Retinitis pigmentosa: Significant improvement with photobiomodulation.

We describe the case of a 38-year-old patient with retinitis pigmentosa. Diagnosed at the age of 20, she presented a progressive decrease in visual acuity and visual field, until she developed a shotgun barrel campimetry. After starting a photobiomodulation treatment of 9 sessions every other day, the patient reported improvement in visual acuity, night vision and quality of life. Clinical evaluation showed a visual acuity of 10/10 in both eyes and a substantial improvement in visual field.

Guía para valoración de lesiones oculares en la práctica forense / Guidelines for ocular injuries assessment in forensic medicine

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[Ophthalmology complaints in Spain]. / Denuncias en oftalmología, en España.

PURPOSE: We reviewed 90 complaints for allegedly incorrect ophthalmic procedures. Most of these complaints (33%) were related to cataract and refractive surgery (18%). In third position in terms of frequency (14%) were complaints concerning oculoplastic surgery and in fourth position were complaints related to retinal detachment (13%). This was followed by a miscellaneous group, which represented 10% of complaints. About 9% of complaints were related to emergency ophthalmic procedures, while just 3% of complaints were related to glaucoma. METHODS: We analysed within each subgroup the characteristics of the claims; the information given to the patient, those cases in which there existed grounds for considering the ophthalmologist's performance as being incorrect, and court orders that were adopted. RESULTS: The most common groups were cataract and refractive surgery, which together represented more than a half of the complaints. We found in 26% of cases, reports from other doctors criticizing the professional performance a posteriori of an accused ophthalmologist, incorrect or incomplete documents of informed consent, as well as patients asserting that their surgeons made them promises of results, or minimized risks about the proposed operation. CONCLUSIONS: In the great majority of cases, the claim was settled due to a characteristic complication inherent in the surgical technique and present in the document of informed consent signed by the patient. We also observed a minority of cases, particularly in refractive surgery, in which a foreseeable and avoidable complication related to incorrectly prescribed surgical techniques was produced. In these exceptional cases, expert evidence is usually unfavorable and charges are typically laid. It is probable that improved information for patients would reduce the number of these claims.

Denuncias en oftalmología, en España / Ophthalmology complaints in Spain

Introducción: Se ha realizado una revisión de 90 denuncias por actuaciones oftalmológicas presuntamente incorrectas. La mayoría de ellas son por intervenciones de cataratas (33%) y de cirugía refractiva (18%). En tercer lugar las intervenciones de cirugía oculoplástica (14%). El cuarto puesto las actuaciones relacionadas con el desprendimiento de retina (13 %), seguidas en quinto lugar por el grupo de miscelánea (10%), en sexto por el de urgencias oftalmológicas (9%) y en séptimo y último puesto denuncias por actuaciones oftalmológicas relacionadas con el glaucoma (3%).Material y métodos: Se analizaron, dentro de cada subgrupo, las características de las denuncias, la información dada al paciente, los casos en los que existieron motivos para considerar incorrecta la actuación del oftalmólogo, y la resolución judicial que se adoptó.Resultados: Los grupos más frecuentes son cirugía de cataratas y refractiva, que conjuntamente representanmás de la mitad de las denuncias. Encontramos en el 26% de los casos informes de otros facultativos criticando a posteriori la actuación profesional del oftalmólogo denunciado y documentos de consentimiento informado incorrectos o incompletos, así como pacientes que aseguran que su cirujano les hizo promesas de resultados o les minimizó los riesgos de la intervención propuesta.Conclusiones: En la inmensa mayoría de los casosla denuncia se plantea por una complicación típica,inherente a la técnica quirúrgica y que figuraba enel documento de consentimiento informado firmadopor el paciente. También vemos una minoría decasos, generalmente intervenciones de cirugíarefractiva, en los que se produce una complicaciónprevisible y evitable, en cirugías incorrectamenteindicadas. En estos casos excepcionales, el informepericial suele ser desfavorable y hemos encontradoalguna condena. Es probable que un mayor cuidadoen la información al paciente redujera el número de estas denuncias (AU)

Purpose: We reviewed 90 complaints for allegedlyincorrect ophthalmic procedures. Most of thesecomplaints (33%) were related to cataract andrefractive surgery (18%). In third position in termsof frequency (14%) were complaints concerningoculoplastic surgery and in fourth position werecomplaints related to retinal detachment (13%).This was followed by a miscellaneous group, whichrepresented 10% of complaints. About 9% of complaintswere related to emergency ophthalmic procedures,while just 3% of complaints were relatedto glaucoma.Methods: We analysed within each subgroup thecharacteristics of the claims; the information givento the patient, those cases in which there existedgrounds for considering the ophthalmologist’s performanceas being incorrect, and court orders thatwere adopted.Results: The most common groups were cataractand refractive surgery, which together representedmore than a half of the complaints. We found in26% of cases, reports from other doctors criticisingthe professional performance a posteriori of anaccused ophthalmologist, incorrect or incompletedocuments of informed consent, as well as patientsasserting that their surgeons made them promises ofresults, or minimized risks about the proposed operation. Conclusions: In the great majority of cases, theclaim was settled due to a characteristic complicationinherent in the surgical technique and presentin the document of informed consent signed by thepatient. We also observed a minority of cases, particularlyin refractive surgery, in which a foreseeableand avoidable complication related to incorrectlyprescribed surgical techniques was produced.In these exceptional cases, expert evidence isusually unfavorable and charges are typically laid.It is probable that improved information for patientswould reduce the number of these claims (AU)