Some ophthalmological misconceptions in medical practice in the Philippines

ABSTRACT

We should get rid of the concept and practice of waiting for the cataract to become fully mature before extracting it, not only because of the mental torture and the social and economic sacrifices which the period of waiting entails to the patient, but also with the use of forceps, sutures, other safety devices,and intracapsular extraction, the removal of immature cataract is technically not more difficult, if not really easier; and the visual results are equal to, if not actually better than, that of the mature cataract. This statement is based on my experience with, and of the results obtained in 300 consecutive cataract extractions during a period of 22 months. Of these cases, 103 were immature, and 46 private cases with corrected postoperative vision were followed up. Out of the 30 uncomplicated cases, 87% had a vision of 20/20 to 20/30, while 95% had a vision of 20/50 or better. Old age, over 75 years, slight to moderate cough, diabetes, and hypertension are not contraindications to cataract extraction if proper precautions are takenWe should enjoy freedom from fear of trachoma in the Philippines. Studies have revealed that, while trachoma exists in this country, mostly among Chinese, Hindus, and Indo-Chinese, it is a rarity among Filipinos; and blindness from trachoma among Filipinos is practically nil. Folliculosis and follicular conjunctivitis are common among our children and these are mistaken for trachoma. These children should not be required to undergo scraping of their conjunctivae before they are allowed to attend classes because of the mistaken concept that they have trachomaAcute non-bacterial kerato-conjunctivitis of viral origin exists here in endemic form with occasional epidemic flare-upsThere should be a widespread concern for glaucoma, because this is the most frequent cause of irremediable blindness in this country. To combat glaucoma, not only should the public be made aware of its dangers but the opticians, medical practitioners and specialists should also be more informed about itSquinting should be treated and if necessary, operated on during the pre-school age, in order to prevent the development of inferiority complex in the child and crumpling of his personality, to avoid blindness from amblyopia, to secure more permanent and better cosmetic results, and to insure binocular single visionThe ophthalmologists should do more ophthalmic plastic surgery and get rid of the fear of excising lid tumors before they cause suffering and threaten lifeAn "oculist" or "ophthalmologist" should not be confused with an "optician" and "optometrist."Refraction is only a part of an ophthalmological examination for eyestrain, the causes of which are many times not an error of refraction, but improper or overuse of the eyes in an unfavorable internal and external environment. Hence, the treatment of eyestrain is not always the wearing of correct glasses or exercises for the extraocular muscular imbalance, but also the proper use of the eyes, providing sufficient lighting and elimination of glare, together with improvement of some medical internal trouble or the relief of some psychosomatic problems. (Summary)