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This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

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 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Central Retinal Artery Occlusion

Varma et al. (2013): doi:10.1038/eye.2013.25

ASSIGNMENT 2
1. How you searched for a source (search strategy – where you went to find it). To search for the above citation, PubMed was used. Advanced search was used specifically to find review articles describing signs and symptoms of central retinal artery occlusion (CRAO) within the past 5-7 years. 48 items were found.

2. What potential sources were identified and considered (give examples of 1 or 2). Besides the article ultimately chosen (Varma et al. (2013)) another article that was given consideration was Hayreh (2018). While being a more recent article, some issues that I had with this review included: being published in a lesser-known journal, having a sole author, and, relatedly, having clear opinions within the text that do not seem to be entirely substantiated by the literature. Examples of this include how Hayreh SS approaches patients that arrive with suspected CRAO. This may be indicative of a bias, and thus may not be appropriate for consultation when looking for signs and symptoms.

3. Why the source was chosen (what made it better than other choices). Varma et al. (2013) was identified as the best possible source using my search strategy because it is a relatively recent article published in a reputable journal (Nature Eye) and was centred around the presentation and management of CRAO. Thus, this article would describe the relevant signs and symptoms and could be useful for extracting information from. The reputability of the journal is what solidified my decision for using this article -- I could trust that the information was peer-reviewed and accurate.

4. List at least three reasons why the source that was selected meets Wikipedia’s reliable medical sources (MEDRS) criteria. Three reasons that this article meets the MEDRS criteria set by Wikipedia are:
 * 1) It is an unbiased secondary source (a review).
 * 2) It is accessible to everyone who wishes to view it (no paywall).
 * 3) It was published within the last 7 years, which makes it a relatively recent, up-to-date article.

5. How do you plan to use the source for improving the article? I plan on using this source to supplement the signs and symptoms portion of the Central Retinal Artery Occlusion Wikipedia page. Due to this being a review article, I believe there should be ample information to accurately and concisely update this section.

ASSIGNMENT 3
1.

Previous version: "Central retinal artery occlusions cause sudden, acute, and painless loss of vision in one eye. Fundoscopic exam will show a red lesion, called a 'cherry red spot,' with surrounding pale retina (the pale color is caused by ischemia of the retina), afferent pupil defect, periorbital eyelid edema, proptosis, ptosis, and at times a hazy/cloudy cornea."

Planned version: "Central retinal artery occlusion is characterized by painless, acute vision loss in one eye. Upon fundoscopic exam, one would expect to find: cherry-red spot (A morphologic description in which the normally red background of the choroid is is sharply outlined by the swollen opaque retina in the central retina) (Figure 1) (90%), retinal opacity in the posterior pole (Figure Y) (58%), pallor (39%), retinal arterial attenuation (32%), and optic disk edema (22%). During later stages of onset, one may also find plaques, emboli, and optic atrophy."

Figure Y image: Retinal opacity in the posterior pole

2. The rationale for the above changes included:
 * 1) It is important to denote typical changes seen upon examination to aid in diagnosis, along with their associated frequency. The previous version had vague signs and symptoms not necessarily indicated of CRAO as per what the literature describes.
 * 2) Grammar and spelling were corrected (ie. cherry red spot,).
 * 3) Hyperlinks to associated wikipedia articles helps to breakdown complex medical language by creating a portal in which a user foreign to the topic could seek clarification.
 * 4) An example figure for the cherry-red spot and retinal opacity in the posterior pole (the two most commonly seen signs) were included due to their prevalence. The retinal opacity of the posterior pole was also not able to be hyperlinked to an existing page for clarity (as it is a more visual phenomenon) thus an image would be the most effective way to explain this sign.
 * 5) The above changes made the section more concise (got rid of repeated words/section) as well as provided clarification for confusing pieces of information. Furthermore, the provided frequencies of observation may assist in diagnosis.
 * 6) Also included was a "later stages of onset" section (absent from the previous version) to explain other presentations that may be seen that are indicative of later-stage onset (ie. treatment may be more emergent) and not commonly seen upon physical observation.

3. N/A (no controversy about planned changes to the section noted).

4. I don't have any major critiques to the source used. Varma et al. (2013) is a review of central retinal artery occlusion published in Eye. Being that it is not a systematic review or a meta-analysis, the level of quality of this journal leads me to believe that it is unbiased (the authors reported no conflicts of interest) and rigoursly peer-reviewed. Potential reasons for concern include the abstracts being reviewed by only two people (no third party to distinguish a tie or if there was a differing opinion). This could also lead to selectively chosen articles that may not represent the full body of information (ie. language bias). There is also the potential for outdated information being that it is from 2013. However, based on other literature I have read regarding this topic, the signs and symptoms described in the review seem relevant and clinically significant, decreasing my hesitation that it is outdated.