Other Medicine and Health Sciences Commons^™

It's How You Ask The Question....., Paul Freeman Od

Optometric Clinical Practice

Letter from the Editor

A Phenomenological Inquiry Into Healthcare Professionals Who Are Experts In Cannabinoid Therapy And The Endocannabinoid System (Ecs), Courtney Collins

Electronic Theses and Dissertations

Cannabis is a prevalent alternative treatment for many symptoms and conditions given its medicinal qualities and few side effects. As legalization for both medical and recreational purposes continue to develop quickly across the United States of America, there is serious discrepancy between legalization and clinical research. Clinical data is difficult since the U.S. federal government still classifies cannabis as a Drug Enforcement Agency (DEA) Schedule I drug with no clearly established medical value. This lag in evidence-base data has affected cannabinoid therapy and endocannabinoid system education (ECS) for healthcare professionals. There are gaps in medical school and continuing medical education …

Allied Health Faculty Members’ Perspective On Interprofessional Collaborative Practice: A Hermeneutic Phenomenological Study, Prajakta Khare-Ranade, Margaret Newsham Beckley, Mary Geders Falcetti

Dissertations

A framework for interprofessional collaborative practice (IPCP) was developed by the World Health Organization (WHO) (WHO, 2010) in response to the need to address the complicated conditions that exist in today’s health systems. Much of the focus of today’s health service delivery is predicated on the social determinants of health (Barzansky et al., 2019), which refer to the environmental conditions associated with where people are born, live, go to school, work, play, age, and worship that have an impact on health, function, quality of life, and risks (Healthy People 2030, n.d.). IPCP is thought to be the only approach effective …

Book Review: The Paradox Of The Immune System: Protection, Chronic Inflammation, Autoimmune Disease, Cancer, And Pandemics, Lourdes A. Fortepiani, Md, Phd

Optometric Clinical Practice

Book Review:

Pandemics, Artificial Intelligence, Optometrists, COVID-19, Immune System Diseases, inflammation

Limitations Of Telemedicine Vs. Face-To-Face Eye Examination In A Patient With New Headaches, Joseph Hallak, Od, Danielle Kalberer, Od

Optometric Clinical Practice

Background: During the emergence and rise of COVID-19, precaution directives and limitations on in-person eye examinations re-routed a significant portion of care to telemedicine and virtual modalities. While these technologies allowed for healthcare communications that otherwise could not occur during such trying times, there are major limitations to these sanctioned applications. This report will present a seemingly benign case that could have easily been re-routed from an in-person examination to a telemedicine version due to the patient’s seemingly “routine” vision complaints.

Case Report: A 50-year-old male patient contacted the eye clinic with a complaint of a minor, new, unexplained headache …

Ocular Manifestations Of Septo-Optic Dysplasia, Rena Cappelli, Od, Tiffany Tucker Christiansen, Od, Danielle Vance Taylor, Od

Optometric Clinical Practice

Background: Septo-optic dysplasia (SOD) is a congenital deformity of the brain which can result in neurologic, systemic, and physical malformation.Due to the proximity of these deformities to the optic chiasm and optic nerves, ocular manifestations are common.

Case Report: A 28-year-old male with a long-standing history of reduced vision presented for a routine eye examination. Upon examination he was found to have an afferent pupillary defect, bilateral optic nerve pallor with corresponding nerve fiber layer thinning by optical coherence tomography. Humphrey visual field testing revealed a bi-temporal visual field defect. Neurological imaging was obtained with a subsequent diagnosis …

Multimodal Imaging Reveals Bilateral Idiopathic Multiple Retinal Pigment Epithelial Detachments: A Case Report, Diana H. Ho, Od, Joseph J. Pizzimenti, Od, Patricia C. Sanchez-Diaz, Dvm, Phd, Stephanie Schmiedecke-Barbieri, Od, Alexandra Zuercher, Od

Optometric Clinical Practice

Background: Retinal pigment epithelial detachment (RPED) is a nonspecific finding that is common in several ocular diseases; however, cases of bilateral idiopathic multiple RPEDs are rare. Less than 50 cases have been reported to date. Bilateral multiple RPEDs are usually idiopathic and benign in nature but can infrequently be associated with various ocular and systemic diseases, including central serous chorioretinopathy (CSC). The potential role of genetic factors in this condition remains elusive. We present a case where multimodal imaging assisted in revealing the diagnosis as well as discuss the potential implications of some of the genetic findings for this …

Acute Syphilitic Posterior Placoid Chorioretinitis; A Case Report And Review, Kristin Wilson, Od, Amy Garbo Maxey, Od

Optometric Clinical Practice

Background: Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is a rare but defining characteristic of ocular syphilis. Clinical findings are subtle, geographic, yellowish, macular lesions, affecting the outer-retina and inner choroid, and often associated with subretinal fluid in the early phase. This case report will review the clinical signs of ASPPC to aid the practitioner in identification and recognition of its clinical importance as it relates to early diagnosis, treatment and prognosis.

Case Report: A 79-year-old African American male presented to clinic with a chief complaint of blur in the right eye for the past two days. Spectral Domain Optical Coherence …

Optic Disc Drusen Resulting In Disqualifying Field Loss, Robert C. Binkley, Od

Optometric Clinical Practice

Background: Optic nerve (or disc) drusen is the presence of hyaline bodies at the optic nerve head. The drusen may be visible upon funduscopic examination or may present as buried. Timely diagnosis and responsible imaging may help inform the patient of the potential for future concerns. The long-term prognosis is good for most patients, however, they may experience progressive peripheral vision loss that may reduce the patient’s quality of life. Neuroprotective options have previously been discussed with minimal clinical effectiveness, however, new medications may aid in future treatment.

Case Report: A patient presenting with mild and slowly progressing vision loss …

You Can Lead A Horse To Water, Paul B. Freeman, Od

Optometric Clinical Practice

Letter from the Editor

Thank You To Our 2021-2022 Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you 2021-2022 Reviewers!

Book Review: Applied Concepts In Vision Therapy 2.0, Paul B. Freeman Od

Optometric Clinical Practice

Press LJ, Taub MB, Schnell PH. Applied Concepts in Vision Therapy 2.0. Santa Ana: Optometric Extension Program; 2022, $159.00, 543 pages, Paperback, ISBN: 9780929780542

Occult Adenocarcinoma Presenting As Presumed Periorbital Cellulitis, Kirk Halvorson Od, Jonathon Thomas Od, Jennifer Prunty Od, Omaya H. Youssef Md, Mba

Optometric Clinical Practice

Background: Orbital tumors are uncommon entities seen by optometrists. They may initially present as common, benign conditions, but if not appropriately diagnosed can lead to devastating results.

Case Report: This case report demonstrates an atypical presentation of adenocarcinoma that was initially diagnosed as preseptal cellulitis. The patient in this case was ultimately referred for imaging and biopsy to reveal the correct diagnosis. Despite treatment, this patient died about 1 year after his clinical presentation.

Conclusion: The detection of orbital tumors and the subsequent management of patients with orbital tumors can be challenging. When considering orbital tumors as a possible diagnosis, …

Diagnosis And Excision Of A Solitary Trichoepithelioma, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Abstract

Background: Solitary trichoepithelioma is a rare benign tumor of hair follicle origin. Although trichoepithelioma has a predilection for the face and neck, it is not usually found on the eyelids. It has similar clinicopathological features to basal cell carcinoma. Surgical excision and histopathologic analysis is helpful for correct diagnosis.

Case Report: A 59-year-old Caucasian female presented with a raised, reddish oval mass on the right lower eyelid. The mass had telangiectatic blood vessels on its surface, was non-pigmented and slightly umbilicated. It was in close approximation of the eyelid margin causing distortion and poor apposition of the lid to …

A Reactivation Of Ocular Toxoplasmosis During Pregnancy, Brett Garee Od, Ms, Sarah Dieter Od, Pete Liette Od

Optometric Clinical Practice

Background: Toxoplasma gondii is a parasite estimated to affect over 500 million people worldwide. The feline is the definitive host for the parasite and infection may be acquired or congenital via maternal transmission. Humans may acquire the infection by ingestion of raw or undercooked meats and vegetables, contaminated water, or exposure to infected cat feces. The infection is often benign, self-limiting, and asymptomatic for humans, but potentially life threatening to infants or the immunocompromised patient.

Case Report: A 22 year-old Caucasian female, pregnant at 12 weeks gestation, presented to the optometry service with acute symptoms of hazy vision …

Just When You Thought It Was Safe To Go Back In The Water, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor

Book Review: The Ophthalmic Laser Handbook, William L. Miller Od, Ms, Phd

Optometric Clinical Practice

Book Review: Freisberg L, Lighthizer N, Skorin, Jr. L, Stonecipher K, and Zimmerman A. The Ophthalmic Laser Handbook. First Edition. Wolters Kluwer Health; 2021. $102.00, 350 pages, Paperback ISBN: 978-1975170172, e-book ISBN: 978-1975170219

Case Report: Bartonella Quintana-Associated Neuroretinitis, Kelly Seidler Od, Kelly A. Malloy Od

Optometric Clinical Practice

Background: Neuroretinitis is a self-limiting condition which typically causes monocular vision loss with good potential for visual recovery. It may be idiopathic or associated with infectious or inflammatory conditions which can carry systemic implications. Neuroretinitis classically presents with disc edema followed by development of a macular star pattern of exudates. It is most commonly attributed to Cat Scratch Disease, or Bartonella henselae infection. However, there have been few published reports of Bartonella quintana associated neuroretinitis.

Case Report: A 60-year-old patient presented with unilateral vision loss preceded by flu-like illness. The patient had exposure to a recently adopted cat. …

Bilateral, Full-Thickness Macular Holes While Undergoing Chemotherapy, Sarah Dieter Od, Brett Garee Od Ms, Susan Zacatelco Od, Julie Henry Od

Optometric Clinical Practice

Background: Bilateral, full-thickness macular holes are a rare condition that can substantially affect quality of life. Macular hole diagnosis and treatment is key for these patients.

Case Report: A 71 year old Caucasian male presented with a chief complaint of distance blur in both eyes, worsening over the past 1-2 weeks. He had no diagnosis of diabetes. He added that his prostate cancer had spread and that his last treatment ended 9 days ago. He was ultimately diagnosed with bilateral, full-thickness macular holes. Referral to a retinal specialist for surgical management yielded good results.

Conclusion: This is …

Cefuroxime-Induced Toxic Maculopathy: A Cataract Co-Management Conundrum, Leonid Skorin Jr., Do, Od, Ms

Optometric Clinical Practice

Background: Cefuroxime-induced toxic maculopathy can occur when an incorrect dilution is injected intracamerally after cataract surgery. This results in a guarded visual prognosis. Cefuroxime-induced toxic maculopathy can also occur sporadically even when the medication dilution is the standard correct dosage. These patients usually recover their vision by the first postoperative week.

Case Report: A 72-year-old Caucasian female developed cefuroxime-induced toxic maculopathy after uneventful cataract surgery. Investigation of the case confirmed that she had a sporadic response to the cefuroxime. It was verified that she received the standard correct dilution of cefuroxime intracamerally. The patient showed a significant improvement in her …

Medication-Induced Oculomotor Dysfunction: A Report Of Two Cases, Eric Lee Od

Optometric Clinical Practice

Background: Consideration of current medications and their interactions as a source of new onset oculomotor dysfunction is imperative for providing good eye care. Medication etiology should be particularly suspected when the symptoms begin with the initiation of a new medication and resolved with discontinuation of the same medication.

Case Reports: Presented are two cases demonstrating that it is prudent to be aware of medications capable of inducing oculomotor dysfunction. Each case reveals instances of acute oculomotor dysfunction after the initiation of a central nervous system affecting medication. Case 1 details a partial pupil sparing third nerve palsy after initiating the …

It’S As Easy As Learning To Fly A Plane, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Thank You Reviewers, Paul B. Freeman Od

Optometric Clinical Practice

Thank you to all the reviewers!

Conjunctival Intraepithelial Neoplasia: A Case Report, Christopher Bugajski Od

Optometric Clinical Practice

Background: Gelatinous, vascularized lesions of the conjunctiva are a subset of ocular surface tumors that are derived from various cell types. The more worrisome origins include diagnoses of conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). Topical treatments such as mitomycin-C, 5-fluorouracil, and interferon alfa-2b are now used as single therapy or in conjunction with surgical excision.

Case Report: This case features a 78-year-old Caucasian male with CIN treated with surgical removal and topical interferon alfa-2b. In addition to discussing the details of this case, this report highlights important caveats of the treatment and management of the …

Choroidal Melanoma: Screening For Metastasis And Frequency Of Incidental Second Primary Cancer Diagnosis., Ethan Leyda Od

Optometric Clinical Practice

Background: Choroidal melanoma is the most common primary intraocular malignancy in adults. This case report reviews clinical diagnostic features, imaging techniques, treatment, prognosis, and systemic work-up of choroidal melanomas. It also addresses choroidal melanoma metastasis and the incidental finding of second primary cancers through whole-body screening.

Case Report: A 71-year-old white male reported to the Cleveland VA Medical Center optometry retina clinic for a second opinion exam of an asymptomatic choroidal lesion in the right eye. The lesion was a 6 mm gray choroidal mass in the inferior peripheral fundus, with orange pigmentation, retinal pigmented epithelial hypertrophy along the superior …

Ocular Characteristics Of Non-Covid-19 Patients: A Retrospective Study Of Time-Sensitive Ophthalmic Care During The Pandemic, Yun-Ping Moore Od, Laura Ward Msph, Farah Gulaid Od, Susan A. Primo Od, Mph

Optometric Clinical Practice

Purpose: To analyze the cohort of clinical patients seen during the COVID-19 pandemic shutdown at Emory Eye Center in comparison with prior weeks.

Method: We conducted a retrospective chart review from three outpatient clinical sites over a period of eighteen weeks, which covered pre-COVID-19 dates as well as the dates of when our clinics were closed near the beginning of the COVID-19 pandemic. We utilized data from providers assigned to daily triage coverage for in-person exams. Primary diagnosis and visit type data were extracted to look for trends and commonalities among urgent or time-sensitive patients.

Results: For the nine weeks …

Dean's View, Timothy Wingert Od

Optometric Clinical Practice

Dean of University of the Incarnate Word-Rosenberg School of Optometry shares insight.

Perfect Storm, Paul B. Freeman Od

Optometric Clinical Practice

Letter from the Editor-in-Chief

Developing A Practical Application Of The Isometric Squat And Surface Electromyography, David Phillips, Angelic Rose Del Vecchio, Kevin Carroll, Evan L. Matthews

Department of Exercise Science and Physical Education Scholarship and Creative Works

Electromyography (EMG) is a research tool used in gait analysis, muscle coordination evaluation, clinical evaluation and sports techniques. Electromyography can provide an insight into neural adaptations, cross education effects, bilateral contraction deficiencies, and antagonist activity in exercise-related movements. While there are clear benefits to using EMG in exercise-related professions, accessibility, cost, and difficulty interpreting the data limit its use in strength and clinical settings. We propose a practical EMG assessment using the isometric squat to identify compensatory activation patterns and report early observations. Ten healthy participants were recruited. Participants performed a 2-min isometric handgrip protocol and an isometric squat protocol. …

Strategies For The Improvement Of Healthcare Through Simulation, Roger Lankheet

Dissertations

Title:Strategies for the improvement of healthcare through simulation

Background: Medical errors continue to plague the healthcare industry. The annual rates of morbidity are approximately 2.69 million (AHRQ, 2019), while mortality rates exceed 400,000 per annum (Makary & Daniel, 2016). There may be no panacea to combat these egregious rates. However, simulation of patient care events may better prepare healthcare professionals to prevent medical errors as it has been proven to be an effective learning strategy (Kirkham, 2018), enhancing skills while gaining experiential knowledge, without risk to actual patients.

Purpose: The purpose of this qualitative study was to gain a …