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PubMed2006

Use of clinical practice guidelines by executive directors of optometric associations.

BACKGROUND: The process of developing the American Optometric Association's (AOA) Optometric Clinical Practice Guidelines began in 1989 under the direction of John F. Amos, O.D., M.S., then chair of the AOA's Clinical Care Center. The guideline development process used by the AOA was modeled after the recommendations established by the Agency for Health Care Policy and Research in response to the federal government encouraging health care groups to develop clinical guidelines to enhance the quality, appropriateness, and effectiveness of health care. The guideline topics were chosen for their importance in the education of members, health care payers, and state legislators. A principal author and a consensus panel of experts then were chosen for each subject area. This group was responsible for transforming the latest scientific research and expert judgment into a document that would apply to everyday optometric practice. Thirteen guidelines were developed and mailed to AOA members in 1994 and 1995. Additional guidelines were mailed as they were approved. Currently, there are 20 guidelines available. METHODS: A survey was mailed to the executive director of the optometric association of each state and the District of Columbia and to the chief of optometry of each of the federal services. Telephone follow-up was made to nonrespondents, and an additional copy of the survey was mailed to them with telephone follow-up again taking place for those who did not respond. RESULT: Forty-three of the surveys were returned for a response rate of 78%. Seventy-six percent of the respondents stated that they had received the guidelines. The sections that were found most useful to the respondents were those related to Description and Classification, Basis of Treatment, and Treatment Options. The guidelines were most often used by these groups to improve the quality of eye care, expand optometric involvement in health programs, affect public policy, and overcome problems with insurance groups. DISCUSSION: Optometric organizations have found the clinical practice guidelines useful beyond their primary goal of enhancing the quality of patient care. They have been used effectively to help educate other parties about optometry and its role as a primary health care profession.

Humans↗
PubMed1977

Predictors of rural practice location.

Attitudes toward the urban environment and place of origin were found to be the best predictors of an optometrist's practice location. When urbanism attitude and origin were scaled and placed in an equation to predict practice location, identification of an optometrist's practice location as rural or urban was highly accurate. Most important, scores on the equation were predictive of optometry students' future practice location. A single cutoff point on the equation correctly identified 79 percent of students who entered a rural or isolated small city practice and 81 percent of those who entered urban practice. The findings imply that optometry students most likely to enter rural practice can be objectively identified early in their training. If certain factors affecting choice of practice location are common to all health professions, the predictive equation presented here may be useful in the selection of students for rural practice in medicine.

Attitude of Health Personnel↗
PubMed1976

Identifying the potential rural optometrist.

Rural optometrists were found to differ from urban optometrists in background, environmental attitude, and interest patterns. Attitude toward the urban environment and place of origin were the best predictors of an optometrist's practice location. When "urbanism" and "origin" were scaled and placed in a multiple regression equation to predict practice location, identification of an optometrist's location as rural or urban was highly accurate. Most importantly, scores on the equation were predictive of optometry students' future practice locations. A single cut-off point on the equation correctly identified 79% of students who entered rural or isolated small city practice and 81% of those who entered urban practice. The findings suggest that optometry students most likely to enter rural (or indeed urban) practice can be objectively identified early in, or even prior to, training. Such identification may assist educators in selecting and training optometrists who will deliver vision care to people in areas of greatest need.

Attitude↗
PubMed1978

Optometric education in Nigeria.

A 3-year optometry program was established at the University of Benin, Nigeria in 1973. The program is considered from the standpoint of curriculum, faculty, clinical instruction, and grading. Some background is given about Nigeria itself. Present eye care facilities are reviewed as well as the increasing requirements of a developing nation. The need of strong support from established optometry schools is indicated.

Adult↗
PubMed1979

Malpractice insurance at optometric institutions.

The optometric educator needs insurance against malpractice suits. A survey was made of the policies available at twelve schools and colleges of optometry in the United States. The object of this survey was to compare the various protections offered by the optometric institutions and also to inform the educators of what is available to them. It was found that coverage and premiums vary considerably between the institutions. At only one of the twelve schools and colleges of optometry responding to this survey were faculty members required to pay for their own policies, but to avoid undue risk, two other colleges highly recommended that their faculty purchase their own coverage. Implications of the low number of claims brought against optometric teaching facilities and other factors are discussed in light of the "malpractice insurance crisis."

Faculty↗
PubMed1983

Use of diagnostic pharmaceutical agents and incidence of adverse effects.

A drug registry was established at Southern California College of Optometry (SCCO) to study use rates and incidence of adverse side effects of the nine pharmaceutical agents in the California optometry law. Data were gathered in clinics of SCCO for 6 months and offices of 20 private practitioners for 3 months. Data included drugs used, the strength and dosage, patient age, sex, and racial or ethnic origin. Adverse drug reactions were reported in detail, including objective and subjective findings, duration of the reaction, and case disposition. A total of 12,493 drug applications were reported. A low incidence of adverse reactions, eight cases (0.208%), which produced no permanent effects, is sound evidence regarding the risk/benefit ratio in support of the use of pharmaceutical agents by optometrists.

Adolescent↗
PubMed1988

Coordination of primary care providers.

Surveys were sent to family physicians in Illinois to determine knowledge and attitude concerning optometry. The respondents were knowledgeable in certain aspects of optometry. However, many need to become more aware of the optometrist as a health care provider.

Attitude of Health Personnel↗
PubMed1989

Delivery of optometric care in nontraditional settings: the long-term care facility.

The changing demographics of our population dictate that in the future optometrists will care for increasing numbers of older patients. Significant numbers of these elders will reside in long-term care facilities. Optometry curricula have begun to respond to this need by training students currently enrolled in colleges of optometry to provide eye care in the nursing home setting.

Aged↗
PubMed1989

Vision care in a juvenile detention facility.

Optometry plays a key role in the provision of vision care services at the San Bernardino Juvenile Hall (SBJH), where 400 juvenile offenders, aged 12 to 18 years, are incarcerated. This program in San Bernardino, California, was established in 1979 by a practicing optometrist with support from federal, state, and local funding agencies. It operates as an outreach clinical program to train senior students of the Southern California College of Optometry for professional practice opportunities in a nontraditional setting. An important component of the SBJH program is an ongoing clinical research program to study the relation between vision problems and juvenile delinquency, and the effect of vision training on the rehabilitation of delinquent youths. Preliminary data indicate a reduction in the recidivism rate for this population group.

Adolescent↗
PubMed1990

Coordination of primary care providers: a follow-up study.

Surveys were sent to family physicians in North Carolina to determine knowledge and attitudes concerning optometry. A similar survey was performed previously with physicians from Illinois. Responses varied in the states regarding the participants' knowledge and opinions of optometric capabilities, perhaps as a function of the scope of optometric practice according to the individual state laws. Optometry's perceived role as a health care provider seems to be affected by their legally permitted mode of practice.

Follow-Up Studies↗
PubMed1995

"The Reading Assistant": user-friendly technology for the visually impaired.

One important way in which optometry must respond to the needs of persons with visual disabilities is to develop innovative applications of technologies that will allow these people to function productively in the workplace, where their performance depends on the ability to read at reasonable rates: to read such documents as letters, memos, contracts, instruction manuals, newspapers, magazines, and the like. In this paper I will describe one example of such an effort, a system that is being developed jointly by the SUNY College of Optometry, the National Eye Institute, and MerlinVision Industries, Inc., a company in Yorktown Heights, NY. I have an interest in what is reported here: I hold a part-time position as Director of Clinical Research at MerlinVision.

Humans↗
PubMed1996

How good is the estimated cover test at predicting the von Graefe phoria measurement?

Results obtained on the estimated cover test and the von Graefe phoria measurement were compared in order to determine how well the former test predicted the result of the latter. Subjects for the study were 25 clinic patients and 28 optometry students. Examiners were two fourth-year optometry interns. For testing at 6 m, correlations between the estimated cover test and the von Graefe measurement were relatively high, although for some subjects the cover test underestimated the von Graefe measurement by as much as 4 delta of exophoria and 6 delta of esophoria. For testing at 40 cm, correlation coefficients were somewhat lower, and the cover test underestimated the von Graefe measurement by as much as 11 delta of exophoria and 13 delta of esophoria. It was concluded that although the estimated cover test is valuable as a screening test, it should be followed by prism neutralization or by von Graefe phoria measurement.

Adult↗
PubMed1997

Variability of the refractive state: meridional profiles and uniform variation.

Variation of the refractive state as measured with autorefraction is the result of many factors which need to be considered if optometry is to develop a more complete understanding of the behavior of the visual process. Various methods can be applied to develop such an understanding including scatter plots, meridional profiles of variance-covariance, and graphs of uniform variation. These methods are used, in this paper, to investigate some results for autorefraction from a sample of 106 university students studying optometry. Some of the eyes in the sample display variation, some or all of whose characteristics are the same in all meridians of the eye. Such eyes are said to exhibit refractive variation that is partially or completely uniform across the meridians of the eye. Most eyes, however, show variation which appears to depart from uniformity. The typical eye in the sample appears to exhibit variation that is mainly spherical in character and of a small magnitude in keeping with the view that the accommodative system mostly is responsible for this variation. Nevertheless, there is an astigmatic component to the variation. The mean variance-covariance matrices for the right and left eyes are presented.

Accommodation, Ocular↗
PubMed2000

The effect of experience on the detection of small eye movements.

PURPOSE: The purpose of this study was to determine whether experience improves detection of small eye movements similar to those seen in the cover test during ideal conditions. METHODS: Three groups of examiners with varying amounts of experience in eye movement detection tasks were studied. Eight examiners were 1st-year optometry students, six were 4th-year optometry students, and six were practicing optometrists. To determine thresholds for eye movement detection, examiners indicated the horizontal direction in which the eyes of one of the experimenters moved. The direction and extent of each eye movement was randomly selected. The extent of the eye movement was one of eight logarithmic steps from a maximum that was determined through an initial session where the approximate sensitivity of the examiners was found (generally +/- 1.75 prism diopters). RESULTS: Detection thresholds were determined by fitting the data with a cumulative Gaussian function. The mean horizontal eye movement eye movement necessary to obtain 99% correct judgments was 2.65 prism diopters for the 1st-year students, 2.47 prism diopters for the 4th-year students, and 2.40 prism diopters for the practicing optometrists. CONCLUSIONS: The results indicate that during ideal conditions, little or no training is required for efficient detection of small eye movements.

Adult↗
PubMed2006

The Australian optometric workforce 2005.

BACKGROUND: This paper presents the findings of the Optometrists Association Australia 2005 optometric workforce study. METHODS: Data from the association's database, the Australian Bureau of Statistics, Medicare and the Department of Veterans Affairs were applied to create a profile of the optometric workforce in Australia, including the number of equivalent full-time optometrists (EFTOs), population to optometrist ratios and workloads. RESULTS: In February 2005, 2,866 (76.7 per cent) of the 3,738 optometrists registered to practise in Australia were in clinical practice. Adjusting for the number of hours worked, there were 2,712 EFTOs in Australia. The ratio of population to EFTO for Australia was 7,016. Ratios were higher in the states without schools of optometry (South Australia 9,413, Western Australia 8,810 and Tasmania 8,172) and in the remote and lightly populated Northern Territory (10,521). The lowest ratio was in New South Wales (6,053). The proportion of women in clinical practice has gradually increased since 1977 and was slightly more than 41 per cent in 2005. The percentage of the profession under the age of 40 years was 48.6. The percentages of female and male optometrists under the age of 50 were 89.3 and 72.5, respectively. On average, female optometrists worked approximately 82 per cent of the hours worked by male optometrists. The average time per week spent on Medicare and Veterans Affairs consultations was 25.8 hours. CONCLUSIONS: The profession of optometry in Australia is undergoing considerable change in age and gender make-up. In 2005, the number of optometrists was adequate for the needs of the Australian population. Further analysis is needed to determine whether the supply of optometrists meets community needs at local levels.

Adult↗
PubMed2000

Pacific's experience with Web-based instruction: bats in the belfry or Webs in the classroom?

BACKGROUND: There is a revolution underway in education that involves a shift from the traditional lecture style of information presentation toward a more active style of learning. Many educators now believe that students must actively participate in the learning process for information to be truly understood and retained. Coincident with this revolution, there is an increased understanding that the body of knowledge in most professions has become too large to retain in the brains of individuals. These concepts have opened the door to innovative, computer-based educational techniques. METHODS: Pacific University College of Optometry has used a variety of Web-based educational methodologies in selected classes. These have ranged from shifting classes totally to the Web, to using the Web for pre-class preparation. RESULTS: Initial student acceptance of Web-based courses has been good. However, an undesirable trend has emerged--the tendency for students to print out Web-presented material rather than reading from the computer screen. Other concerns with shifting material from lecture to the Web include peer and administrator acceptance of this teaching style and issues associated with evaluation of professors who no longer give stand-up lectures. CONCLUSIONS: Changes in educational theory are making their way into the Schools and Colleges of Optometry. These changes will place greater reliance on active learning, reduced student memorization, and increased use of computers as information storage and retrieval devices. This will change the fundamental way in which students are educated, and this, in turn, will change the way in which future doctors, patients, and computers interact in clinical settings.

Computer-Assisted Instruction↗
PubMed1975

Optometric manpower resources--1973. Part III.

The Optometric Manpower Resources Project, funded under government contract since June of 1971, has completed its 1973 national census of licensed optometric manpower in the United States. The first article in this series of three reported on the distribution of optometrists by census region and the current ratios of practicing optometrists to civilian population. The second article reported on the principal forms of employment of active optometrists, the number of years in practice and practice size. This third article reports on the age and sex distributions of licensed optometrists, their racial/ethnic composition, their pattern of specialization, and the schools/colleges of optometry from which they graduated. The data indicate that almost 50% of active optometrists were over 50 years of age. Approximately 90% of male optometrists and only 58.5% of female optometrists were active. The data also indicate that one-third of all optometrists active in 1973 graduated from four schools/colleges of optometry.

Age Factors↗
PubMed1975

An experiment in health careers recruitment: a summer program at Indiana University.

During the summer of 1973, the Indiana University Division of Optometry, via a Special Project Grant from the National Institutes of Health, conducted its first Summer Institute in the Health Related Professions for High School and College Students. Twenty-seven high school students and twenty-nine college students were brought to Indiana University for intensive sessions in career awareness, curriculum and financial counseling, and academic coursework. Assisted by the staffs of Indiana Health Careers, Inc. and the Indiana University Coordinators for School Science, the Institute awakened new interests and goals, relative to the health career prospectus, within the trainees. As a direct consequence of the summer program, four participants in the college institute were matriculated into schools of medicine, pharmacy, and optometry during the semester following the culmination of the Institute; ten more are participating in the followup program for continued guidance and counseling, seeking 1974 entrance into health professions schools and colleges. This experiment in health professions recruitment for minority, disadvantaged, and low-income students proved to be a viable method of increasing the manpower pool of health professionals.

Academies and Institutes↗