Exploring new paths to reveal today's general practice of optometry.
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This paper describes a highly successful pilot program of four audio-teleconferences that was offered in 1993 to optometrists based in rural and regional areas of Queensland. The program represents the first application of such technology for this purpose, either within Australia or overseas. It accessed the facilities of eight of a network of 38 open learning centres across Queensland and comprised an integrated package of three workshops, each of 3 hours duration, covering issues relating to the eye disease, glaucoma, and a stand-alone workshop covering general practice/legal issues. A 'complex directed conference model' of audio-teleconferencing was used, with each workshop incorporating a slide presentation and companion workbook that described individual pre-workshop preparatory activities and was structured to provide a focus for group discussions during the workshop. The program demonstrated audio-teleconferencing to be both a cost- and educationally-effective medium for the delivery of continuing education to a widely distributed audience.
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BACKGROUND: To assist optometrists to deliver care more efficiently and effectively, in 1995 Optometrists Association Australia decided to develop standards that would assist optometrists in better managing their practices. Existing practice management standards for health professionals were thought to be either not specific enough for optometric practice or to have shortcomings in the context of optometric practice in Australia. METHODS: Following a literature search, material previously developed by Optometrists Association Australia to assist practitioners with management of their practices and standards from other professions were used to assist with the development of a draft set of standards for optometric practices in Australia. Successive drafts were circulated for comment to optometrists in practice, non-optometrists with experience in the development of practice standards for other health professions and to Australian General Practice Accreditation Limited. The comments were used to refine the standards and the accreditation guidelines to their final form. RESULTS: Optometric Practice Standards suitable for use in a practice accreditation program were developed. The standards comprise seven sections--Practice administration, Quality assurance, Rights and needs of the patient, Practice services, Practice facilities, Communication and Patient records. These sections are divided into criteria that provide the detail of the requirements of the standard. Indicators describing how criteria can be assessed accompany the criteria.
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Professor Fergus Campbell and colleagues pioneered the use of the interferometric visual stimulator as a tool for separating optical from neural factors which limit spatial vision. The device is now commercially available as a clinical instrument which 'bypasses the optics of the eye' to measure the potential visual acuity of the neural portion of the visual system. However, the clinician needs to be aware of limitations of current instrument designs and recent advances in our understanding of peripheral vision, to correctly interpret patient data gathered with these devices.
A new electrophysiological optometer has been developed, based on Scheiner's principle. Using two light-emitting diodes driven in counterphase, and grating stimuli in Maxwellian view, the system has been used to refract the photoreceptor plane of the pigeon eye. When a grating is conjugate with the photoreceptors, the electroretinographic response (e.r.g.) is minimal, and the image is stationary. As defocus is introduced, so image shift occurs, and the e.r.g. rises on each side of the refractive minimum. Two experiments were devised to test whether a derived minimum point is primary, by using gratings of bar width 3, 5 and 7 units, and by using random checkerboard stimuli. Ray tracing was used to compute the lobe width of dioptric profiles for gratings of spatial frequency 1.47, 0.88 and 0.63 cycles/deg. The computed lobe widths agree well with experimentally determined e.r.g. profiles. Examination of the lateral visual field, on the horizon, shows that the pigeon eye is emmetropic, and well corrected for astigmatism.
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