Off the Cuff: A Chance to Express Your Opinion

The AOA House of Delegates will be voting on creating a new CE accreditation process by authorizing the AOA's Accreditation Council on Optometric Education (ACOE) to accredit CE providers. How do you feel about this? I am an AOA member and I am against this resolution I am an AOA member and I am in favor of this resolution I am NOT an AOA member and I am against this resolution I am NOT an AOA member and I am in favor of this resolution I don't care either way

A few weeks ago, I wrote about the upcoming vote in the AOA House of Delegates that would give the AOA's Accreditation Council on Optometric Education (ACOE) authority to accredit CE providers. Since that editorial was published, the issue has heated to a fast boil. ARBO has taken a strong stand and has issued a White Paper on the issue. The AOA responded with their perspective, as has the AOS. The discussion on websites such as ODWire is raging.

Because this issue is a critical one that is likely to have long-term consequences for our profession, I am turning this week's column over to the profession. I believe it important for the AOA leadership and for every state delegation to understand how we — AOA members and the profession at large — feel about this issue.

It is essential that the profession's leadership understands and respects the wishes of those that they represent. One thing is certain. We do not need more division within our ranks.

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Arthur B. Epstein, OD, FAAO Chief Medical Editor [email protected]

 

 

The purpose of this study was to evaluate the tear film functions and clinical symptoms of patients with migraines. This observational comparative study consisted of 33 migraine (26 women and 7 men) patients referred from neurology clinics and 33 (22 women and 11 men) control subjects referred from ophthalmology outpatient clinics. The control subjects had neither systemic nor ocular disease nor any type of headache. All 66 patients underwent a complete ophthalmic examination and diagnostic tests for dry eye, including tear break-up time, Schirmer test with topical anesthesia, lissamine green staining, and an ocular surface disease score. Patients with migraine were classified as migraine with an aura, migraine without an aura, and basilar migraine; a pain score from 1 to 4 was determined for each patient, based on the American Headache Society's Migraine Disability Assessment Test.

Of the 33 patients who participated in the migraine group, 17 (51%) suffered from migraine with aura, 11 (33%) suffered from migraine without aura, and 5 (15%) suffered from basilar migraine. Significant differences in dry eye scores were found between the patients with migraine and the control subjects. In the migraine group, the mean tear break-up time was 7.75 ± 2.37 seconds, whereas in the control group it was 9.15 ± 1.93 seconds. For the Schirmer test, the migraine group had a mean value of 12.09 ± 4.95 mm/5 minutes, whereas the control group had a mean value of 14.90 ± 4.26 mm/5 minutes. Testing with lissamine green staining resulted in a mean value of 1.00 ± 0.16 in the migraine group and 0.30 ± 0.46 in the control group. In the migraine group, the mean for the ocular surface disease index scoring was 36.27 ± 17.54. In the control group, it was 28.42 ± 9.0. A significant difference was found in the dry eye syndrome testing results between the two groups in this study.

An increased frequency of dry eye disease was found to occur in patients with migraine, which might suggest that migraine headaches are related to dry eye disease. Some migraine attacks may be aggravated in the presence of dry eye syndrome.

This prospective, double-masked, randomized trial with 1-month follow-up was conducted to evaluate patient-reported outcome measures with the use of ready-made spectacles (RMS) and custom spectacles (CS) in an adult population in India with uncorrected refractive error (URE). A total of 363 adults aged 18 to 45 years with ≥1 D of URE (RMS, n = 183; CS, n = 180). All participants received complete refraction and were randomized to receive CS (full sphero-cylindrical correction) or RMS based on the spherical equivalent for the eye with lower refractive error but limited to the powers in the RMS inventory. Visual function and quality of life (VFQoL) instrument and participant satisfaction were administered.

Scores for VFQoL increased from 1.14 to 4.37 logits in the RMS group and from 1.11 to 4.72 logits in the CS group: respective mean changes of 3.23 vs. 3.61, respectively. Mean patient satisfaction also increased by 1.83 points on a 5-point Likert scale in the RMS group and by 2.04 points in the CS group. In bivariate analyses, CS was not associated with increased VFQoL or patient satisfaction compared with the RMS group. In the full multivariable linear regression, the CS group had greater improvement when compared with those receiving RMS (+0.45 logits), and subjects with astigmatism >2.00 D had significantly less improvement (–0.99 logits) after controlling for demographic and vision-related characteristics. In multivariable analysis, increased change in patient satisfaction was related to demographic and optical characteristics, but not spectacle group.

Ready-made spectacles produce large but slightly smaller improvements in VFQoL and similar satisfaction with vision at 1-month follow-up when compared with CS. Ready-made spectacles are suitable for the majority of individuals with URE in our study population, although those with high degrees of astigmatism may benefit from a trial of CS. This study provides further evidence for the use of RMS in settings where CS are unavailable or unaffordable, or refractive services are inaccessible to those in need.

This study aimed at investigating the extent to which saccadic eye movements are disrupted in patients with primary open-angle glaucoma (POAG). This approach followed upon the discovery of differences in the eye-movement behavior of POAG patients during the exploration of complex visual scenes. The eye movements of eight POAG patients and four healthy age-matched controls were recorded. Four of the patients had documented visual field scotoma, and four had no identifiable scotoma on visual field testing. The eye movements were monitored as the observers watched static and kinetic targets. The gain, latency, and velocity-peak latency of the saccades recorded were then analyzed.

In POAG patients, with abnormal visual fields, watching a static target, the saccades were delayed and their accuracy was reduced, compared with those of normal observers. In POAG patients, with normal and abnormal visual fields, watching a kinetic target, a task involving precise motion analysis, the latency and accuracy of the saccades were impaired, compared with those of normal observers.

Our findings suggest that POAG alters saccade programming and execution particularly in the case of moving targets.