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PubMed2001

Initial 67th Combat Support Hospital Optometry Services in Taszar, Hungary, during Operation Joint Endeavor.

BACKGROUND: Existing U.S. Army personnel and equipment authorization documents do not recognize the need for optometry services at deployed combat support hospitals (CSHs). The specific hospital tasked with the mission of supporting Operation Joint Endeavor from a support base in Taszar, Hungary, did not have any documentation authorizing the assignment of ophthalmology assets. Current Army doctrine stipulates the presence of an area support medical battalion, with assigned optometry assets, to deploy and operate near a CSH. However, in the winter of 1995, when Operation Joint Endeavor began, there were no area support medical battalions staffed in Europe, and none deployed to the Taszar support base. Therefore, the 67th CSH's mission to provide comprehensive inpatient and outpatient care on a contingency basis to all personnel in the area of operations did not have a doctrinal means of supporting an eye care requirement. OBJECTIVE: To meet this eye care shortfall between doctrinal policy and actual operational needs or requirements, the optometry staff of the 67th CSH scavenged two optometry field sets from old Operation Desert Storm war stock and deployed with the main body of hospital personnel to Taszar, Hungary, on December 18, 1995. In doing so, the Table of Organization and Equipment was thus supplemented with extra equipment and personnel, beyond doctrinal guidelines, to accomplish the assigned mission. METHOD: This report is a prospectively gathered summary of the eye care provided from December 18, 1995, to September 15, 1996. RESULTS: A total of 1,471 patients were examined and treated, averaging 7 patients per day. Less than half of the case load was medical in nature, with the remaining being refractive in nature or for periodic examination. The most common pathologies seen were soft contact lens complications, non-contact lens corneal pathology, conjunctivitis (bacterial, viral, and adenoviral), and ocular trauma (foreign bodies, chemical splashes, blunt injury). Refractive cases during the entire deployment involved primarily myopes requiring increased correction. However, close to half of the refractive cases in the first month involved habitually uncorrected low hyperopes and early presbyopes. CONCLUSIONS: Based on the productivity presented by the case load demand of this CSH's area medical support mission, an eye care need was clearly met, adding to the overall mission success of the 67th CSH.

Efficiency, Organizational↗

PubMed2006

A nationwide survey on the knowledge and attitudes of Malaysian optometry students on patients' visual experiences during cataract surgery.

INTRODUCTION: During cataract surgery under regional (retrobulbar, peribulbar or sub- Tenon's) or topical anaesthesia, many patients experience a variety of visual sensations in their operated eye intraoperatively. Between 3% and 16.2% of patients are frightened by their intraoperative visual experiences, which may increase the risk of intraoperative complications and affect patients' satisfaction with the surgery. This study aims to determine optometry students' beliefs and knowledge of visual sensations experienced by patients during cataract surgery under regional and topical anaesthesia. MATERIALS AND METHODS: A nationwide survey of all Malaysian optometry students using a standardised, self-administered questionnaire. RESULTS: All 129 optometry students participated in the survey, giving a 100% response rate. Overall, 26.4% and 29.5% of the students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may experience no light perception, while 78.3% and 72.9%, respectively, thought that patients would experience light perception. Many respondents also believed that patients might experience a variety of other visual sensations. Of all respondents, 70.5% and 74.4% of students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may be frightened by their visual experience and 93.0% and 85.3%, respectively, felt that preoperative counselling might help to alleviate this fear. CONCLUSION: Many optometry students are aware that patients might encounter a variety of visual sensations during cataract surgery under local anaesthesia. A high proportion of students believe that patients may experience fear as a result of the intraoperative visual sensations and felt that preoperative counselling would be helpful.

Adult↗

PubMed1979

Optometry in the hospital.

The Optometry Section of the Kansas City Veterans Administration Medical Center (KCVAMC) is an example of "optometry in the hospital" that encompasses three distinct areas: the Optometry Patient Care Program, Optometry Residency Program, and VICTORS Program (Visions Impairment Center to Optimize Remaining Sight). This article will explore the relationships between these areas and how they relate to the medical center's structure, patient care services, and ophthalmology.

Hospitals, Veterans↗

PubMed1978

An interdisciplinary course for optometry students specializing in vision training.

The practice of primary-care optometry often necessitates interaction with professionals from varied backgrounds. This is especially true in the area of vision training, in which close coordination between professionals in schools, agencies, and clinics is necessary. Too often a communcation problem prevents beneficial interdisciplinary liaison. One way of ensuring that optometrists acquire communication and interaction skills is to provide seminars and courses in schools and colleges of optometry. The program described in this paper has helped optometry students refine their communication and referral skills.

Child↗

PubMed1981

A Veterans Administration medical center optometry residency program.

A form of postgraduate optometric education began in 1973 with the initiation of residency programs within two colleges of optometry. The availability of residency programs for optometrists, however, was essentially nonexistent until the Veterans Administration became actively involved. The first Veterans Administration Optometry Residency Program was established by the Kansas City Veterans Administration Medical Center and the Illinois College of Optometry. This paper briefly discusses the development and philosophy of this program and describes its clinical and academic content and future goals.

Hospital Departments↗

PubMed1981

Inter- and intrareferrals within and between Ophthalmology and Optometry.

The general pattern of interprofessional referrals appears to be limited from ophthalmology to optometry, but substantial from optometry to ophthalmology. The intraprofessional referral rate of ophthalmology far exceeds that of optometry. A potential relationship between unused practice capacity and referral rates is suggested. Referral ethics is discussed.

Humans↗

PubMed1993

Increasing knowledge about the older population: the role of geriatric curriculum in optometry.

Education in the area of geriatrics/gerontology alleviates misconceptions about the elderly and lessens ageism. Ageism, negative feelings toward the elderly, represents a substantial obstacle to the delivery of quality health care to older adults. As future primary health care professionals, optometry students will encounter a large segment of the older population. This study looks at the effect that a didactic course and a clinical rotation in geriatrics have on the knowledge and attitude of optometry students toward older adults. Palmore's Facts on Aging Quiz: Part 1 was administered to two classes of optometry students. One class experienced a geriatric course and clinic concurrently; the other class experienced the geriatric clinic before the course. Scores increased significantly post-test for both classes. Exposure to geriatric patients before didactic instruction did not improve pretest scores; however, the number of patient exposures was significant at post-test. Antiage bias scores also improved with intervention of a didactic course and clinical rotation in geriatrics. The results of this study indicate that ageism in optometrists may be ameliorated by providing formal instruction in geriatrics in the optometric curriculum.

Aged↗

PubMed1994

Defining the scope of practice of optometry.

Defining the scope of practice of optometry is difficult, but important for the profession and optometric education. Even though the scope of practice can be defined in various ways and is constantly changing, the schools and colleges of optometry must have some sense of the boundaries of the profession in order to develop educational programs which will prepare students to practice well into the future. The use of three-dimensional diagrammatic models creates a visual representation of the elements which define the scope of practice. Additionally, these models can assist schools and colleges to improve their understanding of the various dynamics which must be considered in developing the most appropriate methods to analyze the competencies required for entry into the practice of optometry.

Humans↗

PubMed1998

Frequency of convergence insufficiency in optometry clinic settings. Convergence Insufficiency and Reading Study (CIRS) Group.

PURPOSE: To estimate the frequency of convergence insufficiency (Cl) and its related characteristics among 8- to 12-year-old children randomly selected from 2 optometry clinic populations. METHODS: Clinic records of 620 children were randomly selected and reviewed according to a standard protocol, using a systematic sampling method based on the total number of 8- to 12-year-old children seen over a 1-year period at 2 optometry clinics. Records were reviewed for demographic and clinical data. Data on Cl-related symptoms were obtained at one of the sites. Records that met the eligibility criteria of: good visual acuity (20/30 or better in both eyes); minimal refractive error (-0.50 to +1.00 D and < or = 1.00 D of astigmatism in either eye, and < or = 1.00 D of anisometropia); and no strabismus were evaluated for Cl-related characteristics. Eligible children were classified according to the direction of their near heterophoria and the number of the following clinical signs present: (1) exophoria at near > or = 4 delta than at far; (2) insufficient fusional convergence [i.e., failing Sheard's criterion or minimum normative positive fusional vergence (PFV) of 12 delta base-out (BO) blur/15 delta BO break]; and (3) receded nearpoint of convergence (NPC) of > or = 7.5 cm break or > or = 10.5 cm recovery. Children were then classified as: no Cl (nonexophoric at near or < 4 delta difference between far and near); low suspect (exophoric at near and 1 sign); high suspect (exophoric at near and 2 signs); or definite Cl (exophoric at near and 3 signs). RESULTS: Sixty-seven percent (415/620) of the records met the eligibility criteria and had complete data on phoria, NPC, and PFV. The age (mean +/- SD) of the study population was 10.2 +/- 1.2 years. Ethnicity data were available for 85% of those eligible; the ethnic distribution was 36% African American, 29% Caucasian, 19% Hispanic, and 1% Asian. About one-half of the 415 children were classified as either low suspect (33%); high suspect (12%); or definite Cl (6%). Clinically significant Cl (high suspect and definite categories) was identified in 17.6% of the children. The percentage of children rated as symptomatic increased with the number of Cl-related clinical signs present. CONCLUSIONS: These findings suggest a high frequency of Cl in optometry clinic populations and a potential correlation between patient symptoms and the number of Cl signs present.

Child↗

PubMed1999

Interview expectations and experiences of women and men applying to an optometry program.

Similar numbers of women and men are admitted to North American optometry programs. We question the notion that these data signify an admission process free of gender bias. This 1996 study of the University of Waterloo School of Optometry (UWSO) examines its admission interview. A written questionnaire was developed, piloted, and mailed to 157 applicants. Their expectations of an ideal optometry interview were compared with their experiences of the UWSO's interview. The response rate was 69.4% (N = 109; 62 women and 47 men). Statistical analyses involved principle component (PC) analysis and paired t-tests (p = 0.01). Women and men believed the UWSO interview was significantly inadequate in its attention to addressing public relations and verifying application information. In addition, women perceived the UWSO interview was significantly deficient in efforts to recruit candidates and gather candidate information.

Female↗

PubMed2000

Interview expectations and experiences of optometry applicants and interviewers.

This 1996 study examined the admission interview employed at the University of Waterloo School of Optometry (UWSO). A questionnaire was developed, piloted, and mailed to 157 UWSO applicants and 23 UWSO interviewers. Their expectations of an ideal optometry admission interview were compared with their experiences of the UWSO admission interview. The response rate was 71.7% (n = 129; 109 applicants, 20 interviewers). Statistical analysis involved principle component analysis and t-tests (independent and paired). Participants believed the ideal optometry admission interview should gather information, verify information, provide information, and select candidates by appraising their 'people skills,' 'professional skills,' and 'attitude orientation.' Although the participants' expectations of the ideal interview resembled the mission statement of the UWSO interview, the expectations, particularly among applicants, significantly deviated from their experiences of the UWSO interview.

Adult↗

PubMed2004

Tensions in the field: teaching standards of practice in optometry case presentations.

PURPOSE: Professional identity formation and its relationship to case presentations were studied in an optometry school's onsite clinic. METHODS: Eight optometry students and six faculty optometrists were audio-recorded during 31 oral case presentations and the teaching exchanges related to them. Using convenience sampling, interviews were audio-recorded of four of the students and four of the optometrists from the field observations. After transcribing these audio-recordings, the research team members applied a grounded theory method to identify, test, and revise emergent themes. The theme reported herein pertains to communicating standards of practice. RESULTS: Faculty optometrists demonstrated three ways of communicating standards of practice to optometry students during case presentations: Official Way, Our Way, and My Way. Although there were differences between these standards, the rationale for the disparities was rarely explicitly articulated by the instructors to the students. Without this information, the incongruity among the standards was left to the students to interpret on their own. CONCLUSIONS: The risk created by faculty not articulating the rationale underlying standards of practice was that students misinterpreted the optometrists' ways as idiosyncratic. Thus, opportunities were missed in the educational setting to assist students in making responsible decisions, locating their position in practice, and shaping their professional identity. Competing responsibilities of patient care and student education left instructors with little time to articulate rationale for standards of practice. Therefore, educators must reflect on innovative ways to bring into relief the logic behind their actions when working with novices.

Education, Professional↗

PubMed2005

Visual experience during cataract surgery: a nation-wide survey on the knowledge of optometry students.

PURPOSE: Many patients experience a variety of visual sensations during cataract surgery under local anaesthesia. Up to 16.2% of patients are frightened by their intraoperative visual experience. This study aimed to determine the knowledge and beliefs of optometry students on this subject. METHODS: A nationwide survey using a standardised, self-administered questionnaire was conducted on all optometry students in Singapore. RESULTS: For cataract surgery under regional anaesthesia, 38.9% of the respondents believed that patients might experience no light perception while 68.5% felt that patients were likely to be able to perceive light. Overall, 70.4% felt that patients might be frightened by their visual experiences and 88.0% believed that preoperative counselling of patients would serve to reduce the fear experienced during the surgery. For cataract surgery under topical anaesthesia, 37.0% of the respondents believed that patients would perceive no light and 74.1% believed that patients would retain light perception. Overall, 67.6% believed that patients may be frightened and 86.1% felt that preoperative counselling would help. CONCLUSION: Many optometry students correctly believed that patients might experience a variety of visual sensations during cataract surgery under local anaesthesia. The majority were also aware that patients might be frightened by this and felt that preoperative counselling would be helpful.

Adolescent↗

PubMed1976

Optometry and the military.

This article comments on several of the major issues facing military optometry which were aired earlier this year at the AOA Federal Service Optometry Seminar. Among these issues, all of which influence recruitment and retention of optometry officers, are constructive credit, bonus and incentive pay, promotion policies, and optimum scope of care. Dr. Turner emphasizes that solutions to these problem areas depend not only upon AOA actions but also personal efforts and professionalism of military OD's.

Humans↗

PubMed1975

Paraprofessional utilization in optometry.

Issues that surround the use of paraprofessionals in optometry are examined. The experiences and findings from paraprofessional programs in other health disciplines are reviewed as they relate to optometry. Paraprofessional utilization is a significant yet neglected alternative that has the potential of relieving the increasing manpower shortage in optometry. This concept is reviewed in terms of its effects on productivity and quality of care. The viability of this concept has been found to be dependent upon the subjective acceptance of paraprofessionals by the health professional as well as the consumer. Patient attitudes and acceptance are largely determined by the professional's acceptance. Values and beliefs held by the optometrist or some other discipline may manifest themselves as significant barriers to increased utilization of paraoptometric personnel. The socialization process must begin during the years of professional education and early years of clinical experience.

Allied Health Personnel↗

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↗

PubMed2001

Optometry and ophthalmology: the Internet connection--assessing consumer health web sites.

BACKGROUND: The Internet is a major conduit of health information. Consumers frequently rely on it without verifying its validity. The purpose of this study was to assess the accuracy and currency of Internet-based information on the roles and practice of optometrists, which has been found to be misleading, inaccurate, and often outdated. METHODS: Using search engines and ranking directories, 16 popular health Web sites were examined for differentiation between optometry and ophthalmology. Each site's eye care content was reviewed for syndication, definitions, provider directories, linkages to eye organizations, and provider recommendations in treatment of certain conditions. RESULTS: Many Web sites use a syndicated source for their health content and several use Merriam-Webster as their primary dictionary. A majority of sites provided poor definitions for optometry. Most Web sites were biased in recommending ophthalmologists and do not include optometrists as licensed providers in treatment of certain eye diseases. For example, Intelihealth, Aetnaushc, and Noah-Health recommend only ophthalmologists for the treatment of conjunctivitis. CONCLUSIONS: Inaccuracies and misleading information about optometry do exist and undermine the role of optometrists in delivery of eye care. When alerted, several Web sites were receptive to proposed changes. While some efforts have been undertaken to monitor Web sites, the profession must develop a concrete effort to ensure that it is correctly represented on the Internet.

Health Education↗

PubMed1992

Basic science research in optometry: are we adequately prepared?

Optometry has not traditionally emphasized basic science research. With the increasing responsibilities taken on for the health care of our patients, it is essential that optometry develop its own scientific base of knowledge on which to rely. The need for good scientific investigators, the need for support for basic science research, as well as the importance of long-range planning for basic science research in optometry are discussed.

Health Planning↗