Nordic research in ophthalmology

Nordic ophthalmologists and vision scientists are active in many fields of eye research. This is most evident at the biannual Nordic Congress of Ophthalmology, most recently held in Malm? in June 2004. The authors here review some of the research in vision and ophthalmology presented at this meeting or published recently by Nordic scientists. This paper does not represent a comprehensive review of all Nordic research in the field, but attempts to give an overview of some of the activities underway in eye research in this part of the world.     

International Federation of Ophthalmological Societies statutes and regulations

PURPOSE: To provide an understanding of the structure, role, and responsibility of the International Federation of Ophthalmological Societies, the International Council of Ophthalmology, and the International Congress of Ophthalmology. These established entities have recently codified their statutes and regulations and registered them in Zurich, Switzerland. METHODS: The International Council of Ophthalmology, which serves as the executive body of the International Federation of Ophthalmological Societies, used historical operating documents to prepare the statutes and regulations, which were reviewed and adopted by the International Federation of Ophthalmological Societies at the 28th International Congress of Ophthalmology in Amsterdam on June 23, 1998. RESULTS: The statutes and regulations of the International Federation of Ophthalmological Societies, the International Council of Ophthalmology, and the International Congress of Ophthalmology are available to supranational ophthalmological organizations, national ophthalmological societies, other ophthalmological organizations, and individual ophthalmologists. CONCLUSIONS: The statutes and regulations of the International Federation of Ophthalmological Societies, the International Council of Ophthalmology, and the International Congress of Ophthalmology provide a basis for an organizational structure in international ophthalmology. The International Congress of Ophthalmology, first held in 1857, is the longest continuing international meeting in medicine. The International Council of Ophthalmology was established in 1927, and the International Federation of Ophthalmological Societies was formed in 1933. These organizations coordinate the International Congress of Ophthalmology, which convenes with the International Federation of Ophthalmological Societies every 4 years. The International Council, as the executive body, meets annually. The International Council of Ophthalmology has for decades worked to coordinate and facilitate interchange, education, and standards in international ophthalmology. Currently, the International Council of Ophthalmology, working with other international organizations, is creating an international ophthalmology strategic plan, which includes focus on ophthalmic training, continuing education, advocacy for the preservation and restoration of vision, clinical guidelines, and research.     

Research contributions in ophthalmology: Australia's productivity

Background: In 2000, the Australian and New Zealand Journal of Ophthalmology (ANZJO) changed title to Clinical and Experimental Ophthalmology. At this time, a review of Australia's contributions to the literature over the previous 21 years appears timely. Bibliometric indicators are used extensively to assess research performance as they offer views of a field that might not otherwise be apparent. The aim of this study was to explore publication output data to construct a picture of ophthalmology that may be of benefit to researchers and ophthalmologists. Methods: Science Citation Index and Social Sciences Citation Index databases were used to collate data on ophthal­mology research literature from 1980 to 2000. Subsequent analysis particularly focused on Australia's contribution to this literature, including publication frequency vis‐à‐vis the world, collaboration, and the journals in which Australian researchers frequently publish. These data were also compared with other countries of similar scientific stature or language. Results: Since 1980, Australia has ranked in the top 10 nations contributing to world ophthalmology research. Its contribution was close to world average in the 1980s, but increasing numbers of researchers and papers show Australia exceeding the world average during the 1990s. Most ophthalmology research collaboration by Australians is within Australia. Although fewer in number, collaborative papers with overseas researchers include 28 other countries. Data on the journals in which Australians publish show that Australian researchers continue to exhibit a preference for publication in their own regional journals. Conclusions: This paper, one of a series on the literature of the vision sciences, provides some initial benchmarks on Australia's standing and contribution to the field of ophthalmology research.     

60 years Alfred Vogt Foundation. The prize winners and their work]

BACKGROUND: The Alfred Vogt-Prize is the highest award in Switzerland for scientific research in ophthalmology and related fields of research. The Alfred Vogt institution was founded 60 years ago in Zürich, where Alfred Vogt was working as the head of the department of Ophthalmology of the University Hospital. For this reason the activity of the foundation was recognized on the occasion of the annual meeting of the Swiss Ophthalmology Society in Zürich 1998. METHOD AND RESULTS: The biographical notes of Alfred Vogt were compiled. The winners of the prize and their distinguished papers are listed below. During the 60 years since the establishment of the foundation the prize was rewarded to 53 researchers or research teams. The awards were divided among several researchers in those years when many outstanding papers were submitted. On the other hand in many years no award was given due to lack of award worthing research papers. 7 researchers received the prize more than once. CONCLUSION: The list of the winners of the Alfred Vogt-Prize reflects the history of the Swiss Ophthalmology. To a number of researchers the awards allowed them further research, which let to excellent contributions to international Ophthalmology.     

Training of an ophthalmologist in concepts and practice of community eye health

Training in community eye health (CEH; public health applied to ophthalmology) complements clinical ophthalmology knowledge and enhances the physician's ability to meet the needs at the individual and community level in the context of VISION 2020. The upcoming version of the ophthalmological residency curriculum that was developed by the International Council of Ophthalmology (ICO) includes a new, specific section on CEH. It has basic, standard, advanced and very advanced levels of goals (the last one is exclusively for fellows/master students), and provides a public health approach to the main causes of blindness and low vision. The number of individuals aged ≥60 years is increasing twice as fast as the number of ophthalmologists, and as this age group is more likely to become blind/visually impaired, accessibility to eye care in the near future might be suboptimal even in wealthier countries. In order to achieve VISION 2020 goals, it is necessary to train more ophthalmologists and other eye care workers. However, the adoption of CEH component of the ICO curriculum for ophthalmology residents will enable them to meet local needs for eye care.     

Analysis of publication trends in two internationally renowned ophthalmology journals

International journals represent a forum for exchange of current information with contributions from all over the world. High standards are essential. In this report, we compared the publishing trends of two internationally renowned ophthalmology journals--the British Journal of Ophthalmology (BJO) and the American Journal of Ophthalmology (AJO).     

An ophthalmologist's definition of ophthalmology.

Ophthalmology has long been on the vanguard of medicine and innovation. Ophthalmologists have enjoyed high levels of satisfaction from restoring sight to patients. But the world as we know it has shifted, and now we are burdened by the pressures of modern medicine and a competitive marketplace. Ophthalmology should take the lead in medicine in learning how to weather these crises and how to emerge a revitalized specialty. It seems that the right choice for the specialty of ophthalmology is to reclaim our role as comprehensive providers of total eye care. Ophthalmologists can lead teams formed to provide comprehensive eye care. A dialogue on a consensus definition of the scope of ophthalmology should take place, involving all segments of the profession. Another dialogue that is critical to the future of the specialty is a deliberate examination of the issue of formal accreditation and/or certification of ophthalmologic subspecialties. Ophthalmology needs to define itself for the future.     

History of Acta Ophthalmologica – the first 50 years

Acta Ophthalmologica appeared as the scientific journal of the Nordic ophthalmological Societies in 1923. The intention was to expose the clinical and experimental developments among the ophthalmological communities of the four Nordic countries: Denmark, Finland, Norway and Sweden. The collaboration within the field of ophthalmology had been attempted with the publication of ‘Nordisk ophthalmologisk Tidsskrift’ in the years 1889–1892. Now, once again, the wish for a tighter Nordic cooperation was explored by enthusiastic ophthalmologists in all four countries. One person stands out as the driving force, K.K.K. Lundsgaard, who in spite of his early death in 1931 was remembered by name on the front page of Acta since 1936 by the Latin phrase ‘A K.K.K. Lundsgaard edi coepta’. The present review recalls details from the early years when the journal found its place in the ophthalmology and creates the background for some reflections on purpose and goals by publishing a scientific journal.     

Book Reviews

Book reviewed in this article: Eyecare in developing nations - second edition Larry Schwab Science of wsion KN Leibovtc (Editor) Springer-Verlag. Optics MH Freeman Radiology of the eye and orbit TH Newton and LT Bilanuk Ultrasonography in Ophthalmology 12 Proceedings of the 12th SIDUO Congress (1988) R Sampolesi (Editor) Kluwer: Dordrecht, Netherlands Night vision. Basic, clinical and applied aspects RFHess, LT Shatpe and K Nordby (Eds) Graves' Ophthalmopathy Edited by Jack R Wall and Jacques How     

Japan's share of published research in ophthalmology

PURPOSE: This study was conducted to determine Japan's share of published research in ophthalmology during the last decade. METHODS: Ophthalmology journals with higher impact factors were accessed through the Medline database to elicit the number of articles published in 1991-2000 that originated in various countries, including Japan. The proportion of articles with a higher grade of evidence (randomized controlled trials/clinical trials, cohort studies, and case-control studies) was determined for Japan and compared with the average values of the total articles published in these journals. In addition, the percentage of published research from the 20 top-ranking countries was calculated, showing the trend over time. RESULTS: Of the total articles (21,327), Japan's share in the selected ophthalmology journals was 6.5% (1,387 articles), ranking third in the world, following the USA (51.5%) and the UK (11.3%). The recent increase in the share was statistically significant for Japan (P =.01). However, the proportionate value of clinical research evidence was lower for Japan-originated articles than the average value for the total clinical research articles in these journals. CONCLUSIONS: Appropriate measures should be taken in the ophthalmology field in Japan to increase the number of clinical research papers with a higher grade of evidence.     

The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics

PURPOSE: To describe and compare the ocular signs in patients diagnosed with acne rosacea by the ophthalmologist with the ocular signs in the patients diagnosed with rosacea by the dermatologist. METHODS: We reviewed the medical records of 176 randomly selected patients diagnosed with rosacea at the University of California, Davis, Medical Center: 88 patients each from the Department of Dermatology and the Department of Ophthalmology. Of the 88 patients diagnosed with acne rosacea by a dermatologist, 22 (25%) had an ophthalmologic evaluation done prior to the study. In those patients without an ophthalmologic assessment, ocular complaints noted by the dermatologist were recorded. We recorded ocular signs including lid, conjunctival, corneal, episcleral, and scleral manifestations as well as charted observations of the iris, lens, intraocular pressures (IOPs), best corrected visual acuity (VA), and funduscopic examination. Age and sex were recorded from the initial ophthalmologic evaluation. The analysis was designed to compare the prevalence of signs and symptoms in two clinical settings. RESULTS: The prevalence of documented meibomian gland dysfunction (p < 0.001), telangiectasia (p = 0.004), and anterior blepharitis (p = 0.008) was significantly higher in ophthalmology patients when compared with dermatology patients. Of the conjunctival signs evaluated, only the presence of interpalpebral conjunctival hyperemia (p = 0.005) was found to be significantly higher in ophthalmology patients. The corneal, episcleral, scleral, and lens findings did not demonstrate a statistically significant difference between groups. CONCLUSION: The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations. As might be expected, eye signs and symptoms are more commonly noted in the eye clinic. A clinician's increased awareness of the common ocular findings of rosacea, however, may aid in earlier diagnosis and treatment of ocular rosacea.     

Book reviews

Book reviewed in this article: Color Atlas & Synopsis of Clinical Ophthalmology: Cornea CJ Rapuano and W‐J Heng Reviewed by: ADRIAN S BRUCE Color Atlas & Synopsis of Clinical Ophthalmology: Neuro‐ophthalmology Edited by PJ Savino and HV Danesh‐Meyer Reviewed by: ASSOCIATE PROFESSOR ALGIS J VINGRYS Ocular Pathology 5th Edition, CD‐ROM Myron Yanoff and Ben S Fine Reviewed by: DR ALEX GENTLE     

循序渐进地进行眼科研究生的培训

在临床医学中,眼科学是相对独立的学科,严密精细是眼科诊断治疗的特色,眼科医生既要着眼于局部,又要放眼于整体。因此在眼科研究生的培训中,我们不仅改进教学方法、利用现有资源进行研究生的理论培训,还要更好地完善临床技能培训,让研究生通过不同阶段的培训具备独立思考和应对的能力,并掌握利用现有教学资源获取前沿知识的技能。（眼科, 2016,25： 425-426）     

我国LASIK专题文献的计量分析

目的 :探讨近年来我国应用LASIK手术治疗中度、高度近视眼的研究现状、取得的进展以及尚存在的问题。方法 :利用文献计量学方法 ,对国内 1995～ 2 0 0 2年 2月所发表的 2 2 5篇相关文献的论文数量及年代、论文合作度、期刊分布及核心期刊、发文机构、地区分布和研究内容等方面进行统计分析。结果 :自 1995年以来 ,其论文数量逐年增加 ,多数论文为 3～ 5人合著。研究LASIK的文献多数集中在《中国实用眼科杂志》、《眼视光学杂志》等眼科专业核心期刊上。以温州医学院眼视光学院、上海第二医科大学附属瑞金医院眼科等核心机构发文较多 ,每家机构平均刊登 9篇论收稿日期 :2 0 0 2 -0 5 -2 1;修回日期 :2 0 0 2 -0 9-2 5作者简介 :陆蓓 ( 195 7-) ,女 ,辽宁沈阳人 ,副教授 ,硕士生导师 ,研究方向 :眼视光学 ,青光眼。通信作者 :陆蓓 (E -mail:lupei@163 .com)。文 ,其他 6 7家机构平均发文 2篇左右。论文多由沿海发达地区及全国中心城市的眼科研究者撰写。研究内容集中在临床疗效、手术并发症分析及处理和手术前后相关检查结果的分析上。结论 :LASIK手术在我国开展虽稍晚 ,但发展迅速。在手术数量和论文数量上增长都很快 ,尤其是 1998年后更是明显。因受经济因素影响 ,我国西部地区手术开展得还不是很理想 ,     

Contact lens articles in the literature.

We searched the ophthalmic literature of the past 5 years looking for patterns in the publication of contact lens articles. Contact lens articles constituted 2.59% of all ophthalmology articles. We found that a substantial percentage of the articles published in The CLAO Journal and selected optometric journals concerned contact lenses; this, however, was not the case with the major ophthalmology journals (American Journal of Ophthalmology [AJO], Ophthalmology, and Archives of Ophthalmology [Archives]). One recent contact lens development, disposable lenses, was covered by both The CLAO Journal and the major ophthalmology journals, but the coverage differed in that the orientation of the articles in the major ophthalmology journals was essentially negative. Articles about another recent development (rigid gas permeable contact lenses for extended wear), although found in The CLAO Journal, could not be found in the other ophthalmology journals. Finally, when the abstracts of all contact lens articles were reviewed, we found a negative slant to articles published in AJO and Archives. We believe that the major ophthalmology journals present a rather negative view of contact lenses; this, we think, impedes unbiased dissemination of information about new contact lens developments.     

Dollars and sight: the economics of ophthalmology

PURPOSE OF REVIEW: The purpose of this paper is to detail the economics of ophthalmology including trends in utilization, cost, and expenditure. RECENT FINDINGS: Eye care accounts for $23.1 billion, or approximately 1.93% of total health care expenditures annually. In 1991, eye care service costs in those 65 years or older were $5.5 billion, comprising 4.7% of Medicare spending. By 1999, the cost of eye care services in the 65 or older group had increased to $6 billion, but comprised only 2.8% of Medicare spending. SUMMARY: Although it is imperative that national health expenditure be controlled, ophthalmology has shouldered a disproportionate share of the cost cutting in recent years. When we consider the advances in ophthalmology and the contributions of ophthalmology to improved quality of life, the financial burden absorbed by ophthalmology is striking.     

Mark Joseph Schoenberg MD: innovator,teacher, leader (1874-1945)

Mark Joseph Schoenberg is known for his leadership and several important contributions to ophthalmology: 1) He performed the first retinal detachment operation in the United States; 2) he established the first glaucoma clinic in the United States; 3) he was the chief founder of the New York Society for Clinical Ophthalmology; and 4) he innovated the standardization of Schiotz tonometers.     

John G. Lindberg and the discovery of exfoliation syndrome

John G. Lindberg, a young Finnish ophthalmology resident, started a research project in 1914 aiming at an academic dissertation. His plan was to elucidate Axenfeld's observations on iris changes in senile eyes. Axenfeld had described two types of degeneration of the iris: a hyaline degeneration of the iris pupillary zone causing poor pupillary dilatation with mydriatics and an atrophy of the iris pigment epithelium at the pupillary border. For his research Lindberg had to construct a slit-lamp biomicroscope by studying Gullstrand's monograph on the matter; slit-lamp biomicroscopes were not commercially available at that time. A Sach's lamp was used for transillumination of the iris. While conducting his research Lindberg paid attention to greyish flakes and fringes at the pupillary border. He also noted how this strange material formed a membrane on the anterior lens surface. Documentation was made by skillful hand drawings. The new phenomenon was found to be as common in cataract patients as in non-cataractous controls older than 55 years. The phenomenon was observed in 50% of glaucoma patients. Age was the decisive factor; the phenomenon was more prevalent with advancing age. Lindberg published his results as a thesis at the University of Helsinki in 1917. When attending a Nordic Congress of Ophthalmology in 1921, Lindberg met Norwegian ophthalmologist, Birger Malling, and gave him his thesis and explained the new findings. In 1920-21 Lindberg worked at Axenfeld's clinic in Freiburg, Germany. During this period he met in Basel, Switzerland, a Swiss ophthalmologist, Alfred Vogt. He told Vogt about his research and provided him with copies of his thesis. Both Malling and Vogt published papers on exfoliation in 1923 without referring to Lindberg's work. Lindberg did not, however, interfere with these papers. Thus Lindberg was forgotten by his contemporaries as a scientist. However, his main conclusions on exfoliation are still valid today. The life of this remarkable ophthalmologist is described in the present paper.     

BOOK REVIEWS

Book reviewed in this article: Contact Lens Fitting. A Clinical Text Atlas FJ Weinstock (ed) Ophthalmic Clinical Debates TA Deutsch Contact lenses in ophthalmology MS Wilson and EAW Mills Cataracts. Transactions of the New Orleans Academy of Ophthalmology DR Caldwell (ed) Vitreoretinal Disease (Second edition) PH Morse