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Questionable Medical Terms In Ophthalmology

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Questionable Medical Terms In Ophthalmology - Shall we pass on to next generation.

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Questionable Medical Terms In Ophthalmology

  1. 1. Questionable Medical Terms in Ophthalmology – Our study- Suggested improvement
  2. 2. Concept <ul><li>Study of ophthalmic grumblings </li></ul><ul><li>- Off the dias </li></ul><ul><li>Scientific speak-out </li></ul><ul><li>On the dias </li></ul>
  3. 3. Appeal <ul><li>Presentation of this paper, is neither of criticism nor of intention of leg-pulling exercise to anybody </li></ul><ul><li>- Authors </li></ul>
  4. 4. Present Need <ul><li>Warrant of Attention </li></ul><ul><li>More than 100 years ago : Retinoscopy , syringing, R.D, ICCE </li></ul><ul><li>40 years ago : ECCE </li></ul><ul><li>28 years ago : Phaco emulsification </li></ul><ul><li>10 years ago : Sics </li></ul><ul><li>8 years ago : Manual phaco, Nonphaco </li></ul><ul><li>5 years ago : CVS </li></ul>
  5. 5. Aim <ul><li>Free ophthalmic literature from non-precise scientific terms throughout the world </li></ul>
  6. 6. Materials & Methods September 01 to July '02 <ul><li>394 eye specialists at and around Hyderabad </li></ul><ul><li>Guest speakers from Mumbai, Delhi, Chennai, Bangalore, UK & USA </li></ul><ul><li>Analytical study in conveyance of the meaning in dictionaries, books, journals </li></ul><ul><li>E-mails </li></ul><ul><li>Letters </li></ul><ul><li>Telephonic discussions </li></ul>
  7. 7. Habituated use of literature <ul><li>Above 55 </li></ul><ul><li>Retired prof-------52 </li></ul><ul><li>Senior prof--------25 </li></ul><ul><li>Senior practioners-110 </li></ul><ul><li>Total-187 </li></ul><ul><li>Below 55 </li></ul><ul><li>Asst.prof-----------50 </li></ul><ul><li>Registrars---------10 </li></ul><ul><li>Senior residents-28 </li></ul><ul><li>Residents---------12 </li></ul><ul><li>Post-graduates—32 </li></ul><ul><li>Practitioners-------75 </li></ul><ul><li>Total---------------207 </li></ul>
  8. 8. Stetho-Scope (Laennac) <ul><li>Steth: G.algos: Chest </li></ul><ul><li>G. Skopeo: to view </li></ul><ul><li>Douglas M. Anderson Donald illustrated medical dictionary - 28th ed. 1994: 1579 </li></ul><ul><li>Majory spraycon Stedman's medical dictionary - 26th ed. 1995-1677 </li></ul><ul><li>Stethophone </li></ul>
  9. 9. Retinoscopy <ul><li>Retina - scopie: view </li></ul><ul><li>Are we viewing the retina ? </li></ul><ul><li>Pupilloscopy </li></ul><ul><li>Shadow test </li></ul><ul><li>Macdonald critchley, Butterworthi Medical dictionary 2nd ed, 1989: 1468 </li></ul>
  10. 10. Syringing <ul><li>VL test (Voie lacrimal = Route lacrimal) (In French) </li></ul><ul><li>Lacrimal patency test </li></ul>
  11. 11. Retinal Detachment (R.D.) <ul><li>Is this the era of using 'misnomer' scientific terminology ? </li></ul><ul><li>Macdonald critchley, In Butterworth's Medical dictionary 2nd edition 1989:1466 </li></ul><ul><li>RPE is not part of retina </li></ul><ul><li>Sensory retina separation (SRS) </li></ul>
  12. 13. Intra-Capsular cataract extraction (ICCE) <ul><li>Macdonald critchley, Butterworth's Medical Dictionary 2nd ed. 1989:635 expresses: &quot;Within the capsule cataract extraction“ </li></ul><ul><li>Instead, WCCE = With capsule cataract extraction </li></ul><ul><li>Or TCE = Total cataract extraction </li></ul><ul><li>Or Catarectomy </li></ul>
  13. 14. Extra-capsular cataract extraction (ECCE) <ul><li>Expresses &quot;Outside the capsule cataract extraction&quot; </li></ul><ul><li>RPCCE : Retained posterior capsule cataract extraction </li></ul><ul><li>Whenever ECCE fails, people are habituated in calling ICCE </li></ul><ul><li>CEPCB : Cataract extraction with posterior capsule break </li></ul>
  14. 15. Phaco Emulsification (Kelman) <ul><li>Majory spraycon, Stedman's Medical dictionary 26th ed, 1995:1338 </li></ul><ul><li>Douglas M Anderson: Donald's illustrated medical dictionary 28th ed, 1994:1270 </li></ul><ul><li>Macdonald critchley, Butterworth's Medical dictionary 2nd ed, 1989-1289 </li></ul><ul><li>Gr. Phakos: Crystalline lens </li></ul><ul><li>L. Emilgere: to mix out </li></ul><ul><li>Are we doing crystallin lens emulsification ? </li></ul>
  15. 16. <ul><li>If phaco expresses cataract, are we allowed to call mature phaco or immature phaco? </li></ul><ul><li>Many doctors express on the stage phaco for communication of emulsification. Is this precise ? </li></ul><ul><li>CE Cataract emulsification </li></ul><ul><li>Posterior capsule is intentionally not emulsified, Are we calling partial phaco emulsification ? </li></ul>
  16. 17. Small Incision Cataract Surgery (SICS) <ul><li>Sufficient sized incision is bound to undergo to remove the nucleus and implant the IOL </li></ul><ul><li>How can we call &quot;small&quot; when we are bound to do the optimum incision to facilitate the nucleus and the IOL to go out and to go in ? </li></ul><ul><li>Is there any big incision ? </li></ul><ul><li>&quot;Small&quot; the word is a relative </li></ul><ul><li>- Tunnel incision cataract surgery (TICS) </li></ul>
  17. 18. Non-phaco Sics <ul><li>People mean non-phaco emulsification Sics </li></ul><ul><li>The word 'Non phaco Sics' expresses nonlenticular cataract surgery </li></ul><ul><li>The word 'phaco' is being used sometimes for lens and some other times for emulsification </li></ul><ul><li>For naming, is the word non ICCE non phaco Sics' good ? </li></ul><ul><li>Non emulsification Tics (NETICS) </li></ul>
  18. 19. Manual cataract surgery <ul><li>People mean 'Non-phaco cataract surgery' </li></ul><ul><li>Are we not using instrumentation ? </li></ul><ul><li>Off the dias : may be good </li></ul><ul><li>On the dias and pen to paper expression in literature (?) </li></ul>
  19. 20. Tunnel incision cataract emulsification (TICE) <ul><li>Some experienced : Phaco to Sics after entering into A.C. </li></ul><ul><li>Some others during learning curve : After tunnel incision try phaco </li></ul>
  20. 21. C V S <ul><li>Fixed distance </li></ul><ul><li>Mind capacity </li></ul><ul><li>Surrounding AC </li></ul><ul><li>Target achieving personality </li></ul><ul><li>Behavioural posture </li></ul>Responsible for discomfort In what way, object (Computer) is responsible ?
  21. 22. C V S <ul><li>All the symptoms do occur with any fixed distance object view for long time </li></ul><ul><li>Do we call </li></ul><ul><ul><li>Cinema vision syndrome ? </li></ul></ul><ul><ul><li>TV vision syndrome ? </li></ul></ul><ul><ul><li>Book vision syndrome ? </li></ul></ul><ul><ul><li>Gold smith vision syndrome ? </li></ul></ul><ul><ul><li>Tailoring syndrome ? </li></ul></ul><ul><li>Fixed distance object visual strain (FDOVS) </li></ul>
  22. 23. CVS Intermission <ul><li>Total break down of all parallel computers for 5 minutes for every one hour - suggested treatment of choice </li></ul><ul><li>In India, intermission is being adopted in cinema halls for many years. But we never floated cinema vision syndrome </li></ul>
  23. 24. C V S-questioned by my patient(prof in comp) drvenkateshwarrao @hotmail.com <ul><li>Unless physiology of light rays emanating from electronic material and pathophysiology of eye tissues due to exposure of those rays proved </li></ul><ul><li>The word 'Computer' is less precise </li></ul>
  24. 26. Our collective study results <ul><li>Above 55 years(187):76 (40.6%) do not want change </li></ul><ul><li>56 (30.2%) silent but grumble </li></ul><ul><li>55 (29.2%) want change but how ? </li></ul><ul><li>Below 55 years(207):145 ( 77.3%) want change </li></ul><ul><li>but how ? </li></ul><ul><li>62 (32.7%) nothing can be done at this stage </li></ul><ul><li>Nil % : Silent </li></ul>
  25. 27. Our analysis of results <ul><li>Psychology plays prominent role than precision, because of habituation </li></ul><ul><li>Is it difficult to change psychology ? (or) shall medical terms play with psychology than science ? </li></ul>
  26. 28. Present Status <ul><li>One side is precision & accuracy and otherside is habituation & ease of communication---Dr.P.N.Nagpal </li></ul>
  27. 29. Present Need <ul><li>How to provide both to future generation ? </li></ul><ul><li>To avoid answerability to the future generations </li></ul>
  28. 30. Conclusion <ul><li>Changing of terminology is difficult but not impossible (History says) papillitis to optic neuritis </li></ul><ul><li>Habituation is continued as long as communicative precision is not questioned. When precision is questioned, habituation is to be altered but how ? </li></ul>
  29. 31. Our answer is <ul><li>From where we have learnt, to them we represent </li></ul><ul><li>View in this angle of research workers, editors, teachers, & all ophthalmology societies is expedient </li></ul><ul><li>Need for creation of separate window in journal for airing views </li></ul><ul><li>ISO standards for medical terms in ophthalmology </li></ul>
  30. 32. “Something new-something fresh” eyeadvance2006 <ul><li>Stethoscope(?)-----------------stethophone </li></ul><ul><li>Retinoscopy(?)-----------------pupilloscopy </li></ul><ul><li>Syringing(?)---------------------lacrimal patency test </li></ul><ul><li>RD(?)-------------------------sensory retina separation </li></ul><ul><li>ICCE(?)-----------------------WCCE </li></ul><ul><li>ECCE(?)----------------------RPCCE </li></ul><ul><li>Phacoemulsification(?)----cataract emulsification </li></ul><ul><li>SICS(?)----------------------------------TICS </li></ul><ul><li>Nonphacosics(?)-----------------------NETICS </li></ul><ul><li>Phaco to sics or sics to phaco-----TICE </li></ul><ul><li>CVS(?)--------------------------------------FDOVS </li></ul>
  31. 33. Audience write…. <ul><li>Do you want change Yes No </li></ul><ul><li>Do you want anonymity Yes No </li></ul><ul><li>Your opinions / suggestions / remarks / comments / up date </li></ul>E-mail : drkattasv@rediffmail.com Your feedback becomes direct contribution to this concept
  32. 34. VOICE of SAARC 2008 Need of Global ophthalmic society representing all ophthalmic societies to provide judgement to such sensitive appeals to avoid answerability to future generation or Need of Forum to form to start with
  33. 35. Samuel Boyd's (E-mail)
  34. 36. Samuel Boyd's (E-mail)
  35. 37. Anderson's (E-mail)
  36. 38. Anderson's (E-mail)
  37. 39. E:mail from International Standard Organisation
  38. 40. E:mail from International Standard Organisation
  39. 41. Sullivan, Paul’s E-mail Thank you it looks very interesting. Ferenc Kuhn has been doing alot of work to clear up the confusing terminology in ocular trauma - you might want to cite some of his work   The Birmingham Eye Trauma Terminology system (BETT). J Fr Ophtalmol. 2004 Feb;27(2):206-10. Review. PMID: 15029055 [PubMed - indexed for MEDLINE] [Sullivan, Paul]           
  40. 42. Paolo Lanzetta’s E-mail   Dear Doctor, Thank you for sending your presentation and asking for my opinion. I tried to understand the spirit of your material and I fully understand that there are a number of imprecise terms in medicine and ophthalmology. I remember how hard were the concept of ICCE and ECCE to understand when I was doing my internship because the two terms do not describe the surgical procedure adequately. I would also take some more examples from the field of eye traumatology. The new terms introduced by dr. Kuhn have simplified our understanding and overall have standardized the terminology. I fully agree that there is a tremendous need for some changes in terminology. Good luck for your presentation. Best regards,   Paolo
  41. 43. Dr Katta ,I just saw your power point presentation.It is excellent.Congratulations--Pran N Nagpal ----- Original Message ----- From: katta venkatesh sv To: [email_address] Sent: Thursday, November 03, 2005 9:33 PM Subject: request for remarks & guidelines Respected Sir, With warm greetings. May I request you to go through the updated file and give your guidelines.Thanking you. -Dr.Katta Dr Katta ,I just saw your power point presentation.It is excellent.Congratulations--Pran N Nagpal Pran Nagpal <pran@drnagpal.com> | Add to Address Book | This is spam
  42. 45. Akira Momose email <ul><li>1957- retinoscopy should be refractoscopy </li></ul><ul><li>Wishing me to do revolutionary effort needed for change in nonprecisive terminology </li></ul>
  43. 46. Dear Dr.Katta, Quite interesting. good presentation , good number of words , good referrels But, it looks like guest lecture with customised free paper presentation.There is no other way to expose such problems. Let us see how our seniors react & work it out- ----- Anonymous
  44. 47.             Note:   To help protect your privacy, images from this message have been blocked. View images | What is this? Go to Attachment(s )    Wed, 07 Feb 2007 18:25:42 IST Date:    Re: drkatta's request Subject:    katta venkatesh sv <drkattasv@rediffmail.com> To:    From:    &quot;Dr.BABU RAJENDRAN&quot; <drbabu@eth.net> | Add to Address Book | This is spam Dear Dr.Venkatesh, This is indeed an outstanding effort. I have added my comments on each slide where relevant. Look forward to your feed back. Thank you for asking me my opinion. Regards Babu             Note:   To help protect your privacy, images from this message have been blocked. View images | What is this? Go to Attachment(s )    Wed, 07 Feb 2007 18:25:42 IST Date:    Re: drkatta's request Subject:    katta venkatesh sv <drkattasv@rediffmail.com> To:    From:    &quot;Dr.BABU RAJENDRAN&quot; <drbabu@eth.net> | Add to Address Book | This is spam Dear Dr.Venkatesh, This is indeed an outstanding effort. I have added my comments on each slide where relevant. Look forward to your feed back. Thank you for asking me my opinion. Regards Babu             Note:   To help protect your privacy, images from this message have been blocked. View images | What is this? Go to Attachment(s )    Wed, 07 Feb 2007 18:25:42 IST Date:    Re: drkatta's request Subject:    katta venkatesh sv <drkattasv@rediffmail.com> To:    From:    &quot;Dr.BABU RAJENDRAN&quot; <drbabu@eth.net> | Add to Address Book | This is spam Dear Dr.Venkatesh, This is indeed an outstanding effort. I have added my comments on each slide where relevant. Look forward to your feed back. Thank you for asking me my opinion. Regards Babu
  45. 48. Babu-President elect AIOS
  46. 49. Dear Dr. Katta, Congratulations for your excellent work. We would like to you to be more specifically about your requirement to HINARI. Our objectives can be read at: http://www.who.int/hinari/about/en/ Best regards, The HINARI Team World Health Organization Avenue Appia, 20 1211 Geneva 27 Switzerland Fax: +41 22 791 41 50 Email: [email_address] www.who.int/hinari
  47. 50. Dear Venkatesh: Thanks for your mail. I would have been happy to review your excellent work, election or no election. Here are my comments: 1. Retinoscopy could be Refractometry 2. Syringing could be Lacrimal Irrigation Test 3. CVS probably has many components other than fixed distance strain, best left as it is Let cataract cowboys decide regarding all terms related to cataract . Good effort! Please do take it forward to a logical conclusion. Best, Santosh
  48. 51. Not for insistence but only for awareness PLEASE ….. my Lord <ul><li>IJO : Appreciation with refusal </li></ul><ul><li>AJO: Appreciation with refusal </li></ul><ul><li>ARCHIVES: Refused </li></ul><ul><li>BJO: Silent </li></ul><ul><li>HOO: Silent </li></ul><ul><li>Ferenckuhn, fkuhn@mindspring.com------silent </li></ul><ul><li>Springer: appreciation with refusal </li></ul>
  49. 52. Deeply obliged to - My patient for enlightening us - Dr.P.N.Nagpal for inspiring us - Prof.I.V.Chalapathi Rao,Registrar,Central Institute of Foreign Languages(retd) for valuable suggestions in language -Audience for providing grumblings - Speakers for awareness - Contributors (email senders,telephonic discutants,background guides,etc)
  50. 53. Om Tat Sat (sanskrit-inside yourown see) <ul><li>This concept is still a scientific embryological state. Let us see its growth period as education is a progressive discovery of our own ignorance and yet to teach us false limitations </li></ul><ul><li>- Thanking you very much </li></ul>

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