SWOT analysis of ortho-K practice in India.

PURPOSE: Orthokeratology (ortho-K) has been well established as a methodology for myopia correction and control its progression. A SWOT analysis serves as a strategic planning tool for intervention hence the purpose of this study to establish and implement ortho-K practice in India. METHOD: The study was conducted between December 2020 and June 2021. A prospective questionnaire-based study was conducted to elicit the responses in the SWOT study. Based on focus group discussion a set of five statements under strengths, weaknesses, opportunities and threats were identified. These were closed ended questions were based on a 5-point likert scale. The Content Validation Index (CVI) was computed for each item taking those answers relevant with a score of three and four on the Likert scale and omitting those with a score of one and two on the Likert scale as non-relevant. RESULTS: Strengths: 'Ortho-K is an excellent option for myopia control' was agreed by more than 50% of respondents. 67% of respondents agreed that advanced topographers has made ortho-K lens fitting easier. Weakness: More than 60% agreed that Ortho-K practice involves investment in instrumentation like topographers and trial lenses. 50% agreed that due to multiple follow up patients may be lost to follow up. OPPORTUNITY: 'Pandemic has necessitated the need for optometrists to explore myopia control options such as ortho-K' was agreed by more than 50%. Threats: 'Reluctance from adults and parents to try overnight contact lenses for myopia correction/control' was agreed by more than 50% of respondents. 62% agreed that atropine is perceived as an effective myopia control option by majority of the Indian ophthalmologists. CONCLUSION: Ortho-K as an emerging modality for Myopia management in India through SWOT analysis, allows practitioners as well as CL industry to approach Ortho-K appropriately with novel designs and practice patterns that suits the market needs.

Opportunities and threats to contact lens practice in Spain / Oportunidades y amenazas para la práctica de lentes de contacto en España

Objective: An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. Methods: A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. Results: A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. Conclusions: Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.(AU)

Opportunities and threats to contact lens practice in Spain.

OBJECTIVE: An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. METHODS: A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. RESULTS: A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. CONCLUSIONS: Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.

Differences in Practitioner Experience, Practice Type, and Profession in Attitudes Toward Growing Contact Lens Practice.

OBJECTIVE: To investigate eye care practitioners' attitudes and perceptions toward potential interventions that can enhance contact lens (CL) practice across the world, and how this is influenced by their practice setting. METHODS: A self-administered, anonymized survey was constructed in English and then forward and backward translated into six more languages. The survey was distributed online via social media platforms and mailing lists involving reputed international professional bodies. RESULTS: In total, 2,222 responses from 27 countries with sufficient responses were analyzed (53% females, median age- 37 years). Most of the respondents were optometrists (81.9%) and 47.6% were from stand-alone/independent practices. Median working experience in CL prescribing was 11.0 years (IQR: 18.0, 4-22 years). Over two-third of them declared themselves to be very hopeful (22.9%) or hopeful (45.1%) about the future of their CL practice. Among the potential interventions proposed, continuous update of knowledge and skills and competently managing CL-related complications were rated the most important (median score: 9/10 for each). Practitioners working in national/regional retail chains expressed higher proactivity in recommending CLs (9/10) than those in local chains, hospitals, and universities (for all 8/10, P <0.05). National differences were also identified in eye care practitioner attitudes and perceptions ( P <0.05). CONCLUSIONS: The study provided important information to delineate a variety of elements characterizing CL practice across the world. These insights can serve as a basis to design strategies at national and international levels.

The impact of COVID-19 on global contact lens education

Purpose: To investigate the effects of the global COVID-19 pandemic on contact lens education around the world. Methods: An online survey among contact lens educators (educator members of the International Association of Contact Lens Educators), conducted in May 2020. Results: A total of 214 responses were received from 32 countries (representing a 39% response rate). Overall, 71% of respondents’ institutions were closed to students to attend at that time. A majority (58%) were delivering more online education than they would normally provide. Live online lectures and discussion was the most commonly used method (68%). Zoom was the most common videoconferencing technology (56%) and the most popular social media platform for communicating with students was WhatsApp (48%). About half (54%) were running online exams or assessments, 24% holding these for students to attend in person, and 27% were conducting practical sessions. Two in three (68%) said they would conduct more than 50% of their total teaching online by the end of 2020, and 12% anticipated 90% or more of their teaching would be online. Of all respondents, 74% expressed interest in an online platform delivering educational resources. Conclusion: The COVID-19 pandemic has had a major impact on the teaching of contact lenses, as educational institutions worldwide move to online delivery. Major challenges remain with online contact lens education, with respect to teaching practical skills, student assessment and interaction. More support will be needed for educators to meet these challenges as the recovery from the pandemic continues. (AU)

The impact of COVID-19 on global contact lens education.

PURPOSE: To investigate the effects of the global COVID-19 pandemic on contact lens education around the world. METHODS: An online survey among contact lens educators (educator members of the International Association of Contact Lens Educators), conducted in May 2020. RESULTS: A total of 214 responses were received from 32 countries (representing a 39% response rate). Overall, 71% of respondents' institutions were closed to students to attend at that time. A majority (58%) were delivering more online education than they would normally provide. Live online lectures and discussion was the most commonly used method (68%). Zoom was the most common videoconferencing technology (56%) and the most popular social media platform for communicating with students was WhatsApp (48%). About half (54%) were running online exams or assessments, 24% holding these for students to attend in person, and 27% were conducting practical sessions. Two in three (68%) said they would conduct more than 50% of their total teaching online by the end of 2020, and 12% anticipated 90% or more of their teaching would be online. Of all respondents, 74% expressed interest in an online platform delivering educational resources. CONCLUSION: The COVID-19 pandemic has had a major impact on the teaching of contact lenses, as educational institutions worldwide move to online delivery. Major challenges remain with online contact lens education, with respect to teaching practical skills, student assessment and interaction. More support will be needed for educators to meet these challenges as the recovery from the pandemic continues.

Opportunities and threats to contact lens practice: A global survey perspective.

AIM: To understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice. METHODS: A self-administered anonymised questionnaire, constructed in English and translated in six more languages, was distributed through reputed international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years. RESULTS: A total of 2408 valid responses were analysed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favourable (Median: 9/10 for all) as compared to colleagues in Asia (Median: 8/10, p < 0.001), South America (Median: 8/10, p < 0.01), and Africa (Median: 8/10p < 0.01). Multifocal CLs for presbyopia was perceived as a better opportunity by practitioners in North America and Europe (Median: 9/10 for both), as well as in Australasia (Median: 8/10), in comparison to Asia, Africa, and Middle East (for all Median: 6/10, p < 0.001). Practitioners expressed concerns about the availability of CLs and CL prescriptions online without direct professional involvement (both 9/10). CONCLUSIONS: Overall, the most appealing opportunities for CL practice growth were identified in occasional use of DD CLs, biocompatible materials to reduce CL discomfort, multifocal CLs for presbyopia correction and management of myopia control with CLs. Lack of regulation in CL sales, especially online, seemed to be a constant threat. The insights from this study can be used to design targeted strategies to enhance CL practice across the globe and in specific geographical areas.

Impact of COVID-19 on Indian optometrists: A student, educator, and practitioner's perspective.

PURPOSE: The optometry profession has experienced massive changes amid lockdown in COVID 19 pandemic. This study gauges the impact of COVID-19 on optometry education and practices in India. METHODS: The impact of COVID-19 among key stakeholders of Indian optometry that included educators, students, and practitioners was surveyed. The content validity of the survey tool was achieved through a focused group discussion with experts. RESULTS: Of the 1408 responses, 118 were educators, 845 were students and 445 were practitioners. Post COVID-19 lock-down, a high percentage of students (96%) and educators (94%) were now using online mode of education to learn and teach. The blended learning methods were reported to be used by 81% of educators. Practical skills were the most difficult to teach by educators and to learn by students. Almost a third of the students were concerned about their internships and job opportunities amid the pandemic. Practitioners felt confident in performing routine eye examinations with personal protective equipment (PPE). Telemedicine was found to be adopted by 55% of the private practitioners and 49% of the eye hospitals. CONCLUSION: The COVID-19 pandemic has provided an opportunity to reform Indian optometry education through blended learning methods. Optometry practices changed and adapted instantly to the new hygiene norms that have raised the standard of care provided to patients. Telemedicine emerged as a mode of providing care by optometrists. Overall, all key stakeholders of optometry in India were found to have adapted well to the sudden changes due to COVID 19 pandemic.

Capacity building for diabetic retinopathy screening by optometrists in India: Model description and pilot results.

Purpose: The present study's objectives are 1) to describe a novel model of Diabetic Retinopathy Capacity Building (DRCB) for optometrists in the detection of diabetes-related retinal pathology in India and 2) to assess the outcomes of this model by comparing the ability of optometrists to detect these diseases using retinal photographs, vis-à-vis, a specialist ophthalmologist. Methods: The DRCB model for optometrists conducted between August 2016 and August 2018 included training, certification in the screening, and referral guidelines for Diabetic Retinopathy (DR) and hospital-and community-based service delivery. Training included a 7-month long fellowship in DR and mentored participation as cofacilitators in 1-day orientation workshops on DR screening guidelines across India. The sensitivity and specificity of study optometrists in screening for DR by fundus photography were compared to a retina specialist before certification. Results: A total of eight optometrists successfully completed their DR fellowship in the project duration of 24 months. The sensitivity and specificity of detection of any DR were 95 and 79%, any Diabetic macular edema (DME) was 80 and 86%. The sensitivity and specificity of detection of sight threatening DR were 88 and 90% and DME was 72% and 92% respectively. Seven workshops were cofacilitated by study optometrists training 870 optometrists in DR screening guidelines across India. Conclusion: The present DRCB model results advocate for an optometry coordinated DR screening in India. Lessons learnt from this model can be useful in designing community-based task sharing initiatives for optometrists in DR screening.

Contact lens education for the practitioners of the future.

The World Health Organization has identified a shortage of trained human resources as one of the greatest challenges to increasing the availability of eye care services and reducing preventable visual impairment around the world. Increased prevalence of myopia and new strategies for myopia management have raised the prospect of various interventions, including contact lenses for therapeutic use as well as for refractive correction. More personnel skilled in contact lens fitting will be needed to address potential worldwide demand for these interventions. This review investigates the current status and future requirements of global contact lens education in light of these developments. The COVD-19 pandemic led educational institutions worldwide to move towards online delivery. An online survey among 546 educators, conducted in May 2020, investigated changes to contact lens education delivery before and after the onset of the pandemic. A total of 214 responses were received from 32 countries. Prior to COVID-19 restrictions, 23% of educators had conducted more than 50% of their total teaching online; however, 69% expected to conduct more than half of their teaching online by the end of 2020 and 12% anticipated 90% or more of their teaching would be online. Some 76% of educators expected to provide more online lectures after the pandemic and 63% anticipated new methods to deliver practical education. Around half were planning to introduce new teaching online platforms (54%) and more online assessment methods (53%). The global need for increasing numbers of skilled personnel points to a crucial role for educators in teaching the contact lens practitioners of the future. Contact lens education delivery was already evolving prior to COVID-19, and changes that are currently occurring may lead to permanent differences in the way contact lenses are taught in future. The International Association of Contact Lens Educators (IACLE) provides educators with a standardised global curriculum, online resources and teaching technology that could also serve as a model for wider ophthalmic education in future.

COVID-19 guidelines for optometry and optical services post-lockdown.

The COVID-19 pandemic has caused disruption in everyone's lives globally. Optometrists, being primary health care professionals are at a higher risk of infection in their practices during these testing times. Optometrists and optical store owners need practically implementable guidelines as lockdown gets lifted in various parts of our country. As these practices gear up to provide eye examination and vision correction to people, they need to take necessary precautions to avoid any cross contaminations. Optometry Council of India guidelines were circulated among optometry and optical associations and among experts in various optometry specialty. A consensus among various bodies were arrived. These guidelines provide recommendation for optical and optometry practices.

International Association of Contact Lens Educators: Exceptional education-Exponential impact.

The International Association of Contact Lens Educators (IACLE) is the leading provider of educational and information resources essential to contact lens educators worldwide. The New IACLE Contact Lens Course is its most important resource, used by members around the world to teach their students, the contact lens practitioners of the future. In 2019, IACLE celebrated the 40th Anniversary of its founding meeting. In this article, we trace the early years of the organization and describes its impact on contact lens education in India.

The role of optometrists in India: an integral part of an eye health team.

India has a proud tradition of blindness prevention, being the first country in the world to implement a blindness control programme which focused on a model to address blinding eye disease. However, with 133 million people blind or vision impaired due to the lack of an eye examination and provision of an appropriate pair of spectacles, it is imperative to establish a cadre of eye care professionals to work in conjunction with ophthalmologists to deliver comprehensive eye care. The integration of highly educated four year trained optometrists into primary health services is a practical means of correcting refractive error and detecting ocular disease, enabling co-managed care between ophthalmologists and optometrists. At present, the training of optometrists varies from two year trained ophthalmic assistants/optometrists or refractionists to four year degree trained optometrists. The profession of optometry in India is not regulated, integrated into the health care system or recognised by the majority of people in India as provider of comprehensive eye care services. In the last two years, the profession of optometry in India is beginning to take the necessary steps to gain recognition and regulation to become an independent primary health care profession. The formation of the Indian Optometry Federation as the single peak body of optometry in India and the soon to be established Optometry Council of India are key organisations working towards the development and regulation of optometry.