Comparing self‐reported optometric dry eye clinical practices in Australia and the United Kingdom: is there scope for practice improvement?

Downie, Laura E; Rumney, Nicholas J.; Gad, Anne; Keller, P.; Purslow, Christine; Vingrys, Algis J.

doi:10.1111/opo.12280

Cited by 34 publications

(36 citation statements)

References 40 publications

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“…Overall, respondents demonstrated strong knowledge of tear film evaluation, with 83% of both optometrists and ophthalmologists listing appropriate techniques for evaluating tear volume and stability. This level of knowledge is similar to that reported in a recent survey of optometrists in Australia and the United Kingdom, and likely reflects the level of interest in DED further to publication of the Tear Film Ocular Surface Society's clinical guidance documents, developed as part of the International Dry Eye Workshop, International Workshop on MGD, and International Workshop on Contact Lens Discomfort …”

Section: Discussionsupporting

confidence: 82%

“…A framework for achieving international consistency in the evidence-based education of clinicians for dry eye practice has recently been proposed. 19 As implied by our findings, this model includes the potential to disseminate information relating to current best practice through informative workshop-based delivery, which reviews the fundamental clinical skills that are critical for implementing evidence-based dry eye care.…”

Section: Discussionmentioning

confidence: 90%

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A comparison of the self‐reported dry eye practices of New Zealand optometrists and ophthalmologists

Xue

Downie

Ormonde

et al. 2017

Ophthalmic Physiologic Optic

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 90%

A comparison of the self‐reported dry eye practices of New Zealand optometrists and ophthalmologists

Xue

Downie

Ormonde

et al. 2017

Ophthalmic Physiologic Optic

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“…These findings suggest that optometrists prefer pre-appraised and synthesised evidence, over independently accessing primary sources and undertaking their own appraisal and interpretation of research studies. These preferences mirror those reported for other areas of optometric practice, including dry eye disease 39,40 and age-related macular degeneration. 41 The task of critically appraising evidence is not trivial.…”

Section: Discussionsupporting

confidence: 71%

Knowledge, perspectives and clinical practices of Australian optometrists in relation to childhood myopia

Douglass

Keller

et al. 2020

Clinical and Experimental Optometry

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Background The aim was to investigate the understanding of Australian optometrists in relation to myopia, its natural history and associations with vision‐threatening ocular disease, self‐reported clinical diagnosis and management approaches for childhood myopia, engagement with adult caregivers, and utilisation of information to guide practice. Methods An online survey was distributed to Australian optometrists (n = 4,124). Respondents provided information about their demographics (for example, gender, age, practice location and modality), myopia knowledge, self‐reported practice behaviours relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results Completed surveys were returned by 239 optometrists (six per cent completed response rate). Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open‐angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non‐cycloplegic refractive measures. The most common approaches to management were single‐vision distance and progressive addition spectacle lenses, despite most optometrists identifying orthokeratology, low‐dose (0.01%) topical atropine and soft peripheral defocus contact lenses as three potentially more effective therapeutic interventions for modifying childhood myopia progression. Almost 90 per cent of respondents considered increasing time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences and events, systematic reviews, and personal experience. Respondents perceived adult caregivers to generally be involved in myopia management decisions, and considered all aspects of myopia education as important. Conclusion Current optometric practices reflect the inconclusive nature of several key aspects of the evidence for childhood myopia management. Australian optometrists appear aware of emerging evidence, but are not routinely adopting measures that have not yet received regulatory approval for modulating childhood myopia progression. Clinical guidelines may be of value for assisting practitioners in making clinical decisions based upon the current, best‐available research evidence.

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“…An initial ophthalmic examination will begin with a thorough history and exploration of the patient's presenting symptoms. Qualitative symptom assessment is highly favoured by clinicians in the evaluation of ocular surface disease, although this is often undertaken without standardisation . Symptoms commonly associated with dry eye disease, for example eye burning, grittiness, foreign body sensation and scratchiness, also frequently occur in contact lens wearers.…”

Section: The Process Of Assessing the Tear Film And Ocular Surface Inmentioning

confidence: 99%

Tear film evaluation and management in soft contact lens wear: a systematic approach

Downie

Craig

2017

Clinical and Experimental Optometry

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The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.Key words: conjunctiva, contact lenses, cornea, dry eye, tearsThe tear film is a complex, precisely ordered fluid structure comprising a thin outer layer of lipid and a thicker underlying aqueous-mucin phase, with increasing mucin concentration toward the corneal epithelial cell layer. A thin layer of membrane-bound mucin, glycocalyx, imparts hydrophilicity to the hydrophobic corneal surface.1 In excess of 1,000 proteins or fractions of proteins have been identified within the human tear film.2,3 The tear fluid also contains a variety of regulated inflammatory mediators, including by-products of arachidonic acid metabolism, the complement cascade, cytokines and components derived from the ocular microbiome. 3,4The integrity of the tear film can strongly influence the likelihood of achieving successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. 5 Comprehensive clinical assessment of tear film quality and quantity, and ocular surface health are therefore essential both prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear, and over the course of lens wear, to identify any aspects requiring clinical attention to maintain optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on tear film composition, and outlines an approach to evaluating tear film and ocular surface integrity, to guide the clinical management of tear film anomalies with respect to contact lens wear. ASSESSING THE TEAR FILM AND OCULAR SURFACE IN CONTACT LENS WEAR: A SYSTEMATIC APPROACHUsing techniques such as in...

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Comparing self‐reported optometric dry eye clinical practices in Australia and the United Kingdom: is there scope for practice improvement?

Cited by 34 publications

References 40 publications

A comparison of the self‐reported dry eye practices of New Zealand optometrists and ophthalmologists

A comparison of the self‐reported dry eye practices of New Zealand optometrists and ophthalmologists

Knowledge, perspectives and clinical practices of Australian optometrists in relation to childhood myopia

Tear film evaluation and management in soft contact lens wear: a systematic approach

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