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Langue M, Soni A. A novel device for digital retinoscopy. J AAPOS 2022; 26:141-142. [PMID: 35469977 DOI: 10.1016/j.jaapos.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
We introduce a portable retinoscopy device designed to allow simultaneous views of the retinoscope's reflex. With built-in Wi-Fi, it allows for viewing from any phone, tablet, or computer. The device easily attaches to a Welch Allyn retinoscope and could facilitate the teaching of retinoscopy for students, ophthalmic technicians, residents, and physicians.
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Affiliation(s)
- Michael Langue
- Department of Ophthalmology, Penn State College of Medicine, Pennsylvania
| | - Ajay Soni
- Department of Ophthalmology, Penn State College of Medicine, Pennsylvania.
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Langue M, Scott IU, Ely AL, Soni A. The Pediatric Examination Assessment Rubric (PEAR) toolkit: reliability study. J AAPOS 2020; 24:365.e1-365.e4. [PMID: 33276095 DOI: 10.1016/j.jaapos.2020.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The Pediatric Examination Assessment Rubric (PEAR) toolkit consists of an examination sheet and rubric designed to assess ophthalmology residents' performance on the pediatric eye examination. The purpose of this study was to evaluate the reliability of the PEAR toolkit. METHODS Six ophthalmology residents (2 PGY-2, 4 PGY-3) at a single ACGME-accredited US program participated in 11 video-recorded pediatric ophthalmology patient encounters. Two pediatric ophthalmologists reviewed the videos and the residents' examination sheets to complete a PEAR evaluation. The inter-rater reliability of the rating for each of the 12 examination skills evaluated using PEAR was determined using kappa statistics, and reliability strength was categorized based on published guidelines (≤0, poor; 0-0.20, slight; 0.21-0.40, fair; 0.41-0.60, moderate; 0.41-0.60, substantial; 0.81-1.00, almost perfect). RESULTS Eleven video encounters were completed. Of the 12 examination skills evaluated using PEAR, 9 had kappa scores with strengths of moderate to almost perfect reliability. Two examination skills, Worth 4-Dot and alignment, showed fair reliability. A kappa score could not be calculated for stereoacuity because of the lack of variability among the evaluators' raw scores. CONCLUSIONS In our small sample of residents from a single institution, the PEAR toolkit showed inter-rater reliability.
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Affiliation(s)
- Michael Langue
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania.
| | - Ingrid U Scott
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Amanda L Ely
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Ajay Soni
- Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania
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Langue M, Scott I, Soni A. The Pediatric Examination Assessment Rubric (PEAR): A Pilot Project. J Acad Ophthalmol 2018. [DOI: 10.1055/s-0038-1668574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Purpose The pediatric ophthalmic examination is often considered a challenge to ophthalmologists at any level of training. New tools need to be developed and tested to enhance resident and fellow training in pediatric ophthalmology. To our knowledge, this pilot project introduces the first educational rubric designed specifically for a pediatric ophthalmic examination.
Methods Preliminary surveys were completed by 11 ophthalmic residents, of all three postgraduate years (PGY), to gauge comfort level with the pediatric ophthalmic examination. A one-page Pediatric Examination Assessment Rubric (PEAR) was developed and reviewed by 13 content experts (12 pediatric ophthalmologists and a lead developer of the Ophthalmic Clinical Exercise Examination [OCEX] tool) at eight academic institutions. A total of five educators from three academic institutions used the rubric to evaluate a total of six residents during a new strabismus evaluation. Postevaluation surveys were completed by both the five educators and the six residents.
Results Preliminary surveys showed that only 18.2% of residents felt their pediatric examination skills were good. Residents noted higher levels of frustration and less comfort with the pediatric examination when compared with an adult examination. Thirteen experts' comments were incorporated into the rubric to establish content validity. Postevaluation surveys showed that 60% of faculty and 100% of residents found the rubric to be very effective in providing feedback.
Conclusion In this pilot project, we established the need for more concrete educational tools in pediatric ophthalmology, created an educational tool, established content validity, and demonstrated feasibility. The PEAR helps residents identify skills to target for improvement based on the quality of their pediatric ophthalmic examinations. At three academic institutions, the PEAR was shown to be easy to use and a useful tool for training residents to perform the pediatric ophthalmic examination.
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Affiliation(s)
- Michael Langue
- Department of Ophthalmology, Penn State Eye Center, Hershey, Pennsylvania
| | - Ingrid Scott
- Department of Ophthalmology, Penn State Eye Center, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Ajay Soni
- Department of Ophthalmology, Penn State Eye Center, Hershey, Pennsylvania
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Ghodasra DH, Fante R, Gardner TW, Langue M, Niziol LM, Besirli C, Cohen SR, Dedania VS, Demirci H, Jain N, Jayasundera KT, Johnson MW, Kalyani PS, Rao RC, Zacks DN, Sundstrom JM. Safety and Feasibility of Quantitative Multiplexed Cytokine Analysis From Office-Based Vitreous Aspiration. Invest Ophthalmol Vis Sci 2017; 57:3017-23. [PMID: 27273720 PMCID: PMC4904801 DOI: 10.1167/iovs.15-18721] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The goals of this study were to evaluate the safety of office-based vitreous sampling, and determine the utility of these samples with multiplex cytokine analysis. Methods Vitreous samples were collected from office-based needle aspiration and the rate of adverse events during follow-up was reviewed. The vitreous cytokine concentrations in a subset of patients with diabetic macular edema (DME) were analyzed using a 42 plex-cytokine bead array. These results were compared with vitreous cytokine concentrations in proliferative diabetic retinopathy (PDR) and controls (macular hole, epiretinal membrane, symptomatic vitreous floaters) from pars plana vitrectomy. Results An adequate volume of vitreous fluid (100–200 μL) was obtained in 52 (88%) of 59 office-based sampling attempts. The average length of follow-up was 300 days (range, 42–926 days). There were no complications, including cataract, retinal tear or detachment, and endophthalmitis. Two patients (3%) had posterior vitreous detachments within 3 months. Vitreous cytokine concentrations were measured in 44 patients: 14 controls, 13 with DME, and 17 with PDR. The concentration of ADAM11, CXCL-10, IL-8, and PDGF-A were higher in PDR compared with controls and DME. The concentration of IL-6 was higher in PDR compared with controls, but not compared with DME. Conclusions Office-based vitreous aspiration is safe and yields high-quality samples for multiplex vitreous cytokine analysis. Significant elevations of vitreous cytokines were found in PDR compared with DME and controls, including the novel finding of elevated ADAM11. As such, office-based aspiration is a safe and effective means to identify vitreous factors associated with vitreoretinal disease.
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Affiliation(s)
- Devon H Ghodasra
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Ryan Fante
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Thomas W Gardner
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Michael Langue
- Penn State Hershey Eye Center, Hershey, Pennsylvania, United States
| | - Leslie M Niziol
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Cagri Besirli
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Steven R Cohen
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Vaidehi S Dedania
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Hakan Demirci
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Nieraj Jain
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | | | - Mark W Johnson
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Partho S Kalyani
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Rajesh C Rao
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - David N Zacks
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
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