Panel ophthalmic practice / by A. Freeland Fergus.

  • Fergus, A. Freeland (Andrew Freeland), 1858-1932.
Date:
[1919?]
Catalogue details

Licence: In copyright

Credit: Panel ophthalmic practice / by A. Freeland Fergus. Source: Wellcome Collection.

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    The Need of an Adequate Staff. At our eye clinics the number of people is far too great for the staff. Take, for example, an afternoon at the Glasgow Eye Infirmary. There may be myself, one of my colleagues, a junior assistant, and possibly a house surgeon. There may, on a busy day, be say 60 new patients and 100 old, in all 160 people to be seen by three of us with all these various complicated diseases which can only be diagnosed with an immense amount of care and time. That works out at something like 60 for each of us ; supposing we each work for four hours, about 12 to the hour. Accurate ophthalmic diagnosis cannot be done like that. It leads, as I know from painful experience, very frequently to failure to recognise many important conditions. Just take a patient with a muscular insufficiency ; a proper examination will take from half an hour to three-quarters of an hour. Supposing, in addition to that, you have a patient with an astigmatism ; that may take 20 minutes to work out even if done hurriedly. Now because I think the results obtained in our eye clinics are not good I wish to see an alteration, but not unless it is an improvement. If merely a certain amount of money is to be distributed in salaries I do not wish to have anything to do with it, but if the poorest of the land will have painstaking, thoroughly well-informed assistance in his or her necessity, then it has my whole-hearted support. Meantime, the first thing to do is to train the ophthalmic surgeons. I personally have suggested on several occasions that there should be an ophthalmic diploma which would make sure that the holder at any rate knew the elements of mathematics ; that in addition he knew conjunctival pathology and bacteriology ; and that he had good labora¬ tory training in physics bearing particularly on the subject and on physiology. The foregoing gives some account of how I would train ophthalmic surgeons and the class of men that I would employ as specialists for panel ophthalmic work. People who have undergone a training such as indicated are the only persons who have any right to be called eye specialists. Hospital Accommodation. The next question is as to where these men are to work. There would require to be in every centre ophthalmic hos¬ pitals, with attending nurses and adequate ward accommoda¬ tion. The days are past when you could see a patient and write a prescription for some lotion and send the patient away. It is not the lotion that is important, but the applica¬ tion of the sterilised fluid to the removal rather than to the