ABSTRACT
BACKGROUND: Optometrists are uniquely placed in the health care field because they provide both services as well as goods to patients. In the event of an influenza pandemic, optometrists may be challenged with a host of issues, including impediments to clinical patient care, manufacture and delivery of ophthalmic devices, and maintaining business continuity and infection control. OVERVIEW: This report reviews pandemic influenza, the effect of a pandemic event on business survival, and response measures for the primary eye care provider. The ethical and legal issues surrounding control of a pandemic influenza and the prospect of telemedicine as a form of social distancing are also discussed. CONCLUSIONS: Knowledge of the pharmacologic and nonpharmacologic measures to control a pandemic influenza will help prepare the eye care provider for addressing challenges to patient care and business continuity in the face of a highly contagious disease. Understanding the legal and ethical issues that arise during a pandemic event will help optometrists make informed choices as health care professionals and as citizens.
Subject(s)
Disease Outbreaks , Influenza, Human/epidemiology , Optometry , Public Health , Disease Outbreaks/legislation & jurisprudence , Humans , Influenza, Human/prevention & control , Influenza, Human/transmission , Patient Care , Professional Practice/economicsABSTRACT
Industrial chemicals in a variety of applications are often found in highly populated areas and their presence carries risks. The threat of serious consequences from inadvertent or intentional events involving hazardous chemicals is a possibility. Extremism and/or other illicit activities pose environmental threats from chemical exposures. We present here a review of the threat of ocular injury in small-and large-scale chemical releases and discuss mechanisms of damage and repair to the eyes. The emerging field of proteomics has been described in relation to its potential role in the assessment of ocular changes following chemical exposures and management of ocular trauma.
Subject(s)
Accidents, Occupational , Burns, Chemical/etiology , Chemical Warfare Agents/toxicity , Disasters , Eye Burns/chemically induced , Eye/drug effects , Hazardous Substances/toxicity , Proteomics/methods , Acids/toxicity , Alkalies/toxicity , Ammonia/toxicity , Burns, Chemical/metabolism , Burns, Chemical/physiopathology , Burns, Chemical/therapy , Chlorine Compounds/toxicity , Eye/metabolism , Eye/physiopathology , Eye Burns/metabolism , Eye Burns/physiopathology , Eye Burns/therapy , Eye Proteins/metabolism , Humans , Isocyanates/toxicity , Mechlorethamine/toxicity , Mustard Gas/toxicity , Proteins/metabolism , Risk Assessment , Wound HealingABSTRACT
BACKGROUND: The threat of bioterrorism and use of biological weapons has drawn renewed attention to smallpox, and smallpox vaccinations have been resumed in the United States. Both smallpox and smallpox vaccine carry risk of potentially debilitating or fatal adverse effects. The optometrist must be familiar with the signs and symptoms of smallpox disease and complications of smallpox vaccine for proper management and preservation of vision. OVERVIEW: The literature on the ocular and systemic effects of smallpox and smallpox vaccination is reviewed to provide the practicing optometrist with an overview of the issues involved in case management. Recent guidelines have placed additional ocular-related contraindications to receiving the smallpox vaccine. Risk factors for complications arising from smallpox vaccination are discussed. A discussion of the ethical implications is also presented. CONCLUSIONS: Knowledge of the signs and symptoms of smallpox infection, and of adverse effects caused by smallpox vaccination, can provide the necessary background to help eye care providers make appropriate diagnoses and referrals. Understanding ethical and legal/Constitutional questions surrounding the risk of outbreak and various vaccination containment strategies will help optometrists make informed decisions as health care professionals, patient advocates, and concerned citizens, as well as weigh the risks and benefits of vaccination, if it is offered to them.
Subject(s)
Smallpox Vaccine/adverse effects , Smallpox/complications , Contraindications , Ethics, Clinical , Ethics, Medical , Eye Diseases/microbiology , Eye Diseases/therapy , Humans , Public Health , Risk Factors , Smallpox/pathology , Smallpox/prevention & control , Vaccination/adverse effects , Vaccination/ethics , Vaccination/methodsABSTRACT
BACKGROUND: Because of growing concerns of terrorist attacks using chemical, biological, radiological, and nuclear weapons, appropriate diagnosis and management of ocular and systemic effects are important issues for eye care practitioners. OVERVIEW: The literature on the ocular and systemic effects of chemical, biological, radiological, and nuclear weapons is reviewed to provide practicing optometrists with an overview of the issues involved in incident management. A discussion of the public health issues and implications is also presented. Chemical, biological, radiological, and nuclear weapons can exert serious consequences on the eye and the entire body. Acts of terrorism can pose unique challenges to patient care and to the healthcare system infrastructure. The clinician must be familiar with signs of potential terrorist activities to aid in appropriate patient care and in the containment of illness in the community. CONCLUSIONS: Knowledge of the signs and symptoms of exposure to potential agents used by terrorists and a review of the public health concerns of managing terrorist events can provide the necessary background to help the eye care provider make the appropriate diagnosis and understand the role of the clinician in the hierarchy of disaster preparedness, surveillance, and response.
