Archives of Ophthalmology

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Emily Dickinson is one of America's premier poets of the 19th century. Henry Willard Williams, MD, was one of the very first physicians to limit his practice to ophthalmology and was the established leader in his field in Boston, Massachusetts. They met during the time of the Civil War, when Emily consulted him about her ophthalmic disorder. No records of the diagnosis survive. Photophobia, aching eyes, and a restriction in her ability to work up close were her main symptoms. Iritis, exotropia, or psychiatric problems are the most frequent diagnoses offered to explain her difficulties...

An optimal clear corneal incision creates a self-sealing intrastomal tunnel. Variability in incision length may pose surgical difficulties for subsequent phacoemulsification. An incision that is too long may lead to challenges including decreased instrument mobility, decreased visibility due to corneal striae, stromal hydration, and a difficult angle of approach to the cataract. These sequelae may lead to surgical complications or abandonment of the original incision. We describe a technique for shortening a long clear corneal incision with the intentional creation of a flap of corneal tissue at the posterior internal wound edge...

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OBJECTIVE: To determine whether racial disparities exist in the use of ancillary testing to evaluate individuals with open-angle glaucoma. METHODS: We identified all enrollees aged 40 years and older in a large US managed care network with retinal or optic nerve conditions that could warrant the use of ancillary testing. Among persons with open-angle glaucoma or glaucoma suspects, we performed repeated-measures multivariable logistic regression to determine the odds and probabilities each year of undergoing visual field testing, fundus photography, and other ocular imaging for black, white, Hispanic, and Asian American men and women and compared the groups...

OBJECTIVE: To evaluate higher-order kinematic analysis, a technique not previously applied to surgical skills assessment, as a tool for elucidating patterns of movement. METHODS: An observational cohort study of 27 subjects, divided into 3 equal groups based on surgical experience consisting of novice (performed <5 prior procedures), intermediate (performed 5-100 prior procedures), and expert (performed >100 prior procedures) subjects. The subjects placed a deep 3-1-1 suture onto a shielded hook on a standardized surgical skills practice board...

OBJECTIVES: To report photographic evidence of eyebrow tissue expansion in patients with thyroid-associated orbitopathy (TAO) and to demonstrate consistency in grading through the use of standardized photographs. METHODS: A retrospective cohort study of patients referred for evaluation of TAO in an orbitofacial tertiary care center between January 1, 2000, and December 31, 2010. A grading key was produced with representative views of each of 4 grades (0 [no expansion] to 3 [severe expansion]), corresponding to increasing severity of eyebrow tissue expansion...