Inaugural-dissertation, Medizinische Fakultät der Friedrich-Wilhelms-Universität zu Berlin, 1900.

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Thesis (MPH)--University of Limpopo, 2011. / Introduction: Diabetes, also known as diabetes mellitus characterized by hyperglycemia is a global health problem. The World Health Organization (WHO) reports an estimated 177 million diabetics worldwide and this number is expected to double by the year 2030 mainly because of the unhealthy life styles of not doing physical exercises and eating unhealthy food. The resultant obesity is putting people at risk of developing diabetes and micro vascular complications like diabetic retinopathy that can affect a person’s eyesight. Aims and Objectives: The aim and objectives of this study were to determine the socio-economic characteristics and the level of awareness regarding the eye care services offered by the diabetic clinic at Dr George Mukhari Hospital as well as to identify the referral patterns and possible factors that may influence diabetic patients to utilize these offered services. Study methodology: Data was collected from adult diabetic patients attending the diabetic clinic at Dr George Mukhari Hospital by making use of an anonymous researcher assisted structured questionnaire. The questionnaire had sections covering the socio demographic and epidemiological information of the respondent; awareness about diabetic complications with emphasis on routine eye care; referral patterns of health professionals to the eye specialist and other barriers that the respondents experienced in attending the available eye care services. Results: Data was collected from a total of 175 respondents. The majority of the respondents were African (98%) females (75%) and older than 56 years of age (82%). Basically all the respondents (98%) did not have a medical aid and 50.3% of them were unemployed and had to make use of public transport to visit the clinic. Ninety six percent of the respondents were aware of the fact that diabetes can cause eye complications and that a routine eye test is important to prevent blindness. In this group of participants there was a referral rate of 95% which proved to be very successful because only 18% of the respondents were in need of an eye operation while the rests were treated for minor problems and then discharged. Conclusions: Based on the findings of this study all indications are that the referral patterns for diabetic patients from the diabetic clinic at the Dr George Mukhari hospital for eye testing is effective. All efforts should be made to ensure that diabetic patients go for a yearly routine eye test.

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Thesis (doctoral)--München, 1935.

Thesis (doctoral)--München, 1935.

The purpose of this research was to develop a psycho-educational counselling programme for the handling of people suffering from a severe ophthalmologically challenge. It appears that people who are severely ophthalmologically challenged do not only experience it physically but also experience negative feelings such as a crumbling self-image, a lack of self-confidence, various fears as well as depression. Their state of mind induces a change with regard to their interpersonal relationships because they avoid social interaction, as well as feelings of loss and they experience a change regarding acceptance by others. However, it has transpired that people who are severely ophthalmologically challenged make use of various mechanisms such as support by others, the gathering of information and humour in order to handle their ophthalmological challenges. Society attaches so much importance to external appearance which does not make it easier for a person suffering from a physical "dissimilarity" and it influences the person's metal health. As a consequence the researcher began asking the following questions: 1. What does the world in which a severely ophthalmologically challenged person live, look like? 2. How can a psycho-educational counselling programme lead such a person to mental health and self-acceptance? A qualitative, explorative, descriptive and contextual research design was followed. The research took place in four phases: In phase 1 the experiences of people with severe ophthalmological challenges were explored and described, by means of phenomenological, unstructured, in-depth interviews with the patient and significant others such as parents, spouses and children. In phase 2 the psycho-educational programme for the person with severe ophthalmological challenges was developed based on the results of phase 1. In phase 3 this psycho-educational counselling programme was implemented. During phase 4 the evaluation of the psycho-educational programme took place by means of a single case study. The motivation behind the development of such a programme was to create a framework in which people with severe ophthalmological challenges could develop constructive interpersonal communication skills. They could also be afforded the opportunity to reflect through discourse. By attaching significance to their discourse they can accept their changing circumstances and act self-assertively. The programme has been facilitated so that psycho-educationists and other professionals may use it to facilitate the counselling programme to improve mental health for people who are severely ophthalmologically challenged. / Prof. C.P.H. Myburgh Prof. M.Poggenpoel

A Thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy / Pterygium, a wing-shaped fibrovascular growth of the conjunctiva onto the cornea, can impair vision and be cosmetically unacceptable. Its frequency varies in Africa and postsurgical recurrence in blacks may be high. Determinants of pterygium occurrence and recurrence in rural Africans are not known. This study aimed to establish the determinants of pterygium occurrence and recurrence in rural blacks. The case controlled study comprised 230 patients and 157 controls. Interviews and eye examination were conducted; however, data from 150 patients and 150 controls were analyzed as pre-calculated. Families of 51 cases and 50 controls were studied. Surgery was done on 200 eligible patients. Those who experienced post-surgical recurrence were subclassified as cases and those who did not, controls. Immunohistochemistry was done on 59 pterygium sections and 7 controls. Family history of pterygium was present in 46 cases (30.6%) of 150, and 15 controls (10%) of 150; Odds ratio (OR) =3.93; p <0.01. Traditional eye medication was used by 79 cases (52.6%) of 150, and 60 controls (40%) of 150; OR =2.03; p <0.01. The tear film was unstable in 10 cases (6.6%) of 150, and 26 controls (17.3%) of 150; OR =0.30; p <0.01. Groups of 3-5 individuals per household were pterygium-affected in 36 pterygium families (70.5%) of 51 vs. 1 control (2%) of 50. After surgery, only 190 patients completed followup for a minimum duration of 6 months, and 52 (27.4%) experienced post-surgical recurrence. Of the 52 cases, 21 (40%) had grade 2 pterygia v. 8 post-surgical controls having grade 2 pterygia (6%) of 138; OR =9.1; p <0.01. The limbal basal epithelium expressed p53 in 11 pterygia (18.6%) of 59 v. 5 controls (71.4%) of 7; p <0.01. It expressed matrixmetalloproteinase-1 (MMP1) in 14 pterygia (23.7%) of 59 v. 5 controls (71.4%) of 7; p =0.02. MMP2 and MMP3 were detected in 16 cases (27.1%) of 59 v. 5 controls (71.4%) of 7; p =0.03. Pterygium occurred in families and was associated with traditional eye medication. Pterygium occurrence was not associated with unstable tear film, p53, and MMPs. Postsurgical recurrence was connected to grade 2 pterygia.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 177-187).

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