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Mohamed Dirani - One of the best experts on this subject based on the ideXlab platform.
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adherence to diabetic Eye Examination guidelines in australia the national Eye health survey
The Medical Journal of Australia, 2017Co-Authors: Joshua Foreman, Hugh R Taylor, Jing Xie, Stuart Keel, Peter Van Wijngaarden, Mohamed DiraniAbstract:OBJECTIVE: To determine adherence to NHMRC Eye Examination guidelines for Indigenous and non-Indigenous Australian people with diabetes. DESIGN: Cross-sectional survey using multistage, random cluster sampling. SETTING: Thirty randomly selected geographic sites in the five mainland Australian states and the Northern Territory, stratified by remoteness. PARTICIPANTS: 1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016 according to a standardised protocol that included a questionnaire (administered by an interviewer) and a series of standard Eye tests. MAIN OUTCOME MEASURES: Adherence rates to NHMRC Eye Examination guidelines; factors influencing adherence. RESULTS: Adherence to screening recommendations was significantly greater among non-Indigenous Australians (biennial screening; 77.5%) than Indigenous Australians (annual screening; 52.7%; P < 0.001). Greater adherence by non-Indigenous Australians was associated with longer duration of diabetes (adjusted odds ratio [aOR], 1.19 per 5 years; P = 0.018), while increasing age was associated with poorer adherence in non-Indigenous Australians (aOR, 0.70 per decade; P = 0.011). For Indigenous Australians, residing in inner regional areas (aOR, 1.66; P = 0.007) and being male (aOR, 1.46; P = 0.018) were significant factors positively associated with adherence. CONCLUSIONS: More than three-quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC Eye Examination guidelines. The discrepancy between the adherence rates may point to gaps in the provision or uptake of screening services in Indigenous communities, or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is needed, particularly in remote areas, to improve adherence rates.
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treatment coverage rates for refractive error in the national Eye health survey
PLOS ONE, 2017Co-Authors: Joshua Foreman, Hugh R Taylor, Jing Xie, Stuart Keel, Mohamed DiraniAbstract:Objective To present treatment coverage rates and risk factors associated with uncorrected refractive error in Australia. Methods Thirty population clusters were randomly selected from all geographic remoteness strata in Australia to provide samples of 1738 Indigenous Australians aged 40 years and older and 3098 non-Indigenous Australians aged 50 years and older. Presenting visual acuity was measured and those with vision loss (worse than 6/12) underwent pinhole testing and hand-held auto-refraction. Participants whose corrected visual acuity improved to be 6/12 or better were assigned as having uncorrected refractive error as the main cause of vision loss. The treatment coverage rates of refractive error were calculated (proportion of participants with refractive error that had distance correction and presenting visual acuity better than 6/12), and risk factor analysis for refractive correction was performed. Results The refractive error treatment coverage rate in Indigenous Australians of 82.2% (95% CI 78.6–85.3) was significantly lower than in non-Indigenous Australians (93.5%, 92.0–94.8) (Odds ratio [OR] 0.51, 0.35–0.75). In Indigenous participants, remoteness (OR 0.41, 0.19–0.89 and OR 0.55, 0.35–0.85 in Outer Regional and Very Remote areas, respectively), having never undergone an Eye Examination (OR 0.08, 0.02–0.43) and having consulted a health worker other than an optometrist or ophthalmologist (OR 0.30, 0.11–0.84) were risk factors for low coverage. On the other hand, speaking English was a protective factor (OR 2.72, 1.13–6.45) for treatment of refractive error. Compared to non-Indigenous Australians who had an Eye Examination within one year, participants who had not undergone an Eye Examination within the past five years (OR 0.08, 0.03–0.21) or had never been examined (OR 0.05, 0.10–0.23) had lower coverage. Conclusion Interventions that increase integrated optometry services in regional and remote Indigenous communities may improve the treatment coverage rate of refractive error. Increasing refractive error treatment coverage rates in both Indigenous and non-Indigenous Australians through at least five-yearly Eye Examinations and the provision of affordable spectacles will significantly reduce the national burden of vision loss in Australia.
Alex V Levin - One of the best experts on this subject based on the ideXlab platform.
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the Eye Examination in the evaluation of child abuse
Pediatrics, 2010Co-Authors: Cindy W Christian, Alex V LevinAbstract:Child abuse can cause injury to any part of the Eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric Eye trauma. Identification and documentation of inflicted ocular trauma requires a thorough Examination by an ophthalmologist, including indirect ophthalmoscopy, most optimally through a dilated pupil, especially for the evaluation of possible RHs. An Eye Examination is helpful in detecting abnormalities that can help identify a medical or traumatic etiology for previously well young children who experience unexpected and unexplained mental status changes with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, and children with unexplained death.
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clinical report the Eye Examination in the evaluation of child abuse
Pediatrics, 2010Co-Authors: Alex V Levin, Cindy W ChristianAbstract:Retinal hemorrhage is an important indicator of possible abusive head trauma, but it is also found in a number of other conditions. Distinguishing the type, number, and pattern of retinal hemorrhages may be helpful in establishing a differential diagnosis. Identification of ocular abnormalities requires a full retinal Examination by an ophthalmologist using indirect ophthalmoscopy through a pupil that has been pharmacologically dilated. At autopsy, removal of the Eyes and orbital tissues may also reveal abnormalities not discovered before death. In previously well young children who experience unexpected apparent life-threatening events with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, victims of abusive head trauma, and children with unexplained death, premortem clinical Eye Examination and postmortem Examination of the Eyes and orbits may be helpful in detecting abnormalities that can help establish the underlying etiology. Language: en
Cindy W Christian - One of the best experts on this subject based on the ideXlab platform.
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the Eye Examination in the evaluation of child abuse
Pediatrics, 2010Co-Authors: Cindy W Christian, Alex V LevinAbstract:Child abuse can cause injury to any part of the Eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in evaluating a differential diagnosis. Eye trauma can be seen in cases of physical abuse or AHT and may prompt referral for ophthalmologic assessment. Physicians have a responsibility to consider abuse in the differential diagnosis of pediatric Eye trauma. Identification and documentation of inflicted ocular trauma requires a thorough Examination by an ophthalmologist, including indirect ophthalmoscopy, most optimally through a dilated pupil, especially for the evaluation of possible RHs. An Eye Examination is helpful in detecting abnormalities that can help identify a medical or traumatic etiology for previously well young children who experience unexpected and unexplained mental status changes with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, and children with unexplained death.
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clinical report the Eye Examination in the evaluation of child abuse
Pediatrics, 2010Co-Authors: Alex V Levin, Cindy W ChristianAbstract:Retinal hemorrhage is an important indicator of possible abusive head trauma, but it is also found in a number of other conditions. Distinguishing the type, number, and pattern of retinal hemorrhages may be helpful in establishing a differential diagnosis. Identification of ocular abnormalities requires a full retinal Examination by an ophthalmologist using indirect ophthalmoscopy through a pupil that has been pharmacologically dilated. At autopsy, removal of the Eyes and orbital tissues may also reveal abnormalities not discovered before death. In previously well young children who experience unexpected apparent life-threatening events with no obvious cause, children with head trauma that results in significant intracranial hemorrhage and brain injury, victims of abusive head trauma, and children with unexplained death, premortem clinical Eye Examination and postmortem Examination of the Eyes and orbits may be helpful in detecting abnormalities that can help establish the underlying etiology. Language: en
Scott W Menzies - One of the best experts on this subject based on the ideXlab platform.
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dermoscopy compared with naked Eye Examination for the diagnosis of primary melanoma a meta analysis of studies performed in a clinical setting
British Journal of Dermatology, 2008Co-Authors: M Vestergaard, Petra Macaskill, P E Holt, Scott W MenziesAbstract:BACKGROUND: Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic Examination of diagnostic features, not seen by the naked Eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta-analyses including studies performed in experimental and clinical settings. OBJECTIVES: To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked Eye Examination by performing a meta-analysis exclusively on studies performed in a clinical setting. METHODS: We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked Eye Examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical Examination with, and without, the use of dermoscopy. RESULTS: We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked Eye Examination, to be 15.6 [95% confidence interval (CI) 2.9-83.7, P = 0.016]; removal of two outlier studies changed this to 9.0 (95% CI 1.5-54.6, P = 0.03). CONCLUSIONS: Dermoscopy is more accurate than naked Eye Examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.
Zahra Tajbakhsh - One of the best experts on this subject based on the ideXlab platform.
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the shiraz pediatric Eye study a population based survey of school age children rationale design and baseline characteristics
Journal of ophthalmic and vision research, 2018Co-Authors: Mohammad Reza Talebnejad, Mohammad Hossein Nowroozzadeh, Hamideh Mahdaviazad, Mohammad Reza Khalili, Masoumeh Beygom Masoumpour, Maryam Keshtkar, Elham Mohammadi, Zahra TajbakhshAbstract:Purpose: To describe the rationale, study design, methodology, and baseline characteristics of the Shiraz Pediatric Eye Study, a population-based survey of schoolchildren in Shiraz, Iran. Methods: This population-based study included schoolchildren aged 6–12 years from all four educational districts of Shiraz who were recruited in years 2015–2016. Stratified random sampling was used to select 2400 participants from all districts. Data were recorded from a detailed interview and ocular evaluation of each eligible student. The Eye Examination comprised uncorrected and best corrected visual acuity measurement, refraction, external Eye Examination (including specific strabismus and lid evaluation tests), slit lamp biomicroscopy, intraocular pressure measurement, the Ishihara color vision test, and stereoacuity. Exophthalmometry, optical biometry, and optical coherence tomography were performed for a randomly selected subset of children. General characteristics and socioeconomic variables were also recorded to assess risk factors. Results: From a total of 2400 selected students, 2001 (83.3%) participated in the study. The mean age of the students was 9.1 ± 1.6 years, and 59.7% were girls. Most children had at least one parent with a diploma or less than diploma (63.5%), and 2.2% had illiterate parents. Conclusion: This study is expected to provide accurate estimates of the prevalence of visual impairments and their related determinants in Shiraz. In addition, it will identify children who should be targeted by blindness prevention programs.
