No abstract

This telemedicine test was developed to determine the relative ease with which an off-the-shelf ophthalmic telemedicine package could be successfully applied from within a remote theatre of operations. The project was conducted at the Camp Doha Health Clinic, located just outside Kuwait City, during the period from April 12(th) through April 23(rd), 1998. The deployed signal unit had contracted for a direct T-1 commercial satellite link (via MCI), which allowed for direct internet connectivity using a PCMCIA network card. Digital images were sent via this connection to 140 e-mail sites throughout the world, including an unsolicited image to each of 134 Army optometry officers for their review, analysis, and diagnosis. Return responses to this unsolicited survey were 53 out of 134, for a 39.7% response rate. Half of the respondents were able to view the image with ease and clarity, rendering an accurate clinical diagnosis. The other half of the respondents either did not have the software to display an image on their clinical desktop PC, or did not know how to use their provided software. This project clearly indicates that an off-the-shelf ophthalmic digital system can be successfully used from a remote deployed site. However, the consulting clinicians require up-to-date training, and their computer packages should have as wide a capability base as possible.

The present research was directed at quantifying possible alterations in corneal epithelial metabolic activity secondary to in vivo exposure to ultraviolet radiation (UVR). Microfluorometric energy metabolite assays on microgram (microgram) sized, freeze-dried tissue samples were used as an in vitro means of assessing overall metabolic activity in the epithelium of control rabbit corneas and in the epithelium of UVR-exposed rabbit corneas 2 min after discontinuation of exposure. The specific assays were for glucose, glycogen, adenosine triphosphate (ATP), and phosphocreatine (PCr). The radiant exposures were kept constant at 0.05 J cm-2 for all UVR wavelengths utilized (290, 300, 310 and 360 nm). Experimental UVR exposure conditions served to increase epithelial glucose and glycogen concentrations. Although the epithelial ATP concentrations were unchanged, the epithelial PCr concentrations (a high energy phosphate bond reservoir) decreased as a result of UVR exposure. Overall, the data demonstrate a decrease in corneal epithelial metabolic activity, which may be wavelength-dependent, as a result of UVR exposure. It is suggested that immediate metabolic stress can be responsible for the pattern of epithelial cell loss seen in photokeratitis.

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