Optometry and Vision Sciences - Research Publications
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ItemInsights into Australian optometrists' knowledge and attitude towards prescribing blue light-blocking ophthalmic devices(WILEY, 2019-05)PURPOSE: The aim of this cross-sectional study was to survey Australian optometrists regarding their attitudes towards, and knowledge of, blue light-blocking lenses designed to attenuate blue light transmission to the eye. METHODS: A 29-item survey was distributed at a major national optometry education conference and through professional networks. Respondents provided information regarding their demographics and practice modalities, knowledge about the potential effects of blue light, and attitudes towards prescribing blue light-blocking ophthalmic devices. Ordinal logistic regression analysis was performed to assess the factors that predicted optometrists' prescribing of blue light-blocking lenses. RESULTS: Of 372 respondents, 75.3% indicated prescribing blue light-blocking spectacle lenses in their clinical practice. Forty-four per cent of optometrists considered daily environmental exposure to blue light as a potential cause of retinal damage, and approximately half of respondents thought blue light emitted from computer screens was an important factor in causing computer vision syndrome. About half of optometrists considered placebo effects to potentially play a role, at least sometimes, in patients' experiences with blue light-blocking lenses. Most optometrists estimated that they first prescribed a blue light-blocking lens in 2016. The most common reason optometrists prescribed these devices was for patients who were computer or electronic device users (87.9%). The two main sources of information used to guide practitioners' management approaches were conference presentations and manufacturer product information. Practitioners were significantly more likely to prescribe blue light-blocking lenses if they considered blue light to cause either retinal damage (odds ratio, OR 2.28, 95%CI 1.34-3.88, p = 0.002) or computer vision syndrome (OR 2.52, 95%CI 1.41-4.50, p = 0.002) compared with practitioners who did not consider such factors to be relevant. CONCLUSION: Prescribing trends by Australian optometrists in relation to blue light-blocking lenses reflect the inconclusive nature of several aspects of the evidence in this field. Blue light-blocking lens prescribing has increased since 2010, despite practitioners acknowledging the lack of high-quality evidence to support their use and also commonly believing that placebo effects may have a role in patient responses to these lenses. Information from this study will help inform the development of resources to guide evidence-based prescribing of blue light-blocking lens products.
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ItemOmega-3 Fatty Acids and Eye Health: Opinions and Self-Reported Practice Behaviors of Optometrists in Australia and New Zealand(MDPI, 2020-04)This study investigated optometrists' attitudes and self-reported practice behaviors towards omega-3 fatty acids for eye health, and knowledge and understanding of their potential risks and benefits. An anonymous online survey was distributed to optometrists in Australia and New Zealand. Questions included practitioner demographics and practice modality; self-reported practices and recommendations relating to diet, nutritional supplements, and omega-3 fatty acids for age-related macular degeneration (AMD) and dry eye disease (DED); and practitioner knowledge about omega-3 fatty acids. Of 206 included surveys, most respondents (79%) indicated recommending for their patients to consume omega-3 fatty acids to improve their eye health. Sixty-eight percent of respondents indicated recommending omega-3-rich foods for AMD management, while 62% indicated recommending omega-3 supplements. Most respondents (78%) indicated recommending omega-3-rich foods or supplements for DED. For DED, recommended omega-3 supplement dosages were (median [inter-quartile range, IQR]) 2000 mg [1000-2750 mg] per day. The main sources of information reported by respondents to guide their clinical decision making were continuing education articles and conferences. In conclusion, optometrists routinely make clinical recommendations about diet and omega-3 fatty acids. Future education could target improving optometrists' knowledge of differences in the evidence for whole-food versus supplement sources of omega-3 fatty acids in AMD. Further research is needed to address uncertainties in the evidence regarding optimal omega-3 dosage and formulation composition in DED.
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ItemMigraine Screening in Primary Eye Care Practice: Current Behaviors and the Impact of Clinician Education(WILEY, 2020-09)BACKGROUND: Migraine is underdiagnosed and undertreated. Optometrists are primary eye care providers, who regularly encounter people with migraine as an incidental finding during routine eye examinations, or when patients present to rule out whether visual or ocular problems are contributing to headache symptoms. Knowledge and use of a migraine screening tool in optometric practice is, therefore, important to be able to identify and refer people with migraine for appropriate management. OBJECTIVE: We sought to investigate optometrists' current behaviors regarding screening for migraine, and to assess the effectiveness of an educational resource in promoting the use of a 3-item validated migraine screening questionnaire, the ID-Migraine. METHODS: We first conducted a cross-sectional study using a survey to assess optometrists' current knowledge and behaviors about migraine screening and willingness to participate in a pilot implementation program. Participants who provided their contact details were invited to watch an online educational resource about a validated migraine screening tool. After 6 weeks, these participants were invited to participate in a follow-up cohort study involving a survey to assess the effectiveness of the educational resource. RESULTS: Ninety-eight optometrists completed the initial survey as part of the cross-sectional study. We found that most optometrists actively asked patients about migraine (79/98 respondents, 81%) as part of routine eye examinations and self-rated themselves as confident in identifying migraine (71/98 respondents, 72%). However, the majority (90/98 respondents, 92%) were not aware of any validated migraine screening tools. Seventy-eight respondents provided their contact details to receive information about the subsequent cohort study. In response to the follow-up study survey (31/78 participants, 40%), 45% (14/31 respondents) of participants self-reported using the ID-Migraine tool after watching our educational video, and most of these participants (12/14 respondents, 86%) were likely or extremely likely to continue to use the tool in their practice. CONCLUSIONS: From our initial cross-sectional survey, we conclude that optometrists do not currently use validated screening tools for migraine and as such, there is an opportunity for continuing professional development in this area. Our follow-up cohort study demonstrates that educating optometrists on the importance and utility of a validated migraine screening tool is achievable with a relatively simple, low-time investment intervention (an online educational video). Such education may result in improved identification of migraine, which may lead to improved management.