Re: Americans getting too fat for eye exams too.

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Re: Americans getting too fat for eye exams too.

Aula	27 Jul 2006 10:00
> Maybe refer them to a diet tech? Obesisty is an epidemic just like > myopia is, but at least you can lose weight much easier than lose > diopters. It depends on the cause of the obesity.

acemanvx@yahoo.com	27 Jul 2006 09:29
> <http://tinyurl.com/mx6m3> > [quoted text clipped - 41 lines] > > And I thought this was only me noticing this alarming trend. Maybe refer them to a diet tech? Obesisty is an epidemic just like myopia is, but at least you can lose weight much easier than lose diopters.

Anon E. Muss

27 Jul 2006 02:26

<http://tinyurl.com/mx6m3>

| Study: More Americans too fat for X-rays, scans
| Obesity hurting accuracy of images, doctors say.
|
| Wednesday, July 26, 2006; Posted: 9:11 p.m. EDT (01:11 GMT)
|
| MRI machines with larger-bore openings are in demand, a reflection of
| increasing obesity in America.
|
| WASHINGTON (Reuters) -- More and more obese people are unable to get
| full medical care because they are either too big to fit into
| scanners, or their fat is too dense for X-rays or sound waves to
| penetrate, radiologists reported Tuesday.

I'd like to add to the following to that list of devices:

o Slit-lamps

I've had quite a few patients I've had to refer out for direct
gonioscopy because they couldn't fit behind the slit-lamp. Or you
don't get the testing done. Bringing a patient down to the OR to
perform Koeppe gonioscopy with a counterbalanced gonioscope costs big
bucks. Most hospitals don't have one -- you have to typically go to a
University ophthalmology residency clinic.

And optic nerve/retinal nerve fiber layer evaluation with a +14D or
MaculaPlus using a head-mounted BIO is not nearly as nice as using a
contact fundus lens or Super66 non-contact fundus lens at a slit-lamp
because patients can't get their forehead close enough to the front of
the slit-lamp for me to obtain or sustain clear focus.

Same thing for Goldmann tonometry. I can't count the number of times
having a TonoPen has alllowed me to check IOPs when I couldn't do it
with a slit-lamp Goldmann.

Good luck to ophthalmologists trying to perform ALT/SLTs on these
pateints. Well, they can bill more for trabeculectomies anyways :(.

Hand-held slit-lamps are a poor substitute.

If this trend keeps up, I expect to start having problems at the
perimeter.

And I thought this was only me noticing this alarming trend.

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