Journal of the American Optometric Association

Do you keep telling yourself it's time to get in shape? Are you adding workouts to your list of New Year's resolutions? If you think you can't balance fitness with a busy schedule, think again. Here are the stories of some optometrists who have done just that (along with a couple of hard-core ODs who've taken fitness to a higher level).

Bringing a new optometrist into a practice, even if only on an employer-employee basis, is a complicated process that should not be taken lightly by hirer or hiree. This article explores the many aspects of the process and the relationship that must be understood and worked out in advance.

BACKGROUND: Penetrating keratoplasty places a patient at risk for wound rupture from blunt trauma because the graft-host interface remains weakened for years after the surgery. Violent environments, contact sports, and strenuous activity put patients with compromised corneal structural integrity at high risk of traumatic injury. CASE REPORT: This case report presents a 42-year-old penetrating keratoplasty patient with a history of homelessness, polysubstance abuse, and domestic violence...

BACKGROUND: Posterior keratoconus has only a few scattered case reports in the literature. Posterior keratoconus is characterized by a posterior stroma thinning and a depression of the posterior corneal surface. The effect on acuity is variable and may be related to other ocular and systemic conditions. CASE REPORT: An African-American woman came to us with posterior concavity (corneal thinning), with stromal scarring in both eyes and an epithelial iron ring present in the left eye...

BACKGROUND: Ophthalmic evaluation of patients with keratoconus (KC) often reveals highly myopic and irregular astigmatic refractive corrections. Irregular corneal astigmatism and central corneal scarring in patients with KC often result in a loss of best-corrected spectacle acuity. Rigid gaspermeable contact lenses generally optimize visual acuities for patients with KC. CASE REPORTS: Two cases are discussed of patients who manifested clinically diagnosed KC but unusually good unaided Snellen visual acuities (20/25+ or better) in both eyes...

BACKGROUND: A convergent (eso) shift in near phoria associated with the onset of myopia has been reported. METHODS: Data from two Midwestern United States optometry practices were used to assess whether the near phoria shifted back in the divergent (exo) direction after the cessation of childhood myopia progression. Data were collected for myopic children who had three or more examinations before the age of 15 years and at least one examination after the age of 17 years...

PURPOSE: The purpose of this study was to determine the testability of the "Co or Vision Testing Made Easy" color vision test, marketed as a screening test for young children, in a population of individuals with mental retardation. The test uses simple geometric figures that are easily identified. Previously, the test has demonstrated validity as a measure of color deficiency. METHODS: The test was presented to Special Olympic athletes, who are individuals with mental retardation or significant developmental delay, at four sites: the 1997 World Winter Games in Toronto, Canada; the Texas Summer Games in Houston, Texas; the Massachusetts Summer Games in Boston, Massachusetts; and Regional European Swim Competition in Seville, Spain...

The 45,000-plus school nurses in the U.S. have an astonishing array of responsibilities, and serve as important gatekeepers to the health care of millions of children. By building relationships with local school nurses, doctors of optometry can play an important part in improving children's vision care, and build their practices as well. We take a look at the challenges school nurses face, and an AOA program designed to reach out to them and improve the quality of vision screenings.

BACKGROUND: Occurrence of refractive errors and uncorrected visual acuity impairment among self-selected, indigent, medically underserved Hispanic, white, and black adults examined by the staff of the UCLA Mobile Eye Clinic (MEC) are described in this study and compared to population-based studies. METHODS: The study sample consisted of all 2,970 Hispanic, 1,228 white, and 1,028 black participants, for a total of 5,226 self-selected adults, ages 25 to 74 years, who received vision screenings and eye examinations by the staff of the UCLA MEC from 1987 to 1997...

BACKGROUND: Glaucomatocyclitic Crisis (AKA Posner-Schlossman syndrome) is a syndrome that affects patients between the ages of 20 and 50 years. It is characterized by a mild recurrent anterior uveitis associated with an out-of-proportion intraocular pressure spike in the same eye. The cause is unclear, but many theories exist. Some researchers have tried to connect it with primary open-angle glaucoma. CASE REPORT: A review of the record of a 41-year-old Hispanic woman with Posner-Schlossman syndrome is discussed...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

As managed care inches closer to becoming the standard mechanism for delivering health benefits to American workers, we looked to see if the status of vision/eye health benefits have changed in the 1990s. Has vision care become a "mainstream" benefit?

The technology is here. Why aren't ODs jumping on board? Building a truly "paperless practice" isn't simply a matter of buying a few computers. Its cost can be measured in money, space, training time, and aggravation. And sometimes the doctors who need it most are the least able to implement it. This author discusses the pros and cons of the paperless practice and shows us how some "paperless" optometrists have done it in their offices.

BACKGROUND: Preseptal cellulitis is a serious ocular condition that--if left untreated--has the potential to cross the septal barrier, spread to the posterior orbit, and may result in fatal complications. Because it is difficult to determine the pathogen responsible for any cellulitis without aspirating a culture sample, treatment is usually instituted by an assumption of the most common causative organisms, Staphylococcus or Streptococcus. CASE REPORT: A 42-year-old black woman manifested signs and symptoms consistent with right preseptal cellulitis...

BACKGROUND: We present a case report on a rare presentation of a conjunctival malignant melanoma in a Native American woman. Malignant melanoma is a rare finding in the general population, and even more rare in Native Americans. Ultraviolet radiation (UVR) damage is postulated as a causal agent for its development and may explain why the vast majority of lesions are found in sun-exposed areas of the body. Human beings with lighter complexion are known to have a higher risk of malignant melanoma as well...

BACKGROUND: There are relatively few studies on causes of childhood visual impairment. This study determines causes of visual impairment and resultant visual acuity among students enrolled at the Alabama School for the Blind (ASB). METHODS: All students enrolled at ASB during the 1996-1997 school year (N = 123) were examined between April 1994 and March 1997. A retrospective record review was performed to determine the primary cause of visual impairment and the visual acuity with best correction...

BACKGROUND: A bifocal rigid gas permeable (RGP) contact lens is now available that totally encapsulates an add segment of a different material within its inferior aspect. The purposes of this study were to determine the effects of the major lens and of its encapsulated segment region on the oxygen uptake rates of underlying cornea. METHODS: Corneal oxygen uptake rates of 10 human corneas were measured--both centrally and inferiorly--for non-wearing conditions and then immediately after 300-second wearing periods of a polymethylmethacrylate (PMMA) lens and of this RGP-encapsulated segment bifocal contact lens...