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Alvarez-Peregrina C, Garcia de la Noceda A, Martinez-Perez C, Sánchez-Tena MÁ. Job satisfaction of Spanish and Portuguese optometrists. JOURNAL OF OPTOMETRY 2024; 17:100492. [PMID: 38171112 PMCID: PMC10796967 DOI: 10.1016/j.optom.2023.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Given the increase in demand for optometry services by society and the importance of the Optometry profession in Portugal and Spain, the objective of this study was to determine job satisfaction and important factors related to this satisfaction in a sample of Portuguese and Spanish optometrists. METHODS A prospective, cross-sectional, and observational study was carried out from June to December 2021. An adaptation of the 15-item job satisfaction in eye-care personnel (JSEP) questionnaire validated by Paudel et al. was administered to Portuguese and Spanish optometrists. The questionnaire was shared through different social media (Facebook, LinkedIn, WhatsApp, etc.) in a Google form during the months of June to December 2021 in Portugal and Spain. RESULTS A total of 530 surveys were collected in Portugal (42.3%; n = 224) and Spain (57.7%; n = 306). The factors that most influence overall job satisfaction are salary, career development opportunities, recognition/prestige in society, good work-life balance (all p<0.001), workplace equipment and facilities, and encouragement reward positive feedback (both p = 0.002). When comparing the determinants of job satisfaction of optometrists, it was found that Portuguese professionals were generally more satisfied than Spanish ones (p<0.001). However, Spanish optometrists reported feeling more supported by their colleagues (p<0.001). CONCLUSION This study has shown that the level of job satisfaction was higher in Portugal than in Spain. The most important factors influencing job satisfaction were salary, job stability, and support from colleagues.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain
| | - Alejandro Garcia de la Noceda
- Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain; Dive Medical SL, Zaragoza, Spain
| | - Clara Martinez-Perez
- ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal
| | - Miguel Ángel Sánchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain; ISEC LISBOA-Instituto Superior de Educação e Ciências, 1750-179 Lisbon, Portugal.
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Rashid ZA, Moodley VR, Mashige KP, Agho KE. Barriers to the Diagnosis and Management of Keratoconus Among Optometrists in Kenya. CLINICAL OPTOMETRY 2024; 16:71-79. [PMID: 38414761 PMCID: PMC10898358 DOI: 10.2147/opto.s446599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/11/2024] [Indexed: 02/29/2024]
Abstract
Background Early diagnosis and management of keratoconus (KC) are important for limiting visual complications of the disease. This study aimed to explore the perspectives of optometrists on the barriers to effective diagnosis and management of KC in Kenya. Methods An online questionnaire was distributed to optometrists in Kenya to collect data on barriers to the diagnosis and management of KC. Results The majority (60.9%) of optometrists were confident in retinoscopy and subjective refraction. Fewer were confident in the use of keratometers (46.4%) and corneal topographers (24.9%) and in the fitting of rigid gas permeable (RGP) contact lenses (25.0%). The most commonly reported barriers to improving their knowledge and skills were, limited continuous professional development opportunities (87.4%), high costs of conferences (86.1%) and the lack of diagnostic tools (79.5%). Impediments cited to diagnosing and managing KC effectively were a lack of national guidelines (64.9%), patient education material (71.5%), equipment (58.9%) and RGP supply (68.2%) and cost (67.5%). Most commonly reported barriers related to patients were compliance (91.4%), affordability (90.7%), RGP discomfort (89.4%), willingness to pay (88.1%) and the lack of patient education about KC (87.4%). Conclusion This study showed that the lack of national guidelines, essential equipment and adequate practitioner knowledge and skills were barriers to KC diagnosis and management. Regulation of optometric education and clinical practice, development of national guidelines for diagnosis and management of KC, up-skilling of practitioners and cost-effective solutions for equipment procurement and maintenance may improve both access to, and quality of, care to patients with KC.
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Affiliation(s)
- Zahra Aly Rashid
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Vanessa Raquel Moodley
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | - Kingsley Emwinyore Agho
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
- School of Health Sciences, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
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Angelo L, Gokul A, McGhee CNJ, Ziaei M. Keratoconus Management in the Community: A Survey of Optometrists. Eye Contact Lens 2024; 50:10-15. [PMID: 37967544 DOI: 10.1097/icl.0000000000001057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Defining the patterns of practice and referral criteria of optometrists within New Zealand to investigate the diagnosis and management of keratoconus. METHODS Optometrists recruited through the New Zealand Association of Optometrists, Cornea and Contact Lens Society of New Zealand, and private practices were invited to complete an anonymous survey. RESULTS Responses were received from 168 optometrists (representing 20.0% of the optometrist population). Half (48%) of optometrists had ≥15 years of experience, and 22% prescribed soft contact lenses daily, whereas only 6.4% prescribed rigid gas-permeable (RGP) lenses daily. The main barriers to prescribing RGPs were experience with fitting, low market demand, and patient discomfort. When referring to an ophthalmologist, 41% reported referring on progression of corneal parameters, 27% on initial diagnosis, 21% at no set time, and 10% with a reduction in visual acuity. Most optometrists (64%) would refer for possible surgery when visual acuity dropped between 6/9 and 6/12. Optometrists with greater experience were more likely to prescribe RGP lenses and co-manage patients with ophthalmologists. Ownership of a corneal imaging unit suggested an increased likelihood of prescribing RGP lenses but did not alter referral patterns. CONCLUSION This survey provides an overview of current practice and highlights the importance of optometrists in the diagnosis and management of keratoconus. There was a significant discrepancy in keratoconus management, regarding optical correction modality and referral criteria for ophthalmology review. Further interdisciplinary work is required between optometry and ophthalmology to standardize referral guidelines and enhance visual outcomes.
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Affiliation(s)
- Lize Angelo
- Ophthalmology Department, The University of Auckland, Grafton, Auckland, New Zealand
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Al-Atawi S, Alghamdi A, Alzahrani K. The Lifetime Expenditure in People with Keratoconus in Saudi Arabia. Vision (Basel) 2023; 7:52. [PMID: 37606498 PMCID: PMC10443371 DOI: 10.3390/vision7030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/10/2023] [Accepted: 07/23/2023] [Indexed: 08/23/2023] Open
Abstract
AIM This study measured and evaluated the socioeconomic burden of people living with keratoconus in Saudi Arabia. METHODS This study employed a cross-sectional design, a Keratoconus Economic Burden Questionnaire, and a convenient sample of 89 keratoconus patients (58.4% male) drawn from multiple regions in Saudi Arabia. It was conducted using online surveys, and the data were analyzed using appropriate quantitative techniques. RESULTS The mean age and annual income of the participants were 33.24 (SD = 6.82) years and USD 9046.52 (SD = 16,866.48), respectively, with only 37% being employed for wages. Up to 94.4% needed glasses or contact lenses at least once a week, and 73.0% received care from optometrists. The condition forced 45.9% of the respondents to change careers or leisure activities, with a further 51.3% having to take time off work. The mean annual out-of-pocket expenses for buying and maintaining glasses or contact lenses, as well as traveling and accommodation for keratoconus-related treatment were USD 2341.76 (SD = 3053.09), with 48.32 incurring upwards of USD 3240 over the period. The treatment costs increased with disease duration, r(89) = 0.216, p < 0.05. Regression results showed that the existence of comorbid eye disease, changing glasses at least once a year, and wearing either glasses or contact lenses at least once a week individually had statistically significant negative effects on the total annual keratoconus treatment costs, while disease duration, utilization of optometrists, and taking time off had a statistically significant increase on the total cost (p < 0.05). CONCLUSION With a prevalence rate of 1 in 375, progressive debilitation, and the lifetime nature of the disease, keratoconus is a critical public health concern in Saudi Arabia. The resulting visual impairment and discomfort, as well as both direct and indirect economic burdens, have considerable impacts on the patient's quality of life.
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Affiliation(s)
- Saleha Al-Atawi
- Optometry Department, Faculty of Applied Medical Science, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Ali Alghamdi
- Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Khaled Alzahrani
- Optometry Department, King Fahad Armed Hospital, Jeddah 23311, Saudi Arabia
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Baenninger PB, Romano V, Figueiredo FC, Pradhan SP, Vohra V, Jeng BH, Iselin KC, Murphy CC, Kaufmann C, Thiel MA, Bachmann LM. Differences in minimal disease knowledge of keratoconus patients: results from an international survey. BMJ Open Ophthalmol 2023; 8:bmjophth-2022-001164. [PMID: 37278427 DOI: 10.1136/bmjophth-2022-001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/06/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND/AIMS The objective of this multicentre, multinational, prospective study was to assess the level of basic understanding that individuals with keratoconus possessed about their condition. METHODS We recruited 200 active keratoconus patients who were under regular review, and cornea specialists established a standard of 'minimal keratoconus knowledge' (MKK) that included an understanding of the definition, risk factors, symptoms and treatment options for the condition. We collected data from each participant regarding their clinical characteristics, highest level of education, (para)medical background and experiences with keratoconus within their social circle, and calculated the percentage of MKK attained by each patient. RESULTS Our findings revealed that none of the participants met the MKK standard, with the average MKK score being 34.6% and ranging from 0.0% to 94.4%. Furthermore, our study showed that patients with a university degree, previous surgical intervention for keratoconus or affected parents had a higher MKK. However, age, gender, disease severity, paramedical knowledge, disease duration and best-corrected visual acuity did not significantly affect the MKK score. CONCLUSIONS Our study demonstrates a concerning lack of basic disease knowledge among keratoconus patients in three different countries. The level of knowledge exhibited by our sample was only one-third of what cornea specialists would typically anticipate from patients. This highlights the need for greater education and awareness campaigns surrounding keratoconus. Further research is needed to determine the most efficient approaches for enhancing MKK and subsequently improving the management and treatment of keratoconus.
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Affiliation(s)
- Philipp B Baenninger
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Vito Romano
- Department of Corneal and External Eye Diseases, Royal Liverpool University Hospital, Liverpool, UK
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- Department of Ophthalmology, Newcastle University, Newcastle upon Tyne, UK
| | - Sayali P Pradhan
- Department of Ophthalmology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Vishal Vohra
- Department of Ophthalmology, Newcastle University, Newcastle upon Tyne, UK
- Department of Ophthalmology, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Bennie H Jeng
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Katja C Iselin
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conor C Murphy
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Claude Kaufmann
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
| | - Michael A Thiel
- Department of Ophthalmology, Cantonal Hospital, Lucerne, Switzerland
| | - Lucas M Bachmann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Medignition AG, Zurich, Switzerland
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Clinical-epidemiological characteristics of keratoconus in Asturias. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:65-71. [PMID: 36375756 DOI: 10.1016/j.oftale.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Keratoconus is the most frequent corneal ectasia and second most common cause of keratoplasty worldwide. The clinical and epidemiological characteristics of keratoconus have rarely been studied in Spain, and to date, no study has been done in Asturias. MATERIAL AND METHODS A cross-sectional study was conducted to analyze all cases of keratoconus diagnosed in the first consultations of the Cornea and Surface section of the Hospital Universitario Central de Asturias (Oviedo) and Hospital Universitario de Cabueñes (Gijón) between 2017 and 2020. Demographic data, visual acuity and corneal topography were collected. RESULTS A total of 112 patients (42.0% women and 58.0% men) were included. The mean age was 36.84 ± 15.59, with 39.3% being older than 40 years. 31.8%, 28.0%, 15.0%, and 25.2% were in stages I, II, III and IV, Amsler-Krumeich scale, respectively. Corneal segments were implanted in 7.5% of patients, cross-linking was performed in 4.7%, and keratoplasty was performed in 13.2%. CONCLUSION Approximately 40% of keratoconus cases are detected at advanced stages and another 40% are detected at an age over 40 years. 13% of these patients require keratoplasty, which is why it is frequently performed in our setting. Therefore, early diagnosis before irreversible visual loss is necessary.
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Rashid ZA, Moodley VR, Mashige KP. Diagnosis and management of keratoconus by eye care practitioners in Kenya. BMC Ophthalmol 2023; 23:37. [PMID: 36707782 PMCID: PMC9881246 DOI: 10.1186/s12886-023-02792-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND To explore current eye care practice in keratoconus diagnosis and management in Kenya. METHODS An online questionnaire was distributed to ophthalmic clinical officers (OCO) and optometrists. RESULTS A total of 203 responses were received from 52 OCOs and 151 optometrists with a response rate of 24.4% and 53.5% respectively. The majority reported having access to retinoscopes (88.5%; p = 0.48) and slit lamps (76.7; p = 0.14). Few practitioners had access to a corneal topographer (13.5%; p = 0.08) and rigid contact lens (CL) fitting sets (OCOs 5.8%, optometrists 33.8%; p < 0.01). One-third did not feel that retinoscopy (38.7%; p = 0.21), slit lamp findings (30.3%; p = 0.10) and corneal topography (36.6%; p = 0.39) are important investigations in keratoconus diagnosis. Corneal topography was not recommended in two-thirds of patients (59.0%; p = 0.33) with vernal keratoconjunctivitis (VKC). The majority counselled against eye rubbing in mild (73.6%; p = 0.90) VKC, 52.9% in moderate (p = 0.40) and 43.6% in severe (p = 0.24) cases. The majority prescribed spectacles in mild (90.2%; p = 0.95), 29% (p = 0.97) in moderate and 1.9% (p = 0.05) in severe cases. When the binocular best corrected visual acuity (BCVA) with spectacles was ≤ 6/18, 76.9% of OCOs and 58.9% of optometrists referred for CLs (p = 0.02). When binocular BCVA with CLs dropped to ≤ 6/18, 83.7% (p = 0.18) referred to the ophthalmologist for surgical intervention. Few OCOs fitted rigid CLs (15.4% OCOs, 51.0% optometrists; p = 0.01), majority referred to optometrists (82.7% OCOs, 43.7% optometrists; p < 0.01). Progression was monitored in 70.1% (p = 0.11) of mild, 50.9% (p = 0.54) moderate and 25.3% (p = 0.31) advanced cases. Few OCOs (15.4%) performed corneal cross-linking (CXL). A few respondents (5.4%; p = 0.13) did not know when to refer keratoconus patients for CXL. Co-management with ophthalmologists was reported by 58.0% (p = 0.06) of respondents. CONCLUSION The results of this study highlight the need to map services for keratoconus patients, review current curricula and continuous education priorities for mid-level ophthalmic workers, develop guidelines for the diagnosis and management of keratoconus and improve interdisciplinary collaboration.
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Affiliation(s)
- Zahra Aly Rashid
- grid.16463.360000 0001 0723 4123School of Health Sciences, Discipline of Optometry, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000 South Africa
| | - Vanessa R Moodley
- grid.16463.360000 0001 0723 4123School of Health Sciences, Discipline of Optometry, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000 South Africa
| | - Khathutshelo Percy Mashige
- grid.16463.360000 0001 0723 4123School of Health Sciences, Discipline of Optometry, University of KwaZulu-Natal, Private Bag X54001, Durban, 4000 South Africa
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Braga Vieira S, Rivadeneira-Bueno D, Ortiz-Toquero S, Martin R. Optometric practices and attitudes in keratoconus patient management in Latin America. Clin Exp Optom 2022; 106:386-394. [PMID: 35298892 DOI: 10.1080/08164622.2022.2048997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
CLINICAL RELEVANCE To explore optometric practices and attitudes in the management of keratoconus patients in LatinAmerica and how they are influenced by eye-care technology will help to minimise disease progression and their impact on patients' quality of life in Latin America. BACKGROUND Keratoconus is a progressive, bilateral and asymmetric corneal disorder that requires a multidisciplinary approach, the use of different eye assessment technology, and different management approaches; mainly contact lenses and surgery. METHODS Self-reported answers to an online survey (adapted to primary eye care) distributed via a newsletter emailed by various professional organisations across 15 Latin American countries were assessed and compared with those previously reported in three European countries. RESULTS Answers from 977 eye care practitioners (60%) with >10 years of experience (396 in Latin America and 581 in Europe) were assessed. A total of 65.9% of Latin American responders prescribed rigid corneal lenses (RCL), although more than half of the respondents (54.0%) would fit more RCL if they underwent further training in RCL fitting. A majority of Latin American practitioners (74.0%) considered that RCL fitting is more difficult in keratoconus, requiring more diagnostic lenses (4.6 ± 2.7; median 4; range 1-10) than are necessary for healthy eyes. Low availability of corneal topography was reported in Latin America (23%), although practitioners with topographers are more likely to prescribe RCL (92.3%) and detect more new patients with keratoconus per year (83.5%). A minority of respondents referred keratoconus patients to another optometrist (25.8%) or (40.4%) participated in comanagement with ophthalmologists. CONCLUSION This study provides initial evidence regarding keratoconus management in Latin America and suggests that actions are necessary to improve RCL training, facilitate eye-care technology accessibility and encourage comanagement between eye care practitioners to minimise disease progression and their impact on patients' quality of life in Latin America.
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Affiliation(s)
- Sabrina Braga Vieira
- Optometry Research Group, IOBA Eye Institute. School of Optometry, University of Valladolid, Valladolid, Spain.,Department Optometry, University of Contestado (UnC), Canoinhas (Brazil)
| | - Doris Rivadeneira-Bueno
- Department of Physic (Optics and Contact Lenses), Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Sara Ortiz-Toquero
- Optometry Research Group, IOBA Eye Institute. School of Optometry, University of Valladolid, Valladolid, Spain
| | - Raul Martin
- Optometry Research Group, IOBA Eye Institute. School of Optometry, University of Valladolid, Valladolid, Spain
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