Eye Care Practitioners Research Articles

THE PREVALENCE OF STRABISMUS AND ASSOCIATED REFRACTIVE ERRORS IN SCHOOL CHILDREN IN AKURE SOUTH LOCAL GOVERNMENT ONDO STATE

Associations between strabismus and refractive errors have been reported inprevious studies. The purpose of this study was to determine the prevalence andassociation of strabismus with refractive errors in school aged children between10?16 years. A total sample size of2600 subjects was employed for this study.Routine eye examinations were carried out on the subjects. Unilateral cover test wasused to detect the presence of strabismus while alternate cover test was used formeasurement of the deviation, thereafter objective and subjective refraction wasconducted on the strabismic subjects. Spearman coefficient correlation test wasused to check for relationship between strabismus and refractive errors. Theprevalence of strabismus in this study was 1.92%.The prevalence of esotropia andexotropia was 1.15% and 0.65% respectively, followed by hypertropia with aprevalence of 0.08% and hypotropia with a prevalence of 0.04%. All strabismicchildren (n=50) had refractive errors. The prevalence of astigmatism, hyperopia andmyopia was 1.27%, 0.35% and 0.31% respectively. There was positive correlationbetween strabismus and refractive errors, (P < 0.05 and ?s was 0.63).Theprevalence of strabismus was low in this study. As the dioptric prism power ofstrabismus increased, the dioptric lens power of the refractive error also increased.Proper detection of refractive errors by eye care practitioners is key in themanagement of strabismus as high uncorrected refractive errors could lead todevelopment of strabismus.

Awareness and Knowledge of the Effect of Ultraviolet (UV) Radiation on the Eyes and the Relevant Protective Practices: A Cross-Sectional Study from Jordan.

Background: Overexposure to ultraviolet (UV) radiation is linked to serious adverse health effects that are cumulative in nature and affect children more than adults. UV radiation has also been reported to have serious complications for the eye, particularly in areas with a high UV radiation index. Increasing public awareness about the harmful effects of UV radiation on the eye and promoting awareness about protection against UV radiation may prevent eye disease related to UV radiation damage and help in the improvement of public health in general. This study aims to assess public awareness and knowledge of UV radiation and practices toward UV protection in Jordan, which is a country recognized as having a relatively high UV index throughout the year. Methods: A cross-sectional study was performed using an online questionnaire using Google Forms® to assess people's awareness, knowledge, practices toward eye protection from UV radiation, and the reasons for not wearing UV-protective eyeglasses in Jordan. Sociodemographic information of participants including age, gender, education level, and employment status was also acquired. People's knowledge on UV protection and harmfulness was measured via rewarding their correctly answered knowledge questions with one mark and zero for incorrectly answered questions based on key answers defined from the literature. Results: A total of 1331 participants (77% females and 23% males) with an average age of 26(±10) years completed the online questionnaire. Participants showed generally high levels of knowledge and awareness about UV radiation and its harmful effects. Nevertheless, participants showed a low level of knowledge about the link between UV radiation and some of the ocular diseases in the questionnaire. Practices toward UV radiation protection where inadequate, with 59% of the respondents reporting that they do not use any protective eyewear from natural UV radiation. The main reported reason for not wearing UV-protective sunglasses was uncertainty in the efficiency of UV protection in sunglasses, as reported by 47% of the participants who do not wear UV-protective sunglasses. Conclusions: The awareness of UV radiation and its harmful effects is high in the studied population. Participant knowledge is also relatively high in relation to nature of solar UV radiation, other synthetic sources of UV radiation, and the most dangerous UV exposure time. However, low participant knowledge was measured on the association between UV radiation with ocular disease and the role of UV-protective eyeglasses. Participant practice toward UV radiation protection was found to be insufficient. Thus, it is important to further increase the knowledge of damaging effects of solar and synthetic UV radiation and emphasize the benefits of eye protection from UV radiation. Eye care practitioners should target youth by different strategies including health campaigns, media, and clinics.

Communication between the Eye Care Practitioner and Parents of the Myopic Child

This article is based on a poster presented at the International Myopia Conference which took place in Rotterdam, Holland in August 2022. The poster and the article were both self-funded. Due to lack of space on the poster not all possibilities were noted therefore only some were chosen. In a follow-up article I will investigate other options available on the market. I have no financial interest in any of the products mentioned in this article. My main objective is to give the eye care practitioner a set of tools to help him illustrate to the parents the reason why their child’s myopia should be treated, and not only corrected, and the importance of trying to slow its progression.

Current Trends in Scleral Lens Prescription, Management, and Evaluation.

To report current trends in scleral contact lens prescription and management, including lens designs prescribed, care products recommended, and procedures performed during routine scleral lens (SL) evaluation. An online survey was designed by the Scleral Lenses in Current Ophthalmic Practice Evaluation study team and administered to eye care practitioners attending a specialty contact lens meeting. The survey was available from November 8, 2019, through March 31, 2020. Participants' demographic data were collected, along with information on lens diameters, landing zone (LZ) designs, recommended care products, and components of routine SL evaluation. In total, 715 participants responded to at least one of the survey items of interest. Most lenses prescribed (63%) were 16 mm or more in diameter. Lenses with toric LZs were the most frequently prescribed (48%), followed by spherical (40%), quadrant-specific (8%), and impression-based or image-based designs (3%). Most participants (61%) recommended hydrogen peroxide products for lens care. Nonpreserved saline in a single-use vial was most frequently recommended to fill the bowl of the lens before application. Intraocular pressure was measured during SL evaluation by 45% of participants; 38% of participants routinely measured corneal thickness. Practitioners increasingly are prescribing SLs with advanced LZ designs. Most practitioners recommend hydrogen peroxide-based disinfection systems and single-use vials of nonpreserved saline for lens care and application. Because differences in components of routine SL evaluations were reported, clinicians may benefit from reaching a consensus on essential components of SL evaluation.

Refracting The Diseased Eye

Refractive error refers to ocular refractive status where images of objects of regard do not fall on the retina in a relaxed eye - the ametropic eye. Thus, objects are perceived as blur. Refractive error is an aberration in an otherwise normal physiological phenomenon and not a disease. Uncorrected refractive errors are the second most causes of blindness after cataract and the cause of almost half of visual impairment. Clinical refraction is a careful scientific procedure employed to correct refractive error. Given that refractive error is the most common reason patients present to the eye care practitioner, a lot of attention must be given to refraction. When an irreversible eye disease co-exist with refractive error, then correction of refractive error under this circumstance; refracting the diseased eye (RDE) become very challenging and painstaking. There will be likelihood of irregularities in the transparent refractive surfaces of the eye due to disease or surgery which make refraction difficult both for the patient and the examiner. Personal clinical experience of the author who is a low vision consultant and review of related literature from textbooks and journals are brought to bear in this article. This paper is a review of the RDE algorithm with delineation of these steps to enable an effective refractive endpoint for the eye with disease. The paper will enable young Optometrists to deal with refractive error masquerading irreversible eye disease. It is also an essential reading for the low vision Optometrist in mastering the art and science of low vision refraction.

Predominant ocular challenges and protective eyewear compliance among welders in Port Harcourt mechanic and steel villages, Rivers State, Nigeria

Purpose: Welding is associated with several ocular and systemic hazards especially where adequate protective measures are not observed resulting in occupational eye challenges which constitutes an appreciable proportion of ocular morbidity, The purpose of this study was to ascertain the pattern of major ocular challenges (symptoms and signs) among welders in the Port Harcourt Mechanic and Steel Villages Rivers State, Nigeria and the level of compliance to the use of protective eye wear during work...
 Methodology: The study which took place at the work sites of the participants adopted a combination of physical eye examination and a survey to find out history of previous ocular injuries and predominant symptoms experienced. A total of 103 welders sampled from two study sites located in two local government areas LGAs of Rivers State participated in the study which involved the use of a well structured interviewer-administered pre-tested and validated questionnaire to ascertain frequently experienced ocular complaints and previous work related ocular injuries, followed by detailed external examination of the eyes and surrounding structures for signs of ocular surface abnormalities resulting from welding related activities. Data generated from the study were analyzed using descriptive and inferential statistical tools of the statistical package for social sciences (SPSS) version 25. Results were presented descriptively using tables and charts while Chi Square statistics was employed to test for statistically significant association at an alpha level of 0.05 (p< 0.05).
 Results: 88.3% of the welders involved in the study were aware that welding could cause harm to their eyes which could be prevented by the use of protective eyewear, 7.8% disagreed, while 3.9% had no idea Only 5.8% of welders complied regularly, 60.2% complied occasionally, 28.2% complied sparingly while 5.8% have never used a protective eyewear before. All (100%) of the welders who have never complied fall within the youngest age group (16 – 25 years). There was no statistically significant association between the age of welders and compliance to protective eyewear(p< 0.05) While 22.3% of welders have no remarkable eye complaint, the most frequent eye symptoms among welders in order of decreasing proportion were sandy sensation (30.1%), cloudy vision (22.3%), painful red eyes (18.5%), watery eyes (3.9%) and itchy eyes (2.9%). The distribution of ocular surface abnormalities in order of decreasing proportion include Pinguecula (31.1%), Pterygium (21.4%), Conjunctiva discoloration (14.6%) and Corneal opacity (3.9%). Also, there is a statistically significant association between age of welders and eye symptoms experienced and predominant ocular surface abnormalities observed.
 Unique Contribution to Theory, Policy and Practices: Findings from this study can be used by government agencies, employers, vocational training institutions and other stakeholders to formulate policies and guide for welders and other artisans to inculcate better work ethics in order to enjoy the benefits of regular compliance to the appropriate protective eyewear and prevent the negative effects of poor compliance. The study findings also reemphasized the need for a well articulated health insurance policy for workers in the informal sector employment to safeguard their ocular and general health. The urgent need for a subsidy regime on the price of quality protective devices and incentives for local production of quality protective eyewear should be looked into... Lastly, welders and eye care practitioners can tap from the findings to fine-tune their policies and practices to ensure ocular safety and better management/ care for welding related eye challenges.

Differentiating primary dry eye disease from ocular neuropathic pain: implications for symptom management

ABSTRACT Clinical Relevance Eyecare practitioners’ management of ocular surface disease is essential in managing increasing dry eye disease (DED) presentations including ocular neuropathic pain (ONP). Topical Proxymetacaine offers a simple, readily available and practical method of detecting ONP in practice and can be used to differentiate ONP from DED by eyecare practitioners, when accompanied with an anterior segment examination. Background Differentiating DED from ONP presents a significant opportunity to eyecare providers, allowing appropriate treatment choices for more adequate symptom control, greater patient satisfaction, and reduced emergent re-presentations. This study aims to differentiate patients presenting with DED symptoms into DED or ONP using a simple diagnostic tool, which can be used in practice to allocate appropriate treatment options for the patient’s respective condition. A comparison of the prevalence of presentations of ONP presenting with DED symptoms in hospital ophthalmology settings and in optometric primary care settings will also be made. Methods Patients with symptoms of DED were opportunistically recruited as they presented to ophthalmology outpatient clinics and primary care optometric services. Patients were then categorised as DED, ONP, or mixed DED/ONP based on their subjective response 30 seconds post-Proxymetacaine Hydrochloride 2% instillation. Results Twenty-one patients were recruited, including 12 patients from ophthalmologic outpatient clinics and nine patients from primary care optometric services. Twelve patients were identified to have primary DED, while nine patients were identified to have ONP. 43% of patients presenting with DED symptoms had features of neuropathic pain in ophthalmologic outpatient presentations compared to 44% of patients in primary care optometric services. Conclusion Categorising DED and ONP patients by their response to Proxymetacaine can be used as a simple diagnostic tool in guiding future patient management and can be indicative of their potential response to topical therapies. The use of topical Proxymetacaine and the resultant change in ocular pain score can facilitate selection of patients who may benefit from centrally acting neuropathic pain agents over topical ocular therapy.

Differences in Practitioner Experience, Practice Type, and Profession in Attitudes Toward Growing Contact Lens Practice.

To investigate eye care practitioners' attitudes and perceptions toward potential interventions that can enhance contact lens (CL) practice across the world, and how this is influenced by their practice setting. A self-administered, anonymized survey was constructed in English and then forward and backward translated into six more languages. The survey was distributed online via social media platforms and mailing lists involving reputed international professional bodies. In total, 2,222 responses from 27 countries with sufficient responses were analyzed (53% females, median age- 37 years). Most of the respondents were optometrists (81.9%) and 47.6% were from stand-alone/independent practices. Median working experience in CL prescribing was 11.0 years (IQR: 18.0, 4-22 years). Over two-third of them declared themselves to be very hopeful (22.9%) or hopeful (45.1%) about the future of their CL practice. Among the potential interventions proposed, continuous update of knowledge and skills and competently managing CL-related complications were rated the most important (median score: 9/10 for each). Practitioners working in national/regional retail chains expressed higher proactivity in recommending CLs (9/10) than those in local chains, hospitals, and universities (for all 8/10, P <0.05). National differences were also identified in eye care practitioner attitudes and perceptions ( P <0.05). The study provided important information to delineate a variety of elements characterizing CL practice across the world. These insights can serve as a basis to design strategies at national and international levels.

An investigation into the causes of abnormal waste of Ortho-K lenses.

PurposeTo investigate the reasons for wasting orthokeratology (OK) lenses due to breakage or loss, provide more comprehensive guidelines for the clinical care of lenses and minimize time and costs for patients due to excessive broken and lost lenses.MethodsA survey was administered to clinic outpatients who had broken or lost their OK lenses before the regularly scheduled replacement cycle (1–1.5 years). The association between the frequency of OK lens breakage and daily care was assessed using Fisher's exact test and multivariable ordered logistic regression analysis.ResultsA total of 306 valid questionnaires were collected. Among the subjects, 141 were male, and 165 were female, with a mean age of 10.57 ± 2.00 years (range: 6–18 years). In the investigation of the causes of OK lens waste, 81.4% of the patients reported lens breakage, 13.1% lost their lenses, and 5.6% of patients experienced both fragmentation and lens loss. More than half of the patients (52.90%) used incorrect lens cleaning techniques. In further analysis of the relationship between the frequency of OK lens fragmentation within a year and daily care habits, a significant difference was observed between the caregiver (P = 0.03) and whether the lenses were cleaned promptly after removal (P < 0.001). Mothers as daily caregivers of OK lenses had a lower frequency of fragmentation in a year compared to nanny or grandparents (P = 0.014, OR = 0.33, 95% CI = 0.13, 0.80). The failure to clean the lenses according to eye care practitioners' guidance was a risk factor for the frequent breakage of OK lenses (P < 0.001. OR = 5.29, 95% CI = 3.15, 8.89).ConclusionsThe causes of OK lens waste were mainly attributed to caregivers, care practices and some unexpected situations that can be avoided through optometrists' reminders. Regardless of the reasons for noncompliant behavior leading to breakage or loss of OK lenses, all of the complications can probably be addressed by better and more frequent reinforcement of care procedures by practitioners. Better clinical guidance measures and more frequent reminders could prevent a large proportion of abnormal waste of OK lenses.

Aerosol generation from tear film during non-contact tonometer measurement

Aerosols, generated and expelled during common human physiological activities or medical procedures, become a vital carrier for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During non-contact intraocular pressure measurements, aerosols can be produced from the tear film on eyes and potentially convey the SARS-CoV-2 in tears, creating a high risk for eye care practitioners and patients. Herein, we numerically investigate deformation and fragmentation of the tear films with various thicknesses and surface tensions that are impinged by an air jet. Evolution of the tear films manifests several types of breakup mechanisms, including both the bag breakup and ligament breakup of tear film on the eyeball, the ligament breakup of tear film on the eyelid margin, and the sheet breakup near the eyelid margin. The sheet near the eyelid margin is critical for generating large droplets and can be formed only if the jet velocity is high enough and the film is sufficiently thick. A criterion based on Weber number and capillary number is proposed for the breakup of tear film into droplets in which three regions are used to classify the film evolution. Our results indicate that eyes with excessive tears have a greater probability of generating aerosols than eyes under normal conditions. We recommend that enhanced protections should be adopted upon measurement for the patients with watery eyes, and the time interval between two adjacent measurements for the same individual should be also prolonged during the COVID-19 pandemic.

A mixed-methods characterisation of patient safety incidents by primary eye care practitioners.

Patient safety in eye health care is an underdeveloped field of research. A patient safety incident occurs when an unintended incident happens that could have (or did) lead to harm. To enable learning from patient safety incidents in optometry, a characterisation of commonly experienced safety incidents is needed to identify options to improve the quality of care. This study aimed to characterise eye health-related patient safety incidents from the perspective of eye care practitioners. At a national conference in Wales, 56 eye care practitioners participated in a stakeholder workshop on eye care-related patient safety incidents. Participants were asked to suggest patient safety incidents that have occurred, or based on their experience, could occur in optometric practice. Using the nominal group technique, participants voted on the incident they perceived could cause the most harm and the incident observed most frequently in practice. Framework analysis supported identification of themes about the nature and outcomes of incidents in eye care. Diagnostic incidents were perceived to be the most severe (highest number of 'severity votes', n= 38), whilst administration-related incidents were most frequent (highest number of 'frequency votes' n= 39). Four themes were identified which are as follows: inappropriate clinical decision-making; delayed or missed referral of patients to general medical practitioners or ophthalmologists; compromised communication with other practitioners or patients and delays in receiving eye care. The results suggest that incidents relating to inappropriate clinical decision-making could result in the most severe harm to patients but may not occur frequently. Diagnostic- and administrative-related incidents pose clear challenges for improvement in quality and safety of care. The breadth of themes reflecting the nature and outcomes from unsafe eye care highlights the complexity underpinning incidents and the burden to patients. This work has informed the content of an all-Wales incident report form for primary eye care practitioners.

Characterizing Refractive Errors, Near Accommodative and Vergence Anomalies and Symptoms in an Optometry Clinic.

Background:Refractive, accommodative and vergence parameters and associated anomalies cause symptoms of asthenopia. Patients consult eye care practitioners mainly due to symptoms they experience. To enhance targeted treatments from various anomalies, it is relevant to study symptoms with associating anomalies.Aim:To determine the frequencies of refractive error, accommodative and vergence anomalies, and their associations with symptoms in sample of Black South Africans.Method:This prospective, cross-sectional study comprised consecutive participants aged 10–40 years who attended the author’s optometry practice in a Black population in South Africa. Visual acuity, refraction, accommodative and vergence tests were performed. Anomalies were classified as either single measure or syndromes based on the number of failed clinical signs.Results:Participants (n = 254) had mean age 22.6 ± 7.22 years. Ninety-four were male (37%) and 160 were female (63%). The frequencies of syndrome anomalies were accommodative insufficiency 17 [(6.6%) 95% CI 3.9–10.5%)], accommodative infacility 32 [(12.6%)] 8.7–17.3%] and convergence insufficiency 22 [(8.6%, 5.1–12.3%)]. Frequencies of coexisting anomalies were refractive error and accommodative 150 (60.0%), refractive error and vergence anomalies 136 (54.4%) and vergence and accommodative disorders 155 (62.0%). Most patients were symptomatic (70.9%). Headache was the most frequent symptom (41.1%).Conclusion:Accommodative anomalies were more frequent than refractive error and vergence anomalies. The high frequency of anomalies suggests a high uptake of optometric services for asthenopia. Accommodative anomalies were the most symptomatic. The study highlights the need for diagnosing visual symptoms and coexisting anomalies. Establishment of validated study protocols for all accommodative and vergence anomalies is recommended.

Identifying the content, functionalities, and features of a mobile application for contact lens wearers

BackgroundLack of attention to end-users' requirements and preferences may lead to the failure of health information technology (IT) interventions. Identifying users’ needs for designing a mobile application can lead to the development of an acceptable intervention. This study aimed to determine the requirements for designing a mobile application to educate and provide needed information to contact lens (CL) wearers.MethodsA qualitative study was conducted on 24 CL wearers and nine eye care practitioners from the three CL clinics in Iran. Data were collected through semi-structured interviews and analyzed using the conventional content analysis proposed by Lundman and Graneheim. Lincoln and Guba's criteria were used to ensure the trustworthiness of the data.ResultsThe three main categories that emerged from the interviews were mobile application content, mobile application functionalities, and mobile application features. Ten subcategories and 57 sub-subcategories were also identified. It was determined that mobile content should focus on advice and information for optimizing the CL wearing experience and training regarding the use of CLs. Entering information required for self-care, computational capability, interactivity, updates, and reminders were determined as needed functionalities. The participants recommended features for the structure and user interface of the mobile application and information presentation methods.ConclusionThis study identified the information needed to develop a mobile application for CL wearers. This also provides insights regarding required functionalities when applying IT interventions. These findings can be used by CL clinics, developers of health information systems, policymakers, and health planners to design better CL-related care and compliance interventions.

Comparison of compliance with care procedures performed by orthokeratology wearers and their parents and factors affecting compliance.

To compare the levels of compliance with care routines of orthokeratology (ortho-k) wearers and their parents and to identify factors affecting compliance in a hospital setting in Chengdu, China. Patients who had worn ortho-k lenses for at least one month were invited to participate in a survey on compliance. Wearers or their parents were required to complete a questionnaire to determine their compliance with hand hygiene, ortho-k lenses and accessory care procedures. A total of 200 wearers, 78 male wearers and 122 female wearers, median age 12 (range 8-18) years were enrolled. Except for use of lens solution, the percentage of participants reporting total compliance with all procedures did not differ significantly between lens wearers and their parents. However, compliance for some items was significantly higher when performed by parents p < 0.001-0.01). 'Eye care practitioner provided instructions' was a significant protective factor for most procedures (p < 0.001-0.04). Age and sex were significant risk factors for some items (p < 0.001-0.04; p =0.03-0.04, respectively), with girls having higher compliance than boys. 'Parental supervision' was a significant protective factor for some items (p =0.02-0.04) when wearers performed the procedures themselves. When parents performed lens care procedures, only 'eye care practitioner provided instructions' was a significant variable (p =0.001-0.04). Some degree of non-compliance was noted in the majority of ortho-k wearers, particularly for the care of the lens case and suction holder. Compliance with care of some items was higher when performed by parents. Regular reinforcement of care procedures by practitioners is important, especially for older and male lens wearers. Parental supervision is necessary when children perform lens care procedures themselves, even for older wearers.

Practice patterns in managing myopia differs among Indian eye care practitioners

Dear Editor, Literature has shown that the prevalence of myopia in India has increased from 4.5% in 1999 to 21.2% in 2019 among children aged 5–15 years.[1] A prediction model using studies done in India estimated an overall 10.53% increase in myopia prevalence over the next three decades.[1] Hussaindeen et al. (2021)[2] cautioned that due to COVID-19 lockdown, the progression of myopia may further accelerate as children spend more time indoors and less time outdoors. Akerman[3] conducted a survey in early 2021 among eye care practitioners (ECPs) in the USA and reported the current attitudes and behaviors regarding myopia management. About 40.0% of the practitioners prescribed single-vision spectacles as the primary mode of correction for myopic patients. More than 50.0% of the ECPs had prescribed multifocal contact lens, visual hygiene, and increased time outdoors. Low-dose atropine (0.01%) and Ortho-K were recommended by about 35.0% of the ECPs, and combinations of treatments were suggested by around 20.0%. The authors used a similar survey to understand the current attitudes and behaviors regarding myopia management among ECPs in India [Fig. 1]. A total of 147 ECPs responded via an online survey, and 81.0% of the ECPs were involved in myopia management among children. Though plethora of treatments are available for managing myopia, about 95.0% of them were still prescribing single-vision spectacles. Increased time outdoors and visual hygiene were suggested by more than 80.0% of the ECPs. Though studies have shown that low-dose atropine[4] and Ortho-K[5] are efficacious in retarding myopia, more than 80.0% of the ECPs have not started practicing these two strategies.Figure 1: Current practice pattern in managing myopia by ECPs in IndiaIn conclusion, this survey of current trends among ECPs in myopia management revealed that despite growing evidence of the increasing prevalence of myopia in India, uptake of appropriate anti-myopia strategies is poor. Low awareness about available products and lack of training among the ECPs in India could be the reasons for the low uptake of anti-myopia strategies. Thus, there is an immediate need to conduct frequent continuing medical education programs focused on myopia management, which should help ECPs to embrace the anti-myopia strategies and tackle this myopia menace.

Awareness and Attitude Towards Digital Screen-Based Binocular Vision Therapy Amongst Eye Care Practitioners of Karnataka

Amblyopia interferes in the critical period of visual development among children. Due to the limitations of conventional management of patching therapy, in the recent decade digital screen based binocular vision therapy was introduced. We aimed to study the awareness and attitude of eye care practitioners towards digital screen based binocular vision therapy in management of amblyopia. The study has been conducted by constructing and validating a questionnaire. The questionnaire was validated through a pilot study. Around 104 eye care practitioners responded to the survey, showing 96% of the eye care practitioners’ awareness towards refractive correction as the first line of management for amblyopia. A high number of respondents (83%) were aware of prescribing computer-based video games for amblyopia therapy in the clinical practice. 'The visual function improvement is very much feasible with digital screen based binocular vision therapy’ was the opinion of 55% (n=52) of eye care practitioners.

Exploring contact lens opportunities for patients above the age of 40 years

PurposeContact lenses offer a good option for patients with presbyopia, especially with improved optical designs available in modern multifocal contact lenses. Due to the ageing population there is good opportunity to increase contact lens penetration by managing these patients better. However, multifocal contact lenses achieve low penetration in the market. MethodsA questionnaire was administered to people aged above 40 years, to investigate their perceptions of contact lenses for presbyopia. Only people, with presbyopia, who were existing contact lens wearers or willing to try contact lenses were included. Participants were recruited from United Kingdom (UK), United States of America (USA), Netherlands, Germany, France, Spain and Italy. ResultsData from 1540 participants above the age of 40 years was collected, 57.9% were females and 42.1% males. Overall, 50.8% of the participants wore contact lenses, but contact lens wear was less common amongst older participants. Some data supported earlier studies, such as 6.1% wore gas permeable lenses. However, only 25% of the contact lens wearers used multifocal contact lenses. The reasons the participants wanted to wear contact lenses were similar to younger patient such as sports or cosmesis reasons. Reasons why participants had dropped out of contact lenses included discomfort and dry eye related issues. Poor visual performance with contact lenses was a reason to dropout of contact lenses for the older participants. ConclusionsThe study highlights some failings by eye care practitioners in the management of patients with presbyopia. It seems that patients of this age group are seeking suggestions and recommendations from their eye care practitioner including upgrading contact lenses and dual wear options. The day-to-day problems encountered by the contact lens wearers in this study seem to be, in the main, things that could be easily tackled by additional counselling and instruction from the eye care practitioners.

Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

PurposeThere remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. MethodsA self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. ResultsResponses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. ConclusionsAfrican ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.

Eye Care Practitioners Are Key Influencer for the Use of Myopia Control Intervention.

BackgroundThe study sought to investigate the self-reported practices of Singaporean eye care practitioners on myopia management and the interaction between eye care practitioners and parents.MethodsSelf-reported questionnaire (1) to eye care practitioners to understand their clinical practice behavior, their opinion in myopia management (2) to parents on their knowledge of myopia control products and interaction with eye care practitioners.Results80.0% of eye care practitioners prescribe myopia control in their practice but only 33.1% of eye care practitioners prescribed myopia control interventions during the first visit, and only 41.4% of parents were recommended myopia control interventions by eye care practitioners, of which 75.6% followed the recommendations of eye care practitioners. Eye care practitioners (53.1%) prefer atropine the most and parents prefer controlling the amount of time doing near work (54.5%) and outdoor activities (52.5%). Eye care practitioners had the highest influence on the choice of vision correction with 78.8% of parents choosing to follow them. 66.9% of eye care practitioners did not prescribe myopia control interventions during the first visit as they lack myopia progression data from the patient. Eye care practitioners felt that more education on myopia control products (57.7%), hands-on workshops (47.7%) and management of children (44.6%) would encourage them to use myopia control interventions more frequently. 40.0% of the eye care practitioners were concerned about the cost of myopia control products.ConclusionsEye care practitioners strongly influence parents to uptake myopia control interventions. More education and hands-on workshops on myopia and children management can help encourage the use of myopia control interventions by eye care practitioners.

Perceptions of potential barriers to soft contact lens wear among university students in Jordan

ABSTRACT Clinical relevance Identifying potential barriers to contact lens wear could increase awareness about contact lenses and their benefits and boost the confidence of optometrists offering contact lenses to their patients. Background Contact lenses provide better visual performance according to many studies. Nevertheless, resistance to wearing them remains an issue. This study will identify barriers to contact lens wear among university students in Jordan. Methods This study enrolled university students who wore spectacles for their refractive error correction and have had no history of contact lens wear. A questionnaire of potential barriers was constructed whereby participants were required to respond to a set of questions that asked how each suggested item was considered a barrier for contact lens wear; responses were recorded within a 5-points scale (1: strongly disagree to 5: strongly agree). Results A total of 260 participants (175 females and 85 males) were enrolled in the study. All participants showed normal findings for contact lens wear candidacy. The mean score of total barriers to contact lens wear was high, at 33.8 (±5.4 SD) (out of 55 the maximum possible score). The major identified barriers were: decision of eye care practitioners that contact lenses are unsuitable for them (64.6% of the study sample); decision of the participants that contact lens were unsuitable for their work environment (63.5%); and reported symptoms of ocular dryness (61.6%) that made participants reluctant to try contact lenses Conclusion This work identified several patient-related barriers to contact lens wear. Probing these barriers may encourage eye care providers and contact lens manufacturers to promote contact lenses as a viable option for the correction of refractive error. This in turn will increase awareness among patients about contact lenses and encourage them to try contact lenses as alternative to spectacles.