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Dear Readers,
We thank you very much for your encouragement and support offered. Today this sitenews is reaching 7000 users across 128 countries all over the world. There are currently over 500 products in this website. We are working our best to make this website become the website for management resources in eye care. As we are bringing out each issue of SiteNews featuring a specific eye disease, we take you to a detailed exploration on the various resources available on the topic featured from our website. All these resources make you clearer on the managing issues of the particular topic.

The theme for this issue is Refractive Correction. Taking inspiration from this theme we have decided to focus this issue on management resources related to Refractive Correction. Refractive Services is getting international focus as an area of concern and it includes the broad areas of refractive error correction through spectacles, contact lens or lasik. In this issue for each area we have covered the history, how to set up the clinic and details of dispensing. Websites which provide details on Refractive correction as well as training programmes. The organization we are featuring is American Academy of Optometry.

We look forward to your continuous support of our website as well as recommendation of materials that we can add to this storehouse of management resources in eye care. With your support this resource site will continue to grow and be of relevance!

Happy Reading!

Regards,

Vision 2020 e-resource team
The Issue Features...
Refractive Correction
Vol. 3 No. 5 May 2006
•   Introduction
•   Magnitude
•   Spectacles
   - History
   - Setting Up
   - Dispensing
•   Contact Lens
   - History
   - Setting Up
   - Dispensing
•   Refractive Surgery
•   Websites
•   Training Programs
•   Collaborating Partner

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It is estimated that worldwide, the number of people with refractive error range from about 800 million to 2.3 billion. In developing countries, like India, it is estimated to be the second largest cause of treatable blindness, after cataract. A recent survey shows an increase in the incidence of refractive errors as a cause of social blindness from 12% to 15%. An easily detectable and correctable condition like Refractive Error still remains a significant cause of avoidable visual disability in our world primarily because appropriate methods of refractive correction are not employed. It is a major cause of concern because it can be easily corrected by a simple pair of spectacles which benefits much more than an operated patient of senile cataract in terms of years of good vision enjoyed and in terms of overall personality development.

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Currently, there is inadequate data on the prevalence rates of Refractive Error for very large population groups. Even the premier organizations such as the WHO and Vision 2020 do not have complete data. We have therefore collated the data gathered through various studies done on small groups and presented the same here. One of the main reasons for lack of it is, Refractive errors is grossly under documented as the definition of blindness in terms of best corrected distance visual acuity which refers to the smallest letter the patient is able to read on a Snellens visual acuity chart. Whereas the presenting distance visual acuity the individuals current refractive correction permits assessment of blindness due to refractive errors.

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The current challenge in many developing countries is to provide spectacles, and at affordable price. Spectacles may be readily available in urban areas, but there should be a system to ensure that it is also available for patients living in rural and remote areas. Different strategies such as the following may be employed to ensure accessibility:
  1. Training the personnel in this key area.
  2. An innovative system for spectacle supply and distribution
  3. Delivering low-cost spectacles to communities
  4. Franchise model.
  5. Immediate delivery of spectacles for those in need.
  6. Effective screening assessment.
  7. Optimize the logistics necessary to provide spectacles.
  • History
    Correction of refractive errors using lenses has a long history. The Roman writer Seneca (4BC to 65 AD) used a glass globe of water to peer through and read books. A millennium later, monks are reported to have used segments of glasses spheres to help magnify letters-basically a magnifying glass called a reading stone. Though the Chinese claim to have invented the frame to mount two such glass lenses, the earliest documented picture in Europe is a painting by di Modena in 1352 which shows two lenses with rims joined centrally. The inconvenience of holding such glasses in position was soon won over first by securing the glasses by a tape tucked under the hat (the earlier Chinese way). But it was only in 1718 that a London optician, Edward Scarlet, seems to have put arms on eyeglasses to hold them on the ears. Nosepieces were soon added to lessen the discomfort. These were the ancestors of the present-day frames, made variously of gold, silver, steel, fish bone, horn, wood, leather and now plastics.

    • EVOLUTION OF SPECTACLES
      Abstract:
      This article provides a details sketch about the history and the evolution of spectacles during the early days.

    • SPECTACLES FOR THE MILLIONS ADDRESSING A PRIORITY OF "VISION 2020 - THE RIGHT TO SIGHT"
      Abstract:
      This article reveals the prevalence of refractive errors and the impact of the disorder in the world population. Amongst the various disease control priorities under the Vision 2020 global initiative, the one that cuts across all regions is blindness and vision impairment caused by refractive errors. It also emphasizes the fact that refractive errors can be easily diagnosed, measured and corrected with spectacles.

    • THE ABCS OF OPENING AN MD OPTICAL DISPENSARY
      Abstract:
      This article describes in detail the management and development areas involved in setting up an optical dispensary like marketing research, financial assessment, design and construction.

    • MORE ABCS OF OPENING AN MD OPTICAL DISPENSARY
      Abstract:
      This article talks about the steps involved in the establishment, and maintenance of an optical dispensary. It also lists the methods of maintaining application records and providing effective quality service to the patients.

    • POPULATION-BASED STUDY OF SPECTACLES USE IN SOUTHERN INDIA
      Abstract:
      This article provides the detailed study undertaken to assess the use of spectacles and its demographic associations in a sample representative of the population of the Indian state of Andhra Pradesh. It provides the statistical report of the use of spectacles in the population with refractive error. It also provides the analysis report of the refractive error leading to the visual impairment.


  • Setting up

    By setting up an optical shop we can ensure that our patients do receive the necessary correction and assure that the spectacles received by them are of good quality (the correct power, appropriate lens and frames). Patients have been found willing to pay for this service; it also serves to generate funds which may be used to subsidize other services.



  • Dispensing

    The effort, resources and time required to go through the process of purchasing spectacles which usually takes 4 visits often discourages the individuals from getting their refractive errors corrected. Hence the process and system of how spectacles are dispensed will need to be recognized as a significant factor that influences uptake. In order to address the issues of dispensing, the first step is to integrate refraction and dispensing as a one-stop service through careful planning. By looking at the hospital data and on the basis of experience it is possible to predict the mix of lenses that will be required and the frames that would be preferred. With the inventory of ready lenses and frames the only processing required to dispense a pair of spectacles is edging and fitting the lens in the frame. This can be done very quickly, making it possible to dispense the spectacles within half an hour.


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  • History
    As early as 1845 Sir John Herschel suggested the idea of contact lenses, though he evidently did nothing about it. The practical application of a lens to the eyeball did not occur until late in the century, when F. E. Muller, a German maker of glass eyes, blew a protective lens to place over the eyeball of a man whose lid had been destroyed by cancer. The patient wore the lens until his death, twenty years later, without losing his vision. The term contact lens originated with Dr. A. Eugen Fick, a Swiss physician, who in 1887 published the results of independent experiments with contact lenses. In 1889 August Muller, a German medical student, described his own experimentation with contact lenses. Although his attempts to use ground lenses were not successful, he did help lay the groundwork for further experimentation. In 1892 other doctors and optical firms in Europe cooperated in developing practical contact lenses; before long several firms began specializing in manufacturing them.



  • Setting Up
    Contact lenses are the ideal choice for refractive errors which give better vision correction without any distortions. At the same time proper lens care and regular follow up are essential in maintaining good ocular health. Setting up a contact lens clinic will help patients to a great extent.

    • SETTING UP AN OPTICAL SHOP
      Abstract:
      This article provides in detail about the processing steps involved in setting up an optical shop. It also talks in detail about the process involved in dispensing spectacles , right from the reception to the service delivery. It also touches upon plastic lenses and the human resources needed in the hospital counseling processes and in the community outreach programmes.

    • CONTACT LENS FITTING
      Abstract:
      This article explains in detail about the history, types, advantages, and fitting procedures followed for contact lenses.

    • FREQUENTLY ASKED QUESTIONS ON CONTACT LENS
      Abstract:
      This section deals answers all queries on contact lens usage.


  • Dispensing

    • GIVE YOUR STAFF TOOLS THEY NEED FOR CONTACT LENS DISPENSING
      Abstract:
      This article speaks in detail about how to maintain, handle and utilize the official procedural records like telephone scripts, brochures, patient instruction sheets, order forms and the information provided in them to effectively plan and operate the optical dispensaries.

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Refractive surgery has been responsible for some of the fastest growth in technology and surgery in the field of ophthalmology. Surgical procedures have enabled millions of people to free themselves from glasses and contact lenses. Refractive surgery is rapidly developing newer, safer, and more precise equipment and techniques, and patients now have many options.
  • REFRACTIVE MANAGEMENT
    Abstract:
    This link has seven modules on Refractive surgery. The first module describes the various surgical options available and in development for the correction of myopia and myopic astigmatism. Laser surgeries, incisional surgeries, intrastromal ring segments, phakic intraocular lenses, and refractive lensectomy are discussed, as is bioptics, an increasingly popular procedure that combines more than one refractive surgical modality. Surgical techniques for treating mixed astigmatism are also discussed.

    The second and third modules describe the surgical procedures available and in development for hyperopia and hyperopic astigmatism and for presbyopia. The fourth module discusses the diagnostic tools used in refractive surgery, including refraction, corneal topography, pachymetry, pupillometry, and wavefront technology.

    The fifth module analyzes the demographics of current and potential refractive surgery patients. As this surgery is elective and a potential source of significant revenue, surgeons have begun advertising their services-a practice heretofore almost unknown in medicine. Knowledge of market trends in refractive surgery has contributed to the understanding of the economics of this field.

    The final module addresses the viable alternatives to refractive surgery: spectacles and contact lenses. Orthokeratology is also addressed.

  • TRENDS IN LASER REFRACTIVE SURGERY IN THE UK 2005

  • LASIK
    Abstract:
    This brochure details the process involved in Lasik surgery - the refractive surgery, the minimal side effects and other steps to be followed.

  • LASIK LASER
    Abstract:
    This brochure briefly explains the use of Lasik to get rid of glasses, the equipment used for it, and the procedures adopted, and also the goals and purpose of Lasik surgery.

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American Academy of Ophthalmology :

Founded in 1922, the goal of the American Academy of Optometry is to maintain and enhance excellence in optometric practice. It does this by fostering research and the dissemination of knowledge in both basic and applied vision science. Since its founding, the Academy's success in achieving this objective has moved the Academy to the forefront of American and international optometry and made fellowship in the Academy a significant and cherished achievement.

Academy Fellows represent all facets of the profession. Approximately 48 percent are optometrists in private practice, 15 percent are optometric educators, 11 percent are optometrists in federal or other government service, 10 percent are optometrists in multidisciplinary settings, eight percent are retired, four percent are vision scientists and another four percent work in a variety of other settings. Thirteen percent reside outside the United States.