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     Physiology & Pathology - Systemic

    Physiology & Pathology - Systemic is one of the modules forming 'Part 1 Assessment' in DOCET's series 'The Ageing Eye' and is designed as a companion piece to 'Physiology & Pathology - Ocular'.

    This programme aims to refresh and update optometrists' understanding of common age-related systemic diseases and their effects on the eye. Each type of systemic condition is considered in turn and includes a look at the ocular effects of medications regularly encountered with older patients. The programme features expert advice and guidance from a GP, an ophthalmologist and an optometrist.

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      Learning objectives

      • 1.1.1 To improve understanding of the relevance of general health and systemic medications on ocular health and the importance of a full history and symptoms.
      • 1.2.3 To improve understanding of how to explain to an older patient the importance of systemic disease and its impact on eye health.
      • 2.6.2 To improve the understanding of referral pathways and the role of different professionals in the care of a patient with systemic and ocular disease.
      • 6.1.1 To improve the understanding of the risk factors for common ocular conditions in the older population.
      • 6.1.13 To improve the recognition of common ocular conditions associated with systemic diseases in the older population and the appropriate management plan for the patient.
      • 6.1.15 To improve the recognition of ocular adverse reactions to common medications taken for systemic conditions in the older patient.
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        Unit 1 - Introduction (~2 mins)

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          Unit 2 - Systemic hypertension (~5 mins)

          Hypertension: clinical management of primary hypertension in adults (NICE clinical guideline 127)
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            Unit 3 - Heart disease (~6 mins)

            Hayreh SS, Podhajsky PA, Zimmerman MB; Retinal Artery Occlusion Associated Systemic and Ophthalmic Abnormalities. Ophthalmology. 2009 Jul 2.
            Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease (NICE clinical guideline 181)
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              Unit 4 - Stroke (~3 mins)


              Please note: In this video clip, there is a small error on the visual field plot demonstrating a homonymous hemianopia, where the blind spot in the right eye is marked on the incorrect side of the plot. Please see correct field plot below.

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              Unit 5 - Diabetes (~4 mins)

              The Information Centre (2011). Health Survey for England 2010
              Hamilton AMP, Ulbig MW, Polkinghorne P (1996). Management of diabetic retinopathy, London: BMJ Publishing
              Scanlon PH (2008). The English national screening programme for sight threatening diabetic retinopathy. Journal of Medical Screening 15 (1); 1–4
              Type 2 diabetes: The management of type 2 diabetes (NICE clinical guideline 87)
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                Unit 6 - Smoking related disease (~2 mins)

                The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014
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                  Unit 7 - Malignant disease (~6 mins)

                  California Cancer registry, annual Statistical tables by Site, accessed December 5, 2011

                  C Huerta, L A García, Rodríguez (2000). Incidence of ocular melanoma in the general population and in glaucoma patients. J Epidemiol Community Health 2001;55:338-339 

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                    Unit 8 - Arthropathies (~3 mins)

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                      Unit 9 - Neurological disease (~5 mins)

                      R. A. Armstrong, “Visual Symptoms in Parkinson's Disease,” Parkinson’s Disease, vol. 2011, Article ID 908306
                      MRC CFAS (1998) Cognitive function and dementia in six areas of England and Wales: the distribution of MMSE and prevalence of GMS organicity level in the MRC CFA Study. Psychological Medicine, 28: 319-335
                      U. Bayer, O. N. Keller, F. Ferrari, and K. P. Maag, “Association of glaucoma with neurodegenerative diseases with apoptotic cell death: Alzheimer's disease and Parkinson's disease,” American Journal of Ophthalmology, vol. 133, no. 1, pp. 135–137, 2002. 
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                        Unit 10 - Systemic medication & summary (~6 mins)

                        Chen YF, Dewey ME, Avery AJ (2001) The Analysis Group of the MRCCFA Study. Self-reported medication use for older people in England Wales. J Clin Pharm Ther 26:129–140  
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                          More information

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