American Uveitis Society Meeting, May 13,1995 Fort Lauderdale, FL, USA

1 Confirmation of Bartonella henselae as the cause of cat scratch related acute neuroretinitis and prospective observation to its response to oral doxycycline and rifampin. Reed B, Smith R, Dolan M, Wong M, Scales D, Department of Ophthalmology & Infectious Disease, Wilford Hall Medical Center, Lackland AFB, TX, USA. 2 Recurrence rate of CMV retinitis in patients following pars plana vitrectomy and silicone oil injection. Marx JL, Thach AB, Reingold W, Terry B, Rao NA, Chong LP. Doheny Eye Institute, Los Angeles, CA, USA. 3 A PCR based assay for the diagnosis of AIDS related VZV retinitis. Margolis T, Short G, Schwartz D, Irvine A, Martin D, Francis I. Proctor Foundation, San Francisco, CA, USA. 4 Presumptive ocular sarcoidosis. Dodds EM, Lowder CY, Meisler DM. Division of Ophthalmology, Cleveland, OH, USA. 5 Prevalence of uveitis in an outpatient juvenile arthritis clinic. Akduman L, Tychsen L, Kaplan HJ, Washington University, St. Louis, MO, USA. 6 The role of choroidal dendritic cells in the pathogenesis of experimental autoimmune uveoretinitis. Choudhury A, Padhye NS, Caspi RR, Bowers WE, University of South Carolina School of Medicine, Columbia, S.C. and The National Eye Institute, Bethesda, MD, USA.     

复方血栓通胶囊联合氪激光治疗糖尿病性视网膜病变的疗效观察

目的观察应用复方血栓通胶囊联合氪激光治疗糖尿病性视网膜病变的疗效。方法对300例 (420只眼)随机分组、对照治疗。根据FFA造影结果分型,行视网膜次全光凝、全光凝。光凝能量、范围及光斑大小视病情而定。治疗组200例(286只眼),光凝后口服复方血栓通胶囊每日3次,每次3片,维生素C 200mg每日3 次,维生素E 100mg每日3次;而对照组100例(286只眼)口服维脑路通300mg每日3次,维生素C 200mg每日3 次,维生素E 100rng每日3次,持续服药一年。治疗前常规检查视力、眼底、FFA及眼压。结果治疗组用药后每隔半月复查视力、眼底。显效56只眼(19．5％),有效182只眼(63．6％),总有效率达83．1％。无效48只眼(16． 9％)。对照组:显效15只眼(15％),有效47只眼(47％),总有效率达62％。无效38只眼(38％)。眼底表现远不如治疗组理想,经卡方检验P<0．05,两组差异有显著性。结论复方血栓通胶囊联合氪激光治疗糖尿病视网膜病变有较好疗效,能改善视力,减少视网膜光凝量,缩短病程,提高疗效。     

放射状角膜切开术后远期角膜内皮细胞的改变

目的 探讨放射状角膜切开术(RK)后远期角膜内皮细胞的损失与变异情况.方法 为病例对照研究.选择1989年1月至1996年12月在首都医科大学附属北京友谊医院眼科行RK并可随访到的51例(101只眼)患者,作为RK组.2006年11月至2007年3月在同院眼科门诊就诊的无其他眼疾的51例(102只眼)近视眼志愿者作为正常对照组.两组患者均由同一检查者使用Topcon SP2000型非接触型角膜内皮显微镜对角膜内皮细胞进行观察,记录中央、上方、下方、颞侧及鼻侧5个方位角膜内皮细胞密度(CD)、细胞平均面积(AVG)、变异系数(CV)及六边形细胞百分比(H%).对计量资料进行数据的正态性榆验与方差齐性榆验.RK组与对照组的各年龄段患眼的数据采用两个独立样本t检验.RK组内数据的比较采用单因素方差分析方法.结果 各年龄段中央、上方、下方、颞侧及鼻侧5个方位,RK组与对照组间CD、AVG、H%的比较差异无统计学意义(P＞0.05).两组间CV的比较差异有统计学意义,两组间30岁～的年龄段中央区比较t=3.742、P=0.000,上方t=3.627、P=0.000,下方t=3.180、P=0.002,鼻侧t=2.448、P=0.016,颞侧t:3.149、P=0.002;两组问40岁～的年龄段中央区比较t=4.446、P=0.000,上方t=2.444、P=0.017,下方t=2.113、P=0.038,鼻侧t=3.214、P=0.002,颞侧t=2.680、P=0.009;两组间50岁～的年龄段中央区比较t=2.360、P=0.024,上方t=2.600、P=0.013,下方t=2.787、P=0.008,鼻侧t=2.144、P=0.038,颞侧t=2.177、P=0.036.但是,RK术后CV与术后时间无相关性(P＞0.05);不同切口数量组问中央、上方、下方、颞侧及鼻侧相应方位CD、AVG、CV、H%的比较差异均无统计学意义(P＞0.05).RK术后远期角膜内皮细胞形态发生了细微的变化,角膜内皮细胞的面积CV增大.结论 RK术后患者行其他内眼手术时,眼科医师应注意对术前角膜内皮情况的评价.     

眼科手术麻醉并发症的预防和处理

眼科手术技术的不断进步和手术器械的不断发展使得眼科手术变碍越来越安全,同时眼科麻醉的方式和选择也发生了相应的改变,但目前仍没有绝对安全的眼科麻醉方法,临床上眼科手术麻醉的并发症仍有发生.眼科手术中麻醉方式的选择主要取决于手术方式、医生的需要、患者的期望及配合程度,大多数眼科手术在局部麻醉下即可完成,但是眼科局部麻醉过程中注射针接近血管、视神经和脑干等重要结构时,可增加相关组织结构损伤的风险,其中最严重的并发症是脑干麻醉,麻醉师和眼科医师应充分认识到这些并发症甚至有危及生命的可能.为了避免麻醉过程中药物意外注射到周围的血管、眼球和脑脊液中而造成神经组织的损伤,需要麻醉师和眼科医师对相关区域的解剖结构进行精确评估,特别是注射部位、深度以及眼球位置的判断.因此,应强调眼科医师提高对眼科手术麻醉并发症,特别是脑干麻醉等严重并发症预防及合理处理的意识.     

A Serious Pain in the Neck

We describe a case of internal carotid artery dissection, an important cause of ischemic cerebrovascular disease. Presentations include a headache, which is usually unilateral to the side of carotid dissection, sharp, nonthrobbing in nature with radiation from the neck. The clinical presentations, investigations, and treatment of the disease are discussed. Drs. Chong, Kodati, Kosmin, Damani, and Werring are with the Department of Ophthalmology, Watford General Hospital, Watford, UK. Dr. Werring is also with the National Hospital for Neurology and Neurosurgery and Stroke Research Group, Institute of Neurology, Queen Square, London WC1N 3BG, UK. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices. The authors report a case of traumatic internal carotid artery dissection and review relevant aspects of presentation, investigation, and treatment.     

Diabetic retinopathy in pregnancy - A review

Diabetes and gestational diabetes (GD) are areas of concern worldwide. GD can eventually lead to serious development of diabetic retinopathy (DR) during pregnancy or worsening of an already existing DR. GD confers future risk of diabetes, both in the mother and fetus, further complicating their lives. DR in pregnant women has been intriguing in terms of understanding the prevalence, assessing risk factors causing pathogenesis, and problems associated with treating them. Pregnancy itself is a risk factor for progression of DR. Physiological changes such as metabolic, vascular, immunologic, and hormonal changes that occur during pregnancy can cause development as well as worsening of DR. This can eventually lead to permanent visual loss if not addressed on time. Timing of laser, choice of treatment for diabetic macular edema with laser, intravitreal anti-vascular endothelial growth factor agents (VEGF), and intravitreal steroids pose a serious challenge in managing these patients without causing damage to the mother and fetus. This review article showcases the prevalence, risk factors, and pathogenesis, outlines the management of DR in pregnancy, and recommends guidelines based on the available evidence. PubMed and MEDLINE searches were performed pertaining to the prevalence of GD in India, DR in pregnancy, risk factors for progression of DR, role of vasoactive mediators in DR, role of angiopoietic factors in DR, hormonal influence of DR, role of growth factors in DR, use of fluorescein and indocyanine green angiography, retinal lasers, anti-VEGF agents, intravitreal steroids, anesthesia, and retinal surgery, all pertaining to pregnancy and guidelines and recommendations for managing DR in pregnancy.     

Nanomedicines for back of the eye drug delivery,gene delivery,and imaging

Treatment and management of diseases of the posterior segment of the eye such as diabetic retinopathy, retinoblastoma, retinitis pigmentosa, and choroidal neovascularization is a challenging task due to the anatomy and physiology of ocular barriers. For instance, traditional routes of drug delivery for therapeutic treatment are hindered by poor intraocular penetration and/or rapid ocular elimination. One possible approach to improve ocular therapy is to employ nanotechnology. Nanomedicines, products of nanotechnology, having at least one dimension in the nanoscale include nanoparticles, micelles, nanotubes, and dendrimers, with and without targeting ligands. Nanomedicines are making a significant impact in the fields of ocular drug delivery, gene delivery, and imaging, the focus of this review. Key applications of nanotechnology discussed in this review include a) bioadhesive nanomedicines; b) functionalized nanomedicines that enhance target recognition and/or cell entry; c) nanomedicines capable of controlled release of the payload; d) nanomedicines capable of enhancing gene transfection and duration of transfection; f) nanomedicines responsive to stimuli including light, heat, ultrasound, electrical signals, pH, and oxidative stress; g) diversely sized and colored nanoparticles for imaging, and h) nanowires for retinal prostheses. Additionally, nanofabricated delivery systems including implants, films, microparticles, and nanoparticles are described. Although the above nanomedicines may be administered by various routes including topical, intravitreal, intravenous, transscleral, suprachoroidal, and subretinal routes, each nanomedicine should be tailored for the disease, drug, and site of administration. In addition to the nature of materials used in nanomedicine design, depending on the site of nanomedicine administration, clearance and toxicity are expected to differ.     

深圳市宝安区街道老年人青光眼的筛查研究

目的探讨街道老年人青光眼的早期筛查方法,提出预防措施。 方法回顾性分析2015年8月至2016年2月于深圳市宝安区松岗人民医院眼科门诊体检及就诊的疑似青光眼的街道老年患者364只眼的临床资料。所有受检者均接受视力、眼压、眼部A型超声及裂隙灯显微镜检查。对检查结果为阳性的受检者继续实施青光眼专项检查,包括24 h眼压、前房角镜、视野、光学相干断层扫描(OCT)及超声生物显微镜(UBM)检查。青光眼诊断的描述及早期检查项目实施的描述采用眼数和百分比,并计算各项专项检查诊断青光眼的敏感度、特异度、准确度、阳性预测值、阴性预测值及Youden指数。各检查项目诊断青光眼的敏感度、特异度、准确度、阳性预测值及阴性预测值的比较采用χ²检验。 结果在364只眼中,开角型青光眼89只眼、闭角型青光眼97只眼、其它眼底疾病27只眼、无法明确诊断31只眼及正常110只眼,分别占比24.4%、26.6%、7.4%、8.5%及30.2%;364只眼共接受青光眼专项检查906次,平均(2.49±1.02)次。各检查项目诊断青光眼的敏感度、特异度、准确度、阳性预测值及阴性预测值差异均有统计学意义(χ²＝66.73,13.41,47.08,11.90,44.20;P<0.05)。24 h眼压检查及OCT检查在老年青光眼专项检查中的敏感度、特异度、准确度、阳性预测值及阴性预测值均高于前房角镜、视野及UBM检查。 结论OCT检查及24 h眼压检查是老年街道人群青光眼筛查理想的专项检查项目,应建立健全街道老年青光眼的三级预防措施,实现预防、早期诊断、治疗青光眼的目的。     

In vitro amoebicidal activity of propolis on Acanthamoeba castellanii.

PURPOSE: The aim of this study was to investigate the in vitro effects of an ethanolic extract of propolis on the growth and adherence of Acanthamoeba castellanii trophozoites and cysts. METHODS: The effect of propolis with concentrations of 8.0, 6.0, 5.0, 4.0, 3.0, and 2.0 mg/mL on the proliferation of A. castellanii trophozoites, and with a concentration of 62.25, 31.25, 15.62, 7.81, 3.90, 1.95, and 0.97 mg/mL on the proliferation of A. castellanii cysts, at 1, 3, 6, 12, 24, 48, and 72 h were examined in vitro. RESULTS: After 1-72 h, incubation in concentrations between 2.0 and 6.0 mg/mL, its effect was amoebistatic; at concentrations of 8.0 mg/mL and higher, its effect was amoebicidal. After 48 h or longer incubation times at 15.62 mg/mL and at higher concentrations, the propolis extract was cysticidal. At concentrations of 1.97 mg/mL or lower, there was no observable effect at any time point. CONCLUSIONS: These findings indicate that ethanolic extract of propolis has amoebicidal, as well as cysticidal, properties for Acanthamoeba trophozoites and cysts. Propolis alone, or in combination with other amoebicidal agents, may be used in clinical practice after further investigations.     

玻璃体切除术联合激光光凝治疗眼内异物伤

目的探讨眼内异物伤应用玻璃体切除术摘出异物联合激光治疗的方法和并发症的防治。方法31例（31眼）眼内异物。其中并发外伤性白内障18例,玻璃体积血10例,严重眼内炎3例,视网膜脱离5例。眼内金属异物25例,非金属异物6例。眼内异物大小1～32mm。异物位于玻璃体腔、视网膜表面、嵌顿于眼球壁或视盘。异物均经玻璃体手术摘出。部分联合角巩膜伤口修补、浑浊晶状体摘出、环扎、气液交换,联合激光光凝、SF6、C3F8、硅油填充或植入人工晶状体。结果异物一次成功摘出30例,1例2次手术摘出。术后并发症有出血、一过性高眼压、白内障和视网膜脱离等。术后视力好转16眼,不变10眼,下降5眼。结论玻璃体切除联合激光治疗眼内异物是一种安全、准确、损伤小、成功率高、并发症少的手术．尤其是及时的应用激光治疗对于防止视网膜脱离的发生具有重要作用。     

Vascular endothelial growth factor in eye disease

Collectively, angiogenic ocular conditions represent the leading cause of irreversible vision loss in developed countries. In the US, for example, retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration are the principal causes of blindness in the infant, working age and elderly populations, respectively. Evidence suggests that vascular endothelial growth factor (VEGF), a 40kDa dimeric glycoprotein, promotes angiogenesis in each of these conditions, making it a highly significant therapeutic target. However, VEGF is pleiotropic, affecting a broad spectrum of endothelial, neuronal and glial behaviors, and confounding the validity of anti-VEGF strategies, particularly under chronic disease conditions. In fact, among other functions VEGF can influence cell proliferation, cell migration, proteolysis, cell survival and vessel permeability in a wide variety of biological contexts. This article will describe the roles played by VEGF in the pathogenesis of retinopathy of prematurity, diabetic retinopathy and age-related macular degeneration. The potential disadvantages of inhibiting VEGF will be discussed, as will the rationales for targeting other VEGF-related modulators of angiogenesis.     

Cataracts in systemic diseases and syndromes.

In the past year, harmony has developed among diverse areas of research in cataractogenesis. A number of epidemiologic studies have identified new, or strengthened the role of previous, risk factors in the development of cataract. Age, tobacco smoking, alcohol consumption, and inhaled corticosteroids have been implicated. Clinical observation of cataract in diseases such as cystic fibrosis, atopic dermatitis, Alzheimer's disease, and mitochondrial cytopathy have led to hypotheses of formation. The basic science research has, in some cases, given support to the clinical hypotheses, especially with respect to the role of estrogens and protein condensation in cataract as well as other systemic diseases. Although oxidative stress continues to be the leading proposed mechanism of cataractogenesis, genetic mechanisms are gaining increasing popularity. Finally, the results of previously contraindicated surgical management of cataract in the setting of advanced diabetic ocular disease and age-related macular disease are highlighted.     

中外眼科学术期刊中视力的检测和统计方法比较

目的 比较《中华眼科杂志》（简称C刊）和〈美国眼科杂志〉（简称A刊）上发表的临床科研论文中采用的视力检测方法和统计方法的区别.方法 收集2003-2005年C刊和A刊所有涉及视力的临床科研论文全文.记录每篇论文是否说明视力表类型、视力记录法、是否将小数或分数记录法转换为对数记录法、视力的描述性统计、推断性统计方法、是否使用图表描述视力、是否使用表格列出所有患者的视力等方面资料.计算两种期刊中各自采用的各种方法的比例,并进行比较.结果 C刊3年共刊出论著400篇,有132篇（33.0%）涉及视力;A刊共刊出论著616篇,有358篇（58.1%）涉及视力.C刊和A刊各有77.3%和50.8%的论文没有说明使用的视力表类型.C刊中91.7%的论文采用小数记录法,其中2.6%转换为对数记录法,另外有3.8%的论文直接采用对数记录法：而A刊中74.9%的论文采用分数记录法,其中29.4%转换为对数记录法,另外有14.0%的论文直接采用对数记录法.C刊中采用平均值、标准差和中位数的比例分别为8.3%、6.1%和0%,而A刊分别为31.0%、16.8%和14.0%.C刊使用t检验或方差分析的比例只有5.3%,而A刊为19.0%.C刊采用图表描述视力和用表格列出全部患者视力的比例分别为2.3%和6.8%,A刊则分别为14.2%和24.9%.结论 C刊主要是采用小数记录法,而A刊除了采用分数记录法外,也有相当部分采用对数记录法,或者将分数记录法转换为对数记录法;A刊的论文更多采用平均值、标准差、中位数、t检验、方差分析等统计学分析方法,更多使用图表描述视力和使用表格列出所有患者视力资料.     

Visual outcome and prognostic factors after vitrectomy for posterior segment foreign bodies

PURPOSE: To identify the prognostic factors that predict final visual outcome in eyes with posterior segment intraocular foreign body (IOFB) injuries managed by primary pars plana vitrectomy. METHODS: Ninety-six consecutive patients with posterior segment IOFB injuries were retrospectively reviewed. Factors analyzed included initial visual acuity (VA), time between injury and presentation, site of entrance wound, uveal prolapse, vitreous prolapse, traumatized iris, endophthalmitis, location and size of IOFB, use of scleral buckling and/or an encircling band, gas tamponade, lensectomy, number of surgical procedures, and development of retinal detachment. Data were analyzed using univariate and multivariate logistic regression analysis. RESULTS: After a mean follow-up of 8.6 months, 63 eyes (65.6%) achieved VA of 20/200 or better, and 9 eyes (9.4%) had total retinal detachment complicated by inoperable proliferative vitreoretinopathy. On univariate analysis, predictors of poor vision (hand movements or less) were poor initial VA, corneoscleral entrance wound, uveal prolapse, vitreous prolapse, traumatized iris, and development of retinal detachment. In contrast, predictors of good visual outcome (20/200 or better) were absence of uveal prolapse, no endophthalmitis, and no retinal detachment. Multivariate analysis identified corneoscleral entrance wound, uveal prolapse, and development of retinal detachment as the only factors significantly associated with poor visual outcome. Absence of uveal prolapse was the only factor significantly associated with good visual outcome. CONCLUSIONS: Final visual outcome is greatly determined by the severity of the primary injury. On multivariate analysis, significant predictive factors of final VA were corneoscleral entrance wound, presence or absence of uveal prolapse, and development of retinal detachment.     

The study of prevalence of neutralization antibody against human adenovirus in ophthalmological medical workers

PURPOSE: We studied the prevalence of neutralization antibodies against human adenovirus (hADV) in ophthalmological medical workers as one measure for the prevention of nosocomial infection. METHODS: The prevalence of neutralization antibodies against hADV-3, -4, -7, -8, -11, -19, and -37, which can cause conjunctivitis, was measured in 288 workers at ten ophthamological facilities in Japan. We studied the prevalence in different facilities, different generations, different types of workers (doctors, nurses, and others), and their medical history of hADV conjunctivitis. RESULTS: Among the workers, the prevalence of neutralization antibodies against hADV-3, -4, -7, -8, -11, -19, and -37 was 70.1%, 43.8%, 18.8%, 16.3%, 16.3%, 8.7%, and 6.3%, respectively. The prevalence of neutralization antibodies against hADV-8 was two times higher in doctors than in other workers. People who have a history of hADV conjunctivitis have a high prevalence of neutralization antibodies against hADV-8, -19, and-37. CONCLUSIONS: The prevalence of neutralization antibodies against hADV-8, -19, and-37 was low in the ophthalmological medical workers. These seroepidemiological data indicate the high possibility of an epidemic of conjunctivitis and occurrence of nosocomial infection caused by these serotypes.     

青光眼引流装置植入术在治疗难治性青光眼中的作用

难治性青光眼是主要的致盲眼病之一,目前青光眼引流装置植入术已成为治疗难治性青光眼的主要方法,因其具有安全、有效、并发症较少等优点,青光眼引流装置在临床已得到广泛应用.通过近几年大量临床应用与青光眼微创手术的创新发展,青光眼引流装置植入术展现出良好的治疗前景.本文总结分析了青光眼外引流装置(Molteno、Schocket、Baerveldt、国产HAD房水引流物、Krupin、Ahmed、Joseph、Whites、Optimed房水引流物)及青光眼微创手术(Ex-PRESS青光眼引流器、Xen凝胶支架、CyPass微型支架、小梁消融术、Schlemm管支架、iStent引流器、SOLX Gold Shunt等)的结构特点和临床疗效,就青光眼引流装置植入术在治疗难治性青光眼中的作用进行综述.     

Differential effects of excitatory amino acids on photoreceptors of the chick retina: an electron-microscopical study using the zinc-iodide-osmium technique

Although excitotoxins derived from acidic amino acids are known to damage neurons in the inner nuclear and ganglion cell layers of the retina, little is known about their effects on photoreceptors. This study examines the acute and long-term effects of excitotoxins on photoreceptors of the chick retina. The zinc-iodide-osmium (ZIO) technique, which darkly labels a substantial subpopulation of synaptic vesicles in normal photoreceptor terminals, was used to supplement routine electron microscopy. Two-day-old chicks received a single intraocular injection of either 10, 50, or 200 nmoles kainic acid (KA), 200 nmoles N-methyl-D-aspartic acid (NMDA), or 200 nmoles quisqualic acid (QUIS), and were allowed to survive for either 6 h, 7 d, or 21 d. At 6 h, following exposure to 10, 50, and 200 nmoles KA, there was swelling and disruption of photoreceptor lamellae of the outer segments. At 7- and 21-d survival, 50 and 200 nmoles KA resulted in rounded, condensed synaptic terminals, which contained a high density of synaptic vesicles. However, there was complete loss of ZIO-positive vesicles within these photoreceptors. Outer segments were still disrupted, although small patches of lamellae were evident, suggestive of regeneration. Following exposure to QUIS, there was extensive swelling of outer segment lamellae at 6 h survival. Synaptic ribbons in terminals were also swollen. At longer survival periods, QUIS exposure resulted in a reduction of ZIO-positive vesicles, as well as swollen lamellae in outer segments. NMDA exposure, at either short or long-term survival, did not alter photoreceptor morphology, including the pattern of ZIO stain. The prolonged effects of KA, and to a lesser extent QUIS, on photoreceptors suggests that these drugs have a long-term effect on photoreceptor function. The ZIO technique provides a novel and potentially useful approach for identification of damaged photoreceptors.     

先天性白内障一家系晶状体蛋白突变基因筛查

目的对先天性白内障一家系进行晶状体蛋白致病基因的初步筛查。方法通过聚合酶链反应（PCR）对先天性白内障一家系中4代8例患者进行CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD6个候选基因的外显子及内含子扩增,扩增产物进行直接测序,测序结果与GeneBank中原始序列进行BLAST比对分析。结果该家系每代均有先天性白内障患者,遗传方式为常染色体显性遗传。该家系的CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD6个晶状体蛋白候选基因的外显子及其邻近的内含子与基因库对照未发现任何突变。结论CRYAA、CRYAB、CRYA1／A3、CRYBB2、CRYGC和CRYGD为该先天性白内障家系的非致病基因。     

Primary care and ophthalmology in the United Kingdom

The National Health Service is now primary care led. There are different definitions for primary care and in this review they are analysed and related to ophthalmology to produce a working definition for ophthalmic primary care, summarised as the provision of first contact care for all ophthalmic conditions and follow up, preventive, and rehabilitative care of selected ophthalmic conditions, in a variety of settings, by a diverse workforce. The attributes of primary care are first contact, accessibility, continuity, longitudinality, comprehensiveness, coordination, equity, and accountability. The delivery of ophthalmic primary care should be governed by these and evaluated accordingly. The clinical content of primary care consists of the first presentation of disease, the management of minor illness and trauma, the recurrence of disease, the follow up and support of some chronic conditions, and the delivery of preventive health care. Planning for ophthalmic primary care needs to take service requirements of these categories of disease into account. Primary care research is abundant in ophthalmology but needs to be more structured and targeted. Ophthalmic primary care itself is urgently in need of recognition and formal adoption by the profession.