Board certification in optometry.

BACKGROUND: In keeping with current expectations in the health care community, the purpose of the American Board of Optometric Practice (ABOP) is to enhance the quality of optometric care available to the public by fostering continued competence for practitioners through administering education and examinations for certification and re-certification. The formation of ABOP makes possible for the first time a board certification process for optometrists. METHODS: The optometry model for board certification and recertification emphasizes the breadth of the profession. ABOP certification will be accomplished through a combination of examinations and high-quality, tested Board Certified Continuing Education (BCCE). Specific requirements for practitioners at various stages of their careers are presented. RESULTS: Board certification provides one important mechanism for an optometrist to demonstrate commitment to quality, professionalism, and ongoing clinical competence. The optometrist benefits from high-quality continuing education designed for timeliness, importance, and breadth. The public benefits by the enhancement of continued competence within the optometric profession. Health care agencies benefit by being able to recognize providers who have elected to demonstrate their qualifications through certification. CONCLUSIONS: Through board certification, optometrists will be able to demonstrate their commitment to maintaining clinical competence through a nationally uniform program, and they will be able to comply with standards that are generally recognized and required throughout the health care community.

Issues for optometrists relating to interprofessional relations in a hospital and medical center.

Managed care and the changes in the health care system are golden opportunities for the optometric profession. There is a major role for optometry in the medical center and there is a major role for optometry in the various managed health care programs. Optometry is well positioned as a primary health care profession. The leaders of this noble profession must be on the alert and plan and work diligently to include optometry in all aspects of the ever-changing health care system.

A survey of eye and vision care in Oklahoma.

We examined the spectrum of vision care intensity, and the relationships of the three principal providers of vision care in Oklahoma. They were active family and general physicians (MD and DO), ophthalmologists (MD and DO), and optometrists. There were 1,356 surveys mailed to the three groups. We determined that vision care services in Oklahoma appear very accessible, are well distributed and generally affordable. The referral patterns appear to be less than optimal and optometrists are not fully utilized. This added cost and travel time for patients.

What are the pros and cons of requiring postgraduate residency training as an entry level practice requirement?

The technological and knowledge explosion that has occurred in this century has created a curriculum crunch within all health professional schools. The various optometric institutions are dealing with this crunch and important decisions need to be made in order to provide the best entry-level practitioners possible. This paper provides some of the pros and cons of requiring a year of postgraduate training as a requirement for entry level optometry practice.

Screening for rubella in schools of optometry.

Rubella can cause birth defects in fetuses of pregnant women who are susceptible to this disease. Because national immunization efforts have been relatively successful, most cases of rubella occur in young adults. The School of Optometry and Jefferson County Department of Health in Alabama, and the Division of Optometry in Northeastern Oklahoma, cooperated to provide a voluntary serologic rubella screening for their students. About 9% were seronegative and were immunized against rubella. To eliminate the risk of future optometrists transmitting rubella to susceptible patients, we recommend that optometry students be screened for rubella antibodies and be provided immunization if found to be seronegative.

Optometric management of the diabetic patient: Part I--The diagnosis and classification of diabetes.

Diabetes is a multifaceted, poorly understood disease and affects approximately 3% of the United States population. Diabetes is the fifth leading cause of death and is the leading cause of blindness in adults. The metabolic pathway which leads to the complications of diabetes is probably the polyol pathway. Diabetes often is a very difficult diagnosis to make and is made based on findings from the history, physical examination, and laboratory data. Routine baseline laboratory testing should be obtained in all new diabetics because of the complications of diabetes. The new classification of diabetes is type 1 and type 2 as opposed to the old classification of juvenile and adult onset. The optometrist should be intimately involved in managing the diabetic patient.

Optometric management of the diabetic patient: Part II--Treatment and office control of the diabetic patient.

Proper management of the diabetic patient and effective communication with other health care providers requires that the optometrist have a sound working knowledge of the accepted standards of total diabetic care. Treatment of type 1 diabetes usually requires insulin and a proper diet. Type 2 diabetes often will respond to a rigid diet alone, but may require insulin or oral antidiabetic medications. Finally, patient education is the backbone of all treatment and must be reinforced by all health care providers at each office visit.

Compulsive water drinking: a review with report of an additional case.

Symptomatic compulsive water drinking is uncommon. The pathophysiology of compulsive water drinking is essentially that of an acute organic brain syndrome from cerebral edema. The syndrome does not occur clinically unless there is an impairment of water excretion, since normal renal function allows up to 20 liters per day excess intake without accumulation. It has been reported that about 80 percent of cases are neurotic middleaged females. In almost all cases there is at least a history of neurotic symptoms or maladaptive symptoms if the history is probed. In most reported cases the patients were psychotic. When symptoms and laboratory aberration are mild, the sole treatment is water restriction. In moderate but very symptomatic cases, treatment includes both intravenous saline and water restriction. In severe cases treatment includes water restriction, intravenous hypertonic saline, diuretics, and anticonvulsants. After the acute phase, patient education may suffice as in the above case, but if psychosis is present, appropriate therapy is indicated accompanined by frequent checks of serum electrolytes to detect early aberration.