2017 National Optometry Workforce Survey.

SIGNIFICANCE: Planning for the effective delivery of eye care, on all levels, depends on an accurate and detailed knowledge of the optometric workforce and an understanding of demographic/behavioral trends to meet future needs of the public. PURPOSE: The purposes of this study were to assess the current and future supply of doctors of optometry and to examine in-depth trends related to (1) demographic shifts, (2) sex-based differences, (3) differences in practice behaviors in between self-employed and employed optometrists, and (4) the concept of additional capacity within the profession. METHODS: The 2017 National Optometry Workforce Survey (31 items) was distributed to 4050 optometrists, randomly sampled from a population of 45,033 currently licensed and practicing optometrists listed in the American Optometric Association's Optometry Master Data File. A stratified sampling method was applied to the population of optometrists using primary license state, age, and sex as variables to ensure a representative sample. RESULTS: With a response rate of 29% (1158 responses), the sample ensured a 95% confidence interval with a margin of error of <5%. Key results include finding no significant differences between men and women for hours worked (38.9 vs. 37.5), productivity (patient visits per hour, 2.0 vs. 1.9), or career options/professional growth satisfaction with 65% for both. The data indicate a likely range of additional patient capacity of 2.29 to 2.57 patients per week (5.05 to 5.65 million annually profession-wide). CONCLUSIONS: The optometric workforce for the next decade is projected to grow 0.6 to 0.7% more annually than the U.S. population. The study found additional capacity for the profession more limited than previously suggested. Findings also illustrate an evolving/equitable workforce based on sex, in terms of both productivity and satisfaction. The trend toward employed versus self-employed was marked with 44% reporting they are employed, up from 29% in 2012.

Driver contrast sensitivity and reaction times as measured through a salt-covered windshield.

BACKGROUND: The objective of this study was to use contrast sensitivity measurements to determine the effect of windshield salt film on driver vision. This effect simulates road salt spray that dries in place on a vehicle windshield during winter driving conditions. METHODS: Ten emmetropic subjects were tested to assess contrast sensitivity functions through windshields that were clear compared with the same stimuli as viewed through windshields coated with salt film. Achromatic stimuli were generated by a VisionWorks system and were presented at 4 spatial frequencies (0.5, 3, 10, and 20 cycles per degree). RESULTS: A significant reduction in contrast sensitivity through the salt film was found at all spatial frequencies. In addition, reaction time to detect the stimuli was also found to be increased significantly at 2 of the 4 spatial frequencies through the saline-covered windshield. CONCLUSION: The results of this study indicate that windshield salt film reduces the ability to detect high and low contrast objects in a simulated driving environment as well as increases the subjects' reaction times.

Use of clinical practice guidelines by executive directors of optometric associations.

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.

Prevalence of ametropia in Ugandan soldiers.

A U.S. Army Optometry team was dispatched as part of the Africa Crisis Initiative to Uganda to provide vision care to a battalion-size task force of the Ugandan Army. Their mission was to ensure vision readiness of the unit and to promote humanitarian good will. Of the 692 soldiers refracted, 117 required spectacle correction to be vision ready. One hundred one records were available to be examined. The distribution of ametropia among this population is consistent with other studies of Third World countries.

Accuracy of pharmaceutical tracking data with regard to optometrists' prescribing.

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.

Optometric support to Pacific Angel--Nepal 2012.

In September 2012, Pacific Angel (PACANGEL)--Nepal 2012 was conducted in Kaski District, Nepal. Health services were provided in optometry, family medicine, pediatrics, physical therapy, midwifery, dentistry, and pharmacy. This report is on optometric care provided. 995 patients were examined. Mean age was 41.34 (median 43). Mean entering distance visual acuity was 20/57 in the right eye, 20/60 in the left. Mean spherical error was +0.08D in the right eye, +0.09D in the left. For those patients with astigmatism, mean cylindrical error was -0.74D in the right eye, -0.54D in the left. A near addition was prescribed for 51.8% of the patients. Cataract was diagnosed in 24.17% of the patients. Other prevalent nonrefractive diagnoses were dry eye (18.17%), conjunctivitis (12.0%), and pterygium (5.17%). Eye and vision care is lacking in Nepal. Sporadic episodes of care have considerable impact on those patients receiving treatment. However, to substantially treat the greatest worldwide cause of visual impairment, local sustainable resources are imperative. Provision of care by local, linguistically competent practitioners would better suit the needs of those in need of care. Those involved in humanitarian missions could be a significant source of training such caregivers.