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Impressum
About the expenditure of examination in preoperative management in strabism
Jokisch K., Haase W.
Augenklinik des Ak Barmbek, Rübenkamp 148, 22307 Harnburg
Background: For a successful operation an exact examination according
to the kind of strabism is necessary. The frequently forwarded discussion
about cost saving / saving of personal requires a neat documentation that
a minimum of diagnostic efforts has to be done to ensure an efficient
therapy.
Methods: 15 patients prepared for an eye muscle operation were
drawn of the patient pool of the department of strabism Eye. The examinations
that were necessary for the indication of an eye muscle operation in the
concrete cases were registered as weIl as the needed time for each of
the examinations.
Results: The minimum of preoperative expenditure of examination
needed for an eye muscle operation can be devided into three phases according
to time as weIl as to content. Phase I: Months and weeks before the operation:
measurement of objective refraction in mydriasis is at minimum two times
in an interval of three to four months; subjective refraction / correction
of refraction has to be worn at minimum three monts before the operation;
measurement of visual acuity and therapy of amblyopia; detection of morphology;
history of a eyedisorders and general health; description of symptoms;
measuring the deviation near / far and ocular motility; accommodation;
binocular vision; convergence AC/A-ratio; fixation Phase II: Two weeks
before the operation: measurement of visual acuity; fixation; morphology;
binocular vision; objective refraction; measuring the deviation near /
far and ocular motility Phase III: measurement of visual acuity; fixation;
morphology; binocular vision; objective refraction; measuring the deviation
near / far and ocular motility; accommodation; correction with prism.
These three phases are describing a stepwise program. The expenditure
of examination in preoperative management in strabism is dependent on
the kind of strabism, age and ability of cooperation of the patient and
therefore shows variance.
Discussion: A minimum of exact examination according to the kind
of strabism is necessary for an efficient and effective therapy of the
patient. Therefore the quality of the achievements should be emphasized
as an important part of the efficiency.