Identification and Prediction of Clinical Phenotypes in Hospitalized Patients With COVID-19: Machine Learning From Medical Records.

Background: There is significant heterogeneity in disease progression among hospitalized patients with COVID-19. The pathogenesis of SARS-CoV-2 infection is attributed to a complex interplay between virus and host immune response that in some patients unpredictably and rapidly leads to "hyperinflammation" associated with increased risk of mortality. The early identification of patients at risk of progression to hyperinflammation may help inform timely therapeutic decisions and lead to improved outcomes.

Ehlers-Danlos syndromes and their manifestations in the visual system.

Ehlers-Danlos syndrome (EDS) is a rare, genetically variable, heterogenous group of (currently recognized) thirteen connective tissue disorders characterized by skin hyperextensibility, tissue fragility, and generalized joint hypermobility. In addition to these commonly recognized phenotypes, recent studies have notably highlighted variable ophthalmic features in EDS. In this review, we comprehensively gather and discuss the ocular manifestations of EDS and its thirteen subtypes in the clinical setting.

Outcomes and Complications in Patients With Hypermobile Ehlers-Danlos Syndrome Who Have Undergone Laser In Situ Keratomileusis Surgery.

Purpose: The purpose of this study was to determine the safety and outcomes of myopic laser in situ keratomileusis (LASIK) in patients who were secondarily diagnosed with hypermobile Ehlers-Danlos syndrome (EDS).

Methods: We conducted a case series study on patients with hypermobile EDS who underwent myopic LASIK surgery. Visual acuity, manifest refraction, a full dilated eye examination, biometry measurements, and Scheimpflug imaging were performed in the Wilmer outpatient clinic.

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis.

Background: The coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to in-office and surgical procedures in the field of ophthalmology. The magnitude of the impact of the pandemic on surgical training among ophthalmology residents is not known. This study aims to quantify changes in average case logs among United States (U.

From Provider to Advocate: The Complexities of Traumatic Brain Injury Prompt the Evolution of Provider Engagement.

Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for a team approach.

Objective Resident Characteristics Associated with Performance on the Ophthalmic Knowledge Assessment Program Examination.

 To determine objective resident characteristics that correlate with Ophthalmic Knowledge Assessment Program (OKAP) performance, as well as to correlate OKAP performance with Accreditation Council for Graduate Medical Education (ACGME) milestone assessments, written qualifying examination (WQE) scores, and oral board pass rates.  Review of administrative records at an ACGME-accredited ophthalmology residency training program at an urban, tertiary academic medical center.  The study included data from a total of 50 resident physicians who completed training from 2012 to 2018.

Teleophthalmology in the Era of COVID-19: Characteristics of Early Adopters at a Large Academic Institution.

COVID-19 led to rapid policy changes to expand telemedicine adoption. We examined rates of early telemedicine adoption among surgical departments at a large academic institution and compared provider characteristics associated with teleophthalmology. With data from departmental and electronic medical records across surgical departments at Johns Hopkins Medicine, we performed a retrospective analysis using the Fisher test and binomial logistic regression.

Parental Leave Policy for Ophthalmology Residents: Results of a Nationwide Cross-Sectional Study of Program Directors.

Background: Many residents become parents during residency and the adequacy of parental leave is integrally related to resident wellness.

Objective: To understand current parental leave policies in ophthalmology residency programs and program director perceptions of the impact of parental leave on trainees.

Design: Cross-sectional study.

Contact Lens Wear, Corneal Complications, and U.S. Service Member Readiness.

Introduction: Ulcerative keratitis (UK), or corneal ulcer, is a sight-threatening and readiness-lowering medical condition that begins with a corneal infiltrative event (CIE). Contact lens (CL) wear poses a particular risk for a CIE and therefore is restricted for most active duty service members (SMs). In this study, we explored a large Department of Defense/Veterans Affairs (DoD/VA) database to estimate the prevalence of UK and CIE and their association with CL wear.

The Relationship Between Severe Visual Acuity Loss, Traumatic Brain Injuries, and Ocular Injuries in American Service Members From 2001 to 2015.

Introduction: Although traumatic brain injury (TBI) is known to cause many visual problems, the correlation between the extent of severe visual acuity loss (SVAL) and severity of TBI has not been widely explored. In this retrospective analysis, combined information from Department of Defense (DoD)/Veterans Affairs ocular injury and TBI repositories were used to evaluate the relationship between chronic SVAL, TBI, ocular injuries, and associated ocular sequelae for U.S.

The Biomechanics of Indirect Traumatic Optic Neuropathy Using a Computational Head Model With a Biofidelic Orbit.

Indirect traumatic optic neuropathy (ITON) is an injury to the optic nerve due to head trauma and usually results in partial or complete loss of vision. In order to advance a mechanistic understanding of the injury to the optic nerve, we developed a head model with a biofidelic orbit. Head impacts were simulated under controlled conditions of impactor velocity.

Survey of Ehlers-Danlos Patients' ophthalmic surgery experiences.

Background: Ehlers-Danlos Syndrome (EDS) is a rare disease affecting approximately 1 in 5,000 people. Although ophthalmic conditions associated with EDS have been described, little data exist concerning ophthalmic surgical outcomes experienced by EDS patients.

Methods: Patients with EDS were surveyed via the EDS Society and asked about their ophthalmic surgical experiences including procedure, complications, and the timing with respect to receiving the EDS diagnosis.

Underlying Ehlers-Danlos syndrome discovered during neuro-ophthalmic evaluation of concussion patients: a case series.

Background: The Ehlers-Danlos syndromes are a heterogenous group of diseases that cause connective tissue defects. At present, there are no published reports focusing upon the neuro-ophthalmic symptoms that might occur in EDS patients after mild traumatic brain injury. The demographics and clinical course of seven patients with subclinical EDS and mild traumatic brain injury are presented.

Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents.

Background: A balance between autonomy and supervision can be difficult to obtain in medical education. In this study, we sought to determine whether the presence and level of supervision of ophthalmology resident outpatient clinic correlates with metrics of resident success, professionalism and stress.

Methods: A survey was emailed to all US ophthalmology program directors requesting it be forwarded to PGY4 residents.

Resident and program characteristics that impact performance on the Ophthalmic Knowledge Assessment Program (OKAP).

Background: To determine which resident and program characteristics correlate with ophthalmic knowledge, as assessed by resident Ophthalmic Knowledge Assessment Program (OKAP) performance.

Methods: An online survey was sent in June 2017 to all US ophthalmology residents who took the OKAP in April 2017.

Results: The survey response rate was 13.

Cost and Visit Duration of Same-Day Access at an Academic Ophthalmology Department vs Emergency Department.

Importance: Convenient outpatient access for ophthalmology patients seeking urgent care could offer savings compared with an emergency department (ED) visit.

Objective: To evaluate the costs and visit durations of same-day access (SDA) in an ophthalmology department at an academic medical center vs ED care.

Design, Setting, And Participants: This single-center study was a retrospective quality improvement analysis of an institutional electronic medical record system at the Wilmer Eye Institute clinics and the Johns Hopkins Hospital ED.

Cost of Military Eye Injury and Vision Impairment Related to Traumatic Brain Injury: 2001-2017.

Introduction: Annual incidence of eye injury among members of the US armed services is high and can cause vision impairment and blindness. Traumatic brain injury is also associated with visual function. An estimate of the cost of treatment, benefits for those who are disabled, productivity loss for those with reduced vision function, and the cost of replacing and retraining others to take the responsibility of those who are discharged from the military will provide a benchmark to which to compare the cost of new methods to prevent, diagnose, mitigate, treat, and rehabilitate vision loss after injury.

Low Sensitivity of the Van Herick Method for Detecting Gonioscopic Angle Closure Independent of Observer Expertise.

Purpose: To evaluate the diagnostic performance characteristics of the Van Herick assessment (VHA) for identifying angle closure compared to gold-standard gonioscopy, as conducted by trained observers of varying expertise.

Design: Reliability analysis.

Methods: Patients (n = 131) from a glaucoma referral clinic aged ≥50 years without prior ocular surgery or iridotomy underwent unilateral VHA by 1 of 11 trained ophthalmic technicians, followed by VHA and indirect gonioscopy by 1 of 15 ophthalmology residents and 1 of 4 glaucoma specialist attending physicians.

Integration of a Physician Assistant Into an Ophthalmology Consult Service in an Academic Setting.

Purpose: To describe the impact of a physician assistant (PA) in an academic ophthalmology consult service.

Design: Evaluation research.

Methods: A PA was integrated into our ophthalmology consult service to enhance resident education.

Research: Validity of Measurements when Reusing Icare Probes.

Background: It has been reported that reusing Icare tonometer probes may not pose a considerable risk of transmission of infection, thereby supporting this practice under extraordinary circumstances, such as mass glaucoma screenings in developing countries. The present study sought to determine whether reusing the probes reduced the validity of pressure readings.

Methods: Thousands of measurements were made with the same Icare probe on a purpose-built calibration device.

CT in the Evaluation of Acute Injuries of the Anterior Eye Segment.

Objective: Slit-lamp ophthalmologic examination and ocular B-scan sonography of the globe are frequently constrained by technical limitations in the setting of traumatic orbital injury. The main purpose of this study was to evaluate the diagnostic performance of CT in acute anterior segment ocular injuries as an adjunctive diagnostic modality.

Materials And Methods: We retrospectively identified 122 patients who presented to the emergency department from April 2011 through April 2016 with recent direct trauma to the anterior segment of the eye.