Letter to the Editor
Is it time to adapt to the sub-specialised model in ophthalmology?
¿Es el momento de adaptar el modelo de asistencia subespecializada en oftalmología?
R. Gallego-Pinazoa,b,
, R. Dolz-Marcoa,b, J. Donate-Lópezc, L. López-Guajardod,e, R. Abreu-Gonzálezf
Corresponding author
a Servicio de Oftalmología, Unidad de Mácula, Hospital Universitario y Politécnico La Fe, Valencia, Spain
b Red Temática de Investigación Cooperativa OFTARED, Instituto de Salud Carlos III, Madrid, Spain
c Hospital Universitario Clínico San Carlos, Madrid, Spain
d Servicio de Oftalmología, Sección de Retina, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
e Departamento de Cirugía, Ciencias Médicas y Sociales, Facultad de Medicina, Universidad de Alcalá, Madrid, Alcalá de Henares, Spain
f Servicio de Oftalmología, Sección de Retina, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
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Even so, on some occasions changes are loudly demanded by ophthalmologists and medical managers as well as by patients.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In ophthalmology, evolution is advancing at a rapid pace. I hope readers can accommodate my professional bias and focus on the subspecialty of retina. In 2006, with the advent of antiangiogenic medication, treatment for the most prevalent macular diseases finally developed from being palliative to actually curing. However, this treatment requires a well-defined dosage and follow-up strategy, and any random modification thereof is systematically in detriment of the vision of patients. On the other hand, retina surgery has been optimized with new instruments and supporting tools that allow us to approach previously incurable cases with guaranteed success. However, beyond the area of retina surgery, we all know the management problems brought about by the treatment of macular and retina medical disease.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite said evolution, many reference hospitals maintain “macroscopic” departments established many years ago, like the “macroscopic” retina Dept. even though they are very far from current treatment approaches. In order to ensure effective and efficient care to patients with subsidiary retinal diseases with intravitreous treatments it is necessary to have qualified medical staff. This involves setting up a specific unit. Moreover, even within a macular disease unit, care and treatment procedures are different for age-related macular degeneration, diabetes, myopia or venous occlusions. Accordingly, a “<span class="elsevierStyleItalic">super-specialization</span>”, which is an aspiration of diagnostic and therapeutic means, would enable said units to become independent training and functional units. In addition, this would enhance interaction with other specialties, promoting the creation of multidisciplinary units. Is it far-fetched to bring in a psychologist to support age-related macular degeneration patients? Or to engage an optometrist specialized in poor vision?</p><p id="par0020" class="elsevierStylePara elsevierViewall">Reality has to be accepted. And the reality is that we are NOT able to approach the management of patients with MEDICAL macular and retinal diseases. Accepting this reality is the first step, which should be followed by an essential modification of the current management and structure of ophthalmology departments. Otherwise, when treatments for geographic atrophy begin to appear, it is likely that the bubble will burst and, one more time, we will be in the midst of it. It is always a good time to improve because, the way we work nowadays in accordance with clinical practice studies, patients simply do not benefit from the results of their treatments. Their vision deteriorates and quality of life goes down with it. This is not fair and is avoidable. We can and we must resolve this problem.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gallego-Pinazo R, Dolz-Marco R, Donate-López J, López-Guajardo L, Abreu-González R. ¿Es el momento de adaptar el modelo de asistencia subespecializada en oftalmología? Arch Soc Esp Oftalmol. 2016;91:508–509.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009100000010/v1_201609240012/S217357941630069X/v1_201609240012/en/main.assets" "Apartado" => array:4 [ "identificador" => "5813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009100000010/v1_201609240012/S217357941630069X/v1_201609240012/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941630069X?idApp=UINPBA00004N" ]
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