Robert D. Reinecke

Anterior Segment Ischemia Following Strabismus Surgery

Anterior segment ischemia (ASI) is a potentially blinding complication of extensive eye muscle surgery. Eyes have been described with this complication following surgery on as few as two rectus muscles, especially in patients with thyroid dysfunction or other medical illnesses. In an attempt to assess the risk of ASI, we have reviewed the records of 34 eyes in 26 patients who underwent surgery on three or four rectus muscles. Seven eyes of six patients with thyroid ophthalmopathy which underwent two-or three-muscle surgery were also studied. Evidence of clinically significant ASI was apparent in only one patient during a follow-up period of seven months to eleven years. This case was mild and no visual loss resulted. Our findings suggest that surgery on three or four rectus muscles in healthy patients is probably safe when performed in a staged fashion.

Ocular motility test administration and analysis by computer in strabismus and amblyopia evaluation

Abstract A minicomputer-based hardware and software system is described that servomechanically administers two standard clinical tests for strabismus and fusion—the cover and prism tests—to a subject, records the resulting eye movements, and provides a variety of routines for analysis of these results by means of an interactive graphics terminal. The system is characterized by simplicity of operation, requiring only fixation of a stationary target during testing on the subjects part, and only single keystroke commands on the operators part to either activate the test sequence or call the various graphic-based analysis routines. Eye movement records are segmented by the program into modular test event-related “frames” for ease of manipulation and graphic visualization and analysis, and modularity of the software itself allows convenient modification of or addition to the test sequence or menu of analysis routines. Quantitative specification of eye movement segments of interest includes latency, average velocity, maximum velocity, and maximum acceleration and deceleration.

Vision Information Center: A User-Oriented Data Base A computerized information system offers instruction and retrieval of biomedical literature on the eye

In response to the information needs of scientists and physicians who work in the field of vision, we have developed a direct-access, on-line specialized information retrieval system which combines computer-assisted instruction and bibliographic retrieval. An essential feature of the system is its accessibility via remote computer terminal. The key to the data base is a thesaurus which contains specific terminology arranged in a hierarchical structure. The thesaurus is used both for indexing the literature and for retrieving the information stored in the computer. Courses of instruction on selected subjects in ophthalmology have been programmed and form part of the data base. A search of the literature retrieval system by single subject, or by a combination of several subjects chosen from the thesaurus, retrieves the appropriate bibliographic citations. The response to the service offered by the Vision Information Center indicates that the center should expand its facilities to satisfy the needs of its clients.

Prevalence of eye disease and number of ophthalmologists.

The incidence and prevalence of eye and vision system disorders indicate that the present growth rate of the number of ophthalmologists continues. The number of residency positions in ophthalmology in the United States should remain at about the present number. To assure that those persons having eye disease but not seeking appropriate care are given the opportunity for such care, appropriate guidelines for referral to and from other specialties and health care providers should be established. Suggestions for specific guidelines of referral optometry and ophthalmology are presented. Specific action should be taken by ophthalmology to encourage appropriate groups to implement mass screening methods and public education for eye disease.