vol. 12 núm. 1 (2014)

<em><strong>Objective:</strong></em> To evaluate the repeatability and reproducibility of the measurements of corneal thickness and curvature obtained with the Oculus Pentacam of the University of La Salle. Materials and <em><strong>Methods:</strong></em> For the repeatability of the measurements of corneal curvature and thickness with the Pentacam, a single observer performed ten repetitions of ten eyes, and for reproducibility, two examiners executed, in separate sessions, three consecutive shots in both eyes of twenty healthy subjects. <em><strong>Results:</strong></em> As for reproducibility, the coefficient of variation of the measurements of corneal curvature was found to be between 0.2% and 0.4%, and in case of corneal thickness, it varied between 0.7% and 1.4%. The coefficient of interobserver variation for corneal curvature was between 3.6% and 4.0%, and for corneal thickness, between 4.9% and 7.9%. There were no statistical (p> 0.05) nor clinically significant differences between inter and intraobserver observations. The interobserver correlation coefficient was higher than 0.90 (p < 0.01). <em><strong>Conclusion:</strong></em> The measurements of corneal curvature and thickness obtained with the Oculus Pentacam are reliable, reproducible and repeatable.

<em><strong>Objective:</strong></em> determine the accommodative state in refractive amblyopia patients between five and twelve years old. <em><strong>Methods:</strong></em> A sample of fifteen refractive amblyopic children was included, and a control group of fifteen children between five and twelve years of age. The control group patients were required to have a maximum VA of 0.32 LogMar without correction, both at distance and near vision, and an uncorrected refractive error. It took into account individuals with mild and moderate refractive amblyopia of both anisometropic and isometropic types, with a minimum VA of 0.4 and a maximum VA of 0.8 LogMar with appropriate optical correction. Subjects suffering from organic ocular alterations, cognitive problems, diagnosis of strabismus, strabismus surgery or trauma were excluded, as well as patients who had attended or at the time were attending vision therapy. The accommodative state was evaluated in each patient, measuring the Lag of accommodation, the flexibility and the amplitude of accommodation (AA) with three subjective (PU, MPD and ML) and one objective technique (MODAA, for its initials in Spanish). <em><strong>Results:</strong></em> AA measured with the four methods was statistically significantly lower in amblyopic patients (p < 0.05), being the difference more pronounced with the use of ML (4.72 D). However, with the objective MODAA technique, which has shown high reliability, the differences were not clinically significant (0.47). Conclusions: The accommodative state of refractive amblyopia patients between five and twelve years is lower when subjective methods are employed. The most common alteration was insufficiency of accommodation.

The strategy on primary health care for workers is an initiative of the World Health Organization, based on the concept of decent work by the International Labour Organization, which aims to create healthy work environments that improve the quality of employment for Latin America. <em><strong>Objective:</strong></em> To conduct a thematic review in order to document experiences regarding the strategy on primary health care for workers: healthy work environments in some Latin American countries. Methodology: A qualitative exploratory research was developed to collect existing data related to the strategy on primary health care for workers in Latin America. Some databases, like Lilacs, Google Scholar, ProQuest and SciELO, were consulted in the period between 2002 and 2012, in the following countries: Argentina, Chile, Colombia, Cuba and Mexico. <em><strong>Results:</strong></em> Significant progress was found regarding primary health care for workers: healthy work environments in Latin America, such as the creation of manuals and policies in different countries that improve the health conditions of Latin American workers. <em><strong>Conclusion:</strong></em> Although there are some experiences in this area, it is necessary to continue to research the case of Colombia, aiming to make the creation of safe and healthy workplaces possible.

Absenteeism, frequent phenomenon in business, is derived from various causes and has a negative impact on the economy and the development of the workers’ normal activities; it results in an increase in labor costs and workload. <em><strong>Objective:</strong></em> To determine the motivations of health professionals at the Hospital Vista Hermosa level I, health institution of the State, to be absent from their scheduled shifts. Materials and <em><strong>Methods:</strong></em> This study, aiming to reach technical importance, requires the qualitative and quantitative analyses of the variables involved in employee satisfaction at the immediate medical attention center (CAMI) Vista Hermosa. <em><strong>Results:</strong></em> The level of permanence of the working relationship with the company is high: 42% of time worked between two and ten years, followed by 33% of time worked for over ten years. A high degree of satisfaction was found (42%), followed by a 25% of very satisfied employees. This finding relates to the motivations and guarantees provided by the hospital to its employees. Conclusions: This study showed that the major causes of absenteeism at the CAMI Vista Hermosa were sick leave, delay or absence due to additional work and domestic calamity; which is directly associated with the fact that the company belongs to the health sector, where there is a high workload and a culture of having simultaneously one or more jobs.

The excimer laser allows the correction of myopic, hyperopic and astigmatic refractive errors by ablating the corneal surface. To get the best treatment and the best postoperative visual correction, it is necessary the proper maintenance and calibration of all laser parameters and environmental factors in the operating room. After surgery, in some situations, an increase in aberrations occurs, which greatly affect the patient’s visual quality. At present new devices have been introduced which are based on guided wavefront ablation and topographic ablation, with the aim of reducing postoperative aberrations. This paper examines the main parameters of excimer laser that influence ablation, like different profiles of corneal ablation, and demonstrates how they directly relate to postoperative visual quality.

This paper’s main objective is to study the costs incurred by health promotion entities in Colombia for the prevention and treatment of HIV/AIDS. The research methodology is based on mixed methods approach (qualitative and quantitative). Patterns of care and treatment rates for HIV positive patients were identified, and annual prices of care for HIV/AIDS patients were estimated according to the stage of the disease. Finally, costs at the stage of clinical latency were described compared to the costs of care for patients with this condition. It is concluded that in Colombia the carrying capacity of health promotion entities and insurers is exceeded, given the high prices of the required pharmaceutical regimens, which are in turn a likely consequence of the little control the government has on the cost of drugs.

<em><strong>Objective:</strong></em> To determine whether there is a significant difference between results obtained by Mohindra retinoscopy and results by cycloplegic retinoscopy in children of age between one and four years eleven months. <em><strong>Methodology:</strong></em> A descriptive comparative analytical study was performed. The selection of the sample consisted of a hundred eyes (fifty children) with a maximum refractive error of 8.00 D for hyperopia, and of 1.00 D for astigmatism. Net results from Mohindra retinoscopy were compared to net results from refraction with cyclopentolate 1%, which was performed eight days after near retinoscopy. For the statistical analysis we used the paired difference test with the SPSS software (version 19), with ≈ 0.05. Then, in order to compare the homogeneity in the variance of the age groups, Levene’s analysis of variance was performed; given that the test had differences in the variances for the different age groups and the groups had different sizes, the robust Welch test was used to double check the equality of means in the groups. <em><strong>Results:</strong></em> According to the socio-demographic variable age, 64% were boys (64 eyes or 32 boys), and 36% girls (36 eyes or 18 girls), differences of a maximum of 0.50 D were demonstrated between the two methods. Conclusions: The research showed a statistically significant dissimilarity, but it did not demonstrate any clinically significant difference between the methods of retinoscopy.

There is a clinical presentation of closed-angle or acute glaucoma with pain symptoms and rapid course, which has great potential for detection and timely treatment. This condition is caused by excessive influx between the iris and the lens that prevents the flow of aqueous humor from the posterior to the anterior chamber with progressive relative pupillary block, occluding the filtering portion of the trabecular meshwork and causing elevated intraocular pressure (IOP). The urgency is manifested by strong eye pain and decreased visual acuity, which can be adequately managed by the optometrist, in order to make a timely referral to ophthalmology, as the consequences of the progression of the disease, or an incorrect diagnosis, are irreversible in terms of loss of visual acuity and visual field, which considerably affects the quality of life of individuals. <em><strong>Objective:</strong></em> To present clinical parameters in order to identify, diagnose and manage the urgency of angle closure with a timely referral for eye treatment. Methodology: Literature review through literature search. <em><strong>Results:</strong></em> A management guide for the optometrist is presented with primary treatment for the ocular emergency caused by closed-angle glaucoma.

Pupillary alteration in diabetes is interpreted as a manifestation of autonomic neuropathy and microvascular injury, as reflected in abnormal fundoscopic findings. <em><strong>Objective:</strong></em> To describe the association between pupillary autonomic neuropathy and diabetic retinopathy in type 2 diabetic patients. Materials and <em><strong>Methods:</strong></em> Comparative analytical descriptive study. 76 subjects were included, divided into two groups: 46 type 2 diabetic patients, and 30 healthy (non-diabetic) subjects over 40 years. The diameter and speed of pupil response were measured with high resolution videoscopic camera, and the retina was evaluated with retinal camera. <em><strong>Results:</strong></em> There was a difference between the pupillary speed and HbA1c of the group of type 2 diabetic patients (0.512 mm/s SD 0.283, HbA1c 7.89% SD 1.88) and the group of healthy patients (3.5 mm SD 0.52; 0.785 mm/s SD 0.368; HbA1c 6.31 SD 0.59). The main fundoscopic findings localized in retina were neovascularization (78.26%), exudates (67.39%) and hemorrhages (60.87%). There was an association between HbA1c greater than 7.89% and pupillary speed less than 0.598 mm/s, and the presence of neovascularization and retinal hemorrhages. Conclusions: Evidence showed association between pupillary responses, HbA1c and retinal findings in type 2 diabetic patients.

It is possible to decompose the wavefront aberration by the Zernike polynomials. Through adaptive optics systems, using such mathematical functions, ocular aberrations can be determined from the clinical and physical points of view. In this paper the components of wavefront aberration are analysed, and the main clinical applications of ocular aberrometry and its major limitations are described.