomy were: a preoperative shallow AC, a history of angle-closure glaucoma, and the use of a fornix-based conjunctival flap. Avoiding wound leakage when performing trabeculectomy in eyes with a shallow AC or a history of angle-closure glaucoma by using a limbus-based flap may help prevent postoperative flat AC.

Adult↗
PubMed1988

Radiological investigation in the management of uveitis.

Patients suffering from Uveitis often undergo radiological investigation in order to detect underlying sarcoidosis or ankylosing spondylitis. We reviewed the results of X-rays performed in this hospital over a four year period in order to determine the efficiency of such screening. Our results suggest that radiological investigation has little role in the management of patients with Uveitis.

Adult↗
PubMed1978

Urinary and plasma cyclic AMP levels during short term starvation in obese man: response to glucagon stimulation.

Glucagon is known to elevate the intracellular concentration of cyclic AMP in the hepatocyte. The increase in intracellular cyclic AMP is reflected by an increase in the plasma concentration of the nucleotide. Intravenous glucagon stimulation was performed on six obese non-diabetic human subjects before and after a three day fast. All patients responded to starvation by a lowering of plasma immunoreactive insulin and blood glucose. Whereas the plasma immunoreactive glucagon concentration increased over the three day period, the plasma and urinary cyclic AMP did not significantly change. Intravenous glucagon promoted qualitatively similar increases in the blood glucose and plasma concentrations of insulin and cyclic AMP before and after three days starvation.

Adult↗
PubMedDate not supplied

Changes in gut capacity with lactation and cold exposure in a species with low rates of energy use, the pine vole (Microtus pinetorum).

Interspecific differences in the adaptive capacity of the gut may contribute to interspecific differences in rate of energy use and life-history traits. We tested the hypothesis that changes in gut capacity when energy demands are elevated are similar in species with low average rates of energy use compared with a species with higher average rates of energy use. We measured changes in gut capacity in Microtus pinetorum, a species with low average rates of energy use, and compared these with published data of changes in gut capacity of other rodent species with higher average rates of energy use. We quantified food ingestion, daily metabolic rate, resting metabolic rate, and gut organ masses, lengths, and functional volumes in nonreproducing, lactating, and cold-exposed females. Cold-exposed females had significantly higher, and lactating females moderately higher, mass-independent daily metabolic rates than control females. No significant changes in the mass or length of the intestinal organs occurred with cold exposure. Length, but not mass, of the gut was significantly greater in lactating females and functional volume was greater in cold-exposed females, compared with control females, independent of body mass. These changes in gut capacity were much less extensive than those reported for other rodent species. Interspecific differences in gut capacity were not attributable to differences in rates of ingestion and energy need among species. A large adaptive capacity of the gut or maintenance of a large reserve capacity may be a requirement for high rates of energy use and may contribute to the positive interspecific correlations that exist between rates of growth and reproduction and energy use for maintenance metabolism.

Adaptation, Physiological↗
PubMedDate not supplied

Surgical management of Graves' ophthalmopathy.

While most patients with Graves' ophthalmopathy have minor or largely cosmetic problems, severe ocular morbidity can occur and lead to blindness or eye loss. In this article the role of surgery in the management of Graves' ophthalmopathy is reviewed.

Eyelids↗