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Optometrists

Distribution by Scientific Domains

Medical Sciences	95%
2 Other Domains	5%

Selected Abstracts

What adjustments, if any, do UK optometrists make to the subjective refraction result prior to prescribing?

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2010
Chris Howell-Duffy
Abstract Aim:, To determine whether UK optometrists routinely prescribe the subjective refraction result, or whether adjustments are made to aid patient comfort and adaptation. Method:, A questionnaire was distributed by post and via the internet to UK optometrists. It incorporated eight case scenarios that included information regarding a patient's age, symptoms, habitual refractive correction, subjective refraction and any other pertinent clinical information. For each case, they were asked to indicate what refractive correction they would prescribe. Results:, A total of 426 questionnaires were completed. In three cases with asymptomatic patients with negligible changes in visual acuity, about 45% of respondents indicated that they would prescribe the subjective refraction result and about 40% would prescribe the habitual correction. In a further case involving a 75 year-old asymptomatic patient, 55% prescribed the habitual correction. In two cases with large cylinder power changes, about 40% of respondents indicated they would partially prescribe the cylinder power. However, there was a large variation in the suggested modification of sphere powers to accompany the partial cylinder changes. Conclusion:, A large sample of UK optometrists indicated that they would prescribe the subjective refraction result regardless of patient age, symptoms and difference between habitual correction and subjective refraction. Optometrists who partially prescribe, employ a wide variety of techniques including some that conflict with conventional teaching. [source]

A critical evaluation of the evidence supporting the practice of behavioural vision therapy

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2009
Brendan T. Barrett
Abstract In 2000, the UK's College of Optometrists commissioned a report to critically evaluate the theory and practice of behavioural optometry. The report which followed Jennings (2000; Behavioural optometry , a critical review. Optom. Pract. 1: 67) concluded that there was a lack of controlled clinical trials to support behavioural management strategies. The purpose of this report was to evaluate the evidence in support of behavioural approaches as it stands in 2008. The available evidence was reviewed under 10 headings, selected because they represent patient groups/conditions that behavioural optometrists are treating, or because they represent approaches to treatment that have been advocated in the behavioural literature. The headings selected were: (1) vision therapy for accommodation/vergence disorders; (2) the underachieving child; (3) prisms for near binocular disorders and for producing postural change; (4) near point stress and low-plus prescriptions; (5) use of low-plus lenses at near to slow the progression of myopia; (6) therapy to reduce myopia; (7) behavioural approaches to the treatment of strabismus and amblyopia; (8) training central and peripheral awareness and syntonics; (9) sports vision therapy; (10) neurological disorders and neuro-rehabilitation after trauma/stroke. There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated. [source]

A survey of the scope of therapeutic practice by UK optometrists and their attitudes to an extended prescribing role

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2008
Justin J. Needle
Abstract Purpose:, Recent changes in medicines legislation in the UK have broadened the opportunities for optometrists to use and supply therapeutic drugs. We set out to investigate the current therapeutic practice of UK optometrists and to elicit their views on an extended prescribing role. Methods:, Members of the College of Optometrists were invited via email to take part in an online survey. The survey questions covered four areas: mode of practice, proximity and relationship to other providers of eye care, scope of current therapeutic practice and future plans regarding prescriber training. Results:, Of the 1288 responses received (response rate 24%), over 90% were from optometrists working in community practice. Common, non-sight-threatening conditions were managed frequently or occasionally by between 69 and 96% of respondents. Blepharitis and dry eye were the most common (managed routinely by >70%). In terms of therapeutic agents used, large numbers of optometrists reported that they commonly supplied or recommended over-the-counter (non-prescription) drugs, particularly lubricants and anti-allergic agents. However, fewer respondents supplied antibiotics (only 14% supplying chloramphenicol or fusidic acid frequently). Overall, relatively few respondents (14%) expressed no interest in undertaking further training for extended prescribing, although several barriers were identified, including cost and time taken for training, lack of remuneration and fear of litigation. Conclusion:, Significant numbers of community optometrists are currently managing a range of common ocular conditions using a limited formulary. Enabling optometrists to train as independent prescribers will further develop this role, allowing greater use of their skills and providing patients with quicker access to medicines. [source]

Optometrists' examination and referral practices for patients presenting with flashes and floaters

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2002
A. Alwitry
Introduction:,Patients experiencing flashes and floaters commonly present to their optometrist. Some of these patients may have significant pathology, yet there is a great deal of variability with regard to examination technique and referral practice. Methods:,A questionnaire survey was undertaken to determine the current management of patients presenting to their optometrist with flashes and floaters. All practising community optometrists within Southern Derbyshire received a questionnaire and 74 (56.9%) completed replies were received. Results:,Optometrists estimated that an average of 14 patients per month per optometrist presented with symptoms of flashes and/or floaters. Mydriasis was utilised routinely for examination in approximately half of the patients. Mean relative confidence was 2.0 at identifying a vitreous haemorrhage and 6.5 for vitreous pigment (complete confidence = 0, complete lack of confidence = 10). Eight percent of responders were unfamiliar with the clinical sign of vitreous pigment, and 17% identifying this sign did not refer all such patients to the hospital services. Conclusions:,Patients presenting to their optometrists with flashes and/or floaters make up a sizeable part of the community optometrist's workload and the management of these patients is highly variable. A large proportion of these patients are examined without mydriasis, even in the presence of various risk factors for retinal detachment. There is a relative lack of confidence amongst optometrists with regards the detection of vitreous pigment and the prognostic implications of this finding. Educational measures such as study days may help the level of understanding and heighten the appreciation of the implications of flashes and floaters and the various clinical signs encountered. [source]

Dyslexia: a review of two theories

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2008
Krithika Nandakumar BSOptom
Optometrists will frequently see patients, who may have a diagnosis or a suspected diagnosis of dyslexia (specific reading disorder) and will need to manage and counsel such patients. There are many propounded theories on the cause(s) of dyslexia. Although most professionals in this area consider that dyslexia is chiefly a linguistic disorder, the possibility of a visual component is contentious. This article is a selective review of two commonly discussed theories that suggest a visual component in dyslexia; the magnocellular deficit theory and Meares-Irlen syndrome. [source]

The mobility of optometrists practising in Australia in 2005: Do optometry graduates move to states without schools of optometry?

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 1 2008
Patricia M Kiely BScOptom PhD
Background:, Three schools of optometry in the eastern states of Australia provide optometrists for the entire country. Concerns have been expressed about attracting optometrists to practise in the other states. This paper analyses the source of optometric qualification of optometrists practising in each state, to assess the proportion who have chosen to practise in a state different from that in which they qualified and to determine whether there are gender differences in preparedness to move to a different state. Method:, Data on year and school of qualification, primary professional activity and current state or territory of practice were extracted from the Optometrists Association Australia database to determine a profile of place of qualification of optometrists in each state or territory of Australia in 2005. Results:, More than 77 per cent of practising optometrists from Australian schools practised in the state where they graduated. The majority of optometrists for the Australian Capital Territory (ACT), South Australia (SA) and Western Australia (WA) were New South Wales graduates; the majority of Tasmanian optometrists were Victorian graduates. Optometrists from overseas accounted for 17.3, 24.6 and 19.9 per cent of optometrists in practice in SA, Tasmania and WA, respectively, but less than 7.5 per cent elsewhere. The highest number of optometrists who had qualified outside Australia practised in NSW. Female graduates from 2000 and later were more likely to move interstate than their male counterparts. Discussion:, Approximately 14 per cent of practising optometry graduates practised in states without schools, where 21 per cent of the population resided. This indicates some degree of mobility but the market needs to work further to match supply of optometric services to demand at state level. Further analysis is necessary to determine patterns of graduate movement in the years following graduation, to determine whether movement to different states is short- or long-term. [source]

Assessment of inherited colour vision defects in clinical practice

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 3 2007
Barry L Cole PhD MAppSc BSc LOSc
Background:, Colour vision deficiency (CVD) has a high prevalence and is often a handicap in everyday life. Those who have CVD will be better able to adapt and make more informed career choices, if they know about their deficiency. The fact that from 20 to 30 per cent of adults with abnormal colour vision do not know they have CVD suggests that colour vision is not tested as often as it should be. This may be because of practitioner uncertainty about which tests to use, how to interpret them and the advice that should be given to patients on the basis of the results. The purpose of this paper is to recommend tests for primary care assessment of colour vision and provide guidance on the advice that can be given to patients with CVD. Methods:, The literature on colour vision tests and the relationship between the results of the tests and performance at practical colour tasks was reviewed. Results:, The colour vision tests that are most suitable for primary care clinical practice are the Ishihara test, the Richmond HRR 4th edition 2002 test, the Medmont C-100 test and the Farnsworth D15 test. These tests are quick to administer, give clear results and are easy to interpret. Tables are provided summarising how these tests should be interpreted, the advice that can be given to CVD patients on basis of the test results, and the occupations in which CVD is a handicap. Conclusion:, Optometrists should test the colour vision of all new patients with the Ishihara and Richmond HRR (2002) tests. Those shown to have CVD should be assessed with the Medmont C-100 test and the Farnsworth D15 test and given appropriate advice based on the test results. [source]

Gordon L. Ruskell: optometrist, teacher and anatomist

JOURNAL OF ANATOMY, Issue 3 2005
R. H. Douglas
First page of article [source]

Fusidic acid viscous eyedrops , an evaluation of pharmacodynamics, pharmacokinetics and clinical use for UK optometrists

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2006
Michael J. Doughty
Abstract Recent changes in UK law have allowed UK-based optometrists to sell and supply fusidic acid viscous eyedrops, providing it is in the course of their professional activity and in an emergency. Alternatively, the optometrist may access fusidic acid viscous eyedrops, for a named patient, using a written order supplied to a pharmacy. This review provides details of the legal background to these changes, examines the common causes of a bacterial conjunctivitis, examines the mechanism of action of this narrow spectrum antibiotic as a bacteriostatic agent, reviews the susceptibility of common ocular isolates of bacteria to the drug and presents details of the expected pharmacokinetics of the viscous eyedrops. From this perspective, a systematic review is provided of the clinical studies which have investigated the use of fusidic acid viscous eyedrops and their outcome. The indicated use is generally for the treatment of bacterial conjunctivitis and/or blepharoconjunctivitis, especially that caused by Staphylococcus, but not Streptococcus or Haemophilus sp. (more likely associated with concurrent nasopharyngeal infections). The usual regimen for use is twice daily for 5,10 days, depending on severity, and can initially be used more intensively (four times per day). It may also be used for the management of corneal and conjunctival abrasions and foreign body injuries, or some cases of chronic blepharitis. [source]

Optometrists' examination and referral practices for patients presenting with flashes and floaters

Paediatric community vision screening with combined optometric and orthoptic care: a 64-month review

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2002
Lisa A. Donaldson
We report a new model of community-based secondary vision screening and demonstrate that a high proportion of children can be effectively managed in such a clinic without referral to the hospital eye service (HES). We performed a 64-month retrospective study of a secondary vision screening clinic providing the combined skills of an optometrist and orthoptist in a community setting. Particular attention was given to the diagnosis and management of children not referred to the HES. During this period, 1755 children were sent appointments and 74% (1300) attended the clinic. The community orthoptist and school nurses referred 53% of the patients and health visitors, general practitioners and community medical officers made 32% of the clinic referrals. Spectacles were prescribed for 41% of the children and 8% were prescribed patching. Sixteen per cent of the children were referred on to the HES. This model of care using the combined expertise of the orthoptist and optometrist is able to diagnose and manage the majority of children who have failed primary vision screening and avoids unnecessary referrals to the HES. [source]

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 2 2001
E. A. H. Mallen
Summary A clinical evaluation of the Shin-Nippon SRW-5000 (Japan), a newly released commercial autorefractor, was undertaken to assess its repeatability and validity compared to subjective refraction. Measurements of refractive error were performed on 200 eyes of 100 subjects (aged 24.4±8.0 years) subjectively (non-cycloplegic) by one optometrist and objectively with the SRW-5000 autorefractor by a second. Repeatability was assessed by examining the differences between the seven autorefractor readings taken from each eye and by re-measuring the objective prescription of 50 eyes at a subsequent session. Although the SRW-5000 read slightly more plus than subjective refraction (mean spherical equivalent +0.16±0.44 D), it was found to be highly valid (accurate) compared to subjective refraction and repeatable over the prescription range of +6.50 to ,15.00 D examined. The Shin-Nippon SRW-5000 autorefractor is therefore a valuable complement to subjective refraction and as it offers the advantage of a binocular open field-of-view, has a great potential benefit for accommodation research studies. [source]

Will the auto-refractor ever replace the optometrist?

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 2000
Mark A. Bullimore
No abstract is available for this article. [source]

Screening for diabetic retinopathy by non-ophthalmologists: an effective public health tool

ACTA OPHTHALMOLOGICA, Issue 4 2003
Lalit Verma
Abstract. Purpose:, To investigate and report the reliability of detection and grading of diabetic retinopathy by direct ophthalmoscopy through a dilated pupil by general physicians (non-ophthalmologists) and optometrists who have undergone a short period of training. Methods:, A total of 400 eyes of 200 diabetes patients were examined by two non-ophthalmologists. Their observations were compared with an ophthalmologist's diagnoses for the same patients. Results:, The diagnoses made by the general physician (kappa = 0.8381, SE = 0.041) and the optometrist (kappa = 0.7186, SE = 0.051) showed good rates of agreement with the ophthalmologist's diagnoses. Conclusions:, The provision of appropriate screening protocols and follow-up parameters can enable primary care physicians and support personnel to reliably screen individuals for retinopathy in diabetes. This will reduce the workload of tertiary hospitals, and provide optimal services to the huge majority of the Indian population that has limited access to eye care services. [source]

A case of preseptal cellulitis

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2003
Paul Sanfilippo BAppSc (Optom) Grad Cert Optom
Infection of the eyelids confined to the preseptal space is relatively common but potentially serious. It occurs with much greater frequency than do orbital infections and if left untreated, it has the potential to be life-threatening. We present a classic case of preseptal cellulitis and discuss how the optometrist can be involved in the diagnosis and management of this infectious disorder. [source]

The 75th anniversary of the World Council of Optometry: Seventy-five years of advancing eye care by optometrists worldwide

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2002
Damien P Smith PhD AM
SUMMARY Over 75 years, the World Council of Optometry has developed as an organisation with the mission and appropriate strategies to improve the quality of eye and vision care around the world, especially by advancing the delivery of that care by educated, regulated, primary care optometrists. However, WCO is unknown to most optometrists and ,international optometry' is not part of the optometric curriculum in our schools, just as it is rarely on the agenda of our professional associations. As a consequence, many optometrists do not understand the difficulties faced by their colleagues in other countries, in both clinical and political challenges. Australian optometrists are regulated by law, educated at state universities, eligible for service coverage by universal health insurance, able to detect disease in the eye using diagnostic agents and, in increasing numbers, able to treat disease in the eye with therapeutic drugs. However, this community standing and professional privilege, taken for granted by most Australian optometrists, cannot be exported. In fact, an Australian optometrist would be jailed in many countries around the world just for doing the ordinary clinical procedures that he or she does on every patient, by routine, day in and day out. All optometrists should feel ownership of WCO and all should have a commitment to its mission to facilitate the enhancement and development of eye and vision care by optometrists worldwide. Australian optometrists are already linked to WCO through their membership of Optometrists Association Australia, which is itself a longstanding and valued member of WCO. To prosper for a further 75 years, WCO needs continued global volunteerism and from those unable to directly participate, financial support through donations and sponsorship. [source]

A comparative evaluation of digital imaging, retinal photography and optometrist examination in screening for diabetic retinopathy

DIABETIC MEDICINE, Issue 7 2003
J. A. Olson
Abstract Aims To compare the respective performances of digital retinal imaging, fundus photography and slit-lamp biomicroscopy performed by trained optometrists, in screening for diabetic retinopathy. To assess the potential contribution of automated digital image analysis to a screening programme. Methods A group of 586 patients recruited from a diabetic clinic underwent three or four mydriatic screening methods for retinal examination. The respective performances of digital imaging (n = 586; graded manually), colour slides (n = 586; graded manually), and slit-lamp examination by specially trained optometrists (n = 485), were evaluated against a reference standard of slit-lamp biomicroscopy by ophthalmologists with a special interest in medical retina. The performance of automated grading of the digital images by computer was also assessed. Results Slit-lamp examination by optometrists for referable diabetic retinopathy achieved a sensitivity of 73% (52,88) and a specificity of 90% (87,93). Using two-field imaging, manual grading of red-free digital images achieved a sensitivity of 93% (82,98) and a specificity of 87% (84,90), and for colour slides, a sensitivity of 96% (87,100) and a specificity of 89% (86,91). Almost identical results were achieved for both methods with single macular field imaging. Digital imaging had a lower technical failure rate (4.4% of patients) than colour slide photography (11.9%). Applying an automated grading protocol to the digital images detected any retinopathy, with a sensitivity of 83% (77,89) and a specificity of 71% (66,75) and diabetic macular oedema with a sensitivity of 76% (53,92) and a specificity of 85% (82,88). Conclusions Both manual grading methods produced similar results whether using a one- or two-field protocol. Technical failures rates, and hence need for recall, were lower with digital imaging. One-field grading of fundus photographs appeared to be as effective as two-field. The optometrists achieved the lowest sensitivities but reported no technical failures. Automated grading of retinal images can improve efficiency of resource utilization in diabetic retinopathy screening. Diabet. Med. 20, 528,534 (2003) [source]

Preservation of sight in diabetes: developing a national risk reduction programme

DIABETIC MEDICINE, Issue 9 2000
L. Garvican
SUMMARY Background Early treatment for diabetic retinopathy is effective at saving sight, but dependent on pre-symptomatic detection. Although 60% of people with diabetes have their eyes examined annually, few UK health authorities have systematic programmes that meet the British Diabetic Association's standards for sensitivity (> 80%) and specificity (> 95%). Screening is generally performed by general practitioners and optometrists, with some camera-based schemes, operated by dedicated staff. The National Screening Committee commissioned a group to develop a model and cost estimates for a comprehensive national risk-reduction programme. Ophthalmoscopy Evidence indicates that direct ophthalmoscopy using a hand-held ophthalmoscope does not give adequate specificity and sensitivity, and should be abandoned as a systematic screening technique. Indirect ophthalmoscopy using a slit lamp is sensitive and specific enough to be viable, and widespread availability in high street optometrists is an advantage, but the method requires considerable skill. Photographic schemes The principal advantage of camera-based screening is the capturing of an image, for patient education, review of disease progression, and quality assurance. Digital cameras are becoming cheaper, and are now the preferred option. The image is satisfactory for screening and may be transmitted electronically. With appropriate training and equipment, different professional groups might participate in programme delivery, based on local decisions. Cost issues Considerable resources are already invested in ad hoc screening, with inevitable high referral rates incurring heavy outpatient costs. Treatment for advanced disease is expensive, but less likely to be effective. The costs of a new systematic screening and treatment programme appear similar to current expenditure, as a result of savings in treatment of late-presenting advanced retinopathy. Conclusion A systematic national programme based on digital photography is proposed. [source]

Comprehensive health assessments during de-institutionalization: an observational study

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 10 2006
N. Lennox
Abstract Background People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase. Methods This research aimed to investigate the effectiveness of a specially designed health review, the comprehensive health assessment program (CHAP) health review, in a group of adults as they transitioned out of the care of the last institution for people with ID in Tasmania. There were 25 residents reviewed by their GPs. Results The CHAP reviews picked up a number of health conditions and stimulated health promotion activities. Some of the findings were: a high number of abnormal Body Mass Indexes (19/23), immunizations given (13/23), vision impairment reported (2/23), mental health issues recorded (4/23) and skin abnormalities described (17/23). There were 22 referrals made to other health professionals (Australian Hearing Service 4, dentists 3, optometrists 3, psychiatrists 2, neurologists 2, ophthalmologist 1, urologist 1, ultrasound 1, mammogram 1, family planning 1, physiotherapist 1, continence nurse 1 and respiratory physician 1). These were in addition to various requests for pathology. Conclusions The CHAP health review was effective in identifying a number of health issues in the population of people with ID as they transitioned out of institutional care into the general community. [source]

The use of tinted lenses to alleviate reading difficulties

JOURNAL OF RESEARCH IN READING, Issue 1 2001
Helen Whiteley
An increasing number of optometrists are offering assessments using the Intuitive Colorimeter (Wilkins, Nimmo-Smith and Jansons, 1992) to determine whether children who have reading difficulties might benefit from the use of tinted lenses. Suggestions have been made in the media that tinted lenses may provide a ,cure' for developmental dyslexia, and there have been many anecdotal accounts of improvements in reading following their use (e.g. Brace, 1993). However, such extreme claims are not typical of the scientific literature supporting the use of tinted lenses. This article provides an overview of the research into the use of tinted lenses for the amelioration of reading difficulties. The electronic databases searched for this review were BIDS, MEDLINE, PsychInfo, PsychLit and Science Direct. Key search terms used were coloured (colored) lenses, Irlen lenses, scotopic sensitivity and visual deficits in combination with the term ,reading difficulties'. [source]

What adjustments, if any, do UK optometrists make to the subjective refraction result prior to prescribing?

Comparison of the IOPen® and iCare® rebound tonometers with the Goldmann tonometer in a normal population

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2010
J. Jorge
Abstract This study proposes to evaluate the level of accuracy of intraocular pressure (IOP) measurements of a second generation rebound tonometer (IOPen®), taking as references the Goldmann Applanation Tonometer (GAT) and the iCare® rebound tonometer. The right eyes of 101 consecutive clinical patients were assessed with the three tonometers. The IOPen® and iCare® measurements were taken by two different optometrists and the GAT by an ophthalmologist. In this study, statistically significant differences were found when comparing the IOPen® tonometer with the other two tonometers (p < 0.001). The IOPen® underestimated the IOP value when compared to the GAT and the iCare® (mean differences were 2.94 ± 4.65 mmHg and 3.20 ± 4.72 mmHg (mean ± S.D.), respectively). The frequency distribution of differences demonstrated that in more than 55% of measurements the IOP readings differed by more than 3 mmHg between the IOPen® and the GAT. Based on the present population study, these results suggest that IOPen® measurements should be interpreted with caution. [source]

A critical evaluation of the evidence supporting the practice of behavioural vision therapy

The content of optometric eye examinations for a young myope with headaches

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 5 2008
Rakhee Shah
Abstract Background:, A recent review found standardised patient (SP) methodology to be the gold standard methodology for evaluating clinical care. We used this to investigate the content of optometric eye care for a young myopic patient with headaches suggestive of migraine. Methods:, We recruited 100 community optometrists who consented to be visited by an unannounced actor for an eye examination and to have that eye examination recorded. The actor received extensive training to enable accurate reporting of the content of the eye examinations, via an audio recording and a checklist completed for each clinical encounter. The actor presented as a 20-year-old student seeking a private eye examination and complaining of symptoms suggestive of migraine headaches. The results of each clinical encounter were recorded on a pre-designed checklist based on evidence-based reviews on headaches, clinical guidelines and the views of an expert panel of optometrists. Results:, The presence of headache was detected in 98% of cases. Eight standard headache questions were considered to be the gold standard for primary care headache investigation. Although none of the optometrists asked all of these questions, 22% asked at least four of the eight questions. Sixty-nine per cent of practitioners asked the patient to seek a medical opinion regarding the headaches. The proportion of the tests recommended by the expert panel that was carried out varied from 33% to 89% and the durations of the eye examination varied from 5 to 50 min. Conclusion:, SP encounters are an effective way of measuring clinical care within optometry and should be considered for further comparative measurements of quality of care. As in research using SPs in other healthcare disciplines, our study has highlighted substantial differences between different practitioners in the duration and depth of their clinical investigations. This highlights the fact that not all eye examinations are the same and that there is no such thing as a ,standard sight test'. We recommend that future optometric continuing education could usefully focus on migraine diagnosis and assessment. [source]

A survey of the scope of therapeutic practice by UK optometrists and their attitudes to an extended prescribing role

Technical Note: Grading the vertical cup:disc ratio and the effect of scaling

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2007
Ruth Bennett
Abstract Purpose:, To evaluate the effect of scaling on sensitivity to change for grading the vertical cup:disc ratio (CDR). Methods:, Vertical CDR was assessed by six observers (three ophthalmologists and three optometrists) on 43 stereo disc photographs. Repeated observations were made for both 0.1 and 0.05 interval scales. Paired differences were calculated for all observers and each observer separately. Mean and standard deviation of differences and agreement statistics were used to compare scales. Results:, Five observers demonstrated a reduction in the spread of differences (mean difference 0.19 to 0.15) and all observers demonstrated a reduction in concordance using the finer scale (mean concordance 54% to 39%). Conclusion:, The use of a finer scale reduces test,retest variability and increases sensitivity to change when estimating the vertical CDR. Use of this scale does not require any additional resource and it may be easily implemented in routine clinical practice. [source]

Fusidic acid viscous eyedrops , an evaluation of pharmacodynamics, pharmacokinetics and clinical use for UK optometrists

Efficacy of treatment for convergence insufficiency using vision therapy

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2002
Paul Adler
Abstract Purpose: The purpose of this study was to determine if vision therapy (VT), as practised within the constraints of UK optometric practice, employing graded routine eye exercises, is as an effective method for treatment of convergence insufficiency (CI) as previously published data suggest. The study also evaluates the associated symptoms before and after therapy. Methods: As many optometrists diagnose CI solely on the basis of near point of convergence (NPC) and treat only when symptoms are present (Letourneau et al., 1979; Rouse et al., 1997), in this study CI was defined as NPC of 10 cm or greater (either with or without the presence of asthenopic symptoms for near work) accompanied by exophoria greater at near than at distance. The effect of treatment by optometric vision therapy (OVT) on the NPC and number of symptoms was investigated for 92 patients by retrospectively reviewing the clinical records. Success was defined as the restoration of NPC to normal values and significant reduction in the presenting symptoms. Results: The effect of treatment on the NPC was shown to be highly significant (t = 14.61, p < 0.001). Although treatment times were slightly longer, the success rates were higher than reported by other authors. Post-treatment values for NPC were: <10 cm (98.9%), <8.5 cm (95.7%) and <6.5 cm (80.4%). Longer treatment times were noted for patients who complained that the text appeared to move (,2, p = 0.007). Conclusion: Vision therapy is an effective method for treatment of CI. [source]

Optometrists' examination and referral practices for patients presenting with flashes and floaters

Detection of uveal melanoma by optometrists in the United Kingdom

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2001
Bertil Damato
Summary In the United Kingdom, most uveal melanomas are detected by optometrists. Prospectively collected data on patients with uveal melanoma presenting to optometrists were analysed retrospectively to determine: (a) the proportion of patients who were asymptomatic at the time of tumour detection, (b) the proportion of symptomatic patients reporting that their tumour was missed at their initial presentation and (c) the clinical features related to immediate tumour detection. The 223 patients had a mean age of 59.7 years, a mean tumour diameter of 11.3 mm and a mean tumour thickness of 4.6 mm. Symptoms were present in 122 patients (55%) and were associated with large tumour size (p<0.0001) and male gender (p=0.003), with more males tending to have a large tumour (p=0.004). Seventy-nine percent of symptomatic patients reported that their tumour was detected at their first visit. Failure of tumour detection in symptomatic patients was associated with absence of tumour extension posterior to equator (p<0.0001). [source]