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PubMed1997

Vision, learning, and dyslexia. A joint organizational policy statement. American Academy of Optometry. American Optometric Association.

1. Vision problems can and often do interfere with learning. 2. People at risk for learning-related vision problems should be evaluated by an optometrist who provides diagnostic and management services in this area. 3. The goal of optometric intervention is to improve visual function and alleviate associated signs and symptoms. 4. Prompt remediation of learning-related vision problems enhances the ability of children and adults to perform to their full potential. 5. People with learning problems require help from many disciplines to meet the learning challenges they face. Optometric involvement constitutes one aspect of the multi-disciplinary management approach required to prepare the individual for lifelong learning.

Academies and Institutes↗
PubMed2004

Patients' perspectives on noncompliance with diabetic retinopathy standard of care guidelines.

BACKGROUND: Periodic dilated eye examinations are recommended by the American Optometric Association, American Academy of Ophthalmology, and American Diabetes Association to detect sight-threatening conditions in diabetic patients. However, many patients with diabetes do not receive this recommended eye care and there is limited research to explain why. The objective of this study was to determine reasons some diabetic patients do not receive a dilated eye examination at least every year. METHODS: A chart review identified patients at The Ohio State University College of Optometry who had not been examined for more than a year, but less than two years. A telephone interview was attempted for all subjects. RESULTS: Of 100 eligible subjects, 43 completed the telephone interview. The reasons patients with diabetes did not return for a recommended dilated eye examination included transfer of care to another eye doctor, limited personal mobility due to poor overall health, last examination at a homeless clinic, self-reported lack of insurance, and self-reported apathy. CONCLUSIONS: Strategies to improve compliance of patients with diabetes should include reaching patients of low socioeconomic status and those institutionalized for poor overall health. Improved compliance may also come by encouraging patients to use medical insurance for eye examinations and using patient recall systems.

Adolescent↗
PubMed2006

Use of clinical practice guidelines by executive directors of optometric associations.

BACKGROUND: The process of developing the American Optometric Association's (AOA) Optometric Clinical Practice Guidelines began in 1989 under the direction of John F. Amos, O.D., M.S., then chair of the AOA's Clinical Care Center. The guideline development process used by the AOA was modeled after the recommendations established by the Agency for Health Care Policy and Research in response to the federal government encouraging health care groups to develop clinical guidelines to enhance the quality, appropriateness, and effectiveness of health care. The guideline topics were chosen for their importance in the education of members, health care payers, and state legislators. A principal author and a consensus panel of experts then were chosen for each subject area. This group was responsible for transforming the latest scientific research and expert judgment into a document that would apply to everyday optometric practice. Thirteen guidelines were developed and mailed to AOA members in 1994 and 1995. Additional guidelines were mailed as they were approved. Currently, there are 20 guidelines available. METHODS: A survey was mailed to the executive director of the optometric association of each state and the District of Columbia and to the chief of optometry of each of the federal services. Telephone follow-up was made to nonrespondents, and an additional copy of the survey was mailed to them with telephone follow-up again taking place for those who did not respond. RESULT: Forty-three of the surveys were returned for a response rate of 78%. Seventy-six percent of the respondents stated that they had received the guidelines. The sections that were found most useful to the respondents were those related to Description and Classification, Basis of Treatment, and Treatment Options. The guidelines were most often used by these groups to improve the quality of eye care, expand optometric involvement in health programs, affect public policy, and overcome problems with insurance groups. DISCUSSION: Optometric organizations have found the clinical practice guidelines useful beyond their primary goal of enhancing the quality of patient care. They have been used effectively to help educate other parties about optometry and its role as a primary health care profession.

Humans↗
PubMed1994

Priorities for optometric education: outcomes of the curriculum conference.

The Association of Schools and Colleges of Optometry (ASCO) and the American Optometric Association (AOA) jointly sponsored a national meeting in July 1992 for the primary purpose of developing a curriculum model for optometric education. The conference was the third in the "Summit in Optometric Education" series and attracted 138 national and international leaders representing organized optometry and academia. This paper discusses the conference framework and presents outcomes as determined by conferee summary reports, postconference surveys, and interviews. There is evidence that the conference produced several successful outcomes that could benefit future educational planners. The task of designing a curriculum with learning objectives, using the innovative outcomes-based education (OBE) approach, was achieved. The conferees identified the importance of refocusing optometry graduate programs to include a greater emphasis in the biological sciences in order to produce educators and researchers for the changing profession. In addition the workshops on alternate teaching strategies, including problem-based learning, raised awareness amongst educators and practitioners of nontraditional options for presenting an ever-expanding information base within the confines of a 4-year professional curriculum.

Colorado↗
PubMedDate not supplied

When should children have their eyes checked?

Timely screening for the early detection of eye and vision problems in children is vital to avoid lifelong visual impairment. Early detection provides the best opportunity for effective treatment. Organizations devoted to the health and well-being of children have issued recommendations or policy statements regarding the timing of eye screenings and examinations. The American Academy of Pediatrics (AAP), American Association of Pediatric Ophthalmology and Strabismus (AAPOS), American Academy of Ophthalmology (AAO), American Association of Certified Orthoptists (AACO), and the American Academy of Family Physicians (AAFP) recommend screening at birth and all well-child visits. The American Optometric Association (AOA) recommends that vision examinations begin at 6 months of age. All children found to have an ocular abnormality or who fail vision assessment should be referred to an eye care specialist trained to treat pediatric patients.

Age Factors↗
PubMed1993

VISION USA--optometry's national charity program.

BACKGROUND: There are an estimated 18 million uninsured working Americans and their families who are unable to afford the cost of eye care. These individuals often fall between the cracks of government and private health care assistance. Members of the American Optometric Association have developed the VISION USA program to provide free eye care to those who might otherwise not receive it. METHODS: Nearly 8,000 doctors of optometry nationwide have volunteered to provide free eye examinations in their offices for VISION USA patients. Patients are screened for eligibility and matched to the nearest available participating doctor using a computerized ZIP code matching system. Examinations are usually provided each year during March in observance of Save Your Vision Week. RESULTS: In the first three years of the program, services have been provided to over 115,000 individuals. For over 21 percent of the patients seen, this was their first eye examination ever. More than 86 percent of the patients had one or more vision problems. More than 70 percent were given new or updated prescriptions. CONCLUSION: The VISION USA program is helping to meet a significant unmet need for eye care which exists within a segment of the American population. The program is an outstanding example of the willingness of doctors of optometry to give back to their communities, and to those in need, some of what they have gained from the practice of their profession.

Adolescent↗
PubMed1996

Postoperative management of cataract surgery patients by ophthalmologists and optometrists.

OBJECTIVES: To assess the frequency and content of post-operative examinations by ophthalmologists and optometrists for cataract surgery patients without operative complications and to assess the referral patterns of optometrists when complications are identified. DESIGN: In 1992 we conducted a survey of randomly selected members of the American Academy of Ophthalmology and American Optometric Association. Responses were obtained from 538 (82%) of 655 eligible ophthalmologists and 130 (84%) of 154 eligible optometrists. RESULTS: Eighty-eight percent of responding ophthalmologists reported that patients had 4 or more visits within 4 months after surgery, 97% of ophthalmologists performed the first postoperative examination on their cataract surgery patients, and 60% of ophthalmologists reported that no other eye professional saw their patients postoperatively. Forty-six percent of responding optometrists participated in postoperative care of cataract surgery patients, and usually performed their first postoperative examination 7 days after surgery; 78% of these optometrists reported that they saw patients 3 or more times after surgery. Postoperatively, 83% of ophthalmologists and 75% of optometrists usually performed at least 1 dilated fundus examination, 87% of ophthalmologists and 47% of optometrists performed 4 or more slit-lamp examinations, 74% of ophthalmologists and 42% of optometrists performed 4 or more tonometry tests, and 83% of both groups performed 2 or more refractions. More than 80% of responding optometrists involved in postoperative care of cataract surgery patients immediately refer a patient to an ophthalmologist if there is evidence of acute glaucoma or an unexplained decrease in vision in the eye that was operated on. For less urgent complications, most optometrists promptly make a referral to an ophthalmologist. CONCLUSIONS: In 1992, a small percentage of ophthalmologists and optometrists were performing fewer follow-up examinations and tests for cataract patients than recommended by the American Academy of Ophthalmology. Not all optometrists immediately refer to an ophthalmologist any acute complication that they identify postoperatively.

Adult↗
PubMed1995

Variation in ophthalmic testing prior to cataract surgery. Results of a national survey of optometrists. Cataract Patient Outcome Research Team.

OBJECTIVE: To assess variation in optometrists' use of ophthalmic tests in the evaluation of patients being considered for cataract surgery who have no history of other eye disease. DESIGN/PARTICIPANTS: National survey of a systematic sample of practicing members of the American Optometric Association (St Louis, Mo), who had referred at least one patient to an ophthalmologist for consideration of cataract surgery in 1991. RESULTS: Ninety-two of 130 eligible responding optometrists reported that they routinely performed preoperative testing on patients being considered for cataract surgery. Of these 92 optometrists, 91 (99%) frequently or always performed refraction, and 82 (89%) frequently or always performed a dilated fundus examination in their evaluation of patients being considered for cataract surgery who had no history of other eye disease. None of these 92 optometrists reported using B-scan ultrasonography or electroretinograms frequently or always, and few used A-scan ultrasonography or visual evoked responses frequently or always. A substantial percentage frequently or always used formal visual field testing (47%), formal color vision testing (40%), fundus photography (24%), potential acuity measurement (25%), glare testing (23%), contrast sensitivity testing (19%), and specular microscopy (14%), while 11% to 81% of optometrists never performed these tests on such patients. More recent graduation from optometry school was associated with a decreased frequency of use of potential acuity measurement and contrast sensitivity testing and with an increased use of dilated fundus examinations. CONCLUSION: There is a substantial variation in optometrists self-reported use of a number of ophthalmic tests in the preoperative evaluation of patients being considered for cataract surgery who have no history of other eye disease.

Adult↗
PubMed1992

Optometry research. Part 1: Funding sources.

Part 1 of this report presents an overview of U.S. ophthalmic research in general and of optometry research in particular and identifies the National Eye Institute (NEI) as the dominant funder of both types of research. Part 2 examines how NEI funding has been distributed among the U.S. schools and colleges of optometry in the past, whereas Part 3 examines the production of published research from the schools and colleges and the Department of Veterans Affairs Optometry Service. Information is presented to indicate that the schools of optometry account for about 3% of all NEI funding and produce about 3% of all published ophthalmic research. Published optometry research results mainly from the activities of four schools and the VA Optometry Service, which has rapidly become the leading source of articles published in The Journal of the American Optometric Association and presenter of continuing education at the Academy's annual Ellerbrock Lectures. This study suggests optometry needs to husband its relatively small research base and, in the author's opinion, concentrate on the support of clinical trials and research directly relevant to primary eye care rather than basic biologic or physiologic research.

Humans↗
PubMed1993

Optometry research. Part 3: Faculty publications.

I compared the production of faculty-produced publications among the U.S. schools and colleges of optometry and the Department of Veterans Affairs (VA) Optometry Service. These publication rates were viewed against the schools' rankings in National Eye Institute (NEI) funding (see Part 2), student/faculty ratios, faculty salaries, and the presence of a graduate degree program. The schools and the VA grouped into three levels of publication production with five of first rank, four of middle rank, and eight of lower rank. The five leading producers in the period 1982 through 1991 were Berkeley, Alabama, Houston, VA, and State University of New York (SUNY). Since 1982 VA optometrists have authored the largest number of articles published in the Journal of the American Optometric Association and since 1985 have been the leading group of continuing education (CE) lecturers at the Academy.

Faculty↗
PubMed1994

Strategic planning for optometric education: the Georgetown Conference.

In 1991, the American Optometric Association (AOA) and the Association of Schools and Colleges of Optometry (ASCO) committed to the joint sponsorship of a national Summit on Optometric Education. The decision began a 3-year effort which will have an impact on both the academic and political arms of the profession for years to come. The purpose of this discussion is to consider the specific parameters and the process involved in a nationally based strategic planning process for optometric education. The planning process began with The Georgetown Conference in April 1992 and will continue through a series of 6 focus conferences ending in November 1993.

District of Columbia↗
PubMed1994

Optometric education: planning for the future.

Collectively, the American Optometric Association (AOA) and the Association of Schools and Colleges (ASCO) have felt a growing need to develop a strategic plan that would ensure that the financial and other resource needs of the educational establishment can and will be met. Only when this is accomplished can the profession of optometry continue to be able to meet the needs of the public. An initial Georgetown Conference--Summit on Optometric Education was held in March 1992. It was followed later in 1992 by a Conference on the Scope of Optometric Practice and a Curriculum Conference. Scheduled for 1993 were four additional conferences which dealt with Optometric Students, Optometric Research, Graduate Education, Residencies and Fellowships, and the Financing of Optometric Education. Critical questions have been addressed and recommendations have been made. Additional efforts are underway to reach the stated objectives of the initial conference.

Clinical Competence↗
PubMed1994

Enhanced vision screening of highway patrol applicants.

BACKGROUND: The Missouri State Highway Patrol (MSHP) required that its vision standards be updated in order to comply with the Americans with Disabilities Act (ADA). This act prohibits employers from using qualification standards to screen out people with disabilities, including vision, unless they are job-related and necessary. METHODS: Since 1992 the author and a team of optometry students have screened all MSHP applicants using the American Optometric Association (AOA)'s Vision Standards for Police Officers with the addition of grating contrast sensitivity. RESULTS: The mean age of this group was 24.8 years and most (87%) were male. Thirty percent wore spectacles, contact lenses, or had refractive modification. Ninety-seven percent of the applicants were able to pass all aspects of the enhanced vision screening. CONCLUSION: The initiation of optometric screening to ensure that all future troopers meet the recommended vision standards for police officers should ensure uniformity of these standards for the MSHP.

Adult↗
PubMed1996

The first conference to establish optometric standards.

In 1901, when optometry first achieved legal status, optometric education in the United States was inadequate. Two-week courses in refraction, correspondence courses, and 2 year apprenticeships were common. Over the next 2 decades, progress was made through the closing of a number of schools and the development of some creditable ones, but across the country optometric education remained unacceptably uneven. There were various calls for improvement, and in 1921 the American Optometric Association (AOA) formed a Council on Optometric Education. In 1921, funds were appropriated by the AOA to fund a nationwide conference on optometric education, which was held in January, 1992. Among other things, this conference resulted in the classification of all schools, closing some in the process; the adoption of minimum entrance requirements; the adoption of subject matter syllabi; and the recommendation of the end of apprenticeship and correspondence courses. Optometric education was forever changed.

Education↗
PubMed2005

The frequency of dilated diabetic eye examinations by optometrists in the state of ohio.

PURPOSE: The purpose of this study was to assess optometric care of diabetic patients. The American Optometric Association recommends dilated eye examinations at least once a year for people with diabetes. METHODS: Onsite chart reviews of 1497 diabetic patient charts were performed at a volunteer sample of Ohio-based optometric practices (n = 82). Four percent of all optometrists in the state of Ohio were surveyed. Data were collected from a 10-year period and included doctor age, membership in the Ohio Optometric Association (OOA) Diabetes Initiative, patient age, date of examinations, chief complaints, and dilation at examination. The primary outcome of the study was the frequency of dilated eye examination for diabetic patients by optometrists. RESULTS: Optometrists dilated 85.8% of diabetic patients at their last comprehensive examination. The percentage of diabetic patients dilated by optometrists increased from 40.0% in 1994 to 91.5% in 2003. The average time since last comprehensive eye examination for diabetic patients was 1.0 +/- 1.8 (mean +/- standard deviation) years. Diabetic patients who were dilated at a comprehensive eye examination returned to care on average 0.7 years sooner than those who were not dilated. Doctor-level factors related to a higher average percentage of dilations were younger doctor age (beta = -6.1%/10 years of doctor age; 95% confidence interval [CI], -10.1 to -2.1) and membership in the OOA Diabetes Initiative (beta = 11.6%; 95% CI, 2.3 to 20.8). CONCLUSIONS: There is variability in diabetic eye care by optometrists. However, the majority of optometrists surveyed in this study provided dilated eye examinations for their diabetic patients. Programs desiring to increase compliance to diabetic standard of care guidelines may benefit by targeting both doctors and patients.

Adult↗
PubMed1976

Health planning and resources development: an opportunity for optometry.

The American Optometric Association views the goal of the National Health Planning and Resources Development Act of 1974, as the promotion of physical, emotional and environmental health for all. The National Health Planning and Resources Development Act will work towards this goal by identifying problems, preparing reports and studies and developing recommendations for implementation directed toward solving the problems. These functions will be carried out in collaboration with private and governmental individuals and organizations concerned with health care services. Only through this coordinated effort will success be achieved.

Health Planning↗
PubMed2000

Workforce projections for optometry.

BACKGROUND: A 1995 workforce study conducted by RAND estimated a large current surplus of eye care providers in the United States. Due to data limitations of the RAND study and the outdated optometric workforce information available, the American Optometric Association contracted with Abt Associates to conduct a study to project future workforce requirements for optometry. METHODS: We collected extensive data on both the supply (work hours, retirement rates, new entrants) and demand (patient encounters and associated time requirements) of optometrists. These data were collected from a survey using stratified random sampling of 1,100 practicing optometrists and were used to develop workforce projections for optometry through the year 2030. Projections were calculated using a forecasting tool that can be used to derive workforce and training requirements under a range of future scenarios. RESULTS: Workforce projections suggest an excess supply of optometrists is likely over the next 20 years. Over the next five years, approximately 550 optometrists are expected to retire each year, while more than 1,100 optometrists enter practice annually. Patient encounter volume is projected to increase steadily, but the effects of this increase are largely offset by an anticipated decrease in optometrist time requirements for routine eye examinations. DISCUSSION: To reduce the size of the anticipated excess supply, optometry may want to focus on ways that demand can be increased. One way to increase demand is through greater convergence between the actual demand for eye care services and the underlying public health need for eye care.

Adult↗