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T Barrie

Publications and source records attributed to T Barrie.

12 recordsLinked to original sources
PubMed1992

Benefits of training junior physicians to detect diabetic retinopathy--the Glasgow experience.

The accuracy and appropriateness of 115 consecutive referrals by non-consultant physicians to a specialist Diabetic Retinopathy Clinic were assessed in a retrospective study. The source of the referrals was masked throughout the study. Referrals were classed as 'appropriate' or 'inappropriate' for patient management, and the referral diagnosis (where specified) was compared with the ophthalmologist's initial assessment. It was graded as 'correct', 'partly correct' and 'incorrect'. Referrals from physicians who had received 40-50 hours of outpatient training in the Diabetic Retinopathy Clinic (group A, n = 49) were compared with referrals from doctors without this special instruction (group B, n = 66). Referral was deemed 'appropriate' in 32 (65%) of group A referrals, but in only 22 (33%) of group B (chi 2 = 11.54, df = 1, P less than 0.001). Referral diagnosis (when expressed) was graded as 'correct' in 28 (67%) of group A referrals compared with only 12 (30%) of group B, being 'incorrect' in 10 (25%) of group B referrals and just two (4.5%) of group A (chi 2 = 12.9, df = 2, P less than 0.005). Regular fundoscopy with accurate assessment and appropriate action is vital to prevent loss of vision in diabetic patients. Short-term outpatient training in a Diabetic Eye Clinic leads junior physicians to more appropriate referral and more accurate referral diagnosis.

Diabetic Retinopathy↗
PubMed1991

Autonomic mechanisms underlying intraocular pressure changes during insulin-induced hypoglycaemia in normal human subjects: effects of pharmacological blockade.

1. A fall in intraocular pressure is induced by acute hypoglycaemia in humans. The role of the autonomic nervous system in mediating this response was investigated in 24 normal volunteers in whom hypoglycaemia was induced with intravenous soluble insulin, under four experimental conditions: (1) control (n = 6), (2) non-selective alpha-adrenoceptor blockade (phentolamine) (n = 6), (3) non-selective beta-adrenoceptor blockade (propranolol) (n = 6) and (4) cholinergic blockade (atropine) (n = 6). Intraocular pressure was measured by using an applanation tonometer. In 12 subjects intraocular pressure was measured during each type of pharmacological blockade of similar duration without induction of hypoglycaemia, to assess the effects of individual antagonists. 2. In the control study intraocular pressure fell during hypoglycaemia from 15 +/- 1.0 to 10 +/- 1.3 mmHg (P less than 0.01) 10 min after the autonomic reaction. beta-Adrenoceptor blockade caused a reduction in intraocular pressure from 15 +/- 1.1 to 9 +/- 1.0 mmHg (P less than 0.001) before the administration of insulin, and when hypoglycaemia was induced intraocular pressure decreased further to 7 +/- 1.0 mmHg (P less than 0.05, compared with immediately before insulin). A decrease in intraocular pressure of similar magnitude was observed with propranolol alone (16 +/- 1.0 to 10 +/- 1.0 mmHg, P less than 0.05). 3. Cholinergic blockade had no immediate effect on intraocular pressure, and the reduction in intraocular pressure during hypoglycaemia was of similar magnitude to that observed during the control study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Contact lens related problems presenting in casualty.

The use of contact lenses in preference to spectacles has gained much popularity over recent years. This, however, is not without its complications and eye departments are now seeing an increasing number of contact lens related eye disease. This study seeks to show the range of complications seen, their treatment and outcome. It also outlines the types of contact lens in popular use, the reason for wear, the duration of wear and the sex, age and professional distribution of contact lens wearers.

Adolescent↗
PubMed1989

How effective is the referral chain for diabetic retinopathy?

Despite the availability of effective photocoagulation treatment, diabetic retinopathy remains the main cause of blindness in persons aged between 20 and 64 years. We have examined the effectiveness of the referral chain for retinopathy by auditing medical records for a representative sample being 226 diabetic patients (35% of attenders) referred to a special photocoagulation clinic. Patients were classified as 'late' or 'not late' by using an algorithm which accounted for the state of retinopathy at referral and the previous frequency of eye examination. Forty-four patients (19%) were considered to have been referred late. These were mainly younger onset patients, aged between 30 and 40, and not attending a diabetic clinic. Patients not attending any other outpatient clinic were 27 times more likely to be referred late.

Adult↗
PubMed1987

The place of elective vitrectomy in the management of patients with Candida endophthalmitis.

A general review of the treatment of Candida endophthalmitis is undertaken, with particular emphasis on the efficacy of various drugs currently in use. Their absorption by the eye when given systemically is also considered. The limitations of medical treatment for this condition are discussed and the theoretical reasons for vitrectomy considered. Six cases that underwent vitrectomy are reviewed, and the indications for vitrectomy in Candida endophthalmitis are discussed. A tentative overall plan for the management of such cases is given.

Amphotericin B↗
PubMed1987

The visual status of diabetics on renal replacement therapy (RRT).

The visual status of 48 patients with end-stage diabetic nephropathy who were undergoing treatment either by dialysis or transplantation was assessed. At the time of starting dialysis, the vision was good in 27 (56 per cent), impaired in 7 (15 per cent) and of navigating standard only in 12 (25 per cent) while the remaining 2 (4 per cent) had no useful vision. During the time on dialysis and/or following transplantation, vision improved in 6 patients (12 per cent), deteriorated in 9 (19 per cent) and remained unchanged in 33 (69 per cent). Changes in the degree of retinopathy in the 96 eyes resulting either from treatment of the renal failure or laser therapy were noted. The reasons for any changes in vision and the effect of ophthalmic treatment will be discussed.

Adult↗
PubMed1985

Colour vision of diabetics.

The Farnsworth-Munsell 100-hue test has been assessed as a screening test for the detection of diabetic retinopathy likely to benefit from laser photocoagulation therapy. Two hundred and thirty-two diabetic eyes of 126 patients were tested. The results were assessed both for total error score relative to age and for the presence of polarity. Although the incidence of abnormal colour discrimination was found to correlate with the severity of retinopathy, the test was not sufficiently selective to be of value as a screening test in the detection of retinopathy requiring treatment.

Aged↗
PubMed1985

Candidal endophthalmitis in Glaswegian heroin addicts: report of an epidemic.

Nine heroin addicts with presumed candidal endophthalmitis were seen in Glasgow between November 1982 and April 1984. Six patients during a two month period in 1983. The physical symptoms and signs observed, results of laboratory investigations and responses to anti-fungal chemotherapy are reported. Epidemiological factors relating to possible sources of infection are explored.

Adolescent↗
PubMed1985

The prevalence of carotid artery disease in patients presenting with amaurosis fugax.

Ninety-five patients with amaurosis fugax were investigated for extracranial carotid artery disease. A doppler system combining imaging with spectrum analysis was used. Stenosis (greater than 25 per cent) and occlusion of the ipsilateral extracranial internal carotid artery occurred in 30 per cent and 26 per cent of patients respectively. The association of amaurosis fugax with ipsilateral carotid disease is highly significant. The role of this Doppler technique in the investigation of patients with amaurosis fugax is considered.

Adult↗
PubMedDate not supplied

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Diabetic Retinopathy↗