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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.

Background: The optometric scope of practice has increased dramatically over the last 30 years. This includes the ability to administer legend drugs to facilitate the examination process and prescribe legend drugs to treat the eye and adjacent areas in accordance with state laws. However, because such laws are relatively new in some states, the prescribing optometric communities in the United States may have difficulty in making their presence known amongst the pharmaceutical tracking companies. This study looked at the relationship between prescriptions written and pharmaceutical tracking company outcomes., Method: Optometrists were recruited from five states--Florida, Illinois, Missouri, North Carolina, and Texas--to participate in this study. They represented urban and rural practices, group and solo practices, and multidisciplinary practices. They were requested to track all prescriptions they wrote for legend pharmaceutical drugs during the months of August, September, and October 2000, as well as the number of refills authorized. Numbers were obtained from a pharmaceutical tracking company for the same optometrists for the period July to September 2000, and October to December 2000. The results reported by the optometrists were compared to the results provided by the pharmaceutical tracking company., Results: There was a significant difference between the numbers reported as outcomes by the pharmaceutical tracking company and the self-reported prescriptions written., Discussion: The current system for crediting prescriptions to optometrists seems to have some shortcomings. All parties involved must work to ensure that optometrists are being properly credited for the pharmaceutical prescriptions they write. Possible steps that may be taken by individuals, the optometric profession, and the pharmaceutical industry are discussed.