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An assessment of the total number, demographics and geographic distribution of optometrists in Australia may inform policy to address the maldistribution of the workforce. Concerns have been expressed about the growth of the optometry workforce in the context of, in the last decade, the establishment of four new optometry programs in addition to the three long-standing programs. This paper analysed data obtained from the Australian Health Practitioner Regulation Agency about registered optometrists during the period 1 January 2012 to 31 December 2019. The de-identified dataset included information about registered optometrists in Australia: their first year of registration, gender, year of birth (in five-year bands), optometry qualification, registration type including endorsement for therapeutic practice and the postcode of the principal place of practice. Data for 6,596 registrants were obtained over the study period during which the number of female optometrists increased significantly. The age profile of the profession shifted, with younger age bands becoming a significantly greater proportion of the profession. The majority of the profession comprised optometrists with a qualification from one of the three long-standing Australian optometry programs. Graduates of those programs accounted for 75.1% of registered optometrists in 2019, while 14.3% held a qualification from an overseas institution. The proportion of optometrists practising in major Australian cities was greater than the proportion of the population in those locations. A concomitant low proportion of optometrists, relative to population size, was found in regional and remote areas. Optometrists practising in Australia can be generalised as mostly female graduates of one of the three long-standing optometry programs holding general registration with a therapeutic endorsement, and with a principal place of practice located in a major Australian city. A significant maldistribution of the workforce was found that did not change significantly during the study period. [ABSTRACT FROM AUTHOR]

Background: Certified training must be provided for lay vision screeners prior to their conduct of a vision screening programme. However, the effectiveness of trained lay screeners does deteriorate over time. This study aims to evaluate the effectiveness of a recertification vision screening training module using the KieVisionTM Preschool Vision Screening Kit for preschool teachers in Malaysia. Methods: This was a randomised control trial. Fifty-nine preschool teachers previously enrolled in a Knowledge Transfer Programme were divided into a Study Group (n = 31) to receive recertification training and a Control Group (n = 28) to attend briefing sessions. Subjects was then asked to perform vision screening on 15 preschool children aged 4 years old--6 years old at their respective premises, then verified by optometrists after 2 weeks from the initial screening on the same children. Results: A total of 894 children were screened, with the Study Group and Control Group screened 49.7% and 50.3%, respectively. There was higher validity in vision screening findings from the Study Group (sensitivity = 66.7%, positive predictive value (PPV) = 61.5%) compared to the Control Group (sensitivity = 36.0 %, PPV = 40.9%). Conclusion: Teachers who received recertification training were more competent in detecting children's vision impairment using KieVisionTM Preschool Vision Screening Kit. Thus, timely recertification training should be emphasised to ensure sustainable consistency and reliability of vision screening programmes conducted by lay vision screeners. [ABSTRACT FROM AUTHOR]

Purpose: Ophthalmic services are currently under considerable stress; in the UK, ophthalmology departments have the highest number of outpatient appointments of any department within the National Health Service. Recognising the need for intervention, several approaches have been trialled to tackle the high numbers of false‐positive referrals initiated in primary care and seen face to face within the hospital eye service (HES). In this mixed‐methods narrative synthesis, we explored interventions based on their clinical impact, cost and acceptability to determine whether they are clinically effective, safe and sustainable. A systematic literature search of PubMed, MEDLINE and CINAHL, guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), was used to identify appropriate studies published between December 2001 and December 2022. Recent Findings: A total of 55 studies were reviewed. Four main interventions were assessed, where two studies covered more than one type: training and guidelines (n = 8), referral filtering schemes (n = 32), asynchronous teleophthalmology (n = 13) and synchronous teleophthalmology (n = 5). All four approaches demonstrated effectiveness for reducing false‐positive referrals to the HES. There was sufficient evidence for stakeholder acceptance and cost‐effectiveness of referral filtering schemes; however, cost comparisons involved assumptions. Referral filtering and asynchronous teleophthalmology reported moderate levels of false‐negative cases (2%–20%), defined as discharged patients requiring HES monitoring. Summary: The effectiveness of interventions varied depending on which outcome and stakeholder was considered. More studies are required to explore stakeholder opinions around all interventions. In order to maximise clinical safety, it may be appropriate to combine more than one approach, such as referral filtering schemes with virtual review of discharged patients to assess the rate of false‐negative cases. The implementation of a successful intervention is more complex than a 'one‐size‐fits‐all' approach and there is potential space for newer types of interventions, such as artificial intelligence clinical support systems within the referral pathway. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To explore the causes and consequences of cortical visual impairment in people with learning disabilities • To understand better how to recognise visual perception issues in people with learning disabilities • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Sight issues, which can be eye-related or brain-related, are common among people with learning disabilities. Premature birth or subsequent developmental delays can cause damage to the areas of the brain that process vision, leading to cortical visual impairment. Eye-related and brain-related sight issues can manifest as impaired visual perception causing, for example, difficulties with light perception, colour perception, object perception or movement perception. People with learning disabilities may display behaviours indicative of visual perception issues, but such behaviours are often ignored or misinterpreted. This article explains the causes and consequences of cortical visual impairment, describes visual perception issues that commonly arise from ocular/retinal or cortical causes, and outlines how learning disability nurses can detect the presence of visual perception issues in service users. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to identify the knowledge of and perceived barriers to providing low vision services among eye care practitioners in Goa. Methods: A pretested and predesigned questionnaire was sent to 72 eye care practitioners, which included the optometrists and ophthalmologists working in Goa, through offline and online (social media like WhatsApp, Instagram, etc.) platforms. Information was collected to understand the barriers that restrict eye care practitioners from providing low vision services. Results: Seventy-two participants took part in this study, of which 26.39% (n=19) were ophthalmologists and 73.61% (n=53) were optometrists. From the practitioner's point of view, lack of awareness (70.83%, n=51) and training (68.06%, n=49) were the major barriers to providing low vision services. Conclusion: A lack of awareness and training facilities among eye care practitioners acts as a barrier to providing low vision services. [ABSTRACT FROM AUTHOR]

Dry eye disease is a very common condition, especially among aging women. People often think of it as a very mild and non-harmful issue, but the reality is that it has a huge deleterious effect on patients' quality of life. Most publications usually focus on the scientific aspects of this pathology: its epidemiology, diagnosis, or management. However, in this article we highlight the patient's perspective and the challenges of living with dry eye disease. With prior informed consent, we interviewed a patient whose life has drastically changed since she first got the diagnosis. We also asked healthcare professionals based in Miami who were involved in this patient's care for their opinions. We hope that the messages and commentaries resonate with patients and physicians involved in the care of dry eye disease worldwide. [ABSTRACT FROM AUTHOR]

This work seeks to identify the most impactful journals, papers, authors, institutions, and countries that cite optometry journal articles. The Scopus database was searched for papers citing at least one article published in any of the 18 optometry journals included in that database (i.e. 'optometry articles'). The 10 most highly cited papers that cite optometry journal articles were determined from 82,830 papers found. A h-index for "optometry journal citations" (the h OJC -index) was derived for each entity in the categories of journals, papers, authors, institutions and countries to serve as a measure of impact. The h OJC -index of the body of papers citing optometry journal articles is 370. Papers citing optometry journal articles have themselves been cited 2,054,816 times. Investigative Ophthalmology & Visual Science (h OJC = 154) is the most impactful journal citing optometry articles and Optometry and Vision Science the most prolific (5310 papers). The most impactful paper citing optometry journal articles (5725 citations) was published in Journal of Clinical Epidemiology. Ophthalmologist Seang Mei Saw (h OJC = 69) is the most impactful author and optometrist Nathan Efron is the most prolific (288 papers). Harvard University (h OJC = 127) is the most impactful and UNSW Sydney is the most prolific institution (1761 papers). The United States is the most impactful and prolific nation (h OJC = 313; 28,485 papers). Optometry journal articles are cited extensively by optometrists, ophthalmologists, and vision scientists world-wide, as well as authors from a broad spectrum of non-ophthalmic research domains. This work confirms the utility and influence of optometry journals. [ABSTRACT FROM AUTHOR]

To assess the agreement between the Eye Refract, an instrument to perform subjective automated refraction, and the traditional subjective refraction, as the gold standard, in young hyperopes under noncycloplegic and cycloplegic conditions. A cross-section and randomized study was carried out, involving 42 participants (18.2 ± 7.7 years, range 6 to 31 years). Only one eye was chosen for the analysis, randomly. An optometrist conducted the refraction with the Eye Refract, while another different optometrist conducted the traditional subjective refraction. Spherical equivalent (M), cylindrical components (J0 and J45), and corrected distance visual acuity (CDVA) were compared between both refraction methods under noncycloplegic and cycloplegic conditions. A Bland-Altman analysis was performed to assess the agreement (accuracy and precision) between both refraction methods. Without cycloplegia, the Eye Refract showed significantly lower values of hyperopia than the traditional subjective refraction (p < 0.009), the mean difference (accuracy) and its 95% limits of agreement (precision) being -0.31 (+0.85, -1.47) D. Conversely, there were no statistical differences between both refraction methods under cycloplegic conditions (p ≥ 0.05). Regarding J0 and J45, both refraction methods manifested no significant differences between them under noncycloplegic and cycloplegic conditions (p ≥ 0.05). Finally, the Eye Refract significantly improved CDVA (0.04 ± 0.01 logMAR) compared with the traditional subjective refraction without cycloplegia (p = 0.01). The Eye Refract is presented as a useful instrument to determine the refractive error in young hyperopes, the use of cycloplegia being necessary to obtain accurate and precise spherical refraction. [ABSTRACT FROM AUTHOR]

The rich history of optometric journal publications has been well documented, but the scientific impact of all optometry journals over all time has not been published. This work aims to determine the most impactful papers, authors, institutions and countries publishing in optometry journals. A h-index for "optometry journal publications" (the "hOJP-index") was derived for each constituent of each category to serve as a measure of impact. The h0Jp-index for the 34,565 papers published in all optometry journals is 136; these papers have been cited 294,239 times. Optometry and Vision Science is the most impactful and prolificjournal (hOJP=118; n=13,095 papers). The most highly cited paper, by Richard Armstrong, is entitled "When to use the Bonferroni correction" (1,172 citations). Australian optometrist Nathan Efron is the most impactful and prolific author (hOJP=41; n=273). UNSW Sydney and the University of California, Berkeley are the most impactful institutions (both hOJP==58), and UNSW Sydney is the most prolific (n=963). The most impactful and prolific nation is the United States (hOJP=109; n=12,050). This quantitative bibliometric analysis demonstrates an impactful optometric research base enshrined in optometry journals. [ABSTRACT FROM AUTHOR]

Purpose: In the UK, ophthalmology has the highest number of outpatient appointments within the National Health Service. False‐positive referrals from primary care are one of the main factors contributing to the oversubscription of hospital eye services (HESs). We reviewed the accuracy of referrals originating from primary care optometrists and contributing factors, such as condition type and years since registration. Recent findings: Of the 31 studies included in the review, 22 were retrospective analyses of referrals and appointments at the HES. Eight were prospective studies, and one used online clinical vignettes. Seven assessed the accuracy of referrals for all ocular conditions. The remaining studies focused on glaucoma (n = 11), cataracts (n = 7), emergency conditions (n = 4), neovascular age‐related macular degeneration (n = 1) and paediatric binocular vision (n = 1). The diagnostic agreement for suspected emergency ocular conditions was the lowest, with only 21.1% of referrals considered to require urgent attention in one study. For glaucoma, the first‐visit discharge rate was high (16.7%–48%). Optometrist referral accuracy was overall 18.6% higher than General Medical Practitioners'; however, the two mainly referred different ocular conditions. Female optometrists made more false‐positive referrals than males (p = 0.008). The proportion of false positives decreased by 6.2% per year since registration (p < 0.001). Summary: There was significant variation in referral accuracy across different ocular conditions, partly due to differences when defining accurate referrals. Optometrists working in primary care are generally more limited in their resources than the HES. Thus, choosing the cautious option of referral when they are unsure could be in the patients' best interests. The possible effect of increased use of advanced imaging on referrals requires evaluation. Although interventions such as refinement schemes have been put in place, these vary across regions, and their approaches such as virtual referral triaging may reduce unnecessary HES face‐to‐face appointments and promote communication between primary and secondary care. [ABSTRACT FROM AUTHOR]