Optom
Photophobia is an involuntary reaction of the eyes when it comes in contact with light, either the natural sunlight or the artificial light from either our bulb or car light; and it is often accompanied with discomforts such as deep piercing ocular pains in the eyeball, associated eyebrow headaches, hyperemia of the conjunctiva, mild to severe blespherospasm etc or sometimes it might present with much milder like slight sandy sensation, but nonetheless ones visual acuity (the extent one sees in open space) is often compromised as a result.
Photophobia could be as a result of active pathology of the eye, it could be as a result of Physiological state of the pupils and the iris pigment or it could affect the individual as a result of error of refraction.
In any active inflammation of the eyes, the iris, which is the most vascularised part of the anterior eye, often responds to postalglandins and other immuno-inflammatory substances present in these area of the eyes. The resultant effect is a breakdown of the blood barrier provided by the iris epithelium with a consequent movement of fluid into the iris spaces and the fluid-logged iris responds to light very sluggishly, rubbing each other in the process, and with am effort too. The pain receptor of the eyes are activated in this situation. Hence, the photophobia experienced in that condition.
When the pupil of the eyes is very large, the extent of contraction under a very bright illumination and/or in an unfavorable glare situation, the pupils often fail to contract enough to allow 'optimum' illumination get into the retina. The individual involuntarily keeps his/her face frowned to cut off the 'excess' light entering the eye and the result is ocular discomfort, pseudo-spasm of the eyebrow and consequently a physiological photophobia ensues. Again, iris with little or no pigment, as seen in light-skinned or Albinos, often exhibits photophobia secondary to light scatter into the eyes. The iris pigments absorbs light from outside the eyes and inside hence reducing total internal reflection of light in the eyes. In absence of these pigments or when these pigments are minimal, total internal reflections, light scatter, enhanced glare sensation results in photophobia.
Photophobia can manifest when an individual is either myopic, hyperopic, astigmatic or anisometropic. Apart from Myopia, the other cases are a consequence of an impaired relationship between accommodation-convergence mechanism of the eyes. The Myopes often have larger than normal pupils and this is an important reason why individuals with myopia exhibit photophobia! It should be remembered that myopes don't accommodate and the induced Amplitude of accommodation they acquire, seldom induces photophobia....
Pupillary sizes change with different levels accommodative changes. Somehow the involuntary 'spasm' that accompanies illumination and the associated change in the accommodative amplitude triggers a form of 'pain' especially if the induced accommodation is beyond the accommodative reserve of the subject, which is always the case in hyperopia, Astigmatism and Anisometropia.
Photophobia as a result of pathology can be relieved when the source of such pathology, e.g. when a patient with anterior uveitis and an associated photophobia has his/her uveitis treated with medications. Physiological Photophobia can only be managed with wearing dark sunshades, especially when outdoors or when exposed to bright light. While the later can be managed by restoring emmetropia with optical lenses that could either be tinted or that could possess be photochromic properties.
Finally, I will advice you with a symptom of photophobia to go and receive an Optometric eye care. This essential step can help you cope and manage with photophobia and the general use of dark sunshades is highly recommended! Don't let any form of photophobia disturb your visual comfort...its your right to enjoy comfortable vision... The Optometrist is your friend. Take care.
Dr Victor Ezebuiroh Okwudiri.
optometry is discussed here, eye diseases and disabilities are highlighted and management of such ocular conditions enumerated.
Wednesday, 25 May 2011
Monday, 23 May 2011
Routine Eye examination, Vision screening and saving the eye sight!
Optom
Most eye conditions are not emergency conditions and are often neglected, often times this becomes our worst undoing!
When Mr X walked into my eye clinic just to do a routine eye examination (he has never been to an eye clinic before and he has no observable symptom) unknown to him, he was going about with 0.6 excavated Optic nerve head bilaterally with his centralvision intact!
In another instance, as I was doing vision screening exercise for a group of volunteers, I saw one Mrs Y who has bilateral degeneration encroaching her macular and on further questioning it became known that she was a chronic diabetic patient (she has been diabetic for almost 12 years!).
A young fellow, A who's just 19 years and wants to be a pilot or a marine engineer did not know that the measles he had when he was 7 years has formed macular scar and drusen in both his eyes. The unfortunate thing is that he wont be able to achieve his dreams since he the condition is a progressive condition.
These are a few persons who do not have any unusual symptom related to vision handicap or any form of visual challenge prior to the eye test. In fact our meeting was out chance and not necessity! They might have been missed in the general population and the ensuring consequence relegated to superstition.
It is a national concern, or should be, that could help save people from unnecessary embarrassment if inculcated into our sub-consciousness- to have time @least ones in a year to visit an eye clinic! It is also welcoming if people would volunteer for eye tests whenever a vision screening program comes to your area, it does not matter if you have an eye problem or not! You could just save your sight by that singular act!
Your eyes are one of the most important organ in the human body. It cannot be replaced ones anything destroys it or makes it become blind! It becomes imperative to pay serious attention to it...We ask you to visit any Optometric or Ophthalmologist clinic in your area for a routine eye examination. Cos a stitch in time always saves nine!
Your eye no get duplicate! Protect it with a passion! You will be doing yourself, your family and the society great service by not becoming blind.
Blindness no dey show for face...it starts with your eyes and ends up affecting the whole society around you. Someone must stop school or work to look after you, your contributions to making the society a better place will be lost and instead you become a burden to yourself and to everyone! We have a role to play here. Do it wisely! Have a lovely week...
Dr Ezebuiroh Victor Okwudiri.
Most eye conditions are not emergency conditions and are often neglected, often times this becomes our worst undoing!
When Mr X walked into my eye clinic just to do a routine eye examination (he has never been to an eye clinic before and he has no observable symptom) unknown to him, he was going about with 0.6 excavated Optic nerve head bilaterally with his centralvision intact!
In another instance, as I was doing vision screening exercise for a group of volunteers, I saw one Mrs Y who has bilateral degeneration encroaching her macular and on further questioning it became known that she was a chronic diabetic patient (she has been diabetic for almost 12 years!).
A young fellow, A who's just 19 years and wants to be a pilot or a marine engineer did not know that the measles he had when he was 7 years has formed macular scar and drusen in both his eyes. The unfortunate thing is that he wont be able to achieve his dreams since he the condition is a progressive condition.
These are a few persons who do not have any unusual symptom related to vision handicap or any form of visual challenge prior to the eye test. In fact our meeting was out chance and not necessity! They might have been missed in the general population and the ensuring consequence relegated to superstition.
It is a national concern, or should be, that could help save people from unnecessary embarrassment if inculcated into our sub-consciousness- to have time @least ones in a year to visit an eye clinic! It is also welcoming if people would volunteer for eye tests whenever a vision screening program comes to your area, it does not matter if you have an eye problem or not! You could just save your sight by that singular act!
Your eyes are one of the most important organ in the human body. It cannot be replaced ones anything destroys it or makes it become blind! It becomes imperative to pay serious attention to it...We ask you to visit any Optometric or Ophthalmologist clinic in your area for a routine eye examination. Cos a stitch in time always saves nine!
Your eye no get duplicate! Protect it with a passion! You will be doing yourself, your family and the society great service by not becoming blind.
Blindness no dey show for face...it starts with your eyes and ends up affecting the whole society around you. Someone must stop school or work to look after you, your contributions to making the society a better place will be lost and instead you become a burden to yourself and to everyone! We have a role to play here. Do it wisely! Have a lovely week...
Dr Ezebuiroh Victor Okwudiri.
Routine Eye examination, Vision screening and saving the eye sight! Part 2
Optom
Most eye conditions are not emergency conditions and are often neglected, often times this becomes our worst undoing!Unlike conditions like hypertension, diabetes, Cardiovascular diseases, Accidents etc which often require an urgent need for medical attention; eye conditions that could lead to blindness don't often present with dramatically serious symptoms and hence it is not given much attention in relation to other health cases. But unfortunately, conditions that can cause blindness, eye diseases that are chronic and that has ability to reduce the patient to visually challenged or visual handicap statue are capable of evading early dictation! Take for instance open angle Glaucoma or senile cataract! Do not forget too that conditions like Retinitis Pigmentosa etc are painless but sight threatening!
Routine eye examination involves voluntary eye tests to ensure that there is no deviation in ocular anatomy and doing functional tests for the eyes to rule out any deviation in ocular physiology. Such tests like Visual Acuity, penlight examination of the pupils etc qualifies for functonal tests! In Routine eye examination, patient is not necessarily symptomatic. individuals are often enlightened and/or motivated to take care of his/her eyes! In routine examination, the following procedure of test batteries are performed! Patient is first required to complete a personal demographic data followed by question and answer session with the eye care specialist. In this process a case history file on the patient is developed and likely chief complaint (if there is any) is identified. The next step involves taking visual acuity @far and @ near followed by doing external examination either with a penlight, ophthalmoscope or with a slit lamp biomicroscope. The eyelid, the conjunctiva, the iris, the conjunctiva and pupillary reaction to light etc are checked and any loss of anatomic and/or physiologic integrity is noted. It is followed by doing an objective refraction either with a retinoscope or auto-refractors. There is need to do a subjective refraction, with or without significant change in visual acuity! The next step involves using the ophthalmoscope to view the posterior fundus of the eye. The aqueous humor, Optic nerve head, the retinal walls and vessels, the vitreous gel, the maculae area and the fovea centralis should be viewed and changes documented. I advocate for dilated fundus examination of atleast one eye except in situation where it could be contra-indicative, say, in closed angle glaucoma or patients with very narrow angle! In most cases, the batteries of tests could reveal subtle changes in the eyes that could be sight threatening! If needs be, I will also encourage further tests for differential diagnosis and confirmation of a particular pathology or defect! Such tests like Tangent screen tests, central visual field tests, intra ocular pressure checks, color vision tests, flouresin tests etc could come in handy to rule out disease conditions!
On the other hand, Vision screening involves gross routine tests to rule out any visual anomaly. It is less complex than routine eye test and even much simpler than a thorough eye examination as performed in a clinic! You can screen for glaucoma in the adult population; you can screen for refractive error among school children; you can screen for hypertensive and/or diabetic retinopathy in patients having this chronic diseases! You can screen for cataract in the adult populations etc! It involves tests like visual acuity tests far and near. Confrontational tests. Shadow tests. Broad H tests etc It is usually carried out in public places but it is not unusual to have it in a clinic! Vision screening is very handy when parents are registering their children in school! it is very important when security men are conscripted or when a company is trying to employ new workers! Though some subtle changes in the eye might be missed, it is nontheless very necessary to identify sight threatening conditions in a group of people! In situation whereby the eyes are suspicious referal to appropiate eye care experts becomes important! A thorough eye examination would be carried out by the expert!
In Optometry practice both here in Nigeria and the world @ large, we are involved continously with patients and the public to nip eye disease condition in the bud! Being primary eye care providers, our practice requires us to encourage the general population to participate fully to screen, examine and/or thoroughly do eye tests to identify and manage eye conditions that might not necessarily be symptomatic but could be sight threatenig! I am encouraging colleagues and other eye care specialists to develop vision screening models, routine eye examination models and other specific examinations to alleviate the consequences of blindness! It is our ethical and moral responsibilities to ensure that blindness is avoided! Thank you.
Dr Ezebuiroh Victor Okwudiri.
Most eye conditions are not emergency conditions and are often neglected, often times this becomes our worst undoing!Unlike conditions like hypertension, diabetes, Cardiovascular diseases, Accidents etc which often require an urgent need for medical attention; eye conditions that could lead to blindness don't often present with dramatically serious symptoms and hence it is not given much attention in relation to other health cases. But unfortunately, conditions that can cause blindness, eye diseases that are chronic and that has ability to reduce the patient to visually challenged or visual handicap statue are capable of evading early dictation! Take for instance open angle Glaucoma or senile cataract! Do not forget too that conditions like Retinitis Pigmentosa etc are painless but sight threatening!
Routine eye examination involves voluntary eye tests to ensure that there is no deviation in ocular anatomy and doing functional tests for the eyes to rule out any deviation in ocular physiology. Such tests like Visual Acuity, penlight examination of the pupils etc qualifies for functonal tests! In Routine eye examination, patient is not necessarily symptomatic. individuals are often enlightened and/or motivated to take care of his/her eyes! In routine examination, the following procedure of test batteries are performed! Patient is first required to complete a personal demographic data followed by question and answer session with the eye care specialist. In this process a case history file on the patient is developed and likely chief complaint (if there is any) is identified. The next step involves taking visual acuity @far and @ near followed by doing external examination either with a penlight, ophthalmoscope or with a slit lamp biomicroscope. The eyelid, the conjunctiva, the iris, the conjunctiva and pupillary reaction to light etc are checked and any loss of anatomic and/or physiologic integrity is noted. It is followed by doing an objective refraction either with a retinoscope or auto-refractors. There is need to do a subjective refraction, with or without significant change in visual acuity! The next step involves using the ophthalmoscope to view the posterior fundus of the eye. The aqueous humor, Optic nerve head, the retinal walls and vessels, the vitreous gel, the maculae area and the fovea centralis should be viewed and changes documented. I advocate for dilated fundus examination of atleast one eye except in situation where it could be contra-indicative, say, in closed angle glaucoma or patients with very narrow angle! In most cases, the batteries of tests could reveal subtle changes in the eyes that could be sight threatening! If needs be, I will also encourage further tests for differential diagnosis and confirmation of a particular pathology or defect! Such tests like Tangent screen tests, central visual field tests, intra ocular pressure checks, color vision tests, flouresin tests etc could come in handy to rule out disease conditions!
On the other hand, Vision screening involves gross routine tests to rule out any visual anomaly. It is less complex than routine eye test and even much simpler than a thorough eye examination as performed in a clinic! You can screen for glaucoma in the adult population; you can screen for refractive error among school children; you can screen for hypertensive and/or diabetic retinopathy in patients having this chronic diseases! You can screen for cataract in the adult populations etc! It involves tests like visual acuity tests far and near. Confrontational tests. Shadow tests. Broad H tests etc It is usually carried out in public places but it is not unusual to have it in a clinic! Vision screening is very handy when parents are registering their children in school! it is very important when security men are conscripted or when a company is trying to employ new workers! Though some subtle changes in the eye might be missed, it is nontheless very necessary to identify sight threatening conditions in a group of people! In situation whereby the eyes are suspicious referal to appropiate eye care experts becomes important! A thorough eye examination would be carried out by the expert!
In Optometry practice both here in Nigeria and the world @ large, we are involved continously with patients and the public to nip eye disease condition in the bud! Being primary eye care providers, our practice requires us to encourage the general population to participate fully to screen, examine and/or thoroughly do eye tests to identify and manage eye conditions that might not necessarily be symptomatic but could be sight threatenig! I am encouraging colleagues and other eye care specialists to develop vision screening models, routine eye examination models and other specific examinations to alleviate the consequences of blindness! It is our ethical and moral responsibilities to ensure that blindness is avoided! Thank you.
Dr Ezebuiroh Victor Okwudiri.
Sunday, 22 May 2011
optometry.naija: The Challenges militating against Optometry practi...
optometry.naija: The Challenges militating against Optometry practi...: "OptomNigerian Optometric practice is essential to effective eye care in Nigeria and no doubt about that...The challenges of eye care in Nige..."
Optom
Optom
The Challenges militating against Optometry practice in Nigeria and effective participation in Vision2020 :Right to Sight. (An Updated version of the origina blog!)
Optom
Nigerian Optometric practice is essential to effective eye care in Nigeria and no doubt about that...
The challenges of eye care in Nigeria with a population of about 150 million with just about 2130 registered Optometrists and I think with a fewer Ophthalmologists who draw strength from their parent body, The Nigerian Medical and Dental Association etc etc, are very enormous. The politico-academic position of the Optometrists is neither helping the matter nor is it alleviating the burden of blindness and visual handicap as envisioned by Vision 2020: Right to Sight!
As I have been saying all along, we need to position our practice, professionalize a Nigerian version of Optometry by empowering members to do researches and hence develop a statistical effect of blindness, causes of such blinding conditions, develop a model of practice, browbeat our professional heads (ODOBN & NOA) into growing some teeth, ensuring our state chapters of Nigerian Optometric Association is fully represented in state ministries of Health... I will advice that another professional body, primarily for Professional Optometrists, be formed. This body should oversee professional Practice among Optometrists in Practice, we can call it Nigerian Optometrist Society (N.O.S.). Unlike ODOBN & NOA, this professional body would require a written exam to become a member! The examination should discuss the scope of practice and developments in visual health and general eye care. Also the body should be conducting an online examination annually for professional Optometrists.
We need to develop our school curriculum to embrace contemporary realities... We are not opticians, need is rife to prove that we are Optometrists, that we are truly Primary eye care Practitioners. There is need to equip our Schools with newer technological advanced instruments and employ fully motivated professionals relating to the general scope of our practice. We should advocate for residency programs and ensure that fellowship courses are institutionalized. N.O.S. school chapters should be involved in eye researches for students and intern Optometrists and it should be funded by the school and the body @ the national level. There is also a serious need to enforce a gold standard both in education and practice of Optometry in Nigeria. We need to specialize and hence become consultants in a particular aspect of eye care, if we aim @ becoming heads of Departments. The later is a prerequisite to forming a Department of Optometry in Health care setting!
We need a stronger representation in Ministry of Health than mere having an office there alone. Optometry can generate more money than most Professional bodies under Federal Ministry of Health in Nigeria if properly packaged. All Optical services and resources should be supervised by Optometrists and dispensing Optician Board of Nigeria (O.D.O.B.N) and a fee should be charged for such services and payable to the coffers of the Ministry of Health! Including the funds generated from renewal of registrations, fees generated by N.O.S/ N.O.S.A (Nigerian Optometrists Society/ Nigerian Optometrist Students Association, if started!), fees generated by dispensing of lenses and other eye care services rendered by Optometrists in both federal and state owned hospitals (If more Optometrists are employed in Public health sector. Currently, they under-employed and under utilized in that sector!), funds generated from manufacturing of lenses both @ home and supervision of those imported into the country.
Finally, we should become fully independent of Ophthalmologists, especially in the area of competence development, professional growth and in practice...we should rather develop a complementary relationship in eye health care services with them. We need the Ministry of Health to wade into this chronic 'warfare' that has left eye care in the mercy of charlatans. The imbroglio between these two bodies is the most important factor that has reduced whatever the dreams of Vision 2020 both @ home and internationally...especially here in Nigeria. We are oppressed by them through that rebellious Decree 34 of 1989 which is very anti-Optometrist and should be totally over hauled and new clauses incorporated into it. Our academic chasm is so obvious that the Nigerian Optometrist is often academically intimidated into whatever name or role they wish us to play (they are the architectural design of O.D.O.B.N, like virus they replicate WHO we should be in practice & the last time I might remember, they don't bloody care about us, "@least the Ophthalmic nurse is there!". To achieve what 'Vision 2020 :Right to Sight' stands for, the current trend of Optometry practice should be updated by us, the constitution reviewed to change outdated clauses, develop a 'Nigerian Optometrist Society' to reposition Optometry professionally through research while ODOBN should supervise Optometry practice including resources and personel. NOA should be responsible both to the dispensing Opticians, Optometrists, Optometric technicians and other members in the eye health sector.
I am not making any political nor sentimental contribution to the obvious discuss; am only stating the fact!
Take for instance the way unlicensed and even some licensed opticians invade people in their homes to make glasses for them, while @ the same time claiming to be healers of sight problems! They end up forcing many optometrists into the foray! What results? A desperate attempt to foist glasses and drugs on people without ethically considering our actions! We need to live up to our doctors status, most are self employed and cannot meet up financially with our peers employed by the state or federal government! There is no regulatory over sight mechanism in place by neither ODORBN nor NOA! They are two toothless bulldogs that cannot even bark...@ least not now; not yet! If am being biased in my opinion, why did Optometry in Nigeria not include its own clause in the recently passed National Health Bill? Why are state branches of NOA/ODORBN not fully assimilated into state ministry of healths just like NMA, Pharmasists, Lab scientists etc?
Look @ this other scenario, an Ophthalmologist who seems to question our credibility in the field! Its always a thing of pride for them to undermine our efforts making it very easy for ophthalmic nurses and even cleaners in eye centres to atimes question our profession! I do not always blame them. Lets call a spade a spade, how many functional slit lamp biomicroscope do we have in Abia State university, school of Optometry now? Because as at 2006 there was no fully functional one in our clinic! How is Optometry learned in Madonna University? Is the school fully accredited to practice Optometry? Has the board visited the institution's school of Optometry for inspection? Credibility of some of our lecturers should be noted here too! In some instance, we often witness some of our lecturers who are not practicing! Optometry is a practical application of theoretical knowledge, I find it very improper for a lecturer not to have a practical knowedge of Optometry and still be allowed to lecture us! And many other sharp practices in our citadels of learning that go unhindered because no serious oversight by our regulatory bodies and absolute lack of "standards"!
It is a fact that a deep chasm exits between us and the Ophthalmologists, but the prejudice against the Optometrists by the Nigerian Medical Association and other allied health assoiations is frustrating!Yet it should not deter us from contributing our quota towards eliminating avoidable causes of blindness by 2020 and beyond.
We should remember that we just have about 9 years to get to year 2020...its rather absurd that we cannot claim any meaningful headway in halting the embarrassment blindness and visual handicap is wreaking on us! We have been busy boxing shadows...Posterity needs more than these from US! Great Optometry in Nigeria!
concluded!
Nigerian Optometric practice is essential to effective eye care in Nigeria and no doubt about that...
The challenges of eye care in Nigeria with a population of about 150 million with just about 2130 registered Optometrists and I think with a fewer Ophthalmologists who draw strength from their parent body, The Nigerian Medical and Dental Association etc etc, are very enormous. The politico-academic position of the Optometrists is neither helping the matter nor is it alleviating the burden of blindness and visual handicap as envisioned by Vision 2020: Right to Sight!
As I have been saying all along, we need to position our practice, professionalize a Nigerian version of Optometry by empowering members to do researches and hence develop a statistical effect of blindness, causes of such blinding conditions, develop a model of practice, browbeat our professional heads (ODOBN & NOA) into growing some teeth, ensuring our state chapters of Nigerian Optometric Association is fully represented in state ministries of Health... I will advice that another professional body, primarily for Professional Optometrists, be formed. This body should oversee professional Practice among Optometrists in Practice, we can call it Nigerian Optometrist Society (N.O.S.). Unlike ODOBN & NOA, this professional body would require a written exam to become a member! The examination should discuss the scope of practice and developments in visual health and general eye care. Also the body should be conducting an online examination annually for professional Optometrists.
We need to develop our school curriculum to embrace contemporary realities... We are not opticians, need is rife to prove that we are Optometrists, that we are truly Primary eye care Practitioners. There is need to equip our Schools with newer technological advanced instruments and employ fully motivated professionals relating to the general scope of our practice. We should advocate for residency programs and ensure that fellowship courses are institutionalized. N.O.S. school chapters should be involved in eye researches for students and intern Optometrists and it should be funded by the school and the body @ the national level. There is also a serious need to enforce a gold standard both in education and practice of Optometry in Nigeria. We need to specialize and hence become consultants in a particular aspect of eye care, if we aim @ becoming heads of Departments. The later is a prerequisite to forming a Department of Optometry in Health care setting!
We need a stronger representation in Ministry of Health than mere having an office there alone. Optometry can generate more money than most Professional bodies under Federal Ministry of Health in Nigeria if properly packaged. All Optical services and resources should be supervised by Optometrists and dispensing Optician Board of Nigeria (O.D.O.B.N) and a fee should be charged for such services and payable to the coffers of the Ministry of Health! Including the funds generated from renewal of registrations, fees generated by N.O.S/ N.O.S.A (Nigerian Optometrists Society/ Nigerian Optometrist Students Association, if started!), fees generated by dispensing of lenses and other eye care services rendered by Optometrists in both federal and state owned hospitals (If more Optometrists are employed in Public health sector. Currently, they under-employed and under utilized in that sector!), funds generated from manufacturing of lenses both @ home and supervision of those imported into the country.
Finally, we should become fully independent of Ophthalmologists, especially in the area of competence development, professional growth and in practice...we should rather develop a complementary relationship in eye health care services with them. We need the Ministry of Health to wade into this chronic 'warfare' that has left eye care in the mercy of charlatans. The imbroglio between these two bodies is the most important factor that has reduced whatever the dreams of Vision 2020 both @ home and internationally...especially here in Nigeria. We are oppressed by them through that rebellious Decree 34 of 1989 which is very anti-Optometrist and should be totally over hauled and new clauses incorporated into it. Our academic chasm is so obvious that the Nigerian Optometrist is often academically intimidated into whatever name or role they wish us to play (they are the architectural design of O.D.O.B.N, like virus they replicate WHO we should be in practice & the last time I might remember, they don't bloody care about us, "@least the Ophthalmic nurse is there!". To achieve what 'Vision 2020 :Right to Sight' stands for, the current trend of Optometry practice should be updated by us, the constitution reviewed to change outdated clauses, develop a 'Nigerian Optometrist Society' to reposition Optometry professionally through research while ODOBN should supervise Optometry practice including resources and personel. NOA should be responsible both to the dispensing Opticians, Optometrists, Optometric technicians and other members in the eye health sector.
I am not making any political nor sentimental contribution to the obvious discuss; am only stating the fact!
Take for instance the way unlicensed and even some licensed opticians invade people in their homes to make glasses for them, while @ the same time claiming to be healers of sight problems! They end up forcing many optometrists into the foray! What results? A desperate attempt to foist glasses and drugs on people without ethically considering our actions! We need to live up to our doctors status, most are self employed and cannot meet up financially with our peers employed by the state or federal government! There is no regulatory over sight mechanism in place by neither ODORBN nor NOA! They are two toothless bulldogs that cannot even bark...@ least not now; not yet! If am being biased in my opinion, why did Optometry in Nigeria not include its own clause in the recently passed National Health Bill? Why are state branches of NOA/ODORBN not fully assimilated into state ministry of healths just like NMA, Pharmasists, Lab scientists etc?
Look @ this other scenario, an Ophthalmologist who seems to question our credibility in the field! Its always a thing of pride for them to undermine our efforts making it very easy for ophthalmic nurses and even cleaners in eye centres to atimes question our profession! I do not always blame them. Lets call a spade a spade, how many functional slit lamp biomicroscope do we have in Abia State university, school of Optometry now? Because as at 2006 there was no fully functional one in our clinic! How is Optometry learned in Madonna University? Is the school fully accredited to practice Optometry? Has the board visited the institution's school of Optometry for inspection? Credibility of some of our lecturers should be noted here too! In some instance, we often witness some of our lecturers who are not practicing! Optometry is a practical application of theoretical knowledge, I find it very improper for a lecturer not to have a practical knowedge of Optometry and still be allowed to lecture us! And many other sharp practices in our citadels of learning that go unhindered because no serious oversight by our regulatory bodies and absolute lack of "standards"!
It is a fact that a deep chasm exits between us and the Ophthalmologists, but the prejudice against the Optometrists by the Nigerian Medical Association and other allied health assoiations is frustrating!Yet it should not deter us from contributing our quota towards eliminating avoidable causes of blindness by 2020 and beyond.
We should remember that we just have about 9 years to get to year 2020...its rather absurd that we cannot claim any meaningful headway in halting the embarrassment blindness and visual handicap is wreaking on us! We have been busy boxing shadows...Posterity needs more than these from US! Great Optometry in Nigeria!
concluded!
Friday, 20 May 2011
optometry.naija: Vision 2020 & the Practise of Optometry in Nigeria...
optometry.naija: Vision 2020 & the Practise of Optometry in Nigeria...: "Optom Prevention of Blindness group in partnership with World Health Organization (WHO) under the umbrella of vision 2020 came up with- Cat..."
Optom
Optom
Vision 2020 & the Practise of Optometry in Nigeria- episode 8
Optom
Prevention of Blindness group in partnership with World Health Organization (WHO) under the umbrella of vision 2020 came up with- Cataract, Trachoma, Onchoceriacis, Childhood blindness, Refractive error/Low Vision, Glaucoma & Diabetes induced blindness- as the most common causes of avoidable causes of blindness that contributes about 80 percent of blindness. It could be avoided or managed effectively when identified early.
Cataract is any opacification of the crystalline lens with a consequent reduction of vision to the point of functional blindness in the affected eye(s). it could be monocular or bilateral depending on the triggering factor(s). such factors as senescense, metabolic, disease, trauma etc can induce cataract formation.
The best treatment of Cataract is surgical extraction of the opacification when the cataract has matured! Though newer technological development has led to earlier (Intumescent stage) removal of the opacification of the crystalline lens. Baring that, Optometrists do manage it @ the intumescent stage, after identifying it with an ophthalmoscope. We use glasses & medications @ this stage, while we ensure that such pre-surgical complications like secondary Glaucoma, itching, tearing, photophobia, pains etc are reduced or even avoided pending cataract surgery.
We refer patients for surgery when the patient's vision is so compromised that either medication or other aids cannot help their vision. Post surgically, the Optometrist ensures that anisometropia is removed, fusion & stereopsis is restored, eye heals properly etc with medications & possibly lenses!
Trachoma & Onchicerciasis ectactically compromises the integrity of the cornea & could ultimately results corneal blindness. Hygiene, therapy & patient education has ultimately proven to effectively check the menace of these oculo-systemic infections. Opthalmologists in conjuntion with Ophthalmic nurses & assistance have used the above method to reduce the incidence & prevalence of these diseases in the Northern & Southern part of Nigeria where Trachoma & Onchocerciasis respectively reigns supreme. But the measure is not complete, especially with the marginal involvement of Optometrists. We could manage corneal complications of these diseases using slit lamps, diagnostic drugs, therapeutic drugs & refering advanced cases for surgery (especially in Trachoma). Post surgically we ensure the lashes maintain aponeurosis & we remove corneal complications as much as medications can.
On Glaucoma and Diabetes induced blindness, the patients are left with retinal blindness in a gradual but steadily chronic fashion. Optometrists are experts in identification of glaucoma, especially during vision screening or routine eye testing. We use medications & glasses to manage Glaucoma; we also encourage patients to go for surgery , when possible. People with Glaucoma frequently show changes in refractive status, just like in ocular manifestations of diabetes.
Ocular manifestation of Diabetes could be in form of glycemic fluctuations of vision in the crystalline lens, cataract, glaucoma (neovascular type, especially), retinopathies & macular degenerations. Maintaining of 'optimum' blood sugar in diabetics can delay these ocular implications & it has proved to have reduced the more serious sequelaes of ocular manifestations of diabetes, especially when accompanied by frequent visit (say ones in a year!) to an eye clinic. Optometrists often use vision check, medications, patient educations & glasses in some cases to help patients with ocular manifestation of diabetes. In cases that require surgery, we prepare the patients & refer them to the specialist Ophthalmologist for surgery. We subsequently co-manage these patients with a resultant 'optimum' vision.
Childhood blindness could be as a result of congenital factors or aquired factors. It manifests in corneal blindness, as in Vit A deficiencies, trauma etc, retinal blindness, as in retinoblastomas, congenital glaucoma etc It could also manifest in crystalline lens opacifications, as in viral infections like measles or pox diseases (this could also affect the cornea). Generally paediatric Optometrists works in partnership with paediatric Ophthalmologists to co-manage these conditions in children. We often use medication pre-surgically & medications and glasses post surgically to induce 'optimization' of the young child's vision!
Finally, Refractive error & low vision which could be primary or a secondary consequence of the other common causes of blindness are expertly managed by the optometrists by removing anisometropia & any form of refractive blur with the use of lenses. apart from blur removal, lenses are also used to restorefusion, stereopsis & other forms of binocularity. We use a retinoscope for this purpose. But most patients blinded by refractive error & low vision cannot access the largely private practise Optometrists, primarily as a result of cost.
It is therefore imperative to build an effective channel to reach an Optometrist in the public sector. Currently, we are very few in public health sector & this should be addressed if Nigeria wants to achieve any meaningful goals of Vision 2020: Right to sight.
Long live Nigeria
Viva Nigerian Optometrist... To be continued...
Dr Ezebuiroh Victor Okwudiri.
Prevention of Blindness group in partnership with World Health Organization (WHO) under the umbrella of vision 2020 came up with- Cataract, Trachoma, Onchoceriacis, Childhood blindness, Refractive error/Low Vision, Glaucoma & Diabetes induced blindness- as the most common causes of avoidable causes of blindness that contributes about 80 percent of blindness. It could be avoided or managed effectively when identified early.
Cataract is any opacification of the crystalline lens with a consequent reduction of vision to the point of functional blindness in the affected eye(s). it could be monocular or bilateral depending on the triggering factor(s). such factors as senescense, metabolic, disease, trauma etc can induce cataract formation.
The best treatment of Cataract is surgical extraction of the opacification when the cataract has matured! Though newer technological development has led to earlier (Intumescent stage) removal of the opacification of the crystalline lens. Baring that, Optometrists do manage it @ the intumescent stage, after identifying it with an ophthalmoscope. We use glasses & medications @ this stage, while we ensure that such pre-surgical complications like secondary Glaucoma, itching, tearing, photophobia, pains etc are reduced or even avoided pending cataract surgery.
We refer patients for surgery when the patient's vision is so compromised that either medication or other aids cannot help their vision. Post surgically, the Optometrist ensures that anisometropia is removed, fusion & stereopsis is restored, eye heals properly etc with medications & possibly lenses!
Trachoma & Onchicerciasis ectactically compromises the integrity of the cornea & could ultimately results corneal blindness. Hygiene, therapy & patient education has ultimately proven to effectively check the menace of these oculo-systemic infections. Opthalmologists in conjuntion with Ophthalmic nurses & assistance have used the above method to reduce the incidence & prevalence of these diseases in the Northern & Southern part of Nigeria where Trachoma & Onchocerciasis respectively reigns supreme. But the measure is not complete, especially with the marginal involvement of Optometrists. We could manage corneal complications of these diseases using slit lamps, diagnostic drugs, therapeutic drugs & refering advanced cases for surgery (especially in Trachoma). Post surgically we ensure the lashes maintain aponeurosis & we remove corneal complications as much as medications can.
On Glaucoma and Diabetes induced blindness, the patients are left with retinal blindness in a gradual but steadily chronic fashion. Optometrists are experts in identification of glaucoma, especially during vision screening or routine eye testing. We use medications & glasses to manage Glaucoma; we also encourage patients to go for surgery , when possible. People with Glaucoma frequently show changes in refractive status, just like in ocular manifestations of diabetes.
Ocular manifestation of Diabetes could be in form of glycemic fluctuations of vision in the crystalline lens, cataract, glaucoma (neovascular type, especially), retinopathies & macular degenerations. Maintaining of 'optimum' blood sugar in diabetics can delay these ocular implications & it has proved to have reduced the more serious sequelaes of ocular manifestations of diabetes, especially when accompanied by frequent visit (say ones in a year!) to an eye clinic. Optometrists often use vision check, medications, patient educations & glasses in some cases to help patients with ocular manifestation of diabetes. In cases that require surgery, we prepare the patients & refer them to the specialist Ophthalmologist for surgery. We subsequently co-manage these patients with a resultant 'optimum' vision.
Childhood blindness could be as a result of congenital factors or aquired factors. It manifests in corneal blindness, as in Vit A deficiencies, trauma etc, retinal blindness, as in retinoblastomas, congenital glaucoma etc It could also manifest in crystalline lens opacifications, as in viral infections like measles or pox diseases (this could also affect the cornea). Generally paediatric Optometrists works in partnership with paediatric Ophthalmologists to co-manage these conditions in children. We often use medication pre-surgically & medications and glasses post surgically to induce 'optimization' of the young child's vision!
Finally, Refractive error & low vision which could be primary or a secondary consequence of the other common causes of blindness are expertly managed by the optometrists by removing anisometropia & any form of refractive blur with the use of lenses. apart from blur removal, lenses are also used to restorefusion, stereopsis & other forms of binocularity. We use a retinoscope for this purpose. But most patients blinded by refractive error & low vision cannot access the largely private practise Optometrists, primarily as a result of cost.
It is therefore imperative to build an effective channel to reach an Optometrist in the public sector. Currently, we are very few in public health sector & this should be addressed if Nigeria wants to achieve any meaningful goals of Vision 2020: Right to sight.
Long live Nigeria
Viva Nigerian Optometrist... To be continued...
Dr Ezebuiroh Victor Okwudiri.
Tuesday, 17 May 2011
optometry.naija: Vision 2020 and the role of Optometry Practise in ...
optometry.naija: Vision 2020 and the role of Optometry Practise in ...: "Optom Vision 2020 : Right to sight is all about strategy, about means to an end in itself, though not necessarily an end. Optometry is stra..."
Optom
Optom
Vision 2020 and the role of Optometry Practise in Nigeria- episode 7
Optom
Vision 2020 : Right to sight is all about strategy, about means to an end in itself, though not necessarily an end. Optometry is strategically straddled with a huge responsibility aimed @ blindness prevention and promotion healthy eye sight. Contrary to that believe that our position in the area of Vision 2020 is @ best a fluke, evidence abounds today that the success of Vision 2020 especially in Africa is a function of how effective Optometrists are and their relationship with the Ophthalmologists. In the hierarchy of Vision 2020 development plan the Optometrists, as the Primary eye care practitioner, are positioned in the upper pyramid of blindness prevention cadre. It is obvious to note that the Optometrist, contrary to popular believe, is pivotal in expunging most embarrassing causes of preventable blindness.
Vision 2020 : Right to sight is based on the following objectives:
1) Creating awareness as a viable option for disease prevention and control. (The Optometrist as a Primary Eye care Physician is expected to play a major role in disease control; having in mind the cliche: "Prevention is better than cure", "A stitch in time saves nine", "Early detection of eye anomalies is sine qua non to effective blindness prevention" etc)
2) Capital to facilitate and sustain blindness prevention activities. (Optometrists are largely in private practise in Nigeria. Capital to sustain blindness prevention activities in private eye care practise shouldered by the patients if it should be sustained and this pinches most the vulnerable patients a lot! Unlike in government run health centres where patient's cost of sustaining prevention of blindness activities is highly subsidized by the government. More Optometrists are expected to absorbed by the ministries of healths [Both @ federal and state levels] to compliment the efforts of the Ophthalmologists, who are largely in public practise! It should be noted that Ophthalmic nurses and GPs are not more versed in Eye care than the Optometrist! Again, the government could encourage the rapid development of Private practise in eye care by providing credits and sustainable environment that can develop a sustained prevention of blindness activities.)
3) How to ensure effective planning, development and implementation of Vision 2020 core stategy. These includes-
a) Disease control: It should be noted that Diabetes Mellitus, Onchocerciasis, Chicken Pox, Small pox, HIV, Hypertension, Trachoma, Tuberculosis etc could lead to sight threatening eye conditions. As Primary eye care Practitioner, we are expected to know about these diseases, how they can cause blindness; we need to develop plans aimed @ preventing these diseases, a need to identify the ocular manifestations of these diseases on time and adopting a management approach...
b) Human resource development : I discussed how Optometrists are building on their human resources from the schools of Optometry (3 of those schools are in Nigeria!), doing continuous education aimed @ practise development by Optometrists etc More needs to be done though, like developing residency in Optometry etc.
c) Developing infrastructure and latest technologies: Eye care requires lots of equipment to increase effectiveness. Most of these equipments are concentrated in private practise...consequently, most patients can not access them because of high cost. Unfortunately still, most government hospital Optometrist's section does not have one single modern equipment to facilitate effectiveness in eye care! This seriously needs to be addressed @ length!
To be continued...
Dr Victor Ezebuiroh Okwudiri.
Vision 2020 : Right to sight is all about strategy, about means to an end in itself, though not necessarily an end. Optometry is strategically straddled with a huge responsibility aimed @ blindness prevention and promotion healthy eye sight. Contrary to that believe that our position in the area of Vision 2020 is @ best a fluke, evidence abounds today that the success of Vision 2020 especially in Africa is a function of how effective Optometrists are and their relationship with the Ophthalmologists. In the hierarchy of Vision 2020 development plan the Optometrists, as the Primary eye care practitioner, are positioned in the upper pyramid of blindness prevention cadre. It is obvious to note that the Optometrist, contrary to popular believe, is pivotal in expunging most embarrassing causes of preventable blindness.
Vision 2020 : Right to sight is based on the following objectives:
1) Creating awareness as a viable option for disease prevention and control. (The Optometrist as a Primary Eye care Physician is expected to play a major role in disease control; having in mind the cliche: "Prevention is better than cure", "A stitch in time saves nine", "Early detection of eye anomalies is sine qua non to effective blindness prevention" etc)
2) Capital to facilitate and sustain blindness prevention activities. (Optometrists are largely in private practise in Nigeria. Capital to sustain blindness prevention activities in private eye care practise shouldered by the patients if it should be sustained and this pinches most the vulnerable patients a lot! Unlike in government run health centres where patient's cost of sustaining prevention of blindness activities is highly subsidized by the government. More Optometrists are expected to absorbed by the ministries of healths [Both @ federal and state levels] to compliment the efforts of the Ophthalmologists, who are largely in public practise! It should be noted that Ophthalmic nurses and GPs are not more versed in Eye care than the Optometrist! Again, the government could encourage the rapid development of Private practise in eye care by providing credits and sustainable environment that can develop a sustained prevention of blindness activities.)
3) How to ensure effective planning, development and implementation of Vision 2020 core stategy. These includes-
a) Disease control: It should be noted that Diabetes Mellitus, Onchocerciasis, Chicken Pox, Small pox, HIV, Hypertension, Trachoma, Tuberculosis etc could lead to sight threatening eye conditions. As Primary eye care Practitioner, we are expected to know about these diseases, how they can cause blindness; we need to develop plans aimed @ preventing these diseases, a need to identify the ocular manifestations of these diseases on time and adopting a management approach...
b) Human resource development : I discussed how Optometrists are building on their human resources from the schools of Optometry (3 of those schools are in Nigeria!), doing continuous education aimed @ practise development by Optometrists etc More needs to be done though, like developing residency in Optometry etc.
c) Developing infrastructure and latest technologies: Eye care requires lots of equipment to increase effectiveness. Most of these equipments are concentrated in private practise...consequently, most patients can not access them because of high cost. Unfortunately still, most government hospital Optometrist's section does not have one single modern equipment to facilitate effectiveness in eye care! This seriously needs to be addressed @ length!
To be continued...
Dr Victor Ezebuiroh Okwudiri.
Wednesday, 11 May 2011
optometry.naija: Vision 2020 and the role of Optometry Practise in ...
optometry.naija: Vision 2020 and the role of Optometry Practise in ...: "Optom Continuing in our bid to throw light on how far, in terms of professionalization of Optometry practise world over; I will like to ex..."
Optom
Optom
Vision 2020 and the role of Optometry Practise in Nigeria- episode 6
Optom
Continuing in our bid to throw light on how far, in terms of professionalization of Optometry practise world over; I will like to explore on the narrative from the academic demands as required by the constitution and regulated by the Optometrists and Dispensing Opticians Board of Nigeria, a body with 2130 registered members as @ date!
There are three universities that educate Optometrists in Nigeria. University of Benin (UNIBEN), Abia state University Uturu (ABSU) and Imo state University Owerri (IMSU).
Historically, University of Benin was the first school that started training Optometrists B.Sc. It is a four year course equivalent to an Optician in the U.S.A. This form of Optometry is more of a dispensing Opticianry and is not trained to identify and manage ocular infections. It is a UK practise system. Optometry started there in January 1974 (Prof Ogbuehi, 1988) or earlier in 1972 (Dr Enechi Gilbert, 2010). It was nurtured under the tutelage of Professor Robert J. Fletcher of the City University, London; and Professor R.W.H. Wright, the then Dean of the faculty of Science University of Benin. In 1993, University of Benin adopted OD program. Prior to the adoption of OD title, the B.Sc Optometry dont go for internship and they were required to bridge to OD, but not many succeeded. In January 2009 it commenced its post graduate program in Optometry, M.Sc in Vision Science and M. Sc in Ocular Health Optometry. They also do PhD in the two areas.
Abia State University Uturu commenced Optometry in 1981 and were the first Nigerian University to produce OD optometrists in 1987.Professor Ogbuehi, Professor Ikonne etc were said to have contributed immensely here.
When Abia State was carved out from the then Imo State, the University known as Imo state University Okigwe became Abia state University Uturu. It was in 1991. It commenced Optometric education in 1993, and like its counterpart in Abia state University it issues OD certificate. Today, the Optometric regulatory body in Nigeria requires and OD which is a six-year program instead of the four-year B.Sc Optometry. The former also involves internship, while the later does not. To remain relevant to the modern trend of Optometric practise, the adoption of the OD can be said to be a welcoming issue and it portrays the evolutionary and revolutionary posturing of this noble profession in Nigeria.
The good news is that plans are on the way to further entrench this profession in the health community of the Nigerian state. Very soon residency in Optometry would soon be adopted, its on the planning stages. But in our watch, continuous education programs have become an entrenched policy in clinical Optometry while colleagues go abroad to acquire fellowship in a sub specialty. In the field of visual science and eye health, Optometry in Nigeria can be said to have bridged the gap despite the gaping challenges occasioned by this great profession. Lets have it in mind that we have a strong role in the area of instituting 'Primary eye Health care' in our health care and this is the secret of our relevance in the prevention of blindness and developing of our 'Vision 2020 : Right to Sight' strategy...
We shall discuss the journey so far tomorrow...
Dr Victor Ezebuiroh Okwudiri.
Continuing in our bid to throw light on how far, in terms of professionalization of Optometry practise world over; I will like to explore on the narrative from the academic demands as required by the constitution and regulated by the Optometrists and Dispensing Opticians Board of Nigeria, a body with 2130 registered members as @ date!
There are three universities that educate Optometrists in Nigeria. University of Benin (UNIBEN), Abia state University Uturu (ABSU) and Imo state University Owerri (IMSU).
Historically, University of Benin was the first school that started training Optometrists B.Sc. It is a four year course equivalent to an Optician in the U.S.A. This form of Optometry is more of a dispensing Opticianry and is not trained to identify and manage ocular infections. It is a UK practise system. Optometry started there in January 1974 (Prof Ogbuehi, 1988) or earlier in 1972 (Dr Enechi Gilbert, 2010). It was nurtured under the tutelage of Professor Robert J. Fletcher of the City University, London; and Professor R.W.H. Wright, the then Dean of the faculty of Science University of Benin. In 1993, University of Benin adopted OD program. Prior to the adoption of OD title, the B.Sc Optometry dont go for internship and they were required to bridge to OD, but not many succeeded. In January 2009 it commenced its post graduate program in Optometry, M.Sc in Vision Science and M. Sc in Ocular Health Optometry. They also do PhD in the two areas.
Abia State University Uturu commenced Optometry in 1981 and were the first Nigerian University to produce OD optometrists in 1987.Professor Ogbuehi, Professor Ikonne etc were said to have contributed immensely here.
When Abia State was carved out from the then Imo State, the University known as Imo state University Okigwe became Abia state University Uturu. It was in 1991. It commenced Optometric education in 1993, and like its counterpart in Abia state University it issues OD certificate. Today, the Optometric regulatory body in Nigeria requires and OD which is a six-year program instead of the four-year B.Sc Optometry. The former also involves internship, while the later does not. To remain relevant to the modern trend of Optometric practise, the adoption of the OD can be said to be a welcoming issue and it portrays the evolutionary and revolutionary posturing of this noble profession in Nigeria.
The good news is that plans are on the way to further entrench this profession in the health community of the Nigerian state. Very soon residency in Optometry would soon be adopted, its on the planning stages. But in our watch, continuous education programs have become an entrenched policy in clinical Optometry while colleagues go abroad to acquire fellowship in a sub specialty. In the field of visual science and eye health, Optometry in Nigeria can be said to have bridged the gap despite the gaping challenges occasioned by this great profession. Lets have it in mind that we have a strong role in the area of instituting 'Primary eye Health care' in our health care and this is the secret of our relevance in the prevention of blindness and developing of our 'Vision 2020 : Right to Sight' strategy...
We shall discuss the journey so far tomorrow...
Dr Victor Ezebuiroh Okwudiri.
Sunday, 8 May 2011
optometry.naija: Vision 2020 and the role of Optometry Practise in ...
optometry.naija: Vision 2020 and the role of Optometry Practise in ...: "Optom Am sorry esteemed readers for the delay...something came up that changed my activities. Lets go into the day's doing the talk. Talki..."
Optom
Optom
Saturday, 7 May 2011
Vision 2020 and the role of Optometry Practise in Nigeria- episode 5
Optom
Am sorry esteemed readers for the delay...something came up that changed my activities. Lets go into the day's doing the talk.
Talking of Decree No 34 of 1989 that professionalized Nigerian Optometrists i will like to run a historical view of what led to all these.
We can gain insight of the larger picture in that decree looking into the origin of Optometric science. What is the origin of Optometric science?
a) From Optics, this can be dated back to some thousand years BC. In BC 434, Aristophanes, an ancient Greek author was said to have wrote something on burning glasses probably used for its decorative purposes. Another Greek Scientist, a mathematician named Euclid in above BC 280 wrote about path of light travel, the angle of incidence, angle of reflection and he introduced the concept of the visual cone equivalent to the concept of visual angle. Claudius Ptolemy measured the angle of incidence, angle of reflection but failed to discover the exact mathematical formula. Johannes Kepler (1571-1630) wrote books to describe the mathematics of lenses, prisms and mirrors. Sir Isaac Newton discovered dispersion of white light into component colors as observed in say, rainbow. Snell discovered the law of Refraction in 1621.
In 1872, Monoyer invented the term Diopter.
b) From knowledge of Image formation by the Eye. Back in c.450 BC, Empedocles proposed the extromission theory and visual ray. Leucippus, Democritus, postulated the theory of intromission, eidola. (This theory was proved by Alhazen [965c-1041 AD]). Aristotle, around the 4th century BC used mediumistic theory of image formation in the eye. With the knowledge of how images are formed in the eye came knowledge of enhancing powers of glasses,such led Opticians like Thomas Young measure Astigmatism, he was the first to measure Astigmatism in 1801, and with the aid of his dispensing Optician, Fuller, corrected with a spherocylinder (in 1827). McAllister, another refracting Optician, was the first to make and prescribe a planoconcave (minus cylinders) for Rev. Goodrich in 1828.
c) Sensory Physiology, this area of visual sciences involves interpretation of the sensory visual pathways and how binocularity, stereopsis and fusion in the intact eye. In ancient Greece visual illusion were discussed and given various supernatural versus scientific interpretations. Later, in 1611, Christopher Scheiner described the size of the images reflected from the cornea. He also described the double aperture principle In 1613, a mathematician known as Aguillon, was the first to publish the first significant analysis of binocular vision. The first optometer, to measure vision, was invented by William Porterfield in mid 1700. It was also used to discover a relationship between accommodation and convergence. Thomas Young propounded trichomatic theory of color vision and discovered that the crystalline lens induces accommodation in the intact eye. Johannes Purkinje, a Czech physiologist, published books on sensory physiology between 1823 and 1826. Such phenomena like Purkinje images, Purkinje tree etc could attest to his works.
In 1838, Charles Wheatstone invented mirror stereoscope and used it to experiment on binocular vision and stereopsis. Between 1821-1894, Hermann von Helmholtz, a Physiologist and Physicist wrote a book on Physiological Optics and better known as the father of Physiological Optics.
One can now understand how Optometry developed from optics and how it has thrived through the medieval era by the contributions from other sciences.
With such deeper knowledge in the eyes, especially in the relationship with visual health in general, some Optometrists became interested in treating some ocular infections and with that came the use of medicines to ameliorate the ocular conditions. It is also a known fact that that Optometrists are more dispersed and closer to the grassroots, especially in the rural areas. As primary eye care practitioners and the long wait to see the Ophthalmologists, including the well established fact that Optometrists are more knowledgeable in conditions of the eyes than general practitioners (G.P.), it became imperative for our earlier colleagues to venture into treating ocular diseases. Another area could be traced back to the smearing campaign Ophthalmologists carry around about Optometrists claiming that the later is not knowledgeable enough to handle eye cases completely.
Optometrists were first allowed to diagnose pathologies in Rhode Island (DPA law of 1971) and the first place and time when Optometrists were first allowed to treat ocular diseases was West Virginia in 1976 (TPA law of 1976).
I think Optometry has come of age, yes, despite all odds. The normal postulations of the decree, which seriously needs review, enabled us to be practicing on category 3 and category 4 based on world model for Optometric practice. This categories allow us both diagnosing an ocular problem and using medication to treat or manage ocular diseases as well as doing what we know best, i.e., using glasses to treat ocular abnormalities... This dexterity led to awarding of doctor titles, even before 1900. In 1889, the Philadelphia Optical College were the first to award Doctor of Optics (O.D.) and was upgraded to Doctor of Optometry (O.D). Around 1968 to 1970, Optometry developed into a six-year old program and hence the title of doctor stuck. In Nigeria, O.D. program was first introduced in Abia State University, Uturu and in 1987 the first set of Doctor of Optometry was graduated, hence the pressing for professionalism in the practise of Optometry in Nigeria and it came true through that decree no 34 of 1989. It should not be forgotten, 2 other Universities study Optometry. They include University of Benin and Evans Ewerem University Imo state...
To be continued...
Dr Ezebuiroh Okwudiri Victor.
Am sorry esteemed readers for the delay...something came up that changed my activities. Lets go into the day's doing the talk.
Talking of Decree No 34 of 1989 that professionalized Nigerian Optometrists i will like to run a historical view of what led to all these.
We can gain insight of the larger picture in that decree looking into the origin of Optometric science. What is the origin of Optometric science?
a) From Optics, this can be dated back to some thousand years BC. In BC 434, Aristophanes, an ancient Greek author was said to have wrote something on burning glasses probably used for its decorative purposes. Another Greek Scientist, a mathematician named Euclid in above BC 280 wrote about path of light travel, the angle of incidence, angle of reflection and he introduced the concept of the visual cone equivalent to the concept of visual angle. Claudius Ptolemy measured the angle of incidence, angle of reflection but failed to discover the exact mathematical formula. Johannes Kepler (1571-1630) wrote books to describe the mathematics of lenses, prisms and mirrors. Sir Isaac Newton discovered dispersion of white light into component colors as observed in say, rainbow. Snell discovered the law of Refraction in 1621.
In 1872, Monoyer invented the term Diopter.
b) From knowledge of Image formation by the Eye. Back in c.450 BC, Empedocles proposed the extromission theory and visual ray. Leucippus, Democritus, postulated the theory of intromission, eidola. (This theory was proved by Alhazen [965c-1041 AD]). Aristotle, around the 4th century BC used mediumistic theory of image formation in the eye. With the knowledge of how images are formed in the eye came knowledge of enhancing powers of glasses,such led Opticians like Thomas Young measure Astigmatism, he was the first to measure Astigmatism in 1801, and with the aid of his dispensing Optician, Fuller, corrected with a spherocylinder (in 1827). McAllister, another refracting Optician, was the first to make and prescribe a planoconcave (minus cylinders) for Rev. Goodrich in 1828.
c) Sensory Physiology, this area of visual sciences involves interpretation of the sensory visual pathways and how binocularity, stereopsis and fusion in the intact eye. In ancient Greece visual illusion were discussed and given various supernatural versus scientific interpretations. Later, in 1611, Christopher Scheiner described the size of the images reflected from the cornea. He also described the double aperture principle In 1613, a mathematician known as Aguillon, was the first to publish the first significant analysis of binocular vision. The first optometer, to measure vision, was invented by William Porterfield in mid 1700. It was also used to discover a relationship between accommodation and convergence. Thomas Young propounded trichomatic theory of color vision and discovered that the crystalline lens induces accommodation in the intact eye. Johannes Purkinje, a Czech physiologist, published books on sensory physiology between 1823 and 1826. Such phenomena like Purkinje images, Purkinje tree etc could attest to his works.
In 1838, Charles Wheatstone invented mirror stereoscope and used it to experiment on binocular vision and stereopsis. Between 1821-1894, Hermann von Helmholtz, a Physiologist and Physicist wrote a book on Physiological Optics and better known as the father of Physiological Optics.
One can now understand how Optometry developed from optics and how it has thrived through the medieval era by the contributions from other sciences.
With such deeper knowledge in the eyes, especially in the relationship with visual health in general, some Optometrists became interested in treating some ocular infections and with that came the use of medicines to ameliorate the ocular conditions. It is also a known fact that that Optometrists are more dispersed and closer to the grassroots, especially in the rural areas. As primary eye care practitioners and the long wait to see the Ophthalmologists, including the well established fact that Optometrists are more knowledgeable in conditions of the eyes than general practitioners (G.P.), it became imperative for our earlier colleagues to venture into treating ocular diseases. Another area could be traced back to the smearing campaign Ophthalmologists carry around about Optometrists claiming that the later is not knowledgeable enough to handle eye cases completely.
Optometrists were first allowed to diagnose pathologies in Rhode Island (DPA law of 1971) and the first place and time when Optometrists were first allowed to treat ocular diseases was West Virginia in 1976 (TPA law of 1976).
I think Optometry has come of age, yes, despite all odds. The normal postulations of the decree, which seriously needs review, enabled us to be practicing on category 3 and category 4 based on world model for Optometric practice. This categories allow us both diagnosing an ocular problem and using medication to treat or manage ocular diseases as well as doing what we know best, i.e., using glasses to treat ocular abnormalities... This dexterity led to awarding of doctor titles, even before 1900. In 1889, the Philadelphia Optical College were the first to award Doctor of Optics (O.D.) and was upgraded to Doctor of Optometry (O.D). Around 1968 to 1970, Optometry developed into a six-year old program and hence the title of doctor stuck. In Nigeria, O.D. program was first introduced in Abia State University, Uturu and in 1987 the first set of Doctor of Optometry was graduated, hence the pressing for professionalism in the practise of Optometry in Nigeria and it came true through that decree no 34 of 1989. It should not be forgotten, 2 other Universities study Optometry. They include University of Benin and Evans Ewerem University Imo state...
To be continued...
Dr Ezebuiroh Okwudiri Victor.
Thursday, 5 May 2011
optometry.naija: Vision 2020 and Optometry practise in Nigeria- epi...
optometry.naija: Vision 2020 and Optometry practise in Nigeria- epi...: "Optom December 7th, 1989, Decree No 34 was passed, whose sole aim was to professionalise the practise of Optometry as body of health care p..."
Optom
Optom
Vision 2020 and Optometry practise in Nigeria- episode 4
Optom
December 7th, 1989, Decree No 34 was passed, whose sole aim was to professionalise the practise of Optometry as body of health care professionals in Nigeria with the duty of being
the 'Primary eye care' professional in the field of visual health. The decree which was passed during the military regime of Ibrahim Badamosi Babangida and under the tutelage the then Minister of health, Late Olikoye Ransome-Kuti and Prince Bola Ajibola as the Attorney General/Minister of Justice. The decree outlined the 'limit of practise' of Optometry in Nigeria:
1) Eye examinations to determine the Refractive errors and other departures from the optimally healthy and visually efficient eye;
2) Correction of Refractive errors using spectacles, contact lenses, low vision aids and other devices.
3) Correction of errors of binocularity by means of vision training (Orthoptics);
4) Diagnosis and management of MINOR ocular infections, WHICH DO NOT POSE A THREAT TO THE INTEGRITY OF THE OCULAR OR VISUAL SYSTEM; and Ocular first aid.
The decree also stipulates the formation of a regulatory body to ensure professionalism in the practise of Optometry in Nigeria. Hence the formation of Optometrists and Dispensing Optician Board Of Nigeria (ODOBN) on 16th October 1992. The inaugurative speech was by the Late Prof Olikoye Ransome-Kuti, who cheered the efforts of Professional Optometrists then for ACTUALIZING the board. The journey of ACTUALIZATION of the board is akin to the stalemated peace process of the Israeli/Palestine axis. But, while this might have been anticipated, we are yet to do enough to evade its consequences supsequently!
Let me say it here, am yet to understand some of the variables and phrases used in part (4) of Decree No 34. The adjective MINOR and the phrase in that line should be thrown out of that sentence to read, "Diagnosis and management of ocular infections; and ocular first aid". This better fits in to the contemporary optometrist's practise protocol. Again, it cannot be effectively said that bacterial conjunctivitis caused by Staphylococcus Aureus or Staphycoccus Epidermis cannot invade the intact cornea and cause lots of visual complications, including blindness; even though many see it as a MINOR apollo! Surely that word leaves a sour test in the mouth. See you tomorrow.
Dr Ezebuiroh Okwudiri Ezebuiroh.
December 7th, 1989, Decree No 34 was passed, whose sole aim was to professionalise the practise of Optometry as body of health care professionals in Nigeria with the duty of being
the 'Primary eye care' professional in the field of visual health. The decree which was passed during the military regime of Ibrahim Badamosi Babangida and under the tutelage the then Minister of health, Late Olikoye Ransome-Kuti and Prince Bola Ajibola as the Attorney General/Minister of Justice. The decree outlined the 'limit of practise' of Optometry in Nigeria:
1) Eye examinations to determine the Refractive errors and other departures from the optimally healthy and visually efficient eye;
2) Correction of Refractive errors using spectacles, contact lenses, low vision aids and other devices.
3) Correction of errors of binocularity by means of vision training (Orthoptics);
4) Diagnosis and management of MINOR ocular infections, WHICH DO NOT POSE A THREAT TO THE INTEGRITY OF THE OCULAR OR VISUAL SYSTEM; and Ocular first aid.
The decree also stipulates the formation of a regulatory body to ensure professionalism in the practise of Optometry in Nigeria. Hence the formation of Optometrists and Dispensing Optician Board Of Nigeria (ODOBN) on 16th October 1992. The inaugurative speech was by the Late Prof Olikoye Ransome-Kuti, who cheered the efforts of Professional Optometrists then for ACTUALIZING the board. The journey of ACTUALIZATION of the board is akin to the stalemated peace process of the Israeli/Palestine axis. But, while this might have been anticipated, we are yet to do enough to evade its consequences supsequently!
Let me say it here, am yet to understand some of the variables and phrases used in part (4) of Decree No 34. The adjective MINOR and the phrase in that line should be thrown out of that sentence to read, "Diagnosis and management of ocular infections; and ocular first aid". This better fits in to the contemporary optometrist's practise protocol. Again, it cannot be effectively said that bacterial conjunctivitis caused by Staphylococcus Aureus or Staphycoccus Epidermis cannot invade the intact cornea and cause lots of visual complications, including blindness; even though many see it as a MINOR apollo! Surely that word leaves a sour test in the mouth. See you tomorrow.
Dr Ezebuiroh Okwudiri Ezebuiroh.
Monday, 2 May 2011
optometry.naija: Vision 2020 and the role of Optometry Practice in ...
optometry.naija: Vision 2020 and the role of Optometry Practice in ...: "Optom Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision info..."
Optom
Optom
Vision 2020 and the role of Optometry Practice in Nigeria- episode 3
Optom
Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. Optometrists are professionals who provide vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. Optometrists qualify to diagnose and treat eye diseases such as Diabetic Retinopathy, Cataracts, Glaucoma, and Macular Degeneration. Like most professions, Optometry education, certification and practice is regulated by the government. (Wikipedia).
Optometry has come a long way. Let me take you down memory lane from the medieval period. The word "Optometry" is a combination of two Greek words, 'opsis' which means view ad 'metron'; which means measure or something to measure. We were first called optometrist by Edmund Landolt in 1886; which means 'glass fitter'. So any one then who constructs lenses on a spectacle or on a stand was known as an Optometrist.
About more than a thousand years ago, Sir Joseph Needham a historian, stated that ancient China invented the earliest eyeglasses. David A. Goss, O.D., Ph.D., argued that most likely Italy were already making glasses as @ 1305 AD. Benito Daza de Valdes published a book in Optometry in 1623 were he described use and fitting of eyeglasses. In 1692, William Molyneux wrote a book on optics and lenses, Myopia and other ocular problems. Johanes Kepler discovered how the retina creates vision. Thomas Young discovered Astigmatism and George Biddel Airy designed the first spherocylinders to treat it between 1773-1829. Mr Peter Brown was the first man to wear a pair of glasses in the USA. The first man buy a pair of Glasses in the USA is McAllister Sr., from Philadelphia Pennsylvania in 1783. McAllister Jr., started making glasses in USA in 1811 and in 1853 they started refraction which they taught students.
In January 11, 1922 American Optometric Association was formed. Same year saw Optometry choosing to become professional instead of business! The first school of Optometry in America was built in 1872. in 1940 the first contact lens were invented.
In Nigeria, Nigerian Optical and Ophthalmic Co limited in 1964 introduced Optometry in Nigeria. It was changed to Optical association and Nigerian Optometric Association in 1968. The umbrella body was an all comers affairs, since there was no regulatory body. But based on the above evolving Optometric definition and with emphasis on professionalism. Hence, the formation of Optometrists and Dispensing Optician board following Decree No 34 of 1989 on 7th December. It was inaugurated by the then Minister of Health, late Professor Ransome-Kuti on 12th October 1992. Optometry has come a long way indeed. To be continued....
Dr Victor Ezebuiroh Okwudiri.
Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. Optometrists are professionals who provide vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. Optometrists qualify to diagnose and treat eye diseases such as Diabetic Retinopathy, Cataracts, Glaucoma, and Macular Degeneration. Like most professions, Optometry education, certification and practice is regulated by the government. (Wikipedia).
Optometry has come a long way. Let me take you down memory lane from the medieval period. The word "Optometry" is a combination of two Greek words, 'opsis' which means view ad 'metron'; which means measure or something to measure. We were first called optometrist by Edmund Landolt in 1886; which means 'glass fitter'. So any one then who constructs lenses on a spectacle or on a stand was known as an Optometrist.
About more than a thousand years ago, Sir Joseph Needham a historian, stated that ancient China invented the earliest eyeglasses. David A. Goss, O.D., Ph.D., argued that most likely Italy were already making glasses as @ 1305 AD. Benito Daza de Valdes published a book in Optometry in 1623 were he described use and fitting of eyeglasses. In 1692, William Molyneux wrote a book on optics and lenses, Myopia and other ocular problems. Johanes Kepler discovered how the retina creates vision. Thomas Young discovered Astigmatism and George Biddel Airy designed the first spherocylinders to treat it between 1773-1829. Mr Peter Brown was the first man to wear a pair of glasses in the USA. The first man buy a pair of Glasses in the USA is McAllister Sr., from Philadelphia Pennsylvania in 1783. McAllister Jr., started making glasses in USA in 1811 and in 1853 they started refraction which they taught students.
In January 11, 1922 American Optometric Association was formed. Same year saw Optometry choosing to become professional instead of business! The first school of Optometry in America was built in 1872. in 1940 the first contact lens were invented.
In Nigeria, Nigerian Optical and Ophthalmic Co limited in 1964 introduced Optometry in Nigeria. It was changed to Optical association and Nigerian Optometric Association in 1968. The umbrella body was an all comers affairs, since there was no regulatory body. But based on the above evolving Optometric definition and with emphasis on professionalism. Hence, the formation of Optometrists and Dispensing Optician board following Decree No 34 of 1989 on 7th December. It was inaugurated by the then Minister of Health, late Professor Ransome-Kuti on 12th October 1992. Optometry has come a long way indeed. To be continued....
Dr Victor Ezebuiroh Okwudiri.
Friday, 29 April 2011
optometry.naija: Vision 2020 and the role of Optometry Practice in ...
optometry.naija: Vision 2020 and the role of Optometry Practice in ...: "Optom Back in 15-18 January 1999 when Vision 2020 was launched, it was aimed @ reversing the roller-coaster drive of blindness Prevalence w..."
Optom
Optom
Vision 2020 and the role of Optometry Practice in Nigeria- episode 2
Optom
Back in 15-18 January 1999 when Vision 2020 was launched, it was aimed @ reversing the roller-coaster drive of blindness Prevalence which was projected to rise up to 58 million in 2010 and 75 million in 2020. But the almighty question staring @ us, the estimated versus prevailing epidemiological data reality, begs for answers. I wish to draw us to events that finally culminated in formation of Vision 2020 Global initiative, also identified as Vision 2020: Right to Sight.
In 1972, the same year the globally accepted minimum definition of blindness as, " VA of <3/60 with a central visual field of <10 degrees" and as incorporated in the international classifications of diseases ninth revision (ICD-9), the estimated prevalence of blindness was between 10-15 million. This projected estimate was said to be an underestimation by epidemiologists and other experts. The need for a more epidemiological sound estimate of blindness and the need to look into causes of blindness and the myth gave birth to International Agency for Prevention of Blindness (IAPB) in 1975. It is an international umbrella body of governmental and non-governmental eye care providers whose aim is to prevent or treat causes of blindness.
In that same year, 1975, WHO/ Prevention of Blindness/Blinding disease (WHO/PBL later WHO/PBD) was created as a partnership between world health organization (WHO) and IAPB and world donor groups. In 1979, the first epidemiologically sound estimate of Blindness prevalence based on ICD-9, from 60 distinct geographic areas, was 28.1 million blind as @ 1975. In 1987 the prevalence of blindness, based on ICD-9, was 31 million from 90 distinct geographical area @ 1984. In 1994, there was an estimated 37.9 million people blind @1990. As @ 2000 there was an estimated 45 million blind and the story continues... this seem to correlate with a projection made in 1975, that by 1990 the world prevalence of blindness will be 38 million, in 2000, 45 million people will be blind. If nothing is done, prevalence of blindness is expected to rise to 58 million in 2010 and record 75 million in 2020.
This worrying scenario is further aggravated by a lackadaisical approach towards the goals of achieving the mission statement of Vision 2020: Right to Sight, which has prevention, treatment and elimination of the various preventable causes of blindness as a core message. Another factor that keeps pandering the escalating proportion of prevalence of blindness and visual impairments, is the chronic and persistent professional in-fighting among the professional eye care providers. The Ophthalmologists, the Optometrists, Dispensing Opticians and the Orthoptists are eye care professionals whose aim is to provide visual 'soundness' for the visually challenged.
Finally, in a subsequent blog, I am going to discuss the eye care professionals with emphasis on Optometry.
To be continued...
Dr Victor Okwudiri Ezebuiroh.
Back in 15-18 January 1999 when Vision 2020 was launched, it was aimed @ reversing the roller-coaster drive of blindness Prevalence which was projected to rise up to 58 million in 2010 and 75 million in 2020. But the almighty question staring @ us, the estimated versus prevailing epidemiological data reality, begs for answers. I wish to draw us to events that finally culminated in formation of Vision 2020 Global initiative, also identified as Vision 2020: Right to Sight.
In 1972, the same year the globally accepted minimum definition of blindness as, " VA of <3/60 with a central visual field of <10 degrees" and as incorporated in the international classifications of diseases ninth revision (ICD-9), the estimated prevalence of blindness was between 10-15 million. This projected estimate was said to be an underestimation by epidemiologists and other experts. The need for a more epidemiological sound estimate of blindness and the need to look into causes of blindness and the myth gave birth to International Agency for Prevention of Blindness (IAPB) in 1975. It is an international umbrella body of governmental and non-governmental eye care providers whose aim is to prevent or treat causes of blindness.
In that same year, 1975, WHO/ Prevention of Blindness/Blinding disease (WHO/PBL later WHO/PBD) was created as a partnership between world health organization (WHO) and IAPB and world donor groups. In 1979, the first epidemiologically sound estimate of Blindness prevalence based on ICD-9, from 60 distinct geographic areas, was 28.1 million blind as @ 1975. In 1987 the prevalence of blindness, based on ICD-9, was 31 million from 90 distinct geographical area @ 1984. In 1994, there was an estimated 37.9 million people blind @1990. As @ 2000 there was an estimated 45 million blind and the story continues... this seem to correlate with a projection made in 1975, that by 1990 the world prevalence of blindness will be 38 million, in 2000, 45 million people will be blind. If nothing is done, prevalence of blindness is expected to rise to 58 million in 2010 and record 75 million in 2020.
This worrying scenario is further aggravated by a lackadaisical approach towards the goals of achieving the mission statement of Vision 2020: Right to Sight, which has prevention, treatment and elimination of the various preventable causes of blindness as a core message. Another factor that keeps pandering the escalating proportion of prevalence of blindness and visual impairments, is the chronic and persistent professional in-fighting among the professional eye care providers. The Ophthalmologists, the Optometrists, Dispensing Opticians and the Orthoptists are eye care professionals whose aim is to provide visual 'soundness' for the visually challenged.
Finally, in a subsequent blog, I am going to discuss the eye care professionals with emphasis on Optometry.
To be continued...
Dr Victor Okwudiri Ezebuiroh.
Thursday, 28 April 2011
optometry.naija: Vision 2020 and the role of Optometry Practice in ...
optometry.naija: Vision 2020 and the role of Optometry Practice in ...: "Optom In 1975, during a World Health Assembly organized by World Health Organization (WHO), WHO Program for the Prevention of Blindness was..."
Optom
Optom
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