Vision Screening in the Elderly and Operations for the Blind: Results in the Year of 2003

PURPOSE: To report the results of vision screening in the elderly and operations for the blind in 2003. METHODS: A nation-wide, indigent aged group of over 65-year-old of low-income population was surveyed. Visual acuity was tested, refractive error was measured, and ocular examination was performed to determine the group needed for operation. RESULTS: Among the indigent subjects who live in urban or rural community, 7, 750 subjects aged over 65 years old were examined by the ophthalmologists. For those screened, the most common ocular disease was cataract (4, 383 subjects, 45.4%), followed by conjunctival and scleral disease (1, 741 eyes, 18%), retinal disease (434 eyes, 4.5%), refractive errors (374 eyes, 3.9%). Surgery was performed on 1, 813 eyes of 1, 109 subjects, and these were classified by the disease category. Surgery for cataract was performed on 1, 762 eyes (97.2%), and for retinal disease on 51 eyes (2.8%). The visual acuity change after cataract surgery was 0.23 +/- 0.15 preoperatively and 0.64 +/- 0.25 postoperatively. CONCLUSIONS: Among the geriatric public health problem in eye care services, the most prevalent cause of visual impairment was senile cataract, for which the vision can be improved by surgery. Therefore, continuous vision screening and surgery for the blind among this group are important and should be performed more extensively.

Difference between Subjective and Objective Estimates of Dementia in the Community Elderly

OBJECTIVE: Evaluation of how much the presence of dementia is underdiagnosed or misdiagnosed in the elderly population by themselves. METHOD: The number of self-professed dementia cases was compared to the estimated number of cases with cognitive impairment based on the Korean version of the Mini-Mental State Examination (MMSEK) employed in a nationwide survey "Need assessment of the long-term care in the elderly" in three representative areas of Korea. The would-be dementia cases were analyzed. RESULTS: Only eighteen (0.7%) of 2,638 reported the presence of dementia while 414 (15.7%) were diagnosed as having questionable cognitive impairment and 385 (14.6%) as having definite cognitive impairment on the MMSEK. On the other hand, some of the self-professed "dementia" cases were not impaired on the MMSEK. CONCLUSION: The public should be educated on clinical manifestations of dementia for its early diagnosis and appropriate treatment because they are mostly without understanding about dementia.

Biliary endoprosthesis

Biliary endoprosthesis could provide permanent internal biliary drainage inpatient with obstructive jaundicewith advantages of absence of troublesome external catheter and no loss of fluid, bile and electrolytes overexternal drainage. Incidence of sepsis and cholangitis may be lowered. Endoprosthesis was performed in 18 patientsof obstructive jaundice from January, 1985 to december, 1985 at Department of Radilogy, Kyungpook NationalUniversity Hospital. The results are as follows: 1. The cases of obstructive jaundice included bile duct cancer in11, stomach ca. metastasis in 3, ca. of ampulla of Vater in 1, ca. of head of pancresas in 1, CBD cancer withpostop. recurrenced in 1, and impacted CBD stone in 1 case. 2. The levels of obstruction were at the trifurcationin 8, CHD in 5, proximal CBD in 3, and distal CBD in 2 cases. 3. Decline of serum bilirubin level was noted in 15cases with the most rapid decline wihtin 1 week after the procedure. 4. The complication occurred in 5 cases. Thethree cases were recovered spontaneously, but one died of bile peritonitis, another experienced obstrution ofendoprosthesis. 5. The endoprosthesis is benificial intreatment of obstructive jaundice for which surgery is notindicated, and saving expensive abdominal surgery and less advantageous percutaneous external drainage, henceenhancing life quality.

Computed tomography of the knee joint

Diagnosis of knee jont pathology has been mainly dependent on clinical manifestations and invasive proceduressuch as arthrography and arthroscopy etc. However, these procedures are invasive. Arthroscopy is perfromed undergeneral anesthesia. Recently, with development of high resuloution CT with thin slices and multiplanarreconstructions capability, CT could be used to verify the internal structures of knee joint in noninvasive orless invasive way. From June ot December 1985, authors have experienced 19 cases of the knee joint CT. Among them,13 cases were operated and confirmed. We concluded as follows. 1. The diagnostic accuracy of the knee CT was 100%in lateral meniscal tearing, 92.3% in medial meniscal tearing, 92.3% in detachment of lateral collateral ligament,92.3% in medial collateral ligament, 100% in tearing of cruciate ligaments. 2. CT could be considered as a primarydiagnostic procedure in the knee pathology rather than more invasive arthrocopy or arthrography. 3. For theaccurate diagnosis of knee joint pathology, CT which can obtain thin slies, high resolution, multiplanarreconstructions is indispensable.