Not long ago, finding help or advice for a difficult patient case was just as difficult for the solo practitioner as the case itself. Searching through old, discarded journals, paging endlessly through Duane's or other encyclopedic resources and calling a colleague were the only options we had for on-the-spot diagnostic or management help.

Fortunately, times have changed and we now have more resources at our fingertips. If you have a computer and a live connection to the Internet, you have one of the most powerful research tools at your disposal. A simple click of your mouse can bring you in touch with experts who can contribute their advice on diagnosis and treatment options.

This month, I'll review six Web sites that will make your job much easier. Keep them on hand in the event you're faced with a case that requires a little bit of help.

Register in a group forum

For the past 10 years, the Optcomlist (www.optcom.com) has been one of the most valuable resources for optometric questions and concerns. The Optcomlist, created by Walt Mayo, O.D., is a mailing list of more than 1,500 optometrists from around the world who communicate daily via e-mail. Messages posted on the Optcomlist are sent to all registered participants, creating an invaluable forum for discussion, information and expert advice.

I've consulted with the Optcomlist group many times regarding particularly difficult and perplexing patient cases. I usually get responses within 24 hours, and the advice givers include anyone from ordinary O.D.s to experts and researchers.

You can also benefit from group discussions, which range from discussions about frame fashions to legal issues. If you're not already a registered participant, I suggest you sign up soon.

Search past articles online

The Internet offers other means of help for specific cases. Log on to the Optometric Management home page at www.optometric.com and click on the "research" button to get information about glaucoma, blepharoconjunctivitis and other conditions from well-known authors such as Arthur B. Epstein, O.D., F.A.A.O., and Eric Schmidt, O.D.

User-friendly online manual

We all know how valuable the Merck Manual is for diagnosis and treatment options. Well, now we can consult the latest edition online at www.merck.com/pubs/mmanual. This version is more user-friendly than the actual manual because it's searchable by typing in keywords. The same information you find in the book version is displayed in an easy-to-navigate version on the Web site.

Resources with a fee

For information on various drugs, The Physician's Desk Reference (PDR) Web site (http://physician.pdr.net) is a great resource. Be forewarned that you have to register before you can use this site and that optometry isn't listed as a specialty (Gee, how'd they miss that?), but "other" is.

Registration is free if you're only looking for general information and news; however, access to the PDR and to Stedman's Medical Dictionary requires a monthly or annual fee, depending on which plan you choose. As with the Merck Manual, the online version of these two publications is simpler and faster to use than paging through the actual books.

An unexpected source of diagnosis and treatment information is the WebMD site, www.webmd.com. This is a pay site, so you must enroll and pay a yearly fee to belong. For your fee, however, the site provides you with a number of useful services including articles on diagnosing and treating diseases, as well as late-breaking drug and treatment news. You'll also have access to the online versions of Scientific American Medicine, Daily Medical News and over 1,100 hours of medical CME.

Utilizing site links

MDSupport is a Web site that offers support for patients with certain eye diseases. This site (www.mdsupport.org) also has a number of links to other eyecare sites where practitioners can find helpful information about conditions such as diabetic retinopathy, Best's disease, cystoid macular edema and more.

Don't forget the basics

In addition to searching the specific sites listed in this article, you can also search for information on diseases or conditions using almost any of the popular commercial search engines, such as www.yahoo.com, www.msn.com, www.aol.com and www.hotbot.com, to name but a few.

Lastly, don't overlook the power of e-mail. I've yet to meet an optometric educator who isn't willing to share his knowledge via an informal e-mail message.

Whichever methods or resources you choose, rest assured that the means to get the information and advice you need are no farther away than a few clicks of your mouse.

Resource Sites at a Glance

www.optcom.com -- a mailing list for you to communicate with other O.D.s for information, ideas and advice.

www.optometric.com -- Optometric Management's home page. Click on the "research" button to access information on various topics by well-known authors.

www.merck.com/pubs/mmanual -- search the online version of the Merck Manual by typing in keywords.

http://physician.pdr.net -- choose a plan (two of the three offered require a monthly or annual fee), and you can use the online versions of the Physician's Desk Reference and Stedman's Medical Dictionary.

www.webmd.com -- pay a yearly fee to view the online versions of various publications and benefit from other services and features.

www.mdsupport.org -- find diagnosis and treatment options for ocular diseases by checking out the links on this Web site.

Dr. Diecidue practices in Stroudsburg, Pa. He's president of Mountain Computer Systems, a producer of software and solutions for optometrists.