Notes on Global Ophthalmology

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Article summary goes here. These few pages are simply notes regarding Global Ophthalmology that I hope will induce comments by others.

Contents

Disease Entity

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Notes for Consideration of Global Ophthalmology as A Potential Sub-Specialty of Ophthalmology:


Global ophthalmology constitutes dedicated eye care for the cure or prevention of visual loss in populations across the world. As such, it has many constants that apply to all populations and many variables that relate to the special circumstances of existent eye disorders amid varied degree of human disadvantage. How, where and by whom the eye care is rendered are matters to be separately addressed in each locale, for which there are again many possibilities dependent upon access to patients, availability of trained personnel with necessary equipment, the financial status of the population in question, its government’s roles in health care, and—not least—the availability of effective advocacy to draw attention to and proper answers for unmet needs that require services.

Unlike existing sub-specialties, global ophthalmology has its own type of administrative skills—essentially a culture within ophthalmology that pertains to nonprofit endeavors, financial constraints, and collaborative undertakings. These are essentials for the various vision-related NGOs but are not necessarily familiar turf for ophthalmologists as administrators or project leaderships.

In view of these specificities, their practical resolutions and their importance in worldwide cure and prevention of blindness, global ophthalmology seems to this writer to deserve being “officially” classified as a specialization within medical eye care, thus distinguishing it as a unique sub-discipline of ophthalmology—just as retinal-vitreous surgery, glaucoma, optics and refraction, ocular pathology, anterior segment surgery, neuro-ophthalmology, etc, etc. are considered specific sub-specialties.

Establishing global ophthalmology as an official sub-specialty would:

• Encourage volunteer, part-time and fulltime colleagues to enter this field
• Provide Public Health with an identity within Ophthalmology
• Aid in the development of curriculum and standards assessments, distinguishing these colleagues from non-medical practitioners
• Favor financial support for a legitimized entity
• Supplement the responsibilities and purposes of the International Council of Ophthalmology, not duplicating its activities or authority
• Provide a permanent source of authority for eye care in national or international emergencies
• Update records on world blindness and on-going work for its prevention
• Promote related clinical and basic research
• Source international advocacy for eye care, domestic and foreign
• Facilitate relationships and collaborations with INGOs, governmental organizations and foreign ophthalmic societies; increase the availability of well qualified colleagues in those organizations

As an off-shoot of residency training, global ophthalmology derives from extensive roots in infectious disease, social psychology, surgical skills, knowledge of emergency care, and the interrelationship of health with vision that is unique to basic ophthalmic training. To some degree, ophthalmology has relinquished its primordial position to others, due to the shortage of colleagues willing and able to direct their careers into the leadership of this field of eye care.


It seems apparent that the organizational ground work for establishing global ophthalmology as an entity within ophthalmology has already been assisted by the development and academic advancement of the International Council of Ophthalmology (ICO). Moreover, there are hundreds if not thousands of American ophthalmologists who frequently or occasionally serve as volunteers abroad, and surely many of them would like to find a special designation in their profile for such activity. The question is whether the various organizations that have a role in designation of sub-specialties consider this of sufficient interest and value to develop into a true sub-specialty to be accepted by the AAO, ABO ABMS, etc. In my opinion, with as much as a decade's work on its curriculum and the education of more colleagues who are prepared to teach its public health and applied ophthalmology basics, in time it will deserve such recognition.In my view that is well worth working toward.  

David Paton




Dr. Bruce E. Spivey’s statement: 

At the time when the newly announced ORBIS fellowship in Global Ophthalmology was introduced at a dinner given by ORBIS International, Inc. in NYC on April 6th, 2011, Dr. Spivey made these remarks:


“With David’s approval I am able to describe a new and nearly full-formed Paton creation/proposal: a new Sub-Specialty in ophthalmology, called Global Ophthalmology. David argues, as he can so persuasively, for the creation of this new ophthalmic subspecialty (there are a number of subspecialties already). Such a specialty would begin as all do—with a fellowship and then develop in practice in a variety of directions based on geography, need, etc. As David sees it—and I do agree —this would not be a Public Health subspecialty in ophthalmology—but would incorporate its tenets. The content of the fellowship—and thus the subspecialty—would include foreign involvement in a developing country, experience working with nongovernmental agencies, specific fundraising capability, acquired skills in team building and organization, and advocacy training as well. The profession will adopt this new subspecialty hesitantly and even reluctantly and with considerable discussion over time which will allow the concept to be strengthened.”

For more about the David Paton Orbis Fellowship in Global Ophthalmology, a new URL is in preparation and should be ready by the time of the AAO meeting in Orlando, Fl: GlobalEyeFellowship.com For more information about the origin of ORBIS and the genesis of Paton’s thoughts on global ophthalmology: SecondSightBook.com


Disease

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Etiology

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Risk Factors

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General Pathology

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Pathophysiology

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Primary prevention

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Diagnosis

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History

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Physical examination

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Signs

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Symptoms

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Clinical diagnosis

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Diagnostic procedures

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Laboratory test

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Differential diagnosis

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Management

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General treatment

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Medical therapy

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Medical follow up

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Surgery

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Surgical follow up

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Complications

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Prognosis

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Additional Resources

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References

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Original article contributed by: User:David Paton, User:MD
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