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Informed consent as an ethical issue in modern optometry.

BACKGROUND: Modern optometric practice contains many more mildly invasive procedures than it has traditionally. Concurrently, patients expect a more active role in decisions concerning their own health care, as, increasingly, these decisions may have harmful, as well as, salubrious, consequences. METHODS: Literature from the philosophy of ethics as it pertains to the issue of informed consent was examined and applied to optometric procedures and practices. RESULTS: A strong analogy exists between particular aspects of optometric practice and corresponding elements of medical practice with respect to well established ethical principles of informed consent. The legal doctrine of informed consent is not the only view applicable to optometry. CONCLUSION: Modern optometric practice may easily and advantageously be adapted to incorporate ethical principles of informed consent. These principles, which should be distinguished from legal principles which bear upon the same issues, may enhance the quality of health-care decisions by optometrists without creating serious obstacles to the individual optometrist's practice mode.

Ethics, Medical

Optometric education and optometry in Africa.

BACKGROUND: For the vast majority of people in Africa, eye care services are not available. Optometrists have long been practicing in parts of Africa, but optometric teaching institutes have only recently appeared in several African nations. METHODS: Utilizing interviews, site visits, and a literature review this article presents a survey of the current status of optometric education, the profession of optometry, and eye care needs in Africa. RESULTS AND CONCLUSIONS: Four countries in Africa have optometric teaching institutes: South Africa, Nigeria, Tanzania, and Ghana. Most of these programs are struggling in difficult economic and/or political environments. The difficulties facing these programs are likely to remain, but the recent dramatic developments in communication and cooperation between these four countries will be a positive force towards seriously addressing the need for more optometric practitioners throughout the African continent.

Africa

Neuro-optometry: an evolving specialty clinic.

Neuro-optometry is evolving as an optometric clinical specialty focusing on neurological dysfunctions of the visual system. Initially, we focused upon abnormalities of ocular movements, and our investigations have now broadened to include static and dynamic measurements of eye movements, accommodation, and the pupil. We feel the clinic serves three fundamental purposes: (1) to provide service to the patient, (2) to perform clinical research, and (3) to broaden the scope of the students' clinical experience. Operation of the clinic, technical methods of measurement, the testing protocol, and examples of interesting clinical recordings are described.

Accommodation, Ocular

Charles F. Prentice Memorial Lecture--1976. Optometry curriculum patterns in Europe.

The education and training of optometrists--more appropriately, ophthalmic opticians--in the western countries of the European continent differ in content and amount from that found in English-speaking countries, particularly the U. S. Current curriculum patterns for 12 European countries are presented. Formalized basic education before professional training averages 9.4 academic years; formalized course work, identified with curricula of schools of optics and optometry, averages 2.8 academic years; and required apprenticeship time averages about 2 years.

Curriculum

Optometry in Israel--a clinical externship.

In recent years, it has become the policy of optometric institutions to expand the scope of the clinical education experience beyond the geographical locale of the parent facility. This article is a presentation of the background and description of one such clinical program organized by the New England College of Optometry with the cooperation of the Department of Ophthalmology Hadassah Hebrew Medical Center, Jerusalem, Israel.

Contact Lenses

[Image methods in the development of optometry].

The review analyzes the authors' own paper aimed at assessing the functional status of human spatial vision. New technologies are shown to provide optometrists with the means of textual image synthesis, which effectively measure contrast sensitivity in relation to the spatial frequency of textual images. The review also outlines new effective methods for measuring human contrast sensitivity and its spatial working range. It is suggested that this line will determine the development of practical optometry.

Child

What should be optometry's role? How should we prepare for it?

This is a position paper which broadly states the role which, in the author's opinion, optometry should adopt as its goal and the educational environment in which we can best prepare graduates to fulfill that role. The role briefly stated, is that of first contact supplier of vision care and of certain aspects of primary health care. The appropriate educational milieu is held to be the academic health center.

Ophthalmology

Men and women in optometry. II. Attitudes toward career and family.

BACKGROUND: Optometry has experienced a dramatic upward shift in the percentage of women entering the profession during the past 20 years. Our survey assessed the mechanisms for sustaining balance in professional and personal roles used by women optometrists and how these mechanisms may differ from those of their male colleagues. METHODS: A survey questionnaire was mailed to a large nationwide random sample of optometrists, composed of equal numbers of men and women. RESULTS: Data were analyzed from 353 men and 358 women; margin of error was +4%. Most of the respondents indicated they derived personal satisfaction from their career. A majority of both groups did not indicate that lack of time for their career was a source of frustration. However, significantly more women than men indicated some frustration in pursuing those activities that lead to career advancement. There were significant differences in response patterns of men and women about the effect of family, child care, and household work on their careers. CONCLUSIONS: Both men and women optometrists are satisfied with their careers and neither group feels compelled to choose between career and family. Optometrists do not fit into one pattern, but instead make individualized career choices on the basis of needs.

Attitude of Health Personnel

A yearly summary of quality assessment and improvement in the optometric pediatric clinics of the SUNY College of Optometry.

BACKGROUND: Each clinic within the University Optometric Center (UOC) of the State University of New York (SUNY) College of Optometry develops a Quality Management (QM) Plan for each calendar year. The vehicle for implementation is a Quality Assessment and Improvement (QA&I) committee. The clinical adherence to the objectives are reviewed each year. The following article is a review of the QA&I reports of the Pediatric Vision Clinics within the College for the year 1996. METHODS: Clinical records were concurrently and retrospectively reviewed for completeness and appropriateness of care. One hundred percent of the records were concurrently reviewed, and 10% of each doctors' total records were retrospectively reviewed. In addition, records with specific diagnoses--chosen as clinical indicators--were reviewed for a specified period of time. RESULTS: Patient satisfaction exceeded predetermined threshold values. On general review, the clinical faculty performed at a 95% efficiency level. The pediatric population yielded only minimal major pathologies. In our strabismic sample, patients with esotropia exceeded those with exotropia (61% vs. 39%). Strabismic amblyopes were more prevalent than refractive amblyopes (80% vs. 20%). Preschool vision therapy appeared to be successful in most cases. CONCLUSION: Quality assessment and improvement is an ongoing process that can provide an overview of case management and type. The process serves to monitor quality of care, provide a modality for improvement, enhance outcomes, and guide future QM plans.

Academic Medical Centers

Myopia in optometry students: family history, age of onset and personality.

The relationship between refractive error and family history, age of onset and personality was investigated in 189 optometry students. Subjects completed a questionnaire requesting details of their refractive history, type of correction and their family history. Subjects also completed an Eysenck Personality Inventory (EPI). Subjects were categorized as hyperopes, emmetropes or myopes on the basis of their questionnaire responses. No significant relationship was found between refractive group and the prevalence of myopia in parents. Myopic subjects, however, showed a significantly higher prevalence of myopic siblings. Furthermore, late-onset myopes showed a higher prevalence of myopic siblings than early-onset myopes. No significant personality differences were found between the refractive groups.

Adolescent

Prevalence of asteroid bodies in a VA optometry clinic.

One thousand, five hundred and fifty-nine consecutive optometry clinic records at the Birmingham Veterans Center (BVAMC) were reviewed in an attempt to determine the prevalence of asteroid bodies in the vitreous. A review of the pertinent literature was conducted and a higher prevalence was found in our population than that reported in the literature. The difference was statistically significant at the 0.05 level.

Adolescent