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PubMed1994

The history of ethics in the American Optometric Association 1898-1994.

BACKGROUND: The history surrounding the development of codes of ethics and other official statements of desired professional conduct adopted by the American Optometric Association reveals the interesting struggle optometry faced in establishing itself as a leading primary health care profession. METHODS: Information regarding the events and documents reported in this paper were obtained through research of the historical literature and achieves at the International Library, Archives and Museum of Optometry located at the American Optometry Association's offices at 243 N. Lindbergh Boulevard, St. Louis, MO. RESULTS: Forces outside as well as within the profession were found to have influenced the drafting and redrafting of the official ethical and professional conduct statements that were meant to guide the professional behavior of the membership of the AOA. CONCLUSIONS: Ethical codes and other statements of desired conduct have been essential to the establishment of the profession of optometry. As optometry has grown and matured as a provider of primary eye and vision care services, so have its ethical emphases.

Codes of Ethics↗
PubMed1977

A personality profile of "Gold Retinoscope" winners: 1961-1975.

Fifteen Gold Retinoscope winners, each judged the most outstanding student in his/her graduating class of the School of Optometry, University of California at Berkeley, were compared with samples of optometry students, Academy Fellows, and non-Academy optometrists. Although most Gold Retinoscope winners had entered optometry school with low to average grades, their grades and clinical performance in optometry school were outstanding. When compared with other optometry students and optometrists in practice, these outstanding students were distinguished by greater self-confidence, initiative, and motivation to achieve. It is suggested that these personality traits were important contributors to their superior achievement.

Achievement↗
PubMed1975

Children's vision--a 20/20 outlook.

Twenty years ago, A. M. Skeffington, O.D., talked about the "uniqueness" of optometry which included prevention, remediation and enhancement. Fifteen years ago, Arnold Gesell, M.D., urged optometry to pay attention to the preschool years and to examine and supervise (with optometric expertise) the vision of these children and to learn to identify those children who would present difficulties in learning. At the same time, Darell Boyd Harmon, Ph.D., suggested that optometry "gear up" for an expected avalanche of visually-related learning problems. Optometry did listen and learn, the avalanche is here and developmental optometry has prospered. This paper briefly explores some of the long and short-range benefits of vision therapy.

Child↗
PubMed1977

A national optometric-student attitudinal survey.

This paper contains the results of a survey of 1549 optometry students who responded to a questionnaire that was sent to all optometry schools and colleges in the United States. The results reflect student attitudes and opinions about such issues as commercial optometry, malpractice suits, price advertising of glasses and professional services, and the cost of professional education. In addition, the survey results disclose the reasons students enter the profession, their anticipated modes of practice and their expected incomes. We believe that the issues encompassed in this survey will affect the future practice of optometry.

Advertising↗
PubMed1993

An international perspective on optometric education.

In many of the world's nations, optometry hardly exists because resources are not sufficient to educate optometrists nor to fund their services. In others, tradition and accommodation with other forces have rendered optometry incapable of change that would expand its scope of services. But, in a growing number of countries, there is an accelerating trend toward expansion of education and scope of practice. Optometry is coming to be defined in those parts of the globe as that independent primary health profession whose practitioners are educated in vision and health sciences, and who meet standards that qualify them to diagnose and treat visual problems and ocular disease. Review of this change, wherever it has transpired, leads to the conclusion that the scope of optometric practice expands only after corresponding expansion in optometric education. These goals are being achieved in a group of highly developed countries in which optometry has long been a major eye care provider, and in countries in which socio-economic and political conditions are improving, but where there is no significant source or tradition of primary eye care of any scope.

Developing Countries↗
PubMed1996

Issues for optometrists relating to interprofessional relations in a hospital and medical center.

Managed care and the changes in the health care system are golden opportunities for the optometric profession. There is a major role for optometry in the medical center and there is a major role for optometry in the various managed health care programs. Optometry is well positioned as a primary health care profession. The leaders of this noble profession must be on the alert and plan and work diligently to include optometry in all aspects of the ever-changing health care system.

Health Facilities↗
PubMedDate not supplied

Willingness of eye care practices to evaluate children and accept Medicaid.

BACKGROUND: The willingness of eye care providers to evaluate children or to accept Medicaid may be a barrier to care for those with an abnormal screen. OBJECTIVES: To determine the proportion of eye care practices that would provide diagnostic evaluation for children and accept Medicaid payment and to evaluate the influence of child age and practice characteristics on provision of care or acceptance of Medicaid. METHODS: We conducted a telephone survey of 364 eye care practices in Michigan, which were randomly selected from telephone directories of 26 rural and urban cities as defined by metropolitan statistical areas. RESULTS: The response rate was 93%. Most eye care practices, but more optometry-listed practices than ophthalmology-listed ones, would evaluate preschool-aged children (88% vs 73%; P <.01) or school-aged children only (11% vs 7%; P <.01). The proportion of practices willing to evaluate preschool-aged children was lower in urban cities compared with rural cities for optometry-listed (83% vs 96%; P <.01) and ophthalmology-listed practices (67% vs 93%; P <.01). Medicaid acceptance among practices that would evaluate children was higher among ophthalmology-listed than optometry-listed practices (74% vs 59%; P =.01) and did not vary by urban or rural status. Practice size was not associated with willingness to provide care for children. However, among practices that would provide care for children, larger practice size was associated with increased odds of Medicaid acceptance in both optometry-listed and ophthalmology-listed practices. CONCLUSIONS: These findings contradict the perception that eye care for children is unavailable. More work is needed to understand the relationship of this availability with the accessibility of eye care.

Attitude of Health Personnel↗
PubMed1976

Paraoptometric education and training in the United States Air Force.

The authors describe military optometry clinic personnel problems prior to 1971 which led to the creation of the Air Force Optometry Specialist/Technician career field. The optometry Specialist, whose civilian counterpart is the optometric assistant/technician, receives a highly intensive 9 week resident course at the USAF School of Health Care Sciences. Additional mandatory training is received on the job and by a career development course specifically designed for the Optometry Specialist. An optional 2-year program is also offered through the Community College of the Air Force.

Aerospace Medicine↗
PubMed1975

Health law in 1985--implications for the optometric profession.

In conclusion, I believe that you should seek to expand the scope of optometry into areas now regarded as exclusively medical practice, and devote less time and effort to protecting your rear from the encroachment of the opticians. I suggest this because it follows a seemingly natural process of expanding upward that one finds in other professions and occupations in the health field. Second, I have suggested that, to achieve an expanded scope of optometry, there may have to be some sacrifice of the concept of the independent, entrepreneurial practitioner in optometry. Even the medical profession is recognizing that the individual entrepreneurial physician is becoming less of a factor than he was before, and the future is not particularly bright for him further down the road. Third, to the extent you can influence the forum where the struggle over the expanded practice of optometry takes place, you may increase the likelihood that the expanded role will be recognized by law sooner. I have already alluded to the idea that costs of health services and funding mechanisms are intimately tied to the law related to optometric practice in the future. As you know from the legislative struggles in many states over inclusion of optometric services within state Medicaid programs, and freedom of choice legislation that required an insurer to pay any legally recognized practitioner who could provide the service, rather than physicians exclusively, the optometric profession is well aware how closely the success of a profession is linked to access to third party payment.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Services Accessibility↗
PubMed2001

Interobserver variability in the estimation of the cup/disk ratio among observers of differing educational background.

BACKGROUND: Accurate assessment of the cup/disk (C/D) ratio is an important skill for eyecare practitioners. Interobserver variability in this estimation has been documented in many studies. This study compares the estimate variation in the C/D ratio as judged by five groups with different educational backgrounds who would provide patient care at a college of optometry. METHODS: Third- and fourth-year students, optometry residents, attending optometrists, and attending ophthalmologists evaluated the C/D ratios of 20 optic nerves using stereoscopic optic nerve photographs. There were five observers in each group, for a total of 25 participants. The results were statistically analyzed with a one-way analysis of variance and the Duncan multiple range test. RESULTS: The one-way analysis of variance showed that a statistically significant difference existed among the five groups. Further analysis with the Duncan multiple range test showed that the attending optometry group was significantly different from the third-year student, fourth-year student, and attending ophthalmology groups. Also, the optometry resident group estimates were significantly different than the fourth-year student and attending ophthalmology group estimates. CONCLUSIONS: There was a statistically significant difference in the estimation of the C/D ratio using stereoscopic disk photographs among five groups that had different educational backgrounds.

Education, Professional↗
PubMed1994

Co-management of patients with diabetes.

Co-management of the diabetic patient emphasizes interdisciplinary care between optometry and ophthalmology, and between optometry and the patient's primary physician. For the optometrist and the patient's primary physician, the emphasis is on written communication with regard to the ocular health of the patient's eyes. The optometrist also participates in educating patients about the complications related to diabetes mellitus, as well as reinforcing medical compliance and encouraging lifestyle changes for better health. By providing this scope of care, optometry becomes an integral part of the health care team. Between ophthalmology and optometry, the success of co-managing diabetic patients will be dependent on several factors, including demonstrating expertise in managing diabetic retinopathy, making timely and appropriate referrals based on results from national clinical trials, and developing a trusting relationship built over time. This paper emphasizes the multi-dimensional role the optometrist plays in the co-management of the diabetic patient with the patient's primary physician and with the ophthalmologist in treating and managing diabetic retinopathy.

Diabetes Mellitus↗
PubMed1997

Professional behavior and the optometric profession.

BACKGROUND: Optometry has been recognized as a profession within the United States, both legally and socially, for the better part of the past century. Historically, there have been expectations placed on the behavior of individuals within the professions that would not generally be placed on the general business person. These expectations have existed to protect the clients or patients of professionals from incompetence, uncaring, or selfish excesses. Behavior of an exceptional nature is expected of professionals because of the unusual vulnerability of clients and patients to unprofessional conduct. Doctors of Optometry, as members of the optometric profession, have professional standards placed on their behavior. METHODS: A search of the literature was conducted to discover the historical and current bases for setting standards for professional behavior. RESULTS: The literature search reinforces the rationale for the optometric professions long-standing practice of setting standards for professional conduct. CONCLUSIONS: Individual Doctors of Optometry will find that the trust resulting from high standards of professional conduct bring many positive benefits to the doctor-patient relationship. The rewards that come to both the doctor and patient from these trusting relationships make the practice of optometry truly an exceptional experience.

Behavior↗
PubMed1985

Muscular and intraocular pressure responses among ocular-hypertensive subjects: is there a rationale for biofeedback?

Several animal and human investigations have indicated that intraocular pressure (IOP) levels may be associated with extreme drug-induced changes in the extraocular muscles. Further, recent data suggest that, among individuals with normal IOP level, moderate increases in facial muscle (EMG) activity around the eye while the eye is open are associated with increases in IOP. To investigate further the relationship between facial EMG activity and IOP levels and to examine a group of individuals with elevated IOP levels, subjects were recruited from outpatients at an optometry clinic. Three groups of subjects were selected: a group of ocular hypertensive subjects who showed elevated pressures at the optometry clinic and upon the day of testing, a group of labile ocular hypertensive subjects who evinced elevated pressures during their visit to the optometry clinic but lower pressures on the day of testing, and a group of normal IOP subjects who showed normal pressures both during their optometry clinic visit and on the day of testing. To investigate anxiety differences, subjects were administered the State-Trait Anxiety Inventory, but subsequent analysis revealed no group differences. To evaluate the role of stress upon muscle (EMG) functioning around the eye, subjects were subjected to imagery and standardized mental arithmetic stressors; analyses of these results also revealed no significant group differences. Finally, subjects were given EMG biofeedback for muscle activity around the eye while IOP was assessed during five alternating periods in which they made decreases and increases in EMG activity. Results revealed significant group, period, and group by period interaction effects. The pattern of results is interpreted as implicating EMG activity in IOP fluctuations; the implications of these data for potential biofeedback and stress management treatments are discussed.

Adult↗
PubMed2006

A tribute to Dr. Robert C. Allen, an inspirational teacher, humanitarian, and friend (Nov. 18, 1950-Mar. 24, 2005).

Dr. Robert C. Allen was a gifted educator, as well as experienced ophthalmologist, who was a close personal friend of Dr. Edlich at the University of Virginia Health System. While serving on the faculty at the University of Virginia Health System, Dr. Allen proved to be a compassionate physician, who developed close personal relationships with the residents, faculty, and his patients. Dr. Allen was invited by Dr Edlich to be a member of the Editorial Board of the Journal of Long-Term Effects of Medical Implants. When Dr. Allen told Dr. Edlich that he had ocular melanoma in 2000, this news was a wake-up call to Dr. Edlich on the need to prevent skin cancer, as well as ocular melanoma. Empowered by this news, Dr. Edlich was honored to co-author four articles on skin cancer prevention, as well as the latest article focusing on prevention of ocular melanoma. The Ocular Melanoma Foundation (Richmond, VA (USA)) was founded in 2003 by Dr. Robert C. Allen to increase awareness, enhance education, and provide advocacy among both patients and health care professionals regarding this rare, but potentially lethal cancer. It has a website that provides patient information, up-to-date information and enables communication/ discourse between and among patients and practitioners (admin@ocularmelanoma.org). Dr. Allen died on March 24, 2005, at his home surrounded by family and loved ones. When surgeons are faced with challenging healthcare diseases, Dr. Edlich's mentor, Dr. Owen Wangensteen, advised Dr. Edlich that he should seek the advice and guidance of skilled basic scientists, who are familiar with the problem. Dr. Wangensteen is recognized as the greatest surgical teacher during the 20th century. Consequently, Dr. Edlich enlisted the advice and guidance from the two co-authors of the next article regarding the scientific basis for the selection of sunglasses to prevent the development of cataracts, pterygia, skin cancer, as well as ocular melanoma. Dr. Reichow is a Professor of Optometry at Pacific University College of Optometry (Forest Grove, OR (USA)). Dr. Citek is Associate Professor of Optometry at Pacific University College of Optometry (Forest Grove (USA)). In their comprehensive evaluation of sunglasses, they found some disturbing results. Despite being endorsed by The Skin Cancer Foundation, the Walgreens eyewear samples offer only partial protection to the potential hazards of sunlight exposure. Those individuals who spend considerable time outdoors should seek sun filter eyewear with impact resistant polycarbonate lenses that provide 100% ultraviolet filtration, high levels of blue light filtration, and full visual field lens/frame coverage as provided by high wrap eyewear. There are several brands that offer products with such protective characteristics. Performance sun eyewear by Nike Vision (Nike Inc., Portland OR [USA]), available in both corrective and plano (nonprescription) forms, is one such brand incorporating these protective features, as well as patented optical and tint designs. Numerous Nike styles offer interchangeable lens options to meet the changing environmental conditions encountered outdoors. These technologies are incorporated into performance-driven frame designs inspired by feedback from some of the world's best athletes. Nonprescription Nike eyewear are available on-line at http://www.nike.com/nikevision, as well as at various well-known retail outlets. Nonprescription and prescription Nike eyewear are also available at the offices of many eye care professionals. Even though our latest report did not include soft contact lens, it is important to emphasize that Dr. Reichow and Dr. Citek have played a leadership role in coordinating the development of the Nike MAXSIGHT, an innovative fully tinted soft contact lens. This contact lens provides distortion-free optics, whether or not you wear prescription contacts. They filter out more than 90% of harmful blue light and 95% of UVA and UVB. For the contact lens, you should go to the website for more information http://www.nike.com/nikevision/content.html. The website has a list of practitioners who can service the patients with the respective sunglasses. With their exciting technologic advances in sunglass products, as well as tinted soft contact lens, the authors would encourage Nike Vision to develop an expanded international marketing program that allows all individuals in the world to easily purchase its products.

Eye Neoplasms↗
PubMed1986

Local validity of OCAT as a predictor of professional school grade point average.

Studies of the validity of the Optometry College Admission Test (OCAT) were carried out nationally by the Psychological Corporation, the test administrator, until 1979. Since then there have been no published national studies and only two local (school-based) validity studies. This paper analyzes the statistical relation between OCAT scores and performance in professional school for the 1981, 1982, and 1983 entering classes at the State College of Optometry, State University of New York (SUNY). The results are compared with the findings of previously published studies of OCAT validity at three other schools of optometry. For the classes entering in 1981 and 1982, there were significant correlations between Quantitative Ability (QA), Study Reading, and Physics subtest scores and both 1 and 2-year grade point averages (GPA's). These findings are, for the most part, consistent with those reported in previous studies.

Achievement↗
PubMed1986

Academic dropout or academic success: a model for prediction.

Why do some students who qualify for admission to optometry school become academic dropouts while others succeed? This question was addressed in a study which compared the admission records of 21 academic dropouts from three classes at the University of Houston College of Optometry (UHCO) with 269 retained students. Academic dropouts were found to have significantly lower preoptometry grades, lower Optometry College Admission Test (OCAT) scores, attended less competitive (i.e., less selective) undergraduate institutions, scored lower on the California Psychological Inventory (CPI), and were older than retained students. When these differentiating admission variables, excepting age, were applied to a new entering class, prediction of subsequent academic dismissal or serious academic difficulty was highly accurate. However, it was found that such prediction must take into account not only areas of weakness, i.e., academic and psychological factors which place a student at risk, but also areas of strength which give the student an advantage. For all students, regardless of age, sex, or ethnic origin, it was the ratio of "advantage" factors to "risk" factors which gave the most valid prediction of academic success or failure.

Achievement↗
PubMed1989

The spiral curriculum in optometric education.

Optometric education should center around clinical training from the first year and develop within a spiral curriculum as far as possible. This does not eliminate the need for a layered curriculum where basic sciences are considered necessary to further learning but serves to make these sciences more applied and relevant to the study of optometry from the very beginning. A philosophy of science component requires to be integrated in the optometry teaching program so as to provide the student with as wide a range of thinking and problem-solving skills possible, in particular those which relate to optometry in general and clinical learning. Advanced technologies in the areas of computers and video materials as well as modern teaching strategies should be used to make paradigm changes in optometric teaching effective.

Clinical Competence↗
PubMed1993

Are optometric faculty guilty of ageism?

Ageism (negative feelings toward the elderly) is common among health care students and impacts upon the delivery of health care. Education serves to promote positive attitudes toward the elderly and alleviates ageism. As role models, faculty in the health professions influence student attitudes and can affect the development of ageism in students. This study was designed to evaluate whether optometric faculty are guilty of ageism. Twenty-nine optometry faculty and 83 optometry students were surveyed using Palmore's "Facts on Aging Quiz: Part 1" (FAQ1). The mean percent score for faculty was 64.14% as compared to a student mean percent score of 63.96% (p = 0.9422, t-test). The faculty also exhibited a larger anti-age bias than the students. Thus, optometry faculty do possess prejudicial attitudes toward older adults and would benefit from increased education in the field of geriatrics.

Adult↗