Building a Culture of Safety in Ophthalmology.

Patient safety focused on a reduction in both procedural and diagnostic error is the number one concern of the United States healthcare system in the 21st century. The American Board of Ophthalmology has a longstanding interest in patient safety, and in 2015, teamed with the American Academy of Ophthalmology to convene all ophthalmology subspecialties and other prominent national organizations to address patient safety in ophthalmology. This article reviews the topic and highlights concerns for ophthalmologists.

Depression care management: impact of implementation on health system costs.

This study examined the mental health care costs associated with implementation of a collaborative care management (CCM) of treatment for depression in primary care. A retrospective review of all costs was performed over a 2-year period associated with providing care to adult patients at clinical sites with CCM versus those with usual care, comparing total and mental health per member per month (PMPM) costs for 2008 and 2009 (patient population = 103,000). The mental health-PMPM costs as a percentage of total health care costs at the clinic without CCM were 4.

Intravitreal alemtuzumab penetrates full-thickness retina in rabbit eyes.

Purpose: The purpose of this study was to assess whether alemtuzamab, a large antibody of 150 kDa, would be able to penetrate through the full-thickness retina of Dutch-belted rabbits.

Methods: Four Dutch-belted rabbits had intravitreal injections of alemtuzumab (1.5 mg in 0.

Validity of overall self-rated health as an outcome measure in small samples: a pilot study involving a case series.

Objective: A single-item measure of overall self-rated health (SRH) commonly is used in population surveys, but has not been used in small pilot projects. The purpose of this study was to assess the validity of SRH in small samples.

Design: We used data from a prospective, observational weight-loss project to compare change in SRH with change in body weight and physical activity (PA) (minutes) over 30 days (n = 34).

HIPAA costs and patient perceptions privacy safeguards Mayo Clinic.

Background: A study was conducted to assess the costs of implementation of the Health Insurance Portability and Accountability Act (HIPAA) and to report patient awareness of Notices of Privacy Practices (NPP) content and HIPAA privacy protections.

Methods: All HIPAA start-up and implementation costs were collected prospectively. A random sample of 2,000 patients receiving services at the Mayo Clinic after HIPAA implementation (April 14, 2003) was surveyed about HIPAA knowledge, HIPAA content, and privacy concerns.

Pars planitis: a 20-year study of incidence, clinical features, and outcomes.

Purpose: To measure the incidence of pars planitis in a community-based population and to report clinical features, complications, and visual prognosis.

Design: Population-based, retrospective, 20-year cohort study.

Methods: Multicenter study using the Rochester Epidemiology Project medical records linkage system, which allows analysis of almost all patients within Olmsted County, Minnesota, with a given medical condition.

Effects of glaucoma medications on corneal endothelium, keratocytes, and subbasal nerves among participants in the ocular hypertension treatment study.

Purpose: To compare subbasal corneal nerve and keratocyte density and endothelial characteristics of ocular hypertensive patients treated with medications or observation.

Methods: Participants in the Ocular Hypertensive Treatment Study (OHTS) randomized at Mayo Clinic to medication or observation were evaluated with specular microscopy annually for 6 years. Confocal microscopy was performed 78 to 108 months after enrollment.

Changes in corneal thickness in patients with treated and untreated ocular hypertension.

Purpose: The elevated intraocular pressure (IOP) in eyes with ocular hypertension is often accompanied by increased corneal thickness. We tested the hypotheses that chronically elevated IOP causes a slow increase in corneal thickness and that lowering the IOP reverses this slow increase.

Methods: Fifty patients with ocular hypertension were randomized to medication and observation groups in the Mayo Clinic site of the Ocular Hypertension Treatment Study.

Topical ocular hypotensive medication and lens opacification: evidence from the ocular hypertension treatment study.

Purpose: To determine whether topical ocular hypotensive medication is associated with refractive changes, visual symptoms, decreased visual function, or increased lens opacification.

Design: Multi-center clinical trial.

Methods: We compared the medication and observation groups of the Ocular Hypertension Treatment Study (OHTS) during 6.

Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature.

Background: Juvenile rheumatoid arthritis (JRA) is the most common systemic cause of pediatric uveitis in Europe and North America. Uveitis is commonly perceived as a frequent sequela of JRA and JRA-associated uveitis is commonly considered to have a complicated course with frequent adverse visual outcomes.

Methods: We performed a systematic literature search for series of consecutive patients with JRA (as defined by the American College of Rheumatology criteria) reporting on the frequency of uveitis and/or complications of uveitis, published between January 1980 and December 2004.

Ocular manifestations of juvenile rheumatoid arthritis in Olmsted County, Minnesota: a population-based study.

Background: Juvenile rheumatoid arthritis (JRA) is the most common systemic cause of uveitis in Europe and North America. The cumulative incidence of uveitis in JRA has been reported at between 8.5% and 25% in series from referral centers in the USA.

Effect of ibopamine on aqueous humor production in normotensive humans.

Purpose: Ibopamine is a prodrug of epinine (deoxyepinephrine) that exhibits activity at dopaminergic and adrenergic receptors. Topical ocular application has been shown to cause mydriasis without cycloplegia and to increase the rate of aqueous humor flow in normotensive human eyes. Mydriasis can interfere with the measurement of aqueous flow.

Iris and anterior chamber involvement in acute lymphoblastic leukemia.

The authors describe a 6-year-old child, with a history of acute lymphoblastic leukemia, who presented with leukemic infiltration of the anterior segment of one eye mimicking anterior uveitis. After tissue diagnosis, administration of radiation therapy to the affected eye resulted in dramatic improvement of the condition. Involvement of the iris and anterior chamber is a recognized but unusual manifestation of leukemia.

Perioperative visual changes.

Background: The goal of this project was to describe the frequency and natural history of perioperative changes in vision.

Methods: The authors performed a prospective evaluation of changes in visual accommodation and acuity in adult patients undergoing various surgical procedures. Patients were evaluated preoperatively and at 1 and 3 days postoperatively.