Optometry

mine self-reported last medical exam (lme), blood pressure (measured day of exam) (BP), history of hypertension (HTN), and diabetes mellitus (DM). HTN was classified as controlled based on BP readings using the recommendations of the Joint National Commission of Prevention, Detection, Evaluation and Treatment of High Blood Pressure cutoff of less than 140/90 for those with HTN and without DM and 130/80 for those with HTN and DM. Results: A total of 583 Hispanic patients were served through the VOHHA program. Average age was 48 years (SD 13). A total of 492 (84.4%) were referred from CHCs, 64 (11%) from SA, and 27 (4.6%) through SR. A total of 534 (91.9%) reported having a primary care doctor. Seventy-seven (13.2%) reported a history of HTN without DM, and 172 (29%) reported HTN and DM. BP was controlled in 28 (37%) of those reporting HTN without DM (BP available, 75 patients). BP was controlled in 27 (16%) of those who reported HTN and DM (BP available, 169 patients.) For all patients with HTN who reported time since lme (193/249), the large majority (167 [86%]) reported lme was Ͻ7 months; 13(6.7%) reported Ͼ18 months. Fifty-five (22%) did not report time since lme. Conclusions: Hypertension control among Hispanic patients seen through the VOHHA program is less than desired especially among those who report HTN and DM despite the large number who reported a primary care physician and recent medical exams. Although this information cannot be generalized, it does correspond to other reports of health care disparities in the Hispanic population.

Approximately 15-20 percent of children entering school have a vision problem. Only fourteen percent of children have had a comprehensive eye examination before entering school. Vision screenings are designed to detect vision problems but in attempting to be efficient often miss vision problems that exist. It is difficult for parents of children entering school to understand the difference between a simple vision screening, performed in a few minutes by a nurse or lay assistant, and a comprehensive eye examination. To address this issue and ensure that children entering school in Missouri were visually ready to learn, Senate Bill 16 was enacted four years ago. This law formed the Missouri Children's Vision Commission and required children entering public school in Missouri to have a comprehensive eye examination prior to December 31 of their first year in school and a school administered vision screening in first and third grade.

This study addresses the wear of Acuvue (R) disposable contact lenses under an Army aviation protective mask developed for the Apache attack helicopter. This potective musk (the M-43) features constant internal air flow to its lenses to prevent fogging. Twelve subjects wore the mask for 3-hour periods with the filter/blower running, both with and without contaCt lenses. No significant differences in corneal thickness, contrast sensitivity, ur tear breakup times were found. Grade 1 (trace) limbal injection and grade I (trace) staining were found to be prevalent when the musk was worn either with or without contuct lenses. This study suggests that disposable contact lens wear is compatible with this unique aviation mask. This is significant because the musk is designed to be worn under the pilot's helmet and helmet-mounted displays, rendering it essentially unremovable during the aircraft mission.

This study evaluated peripheral vision through the M43 protective mask currently worn by aviators in the AH-64 Apache helicopter. A Humphrey Visual Field Analyzer was used to measure the sensitivity of a subject's visual field with and without the mask. The results were analyzed using Dicon's Fieldview software. The monocular visual field was reduced for each eye when wearing the mask, especially superiorly and nasally. The overall size of the visual field was not reduced when both eyes were open; however, the quality of the visual field was reduced. The area of binocular vision (central binocular vision fusion field subserving stereopsis) was restricted to the central 30 degrees.

In 1996 and 1997, the Army conducted an exercise to assess the ability to rapidly mobilize the reserve forces. In accordance with Army requirements, each soldier was evaluated to determine if he or she met vision and optical readiness standards. Of the 1,947 individuals processed through the optometry section, 40% met vision requirements without correction and 32% met vision requirements with their current spectacles. The remaining 28% required examination. A major impediment to processing reserve units for deployment is the lack of vision and optical readiness. In the mobilization for the Persian Gulf War, significant delays were incurred because of the time required to perform eye examinations and fabricate eyewear. However, as a result of this exercise, current prescriptions will be available in the event of mobilization. To ensure readiness, all units should perform such exercises periodically.

In September 2012, Pacific Angel (PACANGEL)--Nepal 2012 was conducted in Kaski District, Nepal. Health services were provided in optometry, family medicine, pediatrics, physical therapy, midwifery, dentistry, and pharmacy. This report is on optometric care provided. 995 patients were examined. Mean age was 41.34 (median 43). Mean entering distance visual acuity was 20/57 in the right eye, 20/60 in the left. Mean spherical error was +0.08D in the right eye, +0.09D in the left. For those patients with astigmatism, mean cylindrical error was -0.74D in the right eye, -0.54D in the left. A near addition was prescribed for 51.8% of the patients. Cataract was diagnosed in 24.17% of the patients. Other prevalent nonrefractive diagnoses were dry eye (18.17%), conjunctivitis (12.0%), and pterygium (5.17%). Eye and vision care is lacking in Nepal. Sporadic episodes of care have considerable impact on those patients receiving treatment. However, to substantially treat the greatest worldwide cau...

INTRODUCTION. Participation in humanitarian missions can result in considerable absence from classroom, laboratory, and clinical instruction. Though few would argue that these encounters make students better global citizens, some faculty question the educational benefit. To address this, a survey was mailed to the last five year’s graduates of the College of Optometry at the University of Missouri-St. Louis to gain insight into their experiences. Humanitarian Missions Survey METHODS. A survey was mailed to 205 optometry alumni of the University of Missouri—St. Louis College of Optometry. RESULTS. 73 surveys were returned for a response rate of 36%. Results are presented in tabular style on the document. CONCLUSION. Students participating in humanitarian missions receive significant exposure to a wide range of ocular and systemic maladies. In addition to improvement to their cultural competence such encounters are of great benefit as a clinical learning experience.

Introduction: The process of developing the American Optometric Association’s Clinical Practice Guidelines was begun in 1989 under the direction of John F. Amos, O.D., M.S., Chair of the Clinical Care Center. The Guideline development process used by the AOA was modeled after the recommendations established by the Agency for Health Care Policy and Research in response to the federal government encouraging groups to develop clinical guidelines to enhance the quality, appropriateness, and effectiveness of health care. The guideline topics were chosen for their importance in the education of members, healthcare payers, and state legislators. A principal author and a consensus panel of experts were then chosen for each subject area. This group was responsible for transforming the latest scientific research and expert judgment into a document that would apply to everyday optometric practice. Thirteen Guidelines were mailed to AOA members in 1994 and 1995. Additional guidelines were maile...

PURPOSE. Soldiers assigned overseas must meet vision standards to be considered deployable. Those who do not meet standards without correction are required to have two pairs of spectacles and one pair of protective mask inserts. The U.S. Army Center for Health Promotion and Preventive Medicine (CHPPM) defines visually ready as having vision necessary to meet job standards, and optically ready as possessing all required optical devices. If soldiers do not maintain visual and optical readiness, last-minute preparations can be inefficient and time-consuming, potentially causing delayed deployment and logistical problems in fabricating and delivering eyewear. In a pilot study conducted by optometrists from CHPPM-Europe, results from two Soldier Readiness Program (SRP) exercises in Kaiserslautern, Germany, indicated that 2.5% of soldiers were not visually ready and 23% were not optically ready. METHODS. Unit commanders were advised that soldiers would continue to be required to prove the...

Background Controversy exists as to whether refractive error is determined by heredity or more influenced by environmental causes. This topic has been debated within optometry and ophthalmology for years. An often-used argument by the environmental theorists is the difference that has been reported in the distribution of refractive errors between those from developed and developing countries. This has led many to hypothesize that environmental causes, specifically prolonged and detailed near work, lead to the development of myopia. However, those who are proponents of heredity as the causal factor argue that all inherited traits are not present at birth. Method As part of the Uganda African Crisis Response Initiative, U.S. Army optometric personnel provided vision screening, examination, and treatment to a battalion size task force from the Ugandan Army. All of those screened as part of this mission were young African men in their early twenties. For comparison 3,247 U.S. soldiers w...

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