Abstract: At this point in time, the importance of medical humanities education has not been fully understood during the standardized training of residents in China. The study of medical humanities is an important facet of ophthalmology residency that needs to be strengthened. During the standardized training of ophthalmology residents, not only the medical sciences should be strengthened, but also the nature and practice of medical humanities knowledge should be enhanced in multiple aspects. Offering medically-relevant literature, history, philosophy and other courses, simulating real medical activities, being enthusiastic in popular medical science and increasing the contents of the examination in medical humanities would all be areas that would further advance the ophthalmology residency. Along with medical science education, residents will be led and trained on medical humanities as to build good medical humanistic spirit of patient care so that they may better serve patients.
Background: The ORVIS infrastructure aims to facilitate the development and availability of valid and adapted tools that will allow functional, perceptual, cognitive and psychological evaluation of low vision clients by researchers and clinicians who work in low vision and visual impairment rehabilitation.
Methods: The tools developed or documented within ORVIS Infrastructure are tests or questionnaires which allow, or will allow to assess—in an accurate and reliable manner—characteristics related to visual impairment. The tools in development are: (I) questionnaire de repérage des hallucinations visuelles liées au syndrome de Charles-Bonnet (QR-SCB); (II) repérage des personnes agées présentant des INDices de déficience VISUELle (IndiVisuel); (III) mesure de l’impact de la déficience visuelle dans les activités quotidiennes (MIDVAQ) and (IV) M’EYE read test. The directory documents 14 tools and offers—within a descriptive sheet—characteristics, components and metrological properties as supported by cited scientific studies.
Results: The ORVIS Infrastructure, which aims at the development and availability of assessment tools, fills researchers’ and clinicians’ needs for measurement tools that are valid, effective and appropriate for use with a visually impaired clientele. Such tools are, especially in French, little known and hard to find, and represent a precious resource for those who want to evaluate the efficacy of treatments or interventions.
Conclusions: ORVIS is available at www.orvis.vision. Between November 2015 and September 2017, the directory has been accessed 1,383 times by 952 unique visitors.
Background: With a large portion of older adults living longer, the number of individuals diagnosed with low vision is increasing. The use of optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO) to diagnose retinal disease has become common place in the last 10 years, yet currently there are no OCT/SLO databases for pathological vision. Our aim is to develop a clinical database of individuals who have drusen (i.e., lipid deposits found under the retina), or have been diagnosed with age-related macular degeneration (AMD), with information as to how the structure of the diseased retina changes over time, as well as measures of visual and cognitive functional performance.
Methods: Fundus photographs and retinal scans will be taken using the same model of optos OCT/SLO located in three test sites (MAB-Mackay Rehabilitation Centre, School of Optometry Clinic at the University of Montreal, and the Lighthouse Institute, New York, USA). For each individual entry in the database, demographic and diagnosis information will be available. All OCT/SLO images will be graded according to the Age-related Eye Disease Study standard, in addition to number and size of drusen, severity of geographic atrophy, severity of pigment mottling and presence of choroidal neovascularization. Retinal topography and Raster scans from the OCT/SLO will provide a cross-sectional look at affected retinas. Fixation stability will be recorded using the SLO function, and present four different tasks that are designed to reproduce typical tasks of daily vision, with each task lasting for 10 seconds. The tasks are cross fixation, face recognition, visual search, and reading. These tasks in addition to the retinal scans will be used to determine the eccentricity of a preferred retinal locus from the anatomical fovea, and can be used as an outcome measure for clinical interventions in visually impaired patients.
Results: The database will be available to professors training eye-care practitioners and rehabilitation specialists as a teaching tool. Students will be able to familiarize themselves with the retina and a variety of AMD-related pathologies before they start working with patients. The database will also be accessible by researchers interested in studying AMD from basic science to epidemiology, to investigate how drusen and AMD impact visual and cognitive functional performance.
Conclusions: The common infrastructure is easily accessible to all VHRN members on request. The database will also be accessible online in 2018 (see http://cvl.concordia.ca for more information).
Background: Dementia is a syndrome that affects a person’s ability to understand and express information. The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care (LTC) facilities interferes with the ability of nurses to provide optimal care because communication is compromised. Therefore, the detection and screening for sensory impairment is of the utmost importance in LTC facilities; however, there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral, and the need for a validated screening measure suitable for nurses in LTC facilities is clear. The present project aims to close this gap by investigating the screening recommendations of vision- and hearing-care professionals working with clients affected by dementia.
Methods: Eleven experts in audiology, optometry, deafblindness, and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss. Interview transcripts were coded by two evaluators using verbal agreement and consensus building.
Results: Three main themes emerged from the interviews with experts: barriers, facilitators, and strategies. Barriers to sensory screening were often mentioned, particularly impaired communication and lack of staff cooperation. Facilitators consisted uniquely of people, such as family members, intervenors, and nurses. Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements; considerations based on familiarity; and inferring an impairment on the basis of patient behaviour. Few of our interviewees were knowledgeable on the topic of screening apps.
Conclusions: Our findings, to be integrated with a similar environmental scan conducted among LTC nurses, can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.
Abstract: Optical coherence tomography (OCT) is a widely used non-invasive medical imaging technology that has revolutionized clinical care in ophthalmology. New developments, such as OCT angiography (OCTA) are expected to contribute even further to the widespread use of OCT-based imaging devices in the diagnosis and monitoring of patients with ophthalmic diseases. In recent years, many of the disadvantages such as limited field of view and imaging artefacts have been substantially reduced. Similar to the progress achieved in the assessment of retinal disorders, OCT is expected to change the approach to patients seen in the neuro-ophthalmology clinic. In this article, we review the technical features of OCT and OCT-based imaging techniques, highlighting the specific factors that should be taken into account when interpreting OCT in the field of neuro-ophthalmology.
Abstract: Age-related macular degeneration (ARMD), one of the most common causes of blindness, should be considered more due to its exponential increase in the coming 20 years as a result of increasing the age of the population. Whereas more recent studies offered newer scaling systems for ARMD, traditionally it is classified as the early and late stages. The main injury in this disease occurred in retinal pigment epithelium (RPE) and the retina. RPE cells have a crucial role in hemostasis and supporting photoreceptors. In the early stages, damages to RPE are minimal and mainly no treatment is needed because most patients are asymptomatic. However, in the late stages, RPE impairment may lead to the invasion of choroidal vessels into the retina. Although anti-angiogenic agents can inhibit this abnormal growth of blood vessels, they cannot stop it completely, and finally, total loss of retinal cells may occur (geographical atrophy). Since this prevalent disease has not had any cure yet, the concept of substituting the RPE cells should be considered. Repairing the injury to central nervous system cells is almost impossible because the regenerative capacity of these cells is limited. Recently, the use of regenerative substitutes has been suggested to replace damaged tissues. Amniotic membrane (AM) has been raised as a suitable substitute for damaged RPE cells due to all of its unique properties: pluripotency, anti-angiogenic effect, and anti-inflammatory effect. Based on the few studies that have been published so far, it seems that the use of this membrane in the treatment of ARMD can be helpful, but more studies are needed.
