A yearly summary of quality assessment and improvement in the optometric pediatric clinics of the SUNY College of Optometry.

BACKGROUND: Each clinic within the University Optometric Center (UOC) of the State University of New York (SUNY) College of Optometry develops a Quality Management (QM) Plan for each calendar year. The vehicle for implementation is a Quality Assessment and Improvement (QA&I) committee. The clinical adherence to the objectives are reviewed each year. The following article is a review of the QA&I reports of the Pediatric Vision Clinics within the College for the year 1996. METHODS: Clinical records were concurrently and retrospectively reviewed for completeness and appropriateness of care. One hundred percent of the records were concurrently reviewed, and 10% of each doctors' total records were retrospectively reviewed. In addition, records with specific diagnoses--chosen as clinical indicators--were reviewed for a specified period of time. RESULTS: Patient satisfaction exceeded predetermined threshold values. On general review, the clinical faculty performed at a 95% efficiency level. The pediatric population yielded only minimal major pathologies. In our strabismic sample, patients with esotropia exceeded those with exotropia (61% vs. 39%). Strabismic amblyopes were more prevalent than refractive amblyopes (80% vs. 20%). Preschool vision therapy appeared to be successful in most cases. CONCLUSION: Quality assessment and improvement is an ongoing process that can provide an overview of case management and type. The process serves to monitor quality of care, provide a modality for improvement, enhance outcomes, and guide future QM plans.

The Council on Clinical Optometric Care (CCOC): The American Optometric Association's Institutional-Practice Reviewer 1967-1993.

BACKGROUND: For 26 years the CCOC served professional optometry as its institutional-practice reviewer. METHODS: The council used nine standards for accrediting clinical institutions. RESULTS: The benefits of the accreditation process were many, with improved patient care as its cornerstone. CONCLUSION: During its 26 year existence, the Council on Clinical Optometric Care (CCOC) had a major influence on the quality of optometric care.

What are the pros and cons of requiring postgraduate residency training as an entry-level practice requirement?

Postgraduate residency training would produce better trained optometrists to meet the future needs of optometry. While residency training would expose a new graduate to experience that may take years to acquire, currently there is no mechanism in place to accommodate such a program.

Clinical management of nearpoint stress-induced vision problems.

Functional vision problems caused by or associated with nearpoint vision stress include: accommodative disorders (insufficiency, ill-sustained, infacility); abnormal heterophorias (esophoria, high exophoria); and vergence disorders. These vision disorders cause problems with acuity, comfort, and performance (efficiency). A combination of lens prescribing, vision therapy, and work/study visual hygiene recommendations can eliminate or greatly reduce nearpoint stress-induced vision problems.