questionable medical terms in ophthalmology
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Questionable Medical Terms In Ophthalmology - Shall we pass on to next generation.TRANSCRIPT
Questionable Medical Terms Questionable Medical Terms in Ophthalmology –in Ophthalmology –
Our study- Our study- Suggested improvementSuggested improvement
ConceptConcept
Study of ophthalmic grumblings Study of ophthalmic grumblings
- Off the dias- Off the dias
Scientific speak-out Scientific speak-out
- On the diasOn the dias
AppealAppeal
Presentation of this paper, Presentation of this paper, is neither of is neither of
criticism nor of intentioncriticism nor of intention of leg-pulling of leg-pulling
exercise to anybodyexercise to anybody
- Authors- Authors
Present NeedPresent Need
Warrant of AttentionWarrant of Attention
More than 100 years agoMore than 100 years ago: Retinoscopy: Retinoscopy, , syringing, R.D, ICCEsyringing, R.D, ICCE
40 years ago40 years ago : : ECCEECCE
28 years ago28 years ago : : Phaco emulsificationPhaco emulsification
10 years ago10 years ago : : SicsSics
8 years ago8 years ago : : Manual phaco, NonphacoManual phaco, Nonphaco
5 years ago5 years ago : : CVSCVS
AimAim
FreeFree ophthalmic literature from ophthalmic literature from
non-precise scientific termsnon-precise scientific terms
throughout the worldthroughout the world
Materials & MethodsMaterials & MethodsSeptember 01 to July '02September 01 to July '02
394 eye specialists394 eye specialists at and around Hyderabad at and around Hyderabad
Guest speakersGuest speakers from Mumbai, Delhi, Chennai, from Mumbai, Delhi, Chennai, Bangalore, UK & USABangalore, UK & USA
Analytical study in conveyance of the meaning Analytical study in conveyance of the meaning in in dictionaries, books, journalsdictionaries, books, journals
E-mailsE-mails
LettersLetters
Telephonic discussionsTelephonic discussions
Habituated use of literatureHabituated use of literature
Above 55Above 55 Retired prof-------52Retired prof-------52 Senior prof--------25Senior prof--------25 Senior practioners-Senior practioners-
110110
Total-187Total-187
Below 55Below 55 Asst.prof-----------50Asst.prof-----------50 Registrars---------10Registrars---------10 Senior residents-28Senior residents-28 Residents---------12Residents---------12 Post-graduates—32Post-graduates—32 Practitioners-------75Practitioners-------75 Total---------------207Total---------------207
Stetho-Scope (Laennac)Stetho-Scope (Laennac)
Steth: G.algos: ChestSteth: G.algos: Chest
G. Skopeo: to viewG. Skopeo: to view
Douglas M. Anderson Donald Douglas M. Anderson Donald illustrated medical dictionary - illustrated medical dictionary -
28th ed. 1994: 157928th ed. 1994: 1579
Majory spraycon Stedman's Majory spraycon Stedman's medical dictionary - 26th ed. medical dictionary - 26th ed.
1995-16771995-1677
StethophoneStethophone
RetinoscopyRetinoscopy
Retina - scopie: viewRetina - scopie: view
Are we viewing the retina ?Are we viewing the retina ?
PupilloscopyPupilloscopy
Shadow testShadow test
Macdonald critchley, Butterworthi Medical Macdonald critchley, Butterworthi Medical dictionary 2nd ed, 1989: 1468dictionary 2nd ed, 1989: 1468
SyringingSyringing
VL test (Voie lacrimal = Route lacrimal)VL test (Voie lacrimal = Route lacrimal)(In French)(In French)
Lacrimal patency testLacrimal patency test
Retinal Detachment (R.D.)Retinal Detachment (R.D.)
Is this the era of using 'misnomer' Is this the era of using 'misnomer' scientific terminology ?scientific terminology ?
Macdonald critchley, In Butterworth's Medical Macdonald critchley, In Butterworth's Medical dictionary 2nd edition 1989:1466dictionary 2nd edition 1989:1466
RPE is not part of retinaRPE is not part of retina
Sensory retina separation (SRS)Sensory retina separation (SRS)
Intra-Capsular cataract extraction (ICCE)Intra-Capsular cataract extraction (ICCE)
Macdonald critchley, Butterworth's Medical Macdonald critchley, Butterworth's Medical Dictionary 2nd ed. 1989:635Dictionary 2nd ed. 1989:635 expresses: "Within the expresses: "Within the capsule cataract extraction“capsule cataract extraction“
Instead, Instead, WCCE = With capsule cataract WCCE = With capsule cataract extractionextraction
Or Or TCE = Total cataract extractionTCE = Total cataract extraction
Or Or CatarectomyCatarectomy
Extra-capsular cataract extraction (ECCE)Extra-capsular cataract extraction (ECCE)
Expresses "Outside the capsule cataract extraction"Expresses "Outside the capsule cataract extraction"
RPCCE :RPCCE : Retained posterior capsule cataract Retained posterior capsule cataract extractionextraction
Whenever ECCE fails, people are habituated in Whenever ECCE fails, people are habituated in calling ICCEcalling ICCE
CEPCB :CEPCB : Cataract extraction with posterior capsule Cataract extraction with posterior capsule breakbreak
Phaco Emulsification (Kelman)Phaco Emulsification (Kelman)
Majory spraycon, Stedman's Medical dictionary 26th Majory spraycon, Stedman's Medical dictionary 26th ed, 1995:1338ed, 1995:1338
Douglas M Anderson: Donald's illustrated medical Douglas M Anderson: Donald's illustrated medical dictionary 28th ed, 1994:1270dictionary 28th ed, 1994:1270
Macdonald critchley, Butterworth's Medical dictionary Macdonald critchley, Butterworth's Medical dictionary 2nd ed, 1989-12892nd ed, 1989-1289
Gr. Phakos: Crystalline lensGr. Phakos: Crystalline lens
L. Emilgere: to mix outL. Emilgere: to mix out
Are we doing crystallin lens Are we doing crystallin lens emulsification ?emulsification ?
If phaco expresses cataract, are we allowed to If phaco expresses cataract, are we allowed to call mature phaco or immature phaco?call mature phaco or immature phaco?
Many doctors express on the stage phaco for Many doctors express on the stage phaco for communication of emulsification. Is this precise ? communication of emulsification. Is this precise ?
CE Cataract emulsificationCE Cataract emulsification
Posterior capsule is intentionally not emulsified, Posterior capsule is intentionally not emulsified, Are we calling partial phaco emulsification ?Are we calling partial phaco emulsification ?
Small Incision Cataract Surgery (SICS)Small Incision Cataract Surgery (SICS)
Sufficient sized incisionSufficient sized incision is bound to undergo to is bound to undergo to remove the nucleus and implant the IOLremove the nucleus and implant the IOL
How can we call "small" when we are bound to do How can we call "small" when we are bound to do the optimum incision to facilitate the nucleus and the the optimum incision to facilitate the nucleus and the IOL to go out and to go in ?IOL to go out and to go in ?
Is there any big incision ?Is there any big incision ?
"Small" the word is a relative"Small" the word is a relative
- Tunnel incision cataract surgery (TICS)- Tunnel incision cataract surgery (TICS)
Non-phaco SicsNon-phaco Sics
People mean non-phaco emulsification SicsPeople mean non-phaco emulsification Sics
The word 'Non phaco Sics' expresses The word 'Non phaco Sics' expresses nonlenticular cataract surgerynonlenticular cataract surgery
The word 'phaco' is being used sometimes for The word 'phaco' is being used sometimes for lens and some other times for emulsificationlens and some other times for emulsification
For naming, is the word non ICCE non phaco For naming, is the word non ICCE non phaco Sics' good ?Sics' good ?
Non emulsification Tics (NETICS)Non emulsification Tics (NETICS)
Manual cataract surgeryManual cataract surgery
People mean 'Non-phaco cataract surgery'People mean 'Non-phaco cataract surgery'
Are we not using instrumentation ?Are we not using instrumentation ?
Off the dias : may be goodOff the dias : may be good
On the dias and pen to paper expression in On the dias and pen to paper expression in
literature (?)literature (?)
Tunnel incision cataract emulsification (TICE)Tunnel incision cataract emulsification (TICE)
Some experienced :Some experienced : Phaco to Sics after Phaco to Sics after
entering into A.C.entering into A.C.
Some others during learning curve :Some others during learning curve : After After
tunnel incision try phacotunnel incision try phaco
C V SC V S
Fixed distanceFixed distance
Mind capacityMind capacity
Surrounding ACSurrounding AC
Target achieving Target achieving personalitypersonality
Behavioural postureBehavioural posture
Responsible for discomfortResponsible for discomfort
In what way, object (Computer) is responsible ?In what way, object (Computer) is responsible ?
C V SC V S
All the symptoms do occur with any fixed All the symptoms do occur with any fixed distance object view for long timedistance object view for long time
Do we call Do we call Cinema vision syndrome ?Cinema vision syndrome ?
TV vision syndrome ?TV vision syndrome ?
Book vision syndrome ?Book vision syndrome ?
Gold smith vision syndrome ?Gold smith vision syndrome ?
Tailoring syndrome ?Tailoring syndrome ?
Fixed distance object visual strain (FDOVS)Fixed distance object visual strain (FDOVS)
CVS IntermissionCVS Intermission
Total break down of all parallel computers Total break down of all parallel computers for 5 minutes for every one hour - for 5 minutes for every one hour - suggested suggested treatment of choicetreatment of choice
In India, intermission is being adopted in In India, intermission is being adopted in cinema halls for many years. But cinema halls for many years. But we never we never floated cinema vision syndromefloated cinema vision syndrome
C V S-questioned by my C V S-questioned by my patient(prof in comp)patient(prof in comp)drvenkateshwarraodrvenkateshwarrao
Unless physiology of light raysUnless physiology of light rays emanating emanating
from electronic material and from electronic material and pathophysiology pathophysiology
of eye tissuesof eye tissues due to exposure of those rays due to exposure of those rays
provedproved
The word 'Computer' is less preciseThe word 'Computer' is less precise
Our collective study resultsOur collective study results
Above 55 years(187):76 (40.6%) Above 55 years(187):76 (40.6%) do not want do not want changechange56 (30.2%) silent but56 (30.2%) silent but grumblegrumble55 (29.2%) 55 (29.2%) want changewant change but how ?but how ?
Below 55 years(207):145 (Below 55 years(207):145 (77.3%) 77.3%) want changewant change but how ?but how ?
62 (32.7%) nothing can be 62 (32.7%) nothing can be done at this stagedone at this stage
Nil % Nil % : : SilentSilent
Our analysis of resultsOur analysis of results
Psychology plays prominent rolePsychology plays prominent role than than precision, because of habituationprecision, because of habituation
Is it difficult to change psychology ? (or) Is it difficult to change psychology ? (or) shall medical terms play with psychology shall medical terms play with psychology than science ?than science ?
Present StatusPresent Status
One side is precision & One side is precision &
accuracyaccuracy and and otherside is otherside is
habituation & ease of habituation & ease of
communication---Dr.P.N.Nagpalcommunication---Dr.P.N.Nagpal
Present NeedPresent Need
How to provide both to future generation ?How to provide both to future generation ?
To avoid answerability to the future generationsTo avoid answerability to the future generations
ConclusionConclusion
Changing of terminology is difficult but not Changing of terminology is difficult but not impossible impossible (History says) papillitis to optic neuritis(History says) papillitis to optic neuritis
Habituation is continued as long as communicative Habituation is continued as long as communicative precision is not questioned. precision is not questioned. When precision is When precision is questioned, habituation is to be altered but how ?questioned, habituation is to be altered but how ?
Our answer isOur answer is
From where we have learnt, to them we representFrom where we have learnt, to them we represent
View in this angleView in this angle of research workers, editors, of research workers, editors, teachers, & all ophthalmology societies is teachers, & all ophthalmology societies is expedientexpedient
Need for creation of separate windowNeed for creation of separate window in journal for in journal for airing views airing views
ISO standardsISO standards for medical terms in ophthalmology for medical terms in ophthalmology
““Something new-something Something new-something fresh” eyeadvance2006fresh” eyeadvance2006
Stethoscope(?)-----------------stethophoneStethoscope(?)-----------------stethophone Retinoscopy(?)-----------------pupilloscopyRetinoscopy(?)-----------------pupilloscopy Syringing(?)---------------------lacrimal patency testSyringing(?)---------------------lacrimal patency test RD(?)-------------------------sensory retina separationRD(?)-------------------------sensory retina separation ICCE(?)-----------------------WCCEICCE(?)-----------------------WCCE ECCE(?)----------------------RPCCEECCE(?)----------------------RPCCE Phacoemulsification(?)----cataract emulsificationPhacoemulsification(?)----cataract emulsification SICS(?)----------------------------------TICSSICS(?)----------------------------------TICS Nonphacosics(?)-----------------------NETICSNonphacosics(?)-----------------------NETICS Phaco to sics or sics to phaco-----TICEPhaco to sics or sics to phaco-----TICE CVS(?)--------------------------------------FDOVSCVS(?)--------------------------------------FDOVS
Audience write….Audience write….
Do you want change Do you want change YesYes NoNo
Do you want anonymityDo you want anonymity YesYes NoNo
Your opinions / suggestions / remarks / Your opinions / suggestions / remarks /
comments / up datecomments / up date
E-mail : [email protected] : [email protected]
Your feedback becomes direct contribution to this conceptYour feedback becomes direct contribution to this concept
VOICE of SAARC 2008VOICE of SAARC 2008Need ofNeed of GlobalGlobal ophthalmicophthalmic
societysociety representing all ophthalmic representing all ophthalmic societies to provide judgement to such societies to provide judgement to such
sensitive appealssensitive appeals to avoid answerability to to avoid answerability to futurefuture generationgeneration
ororNeed of Forum to form to start withNeed of Forum to form to start with
Samuel Boyd's (E-mail)
Samuel Boyd's (E-mail)
Anderson's (E-mail)
Anderson's (E-mail)
E:mail from International Standard OrganisationE:mail from International Standard Organisation
E:mail from International E:mail from International Standard OrganisationStandard Organisation
Sullivan, Paul’s E-mailSullivan, 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]
Paolo Lanzetta’s E-mailPaolo 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
Dr Katta ,I just saw your power point presentation.It is excellent.Congratulations--
Pran N Nagpal----- Original Message ----- From: katta venkatesh sv To: [email protected]
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
Akira Momose emailAkira Momose email
1957- retinoscopy should be 1957- retinoscopy should be refractoscopyrefractoscopy
Wishing me to do revolutionary effort Wishing me to do revolutionary effort needed for change in nonprecisive needed for change in nonprecisive terminologyterminology
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
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.RegardsBabu
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.RegardsBabu
From:
To: katta venkatesh sv <[email protected]>
Subject:
Re: drkatta's request
Date: Wed, 07 Feb 2007 18:25:42 IST
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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.RegardsBabu
Babu-President elect AIOSBabu-President elect AIOS
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 OrganizationAvenue Appia, 201211 Geneva 27
SwitzerlandFax: +41 22 791 41 50Email: [email protected]
www.who.int/hinari
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
Not for insistence but only for Not for insistence but only for awareness awareness PLEASEPLEASE…..…..my Lordmy Lord
IJO : Appreciation with refusalIJO : Appreciation with refusal AJO: Appreciation with refusalAJO: Appreciation with refusal ARCHIVES: RefusedARCHIVES: Refused BJO: SilentBJO: Silent HOO: SilentHOO: Silent Ferenckuhn, Ferenckuhn,
[email protected] [email protected] Springer: appreciation with refusalSpringer: appreciation with refusal
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)
Om Tat SatOm Tat Sat (sanskrit-inside yourown see) (sanskrit-inside yourown see)
This concept is still a This concept is still a scientific embryological scientific embryological
state.state. Let us see its growth period as Let us see its growth period as education education
is a progressive discovery of our own is a progressive discovery of our own
ignorance and yet to teach us false limitationsignorance and yet to teach us false limitations
--Thanking you very muchThanking you very much