Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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A comparison of intraocular pressure (IOP) in cases of infantile glaucoma during general anesthesia was carried out by measurement with the iCare rebound tonometer (RBT) and a handheld applanation tonometer (Perkins). ⋯ The iCare rebound tonometer is useful during general anesthesia in cases of childhood glaucoma. It provides comparable IOP values to applanation tonometry with a tendency to record higher values.
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Although many health care reforms have been enacted in the last few years in Germany, many of the key points in the current social health care system have been retained from former times. All those introductions for an effective health care system from the last 150 years beginning with mandatory guild membership via Bismarck's social laws to the modern health care systems in Germany with the current problems of financing the heavy burden in the German budget are reported. Data and facts on the current health care system are provided. In the following two articles of this series ambulatory and inpatient treatment in the light of economic aspects of health care are reported.
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We report the case of a 31-year-old patient who presented with unilateral acute loss of vision, severe headache, and symptoms of an acute angle-closure glaucoma. Surprisingly, a prepapillary uveal melanoma was the underlying reason; that is, a masquerade syndrome was seen. ⋯ Acute angle-closure glaucoma as the initial presentation of uveal melanoma is rare. Nevertheless, clinicians should be aware that patients with refractory unilateral angle-closure glaucoma and asymmetrically opaque media may harbor an occult uveal melanoma.
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The daily ward round is the main opportunity for communicative interaction between physician and patient during a patient's hospital stay. We analysed to what extent the round was capable of fulfilling the patients' needs for information and emotional support, using the ophthalmologic ward of a university hospital as an example. ⋯ In the future, the ophthalmologic ward round should satisfy the criteria of patient-centric conversation. Therefore, the informational value of the daily ward round must be increased, and organisational and structural changes must be made to promote direct conversation between the patient and the eye specialist. A team conference before and after the physician-patient interaction would allow a focus on team-referred and patient-referred interests within the ward round.
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A 60-year-old patient reported a slight decrease in visual acuity with loss of field of vision. He also noted a mild sense of vertigo and a feeling of "pressure in his head". ⋯ Without special treatment measures the head pressure and feeling of weakness subsided considerably in a spontaneous course within 24 h. Three months later partial optic atrophy of the affected eye was observed with stable visual acuity of 0.8 and unchanged loss of field of vision.