External Cervical Resorption: A Review

External cervical resorption (ECR) is the loss of dental hard tissue as a result of odontoclastic action; it usually begins on the cervical region of the root surface of the teeth. The etiology, predisposing factors, diagnosis, and management of ECR are reviewed. Effective management and appropriate treatment can only be carried out if the true nature and exact location of the ECR lesion are known. The role of cone beam computed tomography as a diagnostic adjunct for the management of ECR is also reviewed.     

Remote ophthalmology services: cost comparison of telemedicine and alternative service delivery options

We calculated the cost of an established tele-ophthalmology service, from a health-provider's perspective, and compared this with the cost of three other existing eye-care service delivery options. During a 12-month study period, 118 persons took part in the tele-ophthalmology consultations between a rural clinic located approximately 900 km from the Lions Eye Institute in Perth. The variable costs of tele-ophthalmology were 166.89 dollars(Australian dollars) per patient, and the alternatives cost 445.96 dollars, 271.48 dollars and 665.44 dollars per patient. Tele-ophthalmology incurred a set-up cost of 13,340 dollars. The threshold at which tele-ophthalmology became cheaper than any of the alternative options occurred at a workload of 128 patients. Tele-ophthalmology offers a viable alternative to conventional eye-care service in rural and remote areas.     

Comparison of optic disc image assessment methods when examining serial photographs for glaucomatous progression

AIM: To assess serial, simultaneous stereo optic disc images by four methods for glaucomatous progression. METHODS: Using varying techniques, two ophthalmologists assessed serial optic disc images of 52 eyes from 27 patients with a mean duration between images of 18 months. The neuroretinal rim width was qualitatively assessed by four assessment methods and compared with quantitative rim measurements made using PC based software. RESULTS: The highest sensitivity of 83% was achieved using computerised stereo chronoscopy. CONCLUSION: Stereo chronoscopy improved the detection of subtle optic disc changes when compared with simpler assessment techniques.     

Light and portable novel device for diabetic retinopathy screening

Background: To validate the use of an economical portable multipurpose ophthalmic imaging device, EyeScan (Ophthalmic Imaging System, Sacramento, CA, USA), for diabetic retinopathy screening. Design: Evaluation of a diagnostic device. Participants: One hundred thirty‐six (272 eyes) were recruited from diabetic retinopathy screening clinic of Royal Perth Hospital, Western Australia, Australia. Methods: All patients underwent three‐field (optic disc, macular and temporal view) mydriatic retinal digital still photography captured by EyeScan and FF450 plus (Carl Zeiss Meditec, North America) and were subsequently examined by a senior consultant ophthalmologist using the slit‐lamp biomicroscopy (reference standard). All retinal images were interpreted by a consultant ophthalmologist and a medical officer. Main Outcome Measures: The sensitivity, specificity and kappa statistics of EyeScan and FF450 plus with reference to the slit‐lamp examination findings by a senior consultant ophthalmologist. Results: For detection of any grade of diabetic retinopathy, EyeScan had a sensitivity and specificity of 93 and 98%, respectively (ophthalmologist), and 92 and 95%, respectively (medical officer). In contrast, FF450 plus images had a sensitivity and specificity of 95 and 99%, respectively (ophthalmologist), and 92 and 96%, respectively (medical officer). The overall kappa statistics for diabetic retinopathy grading for EyeScan and FF450 plus were 0.93 and 0.95 for ophthalmologist and 0.88 and 0.90 for medical officer, respectively. Conclusions: Given that the EyeScan requires minimal training to use and has excellent diagnostic accuracy in screening for diabetic retinopathy, it could be potentially utilized by the primary eye care providers to widely screen for diabetic retinopathy in the community.