Relative importance of the components of the Canadian Residency Matching Service application.

OBJECTIVE: The primary goal of this project was to investigate Canadian ophthalmology residency program directors' and department heads' perceptions about the relative importance of the various components of the Canadian Residency Matching Service (CaRMS) application package. Secondary goals were: (i) to investigate the perceptions of all program directors and department heads at Queen's University's residency programs; and (ii) to compare faculty's perceptions with the perceptions of medical students at Queen's University. DESIGN: Survey. PARTICIPANTS: Queen's University medical students, Queen's University faculty, and Canadian Ophthalmology faculty participated in this survey. METHODS: A validated survey was administered to faculty and students. The study targeted program directors and department heads of 15 Canadian ophthalmology residency programs, 18 residency programs at Queen's University, as well as 404 medical students at Queen's University. Qualitative questions were included in the faculty survey. Quantitative data were analyzed with nonparametric tests. Qualitative data were organized according to primary themes. RESULTS: Response rates ranged from 64% to 87%. On a scale of 1 to 4 in order of increasing importance, faculty and students respectively assigned the highest scores to the following components: interview performance (3.73, 3.89), electives (3.64, 3.83), reference letters (3.53, 3.74), and personal letter (3.27, 3.58). For all 4 components, student scores were significantly higher than faculty scores. First- and fourth-year medical students' scores differed significantly in eight areas including research experience and volunteer experience. In both of these components, there were statistical differences between fourth-year student scores and faculty scores, whereas the first-year class had scores that were comparable with faculty scores. Queen's University faculty and Ophthalmology faculty did not differ significantly. Faculty scores also did not differ significantly based on age or sex. CONCLUSIONS: Faculty and students agreed on the most important components of the application, but significant differences were found in their perceptions of the relative importance of other components.

Predicting retinal tears in posterior vitreous detachment.

OBJECTIVE: The purpose of this study is to determine whether patients with acute posterior vitreous detachment (PVD) who develop delayed retinal tears within the first 6 weeks after initial presentation have predictive characteristics. DESIGN: Prospective cohort study. PARTICIPANTS: All patients presenting to the Hotel Dieu Hospital Emergency Eye Clinic between September 2008 and July 2009 diagnosed with acute PVD were offered enrollment. METHODS: At the initial visit, patients were given the previously validated Queen's University Posterior Vitreous Detachment Patient Diary to record their daily symptoms for 6 weeks. Two or 6 weeks later, patients were reexamined in detail, and their diaries were collected and analyzed. Exact logistic regression was used to establish characteristics predictive of delayed retinal tears. RESULTS: In our study population of 99 patients, 2 developed delayed retinal tears. One had retinal hemorrhages and the other had a cloud-like floater at initial presentation. Vitreal or retinal hemorrhage, large number of floaters at initial presentation, and high floater frequency at initial presentation indicated a high risk of delayed retinal tear formation, yielding a median unbiased estimated odds ratio of 36.18 with p value 0.009. No other presenting risk factors or symptomatology followed daily over the first 6 weeks after acute PVD were predictive of delayed retinal tear formation. CONCLUSIONS: PVD patients with retinal or vitreal hemorrhage, a significant number of floaters or a cloud like appearance to the floaters, or high floater frequency are at higher risk of developing delayed retinal tears.

Visual function analysis in acute posterior vitreous detachment.

OBJECTIVE: To determine whether the visual function of patients with posterior vitreous detachment (PVD)changes between the initial visit and a 6-week follow-up visit, and to compare their visual function with that of patients with macular degeneration, cataract, glaucoma, low vision, cytomegalovirus (CMV) retinitis, or diabetic retinopathy and a reference population. DESIGN: Prospective cohort study. PARTICIPANTS: All patients presenting to the Hotel Dieu Hospital Emergency Eye Clinic between September 2008 and June 2009 who were diagnosed with acute PVD were offered enrollment in the study. METHODS: Patients were administered the National Eye Institute Visual Function Questionnaire NEI VFQ-25 at two points in time. The composite scores from the initial and the 6-week visits were compared. The scores were also compared with established normative data and 6 ophthalmologic diagnoses. RESULTS: The NEI VFQ-25 composite score for patients with acute PVD (n = 84) at baseline was 93.26 ± 5.59 (mean ± SD). After 6 weeks and a second ocular examination, there was no statistical difference in the composite score of 93.47 ± 6.20 (mean ± SD). (1-sided paired t-test, t = 0.57; P = 0.28). CONCLUSIONS: The visual function of patients with acute PVD remains stable over the first 6 weeks after diagnosis. It is significantly higher than that of patients with 6 other ophthalmologic conditions but comparable to that of a normal population.

Validation of patient symptom diary in acute posterior vitreous detachment.

PURPOSE: The purpose of the study is to determine the validity of an original patient symptom diary in recording symptoms of posterior vitreous detachment (PVD). METHODS: In this prospective cohort study, all patients presenting to the Hotel Dieu hospital emergency eye clinic between September 2008 and July 2009 diagnosed with acute PVD were offered enrollment in the study. Patients were given the Queen's University posterior vitreous detachment patient diary at the initial visit after detailed eye examination, assessment of risk factors for retinal tears and detachments and a thorough explanation of their presenting complaints to record their symptoms related to PVD. At a random point during their six-week follow up, the patients were verbally asked the same questions being recorded in the diary over the phone. At the six-week follow up visit, the diaries were collected and the verbal results were compared with the written results. RESULTS: There was substantial to near perfect agreement between the verbal questions and written answers. Cohen's kappa scores for flash frequency, flash intensity, floater frequency, and floater type were 0.6229, 0.6389, 0.6495, and 0.8603, respectively. CONCLUSIONS: The Queen's University posterior vitreous detachment patient diary is a useful tool for investigating the quantity, quality and change in symptoms of patients presenting with PVD in the first 6 weeks of initial presentation.