1. Is it justifiable for us teaching to next generation knowingly nonprecise medical terms when we are talking of precision of every fraction of nanosecond ? *No financial interest at all (Dr.G.Ramachandra rao)-

2. Concept Study of ophthalmic grumblings - Off the dias Scientific speak-out -On the dais

3. Thanks to APOS-2010 for accepting our Appeal-my Lord Presentation of this paper, is neither of criticism nor of intention of leg-pulling exercise to anybody. - Appellants - Appellants

4. Present Need Warrant of Attention  More than 100 years ago: Retinoscopy, syringing, R.D, ICCE  40 years ago: ECCE  28 years ago: Phaco emulsification  10 years ago: Sics  8 years ago: Manual phaco, Nonphaco  5 years ago: CVS

5. Aim Free ophthalmic literature from non-precise scientific terms & provide precision to avoid answerability to next generation

6. Materials & Methods September 01 to July '02  394 eye specialists at and around Hyderabad  Guest speakers from Mumbai, Delhi, Chennai, Bangalore, UK & USA  Analytical study in conveyance of the meaning in dictionaries, books, journals  E-mails  Letters  Telephonic discussions

7. Habituated use of literature  Above 55  Retired prof-------52  Senior prof--------25  Senior practioners- 110  Total-187  Below 55  Asst.prof-----------50  Registrars---------10  Senior residents-28  Residents---------12  Post-graduates—32  Practitioners-------75  Total---------------207

8. Stetho-Scope (Laennac)  Steth: G.algos: Chest  G. Skopeo: to view Douglas M. Anderson Donald illustrated medical dictionary - 28th ed. 1994: 1579 Majory spraycon Stedman's medical dictionary - 26th ed. 1995-1677 Stethophone

9. Retinoscopy  Retina - scopie: view  Are we viewing the retina ?  Pupilloscopy  Shadow test Macdonald critchley, Butterworthi Medical dictionary 2nd ed, 1989: 1468

10. Syringing  VL test (Voie lacrimal = Route lacrimal) (In French) Lacrimal patency test

11. Intra-Capsular cataract extraction (ICCE) Macdonald critchley, Butterworth's Medical Dictionary 2nd ed. 1989:635 expresses: "Within the capsule cataract extraction“ Instead, WCCE = With capsule cataract extraction Or TCE = Total cataract extraction Or Catarectomy

12. Extra-capsular cataract extraction (ECCE)  Expresses "Outside the capsule cataract extraction"  RPCCE : Retained posterior capsule cataract extraction  Whenever ECCE fails, people are habituated in calling ICCE  CEPCB : Cataract extraction with posterior capsule break

13. Phaco Emulsification (Kelman)  Majory spraycon, Stedman's Medical dictionary 26th ed, 1995:1338  Douglas M Anderson: Donald's illustrated medical dictionary 28th ed, 1994:1270  Macdonald critchley, Butterworth's Medical dictionary 2nd ed, 1989-1289  Gr. Phakos: Crystalline lens  L. Emilgere: to mix out  Are we doing crystallin lens emulsification when we talk of phaco?  Kelman’s emulsification

14. Small Incision Cataract Surgery (SICS)  Sufficient sized incision is bound to undergo to remove the nucleus and implant the IOL  How can we call "small" when we are bound to do the optimum incision to facilitate the nucleus and the IOL to go out and to go in ?  Is there any big incision ?  "Small" the word is a relative - Tunnel incision cataract surgery (TICS)

15. Stethoscope(?)-stethophone Stethoscope(?)-stethophone Retinoscopy(?)-pupilloscopy Retinoscopy(?)-pupilloscopy Syringing(?)-lacrimal patency test Syringing(?)-lacrimal patency test RD(?)-sensory retina separation RD(?)-sensory retina separation ICCE(?)-WCCE ICCE(?)-WCCE ECCE(?)-RPCCE ECCE(?)-RPCCE Phacoemulsification(?)- Phacoemulsification(?)- cataract emulsification cataract emulsification SICS(?)-TICS SICS(?)-TICS Nonphacosics(?)-NETICS Nonphacosics(?)-NETICS Phaco to sics or sics to phaco- Phaco to sics or sics to phaco- TICE TICE CVS(?)-FDOVS CVS(?)-FDOVS

16. Our collective study results Above 55 years(187):76 (40.6%) do not want change 56 (30.2%) silent but grumble 55 (29.2%) want change but how ? Below 55 years(207):145 (77.3%) want change but how ? but how ? 62 (32.7%) nothing can be done at this stage Nil % : Silent

17. Our analysis of results  Psychology plays prominent role than precision, because of habituation even in text-books  Is it difficult to change psychology ? (or) shall medical terms play with psychology than science ?

18. Present Need  How to provide both to future generation ? To avoid answerability to the future generations

19. Conclusion  Changing of terminology is difficult but not impossible (History says) papillitis to optic neuritis  Habituation is continued as long as communicative precision is not questioned. When precision is questioned, habituation is to be altered but how ?

20. Our answer is  From where we have learnt, to them we represent ( there is no other go) ( there is no other go)  View in this angle of research workers, editors, teachers, & all ophthalmology societies is expedient  Need for creation of separate window in journal for airing views  ISO standards for medical terms in ophthalmology

21. Audience write…. Do you want change Yes No Do you want anonymityYesNo Your opinions / suggestions / remarks / comments / up date E-mail : drkattasv@rediffmail.com Your feedback becomes direct contribution to this concept

22. Samuel Boyd's (E-mail)

24. Anderson's (E-mail)

26. Sullivan, Paul’s E-mail Thank you it looks very interesting. Ferenc Kuhn has been doing alot of work to clear up the confusing terminology in ocular trauma - you might want to cite some of his work The Birmingham Eye Trauma Terminology system (BETT). J Fr Ophtalmol. 2004 Feb;27(2):206-10. Review. PMID: 15029055 [PubMed - indexed for MEDLINE] [Sullivan, Paul]

27. Paolo Lanzetta’s E-mail Dear Doctor, Thank you for sending your presentation and asking for my opinion. I tried to understand the spirit of your material and I fully understand that there are a number of imprecise terms in medicine and ophthalmology. I remember how hard were the concept of ICCE and ECCE to understand when I was doing my internship because the two terms do not describe the surgical procedure adequately. I would also take some more examples from the field of eye traumatology. The new terms introduced by dr. Kuhn have simplified our understanding and overall have standardized the terminology. I fully agree that there is a tremendous need for some changes in terminology. Good luck for your presentation. Best regards, Paolo

29. Akira Momose- Fax  1957- retinoscopy should be refractoscopy  Wishing me to do revolutionary effort needed for change in nonprecisive terminology

30. Dear Dr.Katta, Quite interesting. good presentation, good number of words, good referrels But, it looks like guest lecture with customised free paper presentation.There is no other way to expose such problems. Let us see how our seniors react & work it out------Anonymous

31. Not for insistence but only for awareness PLEASE ….. my Lord  IJO : Appreciation with refusal  AJO: Appreciation with refusal  ARCHIVES: Refused  BJO: Silent  HOO: Silent  Ferenckuhn, fkuhn@mindspring.com----- -silent  Springer: appreciation with refusal  AIOS: refused 3 times,4 th time accepting with 180 marks

32. Uniqueness of this presentation  First time evidence-based controversy  First time email correspondence  First time thought of opinions of different societies  First time debate & controversy through net passed on to the masses  For manuscript see http://www.eophtha.com And for more details search Google or http://www.slideshare.net

33. Request Appeal-my lord  Whether our presentatation is good? Yes or no  Whether our evidences are good? Yes or no  Whether precision is to be passed on to next generation instead of habituation? Yes or no Is it justifiable for us knowingly non-precise terms passing on to next generation ? when we speak of precision every fraction of nanosecond. OM TAT SAT (Sanskrit – inside your own see) -Thanking you very much my lord -Thanking you very much my lord -Appellants -Appellants