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JAMA Ophthalmology Dec 2022In order to continue to clarify and maintain their role as eye physicians and surgeons, ophthalmologists may want to understand how they are viewed in the public eye and...
IMPORTANCE
In order to continue to clarify and maintain their role as eye physicians and surgeons, ophthalmologists may want to understand how they are viewed in the public eye and online.
OBJECTIVE
To determine the representation of ophthalmologists (OMD) and optometrists (ODs) when a Google search for "eye doctor near me" is made from each county in the US.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cross-sectional study used publicly available data on OMDs and ODs and a Google search application programming interface (API) to search the phrase "eye doctor near me" from the geographic coordinates of each county centroid in the US (searched June 30, 2021). The top 10 sites and 3 Google map links, excluding physician ratings sites, were recorded. Data from the US Centers for Medicare and Medicaid Services were used to estimate the real number of OMDs and ODs per county.
MAIN OUTCOME AND MEASURES
The primary outcome was the mean proportion of OMDs listed by Google search as compared with the real proportion of OMDs for the US overall and for each state and county.
RESULTS
A total of 2955 counties from 52 states and territories were included. The overall mean proportion of OMDs (OMDs with ODs) from the Google search of all counties was 4726.97 of 16 345.93 (28.91%), which was also less than the real proportion of ODs (15 778 of 41 975 [37.58%], a difference of 8.67%; 95% CI, 37.13-38.05%; P < .001). OMDs were underrepresented by Google in 35 of 52 states and territories (67.3%).
CONCLUSIONS AND RELEVANCE
In most counties in the US, Google search of the phrase "eye doctor near me" may underrepresent ophthalmologists. Ophthalmologists may want to pursue search engine optimization to try to achieve balanced representation online.
Topics: Aged; United States; Humans; Cross-Sectional Studies; Search Engine; Medicare; Optometrists; Ophthalmologists; Vision Disorders
PubMed: 36264555
DOI: 10.1001/jamaophthalmol.2022.4343 -
Cureus Apr 2024Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels. Over time, it can lead to serious complications in the eyes, heart,...
BACKGROUND
Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels. Over time, it can lead to serious complications in the eyes, heart, blood vessels, kidneys, and nerves, being the leading cause of blindness among working-age patients.
AIM AND METHODS
This descriptive observational cross-sectional study aims to evaluate the factors affecting the awareness of the general adult diabetic population about their chronic disease and its complications. A survey was distributed anonymously among diabetic patients in different parts of Jordan over four months (January 2023-April 2023), targeting diabetic patients (DMT2 or adults DMT1). The link was sent via WhatsApp to willing candidates. Data collected included age, sex, region, education, home blood sugar (BS) testing, knowledge about cumulative blood sugar test (HbA1c), eye affection by DM, optician role, and doctor and nutritionist follow-up visits. A chi-squared test or Fisher's exact test explored the association between categorical data; a z-test was applied for column proportion differences. An alpha level of 0.05 was deemed statistically significant. IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York) was used for data analysis.
RESULTS
The sample comprised 447 diabetic adults aged 18-80 years. The majority were school-educated or school leavers (278; 62.2%); 20 (4.5%) held a master's or PhD degree. The largest group had DM for one to five years. Insulin was the sole treatment for 188 patients (42.1%), while oral hypoglycemic agents (OHA) were used by 170 patients (38%) as the only anti-DM medication. A total of 174 patients (38.9%) had never been seen by an ophthalmologist, and 153 (34.2%) believed an optometrist checkup suffices. Although 381 (85.2%) reported knowing DM affects the eyes, 272 (60.9%) believed they needed to see an ophthalmologist only when experiencing eye symptoms. Less than half (186; 41.6%) had an HbA1c reading of 7% or less. There was a significant correlation between education level and awareness of DM and diabetic retinopathy (DR): HbA1c, regular home BS checkups, early DR symptoms, and optometrist visits. Significant variations in awareness were noted across Jordan's major areas. Diabetics with abnormal HbA1c who visited a nutritionist were almost triple those who did not. The main information source about DM and DR was the treating physician for 298 (66.7%) respondents.
CONCLUSION
Awareness of DM and DR in Jordan is not satisfactory for assisting patients in their long journey with minimal complications. A national awareness campaign utilizing social media and a sustainable screening program prioritizing the north, south, and middle regions of Jordan are needed.
PubMed: 38800213
DOI: 10.7759/cureus.59020 -
Journal of Optometry 2022The application of artificial intelligence (AI) in diagnosing and managing ocular disease has gained popularity as research highlights the utilization of AI to improve...
PURPOSE
The application of artificial intelligence (AI) in diagnosing and managing ocular disease has gained popularity as research highlights the utilization of AI to improve personalized medicine and healthcare outcomes. The objective of this study is to describe current optometric perspectives of AI in eye care.
METHODS
Members of the American Academy of Optometry were sent an electronic invitation to complete a 17-item survey. Survey items assessed perceived advantages and concerns regarding AI using a 5-point Likert scale ranging from "strongly agree" to "strongly disagree."
RESULTS
A total of 400 optometrists completed the survey. The mean number of years since optometry school completion was 25 ± 15.1. Most respondents reported familiarity with AI (66.8%). Though half of optometrists had concerns about the diagnostic accuracy of AI (53.0%), most believed it would improve the practice of optometry (72.0%). Optometrists reported their willingness to incorporate AI into practice increased from 53.3% before the COVID-19 pandemic to 65.5% after onset of the pandemic (p<0.001).
CONCLUSION
In this study, optometrists are optimistic about the use of AI in eye care, and willingness to incorporate AI in clinical practice also increased after the onset of the COVID-19 pandemic.
Topics: Humans; Optometrists; Artificial Intelligence; COVID-19; Pandemics; Optometry
PubMed: 36137899
DOI: 10.1016/j.optom.2022.06.006 -
Neurology. Clinical Practice Dec 2022Optometric visual rehabilitation therapy has been used for a variety of visual disorders. Descriptively named entities such as posttrauma visual syndrome, visual midline...
Optometric visual rehabilitation therapy has been used for a variety of visual disorders. Descriptively named entities such as posttrauma visual syndrome, visual midline shift syndrome, and vertical heterophoria syndrome are frequently diagnosed by neuro-optometrists and/or behavioral optometrists in patients after stroke or head injury or in the setting of dizziness and/or headache. The scientific underpinnings of these diagnoses and treatments are weak, and published clinical studies comprise case reports and case series without comparison to control populations. Neuro-ophthalmologists are frequently questioned by patients about the utility of such treatment strategies. Many ophthalmologists and neurologists also are involved in the care of patients who carry these diagnoses and undergo these visual therapies. Involved physicians may benefit from guidance about the rationale, evidence, and level of evidence for the efficacy of these therapeutic approaches.
PubMed: 36540149
DOI: 10.1212/CPJ.0000000000200071 -
Clinical & Experimental Optometry Sep 2005Retinitis pigmentosa (RP) is a leading cause of blindness and visual disability in younger people. Optometrists have a major role in detecting RP and in reducing the... (Review)
Review
Retinitis pigmentosa (RP) is a leading cause of blindness and visual disability in younger people. Optometrists have a major role in detecting RP and in reducing the visual disability associated with RP. This review summarises the literature relating to visual function in people with RP, with particular attention given to night-blindness, visual acuity decrease and visual field contraction. The range of low vision aids available for people with RP is reviewed and suggestions given on aids that have been found to be most successful. Most importantly, this review overviews the range of services available to people with RP and emphasises how optometrists need to work with a network of professionals to ensure the best possible visual outcomes for people with RP. Particular mention is made of current findings relating to orientation and mobility training, driving, sensory substitution and adaptive technology. The modern optometrist needs to be aware of the multiple needs of people with RP and have the ability to link them with the professionals best able to help them.
Topics: Adaptation, Ocular; Blindness; Humans; Optometry; Prognosis; Retinitis Pigmentosa; Visual Acuity; Visual Fields
PubMed: 16255692
DOI: 10.1111/j.1444-0938.2005.tb06717.x -
Clinical & Experimental Optometry Mar 2007Acute anterior uveitis is an important ocular disease of considerable interest to therapeutically and non-therapeutically qualified optometrists. This review examines... (Review)
Review
Acute anterior uveitis is an important ocular disease of considerable interest to therapeutically and non-therapeutically qualified optometrists. This review examines the role of optometrists in the primary care setting and gives guidelines for appropriate care of patients with anterior uveitis. Diagnosis and differentiation from other forms of anterior segment inflammation are the initial requirement. In parallel, possible medical conditions associated with acute anterior uveitis must be considered, with appropriate referral to medical practitioners. In uncomplicated cases of recurrent acute anterior uveitis, optometrists can initiate topical treatment and monitor resolution of inflammation, while being aware of possible complications of both the disease and its treatment. It is especially important in new attacks of anterior uveitis to liaise with the patient's general practitioner about medical investigation for underlying disease. Atypical, complicated or severe anterior uveitis should be promptly referred for specialist care.
Topics: Acute Disease; Anterior Eye Segment; Chronic Disease; Diagnosis, Differential; Humans; Inflammation; Optometry; Practice Guidelines as Topic; Primary Health Care; Professional Role; Referral and Consultation; Uveitis, Anterior; Vision Disorders
PubMed: 17311570
DOI: 10.1111/j.1444-0938.2006.00128.x -
Ophthalmic & Physiological Optics : the... Nov 2021To investigate the attitudes and understanding of optometrists in the UK and Ireland towards Digital Eye Strain (DES), and to examine related practice patterns.
PURPOSE
To investigate the attitudes and understanding of optometrists in the UK and Ireland towards Digital Eye Strain (DES), and to examine related practice patterns.
METHODS
An anonymous online questionnaire was developed, covering attitude and understanding of DES, examination of patients who may be experiencing DES and approaches to management options. The questionnaire was promoted to UK and Ireland optometrists via professional bodies and local and area optometric committees.
RESULTS
406 responses were included in the analysis. Most respondents agreed that DES was an important concern for optometrists (88.9%). 91.4% reported they felt confident in discussing possible symptoms of DES and management options; this was weakly and negatively associated with number of years qualified (r = -0.198, p ≤ 0.001). Estimations of the proportion of patients affected by DES were lower than reports in the literature (median 25%, IQR 10%-50%). Most respondents always (60.6%) or frequently (21.9%) inquired about device usage in routine case history taking, and also asked follow-up questions, although 29.3% only asked about the presence of symptoms half the time or less. Advising on regular breaks (84.0%), lubricants (55.7%) and environment/set up (69.2%) were felt to be extremely or very important by most respondents. Advising on specialist spectacle lenses, specifically blue filtering designs, was considered extremely or very important by 34.2% and 15.2%, respectively.
CONCLUSION
Given the agreement that DES is a significant issue causing frequent and persistent symptoms, and practitioners reported high levels of confidence in discussing DES, patients can expect to receive advice on symptoms and management from their optometrist. Simple management strategies were felt to be most important to advise on, with more uncertainty linked to specialist spectacle lenses.
Topics: Health Knowledge, Attitudes, Practice; Humans; Ireland; Optometrists; Optometry; United Kingdom
PubMed: 34545597
DOI: 10.1111/opo.12887 -
Journal of Diabetes Science and... Jul 2022Artificial intelligence (AI) diabetic retinopathy (DR) software has the potential to decrease time spent by clinicians on image interpretation and expand the scope of DR...
INTRODUCTION
Artificial intelligence (AI) diabetic retinopathy (DR) software has the potential to decrease time spent by clinicians on image interpretation and expand the scope of DR screening. We performed a retrospective review to compare Eyenuk's EyeArt software (Woodland Hills, CA) to Temple Ophthalmology optometry grading using the International Classification of Diabetic Retinopathy scale.
METHODS
Two hundred and sixty consecutive diabetic patients from the Temple Faculty Practice Internal Medicine clinic underwent 2-field retinal imaging. Classifications of the images by the software and optometrist were analyzed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and McNemar's test. Ungradable images were analyzed to identify relationships with HbA1c, age, and ethnicity. Disagreements and a sample of 20% of agreements were adjudicated by a retina specialist.
RESULTS
On patient level comparison, sensitivity for the software was 100%, while specificity was 77.78%. PPV was 19.15%, and NPV was 100%. The 38 disagreements between software and optometrist occurred when the optometrist classified a patient's images as non-referable while the software classified them as referable. Of these disagreements, a retina specialist agreed with the optometrist 57.9% the time (22/38). Of the agreements, the retina specialist agreed with both the program and the optometrist 96.7% of the time (28/29). There was a significant difference in numbers of ungradable photos in older patients (≥60) vs younger patients (<60) (p=0.003).
CONCLUSIONS
The AI program showed high sensitivity with acceptable specificity for a screening algorithm. The high NPV indicates that the software is unlikely to miss DR but may refer patients unnecessarily.
Topics: Aged; Artificial Intelligence; Diabetes Mellitus; Diabetic Retinopathy; Humans; Mass Screening; Photography; Retina; Sensitivity and Specificity; Urban Health
PubMed: 33719599
DOI: 10.1177/1932296821999370 -
Clinical & Experimental Optometry Mar 2020To assess the general knowledge and attitude of refractive error correction methods among female Saudi university students.
BACKGROUND
To assess the general knowledge and attitude of refractive error correction methods among female Saudi university students.
METHODS
One thousand, one hundred and sixty-five female university students, between 17 and 32 years of age were randomly interviewed using self-administered questionnaires with open and closed-ended questions. The questions collected information on demographics (gender, age, educational status, college of study, and occupation), addressed general knowledge/perception of the difference between the professions of ophthalmology and optometry, and attitudes toward spectacle, contact lens (CL) usage, including coloured prescription CLs, and refractive surgery for correcting refractive errors.
RESULTS
The response rate was 90 per cent (1,052/1,165). Fifty-two per cent had never had an eye examination and only 28 per cent correctly identified the difference between an 'ophthalmologist' and 'optometrist'. Eighty-one per cent knew that CLs instead of spectacles (81.8 per cent), and coloured CLs (89.7 per cent) can be used for correcting refractive errors. Concerning refractive surgery, although a majority (90 per cent) knew that the technique corrects refractive error and reduces dependency on spectacles/CLs, only five per cent had experienced refractive surgery. Approximately, 46 per cent and 47 per cent used spectacles and CLs, respectively, and while the optometrist was the main source of CL prescriptions (41 per cent), most people visited the ophthalmologist for their eye examination (68 per cent). Surprisingly, 52 per cent had never had an eye examination, or had only had one or two eye examinations (50 per cent) in their lifetime. While 23 per cent of spectacle wearers chose to continue with spectacles at the end of the study, 64 per cent and 12 per cent preferred refractive surgery and CLs, respectively, for refractive correction. Lack of information and fear of complications, but not cost, hindered most people from uptake of CLs and refractive surgery.
CONCLUSION
The students demonstrated high levels of knowledge and awareness of refractive correction methods, especially for refractive surgery. Although many consulted the optometrist or ophthalmologist for their eye examinations and corrective devices, many remain uncorrected and unaware of the main difference between both professions. The lack of information about correction methods and fear of complications may have affected their interest in uptake of eye services and should be addressed to increase uptake and prevent avoidable vision loss.
Topics: Adolescent; Adult; Attitude; Attitude to Health; Eyeglasses; Female; Humans; Refraction, Ocular; Refractive Errors; Retrospective Studies; Students; Vision Tests; Visual Acuity; Young Adult
PubMed: 31115098
DOI: 10.1111/cxo.12919 -
Eye (London, England) Apr 2023It can be difficult for practitioners to determine the likelihood of malignancy in melanocytic choroidal tumours. This author has therefore devised the MOLES acronym to... (Review)
Review
It can be difficult for practitioners to determine the likelihood of malignancy in melanocytic choroidal tumours. This author has therefore devised the MOLES acronym to highlight the most informative clinical features, which comprise mushroom shape, orange pigment, large size, enlargement, and subretinal fluid. Each of these is scored 0 if absent, 1 if subtle or uncertain, and 2 if present. Tumours are categorised as 'common naevus', 'low-risk naevus', 'high-risk naevus' and 'probable melanoma' according to whether the sum of these five scores is 0, 1, 2 or 3 or more, respectively. Tentative recommendations, subject to future studies, include: review of 'common naevi' by a community optometrist whenever the patient attends for another reason, such as a two-yearly 'check-up' (i.e., 'self-care'); non-urgent referral of patients with 'low-risk naevi' or 'high-risk naevi' to an ophthalmologist to plan long-term surveillance (i.e., determining the frequency of assessments and whether these should be undertaken by an ophthalmologist or a community optometrist); and urgent referral of patients with a MOLES score >2 (i.e., 'probable melanoma') to an ophthalmologist for immediate referral to an ocular oncologist if a suspicion of malignancy is confirmed. The MOLES system does not require assessment of internal acoustic reflectivity by ultrasonography. MOLES scores correlate well with diagnosis of choroidal naevi and melanomas by ocular oncologists; however, further evaluation of this aid in routine optometric practice and other situations is needed. MOLES should prevent unnecessary referral of patients with naevi for second opinion and non-essential monitoring of these patients at hospital eye services.
Topics: Humans; Animals; Skin Neoplasms; Moles; Choroid Neoplasms; Nevus, Pigmented; Melanoma
PubMed: 35764877
DOI: 10.1038/s41433-022-02143-x