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UK hospitals without protection.


For several weeks before the
assess eye eclipse, several agencies had run
damage after campaigns warning of the dan-
gers of looking directly at the
solar eclipse sun during the event. There
were fears that because the
Roger Dobson Abergavenny eclipse was occurring at the
95,142 height of summer, when the sun
nears its zenith, over densely

MICHAEL PROBST/AP PHOTO


Public health warnings about the populated areas, the incidence
dangers of looking at the sun of retinal injury would be
with unprotected eyes during the greater than after similar events
solar eclipse earlier this month in the past. “We are quite
seem to have been heeded by pleased that the number of peo-
most British viewers. Several ple suffering solar retinopathy is Eclipse watching: health warnings were largely heeded in the UK
thousand people rang helplines relatively low, and it shows that 15436
or attended special eclipse clinics the campaign and health educa-
after experiencing the event, but tion messages worked and did the lasting effects of glare, about nal receptor cells. The condition
the number of cases of solar reach the vast majority of the headaches, and blurred vision. can occur without pain and with-
retinopathy reported by eye hos- population,’’ said Jonathan Most were false alarms. One out being immediately apparent.
pitals and units was lower than Dowler, consultant ophthalmic overseas tourist who sought help No treatment has been shown to
was widely feared. Almost a week surgeon at Moorfields hospital. in Glasgow said that she was wor- be effective for solar retinopathy.
after the eclipse, on 11 August, Widespread cloud cover over ried because she had not been In some cases the retinal
the BMJ has learned of at least 14 large areas of the United King- exposed to the Scottish sun changes seem to be reversible,
confirmed cases during inquiries dom is also likely to have played before. Another Glasgow patient but in others there is permanent
to leading eye centres. a part in keeping down the num- was concerned that her face had loss of the photoreceptors. In a
On Monday 16 August, ber of cases of serious eye dam- been turned yellow by the eclipse study after an eclipse in Turkey
Moorfields Eye Hospital in Lon- age. Although the number of but was told that her longstand- in 1976, around 10% of those
don reported six confirmed cas- confirmed cases is small, early ing liver problem was the culprit. with damage had permanent
es. Other totals were as follows: indications are that after the There are two main mecha- visual loss to the extent that they
Birmingham Eye Hospital (five), eclipse many more people used nisms of retinal injury from solar were not able to read a car num-
Derbyshire Royal Infirmary’s eye eclipse helplines, run by some of radiation. Thermal burn is ber plate at 25 yards (23 metres)
unit (three), and Bristol Eye Hos- the eye hospitals. Moorfields caused by looking at the sun with the affected eye or eyes.
pital (one suspected case). No received 1600 calls, and Birm- through a telescope or through Simon Keithley, a consultant
confirmed cases were reported in ingham and Bristol received 300 other optical aids, which can ophthalmologist based in Bas-
any of the specialist units serving each. At Moorfields hospital 220 cause a temperature rise of ingstoke, is asking all members of
Scotland, Wales, or Northern Ire- people presented at the accident 10-25°C in the retina. But the the Royal College of Ophthal-
land. Most of the known cases and emergency department, and most common form of solar mology to provide data on the
resulted from looking at the sun at Birmingham Eye Hospital 64 retinopathy is caused by looking incidence of solar retinopathy
without protecting the eyes. In patients were seen at special at the sun without eye protec- before and after the eclipse. He
one of the more serious cases the eclipse clinics. tion. A retinal temperature rise expects to have the data, collect-
patient had reportedly looked at Callers to the helplines of as little as 4°C can trigger ed via the college’s postal surveil-
the sun for around 20 minutes included people worried about photochemical injury to the reti- lance system, by October.

uncomplicated vaginal delivery” and 1995 the trend was towards


Earlier discharge for newborns reflects a change in attitude a stay of 48 hours or less, said
may increase health risks towards childbirth and outpa-
tient care, as well as declining
the authors. The Canadian Pedi-
atric Society and the Society of
David Spurgeon Quebec state funding. Obstetricians and Gynecologists
68,202 Furthermore, they argued, of Canada in 1996 recommend-
childbirth has been “demed- ed a hospital stay of 12 to 48
A Toronto study suggests that and 29 September 1997 at Scar- icalised” and viewed as a natur- hours if there is no maternal or
the trend to early discharge of borough General Hospital in al process requiring minimum neonatal illness and if adequate
newborn infants after uncompli- Toronto, Ontario. Two groups medical intervention if the social support exists. “The
cated vaginal delivery may not were involved: 5936 infants in delivery is uncomplicated. “The demand by practitioners and
be good for the babies. Drs one group were born before the establishment of out of hospital policy-makers for evidence-
Michael Lock and Joel Ray hospital introduced (in April birthing centres and of mid- based and outcomes-based
found that a fall in the average 1997) a clinical guideline aiming wifery led delivery programmes research has not produced a
stay from 2.1 to 1.9 days was at discharge within 24 hours; the is an example of this change. definitive answer to the question
associated with a rise in the other 1073 infants were born The medical community has of length of stay,” the authors
readmission rate of newborn after implementation of the further responded by decreas- reported. As their research
infants from 5.2% to 10.4%. The guideline. ing the use of cesarean delivery shows that small decreases in
primary cause for readmission In their paper, published in and average length of stay in length of stay may result in sig-
was neonatal jaundice. the Canadian Medical Association hospital.” nificant increases in morbidity,
The study was carried out Journal (1999;161:249-53), Drs As recently as the 1980s, a “studies that may help policy-
among all 7009 infants delivered Lock and Ray noted that the stay of four to six days was not makers and clinicians to arrive at
vaginally, and without complica- “progressive move towards early uncommon for women and a reasonable figure for length of
tion, between 31 December 1993 discharge of newborns following their newborns. Between 1984 stay are needed.”

BMJ VOLUME 319 21 AUGUST 1999 www.bmj.com 469

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