Optometry Practice Research Articles

Seeing New Opportunities to Help Smokers Quit: A UK National Survey of Optometrist-Delivered Smoking Cessation Behavioral Support Interventions.

Smoking is a risk factor for various eye conditions. Brief smoking cessation interventions have demonstrated effectiveness when delivered by a range of health care professionals. Optometrists are well placed in the community to advise otherwise healthy smokers to quit, yet remain relatively neglected in smoking cessation research and policy. In a national survey, this study investigated self-reported practices of UK optometrists for delivering brief tobacco smoking cessation interventions to patients. A randomly selected sample of 1200 optometrists out of the 9000 optometrists registered on the UK College of Optometrists database were invited to complete a 40-item, web-based survey assessing: training related to smoking cessation, current practice (ie, the proportion of patients to which components of very brief advice [Ask, Advise, Assist] and other evidence-based smoking cessation behavior change techniques were delivered), and barriers/enablers to intervention delivery. In total, 408 (34%) responses were received. Most (83%) optometrists received no training in practical skills for delivering smoking cessation support. A third (34%) routinely assessed smoking status. Fewer self-reported advising smokers to quit (22%), offering assistance (via referral to dedicated services) (3%), or advice on smoking cessation medications (2%). Perceived barriers included insufficient knowledge/training (81%) and time (65%). Optometrists were more likely to assess and advise on smoking cessation if they practiced in Scotland, χ2(2) = 32.95, p < .001; an independent optometry practice, χ2(1) = 4.27, p = .39; or had received smoking cessation training, χ2(1) = 13.1, p < .001. Substantial gaps exist in UK optometrists' current smoking cessation training and practice. Evidence-based training resources are needed to support the implementation of smoking cessation interventions into routine optometry practice. Optometrists are well placed in the community to deliver brief advice interventions to a large population of smokers. This survey provides a comprehensive description of current UK optometry practice related to the provision of evidence-based brief tobacco smoking cessation interventions to patients. Although optometrists perceive advising on smoking cessation as part of their role, numerous substantial gaps in current practice and training remain, which need to be addressed through targeted interventions to increase implementation.

RAF near point rule for near point of convergence—a short review

RAF near point rule (RNPR) is a routinely used instrument in ophthalmology and optometry practice as well as for research purposes to measure the near point of convergence (NPC). The measurement of NPC is an important criterion for diagnosis and management of convergence insufficiency. The RNPR forms an important tool for ophthalmic clinicians however, only a very little is understood about it. This article tries to describe and review the designs, measurement techniques, merits and demerits of the RNPR and establish the need for its modification. It recommends that clinicians and researchers consider these findings while measuring NPC with the RNPR.

What do patients think about the role of optometrists in providing advice about smoking and nutrition?

Tobacco smoking and nutrition are key lifestyle factors with long-term effects on eye health. However, little is known about patients' perceptions and experiences in these areas in relation to the care received from optometrists. The main aim was to survey patients' perceptions and prior experience regarding the role of optometrists in enquiring and providing advice about tobacco smoking and nutrition. An anonymous, paper-based survey was distributed to a convenience sample of 225 adults attending the University of Melbourne eye care clinic. Respondents provided demographic and other information (age, sex, length of time since last eye examination, country of most recent eye examination, smoking status and intake of nutritional supplements) and indicated their level of agreement (using a five-step Likert scale) with a series of statements relating to the care provided by optometrists in the areas of health, smoking and nutrition. The statements were designed to assess the perceived scope of practice of optometrists and the extent to which patients expect, and feel comfortable, discussing these issues with their optometrist. 220 completed surveys were returned. Most respondents (>80%) agreed that they visit their optometrist to quantify their refractive error and to examine their eye health. About two-thirds of respondents indicated that they expect their optometrist to ask about their general health, with almost half expecting their optometrist to communicate with their general medical practitioner. Approximately one-third of respondents indicated having been routinely questioned about their smoking status, diet and nutritional supplement intake by their optometrist. This was despite about half expecting their optometrist to question them about these factors and almost three out of four respondents indicating that they felt comfortable talking with their optometrist about these lifestyle behaviours. This study provides novel insight into patients' perceptions and experience with optometric practice in the areas of tobacco smoking and nutrition. The majority of respondents expected their optometrist to examine their eye health, ask them about their smoking and diet habits, and indicated feeling comfortable discussing these topics with their primary eye care provider. These findings suggest that brief advice interventions relating to tobacco use and diet are likely to be acceptable to deliver in optometry practice.

Using automated photo-ophthalmic device (APOD) technology in optometry practice

Dr Simon Barnard discusses how the evolution of handheld technology assists the assessment of the anterior eye and supports contact lens practice

The natural history of corneal topographic progression of keratoconus after age 30 years in non-contact lens wearers

Background/aimsTo determine if significant progression of disease occurs in older, non-contact lens wearing, subjects with keratoconus and to identify potential predictive factors.MethodsClinical and computerised corneal topography records of subjects with...

Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes

Ruling out glaucoma in myopic eyes often poses a diagnostic challenge because of atypical optic disc morphology and visual field defects that can mimic glaucoma. We determined whether neuroretinal rim assessment based on Bruch's membrane opening (BMO), rather than conventional optic disc margin (DM)-based assessment or retinal nerve fiber layer (RNFL) thickness, yielded higher diagnostic accuracy in myopic patients with glaucoma. Case-control, cross-sectional study. Myopic patients with glaucoma (n= 56) and myopic normal controls (n= 74). Myopic subjects with refraction error greater than-2 diopters (D) (spherical equivalent) and typical myopic optic disc morphology, with and without glaucoma, were recruited from a glaucoma clinic and a local optometry practice. The final classification of myopic glaucoma or myopic control was based on consensus assessment by 3 clinicians of visual fields and optic disc photographs. Participants underwent imaging with confocal scanning laser tomography for measurement of DM rim area (DM-RA) and with spectral domain optical coherence tomography (SD OCT) for quantification of a BMO-based neuroretinal rim parameter, minimum rim width (BMO-MRW), and RNFL thickness. Sensitivity of DM-RA, BMO-MRW, and RNFL thickness at a fixed specificity of 90% and partial area under the curves (pAUCs) for global and sectoral parameters for specificities ≥90%. Sensitivities at 90% specificity were 30% for DM-RA and 71% for both BMO-MRW and RNFL thickness. The pAUC was higher for the BMO-MRW compared with DM-RA (P < 0.001), but similar to RNFL thickness (P > 0.5). Sectoral values of BMO-MRW tended to have a higher, but nonsignificant, pAUC across all sectors compared with RNFL thickness. Bruch's membrane opening MRW is more sensitive than DM-RA and similar to RNFL thickness for the identification of glaucoma in myopic eyes and offers a valuable diagnostic tool for patients with glaucoma with myopic optic discs.

Understanding and perceptions of inherited eye diseases and attitudes to genetic testing and gene therapy in a primary eye care setting

PurposeTo explore the level of understanding and perceptions of inherited eye diseases and attitudes to genetic testing and gene therapy in a primary eye care setting.MethodsThis study was undertaken as a part of an EVER foundation fellowship at the School of Optometry and Vision Sciences, Cardiff University, UK in 2014. Participant groups were surveyed by questionnaire. The groups were: undergraduate students of optometry, primary eye care professionals and the members of general public attending the optometry practice to have a routine eye test or a routine annual follow‐up. Four focus groups were conducted to design the questionnaire. A preliminary study aimed to understand perceptions and to explore the level of knowledge about genetics, inherited eye diseases and gene therapy. A second questionnaire was designed to explore attitudes to genetic testing and gene therapy.ResultsThe majority of participants (82%) perceived genetics as an important science. However, the level of understanding of genetics and inherited eye diseases was relatively low among all groups of participants. Undergraduate students and primary eye care professionals were better informed about inherited eye diseases than the general public (p = 0.001). The majority (80%) across all three groups had a positive attitude to genetic testing and gene therapy. There was a lack of knowledge about the genetic services available among all groups of participants.ConclusionsThis study shows a broadly supportive attitude to genomic medicine among the public albeit a poor level of knowledge of genetics and genetic eye diseases. Improving public awareness and education in inherited eye diseases can improve the utility of genetic testing and therapy.

Pattern of Optometry Practice and Range of Services in India

This study was conducted to evaluate the range of services provided by optometrists in various modes of optometric practice in India. An online questionnaire was administered to 1674 optometrists to collect information on the range of optometric services offered. Data were analyzed based on variables including sex, educational qualification, and modes of practice. Two-sample Wilcoxon rank sum tests, χ tests, and Fisher exact text were used to conduct inferential statistics. A total of 563 valid and completed survey questionnaires were received from graduates of 41 optometry institutes working across 23 states of India. Of these, 225 (40.0%) were female, 288 (51.2%) had completed postgraduate education, and 340 (60.5%) were involved in more than one mode of practice. The top three modes of practice were hospital-based practice (44.8%), academia (42.8%), and optical retail (33.0%). Of the 441, out of 563 (78.3%) respondents involved in patient care, the majority (98.4%) performed refraction and routine eye examination, 70.3% dispensed contact lenses, and 66.9% practiced optical dispensing. Lower involvement was seen in providing binocular-vision (45.1%) and low-vision services (30.2%). Higher education was associated with advanced level of practice (p < 0.05) except clinical investigative procedures. There was a significant association between postgraduate studies and involvement in academics and research (p < 0.01). Most optometrists are engaged in multiple modes of practice, with optical practice, hospital-based practice, and academia being the leading modes. Optometrists need to be more involved in providing the core optometric services of binocular vision and low vision. Higher education has an impact on the level of optometric practice.

Slit-lamp handling: Learning upgrade with webcam video recordings

Slit lamp handling has always been difficult for students of the degree of Optics and Optometry in Spain. Instruments with associated cameras help a lot in this task. They allow teachers to observe and control students learning and performance. However, these devices are more expensive than those that do not have an integrated camera connected to a display unit. In this paper we present a cost effective alternative. We propose to place a webcam in one of the slit-lamp oculars (in our case, a Microsoft Lifecam HD-5000). The webcams are connected to a PC running Linux Ubuntu 11.0; therefore that is a low-cost device. The system was used during the teaching of slit-lamp handling in the practice of the subject of Contactologia I of the degree in Optics and Optometry at the Universidade de Santiago de Compostela (Spain). The students were asked to complete a survey in order to test its usefulness. 90% of the students found the system very helpful. Our experience shows that with this simple approach we can do things easier: show the slit-lamp handling to all the students at the same time; take pictures or videos of different eye health conditions or exploratory routines for posterior visualization with all the students; increase the interactions between students allowing them to help and correct each other; and also record the final routine exam in order to make possible its revision with the students. We think that the presented option is a cost effective alternative to built-in cameras provided by slit lamp manufacturers for teaching purposes, supporting the training in optometry practice and increasing the student´s confidence without a big outlay.

Optometry and contact lens practice patterns among Indian optometrists - a pilot study

Purpose: The scope of optometry practice and range of clinical services offered by optometrists in India are not well documented. Hence, a pilot study with Bharati VidyaPeeth (BVP) optometry alumni in India was conducted to understand the practice patterns among Indian Optometrists.

Contact lens related awareness and compliance among wearers visiting an optometry practice in south India

Purpose: To determine the knowledge of the basic aspects of lens wear of contact lens users through a questionnaire.

A vision for optometry in Oman

A vision for optometry in Oman

Two luminaries of vision science

Two luminaries of vision science

Microperimetry: a review of fundus related perimetry

Visual field assessment is a key part of optometry and ophthalmology practice. However, in people with non-central or unstable fixation, it is not possible to relate defects on a visual field map to a specific retinal location. Microperimetry (or fundus related perimetry) is a technique that images the retina during visual field testing, enabling a correlation to be made between visual function and retinal structure. In this article, the history of fundus related perimetry is reviewed. Three modern microperimeters (MP-1, OCT/SLO and MAIA) are described and their relative merits identified. Finally, the uses of microperimetry in optometric practice are discussed.

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

BackgroundAlthough a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community.MethodsA retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007.ResultsA total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%).ConclusionsAdequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.

A study of the suitability of disposable coloured contact lenses for a South African clinic based population

Optometrists have always considered the fitting of all types of contact lenses to be an integral part of the scope of practice of their profession. However, since the introduction of disposable cosmetic coloured contact lenses into the market, the frequency of over the counter sales of contact lenses has significantly increased. Patients often present with contact lens complications at the University of Kwa-Zulu Natal clinic and local practices. It is sometimes reported that the lenses were purchased over the counter, from an optometry practice or another non-registered vendor. A common observation in these instances has been that the lenses do not fit optimally and that the incidence of complications associated with tight fitting lenses was much higher amongst the African patients as opposed to those of other race groups. A clinical observational study utilizing convenience sampling of 240 subjects was undertaken to evaluate the fitting criteria of disposable cosmetic coloured contact lenses on a South African clinic based population. All patients requesting the lenses chose their preferred colour and were fitted with Freshlook ColorBlends, Images or Expressions Colors lenses. Lenses were evaluated after 20-25 minutes and then classified into tight, ideal or loose fits according to the lower lid push-up test, lenscentration, post blink movement and version lag and upgaze lens movements. The ages of the subjects ranged from 16 to 45 years with a mean of 24.13 ± 5.66 years. Seventy (29.2%) were males and 170 (70.8%) were females. The majority (62.9%) of the lenses fitted on the subjects were rejected according to the fit criteria. The African subjects had the highest percentage of rejected fits (82.8%) whilst 75% of the White subjects had acceptable fits. The main reason for lens fits being rejected was that they displayed charac teristics of a tight fit (96%) with only 4% of the fits being rejected due to being too loose. These results highlight the need for contact lens manufacturing companies to realize that those lenses that they design and which undergo clinical trials on Caucasian eyes do not necessarily fit well on the majority of patients in this part of the world. The reasons for this may be related to differences in corneal profiles of the different population groups with some being more suitable to particular lens designs than others. It is recommended that the public and practitioners be educated about the potential dangers of over the counter sales of contact lenses and that pre-fitting evaluations consultations of all contact lenses are an essential part of contact lens care.

Risky Business: Planning for Pandemic Flu

Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and ScienceVol. 4, No. 3 Conference ReportsRisky Business: Planning for Pandemic FluBeth Maldin and Kathleen CrissBeth MaldinSearch for more papers by this author and Kathleen CrissSearch for more papers by this authorPublished Online:25 Sep 2006https://doi.org/10.1089/bsp.2006.4.307AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byChallenges and impact of COVID-19 lockdown on Indian optometry practice: A survey-based studyJournal of Optometry, Vol. 15, No. 2The prospect of pandemic influenza: Why should the optometrist be concerned about a public health problem?Optometry - Journal of the American Optometric Association, Vol. 78, No. 12Up to new tricks – A review of cross-species transmission of influenza A viruses13 August 2007 | Animal Health Research Reviews, Vol. 8, No. 1 Volume 4Issue 3Sep 2006 InformationCopyright 2006, Mary Ann Liebert, Inc.To cite this article:Beth Maldin and Kathleen Criss.Risky Business: Planning for Pandemic Flu.Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science.Sep 2006.307-312.http://doi.org/10.1089/bsp.2006.4.307Published in Volume: 4 Issue 3: September 25, 2006PDF download

Developmental Eye Movement Test: reliability and symptomatology

The Developmental Eye Movement Test (DEM) is a widely used visual skill test, especially in the context of a vision therapy evaluation. It is intended to diagnose oculomotor dysfunction (OMD) and can also identify deficient rapid automatized naming. As such, its reliability and associated symptomatology are important. The DEM test-retest reliability was investigated within two populations: a group of 53 office patients who were participating in vision therapy evaluation in a private optometry practice, and a smaller group of 13 subjects at their school. One to four weeks separated the test and retest for both groups. We also studied the relationship between results on a questionnaire of symptoms associated with OMD and DEM test performance in these two populations. The first administration of the DEM significantly correlated with the second for all four of its scores for both groups. The office group had higher intra-class correlation coefficients than the school group. There was good agreement between test and re-test in terms of pass-fail classification for the office group. Symptomatic subjects performed poorer than asymptomatic subjects on the DEM. Failing the DEM Ratio, the score used to diagnose OMD, identified 90% of the subjects who were symptomatic. The DEM has good intra-subject test-retest reliability for all four of its scores when it is administered in an office setting to patients participating in a vision therapy evaluation. It also has good consistency in classifying patients as pass or fail. Performance on the DEM relates to certain symptoms that are associated with OMD.

Four different types of client attitudes towards purchasing spectacles in optometric practice

Unmet expectations are a major cause of client dissatisfaction, yet very little is known about the expectations and health values that clients in optometry practice hold about having an eye examination and purchasing spectacles. This study identified different attitudes and behaviours held by presbyope clients in optometric practices. A total of 158 presbyope clients, recruited from 14 practices, completed a questionnaire which was developed from the theory of planned behaviour. The questionnaire examined attitudes towards spectacles and visiting the optician, motivation to visit the optician, perceptions of barriers to attending the opticians, information requirements, and preferences for shared decision-making. Responses were analysed using principal components analysis. Four factors were identified, which were labelled style, vision, avoiding and seeking. Style is concerned with the importance of appearing fashionable or stylish, and desiring approval from others. Vision relates to clients' attitudes towards obtaining clear vision and to maintaining healthy eyesight. Avoiding describes the perceived difficulties associated with visiting the optician and purchasing new spectacles. Seeking corresponds to the desire for information on the technical details of lenses. Practitioners could use these characteristics to tailor information to meet the needs and address the expectations of individual clients. This may make the information provided more personally relevant, and could enhance client satisfaction.

Visual illusions? Beliefs and behaviours of presbyope clients in optometric practice

Many clients in optometry practice have reported that they do not receive sufficient information from practitioners to make informed purchasing decisions for corrective spectacles. The aim of this study was to identify participants’ attitudes and beliefs towards visiting an optician and purchasing spectacles, to compare clients’ and practitioners’ perceptions of purchasing decisions, and to examine clients’ preferences for information and decision making. One hundred and fifty-eight presbyopes completed a questionnaire to examine attitudes and behaviours regarding visiting an optician. Thirty-four practitioners completed a questionnaire examining the purchasing recommendations they make to clients, and their perceptions of clients’ purchasing decisions and information needs. Participants reported positive attitudes towards visiting an optician but required more information about their eyesight and about purchasing options. A discrepancy was found between client and practitioner perceptions of purchasing decisions and of involvement in the decision making process. Practitioners overestimated the importance of price to clients and underestimated the importance of their own recommendations on purchasing decisions. The findings of this study could be used to guide practitioners in their provision of information to clients.