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CLINICIAN'S CORNER
Preventing and Managing Visual Disability in Primary Care
Clinical Applications
Caroline L. Goldzweig, MD, MSHS;
Susannah Rowe, MD, MPH;
Neil S. Wenger, MD;
Catherine H. MacLean, MD, PhD;
Paul G. Shekelle, MD, PhD
JAMA. 2004;291:1497-1502.
Clinicians in primary care settings are well positioned to participate in the prevention and management of visual disability. They can have a significant impact on their patients' visual health by screening for vision problems, aggressively controlling known risk factors for visual loss, ensuring adherence to ophthalmologic treatment and continuity of eye care, and by timely referral of specific patient populations to qualified eye care professionals (eg, ophthalmologists and optometrists). Using their knowledge about common ophthalmic medications, clinicians can detect adverse effects of these agents, including exacerbations of heart or lung disease. They can ensure that appropriate patients are screened for common serious eye diseases, such as glaucoma, and that patients with disabilities related to vision problems are assessed for treatable conditions, such as cataracts or refractive error. Finally, clinicians can direct patients with low vision from any cause to resources designed to help enhance patient function and emotional support.
Author Affiliations: Greater Los Angeles Veterans Affairs Health Care System, Los Angeles, Calif (Drs Goldzweig and Shekelle); Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (Drs Goldzweig, Wenger, MacLean, and Shekelle); Department of Ophthalmology, Boston University School of Medicine, Boston, Mass (Dr Rowe); and RAND Health, Santa Monica, Calif (Drs MacLean and Shekelle).
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