FROM THE EDITOR
Would it not be insightful to wonder if a patient’s resolution would ever include compliance to recommendations to either periodic eye care or use of contact lenses?
Frankly, I celebrate with those patients who do so. But for those who don’t, I find myself wondering what else can be done. It seems that a catastrophic or dramatic clinical event needs to happen before a change in behavior will occur. Even then, what may still pervade is a sense of immortality that any untoward event is fixable by doctors.
I recently saw a patient for bilateral corneal ulcers from either opportunistic infection or deliberate overwear or under maintenance of contact lenses. Multiple prior scars on both eyes suggested a pattern of abnormal use and care of contact lenses. I was relieved that her clinical course this time was was predictable with medication.
We doctors seem to make patients well without being able to change the underlying behavior of non compliance. So I asked the patient. With a straight face, the patient had a full schedule of of work and home that at bedtime, all that was possible sometimes was to collapse into bed, often fully clothed and wearing contact lenses.
In summary, I think technology and medical eye care have changed to accommodate our busy lives. Without that advance, I fear that similar instances would be more frequent. It is our job to meet this challenge with our clinical knowledge and skill and even our ears and heart.
PRACTICE MANAGEMENT (Curated)
This blog post takes a humorous slant on social media by the negative stimuli rather the positive. Therefore, if you do not believe in social media you don’t need to blov. But social media is not the only method to grow a business. It is complimentary to personal selling and good customer service. Spotted on Twitter via @SocMedSean: 10 Surefire Reasons NOT To Start A Corporate Or Product Blog http://bit.ly/tU3XoL
In an interview, Raphael Bostic, Ph.D. talks about one’s zip code of residence strongly influencing individual health behaviour, beliefs and outcomes. As primary eye care providers, a parallel with our outcomes is likely. Spotted on Twitter via @RWJF_PubHealth: Where you live may have just as much or more impact on your health as what goes on in the doctor’s office: http://t.co/vm6EfSLP ..
El Matri L, Bouraoui R, Chebil A, Kort F, Bouladi M, Limaiem R, Landoulsi H. J. “Bevacizumab injection in patients with age-related macular degeneration associated with poor initial visual acuity” Ophthalmol. 2012;2012:861384. Epub 2011 Nov 29
Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Boulevard 9 Avril, Bab Saadoun Tunis 1006, Tunisia.
Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity.
Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection.
Results. Mean followup was 14.1 months +/- 7.1 (range: 5 to 24 months). Mean logMAR vision at baseline was 1.38 logMAR +/- 0.33, at 6 months was 1.14 logMAR +/- 0.37 (P = 0.001) and at 12 months was 1.22 logMar +/- 0.33 (P = 0.004). Mean baseline central retinal thickness was 431 mum +/- 159.7 at 6 months was 293.43 mum +/- 122.79 (P = 10(-4)) and at 12 months was 293.1 mum +/- 130 (P = 0.004). Visual acuity improved in both patients with or without prior PDT treatment.
Conclusions. Intravitreal bevacizumab injection may increase the chance of visual acuity gain in neovascular AMD even in cases with initial low visual acuity.
PMID: 22174999 [PubMed – in process]