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The Ophthalmologist Is Still Difficult to Clearly Distinguish for the Public

The Ophthalmologist Is Still Difficult to Clearly Distinguish for the Public As a uveitis specialist, I read with great interest the correspondence by Dr Papalkar and Francis1in reference to an earlier ARCHIVES article.2A situation has arisen wherein patients are referred to rheumatologists without a comprehensive ophthalmology evaluation for presumed uveitis. I had recently evaluated a patient with severe bilateral neurosarcoidosis. She was managed entirely by an optometrist and rheumatologist despite a steady decrease in visual acuity. While it is indeed true that all eye professionals indeed have a role, the extent of this patient's disease3clearly was outside the scope of this individual's qualifications and experience.4Notably, the comprehensive ophthalmologist was entirely “out of the loop.” Yet another common practice in the mall is ubiquitous fundus pictures of patients. Such a “screened” patient subsequently happened to have acute retinal necrosis diagnosed. The Academy of Ophthalmology, the American Medical Society, and the American College of Rheumatology (in this case) should promote ethical consultation guidelines for the management of these complicated referrals. The Academy of Ophthalmology must do more to disseminate of the merits of a comprehensive evaluation by an ophthalmologist for all ocular conditions by advertising on media such as local television channels. They should clearly spell out the need for the evaluation by a physician. It will usually be the indigenous poor who suffer these unfortunate situations—one would imagine that the more educated or wealthier patient will see the best specialist in town. Mall-based therapy is booming; it must be controlled and managed to protect patient interests. Correspondence: Dr Kurup, 372 Winding Wolf Pl, Suite 206, Shelby, TN 38120 (skk100@pol.net). Financial Disclosure: None reported. References 1. Papalkar DFrancis IC The ophthalmologist or the optometrist as surgeon. Arch Ophthalmol 2006;124604PubMedGoogle ScholarCrossref 2. Hazel WA Oklahoma's optometrists encroach on surgical rights of ophthalmologists; place politics above patient safety. Arch Ophthalmol 2005;123559- 560PubMedGoogle ScholarCrossref 3. Edelsten CPearson AJoynes EStanford MRGraham EM The ocular and systemic prognosis of patients presenting with sarcoid uveitis. Eye 1999;13748- 753PubMedGoogle ScholarCrossref 4. Kurup SKChan CC Immunotherapeutic approaches in ocular inflammatory diseases. Arch Immunol Ther Exp (Warsz) 2005;53484- 496PubMedGoogle Scholar http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

The Ophthalmologist Is Still Difficult to Clearly Distinguish for the Public

Kurup, Shree K.
Archives of Ophthalmology , Volume 124 (11) – Nov 1, 2006
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The Ophthalmologist Is Still Difficult to Clearly Distinguish for the Public

Abstract

As a uveitis specialist, I read with great interest the correspondence by Dr Papalkar and Francis1in reference to an earlier ARCHIVES article.2A situation has arisen wherein patients are referred to rheumatologists without a comprehensive ophthalmology evaluation for presumed uveitis. I had recently evaluated a patient with severe bilateral neurosarcoidosis. She was managed entirely by an optometrist and rheumatologist despite a steady decrease in visual acuity. While it is indeed true that...
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References (5)

Publisher
American Medical Association
Copyright
Copyright © 2006 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.124.11.1669-b
Publisher site
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Abstract

As a uveitis specialist, I read with great interest the correspondence by Dr Papalkar and Francis1in reference to an earlier ARCHIVES article.2A situation has arisen wherein patients are referred to rheumatologists without a comprehensive ophthalmology evaluation for presumed uveitis. I had recently evaluated a patient with severe bilateral neurosarcoidosis. She was managed entirely by an optometrist and rheumatologist despite a steady decrease in visual acuity. While it is indeed true that all eye professionals indeed have a role, the extent of this patient's disease3clearly was outside the scope of this individual's qualifications and experience.4Notably, the comprehensive ophthalmologist was entirely “out of the loop.” Yet another common practice in the mall is ubiquitous fundus pictures of patients. Such a “screened” patient subsequently happened to have acute retinal necrosis diagnosed. The Academy of Ophthalmology, the American Medical Society, and the American College of Rheumatology (in this case) should promote ethical consultation guidelines for the management of these complicated referrals. The Academy of Ophthalmology must do more to disseminate of the merits of a comprehensive evaluation by an ophthalmologist for all ocular conditions by advertising on media such as local television channels. They should clearly spell out the need for the evaluation by a physician. It will usually be the indigenous poor who suffer these unfortunate situations—one would imagine that the more educated or wealthier patient will see the best specialist in town. Mall-based therapy is booming; it must be controlled and managed to protect patient interests. Correspondence: Dr Kurup, 372 Winding Wolf Pl, Suite 206, Shelby, TN 38120 (skk100@pol.net). Financial Disclosure: None reported. References 1. Papalkar DFrancis IC The ophthalmologist or the optometrist as surgeon. Arch Ophthalmol 2006;124604PubMedGoogle ScholarCrossref 2. Hazel WA Oklahoma's optometrists encroach on surgical rights of ophthalmologists; place politics above patient safety. Arch Ophthalmol 2005;123559- 560PubMedGoogle ScholarCrossref 3. Edelsten CPearson AJoynes EStanford MRGraham EM The ocular and systemic prognosis of patients presenting with sarcoid uveitis. Eye 1999;13748- 753PubMedGoogle ScholarCrossref 4. Kurup SKChan CC Immunotherapeutic approaches in ocular inflammatory diseases. Arch Immunol Ther Exp (Warsz) 2005;53484- 496PubMedGoogle Scholar

Journal

Archives of Ophthalmology – American Medical Association

Published: Nov 1, 2006

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