ORCID Profile
0000-0002-3991-7479
Current Organisations
Liverpool Hospital
,
University of New South Wales
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Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JCJO.2016.11.032
Abstract: To compare medical students' preference of smart phone television display (SPTD) to a slit-l teaching telescope (SLTT) in undergraduate clinical ophthalmology education. This is a randomized, crossover, comparative study. Pairs of medical students were randomly assigned to 2 teaching sessions using either SPTD first followed by SLTT or in reverse order. Students were asked to give feedback on the 2 teaching devices by answering 6 questions using a numeric rating score from 1 to 10. All participating students were sent the results of the study 1 month after the completion of the study and were asked to reflect upon the outcome. Thirty-eight students were recruited. The overall satisfaction scores were significantly higher for SPTD than SLTT (8.6 ± 1.4 vs 7.5 ± 1.0, p < 0.01). The students preferred SPTD compared with SLTT in terms of "visualization" (8.5 ± 1.4 vs 7.0 ± 1.3, p < 0.01), "ocular sign description" (8.4 ± 1.3 vs 7.2 ± 1.2, p < 0.01), "ocular anatomy understanding" (8.3 ± 1.2 vs 7.6 ± 1.2, p < 0.01), and "confidence in identifying clinical signs" (8.4 ± 1.2 vs 7.5 ± 1.2, p < 0.01). A larger proportion of the students gave higher scores to SPTD compared with SLTT in all questions. All students who responded to the follow-up questionnaire (n = 14) agreed with our interpretation of the data and would support the use of SPTD in undergraduate clinical ophthalmology teaching. Our study has demonstrated that the utility of SPTD as a teaching aid can significantly increase the satisfaction of undergraduate medical students during their ophthalmology attachment. It offers specific practical advantages in teaching medical students over the traditional SLTT.
Publisher: Jaypee Brothers Medical Publishing
Date: 2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2013
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.JCJO.2015.01.006
Abstract: To compare family physicians' glaucoma knowledge and clinical skills with ophthalmologists' expectations. An electronic cross-sectional survey of family physicians and ophthalmologists. Participants included members of the Canadian Ophthalmological Society, Canadian Glaucoma Society, and the American Glaucoma Society, as well as family physicians in the Canadian Medical Directory and the Society of Rural Physicians of Canada listserv. Two complementary surveys were developed to evaluate family physicians' glaucoma knowledge and basic examination skills, and ophthalmologists' expected level of family physician clinical knowledge and skills. χ(2) tests identified differences between family physician and ophthalmologist responses. Differences in family physician knowledge based on practice location and frequency of patient visits with a diagnosis of glaucoma were also evaluated. A total of 142 ophthalmologists and 110 family physicians completed the survey. The majority (82%) of family physicians reported seeing patients with diagnosed glaucoma weekly, monthly, or semiannually. Significantly fewer family physicians than expected (p < 0.001) identified African descent (46%) and corticosteroid use (84%) as glaucoma risk factors. Family physicians were significantly less likely to refer based on risk factors (72%) than expected by ophthalmologists (91% p < 0.001). Only 28% of family physicians were comfortable performing direct ophthalmoscopy, and 37% were comfortable checking for a relative afferent pupillary defect. A significant percentage of family physicians lacked knowledge of glaucoma medications (30%) and side effects (57%). This study revealed significant disparities in family physician glaucoma knowledge, clinical examination skills, and referral practices. Educational materials should target these knowledge gaps.
Publisher: Elsevier
Date: 2015
Publisher: American Medical Association (AMA)
Date: 10-2012
Publisher: Jaypee Brothers Medical Publishing
Date: 15-01-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2015
Publisher: Springer Science and Business Media LLC
Date: 28-02-2019
DOI: 10.1007/S12325-019-00899-5
Abstract: To evaluate the safety and efficacy of combined iStent® trabecular micro-bypass device (Glaukos, Laguna Hills, CA) and phacoemulsification in eyes with primary angle closure disease. A two-center prospective interventional case series of consecutive patients with primary angle closure (PAC) or primary angle closure glaucoma (PACG) on at least one glaucoma medication, who underwent iStent implantation with cataract surgery. Postoperatively, patients were assessed on days 1 and 7, and months 1, 3, 6, and 12. The intraocular pressure (IOP), glaucoma medication use, visual acuity, and the presence of complications were assessed at each visit. Complete success was defined as IOP reduction of at least 20% without the use of glaucoma medications. Thirty-seven eyes with angle closure disease were included in this study. At 1-year, postoperative mean IOP (14.8 ± 3.94 mmHg) was significantly decreased compared with preoperative medicated (17.5 ± 3.82 mmHg, p = 0.008) and unmedicated (24.6 ± 3.41 mmHg, p < 0.001) IOP. Complete success was achieved in 89.2% of the eyes. The number of glaucoma medications decreased from 1.49 ± 0.77 to 0.14 ± 0.48 (p < 0.001). Preoperative medicated IOP was a risk factor for failure (hazard ratio 3.45, 95% confidence interval 1.52-7.85, p = 0.003), after adjustment for age, gender, and race. The most common postoperative complications were iStent occlusion with iris (27.0%) and hyphema (18.9%). There were no sight-threatening intraoperative or postoperative complications. Combined iStent implantation with cataract surgery was effective in lowering the IOP and the number of glaucoma medications for at least 12 months, with a favorable safety profile. Glaukos Corporation NMRC Science Translational and Applied Research (STAR) award.
Publisher: Springer International Publishing
Date: 2017
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.OPHTHA.2013.08.027
Abstract: To assess the quality of glaucoma referral letters and to report on the results of a survey of glaucoma specialists about referral letter content. Cross-sectional study. A survey of 135 glaucoma specialists and audit of 200 consecutive referral letters to a tertiary glaucoma unit. An online questionnaire was sent to members of the Canadian and American Glaucoma Societies asking what they considered the most important data to be included in a glaucoma referral. Consecutive referral letters to a tertiary glaucoma unit were assessed for legibility and content on the basis of the survey results and information items in current guidelines. Survey outcome and proportion of included content items in referral letters. The survey revealed that the top 5 most important data that glaucoma specialists would like to be included in a referral letter for progressive glaucoma were serial visual fields (VFs), current glaucoma therapy, current intraocular pressure (IOP), maximum IOP, and serial disc imaging. These items often were omitted in the referral letters audited. A total of 200 referral letters were assessed, 46% from ophthalmologists, 42% from optometrists, 10% from family practitioners, and 2% from other sources. Reasons for referral were diagnosis of glaucoma (37%), unstable glaucoma (25%), angle assessment (17%), and others (21%). Some 26% of the referral letters were deemed illegible (18% from ophthalmologists vs. 6% from optometrists P< 0.01). Degree of urgency was mentioned in 27% of referrals. Optometrists were more likely than ophthalmologists to provide visual acuity (VA), IOP, refraction, and VFs (P< 0.01 for each). Some 24% of referrals for progression included more than 10 of the 14 information points suggested by the Canadian glaucoma guidelines, and 34% included fewer than 8 of the 14 points. Referral letters frequently did not include important information, with 34% of referral letters deemed substandard. Optometrist referrals were better than ophthalmologist referrals in terms of content and legibility. A checklist of clinical details for referring physicians is suggested, which includes maximum and current IOP, disc evaluation, serial VFs, and serial disc imaging.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2013
Publisher: Wiley
Date: 11-02-1970
DOI: 10.1111/CEO.13721
Abstract: Primary angle closure glaucoma (PACG) is a major cause of irreversible visual impairment in Asia, but there is no published data on the effect of iStent on these patients. To compare the efficacy and safety of combined phacoemulsification and iStent implantation with standard phacoemulsification in an Asian population. A prospective, single-masked, randomized study in a public tertiary eye clinic. Patients with concomitant visually significant cataracts and primary angle closure (PAC) or PACG. Patients were randomized and underwent either phacoemulsification alone (phaco) or with concurrent iStent injection (phaco-iStent). Demographic and clinical data were collected. Complete and qualified success rates at 12 months were compared between both treatment arms. Thirty-two patients were recruited between September 2015 and February 2016. All patients completed 12 months of follow-up. There was no statistically significant difference in preoperative IOP (phaco, 17.5 ± 3.1 mmHg phaco-iStent, 18.6 ± 4.7 mmHg, P = .65) and 12-months postoperative IOP (phaco, 15.0 ± 2.5 mmHg phaco-iStent, 14.7 ± 3.1 mmHg, P = .86) between both groups. Complete success rates were 43.8% (95% CI, 19.8-65.6) for the Phaco group and 87.5% (95% CI, 58.6-96.7) for the Phaco-iStent group (P = .01). Thinner preoperative optical coherence tomography (retinal nerve fibre layer) thickness (hazard ratio [HR] = 7.34 [95% CI, 1.53-35.30]) and phacoemulsification alone (HR = 0.93 [95% CI, 0.87-0.02]) were independent factors associated with failure to achieve complete success. Combined phacoemulsification with iStent implantation is associated with a higher likelihood of complete success compared with phacoemulsification alone in eyes with primary angle closure disease at 12 months postoperatively. Further studies are required to establish the longer term efficacy of iStent implantation and to identify other predictors for surgical success.
Publisher: Springer International Publishing
Date: 2017
Publisher: S. Karger AG
Date: 13-06-2016
DOI: 10.1159/000446423
Abstract: b i Purpose: /i /b Swimming goggles increase the intraocular pressure (IOP) via the periorbital frame pressure and suction effect. In comparison, ing masks have a larger frame rim and incorporate the nose. The exact effect(s) of ing masks on IOP is unknown. This study evaluates the influence of ing masks on IOP in normal, healthy subjects. b i Methods: /i /b Tonometry was performed in both eyes of all subjects with an AVIA sup ® /sup Tono-Pen by a single investigator. Measurements were taken at baseline without the ing mask and with the subjects wearing a small-volume, double-window ing mask, but with the mask lenses removed. Two IOP readings in each eye were measured, and an additional reading was measured if the difference between the initial 2 was ≥2 mm Hg. Central corneal thickness (CCT) was also measured in each eye, using a contact pachymeter (OcuScan sup ® /sup Alcon). b i Results: /i /b Forty eyes of 20 healthy volunteers (age 29.7 ± 9.3 years range 21–52) were included. The mean CCT was 544.4 ± 43.5 µm. The mean IOP before the ing mask was worn had been 17.23 ± 2.18 mm Hg (n = 40). The IOP decreased by 0.43 mm Hg (p & #x3c 0.05) to 16.80 ± 2.57 mm Hg after the ing mask had been put on. There was no correlation between IOP change and age (r = 0.143, p = 0.337), gender (r = –0.174, p = 0.283) or CCT (r = –0.123, p = 0.445). b i Conclusion: /i /b There was no increase in IOP after the ing mask had been worn. A small but statistically significant decrease in IOP was observed. This study demonstrates that unlike swimming goggles, the strap tension and frame pressure on the periorbital tissue from a ing mask does not increase IOP. Diving masks may be a suitable alternative to swimming goggles for patients with advanced glaucoma or glaucoma filtration surgery.
Publisher: BMJ
Date: 07-03-2017
DOI: 10.1136/BJOPHTHALMOL-2016-308710
Abstract: To determine the difference in relative intraocular pressure (IOP) measured by the SENSIMED Triggerfish (TF) contact lens in flat compared with 30° head-up sleeping positions in patients with progressive primary open-angle glaucoma or normotensive glaucoma, based on recent or recurrent disc haemorrhage. Prospective, randomised, cross-over, open-label comparative study. IOP was monitored for 24 hours using TF on two separate sessions. Patients were randomly assigned to sleep flat one night and 30° head-up the other. Outputs in arbitrary units were obtained. Sleep and wake periods were defined as 22:00-6:00 and 8:00-22:00, respectively. Mean TF values during sleep and wake periods and wake-sleep and sleep-wake slopes were calculated for each session. TF output signals were compared between positions. Twelve subjects completed the study. Significant mean positive slopes were noted during the sleep period for both positions (p 50% of the subjects requires further investigation to establish whether the increased output values over time are an artefact induced by the TF or a real change in IOP. NCT01351779.
No related grants have been discovered for Jason Cheng.