ABSTRACT
AIM: To evaluate teaching and practice in medical college ophthalmology departments in a representative Indian state and changes following provision of modern instrumentation and training. STUDY TYPE: Prospective qualitative study. MATERIALS AND METHODS: Teaching and practice in all medical colleges in the state assessed on two separate occasions by external evaluators. Preferred criteria for training and care were pre-specified. Methodology included site visits to document functioning and conduct interviews. Assessments included resident teaching, use of instrumentation provided specifically for training and standard of eye care. The first evaluation (1998) was followed by provision of modern instrumentation and training on two separate occasions, estimated at Rupees 34 crores. The follow-up evaluation in 2006 used the same methodology as the first. RESULTS: Eight departments were evaluated on the first occasion; there were 11 at the second. On the first assessment, none of the programs met the criteria for training or care. Following the provision of modern instrumentation and training, intraocular lens usage increased dramatically; but the overall situation remained essentially unchanged in the 8 departments evaluated 8 years later. Routine comprehensive eye examination was neither taught nor practiced. Individually supervised surgical training using beam splitters was not practiced in any program; neither was modern management of complications or its teaching. Phacoemulsification was not taught, and residents were not confident of setting up practice. Instruments provided specifically for training were not used for that purpose. Students reported that theoretical teaching was good. CONCLUSIONS: Drastic changes in training, patient care and accountability are needed in most medical college ophthalmology departments.
Subject(s)
Ambulatory Care/standards , Hospital Departments/organization & administration , Hospitals, Teaching , Humans , India , Internship and Residency , Ophthalmologic Surgical Procedures/standards , Ophthalmology/education , Quality of Health CareABSTRACT
The term ocular surface disorders indicate a close relationship between the conjunctival and corneal epithelium in many corneal and external diseases. The human amniotic membrane has a thick basement membrane and an avascular stromal matrix and its first ophthalmic use was reported by deRoth for conjunctival surface reconstruction. It was subsequently used for different ophthalmic reasons. Amniotic membrane transplantation can be used in a number of conditions eg, as a graft to replace damaged ocular surface stromal matrix or as a patch to prevent unwanted inflammatory insults from gaining access to the damaged ocular surface. Amniotic membrane can be utilised in persistent of recurrent corneal epithelial and stromal defects; in cases of corneal perforation due to ulcer or melting; after conjunctival excision for acquired melanosis, neoplasia, etc; in cases of pemphigoid, Stevens-Johnson syndrome, chemical bums; in cases of symblepharon, in dry eyes or in large leaking filtering blebs.
Subject(s)
Amnion/transplantation , Conjunctival Diseases/surgery , Corneal Diseases/surgery , Epithelium, Corneal/physiology , Eye Diseases/surgery , Humans , Ophthalmologic Surgical Procedures/standardsABSTRACT
Objetivo: Se presenta la técnica quirúrgica y resultados de una serie prospectiva de pacientes portadores de pterigion. Métodos: Estudios prospectivos realizado en el Hospital Base de Osorno y Clínica Alemana de Osorno, entre marzo del 2000 y abril del 2003. Se revisan 8 casos, siendo 9 de ellos recurrentes y 59 primarios, en ojos no operados previamente. Se presenta la técnica quirúrgica en detalle, la que incluyó autoinjerto de conjuntiva y el uso de mitomicina C. Se muestran los resultados a largo plazo (1 año). Resultados: No hubo ninguna recurrencia en esta serie, luego de un seguimiento de un año. Las complicaciones incluyeron dehiscencia de sutura (1 caso), granulomas (3 casos), retardo de la epitelización (3 casos), hipertensión ocular (5 casos). Conclusiones: La técnica se demuestra efectiva y segura en el tratamiento quirúrgico del pterigion, por lo que nos permitimos sugerir su indicación sin importar si el caso es primario o recurrente.