[The most serious incident-Experiences of aggression and violence in ophthalmology]. / Der schwerwiegendste Vorfall ­ Erfahrungen von Aggressionen und Gewalt in der Augenheilkunde.

BACKGROUND: Experiences of aggression/violence influence job satisfaction and can have a long-term psychological and physical impact on employees. In the fall of 2018, the Professional Association of Ophthalmologists (BVA) and the German Ophthalmological Society (DOG) conducted a survey on experiences of aggression and violence. The first results were published in 2020. In the survey it was also possible to describe the most serious incident to date using free text fields, among others. METHOD: All 9411 members of the DOG and BVA were given the opportunity to complete a questionnaire online in 2018 regarding aggression and violence in ophthalmology. RESULTS: Overall, 253 of 1508 (16.8%) ophthalmologists participating in the survey reported their most serious incident, 46.8% of which were classified as moderate and 34.3% were related to verbal violence such as insults and threats. The most serious incident was experienced by 171 (67.6%) physicians in a practice setting, 71% were specialists at the time of the incident and 74.3% of the incidents occurred during regular working hours. The main causes were intercultural conflicts, long waiting times, problems with the allocation of appointments, excessive expectations, differences in treatment and basic aggressiveness. The offenders were male in 86.3% of cases, 15.8% of the incidents were reported to the police and 21 (8.3%) physicians issued a practice reprimand or house ban. DISCUSSION: The description of the most serious incidents illustrates situations that are sometimes hard to imagine and also which incidents were considered serious. There are large subjective variations in the assessment of the incidents. Protective measures in practices and clinics are essential.

[Experiences of aggression and violence against ophthalmologists]. / Erfahrungen von Aggression und Gewalt gegen Augenärztinnen und Augenärzte.

BACKGROUND: The media have reported an increased willingness of patients and relatives to use violence against medical personnel. So far a few studies have been carried out on this topic and the data situation is correspondingly weak. Ophthalmologists in particular have close contact with patients at the slit lamp and are often alone with patients. METHODS: A questionnaire was developed based on the perception of prevalence of aggression scale (POPAS) questionnaire and the survey on aggression and violence among general practitioners. In autumn 2018, all members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists (BVA) received an invitation by e­mail to complete the questionnaire online. RESULTS: Of the 9411 ophthalmologists contacted a total of 1508 (age 49 ± 12 years) took part in the survey (16%). Of the respondents 806 (53.7%) were female and 1139 (75.5%) participants worked in practices. A total of 1264 (83.3%) ophthalmologists had experienced aggression/violence in their work, 986 (65%) respondents had already experienced verbal assaults without threats, 363 (24.1%) doctors reported experiences with threats of physical violence and 30 (2%) participants had received medical treatment for severe physical violence. Sexual intimidation/harassment was affirmed by 322 (21.4%) of respondents, of whom 243 (75.5%) were female and 533 (47.9%) doctors felt that aggressive/violent behavior had increased in the last 5 years. CONCLUSION: The high number of participants indicates the high relevance of the topic. The survey produced astonishing results, which should lead to further discussion and action to improve the safety of employees.

[Toxic substances with silicone oil after intraocular injections]. / Toxische Substanzen im Silikonöl nach intraokularer Injektion.

In articles about the analysis of intraocular silicone oil, mostly the amount and toxicity of low-molecular-weight components (LMWC) have been investigated. This study was intended to analyze the components of silicone oil following a longer intraocular application. We analyzed silicone oil removed from human eyes with PVR a few months postoperatively. The fraction of LMWC was further investigated and we separated 16 different components belonging to hexachlorhexanes (HCH), polybiphenyls (PCB) and dichlor-diphenyl-trichlorethane (DDT). All these substances are said to have a toxic and cancerogenic effect as well as weakening the immune system. The concentration of these organic chloride components measured in intraocular injected silicone oil is about the same as fatty tissue but exceeds the concentration in human blood enormously. Possible damage to the retina by these toxic substances is another reason for early removal of silicone oil if the situation of the retina is stable.