Clinical and Experimental Ophthalmology (2002) 30, 60–61
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Letters to the Editor
Letter to the Editor
Health status of Lebanese
ophthalmologists
Which procedure, which eye?
In modern day-care ophthalmic surgical facilities, it is often
difficult for the surgeon to meet with the next patient on the
list before any preparation or anaesthesia is commenced. For
the surgeon to meet the patient prior to any preparation,
either all the patients would need to be present before the
list begins, or each patient would need to have arrived
before surgery had started on the previous patient.
The commonly used final safeguard to determine the
correct procedure and side, namely the surgeon talking with
the patient and marking the side, is thus not able to be done
without either wasting surgical facility time or inconven-
iencing patients by having them arrive early.
We have recently adopted an idea from the Wills Eye
Hospital in Philadelphia, USA, of having a stamp placed in
the patient’s chart at the time the patient is booked for
surgery (Fig. 1).
In the day or two prior to a list, the surgeon goes through
the charts and completes the stamped details, which serves
as a final clear documentation of the surgical plan. It is a rule
that no preparation, such as eye drops or local anaesthetic,
is to begin unless the stamp has been completed and signed
by the surgeon.
Little is known about the health status of ophthalmologists.
To this end, interviews were conducted with the ophthalmic
community concentrating on medical and ocular problems
as well as smoking habits. Smoking habits were compared to
the general medical population via a second independent
interview (designed to study smoking habits in health pro-
fessionals) and to the national consumption.
All registered 171 ophthalmologists in Lebanon were
interviewed by the authors (AMM, ATS, NGG) either in
person (149) or by telephone (22). Lebanon has 6613 phy-
sicians consisting of 5500 men and 1113 women. A repre-
sentative sample was selected (by FM and MG) covering
9.6% of Lebanese physicians. The sampling was performed
by including all the small private hospitals (31 in number) in
the five districts that form Lebanon. A person-to-person
interview by second-year medical students was conducted
with 635 practitioners filling a questionnaire. The question-
naire included age at initiation of smoking, smoking habits,
attitude towards smoking and towards smoking campaigns,
willingness to stop smoking, and awareness of smoking
hazards (only the smoking habit will be discussed to
compare ophthalmologists to medical practitioners).
The mean age of ophthalmologists was 43 years (range,
28–69 years) with a large male preponderance (93% men).
Systemic disorders included: coronary heart disease (3.0%),
hyperlipidemia (3.0%), spinal disc disease (3.0%), systemic
hypertension (2.4%), diabetes mellitus (1.8%), kidney stone
(1.2%), migraine (1.2%), hyperuricemia (0.6%), asthma
(0.6%), sinusitis (0.6%), and pituitary adenoma (0.6%).
Ocular disorders included: cataract (0.6%), optic nerve
atrophy (0.6%), and keratoconjunctivitis sicca (0.6%).
Female ophthalmologists were all non-smokers. Smoking
habits among male ophthalmologists included non-smokers
(60.4%), smokers (27.7%) and ex-smokers (11.9%).
Smoking in current smokers included cigarette (75.0%),
cigar (13.6%), pipe (6.8%), and hubble-bubble (an Oriental
pipe with a long hose; 4.6%) with mean pack-years of 16.3.
Smoking in ex-smokers included cigarette (94.7%) and cigar
(5.3%) with mean pack-years of 18.6.
The 635 non-ophthalmologist practitioners interviewed
consisted of 450 men and 185 women (1 male and 2 female
physicians refused to participate and were not included in
the analyses). Male physicians were non-smoker (63.5%),
smoker (36.2%), and non-responder (0.3%). Female physi-
cians were non-smoker (81.6%), smoker (17.3%), and non-
responder (1.1%). Male smokers consumed cigarette
This procedure does not address the problem of the
wrong record being associated with the wrong patient, this
still must be verified by cross-checking name, address and
date of birth. Nevertheless, in the setting of a high-volume
day surgery facility, we believe that the simple but obliga-
tory stamp adds another safeguard against error.
O Bruce Hadden FRANZCO
Eye Institute,
Auckland,
New Zealand
Letter to the Editor
EYE: RIGHT / LEFT
OPERATION:………………………………
ANAESTHETIC:
TOPICAL / LA / GA
SURGEON:…………………………………
Figure 1. Stamp placed in patient’s chart.