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PubMed1993

A study of graduate education in physiological optics in the United States: 1938-1989.

For over 50 years, graduate programs in physiological optics (vision science) have been the primary source of supply to schools and colleges of optometry of Master of Science and Doctor of Philosophy degree recipients who teach and conduct research. To determine the supply of M.S. and Ph.D. degree recipients from 1938 through 1989 and the career pursuits of these recipients, a computerized data base was developed. A total of 456 degrees were awarded (287 M.S. and 169 Ph.D.). Among the M.S. recipients, 56 also completed a Ph.D. Although there was a steady increase in the number of degree recipients, the number who pursued optometric education as a career steadily declined, especially among those who received only a M.S. degree. Further analysis suggests that a loss of optometry faculty with graduate degrees, in particular those with Ph.D.'s, due to attrition will likely occur during this decade and become substantial during the first decade of the next century. Clearly, efforts need to be increased by schools and colleges of optometry in the very near future to foster graduate level study of physiological optics, and to encourage the pursuit of optometric education as a career.

Education, Graduate↗

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↗

PubMed1995

Design elements of professional ethics courses.

Optometrists face ethical dilemmas daily in the practice of their profession. Students training to become optometrists also face ethical dilemmas, some of which are unique in their role as students. The focus on ethical practice has been heightened by the increasing scope of optometric practice, the greater demand of society for professional accountability, the greater diversity of membership and viewpoints, the decrease in available dollars for health care delivery, and the conflicting roles of ophthalmology and opticianry with optometry. These factors have led to the addition or expansion of professional ethics courses in optometry programs. This paper examines the difficulties inherent in defining professional ethics and designing ethics courses. Curricular issues are examined, including course objectives, instructors, content, evaluation, timetabling, teaching strategies, student assessment, and resource implications. Much of the research in this area has been done in medical education. Although the content of ethical dilemmas encountered by medical students and physicians may not be applicable to optometry, the process by which they learn to approach the dilemmas is the same.

Curriculum↗

PubMed2004

A survey of clinical prescribing philosophies for hyperopia.

BACKGROUND: Prescribing philosophies for hyperopic refractive error in symptom-free children vary widely because relatively little information is available regarding the natural history of hyperopic refractive error in children and because accommodation and binocular function closely related to hyperopic refractive error vary widely among children. We surveyed pediatric optometrists and ophthalmologists to evaluate typical prescribing philosophies for hyperopia. METHODS: Practitioners were selected from the American Academy of Optometry Binocular Vision, Perception, and Pediatric Optometry Section; the College of Vision Development; the pediatric and binocular vision faculty members of the colleges of optometry; and the American Association for Pediatric Ophthalmology and Strabismus. Surveys were mailed to 314 participants: 212 optometrists and 102 ophthalmologists. RESULTS: A total of 161 (75%) of the optometrists and 59 (57%) of the ophthalmologists responded. About one-third of optometrists surveyed prescribe optical correction for symptom-free 6-month-old infants with +3.00 D to +4.00 D hyperopia, but fewer than 5% of ophthalmologists prescribe at this level. Most eye care practitioners prescribe optical correction for symptom-free 2-year-old children with +5.00 D of hyperopia, and this criterion for hyperopia decreases with age. Most ophthalmologists (71.4%) prescribe the full amount of astigmatism and less than the full amount of cycloplegic spherical component, and most optometrists (71.6%) prescribe less than the full amount of both components. When prescribing less than the full amount of astigmatism, eye care practitioners do not tend to prescribe a specific proportion of the cycloplegic refractive error. CONCLUSION: Pediatric eye care providers show a lack of consensus on prescribing philosophies for hyperopic children.

Data Collection↗

PubMed1982

A case study in the politics of free-market health care.

Historically, most health occupations have developed legal and ethical restrictions on price advertising and other characteristics of "commercial" practice. Many of these regulations recently have come under critical scrutiny, on the grounds that they inhibit free-market health care delivery, thus keeping prices high, and productivity and innovation low. To help inform current health policy deliberations, we analyze the political history of anticompetitive regulations in one health occupation, optometry. Restrictions on commercial practice arose as a result of professional optometry's purge of commercial elements in the 1930s. Optometry's success in achieving commercial-practice restrictions at the state level was determined by the economic structure of the ophthalmic goods and services industry in each state in the 1930s, and by the political resources and organization of the competing interest groups. Efforts to deregulate health occupations will precipate political conflict to the extent that economic interests are threatened. Opposition to deregulation will be based overtly on the grounds that quality of care will deteriorate, and a significant political investment by proponents of free-market health care will be required to overcome such opposition.

Economic Competition↗

PubMed2001

Veterinary school admission interviews, part 1: literature overview.

An analysis of the admission interview used by schools in four health professions (veterinary medicine, allopathic medicine, optometry, and dentistry) portrays a largely similar approach to selection interviews: INTERVIEW USE: At least 80% of schools interview applicants. For schools that offer interviews, at least 40% of candidates are interviewed (a strong academic profile is the number one determinant of receiving an interview offer). The interview is one of the three most important selection tools used by schools. Less than 26% of schools fix the interview's weight in the selection process (fixed weights range from 31% to 35%). INTERVIEW PURPOSE AND CONTENT: The most common purposes of the interview are to (1) gather information, (2) make decisions, (3) verify information provided in other parts of the application, (4) recruit candidates, and/or (5) promote public relations. The most common characteristics and skills interviewers are interested in assessing are motivation for the profession, interpersonal skills, and communication skills. The desire to assess cognitive ability with the interview (>25% of schools) is surprising in view of the use of other selection tools (e.g., GPA). INTERVIEW FORMAT: Medical schools are more likely to offer two interviews per candidate, while optometry schools are more likely to offer one interview per candidate. Individual interviews (one interviewer, one candidate) are the predominant format among medical schools, while panel interviews (more than one interviewer, one candidate) are the most common format among optometry schools. The duration of the interview is 30 to 45 minutes. Interview questions most often address facts and knowledge, hypothetical situations, and the ability to meet program requirements. Most interviews do not meet the criteria for a structured interview, which has demonstrated greater validity and reliability than semi-structured or unstructured interviews. INTERVIEWERS: Interviewers are most likely to be health care faculty members (e.g., veterinarians at a veterinary school). Interviewers receive limited training. RECOMMENDATIONS FOR INCREASING INTERVIEW RELIABILITY AND VALIDITY: The purpose(s) of the interview must be clearly articulated so that the interview and interviewer training can be designed to achieve that purpose. Interview structure should be increased by developing a "job analysis" set of questions that is posed to all candidates and scored using behavioral anchors. Interviewers should receive more training in rater bias, listening skills, and interview structure. Panel interviews should be used to increase reliability. Interviewers should not have access to the candidate's application unless the interview is used to verify information. To increase the utility of the interview in the selection process, the weight of the interview in relation to other selection components should be determined.

Complementary Therapies↗

PubMed1976

Future of optometric education: a student view.

With the growth of optometry and the advent of a national health insurance plan, the practice of optometry will change. As it does, so too must optometric education. This paper outlines a student's views on how admissions, curricula, new schools, and board certification must change if optometry is to fill a primary health care role.

Certification↗

PubMed1989

Vision care benefits and optometric services in HMOs.

General eye care, although not a required basic health service of federally qualified health maintenance organizations (HMOs), is being offered in virtually all HMOs. Reasons for including vision care benefits and optometric services are presented. Data from the Group Health Association of America and the Department of Health and Human Services demonstrates that HMOs are in fact providing vision care benefits and optometric services. The growth of the independent practice association (IPA) model is significant for optometry as it threatens to limit the scope of optometric practice. New professional problems arise as participating optometrists are constrained from performing the full range of optometric services. In recent years optometry has expanded its scope of licensure and practice to incorporate both diagnostic and therapeutic drugs in its management of visual problems. Managed care and alternate delivery systems, however, may restrict the advances that optometry has made in the legislative arena.

Health Maintenance Organizations↗

PubMed1978

Interdisciplinary health care: part III.

Since the spring of 1974, the University of Houston, College of Optometry has been involved in teaching optometry students the benefits of interdisciplinary health care. Optometry students have worked and learned with allied health, dietetic, nursing, pharmacy and social work students in a disadvantaged area in Houston. The primary purposes of the course were to assist students to learn about the expertise of other professional students, to work in an interdisciplinary team, and to learn about the multifaceted components of health care and the health resources of a community. This paper discusses the program and suggests this model of the Houston experience as one way of teaching interdisciplinary care.

Curriculum↗

PubMed1995

A novel approach to providing educationally based low vision services and outreach clinical and vision support services to the visually impaired.

BACKGROUND: The Perkins Low Vision Service is affiliated with the New England Eye Institute, the primary teaching clinic of the New England College of Optometry. Low Vision Services for patients of all ages as well as vision services for the multi-impaired are provided on site at the Perkins School for the Blind in Watertown, Massachusetts. RESULTS: Evaluations are provided by the low vision team comprised of specialists with expertise in pediatric and rehabilitative optometry, special education, orientation and mobility training, rehabilitation teaching and the interns at the New England College of Optometry. The full scope of services offered as well as alternative modes of practice employed will be discussed.

Adolescent↗

PubMed1997

Release of contact lens prescriptions: an update.

BACKGROUND: The release of contact lens prescriptions to patients is a clinicolegal issue of importance to optometrists. Legal obligations to release contact lens prescriptions are created by state optometry statute or optometry board rule or regulation. METHODS: State statutes and optometry board rules or regulations that pertain to contact lens prescription release requirements are reviewed. RESULTS: There are 22 states in which statutes or board rules or regulations require optometrists to provide prescriptions after patients have been fitted with contact lenses. In 29 states, the minimum elements of a contact lens prescription have been established. Optometrists in these states must understand and comply with prescription release requirements. CONCLUSIONS: To minimize misunderstandings and conflicts with patients, optometrists in jurisdictions without contact lens prescription release requirements should establish an office policy for the release of prescriptions and communicate this policy in writing to patients. To minimize the likelihood of injury to patients, contact lens prescriptions should be as complete as possible, thereby ensuring that lenses obtained from a third party dispenser will provide optimum acuity, comfort, and physiological response.

Contact Lenses↗

PubMed1998

Optometric manpower in the Commonwealth of Puerto Rico: estimates and projections, 1982-2025.

BACKGROUND: The 1982 study investigated the potential impact of the IAUPR School of Optometry on the adequacy of supply of optometrists in Puerto Rico for the years of 1980-2000. This article is designed to: (1) update the 1982 study; (2) appraise the accuracy of the 1982 projections; (3) re-evaluate the status of optometric manpower in Puerto Rico through the year 2025; and (4) provide the School of Optometry with information necessary to make informed judgments about future enrollments. METHODS: Estimates of supply are based on data from the Colegio de Optometras de Puerto Rico, the Sección de Oftalmología de la Asociación Médica de Puerto Rico, and the enrollment and graduation registries from the School of Optometry. Requirements are based on estimates of annual effective demand, provider-to-population ratios, per capita demand, and optometric productivity. RESULTS: Optometrists comprised 52.2% of Puerto Rico's actively practicing vision care manpower in 1995, with a mean optometrist-to-population ratio of 8.2 per 100,000. The number ranged from 28 in Mayagüez to 107 in San Juan. Under different assumptions regarding supply, productivity, and demand, surpluses and deficits are estimated and projected for the years 1995 to 2025. CONCLUSIONS: Depending on the assumptions used, an undersupply or an oversupply of optometrists may be found in Puerto Rico, currently and in the future. Projections of supply and demand predict a considerable range--from a surplus of 961 optometrists to a deficit of 2,085 optometrists in the year 2025.

Adolescent↗

PubMedDate not supplied

The accreditation of university teachers: an optometric viewpoint.

The issue of whether university teachers should be required to gain a formal teaching qualification is currently under debate. In the United Kingdom, the development of an accreditation system for university teachers is well advanced. In the future, Australian university teachers may be required to either: 1. prove their teaching competency 2. undertake teaching courses as part of their induction program. Of the current full-time academic staff of the optometry schools in Australia and New Zealand, about 15 per cent have undertaken university courses on higher education teaching: two of 10, one of 12, one of six and one of six for the optometry schools at the Queensland University of Technology, The University of New South Wales, The University of Melbourne and The University of Auckland, respectively. In terms of undergraduate optometry students' views, of those who responded (43 per cent of QUT third and fourth year students) to a survey on a range of teaching and learning issues, 20 out of 26 thought that a teaching qualification should be a requirement, while only six thought that it was not necessary. It has been suggested that an accredited training system is one way of ensuring that university teachers have the skills to deal with a dynamic teaching environment and the challenges of the future. The quality of teaching in universities has particular relevance to the optometric profession both in terms of undergraduate students and postgraduate experiences.

Journal Article↗

PubMed2004

Coverage in screening for diabetic retinopathy according to screening provision: results from a national survey in England and Wales.

AIM: To assess the proportion of people with diabetes screened for retinopathy according to provision of screening services. METHODS: Twenty-five health authorities in England and Wales were sampled after stratification by type of screening provision for diabetic retinopathy. Nine did not have a population-based screening scheme, six had an optometry scheme, six had a camera scheme and four had schemes with more than one method of screening ('mixed schemes'). Within each authority general practices were randomly sampled, 129 in total, and in each the records of a sample of diabetic patients examined. RESULTS: Of the 9200 records examined, 5812 (63.2%) had a record of one or more retinal examinations from any source in the year before the survey. This proportion did not differ significantly according to type of screening provision. The proportion of people with one or more retinal examinations by an 'expert' (defined as ophthalmologist, diabetologist, optometrist or screening scheme) in the last year was 44.7% where there was no screening scheme and 62.2%, 59.4%, and 61.6%, respectively, where optometry, camera and mixed schemes were present. Adjusted relative odds (95% confidence interval) for a retinal examination from any source in the last year compared with areas with no screening schemes were 1.19 (0.73, 1.93), 1.26 (0.80, 1.98), and 1.19 (0.77, 1.84) for camera, optometry and mixed schemes, respectively. Equivalent figures for an expert retinal examination were 2.30 (1.51, 3.49), 1.86 (1.25, 2.78) and 2.13 (1.32, 3.45). Coverage by schemes themselves did not differ according to type of scheme. Highest coverage rates, including examinations by screening schemes, were achieved in those treated with insulin, and the lowest rates found in those treated with diet alone. CONCLUSIONS: Screening schemes have had a small impact on overall retinal examinations, but a higher impact on the coverage of examinations performed by experts.

Adult↗

PubMed2000

Why don't we have enough cornea donors? A literature review and survey.

BACKGROUND: Organ donation provides a second chance for those who have experienced severe disease or injury. Unfortunately there is a huge discrepancy between the supply and demand of transplantable organs, despite the existence of sufficient numbers of potential donors. Through a review of the literature and a survey of optometry students, this article provides insight into the reasons for the shortage of corneal donors and how more corneal donors might be obtained. METHOD: A survey of 200 optometry students at the University California, Berkeley, School of Optometry was conducted to augment the literature review. Seventy-six students (38% of those surveyed) completed the survey process. RESULTS: Results of the survey indicated that 64.5% of who responded were willing to donate body organs, while 31.6% were not. Of those not willing to donate organs, 11.8% cited religious reasons. Other personal reasons included: fear (4%), respect for the human body (7.9%), and parental disapproval (6.4%). Only 46.1% of respondents had donation stickers on their driver's licenses. CONCLUSION: The literature review and survey indicate that age, religion, culture, personality characteristics, views on death and mortality, body image, and humanitarian concerns are among the many factors that influence people's opinion concerning organ donations. Education of the public and health care professionals' awareness of the importance of obtaining corneas for donation is crucial to end the shortage of organ donors.

Cornea↗

PubMed2003

[Study of diopters-cutting in treatment of PRK for myopia].

PURPOSE: To study a method of determining the diopters-cutting for photorefractive keratectomy (PRK) pre-operation. METHODS: By statistics, to analyze the differences of diopter between optometry of mydriasis and keratectomy in 143 cases 209 eyes of medium myopia with complete data recorded. RESULT: The average diopter for optometry of mydriasis is -4.32 D, for keratectomy, -4.74 D. The average of differences is (0.42 +/- 0.173) D, P < 0.01. CONCLUSION: The numerical value of diopter-cutting for operation should be higher than for optometry of mydriasis in treatment of PRK for myopia.

Adolescent↗

PubMed1998

Subspecialty distributions of ophthalmologists in the workforce.

OBJECTIVE: To describe the distribution of the supply and requirements for subspecialty ophthalmologists. METHODS: Estimates from the Eye Care Workforce Study were used to provide subspecialty-based assessments of the supply and public health need, as well as market demand, for care provided by subspecialists. Reconciliation with the boundary models (optometry first, ophthalmology first) of the Eye Care Workforce Study and current market status also were performed. RESULTS: Whether subspecialists are in excess depends first on which boundary model most closely approximates the current market conditions. Under an optometry-first model, 70% of all ophthalmologists are in excess, although subspecialists (39%) are relatively less in excess than comprehensive ophthalmologists (91% excess). Under an ophthalmology-first model, no ophthalmologists would be in excess. Extrapolating from current market conditions, a slight excess of ophthalmologists exists, probably proportional across subspecialists and comprehensive ophthalmologists. Future growth in the ophthalmologist supply will be almost entirely among subspecialists. CONCLUSION: Under current market conditions, substantial excesses in subspecialist ophthalmologists are likely to develop and grow worse over time, given current training levels.

Health Services Needs and Demand↗

PubMed2006

The crisis in health care: is it an optometric concern?

The number of uninsured and underinsured Americans continues to rise. Many large U.S. corporations are finding the burden of providing health insurance for their retirees, as well as their workers, seriously affecting their ability to compete globally. Many smaller companies are eliminating their health insurance entirely, or requiring greater contributions on the part of the insured worker. The problems encountered by industry have resulted in a new form of health insurance called Consumer-Driven Health Plans, which require greater outlays by covered workers. The changes in our health care delivery system in the past 42 years have dramatically changed the practice of optometry as well as medicine. The rapid growth in health care costs, particularly for our citizens who pay for their own health insurance, has outpaced wages by nearly 4 times. The number of citizens who qualify for Medicaid continues to increase. This presents a particular problem for optometry, as vision care is not a mandated service of Medicaid under federal guidelines. In addition, many managed care plans may have to eliminate eye care benefits, which are often a carve-out of a major plan in order to stay competitive. There is also evidence to suggest that many of our citizens who can least afford the present cost of health care will attempt to receive their care from community clinics and charitable programs, including vision care programs.

Delivery of Health Care↗