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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

What kinds of leaders are entering optometry schools?

The purpose of this study was to determine the parameters of leadership of students entering one optometry school, assess the relation between personality types and leadership during optometry school, and forecast potential for leadership beyond school. Personality inventories of 269 students entering University of Houston College of Optometry (UHCO) from 1988 through 1990 were analyzed for personality type according to Gough's two-vector system (V1 = extroversion/introversion; V2 = norm-favoring/norm-doubting) which results in four types or life styles: Alpha, Beta, Gamma, and Delta. Although some sex and ethnic differences were found, most (71%) optometry students were Alphas (extroverted/norm-favoring), accepted leaders who strive to maintain and advance consensual values. Alphas achieved well in classroom and clinic and were student leaders. A lesser number (10%), mostly women, were Gammas; extroverted but norm-questioning, Gammas can provide creative and progressive leadership. Remaining types were Betas (15%) and Deltas (4%), both introverted types who avoid leadership positions. In sum, traditional and, to a lesser degree, innovative leadership potential appears strong among optometry students; they should serve the profession well.

Ethnicity

The influence of a national health policy on optometry and optometric education in Ontario.

Until recently Canada had little or no direction toward forming a National Health Policy. It was not until 1961 that a government agency served as an impetus in establishing a health care program. With this however, came the challenge for optometry to defend itself against the ophthalmological society in an effort to receive its fair share of recognition. Optometry met this challenge, both in the institutional and practical setting. As a result legislation was passed to establish very positive guidelines for the optometric community including the definition of optometry, peer review, standards of practice, continuing education, and the use of diagnostic drugs. Since then, Canada's Minister of Health issued a statement to elaborate on a number of health related issues. In this 1974 statement he emphasized the value of care should be comparable to that of cure. To meet this need a reemphasis on educational training would have to be met. Optometry has looked toward this policy to plan for its future educational objectives and methods of practice. Because these public policies have been formed in a positive way toward optometry the Canadian optometrist will continue to work toward the goal of being a better practitioner within the scope of this Canadian policy.

Humans

The early history of optometry in Maryland.

The progress of optometry in Maryland began with the passage of the first optometry law in 1914. Following its passage by the Maryland Legislature, the Maryland Optometric Association embarked on a plan to develop the profession by sponsoring (1) educational programs, (2) the gradual elimination of store-front practices, (3) the adoption of a code of ethics, and (4) establishing free eye clinics throughout the state. Optometry's steady climb toward professional status also resulted in the introduction of new optical instruments and techniques of refraction. The American Academy of Optometry and the educational courses of the Optometric Extension Program are credited for the impetus to professionalize optometry.

History, 20th Century

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

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

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

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

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

Present status and projected needs of the educational facilities in optometry.

Optometry is affected by political, social and economic forces. Optometric leaders must understand that the issues of health care reform, education reform and economic reform can only be met through cooperation of all professionals, educational associations, as well as individual institutions. With good management, innovative use of available funds, and development of personnel, optometry can overcome contracted revenues and prosper through this decade. However, there is no doubt that educational reform is at the doorstep of the health care professions. Optometry must strive to face its challenges now and into the remaining years of this decade.

Financial Management

The expanding scope of optometry and the impact on the curriculum of schools and colleges.

The expansion of the profession of optometry has placed pressures on the schools and colleges of optometry to reduce traditional curricular elements, add new ones, obtain faculty trained for the new scope of the profession, and provide additional patient experiences for hands-on learning. While the schools have adapted to these pressures and are leading the profession into new areas, the traditional 4-year optometry curriculum is critically filled. Further expansion will require difficult decisions.

Curriculum

Survey of student research in behavioral and developmental optometry.

Behavioral and developmental optometry are in need of research. Studies conducted by optometric students can provide a major contribution. The present paper reviews selected student research studies conducted at the Illinois College of Optometry. The topics include: trends in developmental vision, phenomena in binocular vision, and techniques in diagnosis and treatment.

Adult

Optometry and NHI--where are we going.

The author reviews and estimates the overall trend toward some form of national health entitlement against a background of optometry's position on this issue. He summarizes how optometric services are included in most major NHI bills, and explains the relationship to NHI of the National Health Planning and Resources Development Act of 1974. Stressed are the needs for optometry to more accurately describe its own role and to continue active interest in the NHI issue.

Health Planning

What are the appropriate skills and knowledge of reimbursement systems needed for the entry-level practice of optometry?

Health care reimbursement has increasingly become a major factor in the day-to-day practice of optometry. This paper, originally presented at the 1992 Summit on Optometric Education, outlines the various types of programs the optometrist should be familiar with, and emphasizes the importance of the integration of such knowledge into the curriculum of the schools and colleges of optometry.

Humans

What are the appropriate skills and knowledge required for the entry-level practice of optometry?

All health professions have developed a national program of competence assessment to address the specific issue of "entry-level practice." This is also true in optometry through the 3-Part examinations of the National Board of Examiners in Optometry. These examinations test the cognitive (knowledge) skills necessary to be fit to practice and the communication, affective and psychomotor skills that are required to apply the underlying knowledge in the solution of patient problems. The scope of the National Board examinations and how they change to keep pace with the expansion and the scope of practice, demonstrates that entry-level is a dynamic concept.

Clinical Competence

Preventing transmission of infectious diseases including the human immunodeficiency virus in the practice of optometry.

The risks of acquisition of infectious diseases including the human immunodeficiency virus--1 (HIV) to practitioners and patients in the practice of optometry is discussed. Measures that reduce the risk of contracting or transmitting HIV and other infectious diseases in optometry are presented. Effective disinfection including that for HIV are discussed.

Contact Lenses

Optometry's direction versus public needs.

This paper presents some parallels between the issues relating to our young population's difficulty in vision performance facing optometry in 1976 and medical eye care in the late 1800's. Three specific elements are identified and discussed: namely, (1) difference in practice of optometry and our organizational efforts; (2) the lack of agreed-upon clinical systems; and (3) the lack of availability of care. Suggestion for consideration are presented.

Adolescent