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15 Jan 2009 - Dr Hom gives a lecture "Care of the Later Stage Diabetic - A Primary Care Perspective at the San Diego County Optometric Association's first 2- hour CE course for the year.  Download his presentation.  You will need at least Adobe Acrobat 5 Reader to view and print. Click Here.

02 May 2008 - Dr Hom attends the Alcon Glaucoma Advisory Council to be held in Dallas. He is one of 90 optometrists from across the country to attend this meeting.

15 April 2008  Dr Hom attended the California Optometric Association's Key Person Day in Sacramento, CA in support of SB 1406, a clarification bill to more clearly define optometric practice in CA.
Jan 2008 - The California Healthcare Foundation has accepted the San Mateo Medical Center as a participant to the Digital Photography Diabetic Retinopathy Screening Project.  Dr Hom is the clinical coordinator for this project at the San Mateo Medical Center.
 
 
 

 

After October 2009

our new address will be

http://grandrounds4ods.com

Grand Rounds 120- April 2009

Richard Hom

CC: Red OS; Puffy Lids OU OS>OD x 2  weeks

HPI  A 69 y/o male  presents to my care from the emergency department with a red left eye of 2 weeks.  The provisional diagnosis at the emergency room was corneal foreign body with glaucoma and possible uveitis.  The patient, however, did not behave as if he had a corneal abrasion or foreign body left eye because he was asymptomatic without any photophobia or pain with direct transillumination.  The patient denies itching or a sudden loss of vision, although his eyes are blurry from diabetes and possible diabetic retinopathy. He is a known diabetic with hypertension and lipid problems.  He has no known drug allergies.  He did not start any of the medications that were prescribed by the emergency department yet at this time.   

OBJECTIVE: The patient sees 20/120 in each eye without lenses.  He has equal or even greater pain sensation in the left eye, which is the involved eye, as compared to the right.  TThere are no signs of inflammatory reactions in the right anterior chamber and the eye is slightly watery in that eye.  The right eye also has an intact cornea.  The left eye on the other hand has a large 3.5 x 3.5-mm corneal abrasion in the lower infra temporal quadrant.  There is epithelial growth and migration visible in this area.  The left eye also has grade 2 cells and grade 2 to grade 3 flare.  The left eye has an immobile pupil at this time.  The right eye has an active pupil.  I did not do a retinal examination.  The intraocular pressure in the right eye is 21 and the left is 28 in the morning. Ten minutes later it was 21 and 31.
 

Questions: The diagnosis (es) is/are:
(1) Corneal Abrasion
(2) Herpetic ulcer (either HSK or HZO)
(3) Glaucoma, POAG?
(4) Glaucoma, Uveitic

(5) Other

(6) None of the above

Missed  some cases/Grand Rounds/Teasers?

  1. GrandRounds #119, click here

  2. Grand Rounds #118, click here

  3. Grand Rounds #116, click here.

  4. Grand Rounds #114, click here.

  5. Grand Rounds #113- "the bubble in the eye", click here. 

  6. Brain Teaser? #28 Click Here

  7. Brain Teaser? #27 Click Here

 

 

Richard Hom

 

Technology Corner

What is a NetBook?

One of the newest iterations of portable computers is a notebook like computer that is commonly much smaller than a regular notebook but a bit larger than a common paperback book.  It's lightweight not only physically but also in terms of the operating system used. Some will use Linux or XP Home Basic that is stripped down.  In some cases, instead of a hard disk drive, the computer will house a solid state disk drive not unlike a compact flash or SDHC non-volatile memory card.

With such a modest foundation, the netbook is aimed squarely at users who depend upon web and/or online applications more than stationary applications that are purchased and dedicated solely for a computer.

Netbooks appeal to users because of its smaller size than today's notebook computers which have steadily grown in size, weight and complexity. They don't try to emulate the desktop computer as the traditional notebook does, but can offer the frequent traveler a usable tool where weight, size and complexity are a premium.

On the face, their cost may be a $100-$200 less than traditional notebooks but they can be equally as expensive as their larger brethren if similarly equipped. Then what is their attraction? Mainly their stripped down models are nimble, small and easy to use.

For the frequent traveler or student, it might make a great lecture hall companion or editing or drafting document tool.

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