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The decision to have a routine eye examination involves individual- and service-level judgement. A deeper understanding of patient access barriers and expectations could facilitate the design of better-aligned service models in optometric practice, improving the utilisation rate of an important facet of primary healthcare services. Routine eye examinations achieve several health objectives, including mitigation of sight-threatening risk factors. However, there are barriers to service uptake. Through the qualitative approach, a deeper understanding of these barriers can be realised and enhanced strategies designed to improve the uptake of the routine eye examination. A qualitative study was conducted to identify the factors influencing the decision-making process of older adults to use the routine eye examination service. This study was guided by the grounded theory approach. Participants were purposively recruited from six community elderly centres. Semi-structured interviews were conducted with 25 community-dwelling adults aged 65 years or above in Hong Kong. Data were transcribed and constant comparison techniques were used for data analysis. Difficulty in prioritising and including the routine eye examination in the existing health service utilisation was the central theme associated with its lower use. Four sub-themes were identified to explain this phenomenon: (1) previous health care service utilisation as a reference for judging primary eye care; (2) low perceived primary eye care service needs; (3) low perceived self-efficacy on routine eye care utilisation; (4) service expectations. Multiple modifiable factors influence decision-making by older adults, suggesting that their routine eye care seeking behaviour might be altered through behaviour change intervention. The context in which services are delivered requires further study, with a focus on exploring the factors influencing service experience and its subsequent impact on regular eye care seeking behaviour. [ABSTRACT FROM AUTHOR]

Children in socioeconomically disadvantaged communities often do not access follow-up eye care services when referred from vision screenings; whether this is due to lack of availability is not known. This paper highlights the need for vision and eye care for vulnerable children with practicing clinical optometrists well placed to provide vision care. Vision impairments develop from a young age and may inhibit learning experiences and impact life outcomes. Vision screening to detect and refer vision abnormalities supports children in their education and prevents minor vision impairments from worsening. This research describes outcomes from a vision screening programme for 4– to 5-year-olds delivered in Queensland, Australia. The programme involved all prep children from participating schools in Queensland. Vision screening was conducted with the Parr 4 m Visual Acuity Test and Welch Allyn Spot Vision Screener. A cross-sectional study design was adopted. Descriptive data analyses explored the frequency of vision screening and referral outcomes. Inferential analyses examined associations between vision screening and referral outcomes with socio-economic indexes for areas (SEIFA) scores. Of 71,003 prep students screened, 4,855 (6.8%) received a referral recommendation. A higher proportion of children who received a referral recommendation was from more disadvantaged locations (?2 = 109.16, p < 0.001). Of the students referred, 3,017 were seen by an eye health professional. Further vision assessment of students by an eye health professional revealed that 43.3% of the referred children were diagnosed with a vision abnormality, 18.9% had no vision abnormality and 37.7% had an 'undetermined' diagnosis. A higher proportion of children confirmed with a vision abnormality were from more disadvantaged locations (?2 = 52.27, p < 0.001). It is important that vision screening programmes target disadvantaged populations and support families of children who require further health assessment to access health services. [ABSTRACT FROM AUTHOR]

Background: This healthcare quality improvement report focussed on the effectiveness of an orthoptic-led inpatient vision screening service at Nottingham University Hospitals for older adults admitted with a fragility hip fracture. The service was developed in response to national guidance, which recommended a multifactorial assessment, including a vision assessment for older adults presenting following a fall. Method: Vision screening was carried out by orthoptists on eligible patients ≥65 years of age admitted to the trauma and orthopaedic wards with a hip fracture. Retrospective data for patients screened between 2015–2019 were analysed, including: patient demographics; screening eligibility and outcome; ophthalmology referrals made; ophthalmology appointment attendance; and outcome. Results: Of the 3321 patients admitted with a hip fracture between 2015–2019, 2033 (61%) were eligible for vision screening and 1532 (75%) of these were screened. Furthermore, 784 (51%) of the patients screened had an ocular abnormality requiring an ophthalmology referral, or a sight test at an optician. Only 144 of the 383 (38%) who required an ophthalmology referral via the GP were successfully referred, and only 107 of the 186 (58%) patients who were given appointments attended them. Additionally, 98 of 107 had pathology, with cataracts the most common finding (51%), and 61 of 98 (62%) patients had treatable vision impairment. Conclusions: We found a large proportion of fragility hip fracture patients with impaired vision, much of which was treatable and could be detected effectively with orthoptic-led bedside screening. The most common eye problem in those referred to ophthalmology was cataracts. An internal referral pathway to ophthalmology is proposed. There is a need to investigate reasons for disengagement with eye care services in this population. [ABSTRACT FROM AUTHOR]

Keywords: Blindness; COVID-19; equity; eye health; Indigenous Australians; inequality; telehealth; vision impairment; vision loss EN Blindness COVID-19 equity eye health Indigenous Australians inequality telehealth vision impairment vision loss 215 217 3 03/08/23 20230301 NES 230301 COVID-19 and Aboriginal and Torres Strait Islander eye health Over recent years there have been notable improvements in Aboriginal and Torres Strait Islander eye health outcomes, such as an increase in overall screening and treatment coverage rates of common eye diseases and decreasing rates of blindness.[[1], [3]] However, vision loss remains at least three times more prevalent amongst Aboriginal and Torres Strait Islander peoples than among other Australians. Similarly, in rural South Australia, where travel was restricted for approximately four months in 2020, and again from December 2021 to March 2022, the regional health service initiated a tele-optometry program that utilised an ophthalmic nurse and an off-site optometrist to collaborate in providing refractive and eye health assessments approaching that which is available with traditional face-to-face care. Examples of successful models include a health service in the Northern Territory, where an ACCHS-employed Aboriginal eye health coordinator acted as a central point of contact for both the optometrist and the primary health care staff of the region, facilitating effective patient triage and support. [Extracted from the article]

The unforeseen circumstance of income loss from Medicare rebates and the additional cost per patient in the form of personal protective equipment and use of disposable contact equipment means that optometrists and practice owners will need to develop financially sustainable strategies to ensure that they can continue to safely provide effective primary eye care. Keywords: Coronavirus; eye care; personal protective equipment; primary care; SARS-CoV-2 EN Coronavirus eye care personal protective equipment primary care SARS-CoV-2 728 733 6 08/03/21 20211101 NES 211101 Introduction Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in December 2019. A similar approach has been previously described for self-tonometry using devices like the Icare HOME.[13],[14] Like any health care plan involving patient compliance, the deployment of remote testing technologies still requires patients to use the devices in an accurate and timely fashion to maximise their effectiveness and validity. Could telehealth help eye care practitioners adapt contact lens services during the COVID-19 pandemic?. [Extracted from the article]