Cataract referral pattern among Indian optometrists: A cross-sectional study

Abstract

According to WHO (World Health Organization), cataract is the second leading cause for visual impairment or blindness globally. In the Indian context, Optometrist’s role in identification and appropriate referral of cataracts requiring surgery is of utmost important. The aim of the current study was to investigate the knowledge and cataract referral pattern among Indian optometrists. A cross-sectional study was carried out on 262 optometrists by distribution of a validated, well-structured questionnaire with data on participant demographics and optometric assessment practises, including participant age group and gender, primary clinical practise location, objective patient visual assessment methods, referral criteria for cataract surgery, and factors to be taken into account when deciding where and when to refer patients for cataract surgery was made. The analysis of survey questions with Likert scales was done using ordinal logistic regression. Categorical variables between groups were evaluated using Chi-square test. Statistical Significance was considered if P was less than 0.05. Visual acuity less than 6/18 and glare sensitivity were common benchmarks for cataract referral. A significant proportion of optometrists indicated driving dependent (55%), current employment (33%), high visual demand (31%) and post-operative vision less than 6/18 in other eye (34%) as important factors for urgent referral for cataract surgery to Ophthalmologists. Majority of the participants indicated surgical costs (53.8%), surgeon skills (56.9%) and caring environment/caring staff (49.2%) as extremely important factors in deciding where to refer for cataract surgery. While optometrists were able to refer patients for cataract surgery based on changes in visual acuity, Indian optometrists should also assess contrast sensitivity and take that into consideration when making this decision.