Survey of ophthalmology
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Survey of ophthalmology · Jan 2015
Case ReportsDesmoplastic melanoma of the eyelid and conjunctival melanoma in neurofibromatosis type 1: a clinical pathological correlation.
A 56-year-old woman with neurofibromatosis type 1 (NF1) presented with a left upper eyelid amelanotic nodule with adjacent eyelid margin hyperpigmentation. Physical examination additionally revealed primary acquired melanosis (PAM) on the palpebral conjunctiva of the same eyelid. ⋯ She was treated with surgical excision for the eyelid melanoma and topical mitomycin C for the conjunctival melanoma. We discuss the rare entity of desmoplastic melanoma of the eyelid and its possible association with NF1.
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Survey of ophthalmology · Jan 2015
ReviewPalinopsia revamped: a systematic review of the literature.
Palinopsia, the persistence or recurrence of visual images after the stimulus has been removed, is a nonspecific term that describes multiple types of visual symptoms with a wide variety of etiologies. For example, palinopsia may be the presenting symptom of a potentially life-threatening posterior cortical lesion, yet it may also be a benign medication side effect. We comprehensively review all published cases and subdivide palinopsia into two clinically relevant categories: illusory palinopsia and hallucinatory palinopsia.
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The accreditation of graduate medical education through the evaluation of residency programs and the teaching hospitals that offer them in the United States is the primary mission of the Accreditation Council for Graduate Medical Education (ACGME). In 1999, the ACGME formulated the six ACGME competencies and, ten years later, developed a multi-year plan to restructure the accreditation process in order to assess educational outcomes. The result of these evolving efforts has been termed the Next Accreditation System (NAS). ⋯ Instead of the episodic program biopsies with site visitor reports, detailed program information forms, and formal residency review committee evaluations that characterized the old accreditation system, the NAS will be based upon annual reports of specific quantitative, trended, performance benchmarks; the ACGME milestones; and an institutional clinical competency committee. In addition, a separate but related specialty-specific Clinical Environment Learning Review (CLER) will be a more detailed examination of the learning environment and infrastructure. The CLER, however, will not have a direct role in the accreditation decision-making process of the NAS.
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Survey of ophthalmology · Sep 2014
Video recording of ophthalmic surgery--ethical and legal considerations.
Video documenting is increasingly used in ophthalmic training and research, with many ophthalmologists routinely recording their surgical cases. Although this modality represents an excellent means of improving technique and advancing knowledge, there are major ethical and legal considerations with its use. Informed consent to record is required in most situations. ⋯ Privacy and security of neither patients nor health care professionals should be compromised. Ownership and distribution of video recordings, the potential for their use in medical litigation, the ethics and legality of editing and the impact on surgeon performance are other factors to consider. Although video recording of ophthalmic surgery is useful and technically simple to accomplish, patient safety and welfare must always remain paramount.
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A 38-year-old woman presented with chronic left retro-orbital pain and photophobia. Palpation of the left occipital prominence revealed tenderness in the area of the greater occipital nerve and reproduced the eye pain. The diagnosis of cervicogenic headache was confirmed by symptom resolution following left greater occipital nerve blockade. The functional association between the greater occipital nerve and the trigeminal nerve provides a potential mechanism for this case of cervicogenic eye pain.