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Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer-to-peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes.

Purpose: This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU). Methods: This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations. Results: On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention. Conclusion: The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate rural community-based eye care models from the perspective of community ophthalmology experts and suggest sustainable technological solutions for enhancing rural eye care delivery. Methods: A semi-structured descriptive survey, using close-ended and open-ended questions, was administered to the experts in community ophthalmology sourced through purposive sampling. The survey was self-administered and was facilitated through online platforms or in-person meetings. Uniform questions were presented to all participants, irrespective of their roles. Results: Surveyed participants (n = 22 with 15 from India and 7 from Nepal) in high-volume tertiary eye hospitals faced challenges with resources and rural outreach. Participants had mixed satisfaction with pre-operative screening and theatre resources. Delayed presentations and inexperienced surgeons contributed to the surgery complications. Barriers to rural eye care included resource scarcity, funding disparities, and limited infrastructure. In rural/peri-urban areas 87% of participants agreed with providing primary eye care services, with more than 60% of the experts not in agreement with the makeshift center model of eye care delivery. Key components for an effective eye care model are sustainability, accessibility, affordability, and quality. These can be bolstered through a healthcare management platform and a human-chain supply distribution system. Conclusion: Tailored interventions are crucial for rural eye care, emphasizing the need for stronger human resources, optimized funding, and community awareness. Addressing challenges pertinent to delayed presentation and surgical training is vital to minimizing complications, especially with advanced cataracts. Enhancements in rural eye care demand a comprehensive approach prioritizing accessibility, affordability, and consistent quality. [ABSTRACT FROM AUTHOR]

Heather Machin,1,2 Mark Daniell,1,2 Lauren Entwistle,3 Clare Hafner,4 Anna MK Huigen,5 Harsimrat Kaur,2 Joanna McCulloch,4,6,7 Marina Osadchiy2 1Corneal Research Unit, Centre for Eye Research Australia, Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, Australia; 2Royal Victorian Eye and Ear Hospital, Melbourne, Australia; 3Independent Researcher, Perth, Australia; 4Ophthalmology Outpatients Department, Sydney Hospital and Sydney Eye Hospital, South East Sydney Local Health District, Sydney, Australia; 5Primary and Public Health Care, Community Primary Care, NT Health – Central Australia, Alice Springs, Australia; 6Nursing Education, Research and Leadership Unit, Sydney Hospital and Sydney Eye Hospital, South East Sydney Local Health District, Sydney, Australia; 7School of Nursing and Midwifery, Notre Dame University, Sydney Campus University of Notre Dame, Sydney, AustraliaCorrespondence: Heather Machin, Corneal Research Unit, Centre for Eye Research Australia, University of Melbourne, Level 7 Smorgan Family Wing, 32 Gisborne Street, East Melbourne, Victoria, 3004, Australia, Email heather.machin@unimelb.edu.auPurpose: An estimated 13 million Australians live with one or more chronic eye conditions, with prevalence increasing. Eye care services today and in the future rely on effective workforces, in which nurses play a pivotal role. Despite nurse involvement in eye care, there is no information describing their engagement, deployment, training, and opinion. This paper offers the first review of nurse engagement in eye care in Australia.Methods: We conducted an e-survey on Australian nurse engagement in eye care. Quantitative questions were analysed by descriptive, chi-square and bivariate correlation coefficients with assumed power of 0.80, and significance of p=0.05. Grounded theory, sentiment and saturation analysis extracted key themes, meaning and opinion from the qualitative questions.Results: There were n=238 Australian nurse participants. Results indicated they were satisfied with their role, engaged in a wide range of healthcare and eye care setting and organisations, and adapted to their employer. Task-shifting “to” and “from” nurses was not universally supported but recognised by participants as necessary. Of concern, the results suggested that 68.6% of our participants would exit eye care over the next ten years, with insufficient entry pathways into the field for graduate and early-career nurses.Conclusion: For Australia to meet and sustain eye care services for its population, steps must be taken to improve exposure and entry to the field for students, graduates, and early-career nurses. Strategies to train and prepare nurses for task-shifting are urgently required and the eye care nursing sector must professionalise to achieve positive change.Keywords: Australia, nurse, eye care, ophthalmology, blindness, workforce

To assess differences in eye care utilization by vision difficulty (VD), diabetes status, and sociodemographic characteristics for American adults. The analysis pooled cross-sectional data from the National Health Interview Survey (2010–2018) from US adults ≥ 18 years. The outcome measure was eye care utilization in the past year. The primary independent variable included four groups: no VD or diabetes, only diabetes, only VD, and diabetes and VD. VD was defined as self-reported difficulty seeing even with glasses or contacts. Diabetic status was defined as ever receiving this diagnosis by a health professional. Multivariable logistic regression analyses examined associations between eye care utilization, VD, diabetic status, and sociodemographic characteristics. Of the 284,599 adults included in this study, the majority were female (55%), White (73%), and non-Hispanic (84%). In regression analysis, as compared to adults without diabetes or VD, adults with both diabetes and VD had the greatest utilization (OR = 2.49, 99% CI = 2.18–2.85). Females had higher utilization than men (OR = 1.45, 99% CI = 1.41–1.50). Higher levels of education was associated with greater utilization (OR = 1.82, 99% CI = 1.72–1.92). White and American Indian adults without diabetes had higher utilization compared to other races (OR = 1.17, 99% CI = 1.12–1.24, 0.98–1.39). While adults with VD and diabetes are better connected to eye care, significant eye care disparities persist for marginalized groups in the U.S. Identifying and understanding these disparities and eliminating barriers to care is critical to better support all patient populations. [ABSTRACT FROM AUTHOR]

Vision screening and regular eye care can help detect and treat potentially irreversible vision impairment. This study aims to investigate the associations between sociodemographic and health characteristics and the receipt of eye care among children aged 17 years and younger in the United States. This cross-sectional study used data from the National Survey of Children's Health (NSCH), a nationally representative and population-based survey of randomly sampled households. Participants were children aged 0 to 17 years, residing in all 50 states and the District of Columbia, whose caregivers or parents answered an address-based survey by mail or online. Weighted prevalence calculations were applied to analyze the data, and logistic regression was performed to explore associations between reported eye care and demographic, health, and parent-related variables. Caregiver-reported vision screenings, referral to an eye doctor after vision screening, eye doctor visits, and prescription of corrective lenses. Caregivers reported that 53.2% of children had a vision screening at least once (if child ≤ 5 years) or within the past 2 years (if child > 5 years). Of those screened, 26.9% were referred to an eye doctor. Overall, 38.6% of all children had a previous eye doctor visit, and among them, 55.4% were prescribed corrective lenses during the visit. Factors associated with decreased odds of vision screening included younger age, lack of health care visits, no insurance coverage, parent education high school or less, and lower household income. Non-White ethnicities, households with a non-English primary language, and lower incomes were more likely to be referred to an eye doctor after vision screening. Lower rates of eye doctor visits were associated with younger age, lack of insurance coverage, and primary household languages other than English. Children from disadvantaged backgrounds are less likely to receive vision screening and eye care. Targeted strategies are needed to increase vision screening and access to eye care services in these vulnerable groups. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]

Background: Primary eye care (PEC) is a vital component of primary health care and is the cornerstone for the progress toward universal eye health coverage. To achieve an adequate delivery of PEC services in Nigeria, it should be inclusive, equitable, cost-effective, and people centered. Aim: The aim of the study was to assess the knowledge and practice of PEC among community primary health workers in Calabar metropolis. Materials and Methods: This was a cross-sectional study conducted in Calabar metropolis. A total of 109 randomly selected community health workers at primary health centres located in two local government areas (Calabar Municipality and Calabar South) were assessed on their knowledge of common ocular diseases and the practice of eye health in their facilities using an interviewer-administered questionnaire. Results: One hundred and nine primary health workers participated in the study. Most participants were females 100 (92%). The mean age was 38 ± 8.26 years. More than half (59%) had been working as community health workers for more than five years and 64% stated they had no professional training on management of ophthalmic conditions. One-third of the participants had Snellen’s visual acuity chart in their facility and 46 (42%) could use it properly to assess vision. Less than one-third 23 (21%) could correctly identify the five common eye conditions presented in a picture chart – conjunctivitis, cataract, corneal opacity, strabismus and pterygium. About 102 (94%) of the participants at the primary health centres had no access to standard operating procedures for managing eye diseases. Conclusion: Our study showed that the majority of the community primary health workers require continuous medical educational training on ophthalmic diseases and the provision of standard operating procedures to guide in the identification and prompt referral of eye diseases.

Background: Primary eye care (PEC) is an important component of comprehensive eye care services that allows communities to enjoy basic high-quality services. However, because of various determinants, communities do not use this service. Aim: This study aimed to explore and describe the experience of adults who used PEC services in the last 6 months. Setting: This study was carried out in four districts in southern Ethiopia from June to September 2023. Methods: An exploratory descriptive qualitative study design was used to understand the experiences of adults 40 years and older who had used PEC services. Six focus group discussions were conducted with a total of 48 participants. A nonprobability purposive sampling technique was used to draw participants. Data were analysed thematically using ATLAS.ti software version 23.2.2. Results: Primary eye care service use experiences of adults 40 years and above were discussed in terms of three emerging themes: the experience of community service use, barriers to service and suggestions to improve service. The study identified poor access to services, service provider-related factors and quality and awareness gaps as barriers to the use of PEC services. Conclusion: Attention to PEC services, integration of eye care with other primary health care services, deployment of service providers, awareness creation and expansion of PEC units are needed to improve PEC service use. Contribution: The findings will guide community-based intervention plans to reduce avoidable blindness and low vision, thus improving quality of life.

IntroductionGlobally, the utilization of eye care services varies widely, ranging from 18 to 90%. Low utilization of eye care services can lead to delayed detection of vision problems. However, there are limited data on the proportion of eye care service utilization and its associated factors in Ethiopia at the community level.ObjectiveThe objective of this study was to determine the proportion of eye care service utilization and its associated factors among adults in Debre Birhan town, North Shewa, Ethiopia.MethodsUsing a multistage sampling method, a community-based cross-sectional study was conducted on 960 adults in Debre Birhan town from 8 May to 8 June 2023. Binary logistic regression was performed. Variables with a p-value of less than 0.05 were considered significant.ResultsA total of 940 study participants participated, resulting in a response rate of 97.9%. The mean age of the participants was 54.67 years (SD ± 8.69). The proportion of good-level eye care service utilization was found to be 32.98% [95% confidence interval (CI): 29.97, 35.99]. Factors positively associated with good-level eye care service utilization included older age [adjusted odds ratio (AOR) = 1.58, 95%CI: 1.00, 2.51], higher educational status (AOR = 2.25, 95%CI: 1.25, 4.06), high family monthly income (AOR = 8.70, 95%CI: 4.99,15.18), awareness of regular eye checkups (AOR = 1.77, 95%CI: 1.15, 2.73), a history of eye disease (AOR = 2.57, 95%CI: 1.77,3.74), health insurance (AOR = 1.99, 95% CI: 1.34, 2.95), and history of spectacle use (AOR = 1.94, 95%CI:1.34, 2.80).ConclusionThe study revealed that the proportion of good-level eye care service utilization was low. Older age, higher educational status, high family monthly income, awareness of regular eye checkups, a history of eye disease, health insurance, and history of spectacle use were significantly associated with a good level of eye care service utilization.

Background: Dental professionals are at high risk for eye injuries and eyestrain due to the nature of their work. Aims: This study aimed to evaluate the knowledge, attitudes, and practices of eye care among dental professionals in Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Methods: A cross-sectional survey was conducted among 102 dental professionals at AKTH. A Simple random sampling technique using the one-time balloting system was used in selecting participants for this study. A self-administered questionnaire was used to collect data on participants' demographics, eye health knowledge, attitudes, and practices. Data collected was analysed using the Statistical Package for Social Sciences version 25 (SPSS version 22). Results: The mean age of participants was 34.0 ± 7.5 years with a sex distribution of 3:2 male to female ratio. The majority were dentists (63.7%). Forty percent of participants use prescribed spectacles. The most common eye conditions reported were myopia (29.3%) and astigmatism (21.9%). Overall, participants had poor knowledge of eyecare. About 45.1% knew that eye check-ups should be done annually, and same proportion had heard of refractive surgery. Professional cadre and spectacles-use were the only demographic factors associated with eye care knowledge. The majority of participants (81.4%) had a positive attitude towards eyecare, but only 10.8% used vision enhancers (ocular loupes and binoculars/magnifiers). The most common reasons for not using vision enhancers were lack of provision by their employers (56%) and non-availability (15.4%). Conclusion: Dental professionals in this study exhibited limited knowledge of eyecare, positive attitude towards eyecare but low utilization of vision enhancers that are important for increased workplace efficiency and safety. It is imperative to ensure that dental professionals adopt best practices to prevent workplace hazards.

Aim: This study explores the diverse factors influencing the eye care adherence of individuals diagnosed with type 2 diabetes mellitus in Shiraz. The lack of effective strategies in Iran to improve eye care behaviors and reduce retinopathy incidence in diabetes patients necessitates this research. The goal is to assess factors that affect this adherence. Method: A cross-sectional survey was conducted in Shiraz, Iran during 2022–2023. This study's primary data collection tool was an exhaustive questionnaire. This was carefully designed to include various sections, each focusing on different aspects relevant to the study's aim. Result: The study found that being female, married, literate, and overweight resulted in more annual ophthalmology visits. Possessing additional insurance and adhering to diabetic controls and care were positively correlated with ophthalmology visits. Less reliance on family income or loans led to better eye care. The shorter duration of diabetes and proximity to a diabetic care unit were crucial factors for improved eye protection. Conclusion: This study offers insights into the various factors affecting eye care utilization patterns among individuals diagnosed with type 2 diabetes mellitus in Shiraz. The study's findings underscore the significance of demographic factors in influencing individuals' engagement in self-care practices and their access to eye care services. Further research is needed to delve into the cultural and sociodemographic determinants underlying these trends, which will aid in developing treatments that cater to the diverse needs of individuals with diabetes.

PurposeTimely diagnosis of diabetic retinopathy is important in preventing vision loss. This study aims to determine if remote retinal imaging enables earlier eye care access among newly-diagnosed diabetic patients.DesignRetrospective cohort study.MethodsUsing the OptumLabs® Data Warehouse - a longitudinal, real-world dataset containing deidentified administrative claims and electronic health record (EHR) data, we included 968 846 adults with newly diagnosed type 2 diabetes and at least 1 year of continuous enrollment. We compared time from initial diabetes diagnosis to first eye exam by remote screening or in-person eye exam.ResultsWe found that at year 1 after diagnosis, 5459 (0.56%) patients underwent remote imaging and 208 023 (21.5%) underwent in-person exam. The mean (95% CI) time to eye exam was 3.48 (3.38-3.58) months for remote imaging and 4.22 (4.20-4.23) months for in-person visits (p

Summary: The prevalence of type 2 diabetes (T2D), associated systemic disorders, diabetic retinopathy (DR) and current health policies in south Asian countries were analysed to assess country-specific preparedness to meet the 2030 Sustainable Development Goals. The south Asian countries were classified by human development index, socio-demographic index, multidimensional poverty indices, and eye health resources for epidemiological resource-level analysis. In south Asia, the prevalence of diagnosed and undiagnosed T2D in adults aged 40 years or above, was higher in Pakistan (26.3%) and Afghanistan (71.4%), respectively; India has the highest absolute number of people with DR, and Afghanistan has the highest prevalence of DR (50.6%). In this region, out-of-pocket spending is high (∼77%). This Health Policy is a situational analysis of data available on the prevalence of DR and common eye diseases in people with T2D in south Asia and available resources to suggest tailored health policies to local needs. The common issues in the region are insufficient human resources for eye health, unequal distribution of available workforce, and inadequate infrastructure. Addressing these challenges of individuals with T2D and DR, a 10-point strategy is suggested to improve infrastructure, augment human resources, reduce out-of-pocket spending, employ targeted screening, and encourage public-private partnerships.

Purpose: To explore the barriers to the uptake of eye care services in urban and rural communities in Papua New Guinea. Methods: This was a population-based cross-sectional descriptive study and involved multi-stage sampling. Communities were randomly selected from each of the three clusters of Madang District for free eye care outreaches from June to September 2022. A structured questionnaire was used to collect data from the outreach patients. The study excluded attendees who refused to consent. Responses were rated from 1 (not a barrier) to 10 (a very strong barrier). The p-value significance was set at ≤ 0.05. Results: The majority of the 972 participants (60.2%) were from rural communities. The mean age of participants was 40.82 ± 13.14 years. Almost two-thirds of the participants (61.4%) never had an eye examination before this study was conducted. All the participants reported that time constraint, insufficient income, good vision in the fellow eye, not considering their eye conditions as serious issues and cultural beliefs were personal barriers to accessing eye care services. Provider-related challenges included long waiting periods at eye clinics and fear of procedure complications. There were differences in barriers with respect to the participants' demographic clusters. Conclusion: There are major personal- and service-related barriers to eye care services in Madang. These barriers could be overcome through strategic human resource development, health education, school screening programs, and establishing eye care centres in the communities to improve the uptake of eye care services in Madang and more widely across the country. [ABSTRACT FROM AUTHOR]

Nicolas Blais,1,* Benoit Tousignant,1,2,* Jean-Marie Hanssens1,* 1School of Optometry, Université de Montréal, Montréal, Québec, Canada; 2Department of Social and Preventive Medicine School of Public Health, Université de Montréal, Montréal, Québec, Canada*These authors contributed equally to this workCorrespondence: Nicolas Blais, School of Optometry, Université de Montréal, Montréal, Québec, Canada, Tel +1-418-215-2741, Email nicolas.blais.1@umontreal.caIntroduction: Proper access to primary eye care is essential in addressing vision impairment, and tele-eye care examinations are a promising solution that could facilitate this access in many rural or remote areas. Even though remote eye exams are becoming increasingly frequent, comprehensive tele-eye care exams are still limited by the lack of published data. The aim of this study is to compare a comprehensive tele-eye care exam with a gold standard in-person primary eye care exam with an emphasis on refractive measurements, ocular health assessment, confidence level of the eye care providers and patient satisfaction.Methods: Sixty-six participants underwent two comprehensive eye exams performed by two eye care providers. One was a gold standard in-person exam, while the other was a remote exam performed by an eye care provider through videoconference. An overall patient satisfaction survey and a questionnaire for visual comfort with a trial frame from each modality were completed and the eye care providers scored their confidence level for each test. Exam results and diagnoses were compared between both modalities.Results: Tele-refraction has a good to excellent agreement with in-person subjective refraction in terms of sphero-cylindrical power and best corrected visual acuity. There was no statistically significant difference for visual comfort between both modalities. The agreement between in-person and remote exams for ocular health assessment ranged from fair to almost perfect, but there was a low prevalence of ocular pathologies within the study sample. The confidence level of the eye care providers and patient satisfaction were statistically higher in-person.Conclusion: Tele-eye care appears to be statistically and clinically non-inferior to in-person eye exams, especially for refraction, but the low prevalence of ocular pathologies somewhat limits the comparison of its efficacy for ocular health assessment. More studies on comprehensive tele-eye care exams are needed.Keywords: primary eye care, tele-eye care, tele-ophthalmology, tele-optometry, tele-refraction

Abstract Background Eye examinations and eyeglasses acquisition are typically integrated into a cohesive procedure in China. We conducted a randomized controlled trial using incognito standardized patient (SP) approach to evaluate the impact of separating eyeglasses sales on the accuracy of final prescription. Methods 52 SPs were trained to provide standardized responses during eye examinations, and undergoing refraction by a senior ophthalmologist at a national-level clinical center. SPs subsequently received eye examinations at 226 private optical shops and public hospitals in Shaanxi, northwestern China. The visits were randomly assigned to either control group, where SPs would typically purchase eyeglasses after refraction, or treatment group, where SPs made an advance declaration not to purchase eyeglasses prior to refraction. The dioptric difference between the final prescriptions provided by local refractionists and expert in the better-seeing eye was determined using the Vector Diopteric Distance method, and the completeness of exams was assessed against national standards. Multiple regressions were conducted to estimate the impact of no eyeglasses sales on the accuracy of the final prescription of local refractionists, as well as the completeness of examinations. Results Among 226 eye exams (73 in public hospitals, 153 in private optical shops), 133 (58.8%) were randomized to control group and 93 (41.2%) to no eyeglasses sales group. The inaccuracy rate of final prescriptions provided by local refractionists (≥ 1.0 D, experts’ final prescription as the reference) was 25.6% in control group, while 36.6% in no-sale group (P = 0.077). The likelihood of providing inaccurate final prescriptions was significantly higher in no-sale group compared to control group (OR = 1.607; 95% CI: 1.030 to 2.508; P = 0.037). This was particularly evident in private optical shops (OR = 2.433; 95% CI: 1.386 to 4.309; P = 0.002). In terms of process quality, the no-sale group performed significantly less subjective refraction (OR = 0.488; 95% CI: 0.253 to 0.940; P = 0.032) and less testing SP’s own eyeglasses (OR = 0.424; 95% CI: 0.201 to 0.897; P = 0.025). The duration of eye exams was 3.917 min shorter (95% CI: -6.798 to -1.036; P = 0.008) in no-sale group. Conclusions Separating eyeglasses sales from optical care could lead to worse quality of eye care. Policy makers should carefully consider the role of economic incentives in healthcare reform.

Purpose: To report the seroprevalence of bloodborne viral infection (BBVI) in patients undergoing ophthalmic surgeries and assess the utility and feasibility of preoperative screening for BBVI in India's current eye care system. Methods: This retrospective, hospital-based, descriptive study included data from patients undergoing preoperative screening for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) at a tertiary eye care institute from 2018 to 2022. Rapid diagnostic tests (RDTs) were performed on the blood samples after obtaining informed consent from the patients. Seroreactive patients underwent surgery with additional safety precautions. The demographic data and surgical details of these patients were collected and analyzed. ANOVA was used to carry out statistical analysis between groups. During the study period, the number of healthcare workers (HCWs) sustaining needle stick injury (NSI) and accidental sharp injury (ASI) in the operating theater (OT) and details of these injuries were recorded. Results: Samples from 28,563 patients were included. The seroprevalence of BBVI was 1.87% (536/28563). Hepatitis B virus (322, 60.1%) was the most commonly detected infection, and HIV (59, 11%) was the least detected infection. The mean age of the seroreactive patients was 60.3 ± 30.8 years. The incidence of NSI was 0.49/1000 surgeries. Nurses (11) and technicians (4) in the OT sustained maximum NSI. None of the HCWs had seroconversion after NSI. Conclusion: The overall seroprevalence of BBVI in the current study is lower than that reported in previously published studies from eye care organizations. Currently, mandatory preoperative screening for BBVI to prevent transmission of these infections to HCWs working in the eye care sector in India appears to be less cost-effective. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to examine the factors associated with vision impairment (VI), age-related eye disease (ARED), and frequency of eye examinations among older adults. Methods: A cross-sectional study (N = 166) was designed to identify barriers in vision and eye care services among adults 50 years and older in four counties in Appalachian Tennessee. Surveys were administered in March 2023. Simple and multiple logistic regression analyses were used to determine the risk factors of VI and ARED and the frequency of eye examinations. Results: In two out of the three regression models, predictors such as traveling ≥10 mi to an eye care provider, barriers to eye care, and a lack of exposure to eye health information emerged as significant factors. Individuals who traveled ≥10 mi to an eye care provider were more than twice as likely than individuals who traveled shorter distances to have VI and not maintain routine eye care (adjusted odds ratio [AOR] 2.69, 95% confidence interval [CI] 1.08-6.75; AOR 2.82, 95% CI 1.05-7.55, respectively). Reporting barriers to eye care doubled the odds of ARED (AOR 2.33, 95% CI 1.02-5.34) and substantially increased the odds of reporting a 3-year or longer interval since the last eye examination (AOR 7.45, 95% CI 1.85-29.96) compared with having no barriers to eye care. Moreover, limited exposure to eye health information tripled the odds of VI (AOR 3.26, 95% CI 1.15-9.24) and not maintaining routine eye care (AOR 3.07, 95% CI 0.97-9.70) compared with more exposure to eye health information. Other predictors also were uncovered in the analysis. Conclusions: This study contributes to the scarce literature on risk factors associated with vision health among older adults in Appalachia. [ABSTRACT FROM AUTHOR]

Purpose: The World Report on Vision highlights that health information systems (HIS) should collect information on the determinants of eye conditions and vision impairment (VI) as a step toward integrated people-centered eye care (IPEC). Thus, this retrospective study aims to elucidate VI trends across age and gender of the patients who visited our centres in southern and eastern India. Methods: Electronic medical records of all new patients who visited the network were included. VI was defined as visual acuity less than 6/12; unilateral VI was based on the worse presenting eye (the other eye being normal), and bilateral VI was based on the better eye. “Total VI” includes both unilateral and bilateral VI. Results: The records of 7,31,307 patients from January to December 2019 were extracted. Males were 54%. The mean age was 40 years (SD: 19.16 years). The majority of patients (46.54%) visited a primary care centre. Centres in Andhra Pradesh saw the largest number of patients (46%). Approximately 65% of all patients presented had no VI in either eye. Total VI was 23.5% at the primary-centre level and approximately 45% at other levels, the highest being in Odisha. More females accessed care at primary and secondary centres (46.6%) than at higher levels of care (44%). Odisha had the lowest number of females accessing care (43.01%). Conclusion: Non-visually impairing conditions form an important reason for patients visiting our eye care facilities. Strategies focusing on improving access to eye care for females should be planned at all levels, especially in Odisha.

Background: To improve access to appropriate eye health care services within the community health structures in Ghana, pre- and post-intervention studies were carried out to explore the feasibility of integrating primary eye health into the community health planning services programme. Aim: To explore the feasibility, accessibility and acceptability of integrating primary eye health care into community health planning services. Setting: The study was carried out in the Northern, Western and Eastern regions of Ghana. Methods: A pre- and post-intervention multi-stage cluster randomised design based on two separate cross-sectional surveys with both quantitative and qualitative research techniques were used. The magnitude of change in the dependent variables for the intervention group was compared with those for the comparison group at baseline and endline using a difference-in-difference analysis. Results: The intervention communities were more likely to visit a community health facility with their eye problems. Improved access to eye care medicines reduced the use of herbal preparations to treat eye disease. Conclusion: Integrating primary eye care (PEC) into community health planning service (CHPS) was associated with greater utilisation of community health facilities for eye health care services. Contribution: The results of this study should facilitate the implementation of the vision for everyone integrated into universal health coverage.

Abstract Visual impairment and blindness pose a significant and growing public health threat in Nigeria. Over 1.6 million Nigerians are visually impaired or blind, with more than 80% of these cases being preventable and treatable. The risk for ocular morbidities is expected to increase due to rapid population growth, an aging population, and the rising burden of noncommunicable diseases. Despite efforts to improve eye health services, universal eye health remains elusive, with 35% of Nigerians unable to access eye care in primary healthcare (PHC) facilities. Many Nigerians instead turn to traditional and alternative medicine for primary eye care (PEC), which can worsen their outcomes. This article highlights the potential of the country's PHC system to address these challenges, emphasizing the importance of PEC as an integral part of PHC. The article discusses the various challenges faced by PHC workers in delivering eye care services in Nigeria, focusing on financing, training, leadership, and policies for eye care. It also provides a set of comprehensive recommendations aimed at overcoming these challenges, including improved leadership and policy implementation, optimized financing, strengthened collaborations and partnerships, enhanced education and training, and effective human resource management systems. We emphasize the importance of holistic and strategic efforts to bolster the PHC workforce's capacity to provide universal eye healthcare in Nigeria, ultimately improving access to high‐quality eye care services for all.

Introduction: 'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international agency for the prevention of blindness, was launched in 1999, however, the initiative faces many challenges to hitting its target. One of the challenges for this is, the absence of comprehensive data regarding eye care service utilization among diabetes mellitus patients in Africa. Therefore, this study was aimed at assessing the prevalence of eye care service utilization and associated factors among adult diabetes mellitus patients in Africa. Methods: This systematic review and meta-analysis was conducted as per the international preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Published articles were searched using reputable databases (PubMed, Cochrane Library) and Web searches (Science Direct, African Journals Online, and Google Scholar). Quality appraisal was assessed based on the Joanna Briggs Institute's (JBI) critical appraisal checklist. The extracted data was exported to STATA version 11 (STATA Corp., LLC) for further analysis. Heterogeneity between the results of primary studies was assessed using Cochran's Q chi-square test and quantified with the I2 statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression tests. Results: The database search found 26,966 articles. The pooled prevalence of eye care service utilization among diabetic patients in Africa is found to be 40.92 % (95 % CI: 27.14–54.70, P

Background: The World Health Organization (WHO) introduced the Eye Care Competency Framework (ECCF) as a guideline to ensure proper delivery of eye care in healthcare systems. Improving the eye healthcare system in Saudi Arabia is essential to prevent or limit the high rate of ocular morbidity. This may be achieved by enabling optometrists to function as primary eye care providers within the primary eye healthcare system in line with WHO’s framework. Aim: This study aimed to engage experts in eye healthcare services to explore the possibilities of adopting the WHO’s ECCF in Saudi Arabia’s healthcare system. Setting: A 2-round Delphi study was conducted by enrolling 19 experts with great knowledge and experience in ocular health from different institutes across Saudi Arabia. Methods: The experts’ opinions were collected using a 5-point Likert scale during both rounds to determine their opinions regarding the clinical skills of optometrists in Saudi Arabia. Statements reaching a consensus of ≥ 80% were adopted and considered applicable. Results: The statements were classified into six domains: practice, professionalism, learning and development, management and leadership, community and advocacy, and evidence. All statements were deemed suitable to be adopted and applied to the healthcare system in Saudi Arabia. Conclusion: This study established the applicability of the ECCF as a universal model and guideline to enable optometrists to function as primary eye care providers. Contribution: This model can be applied to improve the primary eye healthcare system in other countries.

Jan Patrick Opulencia Chu,1 Mark Joseph O Lagao2 1Chu Eye Care Center, Tarlac, Philippines; 2Department of Ophthalmology, Good Samaritan Medical Center, Cabanatuan, Nueva Ecija, PhilippinesCorrespondence: Jan Patrick Opulencia Chu, Email janpatrickchu@gmail.comObjective: This study aimed to determine the demography, incidence of surgical complications, and visual outcomes of cataract surgeries at a rural eye care facility in Tarlac, Philippines.Methods: This is a 1-year retrospective case study of the visual outcomes of cataract surgeries in a rural eye care facility in Tarlac, Philippines. Comparative statistics such as t-test for means and Z-test for proportions were used to determine differences between bi-variate groups.Results: During the 1-year period, 340 eyes underwent cataract surgery. Fifty-nine patients were < 60 years of age, whereas 235 patients were > 60 years old. There were 142 males and 152 females. Preoperative visual acuity (VA) appears to be skewed towards poor vision (< 20/200). Two hundred sixteen eyes had VA < 20/200, while the number of eyes with fair (< 20/60 - 20/200) and good (20/20 - 20/60) vision were 95 and 29, respectively. Preoperative and postoperative VA were categorized as good, fair and poor based on the definition stated by the WHO. There are significant differences (p < 0.0001) between the preoperative and postoperative VA in all categories. The number of eyes with good VA increased from 29 to 320, whereas the frequency of fair and poor VA decreased from 95 and 216 to 8 and 12, respectively.Conclusion: The eye care facility achieved the WHO recommendation for adequate visual outcomes of > 80% of good visual outcome. Contrary to other studies, old age does not necessarily equate to poor outcomes in this study. However, pre-existing ocular illnesses and surgical complications do contribute to poor outcomes. It is still possible to gain a good outcome if the pre-existing ocular comorbidity is still on the early stages. In cases of posterior capsular rupture, good outcomes are also achievable if the surgeon is skilled enough to handle such situations.Keywords: cataract, outcomes, complications, rural, Philippines

Context: Various systems are available to stage glaucomatous field defects into different severity grades. Still, the preference for such systems among Indian eye care practitioners (ECPs) and the consensus between them are not explored. Purpose: To compare the clinical performance of perimetric glaucoma staging systems and to assess their preference patterns among Indian ECPs. Setting and Design: Retro-prospective cross-sectional study. Methods: Three investigators stratified 400 perimetry reports using four systems: Hodapp Anderson Parrish (HAP), enhanced Glaucoma Severity Staging (eGSS), Advanced Glaucoma Intervention Study (AGIS), and Collaborative Initial Glaucoma Treatment Study (CIGTS). Their performance was compared in terms of agreement and association. Following this, 30 ECPs from across the country segregated a subset of reports (n = 20) into different stages based on their system of choice, and their preferences/perceptions about the available perimetry staging systems were enquired and documented. Statistical Analysis Used: Descriptive statistics, Kruskal–Wallis, Cohen's kappa, and Spearman's correlation. Results: For the consolidated severity stages, substantial agreements (K ranging from 0.61 to 0.75) were found between all the systems, except for HAP–CIGTS (K = 0.58) and AGIS–CIGTS (K = 0.51). All ECPs were aware of perimetry staging systems, and a high preference was reported for HAP (97%) due to ease of implementation and interpretation. Conclusion: Among the four staging systems, the highest agreement was found between HAP and eGSS. A majority of ECPs proposed the need for a uniform classification system across the practices for clinical comparisons and patient education. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions This study aimed to determine adherence with follow‐up from the New Zealand pre‐school vision screening programme. The study also examined associations between pre‐school vision screening outcomes and cognitive measures assessed at the 54‐month follow‐up in the Growing Up in New Zealand study cohort.A cross‐sectional retrospective record review of pre‐school vision screening outcomes and hospital ophthalmology records with linkage to Growing Up in New Zealand cohort study data.Of 176 children referred from vision screening, 21.6% did not attend a referral appointment. Of 138 children who attended a referral appointment, 21.0% did not attend one or more follow‐up appointments. Ethnic differences were observed in attendance at referral appointments (attended Māori 13%, Pacific 22.5%, European/Other 64.5%; not attended Māori 26.3%, Pacific 28.9%, European/Other 44.7%; P = 0.04) and follow‐up appointments (attended Māori 11.9%, Pacific 15.6%, European/Other 72.5%; not attended Māori 17.2%, Pacific 48.3%, European/Other 34.5%; P = 0.001). Vision screening outcome was significantly associated with letter naming fluency scores (P = 0.01) but not name and numbers scores (P = 0.05).Non‐attendance at referral and follow‐up appointments limits the efficacy of vision screening, particularly for children of Māori and Pacific ethnicity. Children referred from vision screening achieve lower scores on letter naming fluency, a key predictor of reading ability in later childhood. Equity‐based improvements are required to ensure that all children referred from vision screening receive appropriate follow‐up eye care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess self-reported awareness of diabetic retinopathy (DR) and concordance of eye examination follow-up compared with findings from concurrent retinal images. RESEARCH DESIGN AND METHODS: We conducted a prospective observational 10-year study of 26,876 consecutive patients with diabetes who underwent retinal imaging during an endocrinology visit. Awareness and concordance were evaluated using questionnaires and retinal imaging. RESULTS: Awareness information and gradable images were available in 25,360 patients (94.3%). Severity of DR by imaging was as follows: no DR (n = 14,317; 56.5%), mild DR (n = 6,805; 26.8%), or vision-threatening DR (vtDR; n = 4,238; 16.7%). In the no, mild, and vtDR groups, 96.7%, 88.5%, and 54.9% of patients, respectively, reported being unaware of any prior DR. When DR was present, reporting no prior DR was associated with shorter diabetes duration, milder DR, last eye examination >1 year before, no dilation, no scheduled appointment, and less specialized provider (all P < 0.001). Among patients with vtDR, 41.2%, 58.1%, and 64.2% did not report being aware of any DR and follow-up was concordant with current DR severity in 66.7%, 41.3%, and 25.4% (P < 0.001) of patients when prior examination was performed by a retinal specialist, nonretinal ophthalmologist, or optometrist (P < 0.001), respectively. CONCLUSIONS: Substantial discrepancies exist between DR presence, patient awareness, and concordance of follow-up across all DR severity levels. These discrepancies are present across all eye care provider types, with the magnitude influenced by provider type. Therefore, patient self-report should not be relied upon to reflect DR status. Modification of medical care and education models may be necessary to enhance retention of ophthalmic knowledge in patients with diabetes and ensure accurate communication between all health care providers. [ABSTRACT FROM AUTHOR]

When thinking about major health concerns in the U.S. and around the world, eye care ranks lower compared to cardiovascular disease, cancer, and diabetes. However, people do not think about the direct connection between diabetes and eye health. Untreated diabetes can lead to visual impairments such as blindness or difficulty seeing. Studies have found that eye health associated with nutrition, occupational exposure, diabetes, high blood pressure, and heart disease are some of the known risk factors. This study aimed to identify the potential risk factors that are associated with visual impairment (VI). The data used for this analysis were obtained from the Centers for Disease Control and Prevention (CDC) - Behavioral Risk Factor Surveillance System (BRFSS) from 2018 to 2021. We found important characteristics, such as the U.S. region, general health perception, employment status, income status, age, and health insurance source, that are associated with VI. Our study confirmed that the common demographical factors including age, race/ethnicity, the U.S. region, and gender are associated with VI. The study also highlights associations with additional risk factors such as health insurance source, general health perceptions, employment status, and income status. Using this information, we can reach out to communities with large numbers of individuals experiencing vision challenges and help educate them on prevention and treatment protocols, thereby effectively addressing VI and blindness challenges within our communities, neighborhoods, and finally, the broader society.

Abstract Background The elderly comprises the fastest‐expanding age group globally, with the greatest increase occurring in developing countries. The elderly populace is prone to develop various ocular morbidities. Purpose To determine the distribution of ocular morbidities among the elderly population visiting a private eye care facility in Malawi. Methods This was a retrospective cross‐sectional study conducted at St. John's Hospital in Mzuzu, Malawi. We retrieved data from the hospital's ophthalmic outpatient registry from January, 2021 to December, 2021. A nonprobability census sampling technique was used to retrieve 52 elderly patients. Data analysis were done employing SPSS (v.26). Results This study found according to gender a larger proportion were females 27 (51.9%) compared males, who accounted for 25 (48.1%). Refractive error 21 (40.4%) was the most prevalent ocular morbidity followed by cataract 13 (25.0%), pinguecula 6 (11.5%), and glaucoma 4 (7.7%). Although clear differences exist in the distribution of ocular morbidities according to sex (p = 0.529) and age (p = 0.328), the differences are not statistically significant. Conclusion The pattern of eye diseases is typical to the country. More resources should be targeting main causes of preventable blindness including refractive error and cataracts at the facility.

Purpose: To report the seroprevalence of bloodborne viral infection (BBVI) in patients undergoing ophthalmic surgeries and assess the utility and feasibility of preoperative screening for BBVI in India's current eye care system. Methods: This retrospective, hospital-based, descriptive study included data from patients undergoing preoperative screening for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and human immunodeficiency virus (HIV) at a tertiary eye care institute from 2018 to 2022. Rapid diagnostic tests (RDTs) were performed on the blood samples after obtaining informed consent from the patients. Seroreactive patients underwent surgery with additional safety precautions. The demographic data and surgical details of these patients were collected and analyzed. ANOVA was used to carry out statistical analysis between groups. During the study period, the number of healthcare workers (HCWs) sustaining needle stick injury (NSI) and accidental sharp injury (ASI) in the operating theater (OT) and details of these injuries were recorded. Results: Samples from 28,563 patients were included. The seroprevalence of BBVI was 1.87% (536/28563). Hepatitis B virus (322, 60.1%) was the most commonly detected infection, and HIV (59, 11%) was the least detected infection. The mean age of the seroreactive patients was 60.3 ± 30.8 years. The incidence of NSI was 0.49/1000 surgeries. Nurses (11) and technicians (4) in the OT sustained maximum NSI. None of the HCWs had seroconversion after NSI. Conclusion: The overall seroprevalence of BBVI in the current study is lower than that reported in previously published studies from eye care organizations. Currently, mandatory preoperative screening for BBVI to prevent transmission of these infections to HCWs working in the eye care sector in India appears to be less cost-effective.

Purpose: The World Report on Vision highlights that health information systems (HIS) should collect information on the determinants of eye conditions and vision impairment (VI) as a step toward integrated people-centered eye care (IPEC). Thus, this retrospective study aims to elucidate VI trends across age and gender of the patients who visited our centres in southern and eastern India. Methods: Electronic medical records of all new patients who visited the network were included. VI was defined as visual acuity less than 6/12; unilateral VI was based on the worse presenting eye (the other eye being normal), and bilateral VI was based on the better eye. "Total VI" includes both unilateral and bilateral VI. Results: The records of 7,31,307 patients from January to December 2019 were extracted. Males were 54%. The mean age was 40 years (SD: 19.16 years). The majority of patients (46.54%) visited a primary care centre. Centres in Andhra Pradesh saw the largest number of patients (46%). Approximately 65% of all patients presented had no VI in either eye. Total VI was 23.5% at the primary-centre level and approximately 45% at other levels, the highest being in Odisha. More females accessed care at primary and secondary centres (46.6%) than at higher levels of care (44%). Odisha had the lowest number of females accessing care (43.01%). Conclusion: Non-visually impairing conditions form an important reason for patients visiting our eye care facilities. Strategies focusing on improving access to eye care for females should be planned at all levels, especially in Odisha. [ABSTRACT FROM AUTHOR]

Significant disparities in vision health and eye care exist. To achieve health equity, we must understand the root causes and drivers of health disparities and inequities, including social determinants of health and systemic racism.

To assess changes in vision care availability at Federally Qualified Health Centers (FQHCs) between 2017 and 2021 and whether neighborhood-level demographic social risk factors (SRFs) associated with eye care services provided by FQHCs. Secondary data analysis of the Health Resources and Services Administration (HRSA) data and 2017–2021 American Community Survey (ACS). Federally Qualified Health Centers. Patient and neighborhood characteristics for SRFs were summarized. Differences in FQHCs providing and not providing vision care were compared via Wilcoxon-Mann–Whitney tests for continuous measures and chi-square tests for categorical measures. Logistic regression models were used to test the associations between neighborhood measures and FQHCs providing vision care, adjusted for patient characteristics. Odds ratios (ORs) with 95% confidence intervals (CIs) for neighborhood-level predictors of FQHCs providing vision care services. Overall, 28.5% of FQHCs (n = 375/1318) provided vision care in 2017 versus 32% (n = 435/1362) in 2021 with some increases and decreases in both the number of FQHCs and those with and without vision services. Only 2.6% of people who accessed FQHC services received eye care in 2021. Among the 435 FQHCs that provided vision care in 2021, 27.1% (n = 118) had added vision services between 2017 and 2021, 71.5% (n = 311) had been offering vision services since at least 2017, and 1.4% (n = 6) were newly established. FQHCs providing vision care in 2021 were more likely to be in neighborhoods with a higher percentage of Hispanic/Latino individuals (OR, 1.08, 95% CI, 1.02–1.14, P = 0.0094), Medicaid-insured individuals (OR, 1.08, 95% CI, 1.02–1.14, P = 0.0120), and no car households (OR, 1.07, 95% CI, 1.01–1.13, P = 0.0142). However, FQHCs with vision care, compared to FQHCs without vision care, served a lower percentage of Hispanic/Latino individuals (27.2% vs. 33.9%, P = 0.0007), Medicaid-insured patients (42.8% vs. 46.8%, P < 0.0001), and patients living at or below 100% of the federal poverty line (61.3% vs. 66.3%, P < 0.0001). Vision care services are available at a few FQHCs, localized to a few states. Expanding eye care access at FQHCs would meet patients where they seek care to mitigate vision loss to underserved communities. Proprietary or commercial disclosure may be found after the references. [ABSTRACT FROM AUTHOR]