Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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Case Reports
[Bilateral influenza-triggered panuveitis and subsequent therapy with amantadine and hyperimmunoglobulins].
Influenza A is one type of influenza virus that commonly causes acute respiratory illness. Outbreaks of influenza occur every year. Major antigenic variations preclude permanent immunity in the population. Often signs of conjunctivitis or photophobia are common during acute infection. Posterior uveitis is very rare. ⋯ The course of an influenza A infection is usually uncomplicated. Severe affection of the choriocapillaris results in a complicated post-influenza retinal pigmentary degeneration. Treatment with amantadine and therapy with hyperimmunoglobulins seem to be useful.
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Since the year 2004 hospitals in Germany are obliged to participate in a payment system based on diagnosis-related groups (DRG), which bases hospital reimbursement on the diagnosis and treatment of patients. The aim of this study was to analyze the data of the first German national hospital cost data calculation for their homogeneity. ⋯ Many ophthalmologic DRGs are quite inhomogeneous necessitating regrouping to avoid false incentives. For cases with high complexity the current system may lead to cost deficits especially for hospitals providing maximum care.
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Worldwide 45 million people are blind, 180 million people are visually handicapped, 90% of all blind people are living in developing countries and 80% of blindness is preventable. The global economic productivity loss due to blindness was estimated to be 19 billion US$ in the year 2000. The initiative "Vision 2020-the right to sight" aims to increase the cataract surgical rate and to eliminate diseases such as trachoma and onchocerciasis as well as avoidable blindness in children. It is planned that blindness in 100 million people can be avoided by the year 2020.
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Comparative Study Clinical Trial
[Use of lavage fluid containing diphoterine for irrigation of eyes in first aid emergency treatment].
Eye irrigation is a widely accepted therapeutic must in first aid treatment. The burning agent is removed, diluted, and if possible neutralized. Usually water, NaCl 0.9%, Ringer's lactate or phosphate buffer are the most accepted rinsing solutions. We present a relatively new substance called Previn (Diphoterine in countries other than Germany). It is a hypertonic, polyvalent, and amphoteric substance. Its binding energy for acids, bases, reducers, and oxidation is stronger than the binding energy of biological compounds for these burning agents. Concerning its compatibility with the eye and its efficacy, we compare Previn to the rinsing solutions in general use. ⋯ The above studies have shown that Previn (Diphoterine) is comparable to other rinsing solutions concerning its compatibility with the human eye. Its buffering capacity is comparable to phosphate buffer. Previn and phosphate buffer should only be used in first aid treatment and not for continued rinsing therapy.
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The Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in psychologically normal people. It occurs frequently in elderly, visually handicapped patients. ⋯ About 12-13% of people with impaired vision have visual hallucinations. Neurologic and psychiatric diseases should be excluded before making a diagnosis of CBS which has little impact on the general feelings of well-being in the majority of patients. Many patients do not consult a doctor about CBS for fear of being considered insane. It is recommended that all patients with reduced vision are asked about visual hallucinations. Many patients will benefit from an explanation of these phenomena and the assurance of their harmless nature. Treatment of CBS is rarely needed.